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Sample records for anemia status hemoglobin

  1. Pengaruh taburia terhadap status anemia dan status gizi balita gizi kurang

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    Wahyuni Kunayarti

    2014-07-01

    Full Text Available Background: Micronutrient deficiency seriously contributes to child morbidity and mortality. The need for micronutrient can be fulfilled from food, fortified food, and direct supplementation. Taburia is multivitamin multimineral that is aimed to meet the need for micronutrient of undernourished under-fives and to prevent the increased prevalence of undernourishment. It is necessary efficacy and effectiveness study of Taburia to anemia and nutritional status of undernourished under fives of 24-55 months. Objective: To identify the effect of Taburia supplementation to anemia and nutrition status of under fives at District of Lombok Timur. Method: The study was experimental with prospective cohort study design carried out at District of Lombok Timur, Province of Nusa Tenggara Barat. The subject of the study was undernourished under fives at the area of Nutrition Improvement Community through Empowerment (NICE project. The independent variables were Taburia and biscuits; the dependent variables were anemia and nutrition status; and the external variables were the intake of energy, protein, vitamin A, vitamin C, Fe, and zinc. Data analysis used ANOVA and paired t-test. Results: There was a significant difference in the average level of hemoglobin of the subject after the intervention, either in taburia group, biscuit group, or taburia+biscuit group (p<0.05. There was the difference in average weight after intervention in the three groups (p<0.05. There was no significant difference in the average level of hemoglobin and the average level of weight between biscuit group and Taburia+biscuit group. There was a change in anemia status from anemia to nonanemia; the highest was in Taburia group, i.e. 96%; and better nutrition status at the end of the experiment occurred at Taburia+biscuit group from emaciated to normal (100%. Conclusion: Taburia supplementation could increase anemia status. Micronutrient supplementation was needed to increase nutrition

  2. Anemia and hemoglobin levels among Indigenous Xavante children, Central Brazil.

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    Ferreira, Aline Alves; Santos, Ricardo Ventura; Souza, July Anne Mendonça de; Welch, James R; Coimbra, Carlos E A

    2017-01-01

    To evaluate the prevalence of anemia, mean hemoglobin levels, and the main nutritional, demographic, and socioeconomic factors among Xavante children in Mato Grosso State, Brazil. A survey was conducted with children under 10 years of age in two indigenous Xavante communities within the Pimentel Barbosa Indigenous Reserve. Hemoglobin concentration levels, anthropometric measurements, and socioeconomic/demographic data were collected by means of clinical measurements and structured interviews. The cut-off points recommended by the World Health Organization were used for anemia classification. Linear regression analyses with hemoglobin as the outcome and Poisson regression with robust variance and with the presence or absence of anemia as outcomes were performed (95%CI). Lower mean hemoglobin values were observed in children under 2 years of age, without a significant difference between sexes. Anemia was observed among 50.8% of children overall, with the highest prevalence among children under 2 years of age (77.8%). Age of the child was inversely associated with the occurrence of anemia (adjusted PR = 0.60; 95%CI 0.38-0.95) and mean hemoglobin values increased significantly with age. Greater height-for-age z-score values reduced the probability of having anemia by 1.8 times (adjusted PR = 0.59; 95%CI 0.34-1.00). Presence of another child with anemia within the household increased the probability of the occurrence of anemia by 52.9% (adjusted PR = 1.89; 95%CI 1.16-3.09). Elevated levels of anemia among Xavante children reveal a disparity between this Indigenous population and the national Brazilian population. Results suggest that anemia is determined by complex and variable relationships between socioeconomic, sociodemographic, and biological factors.

  3. Individualized anemia management reduces hemoglobin variability in hemodialysis patients.

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    Gaweda, Adam E; Aronoff, George R; Jacobs, Alfred A; Rai, Shesh N; Brier, Michael E

    2014-01-01

    One-size-fits-all protocol-based approaches to anemia management with erythropoiesis-stimulating agents (ESAs) may result in undesired patterns of hemoglobin variability. In this single-center, double-blind, randomized controlled trial, we tested the hypothesis that individualized dosing of ESA improves hemoglobin variability over a standard population-based approach. We enrolled 62 hemodialysis patients and followed them over a 12-month period. Patients were randomly assigned to receive ESA doses guided by the Smart Anemia Manager algorithm (treatment) or by a standard protocol (control). Dose recommendations, performed on a monthly basis, were validated by an expert physician anemia manager. The primary outcome was the percentage of hemoglobin concentrations between 10 and 12 g/dl over the follow-up period. A total of 258 of 356 (72.5%) hemoglobin concentrations were between 10 and 12 g/dl in the treatment group, compared with 208 of 336 (61.9%) in the control group; 42 (11.8%) hemoglobin concentrations were hemoglobin concentrations were >12 g/dl in the treatment group compared with 46 (13.4%) in the control group. The median ESA dosage per patient was 2000 IU/wk in both groups. Five participants received 6 transfusions (21 U) in the treatment group, compared with 8 participants and 13 transfusions (31 U) in the control group. These results suggest that individualized ESA dosing decreases total hemoglobin variability compared with a population protocol-based approach. As hemoglobin levels are declining in hemodialysis patients, decreasing hemoglobin variability may help reduce the risk of transfusions in this population.

  4. The influence of socioeconomic status on the hemoglobin level and anthropometry of sickle cell anemia patients in steady state at the Lagos University Teaching Hospital.

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    Animasahun, B A; Temiye, E O; Ogunkunle, O O; Izuora, A N; Njokanma, O F

    2011-01-01

    Sickle cell anemia (SCA) has multisystemic manifestations and is associated with severe morbidity and high mortality. It commonly affects growth leading to wasting and stunting. This study aimed to determine the influence of socioeconomic status on the nutritional status using anthropometric measurements and steady-state hemoglobin, of children with homozygous SCA, aged 1 year to 10 years in steady state at the Lagos University Teaching Hospital. This is a cross-sectional study involving 100 children with SCA and 100 age-, sex-, and social class-matched controls that fulfilled the inclusion criteria. Social class was assessed using educational attainment and occupation of parents. Hemoglobin concentration was determined using the oxy-hemoglobin method. This study demonstrated a significantly lower mean weight and weight-for-height in the SCA patients than those of controls (P hemoglobin concentration were observed from social class 1 to 4; this was statistically significant in controls (P = 0.00) but not in subjects (P > 0.1). However, SCA patients had significantly lower values than controls in each of the social classes. Poor socioeconomic status has an adverse effect on the nutritional status and hemoglobin of SCA patients.

  5. The High Prevalence of Anemia in Cambodian Children and Women Cannot Be Satisfactorily Explained by Nutritional Deficiencies or Hemoglobin Disorders

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    Wieringa, Frank Tammo; Dahl, Miriam; Chamnan, Chhoun; Poirot, Etienne; Kuong, Khov; Sophonneary, Prak; Sinuon, Muth; Greuffeille, Valerie; Hong, Rathavuth; Berger, Jacques; Dijkhuizen, Marjoleine Amma; Laillou, Arnaud

    2016-01-01

    Background: Anemia is highly prevalent in Cambodian women and children, but data on causes of anemia are scarce. We performed a national micronutrient survey in children and women that was linked to the Cambodian Demographic Health Survey 2014 (CDHS-2014) to assess the prevalence of micronutrient deficiency, hemoglobin disorders and intestinal parasite infection. Methods: One-sixth of households from the CDHS-2014 were selected for a follow-up visit for the micronutrient survey. Households were visited from two weeks to two months after the CDHS-2014 visit. Data on micronutrient status were available for 1512 subjects (792 children and 720 women). Results: Anemia was found in 43% of the women and 53% of the children. Hemoglobin disorders affected >50% of the population, with Hemoglobin-E the most prevalent disorder. Deficiencies of iron (ferritin children, the prevalence of iron, vitamin A, vitamin B12 or folic acid deficiency was anemia in children, whereas in the women none of the factors was significantly associated with anemia. Iron deficiency anemia (IDA) was more prevalent in children children and women, the prevalence of IDA was anemia were hookworm infection and zinc and folic acid deficiency. Over 40% of the anemia was not caused by nutritional factors. Conclusion: The very high prevalence of anemia in Cambodian women and children cannot be explained solely by micronutrient deficiencies and hemoglobin disorders. Micronutrient interventions to improve anemia prevalence are likely to have limited impact in the Cambodian setting. The focus of current interventions to reduce the high prevalence of anemia in children and women should be broadened to include zinc and folic acid as well as effective anti-hookworm measures. PMID:27338454

  6. Do blood tests cause anemia in hospitalized patients? The effect of diagnostic phlebotomy on hemoglobin and hematocrit levels.

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    Thavendiranathan, Paaladinesh; Bagai, Akshay; Ebidia, Albert; Detsky, Allan S; Choudhry, Niteesh K

    2005-06-01

    To determine whether phlebotomy contributes to changes in hemoglobin and hematocrit levels in hospitalized general internal medicine patients. Retrospective cohort study. General internal medicine inpatient service at a tertiary care hospital. All adult patients discharged from the Toronto General Hospital's internal medicine service between January 1 and June 30, 2001. A total of 989 hospitalizations were reviewed and 404 hospitalizations were included in our analysis. Mean (SD) hemoglobin and hematocrit changes during hospitalization were 7.9 (12.6) g/L (Phemoglobin and hematocrit were predicted by the volume of phlebotomy, length of hospital stay, admission hemoglobin/hematocrit value, age, Charlson comorbidity index, and admission intravascular volume status. The volume of phlebotomy remained a strong predictor of drop in hemoglobin and hematocrit after adjusting for other predictors using multivariate analysis (Phemoglobin and hematocrit of 7.0 g/L and 1.9%, respectively. Phlebotomy is highly associated with changes in hemoglobin and hematocrit levels for patients admitted to an internal medicine service and can contribute to anemia. This anemia, in turn, may have significant consequences, especially for patients with cardiorespiratory diseases. Knowing the expected changes in hemoglobin and hematocrit due to diagnostic phlebotomy will help guide when to investigate anemia in hospitalized patients.

  7. Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults

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    Jie Cai

    2017-05-01

    Full Text Available Our aim was to evaluate the cut-off value and efficiency of using reticulocyte hemoglobin content as a marker to diagnose iron deficiency anemia in Chinese adults. 140 adults who needed bone marrow aspiration for diagnosis at the hematology department of the Peking Union Medical College Hospital were enrolled according to the inclusive and exclusive criteria. Venous blood samples were collected to detect complete blood count, including hemoglobin, reticulocyte hemoglobin content, hematocrit, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, free erythrocyte protoporphyrin; iron indexes of serum ferritin, serum transferrin receptor, and unsaturated iron-binding capacity; and inflammation markers of C-reactive protein and α-acid glycoprotein. Bone marrow samples were obtained for the bone marrow iron staining, which was used as the standard for the evaluation of iron status in this study. Subjects were divided into three groups according to hemoglobin levels and bone marrow iron staining results: the IDA (iron deficiency anemia group, the NIDA (non-iron deficiency anemia group, and the control group. The differences of the above-mentioned indexes were compared among the three groups and the effect of inflammation was also considered. The cut-off value of reticulocyte hemoglobin content was determined by receiver operation curves. The IDA group (n = 56 had significantly lower reticulocyte hemoglobin content, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, and serum ferritin; and higher free erythrocyte protoporphyrin, unsaturated iron-binding capacity, and serum transferrin receptor (p < 0.05 compared with the NIDA group (n = 38 and control group (n = 46. Hematocrit, serum ferritin, and unsaturated iron-binding capacity were significantly affected by inflammation while reticulocyte hemoglobin content and other parameters were not. The cut-off value of reticulocyte hemoglobin content for

  8. Evaluation of the Efficiency of the Reticulocyte Hemoglobin Content on Diagnosis for Iron Deficiency Anemia in Chinese Adults.

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    Cai, Jie; Wu, Meng; Ren, Jie; Du, Yali; Long, Zhangbiao; Li, Guoxun; Han, Bing; Yang, Lichen

    2017-05-02

    Our aim was to evaluate the cut-off value and efficiency of using reticulocyte hemoglobin content as a marker to diagnose iron deficiency anemia in Chinese adults. 140 adults who needed bone marrow aspiration for diagnosis at the hematology department of the Peking Union Medical College Hospital were enrolled according to the inclusive and exclusive criteria. Venous blood samples were collected to detect complete blood count, including hemoglobin, reticulocyte hemoglobin content, hematocrit, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, free erythrocyte protoporphyrin; iron indexes of serum ferritin, serum transferrin receptor, and unsaturated iron-binding capacity; and inflammation markers of C-reactive protein and α-acid glycoprotein. Bone marrow samples were obtained for the bone marrow iron staining, which was used as the standard for the evaluation of iron status in this study. Subjects were divided into three groups according to hemoglobin levels and bone marrow iron staining results: the IDA (iron deficiency anemia) group, the NIDA (non-iron deficiency anemia) group, and the control group. The differences of the above-mentioned indexes were compared among the three groups and the effect of inflammation was also considered. The cut-off value of reticulocyte hemoglobin content was determined by receiver operation curves. The IDA group ( n = 56) had significantly lower reticulocyte hemoglobin content, mean cellular volume, corpuscular hemoglobin concentration, hemoglobin content, and serum ferritin; and higher free erythrocyte protoporphyrin, unsaturated iron-binding capacity, and serum transferrin receptor ( p iron-binding capacity were significantly affected by inflammation while reticulocyte hemoglobin content and other parameters were not. The cut-off value of reticulocyte hemoglobin content for diagnosing iron deficiency anemia was 27.2 pg, with a sensitivity of 87.5% and a specificity of 92.9%. The cut-off values for

  9. Preoperative Anemia in Cardiac Operation: Does Hemoglobin Tell the Whole Story?

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    Dai, Lu; Mick, Stephanie L; McCrae, Keith R; Houghtaling, Penny L; Sabik, Joseph F; Blackstone, Eugene H; Koch, Colleen G

    2018-01-01

    Preoperative anemia, defined by hemoglobin level, is associated with elevated risk after cardiac operation. Better understanding of anemia requires characterization beyond this. This investigation focuses on red cell size and its association with patient characteristics and outcomes after cardiac operation. From January 2010 to January 2014, 10,589 patients underwent elective cardiac operations at Cleveland Clinic. Anemia was characterized as normocytic, microcytic, or macrocytic based on mean corpuscular volume (MCV). Models for hospital complications were developed using multivariable logistic regression. Other outcomes were postoperative transfusion and intensive care unit (ICU) and postoperative hospital lengths of stay. A total of 2,715 patients (26%) were anemic. Of these, 2,365 (87%) had normocytic, 219 (8.1%) microcytic, and 131 (4.8%) macrocytic anemia. Non-anemic patients (n = 2,041, 26%) received transfusions compared with 1,553 (66%) normocytic, 148 (68%) microcytic, and 97 (74%) macrocytic anemia patients. Patients with normocytic or macrocytic anemia had more renal failure (normocytic: odds ratio (OR) 1.9, macrocytic: OR 3.5), other complications (normocytic: OR 1.3, macrocytic: OR 2.2) and death (normocytic: OR 2.0, macrocytic: OR 6.2) than non-anemic patients; patients with microcytic anemia had fewer reoperations (OR 0.35) and less postoperative atrial fibrillation (OR 0.50). Anemic patients experienced longer ICU (27 versus 48 hours, p < 0.001) and postoperative hospital (6.1 versus 7.4 days, p < 0.001) length of stay than non-anemic patients. Cardiac surgical patients are often anemic. Demographic characteristics, comorbidities, and outcomes are dissimilar according to red cell size. Patients with microcytic anemia had the lowest hemoglobin levels, yet the best clinical outcomes among anemic patients. MCV from the standard complete blood count adds additional information beyond hemoglobin for targeted intervention. Copyright © 2018 The Society

  10. Estimation of prevalence of anemia using WHO hemoglobin color scale among non pregnant females of urban slum

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    Dhruvendra Pande

    2014-01-01

    Full Text Available Background: Nutritional anemia is a major public health problem worldwide particularly in developing countries among women of reproductive age. WHO Hemoglobin Color Scale is easy, quick and handy technique to estimate hemoglobin level at field. Objective: To find out prevalence of anemia using WHO hemoglobin color scale among the females of reproductive age group. To find out the most common signs and symptoms associated with anemia. To find out the causes associated with anemia among females. Material& Methods: A cross sectional study with written informed consent was conducted in 400 females of an urban slum area of Indore city. Females were selected using systematic random sampling method. All the females of reproductive age group were included in study. Level of hemoglobin was obtaining using WHO Hemoglobin color scale. A questionnaire was used during interpersonal interview of all the anemic females which was followed by clinical examination to assess signs and symptoms associated with anemia. The data was analyzed using Microsoft office excel sheet. Results: 61% of females of reproductive age group were found to be anemic by hemoglobin color scale. 54 % complained of frequent headache, 50 % of difficulty in breathing during normal work and 49.18% of reduced appetite. Conclusion: Anemia is found more in females of reproductive age group in urban slum. Most common symptoms associated with anemia are frequent headache, difficulty in breathing, weakness throughout day.

  11. Individualized Anemia Management Reduces Hemoglobin Variability in Hemodialysis Patients

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    Gaweda, Adam E.; Aronoff, George R.; Jacobs, Alfred A.; Rai, Shesh N.; Brier, Michael E.

    2013-01-01

    One-size-fits-all protocol-based approaches to anemia management with erythropoiesis-stimulating agents (ESAs) may result in undesired patterns of hemoglobin variability. In this single-center, double-blind, randomized controlled trial, we tested the hypothesis that individualized dosing of ESA improves hemoglobin variability over a standard population-based approach. We enrolled 62 hemodialysis patients and followed them over a 12-month period. Patients were randomly assigned to receive ESA ...

  12. Point-of-care hemoglobin testing for postmortem diagnosis of anemia.

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    Na, Joo-Young; Park, Ji Hye; Choi, Byung Ha; Kim, Hyung-Seok; Park, Jong-Tae

    2018-03-01

    An autopsy involves examination of a body using invasive methods such as dissection, and includes various tests using samples procured during dissection. During medicolegal autopsies, the blood carboxyhemoglobin concentration is commonly measured using the AVOXimeter® 4000 as a point-of-care test. When evaluating the body following hypovolemic shock, characteristics such as reduced livor mortis or an anemic appearance of the viscera can be identified, but these observations arequite subjective. Thus, a more objective test is required for the postmortem diagnosis of anemia. In the present study, the AVOXimeter® 4000 was used to investigate the utility of point-of-care hemoglobin testing. Hemoglobin tests were performed in 93 autopsy cases. The AVOXimeter® 4000 and the BC-2800 Auto Hematology Analyzer were used to test identical samples in 29 of these cases. The results of hemoglobin tests performed with these two devices were statistically similar (r = 0.969). The results of hemoglobin tests using postmortem blood were compared with antemortem test results from medical records from 31 cases, and these results were similar. In 13 of 17 cases of death from internal hemorrhage, hemoglobin levels were lower in the cardiac blood than in blood from the affected body cavity, likely due to compensatory changes induced by antemortem hemorrhage. It is concluded that blood hemoglobin testing may be useful as a point-of-care test for diagnosing postmortem anemia.

  13. National Trends in Hemoglobin Concentration and Prevalence of Anemia among Chinese School-Aged Children, 1995-2010.

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    Song, Yi; Wang, Hai-Jun; Dong, Bin; Wang, Zhiqiang; Ma, Jun; Agardh, Anette

    2017-04-01

    To assess the trend of sex disparity in hemoglobin concentration and prevalence of anemia among Chinese school-aged children from 1995 to 2010. Data were collected from 360 866 children aged 7, 9, 12, 14, and 17 years during 4 cross-sectional surveys (1995, 2000, 2005, and 2010) of the Chinese National Surveys on Students Constitution and Health. Shifts in hemoglobin concentration distributions were compared by sex. Average shifts and sex differences were calculated with quantile regression models. Logistic regression was used to estimate the prevalence odds ratio of sex for prevalence of anemia in different surveys. The mean hemoglobin concentration increased among Chinese children between 1995 and 2010, from 132.7 to 138.3 g/L in boys, and from 127.7 to 132.3 g/L in girls. The prevalence of anemia decreased from 18.8% in 1995 to 9.9% in 2010. It was higher in rural than urban children among all age groups. The prevalence odds ratios of girls versus boys for anemia increased in both urban and rural areas over time. Hemoglobin concentration and prevalence of anemia improved among Chinese school-aged children over time. Hemoglobin concentration improved faster in boys than girls and as a result the relative prevalence of anemia in girls compared with boys increased. Sex-specific preventive guidelines and public health policies for childhood anemia are needed in China. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Estimation of prevalence of Anemia using WHO hemoglobin color scale among Non pregnant females of urban slum

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    Satish Saroshe

    2014-05-01

    Full Text Available Background: Nutritional anemia is a major public health problem worldwide particularly in developing countries among women of reproductive age. WHO Hemoglobin Color Scale is easy, quick and handy technique to estimate hemoglobin level at field. Objective: To find out prevalence of anemia using WHO hemoglobin color scale among the females of reproductive age group. To find out the most common signs and symptoms associated with anemia. To find out the causes associated with anemia among females. Material& Methods: A cross sectional study with written informed consent was conducted in 400 females of an urban slum area of Indore city. Females were selected using systematic random sampling method. All the females of reproductive age group were included in study. Level of hemoglobin was obtaining using WHO Hemoglobin color scale. A questionnaire was used during interpersonal interview of all the anemic females which was followed by clinical examination to assess signs and symptoms associated with anemia. The data was analyzed using Microsoft office excel sheet. Results: 61% of females of reproductive age group were found to be anemic by hemoglobin color scale. 54 % complained of frequent headache, 50 % of difficulty in breathing during normal work and 49.18% of reduced appetite. Conclusion: Anemia is found more in females of reproductive age group in urban slum. Most common

  15. [Levels of anemia and hemoglobin in pregnant adolescents who attended health care facilities of Ministry of Health of Peru, 2009-2012].

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    Munares-García, Oscar; Gómez-Guizado, Guillermo

    2014-01-01

    To determine hemoglobin levels and anemia in pregnant adolescents who attended the health care facilities of the Ministry of Health of Peru between the years 2009 and 2012. Cross-sectional study of secondary data analysis using the Information System of the Nutritional Status of Children and Pregnant Women (SIEN). 265,788 records of pregnant women aged 10 to 19 years were reviewed. Hemoglobin levels (g/dL) and the percentage of anemia in the first, second and third trimesters were measured. Descriptive statistics with confidence intervals at 95% were applied. 3.4% of pregnant women were aged 10 to 14 years (early adolescence), 21.6% between 15 to 16 years (middle adolescence) and 75% between 17 to 19 years (late adolescence). Hemoglobin levels in pregnant adolescents were 11.6 ± 1.3 g/dL in 2009 and 11.5 ± 1.3 g/dL during the years 2010, 2011 and 2012. The overall incidence of anemia for 2009 was 25.1% (95% CI 24.4-25.8); for 2010 was 26.0% (95% CI 25.3-26.6) for 2011 was 26.4% (95% CI 25.8-27.1) and 25.2% for 2012 (95% CI 24.6-25.9). Hemoglobin levels were on average lower for pregnant residents in high Andean areas. About a quarter of pregnant adolescents in our sample had anemia.

  16. Acquired hemoglobin H disease in a patient with aplastic anemia evolving into acute myeloid leukemia

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    Maria Stella Figueiredo

    Full Text Available CONTEXT: The prognosis of severe aplastic anemia has improved since the introduction of bone marrow transplantation and treatment with antithymocyte globulin. In contrast to the success of these protocols, studies with long term follow-up have shown the occurrence of clonal diseases such as paroxysmal nocturnal hemoglobinuria, myelodysplastic syndrome and acute leukemia in aplastic anemia. CASE REPORT: We report the first case of a Brazilian patient with aplastic anemia who developed myelodysplastic syndrome and acute myeloid leukemia showing acquired hemoglobin H and increased fetal hemoglobin.

  17. Anemia in young children living in the Surinamese interior: the influence of age, nutritional status and ethnicity

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    Zijlmans CWR

    2017-02-01

    Full Text Available CWR Zijlmans,1 A Stuursma,2 AJ Roelofs,2 BC Jubitana,3 MS MacDonald-Ottevanger1 1Department of Mother & Child Health Care, Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname; 2Faculty of Medicine, University Medical Center Groningen, Groningen, the Netherlands; 3Department of Monitoring Evaluation Surveillance & Research, Medical Mission PHCS, Paramaribo, Suriname Purpose: This study investigates the prevalence of anemia in young children living in the interior of Suriname and the influence of the associated factors age, nutritional status and ethnicity. Patients and methods: In this cross-sectional observational study, 606 children aged 1–5 years from three different regions of Suriname’s interior were included, and hemoglobin levels and anthropometric measurements were collected. Logistic regression models were computed to examine independent associations between anemic and nonanemic groups and to measure the influence of age, nutritional status and ethnicity. Results: A total of 606 children were included, of whom 330 (55% were aged 1–3 years and 276 were aged 4–5 years. The overall prevalence of anemia was 63%. Younger age was associated with anemia (odds ratio [OR]=1.78; 95% confidence interval [CI]: 1.27–2.51. Anemia was less prevalent in Amerindian than in Maroon children (OR=0.51; 95% CI: 0.34–0.76. Hemoglobin level was not influenced by nutritional status nor by sex. Conclusion: The prevalence of anemia in children aged 1–5 years living in Suriname’s interior is high (63% compared to that in similar aged children in Latin America and the Caribbean (4–45%. Children aged 1–3 years were more affected than those aged 4–5 years as were Maroon children compared to Amerindian children. Nutritional status and sex were not of influence. Keywords: Maroon, Amerindian, hemoglobin, malnutrition, stunting, younger age

  18. The high prevalence of anemia in Cambodian children and women cannot be satisfactorily explained by nutritional deficiencies or hemoglobin disorders

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    Wieringa, Frank Tammo; Dahl, Miriam; Chamnan, Chhoun

    2016-01-01

    BACKGROUND: Anemia is highly prevalent in Cambodian women and children, but data on causes of anemia are scarce. We performed a national micronutrient survey in children and women that was linked to the Cambodian Demographic Health Survey 2014 (CDHS-2014) to assess the prevalence of micronutrient...... for 1512 subjects (792 children and 720 women). RESULTS: Anemia was found in 43% of the women and 53% of the children. Hemoglobin disorders affected >50% of the population, with Hemoglobin-E the most prevalent disorder. Deficiencies of iron (ferritin ... and hemoglobinopathy were significantly associated with anemia in children, whereas in the women none of the factors was significantly associated with anemia. Iron deficiency anemia (IDA) was more prevalent in children

  19. Hemoglobin and hematocrit values are higher and prevalence of anemia is lower in the post-folic acid fortification period than in the pre-folic acid fortification period in US adults.

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    Ganji, Vijay; Kafai, Mohammad R

    2009-01-01

    It is not known whether the improved folate status from mandatory folic acid fortification had any impact on indexes and prevalence of anemias in the United States. We investigated trends in indexes and prevalence of anemia and macrocytosis with a focus on comparison of prefortification data with postfortification data. Hemoglobin, hematocrit, mean corpuscular volume (MCV) and prevalences and likelihood of anemia and macrocytosis were determined for 26,596 adults examined in the National Health and Nutrition Examination Surveys, 1988-2004. From 1988-1994 to 1999-2004, hemoglobin modestly but significantly improved from 15.1 to 15.4 g/dL (approximately 2.0%; P 60 y) men (from 91.6 to 92.4; P = 0.0105) and in women (from 90.7 to 91.4; P = 0.0141). Only in women was the prevalence of anemia significantly lower in 1999-2004 than in 1988-1994 (27.9% reduction; P = 0.0005). The odds of having anemia in the postfortification period relative to the prefortification period was 0.64 (95% CI: 0.54, 0.75; P hemoglobin and the decreased prevalence of anemia from 1988-1994 to 1999-2004, especially in women, may be attributable to improved folate status, increased vitamin/mineral supplements use, and other unknown causes after the initiation of folic acid fortification. The cause of increased MCV in men, and in older persons of both sexes, warrants further investigation.

  20. Prevalence of Anemia and Hemoglobin Disorders Among School Children in Myanmar.

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    Wah, Saw Thu; Yi, Yoon Shwe; Khin, Aye Aye; Plabplueng, Chotiros; Nuchnoi, Pornlada

    2017-01-01

    The prevalence of anemia is high in the population of Myanmar and hypochromic microcytic anemia (HMA) is predominant. The objective of our study was to determine the prevalence of anemia and causes of HMA among school children. A cross-sectional study was conducted on 239 children from Thanlyin and Insein Townships, Yangon Region, Myanmar. Complete blood count (CBC) and blood film morphology was examined on venous blood samples. Hypochromic microcytic anemia cases were subsequently analyzed for serum ferritin and cellulose acetate hemoglobin (Hb) electrophoresis. The prevalence of anemia was 46.4%; 27.6% had mild, while 18.8% had moderate anemia, and no case of severe anemia was detected. The mean Hb concentration was 11.7 ± 0.9 g/dL. The younger age group (8-11 years) had a significantly higher prevalence of anemia than the older age group (12-15 years) (p = 0.029). Blood film morphology revealed a 50.6% red blood cell (RBC) disorder; HMA was the most common type (70.2%). Out of 85 children with HMA, three children (3.5%) had iron deficiency and all had comorbidity with Hb AE (β A /β E ) (Hb E trait). Hemoglobin electrophoresis illustrated that Hb AA (β A /β A ) (31, 36.5%) and Hb AE (β A /β E ) trait (31, 36.5%) were the most common types followed by β-thalassemia (β-thal) trait (19, 22.3%) and Hb EE (β E /β E ) (homozygous Hb E; HBB: c.79G>A) (three, 3.5%). Hematocrit [or packed cell volume (PCV)], mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC), showed a significant difference between Hb AE, Hb EE and β-thal trait (p = 0.029, 0.023, 0.015 and 0.01, respectively). Our findings will provide valuable information for the management of anemia in the Myanmar school-age population.

  1. Nutrition education and knowledge, attitude and hemoglobin status of Malaysian adolescents.

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    Yusoff, Hafzan; Daud, Wan Nudri Wan; Ahmad, Zulkifli

    2012-01-01

    A higher occurrence of iron deficiency anemia is present in rural Malaysia than urban Malaysia due to a lower socio-economic status of rural residents. This study was conducted in Tanah Merah, a rural district of Kelantan, Malaysia. Our objective was to investigate the impact of nutrition education alone, daily iron, folate and vitamin C supplementation or both on knowledge, attitudes and hemoglobin status of adolescent students. Two hundred eighty fourth year secondary students were each assigned by school to 1 of 4 different treatment groups. Each intervention was carried out for 3 months followed by 3 months without treatment. A validated self-reported knowledge and attitude questionnaire was administered; hemoglobin levels were measured before and after intervention. At baseline, no significant difference in hemoglobin was noted among the 4 groups (p = 0.06). The changes in hemoglobin levels at 3 months were 11, 4.6, 3.9 and -3.7% for the supplementation, nutrition education, combination and control groups, respectively. The changes at 6 months were 1.0, 6.8, 3.7 and -14.8%, respectively. Significant improvements in knowledge and attitude were evidenced in both the nutritional education and combination groups. The supplementation and control groups had no improvement in knowledge or attitudes. This study suggests nutritional education increases knowledge, attitudes and hemoglobin levels among Malaysian secondary school adolescents.

  2. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States

    OpenAIRE

    Gupta, Priya M.; Perrine, Cria G.; Mei, Zuguo; Scanlon, Kelley S.

    2016-01-01

    Iron deficiency and anemia are associated with impaired neurocognitive development and immune function in young children. Total body iron, calculated from serum ferritin and soluble transferrin receptor concentrations, and hemoglobin allow for monitoring of the iron and anemia status of children in the United States. The purpose of this analysis is to describe the prevalence of iron deficiency (ID), anemia, and iron deficiency anemia (IDA) among children 1–5 years using data from the 2007–201...

  3. Hemoglobin correction factors for estimating the prevalence of iron deficiency anemia in pregnant women residing at high altitudes in Bolivia

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    Jennifer Hadary Cohen

    1999-12-01

    Full Text Available This study had two primary objectives: 1 to derive a method to determine hemoglobin cutoffs that could be used to better estimate the prevalence of iron deficiency anemia in pregnancy at high altitudes and 2 to estimate the prevalence of anemia in a sample of pregnant women residing in two cities in Bolivia, La Paz (3 600 meters and El Alto (4 000 meters. We derived a hemoglobin-altitude curve from previously published data on the mean hemoglobin concentrations of nonanemic women of childbearing age at various altitudes. In addition, we abstracted data on hemoglobin concentration during pregnancy from medical records of women from La Paz and El Alto who had given birth at a maternity hospital in La Paz between January and June of 1996. Using our approach and two other previously published, currently used methods, we calculated and compared prevalences of iron deficiency anemia in this population using hemoglobin cutoffs determined from a hemoglobin-altitude curve corrected for pregnancy. The hemoglobin-altitude curve derived in this study provided a better fit to data for women of childbearing age than the two other models. Those models used cutoffs based on non-iron-replete populations of children or men, both of which were residing below 4 000 m, and then extrapolated to women and higher altitudes. The estimated prevalences of iron deficiency anemia in pregnancy using the hemoglobin cutoffs determined in this study were higher than those estimated by the two other approaches.

  4. Impact of multi-micronutrient fortified rice on hemoglobin, iron and vitamin A status of Cambodian schoolchildren

    DEFF Research Database (Denmark)

    Perignon, Marlene; Fiorentino, Marion; Khov, Kuong

    2016-01-01

    In Cambodia, micronutrient deficiencies remain a critical public health problem. Our objective was to evaluate the impact of multi-micronutrient fortified rice (MMFR) formulations, distributed through a World Food Program school-meals program (WFP-SMP), on the hemoglobin concentrations and iron......Rice) or unfortified rice (placebo) six days a week for six months. Four additional schools not participating in WFP-SMP were randomly selected as controls. A total of 2440 schoolchildren (6–16 years old) participated in the biochemical study. Hemoglobin, iron status, estimated using inflammation-adjusted ferritin...... and transferrin receptors concentrations, and VA status, assessed using inflammation-adjusted retinol-binding protein concentration, were measured at the baseline, as well as at three and six months. Baseline prevalence of anemia, depleted iron stores, tissue iron deficiency, marginal VA status and VA deficiency...

  5. Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children

    Science.gov (United States)

    Iannotti, Lora L.; Delnatus, Jacques R.; Odom, Audrey R.; Eaton, Jacob C.; Griggs, Jennifer J.; Brown, Sarah; Wolff, Patricia B.

    2015-01-01

    Anemia diminishes oxygen transport in the body, resulting in potentially irreversible growth and developmental consequences for children. Limited evidence for determinants of anemia exists for school-aged children. We conducted a cluster randomized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack. Children (N = 1,047) aged 3–13 years were followed longitudinally at three time points for hemoglobin (Hb) concentrations, anthropometry, and bioelectrical impedance measures. Dietary intakes, infectious disease morbidities, and socioeconomic and demographic factors were collected at baseline and endline. Longitudinal regression modeling with generalized least squares and logit models with random effects identified anemia risk factors beyond the intervention effect. At baseline, 70.6% of children were anemic and 2.6% were severely anemic. Stunting increased the odds of developing anemia (adjusted odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.05–2.08) and severe anemia (adjusted OR: 2.47, 95% CI: 1.30–4.71). Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations, whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia, respectively. Further research should explore the full spectrum of anemia etiologies in school children, including genetic causes. PMID:26350448

  6. EFFECT OF ROSELLE (HIBISCUS SABDARIFFA ON CHANGES IN HEMOGLOBIN LEVELS IN PREGNANT WOMEN WITH ANEMIA TAKING IRON SUPPLEMENT

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    Rif’atun Nisa

    2017-12-01

    Full Text Available Background: Anemia during pregnancy is one of the most common disorders in pregnant women in Indonesia. The Government has made efforts to overcome this problem, however, the rate of anemic mothers remains high. Rosella (Hibiscus Sabdariffa is considered able to increase the hemoglobin levels in pregnant mothers. Objective: To analyze the effect of Rosella flower extract (Hibiscus Sabdariffa on the increase of Hemoglobin level in pregnant women with anemia receiving Fe tablet. Methods: This study was a quasy experiment with pretest-posttest control group design conducted in November - December 2016 in the working area of Tlogosari Wetan Community Health Center. Forty-two participants were selected using accidental sampling, which 21 assigned in the experiment and control group. All samples were pregnant women in the second trimester suffering from anemia and receiving iron tablets. Hemoglobin levels were measured using hematology analyzer in laboratory. Independent t-test and paired t-test were used for data analysis. Results: Paired t-test obtained p-value 0.00 (<0.05, indicated that there was an increase of hemoglobin levels in both experiment and control group. The mean increase of hemoglobin levels in the control group was 0.61 gr and in the experiment group was 1.08. The hemoglobin levels in the experiment group were higher than the levels in the control group. Independent t-test obtained p-value 0.000 (<0.05 indicating that there was a significant difference of mean of hemoglobin levels between the control group and the treatment group. Conclusion: The consumption of rosella extract combined with Fe tablet showed a significant increase of hemoglobin levels compared with the consumption of Fe tablet alone. Therefore, it is suggested for midwife to use the result of this research as a evidence practice through counseling for pregnant mother about utilization of rosella extract that can increase hemoglobin level in pregnant woman with anemia.

  7. Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

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    Carina V. Gianserra

    2011-06-01

    estadía hospitalaria prolongada, la presencia de leucocitosis, la hidratación parenteral y colocación de acceso venoso central fueron factores predictivos de descenso de hemoglobina = 2 g/dl.It is common to observe the development of anemia in hospitalized patients, especially in critical cases. Few studies have evaluated its prevalence and associated factors in patients in the general ward. The purpose of this study is to determine the prevalence, characteristics and associated clinical factors of hospital-acquired anemia and the drop of hemoglobin concentration in hospitalized patients. This is a cross-sectional, prospective and descriptive study. A total of 192 consecutive in-patients in the general ward were studied. Associated risk factors to the drop in hemoglobin by = 2g/dl were analyzed; 139 patients (72.4% presented anemia; 89 of them (46.4% had it at admission and 50 (26% developed hospital-acquired anemia, 47 out of 192 showed a drop in hemoglobin = 2 g/dl(24.48%. They also presented lower values of hematocrite and hemoglobin at discharge (p = 0.01, parenteral hydration at a higher volume (p = 0.01, and lengthier hospitalizations (p = 0.0001. In the univariate analysis, the following variables were statistically significant risk factors: leukocytosis = 11 000 mm³ (OR; IC95%: 2,02; 1.03-4; p = 0.01, hospitalization days = 7 (OR; IC95%:3.39; 1.62-7.09; p = 0.0006, parenteral hydration = 1500 ml/day (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, central venous access (OR; IC95%:10.29; 1.75-108.07; p = 0.003 and hospital-acquired anemia (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004. In the multivariate analysis, the following variables were independent predictive factors of the hemoglobin decrease = 2 g/dl: leukocytosis = 11 000 mm³ (OR; IC95%: 2.45; 1.14-5,27; p = 0.02, hospitalization days = 7 (OR; IC95%:5.15; 2.19-12.07; p = 0.0002, parenteral hydration = 1500 ml/day (OR; IC95%: 2.95; 1.13-7.72; p = 0.02, central venous access (OR; IC95%:8.82; 1.37-56.82; p = 0

  8. Sickle cell anemia

    Science.gov (United States)

    Anemia - sickle cell; Hemoglobin SS disease (Hb SS); Sickle cell disease ... Sickle cell anemia is caused by an abnormal type of hemoglobin called hemoglobin S. Hemoglobin is a protein inside red blood cells ...

  9. Prevalência de talassemias e hemoglobinas variantes em pacientes com anemia não ferropênica Prevalence of thalassemias and variant hemoglobins in patients with non-ferropenic anemia

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    Sandrine C. Wagner

    2005-03-01

    patients with non-ferropenic anemia carried some type of inherited anemia: 25.9% of heterozygous alpha-thalassemia, 32.8% of heterozygous beta-thalassemia, 3.4% of heterozygosity for hemoglobin S (Hb AS and 1.7% of homozygosity for hemoglobin C (Hb CC. Inherited anemias were detected in 14.1% of the control group: 11.5% of alpha-thalassemia, 0.9% of beta-thalassemia, 1.3% of heterozygosity for hemoglobin S (Hb AS and 0.4% of heterozygosity for hemoglobin C (Hb AC. The results obtained showed that the prevalence of variant thalassemias and hemoglobins in the control group is coincident with that described in the literature. However, physicians and health services should be informed about the overwhelming prevalence of these inherited homeopathies in individuals with non-ferropenic anemia, due to its importance in the definitive diagnosis of anemia and for the correct therapeutic proceedings.

  10. Impact of Multi-Micronutrient Fortified Rice on Hemoglobin, Iron and Vitamin A Status of Cambodian Schoolchildren: a Double-Blind Cluster-Randomized Controlled Trial

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    Marlène Perignon

    2016-01-01

    Full Text Available In Cambodia, micronutrient deficiencies remain a critical public health problem. Our objective was to evaluate the impact of multi-micronutrient fortified rice (MMFR formulations, distributed through a World Food Program school-meals program (WFP-SMP, on the hemoglobin concentrations and iron and vitamin A (VA status of Cambodian schoolchildren. The FORISCA-UltraRice+NutriRice study was a double-blind, cluster-randomized, placebo-controlled trial. Sixteen schools participating in WFP-SMP were randomly assigned to receive extrusion-fortified rice (UltraRice Original, UltraRice New (URN, or NutriRice or unfortified rice (placebo six days a week for six months. Four additional schools not participating in WFP-SMP were randomly selected as controls. A total of 2440 schoolchildren (6–16 years old participated in the biochemical study. Hemoglobin, iron status, estimated using inflammation-adjusted ferritin and transferrin receptors concentrations, and VA status, assessed using inflammation-adjusted retinol-binding protein concentration, were measured at the baseline, as well as at three and six months. Baseline prevalence of anemia, depleted iron stores, tissue iron deficiency, marginal VA status and VA deficiency were 15.6%, 1.4%, 51.0%, 7.9%, and 0.7%, respectively. The strongest risk factors for anemia were hemoglobinopathy, VA deficiency, and depleted iron stores (all p < 0.01. After six months, children receiving NutriRice and URN had 4 and 5 times less risk of low VA status, respectively, in comparison to the placebo group. Hemoglobin significantly increased (+0.8 g/L after three months for the URN group in comparison to the placebo group; however, this difference was no longer significant after six months, except for children without inflammation. MMFR containing VA effectively improved the VA status of schoolchildren. The impact on hemoglobin and iron status was limited, partly by sub-clinical inflammation. MMFR combined with non

  11. Genetic hemoglobin disorders rather than iron deficiency are a major predictor of hemoglobin concentration in women of reproductive age in rural prey Veng, Cambodia.

    Science.gov (United States)

    Karakochuk, Crystal D; Whitfield, Kyly C; Barr, Susan I; Lamers, Yvonne; Devlin, Angela M; Vercauteren, Suzanne M; Kroeun, Hou; Talukder, Aminuzzaman; McLean, Judy; Green, Timothy J

    2015-01-01

    Anemia is common in Cambodian women. Potential causes include micronutrient deficiencies, genetic hemoglobin disorders, inflammation, and disease. We aimed to investigate factors associated with anemia (low hemoglobin concentration) in rural Cambodian women (18-45 y) and to investigate the relations between hemoglobin disorders and other iron biomarkers. Blood samples were obtained from 450 women. A complete blood count was conducted, and serum and plasma were analyzed for ferritin, soluble transferrin receptor (sTfR), folate, vitamin B-12, retinol binding protein (RBP), C-reactive protein (CRP), and α1 acid glycoprotein (AGP). Hemoglobin electrophoresis and multiplex polymerase chain reaction were used to determine the prevalence and type of genetic hemoglobin disorders. Overall, 54% of women had a genetic hemoglobin disorder, which included 25 different genotypes (most commonly, hemoglobin E variants and α(3.7)-thalassemia). Of the 420 nonpregnant women, 29.5% had anemia (hemoglobin 8.3 mg/L), hemoglobin disorders, respectively. There was no biochemical evidence of vitamin A deficiency (RBP 5 mg/L) and 26% (AGP >1 g/L) of nonpregnant women, respectively. By using an adjusted linear regression model, the strongest predictors of hemoglobin concentration were hemoglobin E homozygous disorder and pregnancy status. Other predictors were 2 other heterozygous traits (hemoglobin E and Constant Spring), parity, RBP, log ferritin, and vitamin B-12. Multiple biomarkers for anemia and iron deficiency were significantly influenced by the presence of hemoglobin disorders, hence reducing their diagnostic sensitivity. Further investigation of the unexpectedly low prevalence of IDA in Cambodian women is warranted. © 2015 American Society for Nutrition.

  12. Hepcidin and hemoglobin content parameters in the diagnosis of iron deficiency in rheumatoid arthritis patients with anemia

    NARCIS (Netherlands)

    Santen, S. van; Dongen-Lases, E.C. van; Vegt, F. de; Laarakkers, C.M.; Riel, P.L. van; Ede, A.E. van; Swinkels, D.W.

    2011-01-01

    OBJECTIVE: To explore the utility of the novel iron indices hepcidin, reticulocyte hemoglobin content (Ret-Hgb), and erythrocyte (red blood cell) hemoglobin content (RBC-Hgb) for detection of iron deficiency in rheumatoid arthritis (RA) patients with anemia and active inflammation and to compare

  13. Population hemoglobin mean and anemia prevalence in Papua New Guinea: new metrics for defining malaria endemicity?

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    Nicolas Senn

    Full Text Available BACKGROUND: The hypothesis is that hemoglobin-based metrics are useful tools for estimating malaria endemicity and for monitoring malaria control strategies. The aim of this study is to compare population hemoglobin mean and anemia prevalence to established indicators of malaria endemicity, including parasite rates, rates of enlarged spleens in children, and records of (presumptive malaria diagnosis among populations living with different levels of malaria transmission. METHODOLOGY/PRINCIPAL FINDINGS: Convenience sample, multisite cross-sectional household surveys conducted in Papua New Guinea. Correlations (r(2 between population Hb mean and anemia prevalence and altitude, parasite rate, and spleen rate were investigated in children ages 2 to 10 years, and in the general population; 21,664 individuals from 156 different communities were surveyed. Altitude ranged from 5 to 2120 meters. In young children, correlations between altitude and parasite rate, population Hb mean, anemia prevalence, and spleen rate were high (r(2: -0.77, 0.73, -0.81, and -0.68; p1500 m (p<0.001. CONCLUSIONS/SIGNIFICANCE: In PNG, where Plasmodium vivax accounts for an important part of all malaria infections, population hemoglobin mean and anemia prevalence correlate well with altitude, parasite, and spleen rates. Hb measurement is simple and affordable, and may be a useful new tool, alone or in association with other metrics, for estimating malaria endemicity and monitoring effectiveness of malaria control programs. Further prospective studies in areas with different malaria epidemiology and different factors contributing to the burden of anemia are warranted to investigate the usefulness of Hb metrics in monitoring malaria transmission intensity.

  14. Iron deficiency and anemia: a common problem in female elite soccer players.

    Science.gov (United States)

    Landahl, Göran; Adolfsson, Peter; Börjesson, Mats; Mannheimer, Clas; Rödjer, Stig

    2005-12-01

    The objective of the study was to determine the prevalence of iron deficiency and iron deficiency anemia among elite women soccer players. Hemoglobin, serum iron, serum total iron binding capacity, and ferritin were determined in 28 female soccer players called up for the national team. Of the investigated female soccer players, 57% had iron deficiency and 29% iron deficiency anemia 6 months before the FIFA Women's World Cup. It is concluded that iron deficiency and iron deficiency anemia is common in female soccer players at the top international level. Some might suffer from relative anemia and measurement of hemoglobin alone is not sufficient to reveal relative anemia. Regular monitoring of hemoglobin concentration and iron status is necessary to institute iron supplementation when indicated.

  15. Anemia among HIV-Infected Patients Initiating Antiretroviral Therapy in South Africa: Improvement in Hemoglobin regardless of Degree of Immunosuppression and the Initiating ART Regimen

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    Simbarashe Takuva

    2013-01-01

    Full Text Available Among those with HIV, anemia is a strong risk factor for disease progression and death independent of CD4 count and viral load. Understanding the role of anemia in HIV treatment is critical to developing strategies to reduce morbidity and mortality. We conducted a prospective analysis among 10,259 HIV-infected adults initiating first-line ART between April 2004 and August 2009 in Johannesburg, South Africa. The prevalence of anemia at ART initiation was 25.8%. Mean hemoglobin increased independent of baseline CD4. Females, lower BMI, WHO stage III/IV, lower CD4 count, and zidovudine use were associated with increased risk of developing anemia during follow-up. After initiation of ART, hemoglobin improved, regardless of regimen type and the degree of immunosuppression. Between 0 and 6 months on ART, the magnitude of hemoglobin increase was linearly related to CD4 count. However, between 6 and 24 months on ART, hemoglobin levels showed a sustained overall increase, the magnitude of which was similar regardless of baseline CD4 level. This increase in hemoglobin was seen even among patients on zidovudine containing regimens. Since low hemoglobin is an established adverse prognostic marker, prompt identification of anemia may result in improved morbidity and mortality of patients initiating ART.

  16. Anemia Due to Excessive Bleeding

    Science.gov (United States)

    ... Hemolytic Anemia Hemoglobin C, S-C, and E Diseases Iron Deficiency Anemia Sickle Cell Disease Thalassemias Vitamin Deficiency Anemia (See ... Hemolytic Anemia Hemoglobin C, S-C, and E Diseases Iron Deficiency Anemia Sickle Cell Disease Thalassemias Vitamin Deficiency Anemia NOTE: ...

  17. Clinical Significance of Reticulocyte Hemoglobin Content in the Diagnosis of Iron Deficiency Anemia

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    Mustafa Karagülle

    2013-06-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the clinical significance of reticulocyte hemoglobin content (CHr in the diagnosis of iron deficiency anemia (IDA and to compare it with other conventional iron parameters. METHODS: A total of 32 female patients with IDA (serum hemoglobin 120 g/L and serum ferritin <20 ng/mL were enrolled. RESULTS: CHr was 24.95±3.92 pg in female patients with IDA and 29.93±2.96 pg in female patients with iron deficiency. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, and transferrin saturation and a significant negative correlation with transferrin and total iron-binding capacity. The cut-off value of CHr for detecting IDA was 29 pg. CONCLUSION: Our data demonstrate that CHr is a useful parameter that can be confidently used in the diagnosis of IDA, and a CHr cut-off value of 29 pg predicts IDA.

  18. Hair Mercury Level is Associated with Anemia and Micronutrient Status in Children Living Near Artisanal and Small-Scale Gold Mining in the Peruvian Amazon.

    Science.gov (United States)

    Weinhouse, Caren; Ortiz, Ernesto J; Berky, Axel J; Bullins, Paige; Hare-Grogg, John; Rogers, Laura; Morales, Ana-Maria; Hsu-Kim, Heileen; Pan, William K

    2017-12-01

    Anemia has been widely studied in global health contexts because of severe nutritional deficiency, and more recently, inflammatory status, but chemical exposures are rarely considered. Until recently, "anemia" was used synonymously with "iron deficiency anemia (IDA)" in global health settings. However, only 50% of anemia cases worldwide are IDA. Environmental toxicology studies of anemia risk have generally focused on populations in developed countries, albeit with high exposure to environmental toxicants, such as lead or cadmium. In the developing world, toxicant exposures commonly coexist with other risk factors for anemia. In particular, artisanal and small-scale gold mining (ASGM) communities are at risk for dietary methylmercury exposure through contaminated fish consumption, and for anemia due to food insecurity and infectious and chronic diseases. Here, we report analysis of total hair mercury content, hemoglobin, and serum micronutrient levels in children association between total mercury and hemoglobin (β = -0.12 g/dL, P = 0.06) that persisted (β = -0.14 g/dL, P = 0.04) after adjusting for age, sex, anthropometrics, and vitamin B 12 in multivariate regression. This study provides preliminary evidence that methylmercury exposure is associated with anemia, which is especially relevant to children living near ASGM.

  19. Anemia and Iron Deficiency in Vietnamese Children, 6 to 11 Years Old.

    Science.gov (United States)

    Le Nguyen Bao, Khanh; Tran Thuy, Nga; Nguyen Huu, Chinh; Khouw, Ilse; Deurenberg, Paul

    2016-07-01

    In a population sample of 385 children, 6 to 11 years old, venous blood parameters-hemoglobin (Hb), ferritin, red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), C-reactive protein (CRP), and α1-acid glycoprotein (AGP)-were determined to get insight into the iron status. The prevalence of anemia was 11.4%; 5.6% had iron deficiency (ID), whereas 0.4% had ID anemia. Correction for inflammation based on CRP and AGP did not markedly change the overall prevalence of ID and ID anemia. Stunted children had lower Hb and ferritin values compared with nonstunted children, and thin children had lower values compared with normal-weight or overweight and obese children. Many nonanemic children had alert values for RBC, MCV, MCH, and MCHC. It is concluded that although the prevalence of anemia is of the magnitude of a mild public health problem, the iron status of many nonanemic children is borderline, as indicated by a high number of children with low values for red blood cytology. © 2016 APJPH.

  20. Hemoglobin status of non-school going adolescent girls in three districts of Orissa, India.

    Science.gov (United States)

    Bulliyy, Gandham; Mallick, Gitanjali; Sethy, Girija Sankar; Kar, Santanu Kumar

    2007-01-01

    Anemia is a major public health problem in young children and pregnant women in SouthEast Asia, but a paucity of data on anemia in adolescent girls in India. Studies are lacking on the entire non-school going adolescent population. To determine the prevalence of anemia in non-school going adolescent girls and the association between hemoglobin (Hb) concentration and socioeconomic and nutritional factors. A cross-sectional community study conducted on a sample of 1937 healthy adolescent girls aged 11-19 years from three districts of Orissa, India. Sample size was determined using a probability proportionate to size cluster sampling. The adolescent girls were interviewed and anthropometric measurements were collected. The Hb estimation was carried out in capillary blood samples using the cyanmethemoglobin method. Anemia and nutritional status were evaluated according to standard procedures. The mean Hb concentration was 9.7 +/- 1.4 g/dL (range, 4.5-13.4 g/dL). Of the total adolescent girls, 1869 (96.5%) were anemic (Hb education levels of girls and their parents' family income, body mass index, and mid-upper arm circumference. This study revealed that prevalence of anemia was extremely high in non-school going adolescent girls (most were moderately anemic) and stressed the need for more research and public health interventions.

  1. Hemoglobin, red blood cell count, hematocrit and derived parameters for diagnosing anemia in elderly males

    International Nuclear Information System (INIS)

    Khan, Z.; Nawaz, M.

    2013-01-01

    Anemia is one of the most common micronutrient deficiency in our community. Nutritional anaemias are caused when there is an inadequate body store of a specific nutrient needed for hemoglobin synthesis. The most common nutrient deficiency is of iron. Therefore, a cross-sectional survey was conducted on the healthy elderly male, aged >= 40 and 77 years (n=60) volunteers in order to assess their blood parameters, such as hemoglobin concentration (Hb), hematocrit (HCT), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) for the diagnosis of anemia. The demographic results showed mean values (50.10+-8.79) years for age, 66-68 +- 1.95 inches for height , 71.43 +- 6.43 kg body weight, 98.34+-0.48 degree F body temperature, 124 +- 8.67 systolic blood pressure, 82.17 +- 4.15 diastolic pressure while, The pulse rate was found to be 74.63 +- 7.02/minute. Similarly, mean values for lean body weight (LBW) found to be 49.9+-2.89, ideal body weight (IBW) 60.9 +- 4.49, body surface area (BSA) was 1.8 +- 0.1 m2 whereas, body mass index (BMI) showed mean value 24.9 +- 2.6 kg/m2. More so, overall mean Hb found to be 13.60 g/dl, RBC 4.6 mill/mm3, HCT/PCV 43%, MCV 92.95fl, MCH 29.42 pg and MCHC was found to be 31.73 g/dl. The normal range of Hb for men was 13-17 g/dl and 31.67% of the subjects participated in the study was considered to be anemic showing less Hb than normal range. The volunteers were suggested to improve the dietary habits and to take iron supplements in order to overcome the iron deficiency anemia. (author)

  2. Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi.

    Science.gov (United States)

    Singh, Tulika; Nagesh, S; Ray, T K

    2018-01-01

    Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized. The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi. A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years). Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis. The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI) were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia. Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

  3. STATUS ZINC PADA LANSIA LAKI-LAKI YANG ANEMIA DAN TIDAK ANEMIA DI DESA DAN KOTA

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    Yuniar Rosmalina

    2014-09-01

    Full Text Available ZINC STATUS OF ANEMIC AND NON-ANEMIC MALE ELDERLY IN RURAL AND URBAN AREAS The elderly peoples are prone to micronutrients deficiency such as zinc. The impact of low intake of zinc is impaired functions of wound healing, immunity and taste and smell. The article presents the zinc state of elderly people with or without anemia. The age of subjects was 60 – 75 years. physically and clinically healthy, and agreed to participate in this study. Data collection including anthropometric measurements (body weight, height, mid-upper circumference, zinc, and Hb. Body Mass Index was calculated using ratio body weight to height. Hemoglobin level was analyzed using cyanmethemoglobin method and serum zinc was analyzed using Atomic Absorption Spectrophotometer method. The average Body weight, height and MUAC of urban elderly were statistically higher compared to rural elderly. The proportion of anemic among elderly in rural was 29.0 percent and 15.7 percent in urban. Serum zinc level showed that the proportion of elderly who have low serum zinc level was higher in rural compared to urban area (76.0% vs 54.9%. Out of 54 elderly whose anemic 87.1 percent have serum zinc level below 70 mg/L, while in urban area out of 64 anemic elderly 68.8 % have serum zinc level below 70 mg/L.The proportion of elderly who have suffered anemia and have low serum level were higher in rural compared to urban area. Keywords: anemia, zinc, elderly

  4. Recovery from Hospital-Acquired Anemia after Acute Myocardial Infarction and Effect on Outcomes

    OpenAIRE

    Salisbury, Adam C.; Kosiborod, Mikhail; Amin, Amit P.; Reid, Kimberly J.; Alexander, Karen P.; Spertus, John A.; Masoudi, Frederick A.

    2011-01-01

    New onset, hospital-acquired anemia (HAA) during acute myocardial infarction (AMI) is independently associated with poor outcomes. Patterns of recovery from HAA after AMI and their association with mortality and health status are unknown. In the prospective 24-center TRIUMPH registry, we identified 530 AMI patients with HAA (defined as normal hemoglobin at admission with development of anemia by discharge) who had repeat, protocol-driven hemoglobin measurement 1 month after discharge. The 1-m...

  5. Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi

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    Tulika Singh

    2018-01-01

    Full Text Available Background: Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized. Objectives: The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi. Materials and Methods: A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years. Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis. Results: The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia. Conclusion: Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

  6. Hemoglobin concentrations and associated factors in adolescentes from Recife, Brazil

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    Elisângela Barros Soares Mendonça

    2014-10-01

    Full Text Available OBJECTIVE: To estimate the prevalence of anemia and associated factors in adolescents from the city of Recife in Pernambuco state. METHODS: This is a cross-sectional study, involving a random sample of 256 adolescents of both genders, aged 13 to 18, whose hemoglobin concentrations were evaluated, along with their nutritional status and socioeconomic and demographic characteristics. RESULTS: The prevalence of inadequate hemoglobin concentrations was 10.2% [CI95%=6.7-14.5], reaching levels considered as mild anemia (9 g/dL 0.05, nor with socioeconomic or demographic characteristics (p>0.05. CONCLUSION: Although the prevalence of anemia was low and classified as a mild health problem, preventive nutrition education involving the dissemination of healthy eating habits in schools and encouraging the consumption of iron-rich foods are strongly recommended.

  7. Chilean complementary feeding program reduces anemia and improves iron status in children aged 11 to 18 months.

    Science.gov (United States)

    Brito, Alex; Olivares, Manuel; Pizarro, Tito; Rodríguez, Lorena; Hertrampf, Eva

    2013-12-01

    Iron deficiency is the most prevalent nutritional deficiency in the world, primarily affecting infants, young children, and women of childbearing age. To evaluate the impact of the National Complementary Feeding Program (NCFP) on anemia and iron status in Chilean children aged 11 to 18 months. Two studies were performed. The first study was performed at one public outpatient health center in Santiago, using data collected in 1999 (n = 128) and 2000 (n = 125), before and after the national introduction of iron-fortified milk. Subsequently, a study of a representative sample (n = 320) from the two most populated areas of the country was performed in 2009. One year after fortification, the prevalence of anemia was 9%; significantly lower (p < .001) than the 27% prevalence observed 1 year before. Ten years after fortification, 14% of children were anemic and 77% of children with anemia (12% of all children) suffered from iron-deficiency anemia. In 2009, 11% of children consuming iron-fortified milk delivered by the NCFP (73%) were anemic, significantly lower (p = .028) than the 21% prevalence of anemia observed in children without consumption. Consumption of iron-fortified milk was positively associated with hemoglobin concentration (r = 0.28, p = .022) and was associated with a lower prevalence of anemia after adjusting for confounding factors (odds ratio, 0.50; 95% CI, 0.26 to 0.96). In Chile, the NCFP has had an impact on the reduction of anemia and improved the iron status of children aged 11 to 18 months. Increasing the consumption of this iron-fortified milk could enhance the impact of the NCFP.

  8. Pengetahuan Gizi dan Kadar Hemoglobin Anak Sekolah Dasar Penderita Anemia Setelah Mendapatkan Suplementasi Besi dan Pendidikan Gizi

    OpenAIRE

    Zulaekah, Siti; Widajanti, Laksmi

    2010-01-01

    Anemia is the major health problem for 26,5 % of the school children and teenagers in Indonesia. It is expected that by giving nutrition education to the anemic school age children, their nutritional knowledge and their diet pattern improve. Their better food intake especially higher iron intake willthen increase their hemoglobin levels. The study was conducted to investigate the effect of iron supplementation and nutrition education on hemoglobin levels of the anemic school age children. Thi...

  9. Fetal hemoglobin in sickle cell anemia: The Arab-Indian haplotype and new therapeutic agents.

    Science.gov (United States)

    Habara, Alawi H; Shaikho, Elmutaz M; Steinberg, Martin H

    2017-11-01

    Fetal hemoglobin (HbF) has well-known tempering effects on the symptoms of sickle cell disease and its levels vary among patients with different haplotypes of the sickle hemoglobin gene. Compared with sickle cell anemia haplotypes found in patients of African descent, HbF levels in Saudi and Indian patients with the Arab-Indian (AI) haplotype exceed that in any other haplotype by nearly twofold. Genetic association studies have identified some loci associated with high HbF in the AI haplotype but these observations require functional confirmation. Saudi patients with the Benin haplotype have HbF levels almost twice as high as African patients with this haplotype but this difference is unexplained. Hydroxyurea is still the only FDA approved drug for HbF induction in sickle cell disease. While most patients treated with hydroxyurea have an increase in HbF and some clinical improvement, 10 to 20% of adults show little response to this agent. We review the genetic basis of HbF regulation focusing on sickle cell anemia in Saudi Arabia and discuss new drugs that can induce increased levels of HbF. © 2017 Wiley Periodicals, Inc.

  10. Sideropenic anemia in preschool children and risk factors

    Directory of Open Access Journals (Sweden)

    Stojanović Dušica

    2006-01-01

    Full Text Available INTRODUCTION: Sideropenic anemia is one of the most common nutritional disorders in the world. The children are at higher risk of iron deficiency than adults due to their rapid growth during infancy and relatively higher requirements of iron. OBJECTIVE: The objective of our study was to investigate the prevalence of sideropenic anemia in pre-school children and relevant risk factors. METHOD: Study on sideropenic anemia of preschool children was performed in Zaječar Municipality in 2003. Subjects: all children, age 6-7 years, who lived in the Zaječar Municipality (554 children. The investigation included: interview of children's parents and laboratory analysis of blood. RESULTS: The frequency of sideropenic anemia was 5.23% in tested children (hemoglobin level less than 11g/dl. Sex and place of residence had no significant impact on hemoglobin concentration in blood of children. Likewise, social status and education of parents had no significant impact on iron deficiency anemia. Higher incidence of infections was found in children with lower hemoglobin concentration in blood (p<0.05. It made no difference if children attended the kindergarten or not. Nutrition of children in kindergarten does not correct domestic nutrition, which should be one of its basic roles. CONCLUSION: Since sideropenic anemia gives rise to serious health problems, such as poor cognitive and motor development and behavioral problems, it is important to take corrective measures regarding domestic and social nutrition of children. Therefore, it is necessary to take action in preventing the sideropenic anemia and provide normal growth and development.

  11. Anemia and nutritional status of schoolchildren living at Saudi high altitude area

    International Nuclear Information System (INIS)

    Abou-Zeid, Alaa H.; Abdel-Fattah, Moataz M.; Hifnawy, Tamer M.; Al-Hassan, Sir-Alkhatima A.; A-Shehri, Abdul Salam A.

    2006-01-01

    To estimate the prevalence and possible risk factors for anemia and abnormal anthropometric measurements among schoolchildren in Al-Hada Area, Taif, Kingdom of Saudi Arabia. We conducted the study between January and April, 2005 at Al-Hada area. A nested case-control study was conducted to estimate risk factors for anemia and abnormal anthropometric measurements. From 5 schools, 513 students were recruited. The mean hemoglobin concentration was 13.4+/-0.9 g/dL, while the prevalence of anemia was 11.6% and 15.5% based on hemoglobin and hematocrit values. At the same time, underweight affected 14.2% of the students, and stunting affected 12.2%. Moreover, 9.8% of the students were obese and 13.8% suffered from wasting. Most of the victims of anemia and erroneous anthropometric measurements were females, except for wasting which was more prevalent among males. Anemia is highly prevalent among these schoolchildren, which is seriously affecting the growth of 6-14 year-old children. Similarly, malnutrition seems to be a significant health problem among those children as estimated by anthropometric measurements, where all forms of abnormal body measurements affected at least 9.8% of the studied group. An in-depth investigation of the etiological factors of iron deficiency and malnutrition is urgently needed, and suitable nutrition-education and iron supplementation programs are recommended. (author)

  12. Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India.

    Science.gov (United States)

    Sinha, N; Deshmukh, P R; Garg, B S

    2008-02-01

    Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children, along with increased morbidity. Iron supplementation at a later age may not reverse the adverse effects. National Nutritional Anemia Control Program was launched in India in 1970, but it failed to make any impact. The present study was undertaken to find out prevalence of anemia and its correlates in rural Wardha in children 6-35 months of age. Seven hundred seventy-two children between 6 months and 35 months of age were studied for anemia by cluster-sampling method. The hemoglobin was estimated in the child by 'Filter paper cyanmethemoglobin method.' Pre-designed and pre-tested questionnaire was used to collect data on socio-demographic and other variables. Data was analyzed by SPSS 12.0.1. Mean hemoglobin level was 98.5+/-12.9 gm/L. Prevalence of anemia was 80.3%. Only 1.3% children had severe anemia (hemoglobineducation of mother and father, occupation of father, socioeconomic status, birth order and nutritional status as measured by weight for age. The final model suggested that only educational status of the mother, occupation of the father, birth order and nutritional status of the child were significantly associated with anemia. For short-term impact, appropriate nutritional interventions remain the only operational intervention as only the nutritional status (weight for age) is a modifiable factor. But for long-term sustained impact, policy makers need to focus on improving maternal education and reducing family size.

  13. Hemoglobin concentrations and associated factors in adolescentes from Recife, Brazil

    OpenAIRE

    Elisângela Barros Soares Mendonça; Lilian Ferreira Muniz; Ilma Kruze Grande de Arruda; Alcides da Silva Diniz

    2014-01-01

    OBJECTIVE: To estimate the prevalence of anemia and associated factors in adolescents from the city of Recife in Pernambuco state. METHODS: This is a cross-sectional study, involving a random sample of 256 adolescents of both genders, aged 13 to 18, whose hemoglobin concentrations were evaluated, along with their nutritional status and socioeconomic and demographic characteristics. RESULTS: The prevalence of inadequate hemoglobin concentrations was 10.2% [CI95%=6.7-14.5], reaching levels cons...

  14. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... counts, hemoglobin or hematocrit levels, or mean corpuscular volume (MCV) that would suggest anemia. Different tests help ... complete blood count measures hemoglobin and mean corpuscular volume (MCV). Hemoglobin of less than 13 grams per ...

  15. Association of mild anemia with cognitive, functional, mood and quality of life outcomes in the elderly: the "Health and Anemia" study.

    Directory of Open Access Journals (Sweden)

    Ugo Lucca

    Full Text Available BACKGROUND: In the elderly persons, hemoglobin concentrations slightly below the lower limit of normal are common, but scant evidence is available on their relationship with significant health indicators. The objective of the present study was to cross-sectionally investigate the association of mild grade anemia with cognitive, functional, mood, and quality of life (QoL variables in community-dwelling elderly persons. METHODS: Among the 4,068 eligible individuals aged 65-84 years, all persons with mild anemia (n = 170 and a randomly selected sample of non-anemic controls (n = 547 were included in the study. Anemia was defined according to World Health Organization (WHO criteria and mild grade anemia was defined as a hemoglobin concentration between 10.0 and 11.9 g/dL in women and between 10.0 and 12.9 g/dL in men. Cognition and functional status were assessed using measures of selective attention, episodic memory, cognitive flexibility and instrumental and basic activities of daily living. Mood and QoL were evaluated by means of the Geriatric Depression Scale-10, the Short-Form health survey (SF-12, and the Functional Assessment of Cancer Therapy-Anemia. RESULTS: In univariate analyses, mild anemic elderly persons had significantly worse results on almost all cognitive, functional, mood, and QoL measures. In multivariable logistic regressions, after adjustment for a large number of demographic and clinical confounders, mild anemia remained significantly associated with measures of selective attention and disease-specific QoL (all fully adjusted p<.046. When the lower limit of normal hemoglobin concentration according to WHO criteria was raised to define anemia (+0.2 g/dL, differences between mild anemic and non anemic elderly persons tended to increase on almost every variable. CONCLUSIONS: Cross-sectionally, mild grade anemia was independently associated with worse selective attention performance and disease-specific QoL ratings.

  16. Use of Recombinant Human Erythropoietin in Renal Anemia in Children

    Directory of Open Access Journals (Sweden)

    Habibur Rahman

    2009-11-01

    Full Text Available Erythropoietin is a hormone highly effective as like as natural erythropoietin to maintain target hemoglobin and hematocrit level in renal anemia. Its advantage over blood transfusion has been proved by improving the quality of life and decreasing morbidity and mortality in ESRD patients. Effectiveness of r-erythropoietin depends on absences of infection, inflammation and vitamin deficiency and iron status. Iron supplementation is needed before r-erythropoietin administration and sub-cutaneous rout is better in renal anemia because of slow and sustained releases of r-erythropoietin from the site of administration. Target hemoglobin level is 11-12.5 gm/dl and hematocrit is 33% which can be achieved by this hormone therapy. Key words- Recombinant erythropoietin, renal anemia, end stage renal disease.DOI: 10.3329/bsmmuj.v2i1.3713 BSMMU J 2009; 2(1: 50-53  

  17. Pulsed-dosing with oral sodium phenylbutyrate increases hemoglobin F in a patient with sickle cell anemia.

    Science.gov (United States)

    Hines, Patrick; Dover, George J; Resar, Linda M S

    2008-02-01

    Increasing hemoglobin F (HbF) appears to be beneficial for patients with sickle cell anemia. We previously demonstrated that daily, oral sodium phenylbutyrate (OSPB) induces HbF synthesis in pediatric and adult patients with hemoglobin SS (HbSS). The high doses and need for daily therapy, however, have limited its use. Here, we report a patient treated with pulsed-dosing of OSPB for over 3 years. This patient developed a modest, but sustained elevation in HbF over the course of therapy without side effects. Although larger studies are needed, this case demonstrates that pulsed-dosing with OSPB enhances HbF synthesis. (c) 2007 Wiley-Liss, Inc.

  18. EFEK PROGRAM PEMBERIAN "TABURIA" TERHADAP KADAR HEMOGLOBIN BALITA PADA KELUARGA MISKIN DI JAKARTA UTARA

    Directory of Open Access Journals (Sweden)

    Abas Basuni Jahari

    2012-11-01

    Full Text Available Effect of "Taburia" Intervention Program on Hemoglobin Concentration Among Children Under-Five Years of Poor Families In North Jakarta.Background: Anemia is one of the main nutritional problems in Indonesia. Anemia in children under fives years will have an impact on growth and mental development. In an effort to improve the nutritional status of infants, especially in poor families, the Japan Funds for Poverty Reduction (JFPR in collaboration with the Center for Nutrition and Food, Ministry of Health, Bogor, making multi-vitamin ingredients and micro nutrients called as TABURIA.Objectives: To study the influence of hemoglobin levels on child under fives years of poor families.Methods: Design of the study was Evaluation Before and After Treatment (Pre-Post Evaluation. This research was conducted in 9 urban villages in 3 Public health centers in North Jakarta City. The numbers of samples were 540 children aged 6-59 months from poor families. Tabuaria was distributed by a cadre posyandu to all children under fives years (5000 children in the research area. The data analyzed included: hemoglobin levels, economic social family, compliance and child morbidity. Data were analyzed by descriptive to determine changes in status of anemia and haemoglobin levels before and after intervention.Results: Most of children under fives years (87.8% to receive and consume Taburia. The average Hb levels increased from 10.5 mg/dl in baseline data to 12.0 mg/dl at endline evaluation. The proportion of anemia (Hb <11 mg/dl decreased significantly from 62.3% (baseline to 24.7%(endline-evaluation.Conclusion: Taburia be accepted by the majority of children under fives and can increase hemoglobin levels of children under fives.Recommendation: Taburia can increase the hemoglobin levels of children under fives years, but if would be implemented as national program, it should be study in others regions (pilot areas to explore the appropriateness Taburia distribution model in

  19. Dietary cellulose has no effect on the regeneration of hemoglobin in growing rats with iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    M. Catani

    2003-06-01

    Full Text Available The objective of the present study was to determine the effect of cellulose on intestinal iron absorption in rats during recovery from iron deficiency anemia. Twenty-one-day-old male Wistar-EPM rats were fed an iron-free ration for two weeks to induce anemia. At 5 weeks of age, the rats were divided into two groups (both groups receiving 35 mg of elemental iron per kg diet: cellulose group (N = 12, receiving a diet containing 100 g of cellulose/kg and control (N = 12, receiving a diet containing no cellulose. The fresh weight of the feces collected over a 3-day period between the 15th and 18th day of dietary treatment was 10.7 ± 3.5 g in the group receiving cellulose and 1.9 ± 1.2 g in the control group (P<0.001. Total food intake was higher in the cellulose group (343.4 ± 22.0 g than in the control (322.1 ± 13.1 g, P = 0.009 during the 3 weeks of dietary treatment. No significant difference was observed in weight gain (cellulose group = 132.8 ± 19.2, control = 128.0 ± 16.3 g, hemoglobin increment (cellulose group = 8.0 ± 0.8, control = 8.0 ± 1.0 g/dl, hemoglobin level (cellulose group = 12.3 ± 1.2, control = 12.1 ± 1.3 g/dl or in hepatic iron levels (cellulose group = 333.6 ± 112.4, control = 398.4 ± 168.0 µg/g dry tissue. We conclude that cellulose does not adversely affect the regeneration of hemoglobin, hepatic iron level or the growth of rats during recovery from iron deficiency anemia.

  20. Hemoglobin C, S-C, and E Diseases

    Science.gov (United States)

    ... quickly than others, resulting in chronic anemia. Hemoglobin C disease Hemoglobin C disease occurs mostly in blacks. ... a common complication of hemoglobin C disease. Hemoglobin S-C disease Hemoglobin S-C disease occurs in people who ...

  1. Study of alpha hemoglobin stabilizing protein expression in patients with β thalassemia and sickle cell anemia and its impact on clinical severity.

    Science.gov (United States)

    Mahmoud, Hanan Mohamed; Shoeib, Ahmed Al-Saiid Hamed; Abd El Ghany, Shereen Mohamed; Reda, Marwa Mohamed; Ragab, Iman Ahmed

    2015-12-01

    The α hemoglobin stabilizing protein (AHSP) binds α-Hb and prevents its precipitation limiting free α-Hb toxicities. Our aim was to study AHSP expression in β thalassemia syndromes in relation to their clinical severity and to compare it with its level in sickle cell anemia. We compared patients with β-thalassemia (n=37) (β-thalassemia major (BTM) (n=19) and β-thalassemia intermedia (BTI) (n=18)) with 12 patients with sickle cell anemia as regards clinical severity, age at presentation, transfusion dependency, mean pre-transfusion hemoglobin level, use of hydroxyurea and AHSP expression by real time quantitative PCR. Median (and IQR) AHSP expression was significantly higher in patients with sickle cell anemia 2275 (3898) compared to thalassemia 283 (718), P=0.001, with no significant difference between BTM and BTI (P=0.346). It was also significantly higher in non-transfusion dependent patients with β thalassemia (NTDT) compared to transfusion dependent ones (P=0.019), and in patients on hydroxyurea therapy (Psickle cell anemia versus thalassemia, with no significant difference between BTM and BTI. Expression was higher in patients with NTDT and on hydroxyurea therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Risk-Based Questionnaires Fail to Detect Adolescent Iron Deficiency and Anemia.

    Science.gov (United States)

    Sekhar, Deepa L; Murray-Kolb, Laura E; Schaefer, Eric W; Paul, Ian M

    2017-08-01

    To evaluate the predictive ability of screening questionnaires to identify adolescent women at high-risk for iron deficiency or iron deficiency anemia who warrant objective laboratory testing. Cross-sectional study of 96 female individuals 12-21 years old seen at an academic medical center. Participants completed an iron deficiency risk assessment questionnaire including the 4 Bright Futures Adolescent Previsit Questionnaire anemia questions, along with depression, attention, food insecurity, and daytime sleepiness screens. Multiple linear regression controlling for age, race, and hormonal contraception use compared the predictive ability of 2 models for adolescent iron deficiency (defined as ferritin anemia (hemoglobin iron deficiency and 5% (5/96) had iron deficiency anemia. Model 1 (Bright Futures) poorly predicted ferritin and hemoglobin values (R 2  = 0.03 and 0.08, respectively). Model 2 demonstrated similarly poor predictive ability (R 2  = 0.05 and 0.06, respectively). Mean differences for depressive symptoms (0.3, 95% CI -0.2, 0.8), attention difficulty (-0.1, 95% CI -0.5, 0.4), food insecurity (0.04, 95% CI -0.5, 0.6), daytime sleepiness (0.1, 95% CI -0.1, 0.3), and body mass index percentile (-0.04, 95% CI -0.3, 0.2) were not significantly associated with ferritin in model 2. Mean differences for hemoglobin were also nonsignificant. Risk-based surveys poorly predict objective measures of iron status using ferritin and hemoglobin. Next steps are to establish the optimal timing for objective assessment of adolescent iron deficiency and anemia. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. [Obesity, overweight and anemia in children from a rural area of Lima, Peru].

    Science.gov (United States)

    Rodríguez-Zúñiga, Milton J

    2015-01-01

    We evaluated the association between anemia, overweight and obesity in a children population of a rural area in Lima.Demographic, anthropometric and hemoglobin information (from the Information System of Nutritional Status of Children, ISNSC, 2014, of schoolchildren 1-15 attending public schools under the Micro Red Pachacamac jurisdiction) were employed in a cross sectional design. Descriptive statistical and association analysis between anemia and nutritional status were carried out. Logistic regression was used to find significant variables associated to anemia.The prevalence of anemia was 10.8% (CI95% 9.5-12.0), overweight was 17.3% (CI95% 15.8-18.9) and 16.2% of children were obese (CI95% 14.7 - 17.7). No significant association between the diagnosis of anemia, overweight or obesity (chi2 = 1.68, p = 0.432) was found. However, there was an inverse significant association between the diagnosis of anemia and Body Mass Index (BMI) (z =-3.77, p = 0.000); and a higher level of hemoglobin among those over 12 y/o (ANOVA, F = 108.19, p = 0.006). In univariate analysis, only age (OR 1.14, IC95% 1.08-1.20) and IMC (OR 1.08, IC95% 1.04-1.13) were associated to anemia. There is no relationship between nutritional diagnosis of obesity, overweight and anemia in this population. However, children with older age and greater BMI were less likely to present anemia. Public policies in the last five years have focused on reducing this double nutritional problem in children.

  4. Impact of Hemoglobin Levels and Anemia on Mortality in Acute Stroke: Analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis.

    Science.gov (United States)

    Barlas, Raphae S; Honney, Katie; Loke, Yoon K; McCall, Stephen J; Bettencourt-Silva, Joao H; Clark, Allan B; Bowles, Kristian M; Metcalf, Anthony K; Mamas, Mamas A; Potter, John F; Myint, Phyo K

    2016-08-17

    The impact of hemoglobin levels and anemia on stroke mortality remains controversial. We aimed to systematically assess this association and quantify the evidence. We analyzed data from a cohort of 8013 stroke patients (mean±SD, 77.81±11.83 years) consecutively admitted over 11 years (January 2003 to May 2015) using a UK Regional Stroke Register. The impact of hemoglobin levels and anemia on mortality was assessed by sex-specific values at different time points (7 and 14 days; 1, 3, and 6 months; 1 year) using multiple regression models controlling for confounders. Anemia was present in 24.5% of the cohort on admission and was associated with increased odds of mortality at most of the time points examined up to 1 year following stroke. The association was less consistent for men with hemorrhagic stroke. Elevated hemoglobin was also associated with increased mortality, mainly within the first month. We then conducted a systematic review using the Embase and Medline databases. Twenty studies met the inclusion criteria. When combined with the cohort from the current study, the pooled population had 29 943 patients with stroke. The evidence base was quantified in a meta-analysis. Anemia on admission was found to be associated with an increased risk of mortality in both ischemic stroke (8 studies; odds ratio 1.97 [95% CI 1.57-2.47]) and hemorrhagic stroke (4 studies; odds ratio 1.46 [95% CI 1.23-1.74]). Strong evidence suggests that patients with anemia have increased mortality with stroke. Targeted interventions in this patient population may improve outcomes and require further evaluation. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  5. Hemoglobin Kinetics and Long-term Prognosis in Heart Failure.

    Science.gov (United States)

    Díez-López, Carles; Lupón, Josep; de Antonio, Marta; Zamora, Elisabet; Domingo, Mar; Santesmases, Javier; Troya, Maria-Isabel; Boldó, Maria; Bayes-Genis, Antoni

    2016-09-01

    The influence of hemoglobin kinetics on outcomes in heart failure has been incompletely established. Hemoglobin was determined at the first visit and at 6 months. Anemia was defined according to World Health Organization criteria (hemoglobin < 13g/dL for men and hemoglobin < 12g/dL for women). Patients were classified relative to their hemoglobin values as nonanemic (both measurements normal), transiently anemic (anemic at the first visit but not at 6 months), newly anemic (nonanemic initially but anemic at 6 months), or permanently anemic (anemic in both measurements). A total of 1173 consecutive patients (71.9% men, mean age 66.8±12.2 years) were included in the study. In all, 476 patients (40.6%) were considered nonanemic, 170 (14.5%) had transient anemia, 147 (12.5%) developed new-onset anemia, and 380 (32.4%) were persistently anemic. During a follow-up of 3.7±2.8 years after the 6-month visit, 494 patients died. On comprehensive multivariable analyses, anemia (P < .001) and the type of anemia (P < .001) remained as independent predictors of all-cause mortality. Compared with patients without anemia, patients with persistent anemia (hazard ratio [HR] = 1.62; 95% confidence interval [95%CI], 1.30-2.03; P < .001) and new-onset anemia (HR = 1.39; 95%CI, 1.04-1.87, P = .03) had higher mortality, and even transient anemia showed a similar trend, although without reaching statistical significance (HR = 1.31; 95%CI, 0.97-1.77, P = .075). Anemia, especially persistent and of new-onset, and to a lesser degree, transient anemia, is deleterious in heart failure. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... hemoglobin levels. This was associated with a greater risk of death even with mild anemia. Now, anemia in older adults is recognized as an important condition. NHLBI Small Business Program. Through the NHLBI Small Business Program , we ...

  7. Impact of hemoglobin on plasma pro-B-type natriuretic peptide concentrations in the general population

    DEFF Research Database (Denmark)

    Nybo, Mads; Benn, Marianne; Mogelvang, Rasmus

    2007-01-01

    , the impact of hemoglobin status on proBNP concentrations has not been established in the general population. METHODS: In the 4th examination in the Copenhagen City Heart Study, we performed a nested case-control study of 6238 individuals from a Danish general population. Of these, 3497 randomly selected...... participants also underwent an echocardiographic examination. The population was stratified into groups depending on health and hemoglobin status. Correlations between hemoglobin and proBNP concentrations were examined by simple and multiple regression analyses, adjusted for variables known to influence...... the proBNP plasma concentration. RESULTS: The mean proBNP concentration was increased 1.7-fold in the group with anemia vs the nonanemic group [mean (SD) 42 (45) pmol/L vs 25 (29) pmol/L, P hemoglobin on pro...

  8. Magnitude of Anemia at Discharge Increases 30-Day Hospital Readmissions.

    Science.gov (United States)

    Koch, Colleen G; Li, Liang; Sun, Zhiyuan; Hixson, Eric D; Tang, Anne; Chagin, Kevin; Kattan, Michael; Phillips, Shannon C; Blackstone, Eugene H; Henderson, J Michael

    2017-12-01

    Anemia during hospitalization is associated with poor health outcomes. Does anemia at discharge place patients at risk for hospital readmission within 30 days of discharge? Our objectives were to examine the prevalence and magnitude of anemia at hospital discharge and determine whether anemia at discharge was associated with 30-day readmissions among a cohort of hospitalizations in a single health care system. From January 1, 2009, to August 31, 2011, there were 152,757 eligible hospitalizations within a single health care system. The endpoint was any hospitalization within 30 days of discharge. The University HealthSystem Consortium's clinical database was used for demographics and comorbidities; hemoglobin values are from the hospitals' electronic medical records, and readmission status was obtained from the University HealthSystem Consortium administrative data systems. Mild anemia was defined as hemoglobin of greater than 11 to less than 12 g/dl in women and greater than 11 to less than 13 g/dl in men; moderate, greater than 9 to less than or equal to 11 g/dl; and severe, less than or equal to 9 g/dl. Logistic regression was used to assess the association of anemia and 30-day readmissions adjusted for demographics, comorbidity, and hospitalization type. Among 152,757 hospitalizations, 72% of patients were discharged with anemia: 31,903 (21%), mild; 52,971 (35%), moderate; and 25,522 (17%), severe. Discharge anemia was associated with severity-dependent increased odds for 30-day hospital readmission compared with those without anemia: for mild anemia, 1.74 (1.65-1.82); moderate anemia, 2.76 (2.64-2.89); and severe anemia, 3.47 (3.30-3.65), P < 0.001. Anemia at discharge is associated with a severity-dependent increased risk for 30-day readmission. A strategy focusing on anemia treatment care paths during index hospitalization offers an opportunity to influence subsequent readmissions.

  9. Severe Anemia in Malawian Children

    NARCIS (Netherlands)

    Calis, J.C.J.; Kamija, S.P.; Faragher, E.B.; Brabin, B.J.; Bates, I.; Cuevas, L.E.; Haan, de R.J.; Phiri, A.I.; Malange, P.; Khoka, M.; Hulshof, P.J.M.; Lieshout, L.; Beld, M.G.H.M.; Teo, Y.Y.; Rockett, K.A.; Richardson, A.; Kwiatkowski, D.P.; Molyneux, M.E.; Hensbroek, van M.B.

    2008-01-01

    Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case¿control study of 381 preschool children with severe anemia (hemoglobin concentration,

  10. Nutritional and Micronutrient Status of Female Workers in a Garment Factory in Cambodia.

    Science.gov (United States)

    Makurat, Jan; Friedrich, Hanna; Kuong, Khov; Wieringa, Frank T; Chamnan, Chhoun; Krawinkel, Michael B

    2016-11-02

    Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant) at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined). Bivariate correlations were used to assess associations. Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative) and serum retinol-binding protein (positive) concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.

  11. Nutritional and Micronutrient Status of Female Workers in a Garment Factory in Cambodia

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    Jan Makurat

    2016-11-01

    Full Text Available Background: Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. Methods: A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined. Bivariate correlations were used to assess associations. Results: Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative and serum retinol-binding protein (positive concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. Conclusions: The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.

  12. Role of Breastfeeding and Complementary Food on Hemoglobin and Ferritin Levels in a Cambodian Cross-Sectional Sample of Children Aged 3 to 24 Months.

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    Anika Reinbott

    Full Text Available Iron deficiency derives from a low intake of dietary iron, poor absorption of iron, and high requirements due to growth as well as blood loss. An estimated number of about 50% of all anemia may be attributed to iron deficiency among young children in Cambodia.A cross-sectional survey was conducted in rural Cambodia in September 2012. Villages in pre-selected communes were randomly chosen using stunting as a primary indicator of nutritional status. In total, 928 randomly selected households with children aged 3-23 months were included. Hemoglobin, ferritin, soluble transferrin receptor (sTfR, and retinol binding protein (RBP were assessed from capillary blood samples. In addition, length/height and weight of mothers and children were taken and data on dietary diversity was collected. A child feeding index (CFI was created. Associations between biomarkers of iron and vitamin A status and nutritional status or food intake were explored.Anemia prevalence was highest among 6- to 12-months-olds (71%. Ferritin and sTfR inversely correlated and were significantly associated with hemoglobin concentrations. The consumption of animal source foods (ASF significantly impacts on the interaction between ferritin, sTfR and hemoglobin. Concentrations of RBP were significantly higher in children who had received a vitamin A supplement. The CFI was associated with sTfR and hemoglobin. Lower length and weight were associated with lower ferritin levels and showed an indirect effect on hemoglobin through ferritin.Nutrition programs targeting children under 2 years of age need to focus on the preparation of complementary foods with high nutrient density to sustainably prevent micronutrient deficiency and generally improve nutritional status. Future assessments of the micronutrient status should include identification of hemoglobinopathies and parasitic infections to better understand all causes of anemia in Cambodian infants and young children.German Clinical Trials

  13. Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers

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    Ana Cláudia F. Vieira

    2007-08-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional de ferro e a prevalência de anemia em crianças menores de 5 anos de creches públicas da cidade do Recife (PE. MÉTODOS: Estudo transversal, com amostra aleatória sistemática de 162 crianças, de 6 a 59 meses. O estado nutricional de ferro foi avaliado em termos de reservas corporais (ferritina sérica, transferrinemia (ferro sérico, capacidade total de ligação do ferro e % de saturação da transferrina, eritropoiese (protoporfirina eritrocitária livre e hemoglobinogênese (hemoglobina. RESULTADOS: A prevalência de anemia (hemoglobina 40 µmol/mol heme em 69,6% (IC95% 61,0-77,1 das crianças. Os parâmetros de ferro não apresentaram correlação com o gênero (p > 0,05. No entanto, crianças 24 meses. A significante correlação observada entre reserva, transferrinemia e eritropoiese representa achado compatível com o esperado ciclo de vida do ferro no organismo. CONCLUSÕES: A deficiência de ferro e a anemia parecem ser um importante problema de saúde pública entre as crianças menores de 5 anos de creches públicas do Recife. Logo, ações efetivas direcionadas à prevenção e ao controle dessa deficiência são fortemente recomendadas nesse contexto ecológico.OBJECTIVE: To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil. METHODS: A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months. Nutritional iron status was assessed in terms of body iron reserves (serum ferritin, transferrinemia (serum iron, total iron binding capacity, and transferrin saturation %, erythropoiesis (free erythrocyte protoporphyrin and hemoglobin production (hemoglobin. RESULTS: The prevalence of anemia (hemoglobin 40 µmol/mol heme in 69.6% (95%CI 61.0-77.1 of the children. Iron parameters were not correlated with sex (p > 0.05. However, children 24 months. The significant

  14. Dietary hemoglobin rescues young piglets from severe iron deficiency anemia: Duodenal expression profile of genes involved in heme iron absorption.

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    Robert Staroń

    Full Text Available Heme is an efficient source of iron in the diet, and heme preparations are used to prevent and cure iron deficiency anemia in humans and animals. However, the molecular mechanisms responsible for heme absorption remain only partially characterized. Here, we employed young iron-deficient piglets as a convenient animal model to determine the efficacy of oral heme iron supplementation and investigate the pathways of heme iron absorption. The use of bovine hemoglobin as a dietary source of heme iron was found to efficiently counteract the development of iron deficiency anemia in piglets, although it did not fully rebalance their iron status. Our results revealed a concerted increase in the expression of genes responsible for apical and basolateral heme transport in the duodenum of piglets fed a heme-enriched diet. In these animals the catalytic activity of heme oxygenase 1 contributed to the release of elemental iron from the protoporphyrin ring of heme within enterocytes, which may then be transported by the strongly expressed ferroportin across the basolateral membrane to the circulation. We hypothesize that the well-recognized high bioavailability of heme iron may depend on a split pathway mediating the transport of heme-derived elemental iron and intact heme from the interior of duodenal enterocytes to the bloodstream.

  15. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... over 65 years of age had low hemoglobin levels. This was associated with a greater risk of death even with mild anemia. Now, anemia in older adults is recognized as an important condition. NHLBI Small Business Program. Through the NHLBI Small Business Program , we ...

  16. The prevalence of anemia and iron deficiency is more common in breastfed infants than their mothers in Bhaktapur, Nepal.

    Science.gov (United States)

    Chandyo, R K; Henjum, S; Ulak, M; Thorne-Lyman, A L; Ulvik, R J; Shrestha, P S; Locks, L; Fawzi, W; Strand, T A

    2016-04-01

    Iron deficiency anemia is a widespread public health problem, particularly in low- and middle-income countries. Maternal iron status around and during pregnancy may influence infant iron status. We examined multiple biomarkers to determine the prevalence of iron deficiency and anemia among breastfed infants and explored its relationship with maternal and infant characteristics in Bhaktapur, Nepal. In a cross-sectional survey, we randomly selected 500 mother-infant pairs from Bhaktapur municipality. Blood was analyzed for hemoglobin, ferritin, total iron-binding capacity, transferrin receptors and C-reactive protein. The altitude-adjusted prevalence of anemia was 49% among infants 2-6-month-old (hemaglobin (Hb) Iron deficiency anemia, defined as anemia and serum ferritin anemia (Hb iron stores. Significant predictors of infant iron status and anemia were infant age, sex and duration of exclusive breastfeeding and maternal ferritin concentrations. Our findings suggest that iron supplementation in pregnancy is likely to have resulted in a low prevalence of postpartum anemia. The higher prevalence of anemia and iron deficiency among breastfed infants compared with their mothers suggests calls for intervention targeting newborns and infants.

  17. PENGARUH PEMBERIAN TABLET BESI DAN VITAMIN E PADA KADAR HEMOGLOBIN DAN STATUS BESI WANITA USIA SUBUR YANG DIDUGA MENDERITA THALASEMIA KARIER

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    M. Saidin

    2012-11-01

    Full Text Available THE EFFECT OF IRON PILL SUPPLEMENTATION ADDED WITH VITAMIN E (ALPHA-TOCOPHEROL TO HEMOGLOBIN AND IRON STATUS OF CHILDBEARING AGE WOMEN SUSPECTED SUFFERING FROM CARRIER THALASSEMIA.Background: Anemia control programme among pregnant women had been conducting for about three decades, but prevalence of anemia still considered high. It was reported by Nutrition and Food Research Centre (2000 that 37.4% of childbearing women indicated fragility of red blood cell membrane wich assumed related to anemia. One of the vitamins which have positive effect to the wall of red blood cells is vitamin E through its rolle as antioxidant. It was recommended to conduct a study to determine the effect of supplementation of iron pill, "Ferro sulfate" (60 mg elemental iron with 25 mg folic acid added with vitamin E (20 mg a-tocopherol to hemoglobin level and iron status of childbearing age of women.Methods: The study design was "Intervention with quacy experiment trial".  The study sites covered 10 villages in Cianjur district of West Java. A total of 210 childbearing age women (19-45 years old with indication of fragility of red blood cell membrane which was determined by procedure of NESTROF (Naked Eye Single Test Tube Red Cell Osmotic Fragility, divided into two groups (105 women/group. Group I received one iron pill daily and vitamin E twice a week for 10 weeks. While group II received Iron pill only, without vitamin E. Data collection was conducted before and after intervention.Results: After 10 weeks intervention, the average of Hb increament of group I (0.4 g/dl was slightly higher than that of group II (0.3 g/dl. There was improvement of serum ferritin of both groups with increament 4.3 mg/dl for group I and 7.2 mg/dl for group II. Vitamin E status of both groups still considered low: 3.1 mg/L for group I and 3.1 mg/L for group II. Normal value of serum vitamin E is 5.0 mg/L.Conclusions: Vitamin E (20 mg of a-tocopherol which was given twice a week bisides

  18. Assessment of anemia during CT pulmonary angiography

    International Nuclear Information System (INIS)

    Jung, Caroline; Groth, Michael; Bley, Thorsten A.; Henes, Frank O.; Treszl, András; Adam, Gerhard; Bannas, Peter

    2012-01-01

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  19. Assessment of anemia during CT pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Caroline, E-mail: cjung@uke.de [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Groth, Michael; Bley, Thorsten A.; Henes, Frank O. [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Treszl, András [Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany)

    2012-12-15

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  20. FAKTOR-FAKTOR YANG MEMPENGARUHI ANEMIA PADA REMAJA

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    Dewi Permaesih

    2012-09-01

    Full Text Available Anemia in Indonesia is a public health problem. The prevalence still have a tendency to increase. The main antecedent factor for anemia is the lack of iron intake. The purpose of this analysis is to learn and find other factors besides iron. Sources of data were from the study of morbidity and disability of the Household Health Survey, 2001. The respondents were adolescents between 10-19 years of age. Data on social economic status, illness records, medicine consumption, physical activities and smoking habits were collected by interview during household visits. Data on anemia were identified from the results of hemoglobin determination by HemoCue. The nutrition status was found from the calculation of Body Mass Index. Data on energy consumption were taken from food expenditure for meal data from SUSENAS. Variable used for the purpose of this analysis were age, gender, smoking habit, alcohol drinking, breakfast, the use of time for physical activities, IMT, hemoglobin value and energy consumption. Data analyse were conducted in 3 stages,i.e., univariate, bivariate and multivariate analyse. Overall, the prevalence of anemia among adolescents was found to be 25.5%; 21% for adolescent boys and 30% for adolescent girls. Around 27.1% adolescents reside in the village and 22.6% in the city. Adolescents who consume > 70% energy from being suggested were around 38% respondents. Seventeen percent was classified as thinny adolescent based on IMT indicator. The result on bivariate analyse showed that respondents who were less educated have a significant relation (p < 0.05 with getting anemia (OR=3.8; 95% CI=1.9-7.2. Male adolescents have lower risk to get anemia (OR=0.6; 95% CI 0.5-7.3. Other variables that showed significant relation with anemia were smoking (OR 1.35; 95% CI 1-1.8, breakfast habit (OR 0.6 ;95% CI 0.4-0.9 and sufficient energy consumption (OR 0.7; 95% CI 0.6-0.9. Result of multiple regression logistic test indicate that variables related

  1. Severe anemia in Malawian children

    NARCIS (Netherlands)

    Calis, Job C. J.; Phiri, Kamija S.; Faragher, E. Brian; Brabin, Bernard J.; Bates, Imelda; Cuevas, Luis E.; de Haan, Rob J.; Phiri, Ajib I.; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul J. M.; van Lieshout, Lisette; Beld, Marcel G. H. M.; teo, Yik Y.; Rockett, Kirk A.; Richardson, Anna; Kwiatkowski, Dominic P.; Molyneux, Malcolm E.; Boele van Hensbroek, Michael

    2008-01-01

    Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and

  2. Severe anemia in Malawian children

    NARCIS (Netherlands)

    Calis, Job Cj; Phiri, Kamija S.; Faragher, E. Brian; Brabin, Bernard J.; Bates, Imelda; Cuevas, Luis E.; de Haan, Rob J.; Phiri, Ajib I.; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul Jm; van Lieshout, Lisette; Beld, Marcel Ghm; teo, Yik Y.; Rockett, Kirk A.; Richardson, Anna; Kwiatkowski, Dominic P.; Molyneux, Malcolm E.; van Hensbroek, Michaël Boele

    2016-01-01

    Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and 757 preschool

  3. Homocysteine and vitamin B 12 status and iron deficiency anemia in female university students from Gaza Strip, Palestine

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    Mahmoud Mohammed Sirdah

    2014-06-01

    Full Text Available OBJECTIVE: Nutritional deficiencies are very significant to the overall health of humans at all ages and for both genders, yet in infants, children and women of childbearing age these deficiencies can seriously affect growth and development. The present work is aimed to assess homocysteine and vitamin B12 status in females with iron deficiency anemia from the Gaza Strip.METHODS: Venous blood samples were randomly collected from 240 female university students (18-22 years old and parameters of the complete blood count, serum ferritin, homocysteine and vitamin B12 were measured. Statistical analysis included the t-test and analysis of variance (ANOVA using the IBM SPSS software (version 18. Statistical significance was set for p-values <0.05.RESULTS: The results revealed that 20.4% of the students have iron deficiency anemia. The mean serum vitamin B12 level in females with iron deficiency anemia (212.9 ± 62.8 pg/mL was significantly lower than in normal controls (286.9 ± 57.1 pg/mL and subjects with microcytic anemia and normal ferritin (256.7 ± 71.1 pg/mL. Significantly higher serum homocysteine levels were reported in the iron deficiency anemia group (27.0 ± 4.6 µmol/L compared to normal controls (15.5 ± 2.9 µmol/L and in subjects with microcytic anemia and normal ferritin (18.1 ± 2.7 µmol/L. Statistically significant negative correlations were reported for serum homocysteine with serum ferritin, vitamin B12, hemoglobin, and hematocrit levels.CONCLUSION: Important associations were found between serum homocysteine and markers of iron deficiency. Monitoring homocysteine levels might be essential to understand the development of different clinical conditions including anemia. It seems necessary to conduct prospective trials to determine whether treating anemia ameliorates homocysteine levels.

  4. Predictors of anemia among haitian children aged 6 to 59 months and women of childbearing age and their implications for programming.

    Science.gov (United States)

    Heidkamp, Rebecca A; Ngnie-Teta, Ismael; Ayoya, Mohamed Ag A; Stoltzfus, Rebecca J; Mamadoultaibou, Aissa; Durandisse, Emmanuela Blain; Pierre, Joseline Marhone

    2013-12-01

    The Haitian National Nutrition Policy prioritizes prevention and treatment of anemia among mothers and young children, but there are few available data to support planning for scale-up of anemia interventions. To describe the prevalence and predictors of anemia among Haitian women (15 to 49 years) and children (6 to 59 months) and to draw implications for national nutrition programming. Descriptive and univariate analyses and multivariate logistic regression models were performed using data from the nationally representative Haitian Demographic Health Survey 2005/06. The prevalence of mild (hemoglobin 11.0 to 11.9 g/dL), moderate (hemoglobin 8.0 to 10.9 g/dL), and severe (hemoglobin education level, p = .022) were different from those in rural women (wealth quintile, p < .05; employment, p = .003). Anemia in urban and rural children aged 6 to 59 months increased with child age (p < .05) and maternal anemia status (p = .004; p < .001). Female sex (p = .007) and maternal overweight (p = .009) were associated with reduced risk of anemia in rural children only. Anemia among Haitian young children and women of childbearing age is a severe public health problem. The findings suggest the need for context-specific rural and urban strategies, reinforcement of anemia prevention in health services reaching women of childbearing age, and targeted interventions for young children.

  5. Oxidant-antioxidant status in Egyptian children with sickle cell anemia: a single center based study

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    Mona Kamal El-Ghamrawy

    Full Text Available OBJECTIVE:the present study was conducted to investigate the oxidant-antioxidant status in Egyptian children with sickle cell anemia.METHODS:the serum levels of total antioxidant capacity (TAO, paraoxonase (PON, vitamin E, nitrite, and malondialdehyde (MDA were measured in 40 steady state children with homozygous sickle cell anemia (24 males and 16 females and 20 apparently healthy age- and gender-matched controls.RESULTS:mean serum TAO, PON, vitamin E, and nitrite levels were significantly lower in the group with sickle cell anemia, whereas mean serum MDA was significantly higher in these children compared to controls. No significant differences in mean levels of TAO, PON, nitrite, vitamin E, and MDA were found in sickle cell anemia patients receiving hydroxyurea when compared with those not receiving hydroxyurea. A significant negative correlation between serum nitrite and the occurrence of vaso-occlusive crises (VOC was observed (r = -0.3, p = 0.04. PON level was found to be positively correlated with patients' weight and BMI (r = -0.4, p = 0.01; r = -0.7, p < 0.001, respectively, but not with frequency of VOC. The area under the curve of serum nitrite in predicting occurrence of VOC was 0.782, versus 0.701 for PON, and 0.650 for TAO (p = 0.006. Serum MDA was not correlated with nitrite, PON, TAO, or vitamin E levels. No significant correlations were detected between serum nitrite and hemoglobin or antioxidant enzymes.CONCLUSION:children with sickle cell anemia have chronic oxidative stress that may result in increased VOC, and decreased serum nitrite may be associated with increases in VOC frequency. A novel finding in this study is the decrease in PON level in these patients, which is an interesting subject for further research.

  6. Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

    Science.gov (United States)

    Aaron, Grant J; Huang, Jin; Varadhan, Ravi; Temple, Victor; Rayco-Solon, Pura; Macdonald, Barbara

    2017-01-01

    Background: A lack of information on the etiology of anemia has hampered the design and monitoring of anemia-control efforts. Objective: We aimed to evaluate predictors of anemia in preschool children (PSC) (age range: 6–59 mo) by country and infection-burden category. Design: Cross-sectional data from 16 surveys (n = 29,293) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed separately and pooled by category of infection burden. We assessed relations between anemia (hemoglobin concentration anemia (hemoglobin concentration anemia with concomitant iron deficiency (defined as an inflammation-adjusted ferritin concentration anemia in >50% of surveys. Associations between breastfeeding and anemia were attenuated by controlling for child age, which was negatively associated with anemia. The most consistent predictors of severe anemia were malaria, poor sanitation, and underweight. In multivariable pooled models, child age, iron deficiency, and stunting independently predicted anemia and severe anemia. Inflammation was generally associated with anemia in the high- and very high–infection groups but not in the low- and medium-infection groups. In PSC with anemia, 50%, 30%, 55%, and 58% of children had concomitant iron deficiency in low-, medium-, high-, and very high–infection categories, respectively. Conclusions: Although causal inference is limited by cross-sectional survey data, results suggest anemia-control programs should address both iron deficiency and infections. The relative importance of factors that are associated with anemia varies by setting, and thus, country-specific data are needed to guide programs. PMID:28615260

  7. Recovery from hospital-acquired anemia after acute myocardial infarction and effect on outcomes.

    Science.gov (United States)

    Salisbury, Adam C; Kosiborod, Mikhail; Amin, Amit P; Reid, Kimberly J; Alexander, Karen P; Spertus, John A; Masoudi, Frederick A

    2011-10-01

    New-onset, hospital-acquired anemia (HAA) during acute myocardial infarction (AMI) is independently associated with poor outcomes. The patterns of recovery from HAA after AMI and their association with mortality and health status are unknown. In the prospective 24-center Translational Research Investigating Underlying disparities in acute myocardial infarction Patients' Health Status (TRIUMPH) registry, we identified 530 patients with AMI and HAA (defined as normal hemoglobin at admission with the development of anemia by discharge) who had a repeat, protocol-driven hemoglobin measurement at 1 month after discharge. The 1-month measures were used to define persistent (persistent anemia) and transient (anemia resolved) HAA. The patients' health status was assessed at 1, 6, and 12 months after AMI using the Short-Form 12 Physical Component Summary, and the health status of patients with persistent and transient HAA was compared using multivariate repeated measures regression analysis. Mortality was compared using the log-rank test and proportional hazards regression analysis. Overall, 165 patients (31%) developed persistent HAA. The adjusted mean Short-Form 12 Physical Component Summary scores at the follow-up visit were significantly lower in those with persistent HAA than in those with transient HAA (-2.0 points, 95% confidence interval -3.6 to -0.3; p = 0.02). During a median follow-up of 36 months, the crude mortality (13% vs 5%, p = 0.002) and multivariate-adjusted mortality (hazard ratio 2.08, 95% confidence interval 1.02 to 4.21, p = 0.04) was greater in patients with persistent HAA. In conclusion, HAA persists 1 month after discharge in nearly 1 of 3 patients and is associated with worse health status and greater mortality. Additional investigation is needed to understand whether HAA prevention, recognition, and treatment, particularly among those with persistent HAA, will improve outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. The Prevalence of Anemia in Head Start Children. Nutrition Evaluation, 1968-69.

    Science.gov (United States)

    Mickelsen, Olaf; And Others

    Concern over the nutritional status of the disadvantaged in America led to this study describing the prevalence of anemia among Head Start children in Pontiac, Michigan. Hemoglobin and hematocrit determinations, along with measurements of height and weight, were performed on 77 children, 4 to 6 years old, enrolled in Head Start classes. These…

  9. Predictors of anemia in women of reproductive age: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project.

    Science.gov (United States)

    Wirth, James P; Woodruff, Bradley A; Engle-Stone, Reina; Namaste, Sorrel Ml; Temple, Victor J; Petry, Nicolai; Macdonald, Barbara; Suchdev, Parminder S; Rohner, Fabian; Aaron, Grant J

    2017-07-01

    Background: Anemia in women of reproductive age (WRA) (age range: 15-49 y) remains a public health problem globally, and reducing anemia in women by 50% by 2025 is a goal of the World Health Assembly. Objective: We assessed the associations between anemia and multiple proximal risk factors (e.g., iron and vitamin A deficiencies, inflammation, malaria, and body mass index) and distal risk factors (e.g., education status, household sanitation and hygiene, and urban or rural residence) in nonpregnant WRA. Design: Cross-sectional, nationally representative data from 10 surveys ( n = 27,018) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed individually and pooled by the infection burden and risk in the country. We examined the severity of anemia and measured the bivariate associations between anemia and factors at the country level and by infection burden, which we classified with the use of the national prevalences of malaria, HIV, schistosomiasis, sanitation, and water-quality indicators. Pooled multivariate logistic regression models were constructed for each infection-burden category to identify independent determinants of anemia (hemoglobin concertation <120 g/L). Results: Anemia prevalence was ∼40% in countries with a high infection burden and 12% and 7% in countries with moderate and low infection burdens, respectively. Iron deficiency was consistently associated with anemia in multivariate models, but the proportion of anemic women who were iron deficient was considerably lower in the high-infection group (35%) than in the moderate- and low-infection groups (65% and 71%, respectively). In the multivariate analysis, inflammation, vitamin A insufficiency, socioeconomic status, and age were also significantly associated with anemia, but malaria and vitamin B-12 and folate deficiencies were not. Conclusions: The contribution of iron deficiency to anemia varies according to a country's infection

  10. Predictors of anemia in women of reproductive age: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

    Science.gov (United States)

    Woodruff, Bradley A; Petry, Nicolai; Macdonald, Barbara; Aaron, Grant J

    2017-01-01

    Background: Anemia in women of reproductive age (WRA) (age range: 15–49 y) remains a public health problem globally, and reducing anemia in women by 50% by 2025 is a goal of the World Health Assembly. Objective: We assessed the associations between anemia and multiple proximal risk factors (e.g., iron and vitamin A deficiencies, inflammation, malaria, and body mass index) and distal risk factors (e.g., education status, household sanitation and hygiene, and urban or rural residence) in nonpregnant WRA. Design: Cross-sectional, nationally representative data from 10 surveys (n = 27,018) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed individually and pooled by the infection burden and risk in the country. We examined the severity of anemia and measured the bivariate associations between anemia and factors at the country level and by infection burden, which we classified with the use of the national prevalences of malaria, HIV, schistosomiasis, sanitation, and water-quality indicators. Pooled multivariate logistic regression models were constructed for each infection-burden category to identify independent determinants of anemia (hemoglobin concertation Anemia prevalence was ∼40% in countries with a high infection burden and 12% and 7% in countries with moderate and low infection burdens, respectively. Iron deficiency was consistently associated with anemia in multivariate models, but the proportion of anemic women who were iron deficient was considerably lower in the high-infection group (35%) than in the moderate- and low-infection groups (65% and 71%, respectively). In the multivariate analysis, inflammation, vitamin A insufficiency, socioeconomic status, and age were also significantly associated with anemia, but malaria and vitamin B-12 and folate deficiencies were not. Conclusions: The contribution of iron deficiency to anemia varies according to a country’s infection burden. Anemia

  11. U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation.

    Science.gov (United States)

    Dewey, Kathryn G; Oaks, Brietta M

    2017-12-01

    Both iron deficiency (ID) and excess can lead to impaired health status. There is substantial evidence of a U-shaped curve between the risk of adverse birth outcomes and maternal hemoglobin concentrations during pregnancy; however, it is unclear whether those relations are attributable to conditions of low and high iron status or to other mechanisms. We summarized current evidence from human studies regarding the association between birth outcomes and maternal hemoglobin concentrations or iron status. We also reviewed effects of iron supplementation on birth outcomes among women at low risk of ID and the potential mechanisms for adverse effects of high iron status during pregnancy. Overall, we confirmed a U-shaped curve for the risk of adverse birth outcomes with maternal hemoglobin concentrations, but the relations differ by trimester. For low hemoglobin concentrations, the link with adverse outcomes is more evident when hemoglobin concentrations are measured in early pregnancy. These relations generally became weaker or nonexistent when hemoglobin concentrations are measured in the second or third trimesters. Associations between high hemoglobin concentration and adverse birth outcomes are evident in all 3 trimesters but evidence is mixed. There is less evidence for the associations between maternal iron status and adverse birth outcomes. Most studies used serum ferritin (SF) concentrations as the indicator of iron status, which makes the interpretation of results challenging because SF concentrations increase in response to inflammation or infection. The effect of iron supplementation during pregnancy may depend on initial iron status. There are several mechanisms through which high iron status during pregnancy may have adverse effects on birth outcomes, including oxidative stress, increased blood viscosity, and impaired systemic response to inflammation and infection. Research is needed to understand the biological processes that underlie the U-shaped curves

  12. Anemia em adolescentes segundo maturação sexual Anemia among adolescents according to sexual maturation

    Directory of Open Access Journals (Sweden)

    Bianca Assunção Iuliano

    2004-03-01

    Full Text Available OBJETIVO: Verificar a prevalência de anemia em adolescentes (hemoglobina0,05. Observou-se aparente aumento do nível médio de hemoglobina com o desenvolvimento do adolescente. Detectou-se anemia em 11,0% dos adolescentes, a maioria na fase púbere, classificada como ''prevalência leve'' segundo a World Health Organization. Não foi encontrada associação entre indicadores sociais e anemia. CONCLUSÃO: O estudo apontou baixa prevalência de anemia, mas acima do esperado entre púberes de escola particular e indica tendência de aumento dos níveis de hemoglobina com o desenvolvimento sexual dos adolescentes. Devem ser realizados novos estudos de prevalência de anemia para se determinar sua causa entre adolescentes de diferentes níveis socioeconômicos.OBJECTIVE: To assess the prevalence of anemia (hemoglobin level <12g/dL in adolescents, according to their sexual maturation stage. METHODS: A cross-sectional study was conducted with all adolescents enrolled in 5th - 8th grades in a private school in the city of São Paulo. Their hemoglobin level was measured (using Hemocue® and sexual development was self-evaluated (with the aid of pictures of the maturation stages proposed by Tanner. The social indicators evaluated were the per capita family income and maternal schooling. Student t test and non-parametric Kruskal-Wallis test were used for mean comparison and Chi-square-test for associations (p<0.05. RESULTS: We analyzed 118 students, of which 66.9% were females (aged 12.2±1.13 years and 33.1% were males (aged 12.0±1.18 years. The mean hemoglobin level was 13.2±1.08 g/dL for females and 13.3±1.21 g/dL for males, with no significant difference. An apparent increase in the mean hemoglobin level was verified along with sexual development of the adolescents. Anemia was detected in 11% of them, most in the pubertal stage, which is classified by the World Health Organization as ''mild prevalence''. No association was found between social

  13. Kadar Hemoglobin dan Kecerdasan Intelektual Anak

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    Yuni Kusmiyati

    2013-10-01

    Full Text Available Kualitas sumber daya manusia dipengaruhi oleh inteligensi anak. Skor kecerdasan intelektual yang tidak menetap pada usia tertentu dapat berubah karena faktor genetik, gizi, dan lingkungan. Tujuan penelitian ini adalah mengetahui hubungan kadar hemoglobin dengan kecerdasan intelektual anak. Penelitian observasional dengan desain potong lintang ini dilakukan pada populasi siswa kelas VI Sekolah Dasar Negeri Giwangan Yogyakarta, tahun 2013. Penarikan sampel dilakukan dengan metode simple random sampling terhadap 37 sampel siswa. Instrumen untuk mengukur kecerdasan intelektual dengan Cultural Fair Intelligence Quotient Test yang dirancang untuk meminimalkan pengaruh kultural dengan memperhatikan prosedur evaluasi, instruksi, konten isi, dan respons peserta. Tes dilakukan oleh Biro Psikologi Universitas Ahmad Dahlan Yogyakarta, kadar hemoglobin diukur menggunakan Portable Hemoglobin Digital Analyzer Easy Touch secara digital.Variabel luar indeks massa tubuh diukur langsung menggunakan parameter tinggi badan dan berat badan. Analisis menggunakan uji regresi linier. Hasil penelitian menunjukkan indeks massa tubuh tidak berhubungan dengan kecerdasan intelektual (nilai p = 0,052. Anemia berhubungan cukup dengan kecerdasan anak (r = 0,491 dan berpola positif, semakin tinggi kadar hemoglobin semakin tinggi kecerdasan intelektual anak. Nilai koefisien determinasi 0,241 menerangkan bahwa 24,1% variasi anemia cukup baik untuk menjelaskan variabel kecerdasan intelektual. Ada hubungan antara kadar hemoglobin dengan kecerdasan intelektual (nilai p = 0,002. Quality of human resources is influenced by the child’s intelligent. Intelligence Quotient (IQ score will not settle at a certain age and can change due to genetic factors, nutrition, and the environment. The objective is known relationship of anemia with IQ to child. Method of observational study with cross sectional design. Population are students of class VI elementary school of Giwangan Yogyakarta in

  14. The influence of socioeconomic status on the hemoglobin level and ...

    African Journals Online (AJOL)

    Conclusion: Poor socioeconomic status has an adverse effect on the nutritional status and hemoglobin of SCA patients. ... Date of Acceptance: 15-Mar-2011 ..... This study was designed to determine the relationship .... mobiles and devices.

  15. Mean hemoglobin levels in venous blood samples and prevalence of anemia in Japanese elementary and junior high school students.

    Science.gov (United States)

    Igarashi, Toru; Itoh, Yasuhiko; Maeda, Miho; Igarashi, Tsutomu; Fukunaga, Yoshitaka

    2012-01-01

    Screening for anemia has been performed in schools in Japan for over 30 years. The long-term effect of the nuclear power plant disaster on the prevalence of anemia in school age children is unknown. This research was performed to evaluate the prevalence of anemia in school age children and to determine grade-level and gender-related reference hemoglobin (Hb) levels prior to the nuclear disaster. Data for this research were obtained from results of screening for anemia obtained by venous blood sampling in schools in 2002. Mean Hb levels were calculated for each grade level (elementary school grades 1-6 and junior high school years 1-3) and according to gender, and the prevalence of anemia was determined. In our research, Tokyo Health Service Association guidelines were used to determine reference Hb levels for anemia. We demonstrated that Hb levels in boys increased with age during childhood and adolescence (from 13.1 ± 0.7 g/dL in 7 year olds to 14.9 ± 1.1 g/dL in 15 year olds); in girls, Hb levels peaked at menarche (13.7 ± 0.8 g/dL in 12 year olds), decreasing slightly thereafter (13.4 ± 1.1 g/dL in 15 year olds). The prevalence of anemia was 0.26% in elementary school boys, 0.27% in elementary school girls, and 1.21% in junior high school boys. The prevalence of anemia in second- and third-year junior high school girls was lower than that in first-year junior high school girls. Among all junior high school girls, 5.73% had mild anemia. Iron-deficiency anemia is the commonest type of anemia in high school girls, secondary to the relative lack of iron due to menstruation, the growth spurt and exercise. Appropriate dietary therapy and treatment of anemia, together with education about the dietary prevention of anemia, are important to reduce the prevalence of anemia in high school students. When complete blood counts are performed in regions thought to be affected by the Fukushima nuclear power plant disaster, our report can serve as a reference during

  16. Mean hemoglobin levels in venous blood samples and prevalence of anemia in Japanese elementary and junior high school students

    International Nuclear Information System (INIS)

    Igarashi, Toru; Itoh, Yasuhiko; Maeda, Miho; Igarashi, Tsutomu; Fukunaga, Yoshitaka

    2012-01-01

    Screening for anemia has been performed in schools in Japan for over 30 years. The long-term effect of the nuclear power plant disaster on the prevalence of anemia in school age children is unknown. This research was performed to evaluate the prevalence of anemia in school age children and to determine grade-level and gender-related reference hemoglobin (Hb) levels prior to the nuclear disaster. Data for this research were obtained from results of screening for anemia obtained by venous blood sampling in schools in 2002. Mean Hb levels were calculated for each grade level (elementary school grades 1-6 and junior high school years 1-3) and according to gender, and the prevalence of anemia was determined. In our research, Tokyo Health Service Association guidelines were used to determine reference Hb levels for anemia. We demonstrated that Hb levels in boys increased with age during childhood and adolescence (from 13.1±0.7 g/dL in 7 year olds to 14.9±1.1 g/dL in 15 year olds); in girls, Hb levels peaked at menarche (13.7±0.8 g/dL in 12 year olds), decreasing slightly thereafter (13.4±1.1 g/dL in 15 year olds). The prevalence of anemia was 0.26% in elementary school boys, 0.27% in elementary school girls, and 1.21% in junior high school boys. The prevalence of anemia in second- and third-year junior high school girls was lower than that in first-year junior high school girls. Among all junior high school girls, 5.73% had mild anemia. Iron-deficiency anemia is the commonest type of anemia in high school girls, secondary to the relative lack of iron due to menstruation, the growth spurt and exercise. Appropriate dietary therapy and treatment of anemia, together with education about the dietary prevention of anemia, are important to reduce the prevalence of anemia in high school students. When complete blood counts are performed in regions thought to be affected by the Fukushima nuclear power plant disaster, our report can serve as a reference during evaluation of Hb

  17. Iron deficiency and anemia are prevalent in women with multiple gestations.

    Science.gov (United States)

    Ru, Yuan; Pressman, Eva K; Cooper, Elizabeth M; Guillet, Ronnie; Katzman, Philip J; Kent, Tera R; Bacak, Stephen J; O'Brien, Kimberly O

    2016-10-01

    Little attention has been placed on the unique iron demands that may exist in women with multiple gestations. This merits attention because iron deficiency (ID) during pregnancy is associated with adverse pregnancy outcomes that are known to be more prevalent in multiple births. We characterized longitudinal changes in iron status across pregnancy in a cohort of healthy women with multiple gestations and identified determinants of maternal ID and anemia. A group of 83 women carrying twins, triplets, or quadruplets (aged 20-46 y) was recruited from 2011 to 2014. Blood samples obtained during pregnancy (∼24 wk; n = 73) and at delivery (∼35 wk; n = 61) were used to assess hemoglobin, serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, serum iron, erythropoietin, serum folate, vitamin B-12, C-reactive protein, and interleukin-6. The prevalence of tissue ID (sTfR >8.5 mg/L) increased significantly from pregnancy to delivery (9.6% compared with 23%, P = 0.03). Women with depleted iron stores (SF anemia at delivery, and 25% (n = 5) developed iron deficiency anemia (IDA). Overall, 44.6% of women studied (n = 37/83) were anemic at delivery, and 18% of women (n = 11/61) had IDA. Erythropoietin during pregnancy was significantly negatively associated with hemoglobin at delivery. Women with erythropoietin >75th percentile during pregnancy exhibited a 3-fold greater risk of anemia, suggesting that erythropoietin is a sensitive predictor of anemia at delivery. Inflammation was present at delivery, which limited the utility of ferritin or hepcidin as iron-status indicators at delivery. ID and anemia are highly prevalent in women with multiple gestations. Additional screening and iron supplementation may be warranted in this high-risk population given the known associations between ID anemia and adverse maternal and neonatal outcomes. This trial was registered at clinicaltrials.gov as NCT01582802. © 2016 American Society for Nutrition.

  18. HUBUNGAN ANTARA ANEMIA GIZI BESI TERHADAP PRESTASI BELAJAR ANAK SEKOLAH DI DAERAH ENDEMIK GAKI

    Directory of Open Access Journals (Sweden)

    Aniek Prihatin

    2017-10-01

    Full Text Available Incidence of nutritional anemia iron is influenced by multiple factors not just a lackof iron intake, but also influenced by the intake of other nutrients. The prevalenceof anemia is iron nutrition of school children in Indonesia at 26.5% 2. Risk factorsfor anemia influenced food consumption patterns particularly iron. Iron causesnutritional anemia oxygen transport is reduced, and the resulting energy productionto be low so that children become easily tired, tired, weak, lethargic, negligent,quickly tired, lack of concentration. Furthermore, can lead to decreased learningachievement, labor productivity, including exercise and decreased endurance.Conducted this research with the aim of studying whether there is a relationshipbetween iron nutritional anemia of the learning achievement of school children inendemic areas GAKI. The results of this study on iron nutritional anemias get theproportion of primary school children about 25%. Consumption of low-iron about30% below the figure adequacy of nutrition. There was no significant relationshipwith the hemoglobin status of Indonesian Language test (p-value = 0.10 andhemoglobin status of the subjects Mathematics test results (p-value = 0.76.Suggestions need to do further analysis on the status of UIE levels of anemiaand the effect on learning achievement (grades in mathematics and Indonesianlanguage in school children in endemic areas GAKI, for the management of localnutrition programs to improve child nutrition program improvement school byovercoming anemia and GAKI.

  19. Middle cerebral artery peak systolic velocity to predict fetal hemoglobin levels in twin anemia-polycythemia sequence.

    Science.gov (United States)

    Slaghekke, F; Pasman, S; Veujoz, M; Middeldorp, J M; Lewi, L; Devlieger, R; Favre, R; Lopriore, E; Oepkes, D

    2015-10-01

    To evaluate the diagnostic accuracy of middle cerebral artery peak systolic velocity (MCA-PSV) Doppler measurements in prediction of hemoglobin levels in twin anemia-polycythemia sequence (TAPS). This study involved a consecutive cohort comprising monochorionic twin pregnancies complicated by TAPS managed at three European fetal medicine centers between 2005 and 2013. The accuracy of MCA-PSV, measured immediately prior to fetal hemoglobin (Hb) measurement by fetal or cord blood sampling, for prediction of anemia and polycythemia was assessed using 2 × 2 tables. A total of 116 measurements (74 recorded in donors and 42 in recipients) from 43 twin pregnancies complicated by TAPS were available for analysis. MCA-PSV multiples of the median (MoM) values correlated well with Hb levels (r = - 0.86; P  5 SD below the mean) in TAPS donors was 94% (95% CI, 85-98%); specificity was 74% (95% CI, 62-83%); positive and negative predictive values were 76% (95% CI, 65-85%) and 94% (95% CI, 83-98%), respectively. The sensitivity of MCA-PSV ≤ 1.0 MoM to predict polycythemia (Hb level > 5 SD above the mean) in TAPS recipients was 97% (95% CI, 87-99%); specificity was 96% (95% CI, 89-99%); positive and negative predictive values were 93% (95% CI, 81-97%) and 99% (95% CI, 93-100%), respectively. MCA-PSV measurement has high diagnostic accuracy for predicting abnormal Hb levels in fetuses with TAPS. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  20. [Anemia: guidelines comparison].

    Science.gov (United States)

    Del Vecchio, Lucia

    2009-01-01

    The development of recombinant human erythropoietin and its introduction into the market in the late 1980s has significantly improved the quality of life of patients with chronic kidney disease (CKD) and reduced the need for blood transfusions. Starting from a cautious target, a progressive increase in the recommended hemoglobin levels has been observed over the years, in parallel with an increase in the obtained levels. This trend has gone together with the publication of findings of observational studies showing a relationship between the increase in hemoglobin levels and a reduction in the mortality risk, with the conduction of clinical trials testing the effects of complete anemia correction, and with the compilation of guidelines on anemia control in CKD patients by scientific societies and organizations. In the last two years, evidence of a possible increase in the mortality risk in those patients who were randomized to high hemoglobin levels has resulted in a decrease in the upper limit of the recommended Hb target to be obtained with erythropoietin stimulating agents (ESA), and consequently in a narrowing of the target range. Comparison of guidelines on anemia control in CKD patients is an interesting starting point to discuss single recommendations, strengthen their importance, or suggest new topics of research to fill up important gaps in knowledge.

  1. Thyroid storm and warm autoimmune hemolytic anemia.

    Science.gov (United States)

    Moore, Joseph A; Gliga, Louise; Nagalla, Srikanth

    2017-08-01

    Graves' disease is often associated with other autoimmune disorders, including rare associations with autoimmune hemolytic anemia (AIHA). We describe a unique presentation of thyroid storm and warm AIHA diagnosed concurrently in a young female with hyperthyroidism. The patient presented with nausea, vomiting, diarrhea and altered mental status. Laboratory studies revealed hemoglobin 3.9g/dL, platelets 171×10 9 L -1 , haptoglobin storm and warm AIHA. She was started on glucocorticoids to treat both warm AIHA and thyroid storm, as well as antithyroid medications, propranolol and folic acid. Due to profound anemia and hemodynamic instability, the patient was transfused two units of uncrossmatched packed red blood cells slowly and tolerated this well. She was discharged on methimazole as well as a prolonged prednisone taper, and achieved complete resolution of the thyrotoxicosis and anemia at one month. Hyperthyroidism can affect all three blood cell lineages of the hematopoietic system. Anemia can be seen in 10-20% of patients with thyrotoxicosis. Several autoimmune processes can lead to anemia in Graves' disease, including pernicious anemia, celiac disease, and warm AIHA. This case illustrates a rarely described presentation of a patient with Graves' disease presenting with concurrent thyroid storm and warm AIHA. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Anemia

    Science.gov (United States)

    ... a hemoglobin value of less than 13.5 gm/dl in a man or less than 12.0 gm/dl in a woman. Normal values for children ... types of anemia cannot be prevented, eating healthy foods can help you avoid both iron-and vitamin- ...

  3. ASUPAN ZAT GIZI, STATUS GIZI, DAN STATUS ANEMIA PADA REMAJA LAKI-LAKI PENGGUNA NARKOBA DI LEMBAGA PEMASYARAKATAN ANAK PRIA TANGERANG

    Directory of Open Access Journals (Sweden)

    Utami Wahyuningsih

    2014-08-01

    Full Text Available ABSTRACTThe objective of this study was to analyze the intake of energy and nutrients, nutritional status, and anemia status in adolescent boys with drug abuse at boys penitentiary class IIA Tangerang. This study used cross sectional design. Subjects of this study were adolescent boys with drug addiction. Sampling method used was purposive sampling and the number of subjects was 40 people. Descriptive analysis showed energy (35.0% and protein (27.5% adequacy level were categorized as severe deficit. Mean energy from food provided by the penintentiary hadn’t met subjects’ daily requirement while mean protein had met subjects’ daily requirement. Iron adequacy level was categorized as adequate (82.5% and vitamin C adequacy level was categorized as inadequate (100.0%. Most subjects had normal nutritional status (85.0% and anemia (57.5%.Keywords: adolescent, anemia, drugs, nutritional statusABSTRAKTujuan penelitian ini adalah untuk menganalisis asupan energi dan zat gizi, status gizi, dan status anemia remaja laki-laki pengguna narkoba di lembaga pemasyarakatan (LAPAS anak pria kelas IIA Kota Tangerang. Penelitian ini menggunakan desain cross sesctional study. Subjek dalam penelitian ini adalah remaja laki-laki pengguna narkoba. Cara pengambilan subjek secara purposive. Jumlah subjek yang digunakan sebanyak 40 orang. Hasil analisis deskriptif menunjukkan tingkat kecukupan energi (35.0% dan protein (27.5% subjek berada pada kategori defisit berat. Rata-rata energi dari makanan yang disediakan LAPAS belum memenuhi kebutuhan subjek dalam sehari, sedangkan rata-rata protein sudah cukup memenuhi kebutuhan subjek dalam sehari. Tingkat kecukupan zat besi subjek berada pada kategori cukup (82.5% dan tingkat kecukupan vitamin C subjek berada pada kategori kurang (100.0%. Subjek berada dalam kategori status gizi normal (85.0% dan mengalami anemia (57.5%.Kata kunci: anemia, narkoba, remaja, status gizi

  4. The challenge of defining and treating anemia and iron deficiency in pregnancy: A study of New Zealand midwives' management of iron status in pregnancy and the postpartum period.

    Science.gov (United States)

    Calje, Esther; Skinner, Joan

    2017-06-01

    Early recognition and management of low maternal iron status is associated with improved maternal, fetal, and neonatal outcomes. However, existing international guidelines for the testing and management of maternal iron-deficiency anemia are variable, with no national guideline for New Zealand midwives. Clinical management is complicated by normal physiological hemodilution, and complicated further by the effects of inflammation on iron metabolism, especially in populations with a high prevalence of obesity or infection. This study describes how midwives in one New Zealand area diagnose and treat anemia and iron deficiency, in the absence of established guidelines. Data on demographics, laboratory results, and documented clinical management were retrospectively collected from midwives (n=21) and women (n=189), from September to December 2013. Analysis was predominantly descriptive. A secondary analysis of iron status and body mass index (BMI) was undertaken. A total of 46% of 186 women, with hemoglobin testing at booking, did not have ferritin tested; 86% (of 385) of ferritin tests were not concurrently tested with C-reactive protein. Despite midwives prescribing iron for 48.7% of second trimester women, 47.1% still had low iron status before birth. Only 22.8% of women had hemoglobin testing postpartum. There was a significant difference between third trimester median ferritin levels in women with BMI ≥25.00 (14 μg/L) and BMI iron status was difficult to categorize, because of inconsistent testing. This study indicates the need for an evidence-based clinical guideline for New Zealand midwives and maternity care providers. © 2017 Wiley Periodicals, Inc.

  5. Spin Label Studies of the Hemoglobin-Membrane Interaction During Sickle Hemoglobin Polymerization

    International Nuclear Information System (INIS)

    Falcon Dieguez, Jose E.; Rodi, Pablo; Lores Guevara, Manuel A.; Gennaro, Ana Maria

    2009-12-01

    An enhanced hemoglobin-membrane association has been previously documented in Sickle Cell Anemia. However, it is not known how this interaction is modified during the hemoglobin S polymerization process. In this work, we use a model of reconstituted erythrocytes from ghost membranes whose cytoskeleton proteins had been previously labeled with the 4-maleimido Tempo spin label, and that were subsequently resealed with hemoglobin S or A solutions. Using EPR spectroscopy, we studied the time dependence of the spectral W/S parameter, indicative of the conformational state of cytoskeleton proteins (mainly spectrin) under spontaneous deoxygenation, with the aim of detecting the eventual effects due to hemoglobin S polymerization. The differences observed in the temporal behaviour of W/S in erythrocytes reconstituted with both hemoglobins were considered as experimental evidence of an increment in hemoglobin S-membrane interaction, as a result of the polymerization process of hemoglobin S under spontaneous deoxygenation. (author)

  6. Hemoglobin cut-off values in healthy Turkish infants

    Institute of Scientific and Technical Information of China (English)

    Ahmet Arvas; Emel Gür; DurmuşDoğan

    2014-01-01

    Background: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality. This study was undertaken to determine the cut-off value of hemoglobin for infant anemia. Methods: A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital. A total of 1484 healthy infants aged between 4 to 24 months were included in the study. The relationship of hemoglobin (Hb) levels with mother age, birth weight, weight gain rate, feeding, and gender was evaluated. Results: The Hb levels were assessed in four age groups (4 months, 6 months, 9-12 months, and 15-24 months) and the cut-off values of Hb were determined. Hb cut-off values (5th percentile for age) were detected as 97 g/L and 93 g/L at 4 months and 6 months, respectively. In older infants, the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months, respectively. The two values were lower than the World Health Organization criteria for anemia, which could partly due to the lack of information on iron status in our population. However, this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries. Hb levels of females were higher in all age groups; however, a statistically significant difference was found in gender in only 6 month-old infants. No statistically significant difference was found among Hb levels, mother's age, birth weight, weight gain rate, and nutritional status. Conclusion: Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.

  7. [Impact of the provision of fortified cornmeal on anemia in preschoolers in the indigenous areas of Mexico].

    Science.gov (United States)

    Aguirre Arenas, Judith; Chávez Villasana, Adolfo; Medina Carranza, Blanca Estela; García Villegas, Elsy Aidee; Carrasco Quintero, María del Refugio; Guarneros Soto, Noé

    2013-01-01

    To estimate changes in anemia status in preschool age children at 9 months after the provision of soy- and iron-fortified cornflour. A non-experimental pre-post evaluation study was performed in a sample of 98 boys and 96 boys aged between 6 and 24 months. We analyzed demographic, anthropometric, and biochemical variables. During the 9-month period, the hemoglobin level increased from 11.0 to 11.9 mg/dL (p<0,001). The prevalence of anemia (hemoglobin <11.0mg/dL) decreased from 52.6% to 25.3% (p<0,001). The indicators of height for age and body mass index changed from -2.1 (-5.5 to 2.8) to -2.3 (-6.5 to 1.3) (p<0,001) and from 0,4 (-3.1 to 2.9) to 0,7 (-2.2 to 3.9) (p<0,001), respectively. The decreased prevalence of anemia suggests that the provision of soy- (3%) and iron-fortified flour is a viable alternative for combating childhood anemia. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Prevalence of Anemia among Older Adults Residing in the Coastal and Andes Mountains in Ecuador: Results of the SABE Survey

    Directory of Open Access Journals (Sweden)

    Carlos H. Orces

    2017-01-01

    Full Text Available Objectives. To estimate the prevalence of anemia and its determinants among older adults in Ecuador. Methods. The present study was based on data from the National Survey of Health, Wellbeing, and Aging. Hemoglobin concentrations were adjusted by participants’ smoking status and altitude of residence, and anemia was defined according to the World Health Organization criteria (<12 g/dL in women and <13 g/dL in men. Gender-specific logistic regression models were used to examine the association between demographic and health characteristics and anemia. Results. A total of 2,372 subjects with a mean age of 71.8 (SD 8.2 years had their hemoglobin measured, representing an estimated 1.1 million older adults. The crude prevalence of anemia was 20.0% in women and 25.2% in men. However, higher anemia prevalence rates were seen with advancing age among black women and subjects residing in the urban coast. Likewise, certain health conditions such as hypoalbuminemia, cancer in men, chronic kidney disease, iron deficiency, and low grade inflammation were associated with increased odds of having anemia. Conclusions. Anemia is a prevalent condition among older adults in Ecuador. Moreover, further research is needed to examine the association between anemia and adverse health-related outcomes among older Ecuadorians.

  9. Sickle Cell Anemia: MedlinePlus Health Topic

    Science.gov (United States)

    ... Cell Disease Also called: Hemoglobin SS disease, Sickle cell anemia On this page Basics Summary Start Here Diagnosis ... red blood cells. This is a condition called anemia , and it can make you feel tired. The ...

  10. Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates.

    Science.gov (United States)

    Zhao, Gengli; Xu, Guobin; Zhou, Min; Jiang, Yaping; Richards, Blair; Clark, Katy M; Kaciroti, Niko; Georgieff, Michael K; Zhang, Zhixiang; Tardif, Twila; Li, Ming; Lozoff, Betsy

    2015-08-01

    Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ≤20 wk gestation, aged ≥18 y, and with hemoglobin ≥100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) iron (BI) anemia [ID + anemia (IDA); hemoglobin 118 μmol/mol). A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (β per 10 capsules = 2.60, P iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women and >45% of neonates had ID, regardless of supplementation. This trial was registered at clinicaltrials.gov as NCT02221752. © 2015 American Society for Nutrition.

  11. Anemia and growth failure among HIV-infected children in India: a retrospective analysis

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    Shet Anita

    2009-06-01

    Full Text Available Abstract Background Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods We analyzed retrospective data from 248 HIV-infected children aged 1–12 years attending three outpatient clinics in South India (2004–2006. Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses. Results The overall prevalence of anemia (defined as hemoglobin Conclusion The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children.

  12. Toward laboratory blood test-comparable photometric assessments for anemia in veterinary hematology

    Science.gov (United States)

    Kim, Taehoon; Choi, Seung Ho; Lambert-Cheatham, Nathan; Xu, Zhengbin; Kritchevsky, Janice E.; Bertin, Francois-René; Kim, Young L.

    2016-10-01

    Anemia associated with intestinal parasites and malnutrition is the leading cause of morbidity and mortality in small ruminants worldwide. Qualitative scoring of conjunctival redness has been developed so that farmers can gauge anemia in sheep and goats to identify animals that require treatment. For clinically relevant anemia diagnosis, complete blood count-comparable quantitative methods often rely on complicated and expensive optical instruments, requiring detailed spectral information of hemoglobin. We report experimental and numerical results for simple, yet reliable, noninvasive hemoglobin detection that can be correlated with laboratory-based blood hemoglobin testing for anemia diagnosis. In our pilot animal study using calves, we exploit the third eyelid (i.e., palpebral conjunctiva) as an effective sensing site. To further test spectrometer-free (or spectrometerless) hemoglobin assessments, we implement full spectral reconstruction from RGB data and partial least square regression. The unique combination of RGB-based spectral reconstruction and partial least square regression could potentially offer uncomplicated instrumentation and avoid the use of a spectrometer, which is vital for realizing a compact and inexpensive hematology device for quantitative anemia detection in the farm field.

  13. Anemia ferropriva e estado nutricional de crianças de creches de Guaxupé Anemia and nutritional status of children in day-care centers in Guaxupé

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    Carlos César Camillo

    2008-04-01

    Full Text Available OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia ferropriva de crianças que freqüentam creches no município de Guaxupé, MG. MÉTODOS: Foram incluídas no estudo crianças de ambos os sexos, de 6 a 72 meses de idade, matriculadas em creches do município de Guaxupé. O estado nutricional foi aferido por meio do escore Z das relações estatura para idade e peso para a estatura. Para o diagnóstico de anemia utilizou-se a dosagem de hemoglobina, ferro sérico, capacidade total de ligação de ferro e o índice de saturação de transferrina. RESULTADOS: Escore Z OBJECTIVE: To evaluate the nutritional status and the prevalence of iron deficiency anemia in children attending public day care centers in the city of Guaxupé (MG, Brazil. METHODS: Children of both genders, from 6 to 72 months, registered in public day-care centers in the city of Guaxupé, were studied. Nutritional evaluation was conducted using the Z-score for height-to-age and weight-to-height relationships. Hemoglobin dosage, serum iron, total iron binding capacity and the transferrin saturation index were used for diagnosis of anemia. RESULTS: Z score < - 2 was observed in 3.3% of the children for the height-to-age relationship and of 0.4% for the weight-to-height relationship. Prevalence of total iron deficiency anemia was of 16.1%. In the age span from 6 to 36 months it was of 44.6%. The entire sample showed 45% with low serum iron, 37.9% with high total iron binding capacity and 43.1% with a low transferrin saturation index. CONCLUSION: Malnutrition was not considered to be a problem due to its low prevalence; however, an important prevalence of iron deficiency was observed. Iron deficiency anemia is more prevalent in children between 6 and 36 months confirming that this age span is more vulnerable. No association between iron deficiency anemia and the Z score of the studied anthropometry relationships was found.

  14. Low prevalence of iron deficiency anemia between 1981 and 2010 in Chilean women of childbearing age.

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    Israel Ríos-Castillo

    2013-09-01

    Full Text Available Objective. To determine the prevalence of anemia and iron status among Chilean women of childbearing age between 1981 and 2010. Materials and methods. Calculation of the prevalence of anemia and iron status was based on multiple cross-sectional iron absorption studies performed in 888 women during this period of time. All studies included measurements of hemoglobin, mean corpuscular volume, zinc protoporphyrin, percentage of transferrin saturation and serum ferritin. Data were grouped by decade (1981-1990,1991-2000, and 2001-2010. Results. Prevalence of anemia for these decades was 9, 6 and 10%, respectively (p=NS. Iron deficiency anemia was the main cause of anemia in all periods (55, 85 and 75%, respectively; p=NS. A high prevalence of women with normal iron status was observed for all periods (64, 69, and 67, respectively; p=NS. Prevalence of iron deficiency without anemia in 1981-1990, 1991-2000 and 2001-2010 was 7, 20 and 12%, respectively (p menor que 0.05. Finally, prevalence of iron depleted stores was 20, 6 and 10%, respectively (p menor que 0.05. Conclusions. Prevalence of iron deficiency anemia in Chilean women of childbearing age was mild between 1981 and 2010. More than 60% of childbearing age women presented normal iron status in all periods. However, prevalence of iron depleted stores was moderate during 1981-1990, and was mild during 1991-2000 and 2001-2010.

  15. Helicobacter pylori Infection and Anemia in Taiwanese Adults

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    Hsiang-Yao Shih

    2013-01-01

    Full Text Available Background. Chronic Helicobacter pylori infection and iron-deficiency anemia (IDA are common in adults. Although the most common causes of IDA usually arise from the gastrointestinal tract, the association between chronic Helicobacter pylori infection and anemia remains unclear. Aim. To evaluate the association of chronic Helicobacter pylori infection and IDA. Materials and Methods. We enrolled 882 patients from January 2010 to April 2013. The status of Helicobacter pylori (H.p infection was confirmed and blood samples from the same participants were taken on the same day to check the level of hemoglobin, serum iron, ferritin, and total iron-binding capacity (TIBC. Results. No significant difference was noted from the demographic data. The average level of hemoglobin (Hb was not different between negative and positive groups, pos 13.57 g/dL versus neg 13.65 g/dL (P=0.699. Although the levels of serum IDA related parameters were expected in positive group (lower serum iron and ferritin and higher TIBC these differences did not reach statistical significance (P=0.824 for iron, P=0.360 for ferritin, and P=0.252 for TIBC. Conclusion. Chronic Helicobacter pylori infection is not attributed to IDA. The levels of hemoglobin, serum iron and ferritin, and TIBC remain unaffected after chronic H.p infection. Large-scale clinical studies are needed to prove the association.

  16. Anemia, Iron Deficiency and Iodine Deficiency among Nepalese School Children.

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    Khatiwada, Saroj; Lamsal, Madhab; Gelal, Basanta; Gautam, Sharad; Nepal, Ashwini Kumar; Brodie, David; Baral, Nirmal

    2016-07-01

    To assess iodine and iron nutritional status among Nepalese school children. A cross-sectional, community based study was conducted in the two districts, Ilam (hilly region) and Udayapur (plain region) of eastern Nepal. A total of 759 school children aged 6-13 y from different schools within the study areas were randomly enrolled. A total of 759 urine samples and 316 blood samples were collected. Blood hemoglobin level, serum iron, total iron binding capacity and urinary iodine concentration was measured. Percentage of transferrin saturation was calculated using serum iron and total iron binding capacity values. The mean level of hemoglobin, serum iron, total iron binding capacity, transferrin saturation and median urinary iodine excretion were 12.29 ± 1.85 g/dl, 70.45 ± 34.46 μg/dl, 386.48 ± 62.48 μg/dl, 19.94 ± 12.07 % and 274.67 μg/L respectively. Anemia, iron deficiency and iodine deficiency (urinary iodine excretion iron deficient children. Iron deficiency and anemia are common in Nepalese children, whereas, iodine nutrition is more than adequate. Low urinary iodine excretion was common in iron deficiency and anemia.

  17. A Candidate Trans-acting Modulator of Fetal Hemoglobin Gene Expression in the Arab-Indian Haplotype of Sickle Cell Anemia

    Science.gov (United States)

    Vathipadiekal, Vinod; Farrell, John J.; Wang, Shuai; Edward, Heather L.; Shappell, Heather; Al-Rubaish, A.M.; Al-Muhanna, Fahad; Naserullah, Z.; Alsuliman, A.; Qutub, Hatem Othman; Simkin, Irene; Farrer, Lindsay A.; Jiang, Zhihua; Luo, Hong-Yuan; Huang, Shengwen; Mostoslavsky, Gustavo; Murphy, George J.; Patra, Pradeep.K.; Chui, David H.K.; Alsultan, Abdulrahman; Al-Ali, Amein K.; Sebastiani, Paola.; Steinberg, Martin. H.

    2016-01-01

    Fetal hemoglobin (HbF) levels are higher in the Arab-Indian (AI) β-globin gene haplotype of sickle cell anemia compared with African-origin haplotypes. To study genetic elements that effect HbF expression in the AI haplotype we completed whole genome sequencing in 14 Saudi AI haplotype sickle hemoglobin homozygotes—seven selected for low HbF (8.2±1.3%) and seven selected for high HbF (23.5±.2.6%). An intronic single nucleotide polymorphism (SNP) in ANTXR1, an anthrax toxin receptor (chromosome 2p13), was associated with HbF. These results were replicated in two independent Saudi AI haplotype cohorts of 120 and 139 patients, but not in 76 Saudi Benin haplotype, 894 African origin haplotype and 44 Arab Indian haplotype patients of Indian descent, suggesting that this association is effective only in the Saudi AI haplotype background. ANTXR1 variants explained 10% of the HbF variability compared with 8% for BCL11A. These two genes had independent, additive effects on HbF and together explained about 15% of HbF variability in Saudi AI sickle cell anemia patients. ANTXR1 was expressed at mRNA and protein levels in erythroid progenitors derived from induced pluripotent stem cells (iPSCs) and CD34+ cells. As CD34+ cells matured and their HbF decreased ANTXR1 expression increased; as iPSCs differentiated and their HbF increased, ANTXR1 expression decreased. Along with elements in cis to the HbF genes, ANTXR1 contributes to the variation in HbF in Saudi AI haplotype sickle cell anemia and is the first gene in trans to HBB that is associated with HbF only in carriers of the Saudi AI haplotype. PMID:27501013

  18. Hemoglobin levels in persons with depressive and/or anxiety disorders

    NARCIS (Netherlands)

    Lever-van Milligen, Bianca A.; Vogelzangs, Nicole; Smit, Johannes H.; Penninx, Brenda W. J. H.

    Objective: Both low and high hemoglobin levels lead to more physical diseases, and both are linked to mortality. Low hemoglobin, often classified as anemia, has also been linked to more depressive symptoms, but whether both hemoglobin extremes are associated with depressive disorder and potentially

  19. Effect of counseling on nutritional status during pregnancy.

    Science.gov (United States)

    Garg, Aashima; Kashyap, Sushma

    2006-08-01

    To assess the nutritional status and dietary practices among underprivileged pregnant women, identify the lacune, outline implement and assess the effect of nutritional counseling on their dietary intake, anthropometric status and anemia status. Hundred pregnant women belonging to low socio-economic status were interviewed. Based on lacune, nutrition education (NE) was given in the form of simple messages to 50 subjects (NE-group) over 10-16 weeks period, while the remaining 50 formed the comparison group (Non-NE group). Tools used were individual counseling, weekly home visits and group meetings. Anthropometric measurements taken were height and weight. Dietary data was collected using 24-hour recall and food frequency questionnaire. Hemoglobin estimation was done. Effect of intervention was assessed by monitoring changes in dietary practices, weight gain, and nutritional status of the subjects. Baseline findings--low mean maternal body weight (51.05 +/- 7.26 kg), 96.3% anemia prevalence and severely sub-optimal dietary intakes. Post-NE results revealed a significant increase in quality and quantity of the diets consumed. Mean hemoglobin levels significantly increased (Post-NE vs Non-NE = 9.65 +/- 0.97 vs 7.85 +/- 1.58, p nutritional status during pregnancy.

  20. ANEMIA, PRESTASI, DAN KECERDASAN PADA REMAJA AWAL LAKI-LAKI DAN PEREMPUAN

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    Leny Latifah

    2017-02-01

    Full Text Available Background. Anemia and IDD are interlinked nutritional problem especially indeveloping countries. Anemic conditions has been known to decreased iodiumefectivity. Attention in adolescence nutritional status is still limited that studies onnutrition and micronutrient status of adolescents are still needed. Relationshipsbetween micronurient and cognitive development in adolescents require clarification.Objective. To determine the relationship between anemia status with cognitivefunction, using level of intelligence and learning achievement, in early adolescenceperiode. Method. This was a cross-sectional study conducted in the Bulu and Kedudistrict, Temanggung. Samples were 120 first grade junior high school students. Datacollected include cognitive function, with level of intelligence and learning achievementas indicators. Intelligence was measured with CFIT (Culture Fair Intelligence Testand academic achievement measured by standardized tests on mathematics. Anemiastatus was measured with hemoglobin levels using CyanmetHb method. Researchdata were analyzed by independent sample t-test and linear regression. Results. Theresults showed that student with cognitive function with intelligence level indicator onis quite high (62.9%. Female in early adolescent had 1.5 times risks to have anemiathan male, but statistically not significant (OR: 1.55; 95% CI; 0.61-3.93. There wasno association between anemia status (p>0.05 and gender (p>0.05 with intelligence(p>0.05 and learning achievement (p>0.05. Intelligence level contributed most tomathematics achievement (beta=0.257 p<0.05. Conclusion. There is no differencein the level of intelligence and learning achievement in early adolescence period,based on the anemia status and gender. Intelligence is a dominant factor influencingmathematics achievement. Further research is necessary in the middle or lateadolescence to obtain more comprehensive understanding in the effect of anemiaon adolescents cognitive

  1. Fructosamine and Hemoglobin A1c Correlations in HIV-Infected Adults in Routine Clinical Care: Impact of Anemia and Albumin Levels

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    Luisa Duran

    2015-01-01

    Full Text Available Fructosamine is an alternative method to hemoglobin A1c (HbA1c for determining average glycemia. However, its use has not been extensively evaluated in persons living with HIV (PLWH. We examined the relationship between HbA1c and fructosamine values, specifically focusing on anemia (which can affect HbA1c and albumin as a marker of liver disease. We included 345 PLWH from two sites. We examined Spearman rank correlations between fructosamine and HbA1c and performed linear test for trends to compare fructosamine and HbA1c correlations by hemoglobin and albumin quartiles. We examined discrepant individuals with values elevated only on one test. We found a correlation of 0.70 between fructosamine and HbA1c levels. Trend tests for correlations between fructosamine and HbA1c were significant for both albumin (p=0.05 and hemoglobin (p=0.01 with the lowest correlations in the lowest hemoglobin quartile. We identified participants with unremarkable HbA1c values but elevated fructosamine values. These discrepant individuals had lower mean hemoglobin levels than those elevated by both tests. We demonstrated a large correlation between HbA1c and fructosamine across a range of hemoglobin and albumin levels. There were discrepant cases particularly among those with lower hemoglobin levels. Future studies are needed to clarify the use of fructosamine for diabetes management in PWLH.

  2. An evaluation of hemoglobin measurement tools and their accuracy and reliability when screening for child anemia in Rwanda: A randomized study.

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    Megan Parker

    Full Text Available Blood hemoglobin (Hb is a common indicator for diagnosing anemia and is often determined through laboratory analysis of venous samples. One alternative to laboratory-based methods is the handheld HemoCue® Hb 201+ device, which requires a finger prick and wicking of blood into a pretreated cuvette for analysis. An alternative HemoCue® gravity method is being investigated for improved accuracy. Further, recent developments in noninvasive technologies could provide an accurate, rapid, safe, point-of-care option for hemoglobin estimation while addressing some limitations of current tools, but device performance must be assessed in low-resource settings. This study evaluated the performance of two HemoCue® Hb 201+ blood sampling methods and a noninvasive device (Pronto® with DCI-mini™ sensors in a Rwandan pediatric clinic. Reference hemoglobin values were determined in 132 children 6 to 59 months of age by using a standard hematology analyzer (Sysmex KN21TM. Half were tested using the HemoCue® wicking method; half were tested using the HemoCue® gravity method; and 112 had successful hemoglobin readings with Pronto® DCI-mini™. Statistical analysis was used to assess the level of bias generated by each method and the key drivers of bias. The HemoCue® gravity method was the least biased. The HemoCue® wicking and Pronto® methods biases were inversely related to the Sysmex KN21TM results. Both HemoCue® sampling methods correctly classified patients' anemic status in 80% or more of instances, whereas the Pronto® device had a correct classification rate of only 69%. The HemoCue® gravity method was more accurate than the traditional HemoCue® wicking method in this study, but its accuracy and operational feasibility should be confirmed by future studies. The Pronto® DCI-mini™ devices showed considerable promise but require further improvements in sensitivity and specificity before wider adoption.

  3. Parvovirus B19 Is Associated with a Significant Decrease in Hemoglobin Level among Children <5 Years of Age with Anemia in Northwestern Tanzania.

    Science.gov (United States)

    Tizeba, Yustina A; Mirambo, Mariam M; Kayange, Neema; Mhada, Tumaini; Ambrose, Emmanuela E; Smart, Luke R; Mshana, Stephen E

    2017-12-13

    Parvovirus B19 (B19) can cause transient aplastic crisis and lead to acute severe anemia. This study investigated the relationship between B19 and anemia among children B19 IgM- and IgG-specific antibodies among children with various categories of anemia according to the World Health Organization (WHO) guidelines. A total of 265 children with median age of 28.5 months (interquartile range 18-39.5) were investigated. Eighty-six children (32.5%) had severe anemia. B19-specific IgM and IgG antibodies were detected in 24 (9%) and 46 (17.4%) children, respectively. Low hemoglobin (Hb) level (p = 0.031), Plasmodium falciparum infection (p = 0.001) and residing in rural areas (p = 0.025) independently predicted B19 IgM seropositivity. Acute B19 infection decreased Hb level by 1.1 g/dl (p = 0.003). In malaria endemic areas, acute B19 infections should be considered among children with severe anemia from rural areas. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Etiology of anemia of blood donor candidates deferred by hematologic screening

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    Michel Alves da Silva

    2012-01-01

    Full Text Available OBJECTIVE: Iron deficiency is the most common cause of anemia and one of the main factors in the clinical deferral of blood donors. This fact prompted the current study that aimed to determine the prevalence and etiology of anemia in blood donor candidates and to evaluate the hematological screening technique used for the exclusion of these donors. METHODS: This was a prospective study that compared two groups (Anemic and Non-anemic. Initially screening for anemia was performed by manually measuring hemoglobin (Bioclin® Kit; the results were subsequently compared with an automated screening method (Coulter T-890. The etiology was investigated by hemoglobin electrophoresis in alkaline and acid pH, Hb A2 dosage and measurement of the ferritin concentration by immunoagglutination. Differences and associations of interest were analyzed using the Yates and McNemar's Chi-square tests and the Fisher, Mann-Whitney, Wilcoxon and Kruskal-Wallis tests. RESULTS: The deferral rate due to anemia was 4.2%; iron deficiency was identified in 37.5% and beta thalassemia in 9.3% of the excluded candidates. There was a significant discrepancy between the two techniques used to measure hemoglobin with 38.1% of initially deferred donors presenting normal hemoglobin levels by the automated method. CONCLUSION: The results show a high rate of blood donors being deferred for anemia and confirm that iron deficiency is the most prevalent cause. The discrepancies found by comparing screening methods suggest that hemoglobin and hematocrit levels should be confirmed before deferring a donor due to anemia; this may increase supplies in blood banks.

  5. Status gizi, kadar hemoglobin, ureum, dan kreatinin pasien konseling gizi hemodialisa

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    Kristiawan P. A. Nugroho

    2018-01-01

    Full Text Available ABSTRACTBackground : Patients who are undergoing hemodialysis therapy must know which foods that may be consumed including foods containing animal protein, low potassium, and low salt. The role of nutritionists is needed to provide nutritional counseling related to dietary adjustment. Studies that have been conducted by previous researchers are about diet from hemodialysis patients and the various factors that affect dietary compliance of patients, but no one has been studying the relation related to nutritional status, hemoglobin, ureum, and creatinine levels before and after doing a counseling that also has a relationship with diet and dietary compliance for hemodialysis patients.Objectives : To analyze the relationship of nutritional status, hemoglobin, ureum, and creatinine levels of hemodialysis patients before and after doing nutritional counseling in RSUD Ungaran. Methods : The study used a descriptive quantitaive method with one group pretest posttest design with cross sectional approach. The research was conducted in Hemodialysis Unit of RSUD Ungaran with a total sampling of 30 hemodialysis patient. Primary data were obtained from respondent’s data entry and FFQ, observation, and interviews. Secondary data were obtained from respondent’s medical records include the level of hemoglobin, urea, and cretinine. Data were analyzed using SPSS programme with Paired t Test. Results : The results of SPSS analysis showed that probability value from urea men 0,016 < 0,05 and urea women – hemoglobin men and women – creatinin men and women overall 0,000 < 0,05, which means that the average levels of those components before and after doing a nutritional counseling is different.Conclusions : A nutritional counseling indicate any change in the nutritional status of the entire hemodialysis patients, based on hemoglobin levels increased, while urea and creatinine levels decreased; but all those components are not in the normal category. Levels of

  6. Triumph and tragedy: anemia management in chronic kidney disease.

    Science.gov (United States)

    Novak, James E; Szczech, Lynda A

    2008-11-01

    Recent trial data have resulted in a reevaluation of the management of anemia in chronic kidney disease, including the use of erythropoiesis-stimulating agents, intravenous iron, and novel pharmaceuticals. In this review, we evaluate the latest research on anemia management in chronic kidney disease. Clinical trials of erythropoiesis-stimulating agents indicate that targeting the complete correction of anemia in patients with chronic kidney disease results in a greater risk of morbidity and mortality despite improved hemoglobin and quality of life. Conversely, intravenous iron has been found effective and relatively well tolerated in treating anemia in chronic kidney disease, even in patients with elevated ferritin. New agents to manage anemia, including long-acting erythropoietin derivatives, are also in active development. Erythropoiesis-stimulating agents should be used to target hemoglobin 11-12 g/dl in patients with chronic kidney disease. Intravenous iron may be beneficial for patients with hemoglobin less than 11 g/dl and transferrin saturation less than 25% despite elevated ferritin (500-1200 ng/ml). An upcoming placebo-controlled trial of darbepoetin should help to define the role of erythropoiesis-stimulating agents in chronic kidney disease.

  7. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... anemia may cause the following complications: Depression Heart problems. If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your ...

  8. Low Hemoglobin among Pregnant Women in Midwives Practice of Primary Health Care, Jatinangor, Indonesia: Iron Deficiency Anemia or β-Thalassemia Trait?

    Science.gov (United States)

    Susanti, Ari Indra; Winarno, Gatot; Sugianli, Adhi Kristianto; Susanto, Herman; Panigoro, Ramdan

    2017-01-01

    Low hemoglobin (Hb) or anemia is common among pregnant women in developing countries which may cause adverse pregnancy outcomes and maternal deaths. Our study aimed to assess Hb level measured by midwives in primary health care facility at rural area of Jatinangor, Indonesia, and to explore whether the anemia was due to iron deficiency (IDA) or β-thalassemia trait (β-TT). Pregnant women (n = 105) had finger prick test for Hb level during a regular antenatal care examination from October to November 2016. Hb level by finger prick test was compared with venous blood, measured by complete blood count (CBC). Indices including MCV and MCH and indices of Shine & Lal, Mentzer, Srivastava, Engels & Frase, Ehsani, and Sirdah were analyzed to differentiate anemia due to IDA and anemia due to suspect β-TT. HbA2 was measured to confirm β-TT. Anemic pregnant women were found in 86.7% by finger prick test compared to 21.9% (n = 23) by CBC. The prevalence of β-TT in our study was 5.7%. Hb measurement among pregnant women in low resource area is highly important; however, finger prick test in this study showed a high frequency of anemia which may lead to iron oversupplementation. A standard CBC is encouraged; MCV and MCH would help midwives to identify β-TT. PMID:28634546

  9. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... Health and Human Development, we are investigating how best to treat premature newborns with low hemoglobin levels. ... are hoping to determine which iron supplements work best to treat iron-deficiency anemia in children who ...

  10. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... breastfeeding women older than 18 need 9 mg. Problems absorbing iron Even if you consume the recommended ... anemia may cause the following complications: Depression Heart problems. If you do not have enough hemoglobin-carrying ...

  11. Iron deficiency or anemia of inflammation? : Differential diagnosis and mechanisms of anemia of inflammation.

    Science.gov (United States)

    Nairz, Manfred; Theurl, Igor; Wolf, Dominik; Weiss, Günter

    2016-10-01

    Iron deficiency and immune activation are the two most frequent causes of anemia, both of which are based on disturbances of iron homeostasis. Iron deficiency anemia results from a reduction of the body's iron content due to blood loss, inadequate dietary iron intake, its malabsorption, or increased iron demand. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, particularly the mononuclear phagocytes system in liver and spleen. This results in iron-limited erythropoiesis and anemia. This review summarizes current diagnostic and pathophysiological concepts of iron deficiency anemia and anemia of inflammation, as well as combined conditions, and provides a brief outlook on novel therapeutic options.

  12. CLINICO PATHOLOGICAL STUDY OF PATTERNS OF ANEMIA DURING PREGNANCY

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    Chamakuri

    2015-10-01

    Full Text Available INTRODUCTION: Anemia is defined as haemoglobin level in the blood below the lower extreme of the normal range for the age and sex of the individual. According to WHO, in developing countries the prevalence of anemia among pregnant women averages 60%, ranging between 35 to 100% among different regions of the world. A hemoglobin concentration below 11.0g/dl or packed cell volume (PCV of less than 33.0% is regarded as anemia during pregnancy by the WHO. It occurs in 40 - 80% of the pregnant women. Iron and folic acid defici encies, malaria, intestinal parasitic infections and hemoglobinopathies are the principal causes of anemia in pregnancy. Predisposing factors include young age, grand multiparity, low socioeconomic status, illiteracy, ignorance and short intervals of pregn ancy. AIM AND OBJECTIVES: 1. To study various patterns of anemia in pregnant women having haemoglobin level < 11 gm%. 2. To determine the most common pattern of anemia in pregnancy based on red cell morphology. MATERIALS AND METHODS: This study is a prospe ctive study over a period of one year from September 2014 to August 2015 in the department of pathology, Andhra medical college, Visakhapatnam . The study was conducted on 120 pregnant women whose haemoglobin level is < 11 gm/dl. All the haemotological parameters & peripheral blood smear stained by Leishman’s stain were evaluated. Complete clinical & obstetric history was recorded. Socioeconomic status was also noted. RESULTS: Out of 120 cases of anemia, we found 47 patie nts (39.1% having dimorphic anemia, 36(30% – microcytic hypochromic anemia, 23(19.1% - normocytic hypochromic anemia, 11(9.16% - sickle cell anemia and 1(0.83% case of pancytopenia. Maximum cases were seen in the age group of 21 - 30 years. 52 cases (43. 3% were primigravida and remaining 68 cases (56.6% were gravida two to four. 20 cases (16.6% were diagnosed in the first trimester, 38 cases (31.6% in the second trimester & 62 cases (51.6s% in the

  13. Donor deferral due to anemia: A tertiary care center-based study

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    Bahadur Shalini

    2011-01-01

    Full Text Available Background: The minimum hemoglobin cutoff for blood donation in India is 12.5 gm% for both male and female donors and the minimum donation interval is 3 months. Donation of one unit of blood results in decrease in hemoglobin by 1 gm% and loss of 200-250 mg of iron. Donor deferral due to anemia is one of the major reasons of temporary rejection of blood donors. In the absence of further workup or advise, it results in loss of valuable donor base. Aim and Objective: To provide baseline information regarding the prevalence and spectrum of anemia in prospective blood donors to help plan a future strategy for donor management. Materials and Methods: Hemoglobin testing of donors was performed using Hemocue and Copper sulfate specific gravity method. Ethylene diamine tetraacetic acid sample of all the donors who failed either or both the screening tests was tested on automated analyzer for evaluation of hemoglobin and red blood cell indices. Results: Of all the donors, 15.5% were deferred due to anemia. Prevalence of anemia in prospective blood donors was 1.8%. It was significantly higher in female donors compared with male donors (34.2% vs 1.2%. The most common type of anemia was normocytic normochromic.

  14. Iron Supplementation, Response in Iron-Deficiency Anemia: Analysis of Five Trials.

    Science.gov (United States)

    Okam, Maureen M; Koch, Todd A; Tran, Minh-Ha

    2017-08-01

    Oral iron-replacement therapy is the mainstay of treatment for iron-deficiency anemia, but it is often poorly tolerated or ineffective. Hemoglobin response at day 14 of oral iron may be useful in assessing whether and when to transition patients from oral to intravenous (IV) iron. Pooled data from 5 randomized trials were analyzed to compare oral and IV iron-replacement therapy for iron-deficiency anemia. Treatment criteria and assignment to oral versus IV iron were defined per protocol; this analysis included only subjects receiving oral iron. Responders were subjects with ≥1.0-g/dL increases in hemoglobin at day 14, and nonresponders were those with smaller increases. Demographic and clinical characteristics were evaluated for association with hemoglobin response at multiple timepoints. Most subjects (72.8%) were classified as responders. The proportion of subjects with hemoglobin increases ≥1.0, ≥2.0, and ≥3.0 g/dL was greatest among those with postpartum anemia, intermediate among those with heavy uterine bleeding or gastrointestinal-related causes of anemia, and lowest among those with other causes; this proportion was also significantly greater among responders than nonresponders. A ≥1.0-g/dL increase in hemoglobin on day 14 most accurately predicted satisfactory overall hemoglobin response to oral iron on day 42/56 (sensitivity 90.1%; specificity 79.3%; positive and negative predictive values of 92.9% and 72.7%, respectively). Iron-replacement therapy improved quality of life and reduced fatigue. Hemoglobin responses <1.0 g/dL at day 14 of oral iron identify subjects with iron-deficiency anemia who should be transitioned to IV iron supplementation. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Prevalence, severity, and related factors of anemia in HIV/AIDS patients

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    Mohsen Meidani

    2012-01-01

    Full Text Available Objective: The prevalence of anemia in HIV infected patients has not been well characterized in Iran. This study aimed to describe the prevalence of anemia and related factors in HIV positive patients. Materials and Methods: In a cross-sectional study, anemia prevalence and risk factors of 212 HIV positive patients were assessed, at the behavioral disease consulting center in Isfahan. The relationship between anemia, demographic variables, and clinical histories were analyzed. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin, 8 g/dL. Results: A total of 212 HIV positive patients with a mean±SD age of 36.1 ± 9.1 years were assessed. We found that hemoglobin levels were between 4.7 and 16.5 gr/dL. In this study, the overall prevalence of anemia was 71%, with the majority of patients having mild to moderate anemia. Mild to moderate anemia and severe anemia occurred in 67% and 4% of patients, respectively. The mean absolute CD4 count was 348 ± 267.8 cells/cubic mm. Sixty one of 212 patients were at late stage of HIV infection (males=51 and female=10. Of the 212 HIV positive patients enrolled, 17 (8% had a positive history of tuberculosis. We found a strong association between anemia and death. Conclusion: Normocytic anemia with decreased reticulocyte count was the most common type of anemia in overall. Prevalence of anemia in this study is relatively higher than other similar studies. Such a high prevalence of anemia needs close monitoring of patients on a zidovudine-based regimen. Better screening for anemia and infectious diseases, and modified harm reduction strategy (HRS for injection drug users are primary needs in HIV seropositive patients.

  16. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... interferes with the body’s ability to make hemoglobin. Family history and genetics Von Willebrand disease is an ... deficiency anemia. Return to Risk Factors to review family history, lifestyle, unhealthy environments, or other factors that ...

  17. A method comparison study between two hemoglobinometer models (Hemocue Hb 301 and Hb 201+) to measure hemoglobin concentrations and estimate anemia prevalence among women in Preah Vihear, Cambodia.

    Science.gov (United States)

    Rappaport, A I; Karakochuk, C D; Whitfield, K C; Kheang, K M; Green, T J

    2017-02-01

    Hemoglobin (Hb) concentration is often measured in global health and nutrition surveys to determine anemia prevalence using a portable hemoglobinometer such as the Hemocue® Hb 201+. More recently, a newer model was released (Hemocue Hb 301) utilizing slightly different methods to measure Hb as compared to the older model. The objective was to measure bias and concordance between Hb concentrations using the Hemocue Hb 301 and Hb 201+ models in a rural field setting. Hemoglobin (Hb) concentration was measured using one finger prick of blood (approximately 10 μL) from 175 Cambodian women (18-49 years) using three Hemocue Hb 201+ and three Hb 301 machines. Bias and concordance were measured and plotted. Overall, mean ± SD Hb concentration was 116 ± 13 g/L using the Hb 201+ and 118 ± 12 g/L using the Hb 301; and anemia prevalence (Hb < 120 g/L) was 58% (n = 102) and 58% (n = 101), respectively. Overall bias ± SD was 2.0 ± 10.5 g/L and concordance (95% CI) was 0.63 (0.54, 0.72). Despite the 2 g/L bias detected between models, anemia prevalence was very similar in both models. The two models measured anemia prevalence comparably in this population of women in rural Cambodia. © 2016 John Wiley & Sons Ltd.

  18. Middle cerebral artery Doppler reference centile charts for the prediction of fetal anemia in a population from India.

    Science.gov (United States)

    Kumar, Manisha; Umrawal, Tarul; Singh, Anuradha

    2017-12-01

    To construct reference charts for the fetal middle cerebral artery (MCA) peak systolic velocity (PSV,) and the corresponding cord blood hemoglobin values at 24-40 weeks of pregnancy for the identification of fetal anemia. In a cross-sectional study, 300 women with a pregnancy duration of 24-40 weeks planned for delivery within 72 hours underwent a Doppler study of the MCA and cord blood hemoglobin estimation at delivery. Regression analysis was used to construct reference charts. The validity of the charts was assessed in 40 fetuses from Rhesus-isoimmunized pregnancies. The MCA PSV and hemoglobin values increased with advancing gestational age. Multiples of the median (MOM) were calculated and reference charts were constructed for mild anemia (MCA PSV 1.29 MOM; hemoglobin 0.8 MOM), moderate anemia (MCA PSV 1.50 MOM; hemoglobin 0.6 MOM), and severe anemia (MCA PSV 1.55 MOM; hemoglobin 0.5 MOM). In the validation sample, the hemoglobin value estimated on the basis of the MCA PSV corresponded with the actual hemoglobin range in 90% of the fetuses. The sensitivity was 92% and the specificity was 95%. The constructed charts are suitable for the evaluation of fetal anemia in the regional population. © 2017 International Federation of Gynecology and Obstetrics.

  19. Anemia em gestantes de municípios das regiões Sul e Centro-Oeste do Brasil Anemia en mujeres enbarazadas de ciudades de regiones Sur y Centro-Oeste de Brasil Anemia in pregnant women from two cities in the South and Mid-West Regions of Brazil

    Directory of Open Access Journals (Sweden)

    Elizabeth Fujimori

    2009-12-01

    hemoglobin lower then 11g/dL were considered having anemia. Social inequity between the two cities was evident. Pregnant women from Cuiabá-MT were significantly poorer then those from Maringá-PR. Anemia prevalence was higher and means of hemoglobin were lower in Cuiabá-MT, apart from gestational age. We found that the age, marital status, number of previous pregnancies, nutritional status and gestational trimester were associated with the level of hemoglobin. Regional differences in the occurrence of anemia are social determined and should be considered in the proposal of interventions in the public health field.

  20. Effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia and improvement of nutritional status in children attending day-care centers in Belo Horizonte, Brazil.

    Science.gov (United States)

    Rocha, Daniela da Silva; Capanema, Flávio Diniz; Netto, Michele Pereira; de Almeida, Carlos Alberto Nogueira; Franceschini, Sylvia do Carmo Castro; Lamounier, Joel Alves

    2011-12-01

    Because of the high prevalence of iron-deficiency anemia in Brazil, individual control measures tend to be ineffective, and fortification of foods with iron is considered the most effective method to fight anemia. To evaluate the effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia in children in day-care centers in Belo Horizonte, Brazil. This before-and-after study evaluated 318 children aged 6 to 74 months. Identification data and data on socioeconomic variables were collected; anthropometric and biochemical measurements were performed before and after 5 months of fortification of water with 5 mg of elemental iron and 50 mg of ascorbic acid per liter. The fortified water was used for drinking and cooking at the day-care center. Wilcoxon's nonparametric test was used to evaluate the differences in continuous variables, and McNemar's test was used to compare the prevalence rates of anemia. The prevalence of anemia decreased significantly from 29.3% before fortification to 7.9% at the end of the study, with a significant increase in hemoglobin levels. Reductions in the prevalence rates of stunting and underweight were observed. Fortification of water with iron and vitamin C significantly reduced the prevalence of anemia and improved nutritional status among children attending day-care centers.

  1. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... Complications Undiagnosed or untreated iron-deficiency anemia may cause the following complications: Depression Heart problems. If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your ...

  2. Reticulocyte parameters in hemoglobinopathies and iron deficiency anemia

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    Cortellazzi Laura C.

    2003-01-01

    Full Text Available Flow cytometric reticulocyte analysis allows the evaluation of reticulocyte maturity. New reticulocyte parameters have been used in the diagnosis and management of anemias, in the bone marrow transplant setting and in the monitoring of iron replacement or erythropoiet in therapy. Reticulocyte numbers and maturation levels have been studied in different hemoglobinopathies and the results have been correlated with the degree of ineffective erythropoiesis. In order to verify differences in reticulocyte parameters in various types of anemias and to test the absolute number of immature reticulocytes as a possible discriminating factor among various types of anemias, reticulocyte counts were performed on 219 samples from patients with sickle cell anemia (SS (n= 62, hemoglobin S trait (n=9, Sbeta thalassemia (n=7, hemoglobin SC disease (n=11, beta thalassemia trait (n=33 and iron deficiency anemia (n= 47, and non-anemic individuals (n= 50. Mean fluorescence index (MFI was defined as representative of the degree of reticulocyte immaturity and it was evaluated as a percentage and in absolute values. Reticulocyte counts and MFI values were significantly higher in SS, Sbeta thalassemic and SC groups when compared to controls, but not different among the three anemia groups. Patients with hemoglobin S trait, iron deficiency anemia and beta thalassemia trait showed reticulocyte parameters similar to the non-anemic group. There was no difference between the b thalassemic trait and iron deficiency anemia in relation to any parameters. MFI in absolute numbers were significantly higher in anemias that develop with the hemolytic process, although this was not evident in MFI percentage values. Our results showed that the erythoid expansion in sickle cell diseases (SS, SC and Sb thalassemia leads to an enhanced immature reticulocyte release from bone marrow and that the phenomena is more evident by the MFI counting in absolute figures than in percentages. We

  3. Fatores associados a anemia por deficiência de ferro em crianças pré-escolares brasileiras Factors associated with iron deficiency anemia in Brazilian preschool children

    Directory of Open Access Journals (Sweden)

    Carlos A. N. de Almeida

    2004-06-01

    Full Text Available OBJETIVO: Avaliar fatores determinantes de anemia e deficiência de ferro em crianças de duas creches da cidade de Pontal, sudeste do Brasil. MÉTODOS: Estudo transversal foi realizado avaliando-se 192 crianças com idades entre 12 e 72 meses. Dados pessoais (idade, sexo, uso de ferro medicamentoso, duração do aleitamento materno, tipo de parto, cuidados pré-natais, peso e estatura e dados socioeconômicos (número de co-habitantes, escolaridade dos pais e renda per capita familiar foram obtidos e correlacionados com hemoglobina, receptores de transferrina, ferritina e anemia ferropriva. RESULTADOS: A idade foi a variável mais afetada pelo estado nutricional de ferro, correlacionando-se com maiores valores de hemoglobina e ferritina e menores valores de receptor de transferrina, sendo que menos anemia ferropriva foi detectada quanto maior a idade. As outras variáveis estudadas não apresentaram correlação com o estado nutricional de ferro. CONCLUSÃO: Os dados sugerem que as estratégias de controle para essa população de crianças pré-escolares devem ser direcionadas especialmente para aquelas de menor idade.OBJECTIVE: To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil. METHODS: Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height, and socioeconomic data (number of co-inhabitants, parental schooling, and per capita family income were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia. RESULTS: Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing

  4. CLASSIFICATION AND DIAGNOSTICS OF ANEMIA IN CHILDREN

    OpenAIRE

    A. G. Rumyantsev

    2011-01-01

    Anemia in children is one of the most frequent somatic diseases. Criteria of anemia diagnosis are strictly regulated as decrease of hemoglobin/erythrocytes level accompanies majority of infectious, inflammatory, autoimmune, hereditary diseases and, in several cases, it is estimated as transitory disease in some periods of children’s growth and development. The article presents main classification and differential diagnostic schemes of anemia. Diagnostics makes accent on laboratory analysis; t...

  5. Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?

    International Nuclear Information System (INIS)

    Bishop, Andrew J.; Allen, Pamela K.; Klopp, Ann H.; Meyer, Larissa A.; Eifel, Patricia J.

    2015-01-01

    Purpose: Previous reports have suggested that anemia increases rates of recurrence after radiation therapy for cervical cancer. However, these studies may not have fully corrected for confounding risk factors. Using a well-characterized cohort of cervical cancer patients, we examined the association between anemia and outcomes before and after the introduction of chemoradiation as standard of care. Methods and Materials: We reviewed the records of 2454 patients who underwent definitive radiation therapy from 1980 through 2011. Minimum hemoglobin level (Hgb min ) was recorded for 2359 patients (96%). Endpoints included freedom from central recurrence (FFCR), freedom from distant metastasis (FFDM), and disease-specific survival (DSS). Results: For the entire cohort, hemoglobin concentrations of 9, 10, and 12 g/dL before and during radiation were all significantly associated with FFCR, FFDM, and DSS (all P<.001) on univariate analysis. However, on multivariate analysis, only Hgb min less than 10 g/dL during RT (RT-Hgb <10 ) remained significant, and it was correlated with lower DSS (P=.02, hazard ratio [HR] = 1.28) and FFDM (P=.03, HR = 1.33) but not with FFCR. In a subset analysis of patients receiving chemoradiation (n=678), RT-Hgb <10 was associated only with DSS (P=.008, HR = 1.49), not with FFCR or FFDM. In this subgroup, despite an association between RT-Hgb <10 and DSS, the use of transfusion was not correlated with benefit. Conclusions: No evidence was found supporting anemia as an independent predictor of central recurrence in patients treated with definitive radiation therapy with or without chemotherapy. Less emphasis on correcting anemia in cervical cancer patients may be warranted

  6. Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Andrew J.; Allen, Pamela K.; Klopp, Ann H. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Meyer, Larissa A. [Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eifel, Patricia J., E-mail: peifel@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-01-01

    Purpose: Previous reports have suggested that anemia increases rates of recurrence after radiation therapy for cervical cancer. However, these studies may not have fully corrected for confounding risk factors. Using a well-characterized cohort of cervical cancer patients, we examined the association between anemia and outcomes before and after the introduction of chemoradiation as standard of care. Methods and Materials: We reviewed the records of 2454 patients who underwent definitive radiation therapy from 1980 through 2011. Minimum hemoglobin level (Hgb{sub min}) was recorded for 2359 patients (96%). Endpoints included freedom from central recurrence (FFCR), freedom from distant metastasis (FFDM), and disease-specific survival (DSS). Results: For the entire cohort, hemoglobin concentrations of 9, 10, and 12 g/dL before and during radiation were all significantly associated with FFCR, FFDM, and DSS (all P<.001) on univariate analysis. However, on multivariate analysis, only Hgb{sub min} less than 10 g/dL during RT (RT-Hgb{sub <10}) remained significant, and it was correlated with lower DSS (P=.02, hazard ratio [HR] = 1.28) and FFDM (P=.03, HR = 1.33) but not with FFCR. In a subset analysis of patients receiving chemoradiation (n=678), RT-Hgb{sub <10} was associated only with DSS (P=.008, HR = 1.49), not with FFCR or FFDM. In this subgroup, despite an association between RT-Hgb{sub <10} and DSS, the use of transfusion was not correlated with benefit. Conclusions: No evidence was found supporting anemia as an independent predictor of central recurrence in patients treated with definitive radiation therapy with or without chemotherapy. Less emphasis on correcting anemia in cervical cancer patients may be warranted.

  7. Determinants of anemia among 6-59 months aged children in Bangladesh: evidence from nationally representative data.

    Science.gov (United States)

    Khan, Jahidur Rahman; Awan, Nabil; Misu, Farjana

    2016-01-11

    Anemia is a global public health problem but the burden of anemia is disproportionately borne among children in developing countries. Anemia in early stages of life has serious consequences on the growth and development of the children. We examine the prevalence of anemia, possible association between anemia and different socio-economic, demographic, health and other factors among children with ages from 6 to 59 months from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). Data on hemoglobin (Hb) concentration among the children aged 6-59 months from the most recent BDHS (2011) were used. This nationally representative survey allowed a multistage stratified cluster sampling design and provided data on a wide range of indicators such as fertility, mortality, women and child health, nutrition and other background characteristics. Anemia status was determined using hemoglobin level (<11.0 g/dl), and weighted prevalence of childhood anemia along with 95 % confidence intervals were provided. We also examined the distribution of weighted anemia prevalence across different groups and performed logistic regression to assess the association of anemia with different factors. A total of 2171 children aged 6-59 months were identified for this analysis, with weighted prevalence of anemia being 51.9 % overall- 47.4 % in urban and 53.1 % in rural regions. Results of a multivariable logistic regression analysis showed that, children below 24 months of age (odds ratio, [OR] 3.01; 95 % confidence interval [CI] 2.38-3.81), and those from an anemic mother (OR 1.80; 95 % CI 1.49-2.18) were at higher risk of anemia. Childhood anemia was significantly associated with chronic malnutrition of child, source of drinking water, household wealth and geographical location (defined by division). A high prevalence of anemia among 6-59 months aged children was observed in Bangladesh. Given the negative impact of anemia on the development of children in

  8. The Influence of Vitamin A Supplementation on Iron Status

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    Patricia H. C. Rondó

    2013-11-01

    Full Text Available Vitamin A (VA and iron deficiencies are important nutritional problems, affecting particularly preschool children, as well as pregnant and lactating women. A PubMed (National Library of Medicine, National Institutes of Health, Bethesda, MD, USA literature review was carried out to search for clinical trials published from 1992 to 2013 that assessed the influence of vitamin A supplementation on iron status. Simultaneous use of iron and vitamin A supplements seemed to be more effective to prevent iron deficiency anemia than the use of these micronutrients alone. Some studies did not include a placebo group and only a few of them assessed vitamin A status of the individuals at baseline. Moreover, the studies did not consider any inflammatory marker and a reasonable number of iron parameters. Another important limitation was the lack of assessment of hemoglobin variants, especially in regions with a high prevalence of anemia. Assessment of hemoglobin variants, inflammatory markers and anemia of chronic inflammation would be important to the studies investigated. Studies involving different populations are necessary to elucidate the interaction between the two micronutrients, especially regarding iron absorption and modulation of erythropoiesis.

  9. The influence of vitamin A supplementation on iron status.

    Science.gov (United States)

    Michelazzo, Fernanda B; Oliveira, Julicristie M; Stefanello, Juliana; Luzia, Liania A; Rondó, Patricia H C

    2013-11-07

    Vitamin A (VA) and iron deficiencies are important nutritional problems, affecting particularly preschool children, as well as pregnant and lactating women. A PubMed (National Library of Medicine, National Institutes of Health, Bethesda, MD, USA) literature review was carried out to search for clinical trials published from 1992 to 2013 that assessed the influence of vitamin A supplementation on iron status. Simultaneous use of iron and vitamin A supplements seemed to be more effective to prevent iron deficiency anemia than the use of these micronutrients alone. Some studies did not include a placebo group and only a few of them assessed vitamin A status of the individuals at baseline. Moreover, the studies did not consider any inflammatory marker and a reasonable number of iron parameters. Another important limitation was the lack of assessment of hemoglobin variants, especially in regions with a high prevalence of anemia. Assessment of hemoglobin variants, inflammatory markers and anemia of chronic inflammation would be important to the studies investigated. Studies involving different populations are necessary to elucidate the interaction between the two micronutrients, especially regarding iron absorption and modulation of erythropoiesis.

  10. Anemia and survival in human immunodeficiency virus

    DEFF Research Database (Denmark)

    Lundgren, Jens Dilling; Mocroft, Amanda

    2003-01-01

    The prospective, multicenter cohort study EuroSIDA has previously reported on predictors and outcomes of anemia in patients infected with human immunodeficiency virus. In a Cox proportional-hazards model with serial measures of CD4+ cell count, plasma viral load, and degrees of anemia fitted...... as time-dependent variables, the relative hazard of death increased markedly for patients with anemia versus no anemia. A clinical scoring system was developed and validated for patients receiving highly active antiretroviral therapy using the most recent laboratory measures. Mild and severe anemia were...... independently (Panemia. The mechanisms underlying why hemoglobin is such a strong prognostic...

  11. Anemia do lactente: etiologia e prevalência Anemia in infancy: etiology and prevalence

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    Maria Claret C.M. Hadler

    2002-01-01

    Full Text Available Objetivo: verificar a prevalência de anemia, anemia ferropriva e deficiência de ferro em lactentes, de unidade pública de saúde, no município de Goiânia, Brasil, analisar e correlacionar as variáveis bioquímicas e hematológicas. Métodos: realizou-se estudo transversal. De 120 mães entrevistadas, foram incluídos 110 lactentes de 6 a 12 meses de idade, a termo e não gemelares. Dados socioeconômicos e hematológicos foram obtidos. Colheu-se sangue venoso dos lactentes em jejum para realização do hemograma completo por contagem eletrônica, ferro sérico, ferritina sérica e proteína C-reativa, os quais foram utilizados na avaliação da etiologia ferropriva nos anêmicos. Crianças com hemoglobina Objective: To verify the prevalence of anemia, iron deficiency anemia and iron deficiency in infants, at a Public Health Unit in the city of Goiânia - Brazil; to analyze and to correlate the hematologic and biochemical variables. Methods: A cross-sectional study was carried out. One hundred and ten full-term infants of the 120 mothers interviewed were included. The infants aged between six and twelve months and there were not twins. Socioeconomic and hematologic data was obtained. Venous blood was taken from fasting infants in order to carry out a complete hemogram through electronic cell counting, serum iron, serum ferritin and C-reactive protein, which were used in the evaluation of the etiology of iron deficiency in the anemic infants. Children with hemoglobin < 11g/dL were considered anemic. Results: The prevalence of anemia was 60.9%. In the diagnosis of the iron deficiency etiology in infants without an inflammation process, when considering the alteration of hemoglobin plus two more indices among mean corpuscular volume (MCV or mean corpuscular hemoglobin (MCH or serum ferritin or serum iron, the prevalence of the iron deficiency was 87%. Nevertheless, when red cell distribution width (RDW was included in the indices, the

  12. Anemia of chronic disease is the more frequent type of anemia seen in patients with chronic idiopathic neutropenia of adults.

    Science.gov (United States)

    Papadaki, H A; Eliopoulos, D G; Valatas, V; Eliopoulos, G D

    2001-04-01

    This study describes the frequency and the type of anemia seen in patients with nonimmune chronic idiopathic neutropenia of adults (NI-CINA). We found that NI-CINA patients had low hemoglobin levels and increased serum concentrations of erythropoietin (EPO), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1beta (IL-1beta). The hemoglobin levels correlated positively with the number of circulating neutrophils and inversely with the levels of EPO and TNF-alpha but not of IL-1beta. Anemia, defined as the reduction of the hemoglobin below 12.0 g/dl for women and 13.3 g/dl for men, was found in 23 out of 148 patients studied, a proportion of 15.5%. Two of the anemic patients had iron deficiency anemia (8.7%), 11 had anemia of chronic disease (ACD; 47.8%) presenting with normal or slightly reduced erythrocytic indices, low serum iron, and increased serum ferritin, and the remaining ten had anemia of undefined pathogenesis (AUP; 43.5%) with normal or slightly decreased erythrocytic indices, serum iron ranging from 43 to 88 microg/dl, and ferritin values ranging from 12 to 50 ng/ml. We conclude that ACD is the more frequent type of anemia seen in patients with NI-CINA, and that pro-inflammatory cytokines, notably TNF-alpha, may be involved in the pathogenesis of both ACD and AUP, given that serum levels of the cytokine were significantly increased and that the EPO response to anemia was blunted in these patients. These findings further support our previously reported suggestion for the possible existence, in NI-CINA patients, of an unrecognized low-grade chronic inflammatory process that may be involved in the pathogenesis of the disorder.

  13. Prevalence of anemia in children 1 to 12 years of age: results from a nationwide probabilistic survey in Mexico

    Directory of Open Access Journals (Sweden)

    Villalpando Salvador

    2003-01-01

    Full Text Available OBJECTIVE: To describe the epidemiology and analyze factors associated with iron deficiency anemia in a probabilistic sample of the Encuesta Nacional de Nutrición 1999 (ENN-99 [National Nutritional Survey 1999 (NNS-99]. MATERIAL AND METHODS: The sample included 8 111 children aged 1 to 12 years, and was nationaly representative by rural and urban strata and by four geographical regions. Capillary hemoglobin was measured using a portable photometer (HemoCue. The analysis of the determining factors of anemia was performed by odds ratios derived from a logistic regression model and multiple regression models. RESULTS: The prevalence of anemia was 50% in infants <2 years of age, with no significant differences between urban and rural strata or among regions. It varied between 14 and 22% in 6-11 year-old children and was higher in the South region and among the indigenous children. Dietary intake of iron was 50% of the recommended daily allowance in children <2 years of age, but not in older children. Phytate (»500-800 mg/d and tannin (»19 mg/d intakes were very high in children over 7 years of age. Hemoglobin was positively associated with nutritional status of children (p=0.01, socioeconomic status (p range 0.05-0.001, duration of lactation in children under 2 years of age (p=0.1, and iron and calcium intake (p=0.02, but not with folic acid or vitamin B12 intake. Hemoglobin was negatively associated with maternal education (p=0.01 in older children, but not in those under 2 years of age. CONCLUSIONS: We present evidence of an alarming national epidemic of anemia, particularly marked in children 12 to 24 months of age. The control of anemia should be considered as an urgent national concern given its grave consequences on the physical and mental development of these children and on their long-term health.

  14. The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review.

    Science.gov (United States)

    Chan, Lingtak-Neander; Mike, Leigh Ann

    2014-08-01

    Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach. © 2014 American Society for Parenteral and Enteral Nutrition.

  15. Individualized drug dosing using RBF-Galerkin method: Case of anemia management in chronic kidney disease.

    Science.gov (United States)

    Mirinejad, Hossein; Gaweda, Adam E; Brier, Michael E; Zurada, Jacek M; Inanc, Tamer

    2017-09-01

    Anemia is a common comorbidity in patients with chronic kidney disease (CKD) and is frequently associated with decreased physical component of quality of life, as well as adverse cardiovascular events. Current treatment methods for renal anemia are mostly population-based approaches treating individual patients with a one-size-fits-all model. However, FDA recommendations stipulate individualized anemia treatment with precise control of the hemoglobin concentration and minimal drug utilization. In accordance with these recommendations, this work presents an individualized drug dosing approach to anemia management by leveraging the theory of optimal control. A Multiple Receding Horizon Control (MRHC) approach based on the RBF-Galerkin optimization method is proposed for individualized anemia management in CKD patients. Recently developed by the authors, the RBF-Galerkin method uses the radial basis function approximation along with the Galerkin error projection to solve constrained optimal control problems numerically. The proposed approach is applied to generate optimal dosing recommendations for individual patients. Performance of the proposed approach (MRHC) is compared in silico to that of a population-based anemia management protocol and an individualized multiple model predictive control method for two case scenarios: hemoglobin measurement with and without observational errors. In silico comparison indicates that hemoglobin concentration with MRHC method has less variation among the methods, especially in presence of measurement errors. In addition, the average achieved hemoglobin level from the MRHC is significantly closer to the target hemoglobin than that of the other two methods, according to the analysis of variance (ANOVA) statistical test. Furthermore, drug dosages recommended by the MRHC are more stable and accurate and reach the steady-state value notably faster than those generated by the other two methods. The proposed method is highly efficient for

  16. Prevalência e caracterização da anemia em idosos do Programa de Saúde da Família Prevalence and characteristics of anemia in an elderly population attending a Health Family Program

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    Diana L. Barbosa

    2006-12-01

    concentration, mean cell volume and red cell distribution width. The prevalence of anemia was around 11.0%. Red cell distribution width and mean cell volume were not correlated to hemoglobin count. The major characteristics of anemia were normochromia with normocytosis without anisocytosis suggesting anemia due to chronic diseases. The very low prevalence of microcytosis, macrocytosis and anisocytosis seems to be more likely due to causes other than iron, vitamin B12 or folic acid deficiencies. The use of indicators that reflect the degree of anisocytosis, as well as parameters to assess iron status should be strongly recommended in the screening of anemia in the elderly population.

  17. An Etiologic Profile of Anemia in 405 Geriatric Patients

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    Tabea Geisel

    2014-01-01

    Full Text Available Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients. Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine in addition to medical history and demographics. Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1% in a mild form. Anemia was primarily due to iron deficiency (65%, frequently due to underlying chronic infection (62.1%, or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role. Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.

  18. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... the Eunice Kennedy Shriver National Institute of Child Health and Human Development, we are investigating how best to treat premature newborns with low hemoglobin levels. We also are hoping to determine which iron supplements work best to treat iron-deficiency anemia in children ...

  19. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... with the Eunice Kennedy Shriver National Institute of Child Health and Human Development, we are investigating how best to treat premature newborns with low hemoglobin levels. We also are hoping to determine which iron supplements work best to treat iron-deficiency anemia in children ...

  20. The relationship between Type D personality, affective symptoms and hemoglobin levels in chronic heart failure.

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    Nina Kupper

    Full Text Available BACKGROUND: Anemia is associated with poor prognosis in heart failure (HF patients. Contributors to the risk of anemia in HF include hemodilution, renal dysfunction and inflammation. Hemoglobin levels may also be negatively affected by alterations in stress regulatory systems. Therefore, psychological distress characterized by such alterations may adversely affect hemoglobin in HF. The association between hemoglobin and Type D personality and affective symptomatology in the context of HF is poorly understood. AIM: To examine the relationship between Type D personality and affective symptomatology with hemoglobin levels at inclusion and 12-month follow-up, controlling for relevant clinical factors. METHODS: Plasma levels of hemoglobin and creatinine were assessed in 264 HF patients at inclusion and at 12-month follow-up. Type D personality and affective symptomatology were assessed at inclusion. RESULTS: At inclusion, hemoglobin levels were similar for Type D and non-Type D HF patients (p = .23, and were moderately associated with affective symptomatology (r = -.14, p = .02. Multivariable regression showed that Type D personality (β = -.15; p = .02, was independently associated with future hemoglobin levels, while controlling for renal dysfunction, gender, NYHA class, time since diagnosis, BMI, the use of angiotensin-related medication, and levels of affective symptomatology. Change in renal function was associated with Type D personality (β = .20 and hemoglobin at 12 months (β = -.25. Sobel mediation analysis showed significant partial mediation of the Type D - hemoglobin association by renal function deterioration (p = .01. Anemia prevalence increased over time, especially in Type D patients. Female gender, poorer baseline renal function, deterioration of renal function and a longer HF history predicted the observed increase in anemia prevalence over time, while higher baseline hemoglobin was protective

  1. Anemia prevalence in children and adolescents from educational centers in the outskirts of Londrina, PR, Brazil

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    MIGLIORANZA Lúcia Helena da Silva

    2002-01-01

    Full Text Available Iron deficiency anemia is the world most prevalent nutritional problem. To investigate anemia prevalence and its relation to nutritional status, 526 children and adolescents, 284 males and 242 females, aged 7 to 14 years old, were evaluated. The studied subjects take part in a program of the Social Action Department of the city of Londrina, state of Paraná, and attend Public Educational Centers which provides them three daily meals and pedagogic assistance. These individuals belong to deprived areas in the city outskirts, where the per capita income is lower than US$500 a year. The hemoglobin dosage was determined by digital puncture and read by Hemocue portable photometer. Anemia prevalence was verified in 41.3% of the assessed population, with no significant statistical differences between males and females (p=0.412. No association between anemia and malnutrition was found. In conclusion, high prevalence of anemia was observed in this population.

  2. Association between food insecurity and anemia among women of reproductive age

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    Bishwajit Ghose

    2016-05-01

    Full Text Available Background: Food insecurity and hidden hunger (micronutrient deficiency affect about two billion people globally. Household food insecurity (HFI has been shown to be associated with one or multiple micronutrient (MMN deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh. Methodology: Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011. Food security was measured by the Household Food Insecurity Access Scale (HFIAS. Capillary hemoglobin concentration (Hb measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods. Results: Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840–1.082, wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176–1.594; and average: p = 0.030; 95%CI = 1.017–1.398, educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132–1.439 and household food insecurity (p < 0.001; 95%CI = 1.348–1.830. Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts. Conclusion: HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken

  3. Anemia ancilostomótica: estudo da fisiopatologia Ancylostomotic anemia: a contribution to the study of its physiopathology

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    Victório Maspes

    1981-12-01

    Full Text Available Foram estudados 17 casos de ancilostomose e determinados alguns parâmetros hematológicos como: dosagem de hemoglobina, do ferro sérico e da transferrina, contagem de hemácias, hematócrito, volume corpuscular médio (VCM e hemoglobina corpuscular média (HCM. O estudo incluiu também a obtenção de alguns dados eritrocinéticos, como a determinação da velocidade de decaimento do ferro plasmático (T1V2 do 59Fe e da incorporação do ferro à hemoglobina. O estudo radioisotópico permitiu ainda determinar o volume de sangue e a quantidade de hemoglobina perdida nas fezes, bem como o teor de ferro reabsorvido dessa hemoglobina. Estabeleceram também o grau de infecção através da contagem de ovos e de vermes nas fezes. Os doentes não apresentaram evidente alteração nutricional. A carência de ferro foi o fator comum a todos os casos que exibiram anemia, constituindo a base fisiopatológica da anemia ancilostomótica. O verme fixado à mucosa duodenal suga o sangue do hospedeiro e esta espoliação de sangue a longo prazo provoca a anemia. O volume de sangue perdido é geralmente proporcional ao grau de infecção, mas a quantidade de hemoglobina perdida mostrou ser independente do volume de sangue espoliado. A reabsorção de grande parte do ferro da hemoglobina perdida na luz intestinal concorre para que a anemia se estabeleça mais tardiamente que em outras hemorragias como a vaginal. Os indivíduos anêmicos foram submetidos a transfusões de sangue e com isso apresentaram melhora clínica e laboratorial, imediata mas temporária. A cura clínica foi estabelecida somente após tratamento adequado com vermífugos.Seventeen ancylostomotic patients was studied and several hematological parameters: hemoglobin level, serum iron level and transferrin, erythrocyte count, hematocrit, mean corpuscular volume (VCM and mean corpuscular hemoglobin (HCM was established. This study also included the determination of several erythrokinetic data

  4. A microfluidic approach for hemoglobin detection in whole blood

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    Nikita Taparia

    2017-10-01

    Full Text Available Diagnosis of anemia relies on the detection of hemoglobin levels in a blood sample. Conventional blood analyzers are not readily available in most low-resource regions where anemia is prevalent, so detection methods that are low-cost and point-of-care are needed. Here, we present a microfluidic approach to measure hemoglobin concentration in a sample of whole blood. Unlike conventional approaches, our microfluidic approach does not require hemolysis. We detect the level of hemoglobin in a blood sample optically by illuminating the blood in a microfluidic channel at a peak wavelength of 540 nm and measuring its absorbance using a CMOS sensor coupled with a lens to magnify the image onto the detector. We compare measurements in microchannels with channel heights of 50 and 115 μm and found the channel with the 50 μm height provided a better range of detection. Since we use whole blood and not lysed blood, we fit our data to an absorption model that includes optical scattering in order to obtain a calibration curve for our system. Based on this calibration curve and data collected, we can measure hemoglobin concentration within 1 g/dL for severe cases of anemia. In addition, we measured optical density for blood flowing at a shear rate of 500 s-1 and observed it did not affect the nonlinear model. With this method, we provide an approach that uses microfluidic detection of hemoglobin levels that can be integrated with other microfluidic approaches for blood analysis.

  5. A microfluidic approach for hemoglobin detection in whole blood

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    Taparia, Nikita; Platten, Kimsey C.; Anderson, Kristin B.; Sniadecki, Nathan J.

    2017-10-01

    Diagnosis of anemia relies on the detection of hemoglobin levels in a blood sample. Conventional blood analyzers are not readily available in most low-resource regions where anemia is prevalent, so detection methods that are low-cost and point-of-care are needed. Here, we present a microfluidic approach to measure hemoglobin concentration in a sample of whole blood. Unlike conventional approaches, our microfluidic approach does not require hemolysis. We detect the level of hemoglobin in a blood sample optically by illuminating the blood in a microfluidic channel at a peak wavelength of 540 nm and measuring its absorbance using a CMOS sensor coupled with a lens to magnify the image onto the detector. We compare measurements in microchannels with channel heights of 50 and 115 μm and found the channel with the 50 μm height provided a better range of detection. Since we use whole blood and not lysed blood, we fit our data to an absorption model that includes optical scattering in order to obtain a calibration curve for our system. Based on this calibration curve and data collected, we can measure hemoglobin concentration within 1 g/dL for severe cases of anemia. In addition, we measured optical density for blood flowing at a shear rate of 500 s-1 and observed it did not affect the nonlinear model. With this method, we provide an approach that uses microfluidic detection of hemoglobin levels that can be integrated with other microfluidic approaches for blood analysis.

  6. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan.

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    Baig-Ansari, Naila; Badruddin, Salma Halai; Karmaliani, Rozina; Harris, Hillary; Jehan, Imtiaz; Pasha, Omrana; Moss, Nancy; McClure, Elizabeth M; Goldenberg, Robert L

    2008-06-01

    Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal morbidity and mortality and to low birthweight. To determine the prevalence of anemia and the dietary and socioeconomic factors associated with anemia in pregnant women living in an urban community setting in Hyderabad, Pakistan. This was a prospective, observational study of 1,369 pregnant women enrolled at 20 to 26 weeks of gestation and followed to 6 weeks postpartum. A blood sample was obtained at enrollment to determine hemoglobin levels. Information on nutritional knowledge, attitudes, and practice and dietary history regarding usual food intake before and during pregnancy were obtained by trained interviewers within 1 week of enrollment. The prevalence of anemia (defined by the World Health Organization as hemoglobin hemoglobin from 9.0 to 10.9 g/dL) and 14.8% had moderate anemia (hemoglobin from 7.0 to 8.9 g/dL). Only 0.7% were severely anemic (hemoglobin education, pregnancy history, iron supplementation, and height showed that drinking more than three cups of tea per day before pregnancy (adjusted prevalence odds ratio [aPOR], 3.2; 95% confidence interval [CI], 1.3 to 8.0), consumption of clay or dirt during pregnancy (aPOR, 3.7; 95% CI, 1.1 to 12.3), and never consuming eggs or consuming eggs less than twice a week during pregnancy (aPOR, 1.7; 95% CI, 1.1 to 2.5) were significantly associated with anemia. Consumption of red meat less than twice a week prior to pregnancy was marginally associated with anemia (aPOR, 1.2; 95% CI, 0.8 to 1.8) but was significantly associated with lower mean hemoglobin concentrations (9.9 vs. 10.0 g/dL, p = .05) during the study period. A subanalysis excluding women with mild anemia found similar associations to those of the main model, albeit even stronger. A high percentage of women at 20 to 26 weeks of pregnancy had mild to moderate anemia. Pica, tea consumption, and low intake of eggs and red meat were associated with

  7. Iron-Deficiency Anemia

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    Full Text Available ... This is sometimes used to deliver iron through a blood vessel to increase iron levels in the blood. One benefit of IV iron ... over 65 years of age had low hemoglobin levels. This was associated with a greater risk of death even with mild anemia. ...

  8. Iron-Deficiency Anemia

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    Full Text Available ... to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, ... Kennedy Shriver National Institute of Child Health and Human Development, we are investigating how best to treat premature newborns with low hemoglobin ... resources Your Guide to Anemia [PDF, 1. ...

  9. Iron-Deficiency Anemia

    Medline Plus

    Full Text Available ... with the Eunice Kennedy Shriver National Institute of Child Health and Human Development, we are investigating how best to treat premature newborns with low hemoglobin levels. We also are hoping to determine which iron ... anemia in children who do not consume the daily recommended amount ...

  10. Unexpected Anemia and Reticulocytopenia in an Adolescent With Sickle Cell Anemia Receiving Chronic Transfusion Therapy.

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    Blauel, Emily R; Grossmann, Lily T; Vissa, Madhav; Miller, Scott T

    2015-10-01

    In a patient with sickle cell disease receiving chronic transfusion, exacerbation of anemia with reticulocytopenia must prompt consideration of a delayed hemolytic transfusion reaction with hyperhemolysis, as further transfusion may worsen this condition; definitive diagnosis is sometimes difficult. Anemia evolving during parvovirus B19-induced erythroid hypoplasia (transient aplastic crisis) should be attenuated in chronic transfusion patients due to superior survival of transfused over endogenous red blood cells. A 16-year-old with sickle cell disease receiving chronic transfusion of modified intensity (goal to maintain hemoglobin S<50%) who developed symptomatic anemia with reticulocytopenia was later shown to have had transient aplastic crisis.

  11. Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

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    Eloísa Urrechaga

    2013-01-01

    Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

  12. Anemia, tumor hypoxemia, and the cancer patient

    International Nuclear Information System (INIS)

    Varlotto, John; Stevenson, Mary Ann

    2005-01-01

    Purpose: To review the impact of anemia/tumor hypoxemia on the quality of life and survival in cancer patients, and to assess the problems associated with the correction of this difficulty. Methods: MEDLINE searches were performed to find relevant literature regarding anemia and/or tumor hypoxia in cancer patients. Articles were evaluated in order to assess the epidemiology, adverse patient effects, anemia correction guidelines, and mechanisms of hypoxia-induced cancer cell growth and/or therapeutic resistance. Past and current clinical studies of radiosensitization via tumor oxygenation/hypoxic cell sensitization were reviewed. All clinical studies using multi-variate analysis were analyzed to show whether or not anemia and/or tumor hypoxemia affected tumor control and patient survival. Articles dealing with the correction of anemia via transfusion and/or erythropoietin were reviewed in order to show the impact of the rectification on the quality of life and survival of cancer patients. Results: Approximately 40-64% of patients presenting for cancer therapy are anemic. The rate of anemia rises with the use of chemotherapy, radiotherapy, and hormonal therapy for prostate cancer. Anemia is associated with reductions both in quality of life and survival. Tumor hypoxemia has been hypothesized to lead to tumor growth and resistance to therapy because it leads to angiogenesis, genetic mutations, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy. Nineteen clinical studies of anemia and eight clinical studies of tumor hypoxemia were found that used multi-variate analysis to determine the effect of these conditions on the local control and/or survival of cancer patients. Despite differing definitions of anemia and hypoxemia, all studies have shown a correlation between low hemoglobin levels and/or higher amounts of tumor hypoxia with poorer prognosis. Radiosensitization through improvements in tumor oxygenation/hypoxic cell

  13. Infection by Intestinal Parasites, Stunting and Anemia in School-Aged Children from Southern Angola.

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    Oliveira, Dinamene; Ferreira, Filipa Santana; Atouguia, Jorge; Fortes, Filomeno; Guerra, António; Centeno-Lima, Sónia

    2015-01-01

    Intestinal parasites are responsible for morbidity in children worldwide, especially in low income countries. In the present study we determine the prevalence of intestinal parasites and explore its association with anemia and stunting in school-aged children. A cross-sectional study was conducted from September to October 2010 enrolling 328 children attending the primary school in Lubango, the second largest city after the capital Luanda. Stool samples were collected for parasite detection through microscopy and molecular identification of Entamoeba histolytica and Entamoeba dispar. Stunting was assessed using the z-scores of height for age and hemoglobin concentration was determined using a portable hemoglobin analyzing system. The global prevalence of pathogenic intestinal parasites was 44.2%, the most common being Ascaris lumbricoides (22.0%), Giardia lamblia (20.1%) and Hymenolepis nana (8.8%). Molecular detection revealed that 13.1% of the children carried E. dispar and 0.3% were infected with E. histolytica. The prevalence of stunting (mild to severe) was 41.5%. Stunting was more frequent in older children (p = 0.006, OR = 1.886), while anemia was more frequent in younger children (p = 0.005, OR = 2.210). The prevalence of anemia was 21.6%, and we found a significant association with infection by H. nana (p = 0.031, OR = 2.449). This is one of the few published studies reporting intestinal parasites infection, nutritional status and anemia in children from Angola. Furthermore, the present work highlights the importance of regular intestinal parasites screening in children.

  14. Association of Living Arrangement Conditions and Socioeconomic Differentials with Anemia Status among Women in Rural Bangladesh

    Science.gov (United States)

    Tang, Shangfeng; Hossain, Akmal; Fan, Yang; Akter, Mahmuda

    2016-01-01

    In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p = 0.014; OR = 1.195; 95% CI = 1.036–1.378) and microcredit membership (p = 0.014; OR = 1.19; 95% CI = 1.037–1.386). Regarding the household arrangements, women utilizing biomass fuel for cooking (p < 0.019; OR = 1.82; 95% CI = 0.981–2.460) were more likely to be anemic. PMID:27517045

  15. Association of Living Arrangement Conditions and Socioeconomic Differentials with Anemia Status among Women in Rural Bangladesh

    Directory of Open Access Journals (Sweden)

    Ghose Bishwajit

    2016-01-01

    Full Text Available In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p=0.014; OR = 1.195; 95% CI = 1.036–1.378 and microcredit membership (p=0.014; OR = 1.19; 95% CI = 1.037–1.386. Regarding the household arrangements, women utilizing biomass fuel for cooking (p<0.019; OR = 1.82; 95% CI = 0.981–2.460 were more likely to be anemic.

  16. Association of Living Arrangement Conditions and Socioeconomic Differentials with Anemia Status among Women in Rural Bangladesh.

    Science.gov (United States)

    Bishwajit, Ghose; Yaya, Sanni; Tang, Shangfeng; Hossain, Akmal; Fan, Yang; Akter, Mahmuda; Feng, Zhanchun

    2016-01-01

    In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p = 0.014; OR = 1.195; 95% CI = 1.036-1.378) and microcredit membership (p = 0.014; OR = 1.19; 95% CI = 1.037-1.386). Regarding the household arrangements, women utilizing biomass fuel for cooking (p < 0.019; OR = 1.82; 95% CI = 0.981-2.460) were more likely to be anemic.

  17. Distribuição da anemia em pré-escolares do semi-árido da Bahia Distribution of anemia among preschool children from the semi-arid region of Bahia

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    Ana Marlúcia O. Assis

    1997-04-01

    Full Text Available O objetivo desta investigação foi identificar a prevalência da anemia e alguns de seus potenciais determinantes em 754 crianças de áreas urbanas de sete municípios na região do semi-árido baiano. Hemoglobina foi determinada em 745 crianças de um a 72 meses de idade. Para o grupo etário de seis a 72 meses um valor de hemoglobina The objective of this survey was to determine the prevalence of anemia and potential determinants thereof in 754 children from urban areas of seven small towns in the semi-arid region of Bahia. Hemoglobin was measured in 745 children 1 to 72 months of age. For the 6-to-72 month-old group, hemoglobin < 11.0 g/dl was considered anemia (following WHO recommendations whereas <9.5 g/dl was considered severe anemia. The same cutoffs were used for children under 6 months, which are the same ones used in clinical-hematology. A mean hemoglobin of 12.1 g/dl was found, distributed differently according to age groups (p=0.001. The study found prevalences of 22.2 % for anemia and 5.8% for severe anemia, respectively. Occurrence of anemia varied significantly with age (p=0.001; the highest prevalence was 50.0% in children 12 to 23 months of age, followed by 29.9% in children below 12 months. The association of anemia with mother's education (controlled for age and per capita family income was not statistically significant.

  18. Prevalence and severity of anemia in pediatric hemodialysis patients, a single center study

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    Afshin Azhir

    2006-12-01

    Full Text Available BACKGROUNDS: This study was conducted to determine the prevalence and severity of anemia in children and adolescents on chronic hemodialysis, and to identify independent predictors of anemia in children on hemodialysis. METHODS: This cross-sectional study was performed between September 2005 and January 2006. The study population consisted of 25 patients aged 7−20 years on chronic hemodialysis from pediatric hemodialysis centers in Isfahan. RESULTS: A total of 22 (88% patients had hemoglobin levels of <11 g/dL (anemic and 12 patients (48% had hemoglobin levels of <8 g/dL (severe anemia. The mean age of these patients was 15.5 ± 3.7 years. Mean time on chronic dialysis was 20.44 ± 15.25 months. Anemia was more common and more severe among children who were on dialysis for less than 6 months. There was an inverse relationship between the severity of anemia and duration of hemodialysis (P = 0.019, r = – 0.465. Nearly all patients were treated with erythropoietin, Children with more severe anemia received slightly higher dose of erythropoietin (P = 0.09, r = 0.202. There was a significant difference between serum albumin values in anemic patients and patients without anemia (P = 0.023. There was a correlation between serum albumin and hemoglobin level (r = 0.511, P = 0.01. Intact PTH levels were >200 pg/ml in 16 patients (66% and >400 pg/ml in 9 patients (37. 5%. There was a reverse correlation between intact PTH level >200 pg/ml and hemoglobin level (r = -0.505, P = 0.046. CONCLUSIONS: The prevalence of anemia in hemodialysis children in Isfahan appears to be higher than that reported in the other studies in spite of extensive use of rHuEPO and iron supplementation. We found this to be especially true for patients new on hemodialysis (less than 6 months and in those with low albumin and severe hyperparathyroidism. KEY WORDS: Hemodialysis, anemia, children.

  19. Elliptocytes and tailed poikilocytes correlate with severity of iron-deficiency anemia.

    Science.gov (United States)

    Rodgers, M S; Chang, C C; Kass, L

    1999-05-01

    This study examines the relationships between abnormal RBC morphology, RBC indices measured with an automated hematology analyzer, serum iron studies, and severity of anemia in patients with findings indicative of iron-deficiency anemia. Counts and morphologic classification of 1,000 RBCs from each of 22 patients were performed, and correlations were determined between parameters. The Student t test was used to determine the level of significance for correlations between parameters. Several significant relationships were found. As the percentage of elliptocytes increased, hemoglobin concentration, hematocrit, RBC concentration, and mean corpuscular hemoglobin level decreased (r = .48, .44, .40, and .49, respectively; P < .05). As the percentage of tailed poikilocytes increased, hemoglobin concentration, hematocrit, and RBC concentration decreased (r = .70, .77, and .71, respectively; P < .01) and RBC distribution width increased (r = .73; P < .01). Of significance, serum ferritin levels, long considered the best single indicator of iron deficiency, showed no correlation with the morphologic abnormalities assessed, severity of anemia, or any of the analyzer-generated indices. Our results indicate that microscopic evaluation of RBC morphology remains an important tool for the pathologist to evaluate the severity of anemia in patients with iron deficiency.

  20. A Micronutrient Fortified Beverage Given at Different Dosing Frequencies Had Limited Impact on Anemia and Micronutrient Status in Filipino Schoolchildren

    Science.gov (United States)

    Angeles-Agdeppa, Imelda; Magsadia, Clarita R.; Aaron, Grant J.; Lloyd, Beate B.; Hilmers, David C.; Bhutta, Zulfiqar A.

    2017-01-01

    This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations. PMID:28895887

  1. HUBUNGAN ANTARA ANEMI DAN STATUS BESI DENGAN STATUS IMUNITAS PADA ANAK YANG MENDAPAT VAKSINASI CAMPAK

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    Susi Suwarti Suwardi

    2012-11-01

    Full Text Available THE RELATIONSHIP BETWEEN ANEMIA AND IRON STATUS WITH IMMUNE STATUS OF CHILDREN VACCINATED WITH MEASLES VACCINE.Background: Anemia, especially caused by iron deficiency, is one of several health problems in Indonesian children below 5 years of age. That condition seems appear in young children whose food is lack of iron. When those children are going to be vaccinated, how will the result be?.Objective: We sought to determine the relationship between anemia and iron with immune status of children who have got measles vaccine.Method: The study was conducted in village of Bantarjaya district of Bogor, from June 1997 to February 1998 in 86 children above 9 months old who received measles vaccines in local Post Integrated Service (Posyandu. Before intervention, data on physical examination, weight, height, hemoglobin, hematocrit serum ferritin, free erythrocyte protoporphyrin (FEP and measle immunoglobin G were obtained from all Subjects. Information on morbidity, socioeconomic, environment and food consumption also were recorded. After intervention or six mouths later, the same data were collected again.Results: Subjects were divided into two group; (1 anemic group (Hb<11 g/dl consisting of 46 subjects (53,5% and (2 non anemic group (Hb>11 g/dl with 40 subjects (45,5%. The study revealed that 27,9% subjects have iron deficiency and 43,0% suffered from iron deficiency anemia. Six months after vaccination, the level of measles IgG was increased in 87,4% subjects. The measle IgG level of the non anemic group was increased significantly, but was not significant for the anemic group.Conclusions: There were no relationship between iron status and immune status but however anemic condition influenced the level of measles IgG.Key Words: iron status, anemia, immunoglobulin G.

  2. Is Doppler prediction of anemia effective in the growth-restricted fetus?

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    Makh, D S; Harman, C R; Baschat, A A

    2003-11-01

    To evaluate the utility of middle cerebral artery (MCA) and umbilical artery (UA) Doppler to predict anemia in intrauterine growth restricted (IUGR) fetuses. Fetuses with an abdominal circumference complete blood count was determined from a peripheral venous sample drawn at delivery. Anemia was defined as a hemoglobin value of references ranges by Mari et al. and Kurmanavicius et al.) were related to hemoglobin using linear regression analysis. In addition, UA absent end-diastolic velocity (AEDV), brain sparing (MCA PI > 2 SDs below gestational age mean), low CPR (> 2 SDs below gestational age mean) and an elevated MCA PSV (> 2 SDs) were evaluated for their predictive accuracy for anemia. Of 97 IUGR neonates 23 were anemic (23.7%). The MCA PSV was significantly related to hemoglobin using either reference range (Mari et al., F = 22.1577, Kurmanavicius et al., F = 21.8188, P < 0.001, respectively). However, using categorical cut-offs as well as regression analysis none of the Doppler parameters could be identified to provide clinically useful prediction of anemia. Parameters of MCA and UA vascular impedance and MCA PSV are significantly related to anemia in IUGR neonates. Despite this relationship the predictive accuracy is unacceptable for the clinical application in the setting of IUGR. Altered cardiovascular dynamics in IUGR fetuses may be responsible for this effect. Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.

  3. Oxygen Status Parameters as Markers of Renal Dysfunction in Neonatal Infants with Critical Status

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    Ye. V. Parshin

    2010-01-01

    Full Text Available Objective: to study whether the use of donor blood components can be reduced in patients with baseline anemia during endo-prosthetic replacement of the hip joint. Subjects and methods. The trial was carried out in 262 patients, including 233 patients who had normal preoperative hemoglobin levels and 29 were found to have anemia that was perioperatively corrected using erythropoiesis stimulants (Eprex® (Silag AG, Switzerland. The patients with normal hemoglobin levels were operated on under normotensive spinal anesthesia (SA (n=129 and spinal anesthesia with moderate controlled intraoperative hypotension during infusion of microdoses of adrenaline (n=104. All the patients with baseline anemia were operated on under SA with moderate controlled intraoperative hypotension. Results. Preoperative hemopoiesis stimulation in patients with anemia caused a significant increase in hemoglobin and red blood cells in the preoperative period. The volume of intraoperative, drainage, and total blood losses under SA in patients with intraoperative moderate hypotension was significantly lower than that in those with normotensive SA. Throughout the hospitalization, hemotransfusions during erythropoiesis stimulation were needed in 17% of the patients with baseline anemia, in 7% of those with normal preoperative hemoglobin levels, operated on under SA with moderate intraoperative hypotension, and in 40% of those operated on under normotensive SA. Conclusion. The use of erythropoiesis stimulants during preoperative preparation of patients with baseline anemia makes it possible to substantially elevate hemoglobin before surgery and to avoid its considerable postoperative decrease. That of SA with moderate controlled hypotension during endoprosthetic replacement of the hip joint results in the volume of perioperative blood loss, which permits avoidance of packed donor red blood cells in the majority of patients with preoperative anemia during its correction with

  4. Anemia em menores de seis anos: estudo de base populacional em Pelotas, RS Anemia in children under six: population-based study in Pelotas, Southern Brazil

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    Maria Cecília Formoso Assunção

    2007-06-01

    Full Text Available OBJETIVO: Analisar a prevalência de anemia em crianças menores de seis anos, em uma amostra probabilística de área urbana. MÉTODOS: Foi realizado estudo com crianças de zero a cinco anos de idade, na cidade de Pelotas, RS, em 2004. Foram coletadas informações sobre características demográficas, socioeconômicas, antropométricas, de morbidade e sobre alimentação, por meio de questionário aplicado às mães ou responsáveis. As crianças foram pesadas e medidas. A concentração de hemoglobina foi medida com hemoglobinômetro portátil, HemoCue e anemia foi definida como valores de hemoglobina OBJECTIVE: To assess the prevalence of anemia among children under six years of age in a probabilistic sample from an urban area. METHODS: A study was conducted comprising children aged zero to five years in the city of Pelotas, Southern Brazil, in 2004. Data were collected on demographic, socioeconomic, and anthropometric characteristics, morbidity and nutrition using a questionnaire applied to the mothers and guardians. Children's weight and height measurements were obtained. Hemoglobin concentration was measured using the HemoCue portable hemoglobinometer and anemia was defined as hemoglobin <11 g/dL. The association between anemia and predictors was expressed as prevalence ratio. Multivariate analysis was carried out using Poisson regression following a conceptual model and taking into account the study design effect. RESULTS: There were identified 534 children and total losses and refusals were 27 (5.1%. The prevalence of anemia was 30.2% (95% CI 23.5%;37.0%. In the multivariate analysis, only age and family income remained significantly associated with anemia. CONCLUSIONS: Anemia was largely socially determined in the population studied. Interventions aiming at reducing anemia should be developed to lessen this condition in the short run targeting disadvantaged populations.

  5. Anemia: An approach to evaluation, 2014

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    Philip Kuriakose

    2015-01-01

    Full Text Available Anemia is very commonly encountered in general clinical practice among all age groups. The more commonly used way to classify anemia has been to categorize it as being microcytic (mean corpuscular volume [MCV] 100 fL, which in turn allows for a more practical way to attempt to come up with a cause for any decrease in hemoglobin. Microcytic anemias are usually due to iron deficiency (in turn, a result of a number of different etiologies ranging from decreased intake, malabsorption, or blood loss, hemoglobinopathies (thalassemic syndromes, and some cases of severe anemia resulting from chronic disease. Normocytic anemia is often a result of anemia of chronic disease, hemolysis, or secondary to bone marrow failure. Macrocytic anemias are frequently caused by deficiencies of folic acid and/or Vitamin B12, exposure to toxic agents like drugs that interfere with DNA metabolism and alcohol, as also bone marrow failure states, such as from myelodysplastic syndrome. A comprehensive history, physical examination, and directed laboratory evaluation will help to identify a specific cause for anemia.

  6. The influence of hydroxyurea on oxidative stress in sickle cell anemia

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    Lidiane de Souza Torres

    2012-01-01

    Full Text Available OBJECTIVE: The oxidative stress in 20 sickle cell anemia patients taking hydroxyurea and 13 sickle cell anemia patients who did not take hydroxyurea was compared with a control group of 96 individuals without any hemoglobinopathy. METHODS: Oxidative stress was assessed by thiobarbituric acid reactive species production, the Trolox-equivalent antioxidant capacity and plasma glutathione levels. RESULTS: Thiobarbituric acid reactive species values were higher in patients without specific medication, followed by patients taking hydroxyurea and the Control Group (p < 0.0001. The antioxidant capacity was higher in patients taking hydroxyurea and lower in the Control Group (p = 0.0002 for Trolox-equivalent antioxidant capacity and p < 0.0292 for plasma glutathione. Thiobarbituric acid reactive species levels were correlated with higher hemoglobin S levels (r = 0.55; p = 0.0040 and lower hemoglobin F concentrations(r = -0.52; p = 0.0067. On the other hand, plasma glutathione levels were negatively correlated with hemoglobin S levels (r = -0.49; p = 0.0111 and positively associated with hemoglobin F values (r = 0.56; p = 0.0031. CONCLUSION: Sickle cell anemia patients have high oxidative stress and, conversely, increased antioxidant activity. The increase in hemoglobin F levels provided by hydroxyurea and its antioxidant action may explain the reduction in lipid peroxidation and increased antioxidant defenses in these individuals.

  7. Malnutrition in Very Old Hospitalized Patients: A New Etiologic Factor of Anemia?

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    Frangos, E; Trombetti, A; Graf, C E; Lachat, V; Samaras, N; Vischer, U M; Zekry, D; Rizzoli, R; Herrmann, F R

    2016-01-01

    Anemia and malnutrition are highly prevalent, frequently concomitant and associated with negative outcomes and mortality in the elderly. To evaluate the association between these two entities, and test the hypothesis that protein-energy deficit could be etiology of anemia. Prospective case-control study. Geriatric and Rehabilitation Hospital, Geneva University Hospitals, Switzerland. 392 patients (mean age 84.8 years old, 68.6% female). Hematological (hemoglobin (Hb)), chemical (iron work up, cyanocobalamin, folates, renal function, C-Reactive Protein (CRP)) and nutrition (albumin, prealbumin) parameters, and mini nutritional assessment short form (MNA-SF). The prevalence of anemia (defined as Hbmalnutrition according to the MNA-SF (p=0.047), with lower serum albumin (p 10). Albumin levels are strongly associated with anemia in the elderly. Screening for undernutrition should be included in anemia assessment in those patients. Further prospective studies are warranted in order to explore the effect of protein and energy supplementation on hemoglobin level.

  8. Incidencia y mortalidad por anemia en pacientes gravemente enfermos Incidence and mortality due to anemia in acutely ill patients

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    Maicelys Ramírez Zaldívar

    2012-09-01

    Full Text Available Introducción: la anemia es una de las enfermedades más conocidas y evaluadas en la práctica médica diaria. Objetivo: determinar la morbilidad y mortalidad de pacientes graves con anemia. Métodos: se realizó un estudio prospectivo de 118 pacientes ingresados en la Unidad de Terapia Intensiva del Hospital General Universitario "Vladimir Ilich Lenin" de Holguín, desde agosto hasta diciembre de 2010. Las variables discretas fueron comparadas mediante el test de £i al cuadrado y el de Fisher, y las continuas, por medio de las pruebas de T-Student y Mann-Whitney (la hemoglobina media, para á=0,05. Resultados: la anemia afectó 79,6 % de los integrantes de la serie y aumentó evolutivamente, con el consecuente empeoramiento de estos, de los cuales fallecieron 34,0 %, quienes tenían mayor edad (p=0,0004, necesitaron más transfusiones sanguíneas (p=0,005 y presentaron el trastorno de la hemoglobina más tardíamente (5,1 días. De los pacientes con anemia grave (hemoglobina:0,05. Conclusiones: la anemia en los pacientes graves se relacionó con una mayor mortalidad, estadía, necesidad de transfusiones de glóbulos rojos y causas médicas (neurológicas, en tanto, la edad avanzada y la gravedad de la anemia de aparición tardía se asociaron fundamentalmente a la mortalidad.Introduction: anemia is one of the well-known and evaluated diseases in the daily medical practice. Objective: to determine the morbidity and mortality of acutely ill patients with anemia. Methods: a prospective study of 118 patients admitted in the Intensive Therapy Unit of "Vladimir Ilich Lenin" General University Hospital in Holguín was carried out from August to December, 2010. Discrete variables were compared by means of the X² and Fisher tests, and the continuous variables, by means of the T-Student and Mann-Whitney tests (the mean hemoglobin, for á =0.05. Results: anemia affected 79.6% of the members of the series and it increased progressively, with the

  9. [Differences between observed and estimated by hematocrit hemoglobin and its relevance in the diagnosis of anemia among coastal population in Venezuela: analysis of the second national study of human growth and development (SENACREDH)].

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    Flores-Torres, Jessica; Echeverría-Ortega, María; Arria-Bohorquez, Melissa; Hidalgo, Glida; Albano-Ramos, Carlos; Sanz, Rafael; Rodríguez-Morales, Alfonso J

    2011-03-01

    To evaluate the differences between the observed hemoglobin levels and those estimated based on hematocrit in the context of the 2nd National Study of Human Growth and Development of the Venezuelan Population (SENACREDH). 6,004 individuals were chosen by a probabilistic multistage cluster sampling representing 7,286,781 inhabitants from North Central Coastal area (Vargas, Carabobo, Capital District, Aragua and Miranda). Means of observed and estimated hemoglobin (hematocrit/3) were compared, using t test for related samples and linear regression. Mean difference between the values of observed and estimated hemoglobin was -0.3446 ±0.0002 (phemoglobin values. Regression models of hemoglobin on hematocrit showed an r2=0,87. In order to correct the estimation, we propose a new formula for calculating hemoglobin based on haematocrit values: estimated hemoglobin=(Haematocrit/3.135)+ 0.257. There is an overestimation of hemoglobin levels from hematocrit levels and therefore an underestimation of the prevalence of anemia; however, a high positive correlation between them was found, allowing modeling for achieving a better estimation of the hemoglobin from the hematocrit value.

  10. Eating habit and other factors related to anemia in civil female flight attendant in Indonesia

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    Resna Nurhantika Sary

    2015-01-01

    Full Text Available AbstractLatar belakang: Anemia masih merupakan masalah kesehatan pada wanita yang dapat mengganggu performa kerja termasuk pramugari. Tujuan penelitian ialah untuk mengidentifiasi faktor-faktor dominan terhadap anemia pada pramugari. Metode: Penelitian potong lintang dengan metode sampling purposif pada pramugari yang melakukan pemeriksaan kesehatan berkala di Balai Kesehatan Penerbangan pada 1-15 Mei 2013. Data dikumpulkan menggunakan formulir khusus untuk penelitian ini. Data yang dikumpulkan adalah karakteristik demografi dan pekerjaan, kebiasaan makan, riwayat haid, indeks masa tubuh (IMT, serta kadar hemoglobin. Kadar hemoglobin berasal dari rekam medik di Balai Kesehatan Penerbangan.  Anemia ialah jika kadar hemoglobin kurang dari 12 g/dl. Hasil: Di antara 225 pramugari yang melakukan pemeriksaan kesehatan, 185 d pramugari berusia 18-46 tahun bersedia untuk berpartisipasi studi ini, dan 28,1% menderita anemia. Frekuensi makan daging merah per minggu, masa kerja total, jenis penerbangan, dan menstruasi merupakan faktor risiko yang dominan yang berhubungan dengan anemia. Faktor risiko yang paling dominan adalah makan daging merah / minggu. Pramugari yang makan daging 3 kali atau lebih dalam per minggu dibandingkan yang kurang dari 3 kali per minggu berisiko 43% lebih kecil mengalami anemia [risiko relatif suaian (RRa = 0,57; 95% interval kepercayaan (CI = 0,32–1,03; P = 0,064]. Pramugari yang mengalami menstruasi berlebihan dibandingkan yang menstruasi normal memiliki risiko 3,5 kali lebih tinggi mengalami anemia (RRa = 3,45; P = 0,000. Kesimpulan: Kebiasaan makan daging kurang dari tiga kali seminggu dan yang mengalami menstruasi berlebihan memiliki risiko lebih tinggi mengalami anemia di antara Pramugari di Indonesia. (Health Science Indones 2014;2:67-72Kata kunci: anemia, pramugari, daging merah, menstruasi, IndonesiaAbstractBackground: Anemia is a health problem in women that can interfere work performance including female flight

  11. Prospective assessment of the occurrence of anemia in patients with heart failure: results from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry.

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    Adams, Kirkwood F; Patterson, James H; Patterson, John H; Oren, Ron M; Mehra, Mandeep R; O'Connor, Christopher M; Piña, Ileana L; Miller, Alan B; Chiong, Jun R; Dunlap, Stephanie H; Cotts, William G; Felker, Gary M; Schocken, Douglas D; Schwartz, Todd A; Ghali, Jalal K

    2009-05-01

    Although a potentially important pathophysiologic factor in heart failure, the prevalence and predictors of anemia have not been well studied in unselected patients with heart failure. The Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry prospectively studied the prevalence of anemia and the relationship of hemoglobin to health-related quality of life and outcomes among patients with heart failure. A random selection algorithm was used to reduce bias during enrollment of patients seen in specialty clinics or clinics of community cardiologists with experience in heart failure. In this initial report, data on prevalence and correlates of anemia were analyzed in 1,076 of the 1,082 registry patients who had clinical characteristics and hemoglobin determined by finger-stick at baseline. Overall (n = 1,082), the registry patients were 41% female and 73% white with a mean age (+/-SD) of 64 +/- 14 years (68 +/- 13 years in community and 57 +/- 14 years in specialty sites, P 70 years affected. Initial results from the STAMINA-HFP Registry suggest that anemia is a common comorbidity in unselected outpatients with heart failure. Given the strong association of anemia with adverse outcomes in heart failure, this study supports further investigation concerning the importance of anemia as a therapeutic target in this condition.

  12. Nutritional status, oral hygiene and Angular cheilitis in schoolchildren in Cianjur district, West Java

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    Fatimah Boenjamin Partakusuma

    2017-08-01

    Full Text Available Background: Angular cheilitis is a lesion at the corner of the mouth. Clinically, it is visible as an erythema and ulceration that occasionally extend beyond the vermillion border onto the skin. Anemia in children is an issue of global nutritional problems that need attention. The objectives of the study  was to determine the association between nutritional status, oral hygiene  and angular cheilitis in elementary schoolchildren in District of Cianjur. Methods: This cross sectional study was conducted on 349 schoolchildren in five Subdistrict of Cianjur. Angular cheilitis status was determined based on the criteria set by Ohman (1986. Anhropometric status was determined by CDC BMI-for-age percentile growth chart. Anemia status was determine by the level of hemoglobin concentration using the HemoCue device. Oral hygiene was measured by OHI-S index. Results: The prevalence of angular cheilitis, anemia, wasting and poor oral hygiene were: 62.5%, 12,6%, 20.6%, and 67.3%, respectively. There are no relationships between  anthropometric status, oral hygiene and angular cheilitis. (p> 0.05. However there is a relationship significant relationship beween anemia and angular cheilitis (p <0.05. Logistic regression test showed that anemia is a risk factor on the occurrence of angular cheilitis. Conclusion: Anemia is a factor on the occurrence of angular cheilitis in schoolchildren in Cianjur.

  13. Hypoxia and anemia: factors in decreased sensitivity to radiation therapy and chemotherapy?

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    Harrison, Louis; Blackwell, Kimberly

    2004-01-01

    Hypoxia is a common feature of solid tumors that occurs across a wide variety of malignancies. Hypoxia and anemia (which contributes to tumor hypoxia) can lead to ionizing radiation and chemotherapy resistance by depriving tumor cells of the oxygen essential for the cytotoxic activities of these agents. Hypoxia may also reduce tumor sensitivity to radiation therapy and chemotherapy through one or more indirect mechanisms that include proteomic and genomic changes. These effects, in turn, can lead to increased invasiveness and metastatic potential, loss of apoptosis, and chaotic angiogenesis, thereby further increasing treatment resistance. Investigations of the prognostic significance of pretreatment tumor oxygenation status have shown that hypoxia (oxygen tension [pO(2)] value effect of hypoxia on standard cancer treatment, a variety of hypoxia- and anemia-targeted therapies have been studied in an effort to improve therapeutic effectiveness and patient outcomes. Early evidence from experimental and clinical studies suggests the administration of recombinant human erythropoietin (rHuEPO) may enhance the effectiveness of radiation therapy and chemotherapy by increasing hemoglobin levels and ameliorating anemia in patients with disease- or treatment-related anemia. However, further research is needed in the area of hypoxia-related treatment resistance and its reversal.

  14. Infection by Intestinal Parasites, Stunting and Anemia in School-Aged Children from Southern Angola.

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    Dinamene Oliveira

    Full Text Available Intestinal parasites are responsible for morbidity in children worldwide, especially in low income countries. In the present study we determine the prevalence of intestinal parasites and explore its association with anemia and stunting in school-aged children.A cross-sectional study was conducted from September to October 2010 enrolling 328 children attending the primary school in Lubango, the second largest city after the capital Luanda. Stool samples were collected for parasite detection through microscopy and molecular identification of Entamoeba histolytica and Entamoeba dispar. Stunting was assessed using the z-scores of height for age and hemoglobin concentration was determined using a portable hemoglobin analyzing system.The global prevalence of pathogenic intestinal parasites was 44.2%, the most common being Ascaris lumbricoides (22.0%, Giardia lamblia (20.1% and Hymenolepis nana (8.8%. Molecular detection revealed that 13.1% of the children carried E. dispar and 0.3% were infected with E. histolytica. The prevalence of stunting (mild to severe was 41.5%. Stunting was more frequent in older children (p = 0.006, OR = 1.886, while anemia was more frequent in younger children (p = 0.005, OR = 2.210. The prevalence of anemia was 21.6%, and we found a significant association with infection by H. nana (p = 0.031, OR = 2.449.This is one of the few published studies reporting intestinal parasites infection, nutritional status and anemia in children from Angola. Furthermore, the present work highlights the importance of regular intestinal parasites screening in children.

  15. Maternal and perinatal outcomes in second hemoglobin measurement in nonanemic women at first booking: effect of altitude of residence in peru.

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    Gonzales, Gustavo F; Tapia, Vilma; Fort, Alfredo L

    2012-01-01

    Objective. To determine changes in hemoglobin concentration at second measurements after a normal hemoglobin concentration was detected at first booking during pregnancy at low and at high altitudes. Methods. This is a secondary analysis of a large database obtained from the Perinatal Information System in Peru which includes 379,816 pregnant women and their babies from 43 maternity units in Peru. Results. Most women remained with normal hemoglobin values at second measurement (75.1%). However, 21.4% of women became anemic at the second measurement. In all, 2.8% resulted with moderate/severe anemia and 3.5% with erythrocytosis (Hb>14.5 g/dL). In all cases Hb was higher as altitude increased. Risk for moderate/severe anemia increased associated with higher gestational age at second measurement of hemoglobin, BMI anemia was observed with normal high Hb level at first booking living at moderate and high altitude, and high BMI. Conclusion. Prevalence of anemia increases as pregnancy progress, and that a normal value at first booking may not be considered sufficient as Hb values should be observed throughout pregnancy. BMI was a risk for anemia in a second measurement.

  16. [Effects of the iron fortified soy sauce on improving students' anemia in boarding schools].

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    Chen, Di; Sun, Jing; Huang, Jian; Wang, Lijuan; Piao, Wei; Tang, Yanbin; Li, Jin; Gao, Jie; Huo, Junsheng

    2016-03-01

    To evaluate the effect of iron fortified soy sauce on improving the anemia of boarding school students. A total of 3029 students of the boarding schools in the 27 provinces in China including 1576 boys and 1453 girls were treat with the iron-fortified soy sauce for 12 months. The concentration of hemoglobin was detected before and after intervention. The statistical analysis was conducted to analyze the anemia rate and the hemoglobin concentration in boarding school students. After the intervention, the average hemoglobin of students were increased from 142.1 g/L to 146.5 g/L compared to the baseline. The boys average haemoglobin concentration increased 6.7 g/L, girls average haemoglobin concentration increased 1.9 g/L. They were significantly higher than those of the baseline (P boarding school students, reduce anemia prevalence of students significantly.

  17. Hydroxyurea-Increased Fetal Hemoglobin Is Associated with Less Organ Damage and Longer Survival in Adults with Sickle Cell Anemia.

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    Fitzhugh, Courtney D; Hsieh, Matthew M; Allen, Darlene; Coles, Wynona A; Seamon, Cassie; Ring, Michael; Zhao, Xiongce; Minniti, Caterina P; Rodgers, Griffin P; Schechter, Alan N; Tisdale, John F; Taylor, James G

    2015-01-01

    Adults with sickle cell anemia (HbSS) are inconsistently treated with hydroxyurea. We retrospectively evaluated the effects of elevating fetal hemoglobin with hydroxyurea on organ damage and survival in patients enrolled in our screening study between 2001 and 2010. An electronic medical record facilitated development of a database for comparison of study parameters based on hydroxyurea exposure and dose. This study is registered with ClinicalTrials.gov, number NCT00011648. Three hundred eighty-three adults with homozygous sickle cell disease were analyzed with 59 deaths during study follow-up. Cox regression analysis revealed deceased subjects had more hepatic dysfunction (elevated alkaline phosphatase, Hazard Ratio = 1.005, 95% CI 1.003-1.006, phydroxyurea, although only 66% of those received a dose within the recommended therapeutic range. Hydroxyurea use was associated with improved survival (Hazard Ratio = 0.58, 95% CI 0.34-0.97, p = 0.040). This effect was most pronounced in those taking the recommended dose of 15-35 mg/kg/day (Hazard Ratio 0.36, 95% CI 0.17-0.73, p = 0.0050). Hydroxyurea use was not associated with changes in organ function over time. Further, subjects with higher fetal hemoglobin responses to hydroxyurea were more likely to survive (p = 0.0004). While alkaline phosphatase was lowest in patients with the best fetal hemoglobin response (95.4 versus 123.6, p = 0.0065 and 96.1 versus 113.6U/L, p = 0.041 at first and last visits, respectively), other markers of organ damage were not consistently improved over time in patients with the highest fetal hemoglobin levels. Our data suggest that adults should be treated with the maximum tolerated hydroxyurea dose, ideally before organ damage occurs. Prospective studies are indicated to validate these findings.

  18. Improving dietary intake to prevent anemia in adolescent girls through community kitchens in a periurban population of Lima, Peru.

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    Creed-Kanashiro, H M; Uribe, T G; Bartolini, R M; Fukumoto, M N; López, T T; Zavaleta, N M; Bentley, M E

    2000-02-01

    Peru has high rates of iron deficiency anemia. The prevalence is 35% in nonpregnant women of fertile age and 24.7% in adolescent girls in slums of periurban Lima. The major cause of anemia is low intake of dietary iron. A community-based, randomized behavioral and dietary intervention trial was conducted to improve dietary iron intake and iron bioavailability of adolescent girls living in periurban areas of Lima, Peru. Results show that there was a change in knowledge about anemia and improved dietary iron intake in the 71 girls who completed the study compared with the 66 girls in the control group. Although the 9-mo. intervention was not sufficient to improve hemoglobin levels significantly, there appeared to be a protective effect in maintaining the iron status of girls in comparison with the control group.

  19. Jardinópolis sem anemia, primeira fase: avaliação antropométrica e do estado nutricional de ferro Jardinópolis without anemia, first stage: anthropometric and iron nutrition status evaluation

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    Carlos Alberto N. Almeida

    2007-09-01

    Full Text Available OBJETIVOS: Com a finalidade de preparar um programa municipal de fortificação da água de beber com ferro, foi realizado levantamento antropométrico e do estado nutricional de ferro das crianças institucionalizadas nas cinco creches de período integral da cidade de Jardinópolis, São Paulo. MÉTODOS: Em estudo transversal, foram avaliadas 184 crianças com idades entre 12 e 59,9 meses, no período entre 1º e 31 de agosto de 2006. De cada criança, foram obtidos dados pessoais, peso, estatura e colhida amostra de sangue para dosagem de hemoglobina, volume corpuscular médio (VCM, índice de saturação da transferrina (IST e o red cell distribution width (RDW. RESULTADOS: A prevalência global de anemia foi de 29,3% e a média de hemoglobina de 11,5g/dL. Deficiência de ferro foi observada em 75% das crianças. As prevalências de deficit (escore Z 2 foi de 2,2%. CONCLUSÕES: Apesar de inferior a outros estudos brasileiros, a prevalência de anemia mostrou-se elevada. A antropometria mostrou que a oferta de macronutrientes está bastante próxima do ideal, mas a elevada prevalência de crianças deficientes em ferro indica a necessidade da adoção de medidas para aprimorar a oferta de ferro.OBJECTIVE: The aim of this study was to get basic information about the nutritional status of institutionalized preschool children who attend full time day-care centers in the city of Jardinópolis, São Paulo, Brazil, with the purpose of preparing a fortification trial. METHODS: This cross-sectional study enrolled 184 children, aged 12 to 59.9 months, between August 1st to 31st, 2006. Personal data on each child along with weight, height, hemoglobin, mean corpuscular volume (MCV, transferrin saturation and the red cell distribution width (RDW were obtained. RESULTS: Anemia was present in 29.3% of the children and the mean hemoglobin value for the whole group was 11.5g/dL. Iron deficiency was observed in 75% of all children. Deficit prevalence (Z score

  20. Nutritional status of iron, vitamin B12, folate, retinol and anemia in children 1 to 11 years old. Results of the Ensanut 2012

    Directory of Open Access Journals (Sweden)

    Salvador Villalpando

    2015-09-01

    Full Text Available Objective. To describe the frequency of anemia, iron, vitamin B12, folate, retinol and predictors of anemia among Mexican children from Ensanut 2012. Materials and methods. Hemoglobin, ferritin, CRP, vitamin B12, retinol and folate concentrations were measured in 2 678 children aged 1-4 y and 4 275 children aged 5-11 y. Adjusted logistic regression models were constructed to assess the risk for anemia and micronutrient deficiencies. Results. In preschoolers and scholars, the overall prevalence of anemia was 20.4 and 9.7%, iron deficiency 14 and 9.3%, low vitamin B12 (LB12S 1.9 and 2.6%; Folate 0.30 and 0%, and retinol depletion (VADp 15.7 and 2.3%, respectively. ID and VADp were negatively associated with Hb (coefficient: -0.38 and -0.45, p<0.05; a higher log-CRP was associated with higher risk for anemia and VADp (OR=1.13 and OR=2.1, p<0.05, respectively. Conclusions. Iron deficiency, anemia and VADp are some of the main nutritional problems among Mexican infants

  1. Nutritional status of iron, vitamin B12, folate, retinol and anemia in children 1 to 11 years old: Results of the Ensanut 2012.

    Science.gov (United States)

    Villalpando, Salvador; Cruz, Vanessa de la; Shamah-Levy, Teresa; Rebollar, Rosario; Contreras-Manzano, Alejandra

    2015-01-01

    To describe the frequency of anemia, iron, vitamin B12, folate, retinol and predictors of anemia among Mexican children from Ensanut 2012. Hemoglobin, ferritin, CRP, vitamin B12, retinol and folate concentrations were measured in 2 678 children aged 1-4 y and 4 275 children aged 5-11 y. Adjusted logistic regression models were constructed to assess the risk for anemia and micronutrient deficiencies. In preschoolers and scholars, the overall prevalence of anemia was 20.4 and 9.7%, iron deficiency 14 and 9.3%, low vitamin B12 (LB12S) 1.9 and 2.6%; Folate 0.30 and 0%, and retinol depletion (VADp) 15.7 and 2.3%, respectively. ID and VADp were negatively associated with Hb (coefficient: -0.38 and -0.45, p<0.05); a higher log-CRP was associated with higher risk for anemia and VADp (OR=1.13 and OR=2.1, p<0.05, respectively). Iron deficiency, anemia and VADp are some of the main nutritional problems among Mexican infants.

  2. Serum Copper Level Significantly Influences Platelet Count, Lymphocyte Count and Mean Cell Hemoglobin in Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    Okocha Chide

    2015-12-01

    Full Text Available Background Changes in serum micro nutrients levels affect a number of critically important metabolic processes; these could potentially influence blood counts and ultimately disease presentation in patients with sickle cell anemia (SCA. Objectives To evaluate the influence of serum micro-nutrients levels; zinc, copper, selenium and magnesium on blood counts in steady state SCA patients. Methods A cross sectional study that involved 28 steady state adult SCA subjects. Seven milliliters (mls of blood was collected; 3 mls was for hemoglobin electrophoresis and full blood count determination while 4 mls was for measurement of serum micro nutrients levels, by the atomic absorption spectrophotometry. Correlation between serum micro-nutrient levels and blood counts was done by the Pearson’s linear regression. Ethical approval was obtained from the institutional review board and each participant gave informed consent. All data was analyzed by SPSS software version 20. Results There was a significant correlation between serum copper levels and mean cell hemoglobin (MCH, platelet and lymphocyte counts (r = 0.418; P = 0.02, r = -0.376; P = 0.04 and r = -0.383; P = 0.04, respectively. There were no significant correlations between serum levels of other micro nutrients (selenium, zinc and magnesium and blood counts. Conclusions Copper influences blood count in SCA patients probably by inducing red cell haemolysis, oxidant tissue damage and stimulating the immune system.

  3. From Bad to Worse: Anemia on Admission and Hospital-Acquired Anemia.

    Science.gov (United States)

    Koch, Colleen G; Li, Liang; Sun, Zhiyuan; Hixson, Eric D; Tang, Anne S; Phillips, Shannon C; Blackstone, Eugene H; Henderson, J Michael

    2017-12-01

    Anemia at hospitalization is often treated as an accompaniment to an underlying illness, without active investigation, despite its association with morbidity. Development of hospital-acquired anemia (HAA) has also been associated with increased risk for poor outcomes. Together, they may further heighten morbidity risk from bad to worse. The aims of this study were to (1) examine mortality, length of stay, and total charges in patients with present-on-admission (POA) anemia and (2) determine whether these are exacerbated by development of HAA. In this cohort investigation, from January 1, 2009, to August 31, 2011, a total of 44,483 patients with POA anemia were admitted to a single health system compared with a reference group of 48,640 without POA anemia or HAA. Data sources included the University HealthSystem Consortium database and electronic medical records. Risk-adjustment methods included logistic and linear regression models for mortality, length of stay, and total charges. Present-on-admission anemia was defined by administrative coding. Hospital-acquired anemia was determined by changes in hemoglobin values from the electronic medical record. Approximately one-half of the patients experienced worsening of anemia with development of HAA. Risk for death and resource use increased with increasing severity of HAA. Those who developed severe HAA had 2-fold greater odds for death; that is, mild POA anemia with development of severe HAA resulted in greater mortality (odds ratio, 2.57; 95% confidence interval, 2.08-3.18; P < 0.001), increased length of stay (2.23; 2.16-2.31; P < 0.001), and higher charges (2.09; 2.03-2.15; P < 0.001). Present-on-admission anemia is associated with increased mortality and resource use. This risk is further increased from bad to worse when patients develop HAA. Efforts to address POA anemia and HAA deserve attention.

  4. Prevalence of anemia in a sample of elderly southeastern Brazilians

    Directory of Open Access Journals (Sweden)

    Fernando Callera

    2015-02-01

    Full Text Available Objective: To demonstrate the proportion of anemia and its association with demographic and clinical characteristics in a representative sample of elderly people from São José dos Campos, São Paulo. Methods: Demographic data and blood samples were collected from 398 over 65-year-old male and female individuals. Anemia was defined as hemoglobin concentration 75-80, >85-90 and >90-95 years (p-value = 0.0251. There were no significant differences in gender, ethnic background, place of residence, years of schooling, income, comorbidities and use of medications. Accord- ing to gender, the mean hemoglobin concentration and mean corpuscular volume were 11.5 g/dL (range: 8.4-11.9 g/dL and 90.7 fL (range: 63.0-111.7 fL for women and 11.9 g/dL (range: 8.6-12.8 g/dL and 92.1 fL (range: 59.8-100.1 fL for men. The great majority of ane- mia cases were mild with less than 6% having hemoglobin concentrations below 10.9 g/dL. Mean corpuscular volume was lower than 80 fL in six cases (8%, between 80 and 100 fL in 65 cases (88% and higher than 100 fL in three cases (4%. Conclusion: A total of 18.6% of elderly people from São José dos Campos had mild anemia with the majority being normocytic. The percentages of anemia rose as the age increased demonstrating an association between age and anemia.

  5. Impact of food supplements on hemoglobin, iron status, and inflammation in children with moderate acute malnutrition

    DEFF Research Database (Denmark)

    Cichon, Bernardette; Fabiansen, Christian; Iuel-Brockdorf, Ann-Sophie Julie D

    2018-01-01

    Background: Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplements (LNSs) or corn-soy blends (CSBs) but little is known about the impact of these supplements on hemoglobin, iron status, and inflammation. Objective: The objective of this study was to inve......Background: Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplements (LNSs) or corn-soy blends (CSBs) but little is known about the impact of these supplements on hemoglobin, iron status, and inflammation. Objective: The objective of this study...

  6. Anemia in Patients with Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Naser Ahmed

    2014-09-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is usually associated with polycythemia. It is assumed that systemic inflammatory components of COPD can interfere with erythropoietin and can result in anemia of chronic disease which will impair the functional capacity of these patients and also increase morbidity and mortality. Objective: To evaluate anemia status in COPD patients. Materials and Methods: This cross-sectional study was conducted in clinically stable 50 COPD patients in the outpatient department of Medicine in Bangabandhu Sheikh Mujib Medical University (BSMMU, Dhaka during the period of July to December 2011. The demographic characteristics, smoking habit, duration of disease, types and severity of anemia, BMI and results of 6-minute walk test were recorded. Results: Out of 50 COPD patients, 76% were male and 24% were female. Among them 32% patients were anemic, 20% were polycythemic and 48% patients had normal hemoglobin. Among the anemic patients with COPD, 87% were male and 13% were female,75% were mildly anemic and 4% moderately anemic, 62.5% had normocytic and 37.5% had microcytic anemia. Conclusion: Anemia in COPD patients is often overlooked and underestimated. Clinicians should be aware of the presence of anemia in patients with COPD so that appropriate treatment could be initiated to improve the quality of life and prognosis

  7. Surgery in sickle cell anemia | Fokam | Clinics in Mother and Child ...

    African Journals Online (AJOL)

    Sickle cell anemia is a hemoglobin disorder with a wide range of clinical manifestations and complications. Medical treatment is the mainstay of management but surgery is indicated in some cases. The authors review the main surgical indications in sickle cell anemia as frequently encountered and review treatment ...

  8. Predictors of hemoglobin in Danish blood donors

    DEFF Research Database (Denmark)

    Kotzé, Sebastian R; Pedersen, Ole B; Petersen, Mikkel S

    2015-01-01

    BACKGROUND: It is well known that blood donors are at increased risk of iron deficiency and subsequent development of iron deficiency anemia. We aimed to investigate the effect of factors influencing hemoglobin (Hb) levels. STUDY DESIGN AND METHODS: Initiated in 2010, the Danish Blood Donor Study...

  9. Zonulin, iron status, and anemia in kidney transplant recipients: are they related?

    Science.gov (United States)

    Malyszko, Jolanta; Koc-Zorawska, E; Levin-Iaina, N; Malyszko, Jacek

    2014-10-01

    In patients after kidney transplantation, anemia is relatively common and is associated with impaired kidney function, subclinical inflammatory state, and immunosuppressive treatment. Zonulin-prehaptoglobin-2, a newly discovered protein, is necessary for integrity of intracellular tight junctions in the gut. Taking into consideration iron metabolism, including its absorption in the gut, we designed a cross-sectional study to look for the possible interactions among zonulin, iron status, and anemia in kidney transplant recipients. The study was performed on 72 stable kidney transplant recipients and 22 healthy volunteers. Zonulin, iron status, and inflammatory markers were assessed with the use of commercially available kits. Zonulin was significantly lower in kidney allograft recipients than in healthy volunteers (P Zonulin correlated with systolic blood pressure (r = -0.33; P Zonulin was not affected by sex, type of immunosuppressive therapy, presence of diabetes, coronary artery disease, heart failure, hypertension, or cause of end-stage renal disease. Zonulin was not related to any of the iron parameters studied. In multiple regression analysis, predictors of zonulin were total protein and thyroglobulin-binding protein, explaining 46% of variation. Zonulin, with its poorly defined function, does not seem to play a role in the anemia in kidney allograft recipients; however, it seems to be related to the absorption process in the gut.

  10. Anemia of Chronic Liver Diseases

    International Nuclear Information System (INIS)

    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho

    1971-01-01

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T 50 Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  11. Intravenous iron sucrose for treatment of anemia in gynecology patients awaiting surgery

    OpenAIRE

    Animesh Gandhi; Meena N. Satia

    2016-01-01

    Background: Anemia refers to reduction in the total circulatory erythrocyte mass which results in decrease in the oxygen carrying capacity of the blood. Patients who require a surgical intervention as regards their complaints are many a times denied fitness because of anemia. Current anesthetic and surgical practice ideally recommend a hemoglobin level of > 10 g/dl or a hematocrit of >30 % for any surgical intervention. Surgery is postponed until cause of anemia is identified and the anemia c...

  12. The relationship between Type D Personality, affective symptoms and hemoglobin levels in chronic heart failure

    NARCIS (Netherlands)

    Kupper, N.; Pelle, A.J.M.; Szabó, B.M.; Denollet, J.

    2013-01-01

    Background Anemia is associated with poor prognosis in heart failure (HF) patients. Contributors to the risk of anemia in HF include hemodilution, renal dysfunction and inflammation. Hemoglobin levels may also be negatively affected by alterations in stress regulatory systems. Therefore,

  13. Lymphocyte DNA damage and oxidative stress in patients with iron deficiency anemia.

    Science.gov (United States)

    Aslan, Mehmet; Horoz, Mehmet; Kocyigit, Abdurrahim; Ozgonül, Saadet; Celik, Hakim; Celik, Metin; Erel, Ozcan

    2006-10-10

    Oxidant stress has been shown to play an important role in the pathogenesis of iron deficiency anemia. The aim of this study was to investigate the association between lymphocyte DNA damage, total antioxidant capacity and the degree of anemia in patients with iron deficiency anemia. Twenty-two female with iron deficiency anemia and 22 healthy females were enrolled in the study. Peripheral DNA damage was assessed using alkaline comet assay and plasma total antioxidant capacity was determined using an automated measurement method. Lymphocyte DNA damage of patients with iron deficiency anemia was significantly higher than controls (ptotal antioxidant capacity was significantly lower (ptotal antioxidant capacity and hemoglobin levels (r=0.706, ptotal antioxidant capacity and hemoglobin levels were negatively correlated with DNA damage (r=-0.330, p<0.05 and r=-0.323, p<0.05, respectively). In conclusion, both oxidative stress and DNA damage are increased in IDA patients. Increased oxidative stress seems as an important factor that inducing DNA damage in those IDA patients. The relationships of oxidative stress and DNA damage with the severity of anemia suggest that both oxidative stress and DNA damage may, in part, have a role in the pathogenesis of IDA.

  14. An international observational study suggests that artificial intelligence for clinical decision support optimizes anemia management in hemodialysis patients.

    Science.gov (United States)

    Barbieri, Carlo; Molina, Manuel; Ponce, Pedro; Tothova, Monika; Cattinelli, Isabella; Ion Titapiccolo, Jasmine; Mari, Flavio; Amato, Claudia; Leipold, Frank; Wehmeyer, Wolfgang; Stuard, Stefano; Stopper, Andrea; Canaud, Bernard

    2016-08-01

    Managing anemia in hemodialysis patients can be challenging because of competing therapeutic targets and individual variability. Because therapy recommendations provided by a decision support system can benefit both patients and doctors, we evaluated the impact of an artificial intelligence decision support system, the Anemia Control Model (ACM), on anemia outcomes. Based on patient profiles, the ACM was built to recommend suitable erythropoietic-stimulating agent doses. Our retrospective study consisted of a 12-month control phase (standard anemia care), followed by a 12-month observation phase (ACM-guided care) encompassing 752 patients undergoing hemodialysis therapy in 3 NephroCare clinics located in separate countries. The percentage of hemoglobin values on target, the median darbepoetin dose, and individual hemoglobin fluctuation (estimated from the intrapatient hemoglobin standard deviation) were deemed primary outcomes. In the observation phase, median darbepoetin consumption significantly decreased from 0.63 to 0.46 μg/kg/month, whereas on-target hemoglobin values significantly increased from 70.6% to 76.6%, reaching 83.2% when the ACM suggestions were implemented. Moreover, ACM introduction led to a significant decrease in hemoglobin fluctuation (intrapatient standard deviation decreased from 0.95 g/dl to 0.83 g/dl). Thus, ACM support helped improve anemia outcomes of hemodialysis patients, minimizing erythropoietic-stimulating agent use with the potential to reduce the cost of treatment. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  15. Experimental anemia induced by excess iron excretion.

    OpenAIRE

    Kimura,Ikuro; Sugiyama,Motoharu; Ishibashi,Ken; Miyata,Akira; Matsuzaka,Hiroto

    1980-01-01

    The effect of desferrioxamine on several hematological parameters was studied in growing rats. Animals given desferrioxamine intramuscularly (150 mg/kg daily) had increased urinary iron after one week, and decreased hemoglobin after 2 weeks. The difference in hemoglobin concentration between the treated and control groups was significant after 4 weeks of treatment with desferrioxamine, but the difference in the numbers of erythrocytes was not significant. The anemia was of hypochromic type. D...

  16. Does Smoke from Biomass Fuel Contribute to Anemia in Pregnant Women in Nagpur, India? A Cross-Sectional Study

    Science.gov (United States)

    Page, Charlotte M.; Patel, Archana; Hibberd, Patricia L.

    2015-01-01

    Background Anemia affects upwards of 50% of pregnant women in developing countries and is associated with adverse outcomes for mother and child. We hypothesized that exposure to smoke from biomass fuel – which is widely used for household energy needs in resource-limited settings – could exacerbate anemia in pregnancy, possibly as a result of systemic inflammation. Objective To evaluate whether exposure to smoke from biomass fuel (wood, straw, crop residues, or dung) as opposed to clean fuel (electricity, liquefied petroleum gas, natural gas, or biogas) is an independent risk factor for anemia in pregnancy, classified by severity. Methods A secondary analysis was performed using data collected from a rural pregnancy cohort (N = 12,782) in Nagpur, India in 2011-2013 as part of the NIH-funded Maternal and Newborn Health Registry Study. Multinomial logistic regression was used to estimate the effect of biomass fuel vs. clean fuel use on anemia in pregnancy, controlling for maternal age, body mass index, education level, exposure to household tobacco smoke, parity, trimester when hemoglobin was measured, and receipt of prenatal iron and folate supplements. Results The prevalence of any anemia (hemoglobin < 11 g/dl) was 93% in biomass fuel users and 88% in clean fuel users. Moderate-to-severe anemia (hemoglobin < 10 g/dl) occurred in 53% and 40% of the women, respectively. Multinomial logistic regression showed higher relative risks of mild anemia in pregnancy (hemoglobin 10-11 g/dl; RRR = 1.38, 95% CI = 1.19-1.61) and of moderate-to-severe anemia in pregnancy (RRR = 1.79, 95% CI = 1.53-2.09) in biomass fuel vs. clean fuel users, after adjusting for covariates. Conclusion In our study population, exposure to biomass smoke was associated with higher risks of mild and moderate-to-severe anemia in pregnancy, independent of covariates. Trial Registration ClinicalTrials.gov NCT 01073475 PMID:26024473

  17. Effects of maternal education on diet, anemia, and iron deficiency in Korean school-aged children

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    Choi Hyeon-Jeong

    2011-11-01

    Full Text Available Abstract Background We investigated the relationship among socioeconomic status factors, the risk of anemia, and iron deficiency among school-aged children in Korea. Methods The sample consisted of fourth-grade students aged 10 y recruited from nine elementary schools in Korean urban areas in 2008 (n = 717. Anthropometric and blood biochemistry data were obtained for this cross-sectional observational study. Anemia was defined as hemoglobin levels lower than 11.5 g/dl. Iron deficiency was defined as serum iron levels lower than 40 ug/dl. We also obtained data on parental education from questionnaires and on children's diets from 3-day food diaries. Parental education was categorized as low or high, with the latter representing an educational level beyond high school. Results Children with more educated mothers were less likely to develop anemia (P = 0.0324 and iron deficiency (P = 0.0577 than were those with less educated mothers. This group consumed more protein (P = 0.0004 and iron (P = 0.0012 from animal sources than did the children of less educated mothers, as reflected by their greater consumption of meat, poultry, and derivatives (P Conclusions As a contributor to socioeconomic status, maternal education is important in reducing the risk of anemia and iron deficiency and in increasing children's consumption of animal food sources.

  18. Evans Syndrome Complicated by Intratubular Hemoglobin Cast Nephropathy

    Directory of Open Access Journals (Sweden)

    Iván González

    2017-01-01

    Full Text Available Evans syndrome (ES is a rare autoimmune disorder whose exact pathophysiology is unknown. It is characterized by the simultaneous or subsequent development of autoimmune hemolytic anemia (AIHA and immune thrombocytopenia (ITP. Intravascular hemolysis, with hemoglobinemia, is known to produce acute kidney injury; however, the development of intratubular hemoglobin casts (hemoglobin cast nephropathy in the setting of acute hemolysis is uncommon. Likewise, the association of ES and acute renal failure is equally uncommon. We present a case of a 7-year-old girl with ES who developed acute kidney injury in the setting of intravascular hemolysis and had widespread intratubular hemoglobin casts.

  19. Incidence of anemia in pediatric cancer patients in Europe: results of a large, international survey.

    Science.gov (United States)

    Michon, Jean

    2002-10-01

    Anemia occurs frequently in children with cancer, but there is little information quantifying the incidence of anemia or treatment. A survey was conducted in 1998 in Europe by The Research Partnership with the objective of determining the incidence of anemia, identifying the hemoglobin triggers that initiated anemia treatment, and the current anemia treatment options available to clinicians. The survey was conducted in the 10 largest pediatric oncology centers each in France, Germany, Italy, Spain, and the UK, and in the 8 largest centers in both Belgium and The Netherlands. Telephone interviews with the most senior physician available in the institution were used to collect data, which included the numbers of patients treated or under follow-up, cancer types, and treatment practices for anemia. Data were collected for 25,093 patients. Over 80% of patients were anemic (WHO: hemoglobin disadvantages of epoetin alfa as a treatment option for treating anemia in children with cancer, which reflects the limited knowledge of and experience with this agent. Copyright 2002 Wiley-Liss, Inc.

  20. Burden and determinant factors of anemia among elementary ...

    African Journals Online (AJOL)

    Background: Anemia is an indicator of both poor nutrition and health. ... Intestinal parasitosis infections and hemoglobin level were determined by formula ... water, availability of latrine, maternal education, family size and hookworm infection.

  1. A clinically meaningful fetal hemoglobin threshold for children with sickle cell anemia during hydroxyurea therapy.

    Science.gov (United States)

    Estepp, Jeremie H; Smeltzer, Matthew P; Kang, Guolian; Li, Chen; Wang, Winfred C; Abrams, Christina; Aygun, Banu; Ware, Russell E; Nottage, Kerri; Hankins, Jane S

    2017-12-01

    Hydroxyurea has proven clinical benefits and is recommended to be offered to all children with sickle cell anemia (SCA), but the optimal dosing regimen remains controversial. Induction of red blood cell fetal hemoglobin (HbF) by hydroxyurea appears to be dose-dependent. However, it is unknown whether maximizing HbF% improves clinical outcomes. HUSTLE (NCT00305175) is a prospective observational study with a primary goal of describing the long-term clinical effects of hydroxyurea escalated to maximal tolerated dose (MTD) in children with SCA. In 230 children, providing 610 patient-years of follow up, the mean attained HbF% at MTD was >20% for up to 4 years of follow-up. When HbF% values were ≤20%, children had twice the odds of hospitalization for any reason (P 20% was associated with fewer hospitalizations without significant toxicity. These data support the use of hydroxyurea in children, and suggest that the preferred dosing strategy is one that targets a HbF endpoint >20%. © 2017 Wiley Periodicals, Inc.

  2. Iron deficiency anemia and megaloblastic anemia in obese patients.

    Science.gov (United States)

    Arshad, Mahmoud; Jaberian, Sara; Pazouki, Abdolreza; Riazi, Sajedeh; Rangraz, Maryam Aghababa; Mokhber, Somayyeh

    2017-03-01

    The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients' age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.

  3. Thalassemia and Hemoglobin E in Southern Thai Blood Donors

    OpenAIRE

    Nuinoon, Manit; Kruachan, Kwanta; Sengking, Warachaya; Horpet, Dararat; Sungyuan, Ubol

    2014-01-01

    Thalassemia and hemoglobin E (Hb E) are common in Thailand. Individuals with thalassemia trait usually have a normal hemoglobin concentration or mild anemia. Therefore, thalassemic individuals who have minimum acceptable Hb level may be accepted as blood donors. This study was aimed at determining the frequency of α-thalassemia 1 trait, β-thalassemia trait, and Hb E-related syndromes in Southern Thai blood donors. One hundred and sixteen voluntary blood donors, Southern Thailand origin, were ...

  4. Anemia and Iron Status Among Different Body Size Phenotypes in Chinese Adult Population: a Nation-Wide, Health and Nutrition Survey.

    Science.gov (United States)

    Li, Jiang; Xiao, Cheng; Yang, Hui; Zhou, Yun; Wang, Rui; Cao, Yongtong

    2017-12-09

    Previous studies have shown that there is a controversial relationship between iron homeostasis and obesity. This study aims to explore the relationship of anemia and iron status with different body size phenotypes in adult Chinese population. Using information on iron status-related parameters and lifestyle data from 8462 participants of the 2009 wave of China Health and Nutrition Survey (2009 CHNS), we performed multivariable logistic regression analyses to estimate the odds ratios (ORs) for the risk of anemia and iron parameters according to different body size phenotypes. Participants with higher body mass index (BMI) had a lower anemia prevalence with significant trends in both metabolic status groups (P different metabolic status groups and in different body size phenotypes, respectively. The ORs for higher ferritin and transferrin increased across different body size phenotypes in both genders, and for sTfR/log ferritin index decreased (P < 0.01 for trend). This association was still statistically significant after adjustment for multiple confounders. We found an inverse association of BMI levels with the prevalence of anemia and strong association of serum ferritin and transferrin with higher risk of obesity or overweight in both metabolic status groups.

  5. Radiological profile of anemia on unenhanced MDCT of the thorax

    International Nuclear Information System (INIS)

    Kamel, Ehab M.; Rizzo, Elena; Duran, Rafael; Goncalves-Matoso, Vasco; Schnyder, Pierre; Duchosal, Michel A.; Qanadli, Salah D.

    2008-01-01

    Our aim was to investigate the diagnostic value of unenhanced MDCT in anemic patients. Fifty consecutive patients with proven anemia and 50 nonanemic matched group for age, sex and body mass index were evaluated. In either group, hemoglobin levels were assessed no more than 24 h from an unenhanced CT of the thorax. For each patient, the presence of a hyperattenuating aortic wall (aortic ring sign) and/or dense interventricular septum (subjective parameters) were identified by two radiologists who were blinded to the laboratory findings. Furthermore, the aortic CT attenuation values (objective parameter) were also obtained and correlated with the hemoglobin levels. The sensitivity and specificity in detecting anemia were calculated for each variable, and ROC analysis was generated for subjective and objective parameters. Subjective image analysis revealed that the aortic ring sign was more sensitive than the interventricular septum sign for anemia detection (84% vs. 72%), whereas this latter sign was more specific (100% vs. 92%). A good correlation (r=0.60) was observed between the aortic CT attenuation values and the hemoglobin levels in the whole study population. Using a threshold of ≤35 HU for anemia diagnosis, the sensitivity and specificity of aortic CT attenuation value were 84% and 94%, respectively, with the largest area under the curve (0.89) among all diagnostic criteria. However, the best trade-off between sensitivity (80%) and specificity (100%) was obtained from combining both subjective and objective analysis. Interpreting anemia upon unnenhanced MDCT of the thorax is quite feasible. A diagnostic approach that considers both subjective and objective analysis offers the best trade-off between sensitivity and specificity. (orig.)

  6. The Relationship between Food Pattern and Hemoglobin Level in Pregnant Women at Maros, South Sulawesi

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    Zulkifli Abdullah

    2011-06-01

    Full Text Available Food consumption pattern is known as a determinant factor for nutritional problems among pregnant mothers. This study was intended to assess food consumption and its relationship to anemia in Maros Districts, Indonesia. This study was conducted in two sub-districts and pregnant mothers was randomly selected (n = 200 and proportionally from both districts. Data was collected by train field workers including measurement of hemoglobin, height and weight, 24-hour recall and food frequency questionnaire. Multivariate analyses were performed to see the relationship between food consumption and anemia. It showed that anemia prevalence was 41% whereas mostly in mild and moderate levels (44% and 55% respectively. The most common pattern of food consumption was rice, fish, and some vegetables. However, vegetables and fruit mostly consumed only 3-6 time a week. Energy and protein intakes were only 59% to 72% recommended dietary allowance (RDA or 1300 kcal and 48 gr respectively. Most vitamin was consumed only around 40% except for vitamin A (76%, 605 RE, folic acid (195%, 1170 ug, and Vitamin B12 (142%, 3,7 ug. However, iron and zinc intakes were only 6.1 gr (17.5% RDA and 5.9 gr (44% RDA, respectively. Multivariate analyses showed that education duration of mothers, nutritional status, iron tablet intakes, vitamin C, and B6 consumption were significantly related to anemia of pregnant mothers in the study and accounted for 24% (p<0.05. We conclude that food consumption was relatively low and caused lack intakes for both macro and micro nutrients of pregnant mothers in the study. Education and nutritional status of the mothers contributed also to the anemia prevalence.

  7. Frequency of anemia in chronic psychiatry patients

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    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  8. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, growth, and morbidity of Peruvian infants.

    Science.gov (United States)

    López de Romaña, Guillermo; Cusirramos, Sandra; López de Romaña, Daniel; Gross, Rainer

    2005-03-01

    Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious.

  9. Effect of NaFeEDTA-Fortified Soy Sauce on Anemia Prevalence in China: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Huo, Jun Sheng; Yin, Ji Yong; Sun, Jing; Huang, Jian; Lu, Zhen Xin; Regina, Moench-Pfanner; Chen, Jun Shi; Chen, Chun Ming

    2015-11-01

    To assess the effect of sodium iron ethylenediaminetetraacetate (NaFeEDTA)-fortified soy sauce on anemia prevalence in the Chinese population. A systematic review was performed to identify potential studies by searching the electronic databases of PubMed, Cochrane Library, WHO Library, HighWire, CNKI, and other sources. The selection criteria included randomized controlled trials that compared the efficacy of NaFeEDTA-fortified soy sauce with that of non-fortified soy sauce. Anemia rates and hemoglobin levels were the outcomes of interest. Inclusion decisions, quality assessment, and data extraction were performed by two reviewers independently. A total of 16 studies met the inclusion criteria for anemia rate analysis, of which 12 studies met the inclusion criteria for hemoglobin analysis. All included studies assessed the effect of NaFeEDTA-fortified soy sauce on anemia rates and hemoglobin concentrations. After the intervention, the hemoglobin concentration increased and anemia rates decreased significantly as compared with the non-fortified soy sauce groups. For anemia rates, data from 16 studies could be pooled, and the pooled estimate odds ratio was 0.25 (95% CI 0.19-0.35). For hemoglobin concentrations, data from 12 studies could be pooled, and the pooled weighted mean difference was 8.81 g/L (95% CI 5.96-11.67). NaFeEDTA-fortified soy sauce has a positive effect on anemia control and prevention in the at-risk population. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  10. In anemia of multiple myeloma hepcidin is induced by increased bone-morphogenetic protein-2

    Science.gov (United States)

    Hepcidin is the principal iron-regulatory hormone and pathogenic factor in anemia of inflammation. Patients with multiple myeloma (MM) frequently present with anemia. We showed that MM patients had increased serum hepcidin, which inversely correlated with hemoglobin, suggesting that hepcidin contrib...

  11. Anemia of Chronic Liver Diseases

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    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-09-15

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T{sub 50} Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  12. Combatting anemia in adolescent girls: a report from India.

    Science.gov (United States)

    Kanani, S

    1994-01-01

    In a study on anemia in adolescent girls living in slum areas, 105 girls, aged 10 to 18, participated in qualitative (focus group discussions; open ended, in depth interviews) and quantitative (structured survey and hemoglobin estimation) research activities before and after intervention. Perceptions of mothers were also surveyed. The qualitative methods were used on selected subsamples in order to represent all age and ethnic groups and geographic areas of the slum. Quantitative methods were used on all 105 girls. The prevalence of anemia was 98%. The patterns of responses were similar for the focus groups, interviews, and surveys. Mothers and their daughters believed the girls were healthy (" one who ate well, worked without tiring easily and did not fall sick often"). There was no major connection made between menstruation and health, or between present and future health. Most of the girls were unaware of the Gujarati term for anemia, pandurog, which is used in awareness campaigns. The girls described symptoms (weakness = kamshakti) associated with anemia and knew these could be remedied with green leafy vegetables, fruit, milk, meat, tonics from the doctor, and iron tablets (shakti ni goli). Based on these results, a puppet show, using local terms and events, was developed that covered the causes, symptoms, treatment, and prevention of anemia. The term, pandurog, was introduced and reinforced. The girls were encouraged to have their blood tested and to take iron tablets. The hemoglobin levels of the girls were taken after the show and after an iron supplement program lasting three months. Compliance with the supplementation program was monitored biweekly. Group discussions with flash cards reinforced the information in the puppet show. Results from the last hemoglobin level showed a significant increase; however, the prevalence of anemia was 87%. About half of the girls consumed at least 60% of the tablets; one-fifth consumed 80%. Forgetfulness and fasting

  13. The effects of higher hemoglobin levels on mortality and hospitalization in hemodialysis patients.

    Science.gov (United States)

    Ofsthun, Norma; Labrecque, John; Lacson, Eduardo; Keen, Marcia; Lazarus, J Michael

    2003-05-01

    The introduction of recombinant human erythropoietin for the treatment of anemia of chronic renal failure provided the opportunity to correct anemia in this patient population. The optimal target hemoglobin for patients with end-stage renal disease (ESRD) remains controversial. A large database of hemodialysis patients was analyzed to determine whether increasing hemoglobin level above the current Kidney Dialysis Outcomes Quality Initiative (K/DOQI) recommendations was associated with increased risk of mortality and hospitalization. A longitudinal study of hemodialysis patients in Fresenius Medical Care-North America facilities was performed. Selection was restricted to patients in the census for 6 consecutive months from July 1, 1998 through June 30, 2000. Patient mean hemoglobin and other covariates measured during the initial 6 months were related to survival, number of hospitalizations, and length of stay over the subsequent 6 months of follow-up. Patients with hemoglobin /=13 g/dL had an adjusted length of stay of 9.6 days compared to 10.9 days for those with 11 12 g/dL.

  14. Hydroxyurea-Increased Fetal Hemoglobin Is Associated with Less Organ Damage and Longer Survival in Adults with Sickle Cell Anemia.

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    Courtney D Fitzhugh

    Full Text Available Adults with sickle cell anemia (HbSS are inconsistently treated with hydroxyurea.We retrospectively evaluated the effects of elevating fetal hemoglobin with hydroxyurea on organ damage and survival in patients enrolled in our screening study between 2001 and 2010.An electronic medical record facilitated development of a database for comparison of study parameters based on hydroxyurea exposure and dose. This study is registered with ClinicalTrials.gov, number NCT00011648.Three hundred eighty-three adults with homozygous sickle cell disease were analyzed with 59 deaths during study follow-up. Cox regression analysis revealed deceased subjects had more hepatic dysfunction (elevated alkaline phosphatase, Hazard Ratio = 1.005, 95% CI 1.003-1.006, p<0.0.0001, kidney dysfunction (elevated creatinine, Hazard Ratio = 1.13, 95% CI 1.00-1.27, p = 0.043, and cardiopulmonary dysfunction (elevated tricuspid jet velocity on echocardiogram, Hazard Ratio = 2.22, 1.23-4.02, p = 0.0082. Sixty-six percent of subjects were treated with hydroxyurea, although only 66% of those received a dose within the recommended therapeutic range. Hydroxyurea use was associated with improved survival (Hazard Ratio = 0.58, 95% CI 0.34-0.97, p = 0.040. This effect was most pronounced in those taking the recommended dose of 15-35 mg/kg/day (Hazard Ratio 0.36, 95% CI 0.17-0.73, p = 0.0050. Hydroxyurea use was not associated with changes in organ function over time. Further, subjects with higher fetal hemoglobin responses to hydroxyurea were more likely to survive (p = 0.0004. While alkaline phosphatase was lowest in patients with the best fetal hemoglobin response (95.4 versus 123.6, p = 0.0065 and 96.1 versus 113.6U/L, p = 0.041 at first and last visits, respectively, other markers of organ damage were not consistently improved over time in patients with the highest fetal hemoglobin levels.Our data suggest that adults should be treated with the maximum tolerated hydroxyurea dose

  15. ANEMIA DAN ANEMIA GIZI BESI PADA KEHAMILAN: HUBUNGANNYA DENGAN ASUPAN PROTEIN DAN ZAT GIZI MIKRO

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    Nur Handayani Utami

    2015-03-01

    Full Text Available Anemia masih menjadi permasalahan kesehatan pada wanita hamil. Zat besi dianggap sebagai salah satu zat gizi mikro yang berperan terhadap terjadinya anemia. Kekurangan gizi besi dalam tingkat lanjut dapat menyebabkan anemia, yang disebut sebagai anemia gizi besi. Tujuan studi ini adalah untuk menganalisis perbedaan antara asupan protein dan gizi mikro serta menghitung odd ratio (OR kejadian anemia dan anemia gizi besi akibat asupan protein dan gizi mikro pada wanita hamil di lokasi studi. Analisis ini merupakan analisa dari data studi kohor Tumbuh Kembang anak pada tahun pertama, yang dilaksanakan di Kelurahan Kebon Kalapa dan Ciwaringin, Kota Bogor yang dianalisa menggunakan disainkasus kontrol. Sebanyak 47 ibu hamil menjadi sampel dalam analisa ini. Kategori untuk anemia yaitu apabila kadar hemoglobin (Hb ibu hamil ≤11 g/dL. Kekurangan gizi besi dikategorikan apabila kadar serum transferrin reseptor (sTfR diatas 4.4 mg/L. Sedangkan Anemia Gizi Besi dikategorikan apabila memiliki kadar Hb < 11 g/dL dan sTfr > 4.4 mg/L. Tes one way anova digunakan untuk menganalisa adanya perbedaan asupan energi, protein dan zat gizi mikro antara ibu hamil yang mengalami anemia, anemia gizi besi maupun yang normal. Odd ratio dianalisa dengan menggunakan uji chi square. Nilai signifikan ditentukan apabila nilai p value < 0.05 dan perhitungan OR> 1. 27.7% dari ibu hamil di lokasi studi mengalami anemia, 14.9% tergolong dalam anemia ringan, 10.6% anemia sedang dan 2.1% anemia berat. Anemia gizi besi dialami oleh 17% dari wanita hamil. Terdapat hubungan yang signifikan antara keparahan anemia dan terjadinya anemia gizi besi. Tidak ditemukan perbedaan antara asupan protein, besi, folate dan zink pada wanita yang mengalami anemia, anemia gizi besi maupun yang normal. Akan tetapi terdapat kecenderungan bahwa asupan zat besi dan seng pada ibu yang anemia dan anemia gizi besi lebih rendah daripada ibu yang normal. Anemia masih menjadi permasalahan kesehatan pada ibu

  16. Slow Hematological Recovery in Children With IBD-associated Anemia in Cases of "Expectant Management"

    NARCIS (Netherlands)

    Pels, Lise P. M.; de Vijver, Els Van; Waalkens, Herman J.; Uitentuis, Jan; Gonera-de Jong, Gieneke; van Overbeek, Lidy A. T.; Norbruis, Obbe F.; Rings, Edmond H. H. M.; van Rheenen, Patrick F.

    2010-01-01

    Background and Objective: Allowing children with inflammatory bowel disease (IBD) to live with subnormal hemoglobin (Hb) levels affects their quality of life. The therapeutic approach to normalize Hb varies according to the cause of IBD-associated anemia. In exclusive iron-deficiency anemia (IDA)

  17. Idiopathic pulmonary hemosiderosis: Alveoli are an answer to anemia

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    S Bhatia

    2011-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare disorder (triad of iron-deficiency anemia, hemoptysis, and alveolar infiltrates. A 3-year-old male presented with mild fever, breathlessness, dry cough, and bluish nail discoloration for 8 days. He had required five blood transfusions in the past 1 year (last transfusion was given 4 months ago. He had a respiratory rate of 58/min with respiratory distress, cyanosis, and grade III clubbing. Respiratory system examination was normal. Several previous reports of hemoglobin were as low as 3.6 g/dl with hypochromic and microcytic anemia. There were transient increases in the hemoglobin and normalization of red cell morphology with blood transfusions. Serum iron, G6PD enzyme assay, hemoglobin electrophoresis, the sickling test, Coomb′s test, stool and urine analysis, and a Meckel′s scan were normal. HIV antibody and dsDNA were negative. The chest radiograph revealed symmetrical patchy infiltrates sparing lung apices (confirmed on high-resolution computed tomography. Lung biopsy diagnosed pulmonary hemosiderosis (interstitial lung disease with hemosiderin-laden macrophages scattered in the alveoli and areas of fibrosis in the alveolar septa. The patient showed marked clinical improvement in 10 days of therapy with prednisolone. IPH should be listed in the differential diagnosis of a child presenting with unexplained hypochromic, microcytic anemia and respiratory symptoms.

  18. PREVALENCE OF ANEMIA AND ITS POSSIBLE ATTRIBUTING FACTORS IN PSYCHOLOGICALLY HEALTHY WOMEN OF REPRODUCTIVE AGES IN MIDNAPORE (JANGALMAHAL-AREA, INDIA

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    N K Sinha

    2013-09-01

    Full Text Available Background: Worldwide, anemia in pregnant women is associated with low birth-weight, perinatal and maternal mortality. The Childhood malnourishment results in ill-health and psychosocial problems. In the present study, prevalence of anemia is determined in a community-based cross-sectional survey (June 2010 to May 2011 in non-pregnant, psychologically fit and economically backward women (total 241, 15-49 years. Methods: The investigation is based on interviews on a pre-tested, semi-structured questionnaire after testing with Mental Status Examination. Body mass index is assessed to evaluate undernutrition and thinness. Data processing and descriptive statistics were done using the SPSS, 2010. The Pearson ÷2 and ANOVA tests were performed to predict the level of significance. Results: Anthropometric indices and hemoglobin level indicate that the prevalence of anemia (Hb<12 g/dl, WHO is 69.7% (p<0.01, which is severe in malnourished individuals (30%. It is found that, the anemia status (primary and mild is better correlated with undernutrition and thinness. It is also noticed that the moderate to severe anemia is more indicative to pathological state than physiological state in grade II/ III thinness. Likewise, anemia also occurring in normal or overweight group indicates, beside nutrition, influence of possible pathological, psychological or environmental factors are also occurring. Conclusion: Present findings necessitates extensive health program. An unplanned urbanization resulting unfriendly socio-demographic changes is more detrimental than natural adversity associated rudimentary character of a rural area. Beside supplementation, proper health awareness is more important at policy making level for global management of anemia.

  19. ANEMIA DAN LAMA KONSUMSI OBAT ANTI TUBERCULOSIS

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    Anny Thuraidah

    2017-12-01

    Full Text Available Tuberkulosis adalah penyakit infeksi akibat kuman Mycobacterium tuberculosis yang dapat menginfeksi beberapa organ tubuh, diantaranya paru-paru, ginjal, dan tulang.Tujuan pengobatan tuberkulosis adalah memusnahkan basil tuberkulosis dengan cepat dan mencegah kekambuhan. Obat anti tuberkulosis (OAT dapat diterima dalam terapi, namun mempunyai efek toksik seperti agranulositosis, eosinofilia, trombositopenia dan anemia. Penelitian ini bertujuan untuk mengetahui hubungan lama konsumsi OAT pada pasien TB paru terhadap anemia. Penelitian ini bersifat Survey Analitic dengan rancangan Cross Sectional. Hasil penelitian rata-rata hitung sel darah merah 0 bulan 5,16 106/uL, 2 bulan 4,39 106/uL dan 6 bulan 4,61 106/uL, rata-rata kadar hemoglobin 0 bulan 15,17 g/dL, 2 bulan 12,73 g/dL dan 6 bulan 13,28 g/dL serta ratarata nilai hematokrit 0 bulan 44,26 %, 2 bulan 38,24 % dan 6 bulan 39,04 %. Dari hasil uji Spearman diperoleh nilai signifikan sebesar hitung sel darah merah 0,004 < α (0,05, kadar hemoglobin 0,007 < α (0,05 dan nilai hematokrit 0,015 < α (0,05 sehingga dapat disimpulkan ada hubungan antara lama konsumsi obat anti tuberkulosis pada pasien TB paru terhadap anemia dan nilai correlation coefficient hitung sel darah merah -0,531, kadar hemoglobin -0,479 serta nilai hematokrit -0,440 berarti memiliki kekuatan hubungan yang sedang. Disarankan untuk penelitian selanjutnya menggunakan parameter yang berbeda seperti jumlah trombosit, kadar AST/ALT dan sebaiknya menggunakan sampel atau pasien yang sama dari 0 bulan sampai 6 bulan.

  20. Anemia and associated factors among Kuwaiti preschool children ...

    African Journals Online (AJOL)

    Nawal Mubarak Al-Qaoud

    2014-07-25

    Jul 25, 2014 ... Abstract Background: Anemia is a major nutritional health problem throughout the ... mia was defined as hemoglobin <11 g/dl for children and <12 g/dl for mothers. .... Also the mother's age, education, and occupation informa-.

  1. Anemia and iron homeostasis in a cohort of HIV-infected patients in Indonesia

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    Jusuf Hadi

    2011-08-01

    Full Text Available Abstract Background Anemia is a common clinical finding in HIV-infected patients and iron deficiency or redistribution may contribute to the development of low hemoglobin levels. Iron overload is associated with a poor prognosis in HIV and Hepatitis C virus infections. Iron redistribution may be caused by inflammation but possibly also by hepatitis C co-infection. We examined the prevalence of anemia and its relation to mortality in a cohort of HIV patients in a setting where injecting drug use (IDU is a main mode of HIV transmission, and measured serum ferritin and sTfR, in relation to anemia, inflammation, stage of HIV disease, ART and HCV infection. Methods Patient characteristics, ART history and iron parameters were recorded from adult HIV patients presenting between September 2007 and August 2009 in the referral hospital for West Java, Indonesia. Kaplan-Meier estimates and Cox's regression were used to assess factors affecting survival. Logistic regression was used to identity parameters associated with high ferritin concentrations. Results Anemia was found in 49.6% of 611 ART-naïve patients, with mild (Hb 10.5 - 12.99 g/dL for men; and 10.5 - 11.99 g/dL for women anemia in 62.0%, and moderate to severe anemia (Hb Conclusion HIV-associated anemia is common among HIV-infected patients in Indonesia and strongly related to mortality. High ferritin with low sTfR levels suggest that iron redistribution and low erythropoietic activity, rather than iron deficiency, contribute to anemia. Serum ferritin and sTfR should be used cautiously to assess iron status in patients with advanced HIV infection.

  2. Iron deficiency anemia in inflammatory bowel disease

    Science.gov (United States)

    Kaitha, Sindhu; Bashir, Muhammad; Ali, Tauseef

    2015-01-01

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia (IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used laboratory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and convenient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD. PMID:26301120

  3. HbQ-India associated with microcytosis: An uncommon hemoglobin variant associated with a common hematologic condition

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    Amit Kumar Yadav

    2010-09-01

    Full Text Available HbQ-India is a rare alpha chain variant that usually presents in the heterozygous state. Normally, HbQ-India is clinically silent. It becomes symptomatic when present in association with other conditions. We report a case of HbQ-India with concomitant presence of iron deficiency anemia. A 16-year-old female presented with weakness and pallor intermittently for six years. Complete blood count showed severe microcytic hypochromic anemia. Hemoglobin electrophoresis showed a prominent band in the S,D,G region. Tests for sickling were negative. High performance liquid chromatography (HPLC showed a peak in the unknown window (4.70-4.90 min suggestive of HbQ-India. Serum iron profile was suggestive of iron deficiency anemia. Based on the above findings, a diagnosis of coexistent HbQ-India–iron deficiency anemia was made. A family study revealed the father as having moderate anemia with similar findings while the mother was normal. Abnormal hemoglobin in the patient was confirmed by molecular diagnosis.HbQ variants are the alpha globin chain variants due to structural mutations (α64 Asp→His inherited in autosomal dominant fashion. Three molecular variant types have been documented, namely HbQ-India, HbQ-Thailand and HbQ-Iran. Normally, HbQ is clinically silent. Therefore, careful screening of the samples using routine techniques like Hb electrophoresis and HPLC are needed for identification of such abnormal hemoglobin variants like HbQ-India.

  4. Clinical and laboratory profile of patients with sickle cell anemia

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    Phelipe Gabriel dos Santos Sant'Ana

    Full Text Available Abstract Objective: This study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea. Methods: Clinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia. Results: Data from the medical records of 50 patients were analyzed. Most of the patients were female (56%, aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55 ± 1.33 g/dL and 25.7 ± 4.4%, respectively and increased fetal hemoglobin levels (12 ± 7%. None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value = 0.005 and p-value = 0.001, respectively. Conclusion: Sickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.

  5. Factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years

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    Hercílio Paulino ANDRÉ

    Full Text Available ABSTRACT Objective To evaluate factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years in the city of Viçosa, Minas Gerais state, Brazil. Methods This is a cross-sectional study of 357 children aged 4-7 years who had been followed-up up for during their first six months of life by the Breastfeeding Support Program. Socioeconomic and demographic characteristics, feeding practices, nutritional status (height-for-age and body mass index-for-age, and serum ferritin and hemoglobin concentrations were evaluated. Multiple linear regression analysis was carried out to evaluate factors independently associated with iron nutritional status (hemoglobin and ferritin, considering α=0.05 as the significance level. Results The prevalence of anemia and iron deficiency was (34 9.52% and (11 11.00%, respectively. The factors independently associated with anemia were younger child age, low maternal education, low height-for-age Z-scores, and children of single and separated mothers or widows. Iron deficiency was associated with child younger age and consumption of chocolates and chocolate flavored milk. Conclusion The results obtained allow us to conclude that anemia among children 4-7 years of age is a public health problem in the city of Viçosa, Minas Gerais. Therefore, there is a need for intervention measures targeting children in this age group. These measures can be implemented through food and nutritional education by encouraging the consumption of iron-rich foods.

  6. The Prevalence of Anemia and Moderate-Severe Anemia in the US Population (NHANES 2003-2012)

    Science.gov (United States)

    2016-01-01

    Since anemia is associated with poor health outcomes, the prevalence of anemia is a significant public health indicator. Even though anemia is primarily caused by iron deficiency, low oxygen-carrying capacity may result from other conditions such as chronic diseases, which remain a relevant health concern in the United States. However, studies examining current rates of anemia in the total US population and in more specific subgroups are limited. Data from five National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2012 were analyzed to assess two outcomes: anemia and moderate-severe anemia, which were based upon serum hemoglobin levels (Hb) as per World Health Organization (WHO) definitions. Statistical analysis using SAS examined temporal trends and the prevalence of anemia among sexes, age groups, and races/ethnicities. The study estimated that an average of 5.6% of the U.S. population met the criteria for anemia and 1.5% for moderate-severe anemia during this 10-year period. High-risk groups such as pregnant women, elderly persons, women of reproductive age, non-Hispanic blacks, and Hispanics were identified, and relationships between multiple risk factors were examined. Rates of anemia in men increased monotonically with age, while that of women increased bimodally with peaks in age group 40–49 years and 80–85 years. The effect of risk factors was observed to compound. For instance, the prevalence of anemia in black women aged 80–85 years was 35.6%, 6.4 times higher than the population average. Moreover, anemia is a growing problem because of the increased prevalence of anemia (4.0% to 7.1%) and moderate-severe anemia (1.0% to 1.9%), which nearly doubled from 2003–2004 to 2011–2012. Thus, these results augment the current knowledge on anemia prevalence, severity, and distribution among subgroups in the US and raised anemia as an issue that requires urgent public health intervention. PMID:27846276

  7. Causes and correlates of anemia in 200 patients with acute cardiogenic pulmonary edema.

    Science.gov (United States)

    Rovellini, Angelo; Graziadei, Giovanna; Folli, Christian; Brambilla, Anna Maria; Cosentini, Roberto; Canetta, Ciro; Monzani, Valter

    2012-12-01

    Acute heart failure has a poor prognosis and the presence of anemia may increase the risk of adverse outcomes. However, the clinical and laboratory characteristics of anemia in acute heart failure are poorly known. We aimed to assess the causes and the clinical and laboratory correlates of anemia in patients with acute cardiogenic pulmonary edema (ACPE). This observational study, performed in an Emergency Unit, enrolled 200 patients treated with medical therapy and continuous positive airway pressure. Anemia was found in 36% of patients (38.5% of females and 32.5% of males) and was severe (hemoglobin <9 g/dL) in 6.9% of cases. The most frequent causes of anemia were chronic renal failure (27.8%), chronic inflammatory states (27.8%) and the clustering of multiple factors (18.1%). A wider spectrum of etiological factors was found in females than in males. Microcytic anemia was observed only in females (20% of those anemic), mainly due to iron deficiency/chronic blood loss. Glomerular filtration rate, serum iron, serum albumin, total cholesterol and diastolic blood pressure were independently associated with hemoglobin levels. The etiology of anemia in ACPE is heterogeneous, with several causal factors besides impaired renal function. The pattern of anemia is different between genders, suggesting that sex-specific diagnostic and therapeutic targets should be implemented. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Importância da avaliação da hemoglobina fetal na clínica da anemia falciforme The importance of the evaluation of fetal hemoglobin in the clinical assessment of sickle cell disease

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    Rita de Cassia Mousinho-Ribeiro

    2008-04-01

    Full Text Available A anemia falciforme está entre as doenças genéticas mais comuns e mais estudadas em todo o mundo. Ela é causada por mutação no gene β, produzindo alteração estrutural na molécula da hemoglobina. As moléculas de HbS, decorrentes da mutação, sofrem processo de polimerização fisiologicamente provocado pela baixa tensão de oxigênio, acidose e desidratação. Com isso, os eritrócitos passam a apresentar a forma de foice, causando vaso-oclusão e outras conseqüências. O objetivo desse estudo foi revisar a importância da hemoglobina fetal na clínica de pacientes portadores de anemia falciforme. O significado clínico da associação da elevação da hemoglobina fetal na anemia falciforme mostra-se favorável em termos hematológicos, pois, nessa interação, as células-F têm baixas concentrações de HbS e, com isso, inibem a polimerização da HbS e a alteração da morfologia dos eritrócitos. O tratamento com hidroxiuréia, em função do aumento na expressão da hemoglobina fetal que este fármaco proporciona, traz aos pacientes falcêmicos uma melhora significativa em sua clínica. Portanto, a hemoglobina fetal consiste no maior inibidor da polimerização da desoxi-HbS e, com isso, evita a falcização do eritrócito, a anemia hemolítica crônica, as crises dolorosas vaso-oclusivas, o infarto e a necrose em diversos órgãos, melhorando a clínica e a expectativa de vida dos pacientes.Sickle cell disease is one of the commonest and most studied genetic diseases in the world. Caused by a mutation of the β gene, it changes the molecular structure of hemoglobin. Abnormal Hb S molecules suffer polymerization physiologically provoked by a low oxygen tension, acidosis and dehydration. As a result, red blood cells take on a sickle cell form, which causes microvascular occlusion with varying consequences. The objective of this study was to review the importance of fetal hemoglobin in the clinical assessment of sickle cell

  9. Sickle cell anemia and mitral valve replacement. Case report.

    Science.gov (United States)

    Bomfim, V; Ribeiro, A; Gouvea, F; Pereira, J; Björk, V

    1989-01-01

    An 8-year-old black boy with sickle cell disease and severe hemolytic anemia crisis (95% hemoglobin S) also had mitral incompetence due to rheumatic valve disease. A 27 mm monostrut Björk-Shiley valve prosthesis was implanted after partial exchange transfusions had reduced the hemoglobin S to less than 40%. High-flow normothermic perfusion was used during extracorporeal circulation, with care taken to avoid hypoxia and acidosis. Postoperative recovery was uneventful.

  10. Prediction models for hemoglobin deferral in whole blood donors

    NARCIS (Netherlands)

    Baart, A.M.

    2013-01-01

    Each year, a relevant proportion of the invited blood donors is eventually deferred from donation because of low hemoglobin (Hb) levels. Deferrals are meant to protect donors from developing iron deficiency anemia after a blood donation, however, they may increase the risk of donor lapse, even

  11. Hepcidin-Induced Iron Deficiency Is Related to Transient Anemia and Hypoferremia in Kawasaki Disease Patients

    Science.gov (United States)

    Huang, Ying-Hsien; Kuo, Ho-Chang; Huang, Fu-Chen; Yu, Hong-Ren; Hsieh, Kai-Sheng; Yang, Ya-Ling; Sheen, Jiunn-Ming; Li, Sung-Chou; Kuo, Hsing-Chun

    2016-01-01

    Kawasaki disease (KD) is a type of systemic vasculitis that primarily affects children under the age of five years old. For sufferers of KD, intravenous immunoglobulin (IVIG) has been found to successfully diminish the occurrence of coronary artery lesions. Anemia is commonly found in KD patients, and we have shown that in appropriately elevated hepcidin levels are related to decreased hemoglobin levels in these patients. In this study, we investigated the time period of anemia and iron metabolism during different stages of KD. A total of 100 patients with KD and 20 control subjects were enrolled in this study for red blood cell and hemoglobin analysis. Furthermore, plasma, urine hepcidin, and plasma IL-6 levels were evaluated using enzyme-linked immunosorbent assay in 20 KD patients and controls. Changes in hemoglobin, plasma iron levels, and total iron binding capacity (TIBC) were also measured in patients with KD. Hemoglobin, iron levels, and TIBC were lower (p < 0.001, p = 0.009, and p < 0.001, respectively) while plasma IL-6 and hepcidin levels (both p < 0.001) were higher in patients with KD than in the controls prior to IVIG administration. Moreover, plasma hepcidin levels were positively and significantly correlated with urine hepcidin levels (p < 0.001) prior to IVIG administration. After IVIG treatment, plasma hepcidin and hemoglobin levels significantly decreased (both p < 0.001). Of particular note was a subsequent gradual increase in hemoglobin levels during the three weeks after IVIG treatment; nevertheless, the hemoglobin levels stayed lower in KD patients than in the controls (p = 0.045). These findings provide a longitudinal study of hemoglobin changes and among the first evidence that hepcidin induces transient anemia and hypoferremia during KD’s acute inflammatory phase. PMID:27187366

  12. Hepcidin-Induced Iron Deficiency Is Related to Transient Anemia and Hypoferremia in Kawasaki Disease Patients

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    Ying-Hsien Huang

    2016-05-01

    Full Text Available Kawasaki disease (KD is a type of systemic vasculitis that primarily affects children under the age of five years old. For sufferers of KD, intravenous immunoglobulin (IVIG has been found to successfully diminish the occurrence of coronary artery lesions. Anemia is commonly found in KD patients, and we have shown that in appropriately elevated hepcidin levels are related to decreased hemoglobin levels in these patients. In this study, we investigated the time period of anemia and iron metabolism during different stages of KD. A total of 100 patients with KD and 20 control subjects were enrolled in this study for red blood cell and hemoglobin analysis. Furthermore, plasma, urine hepcidin, and plasma IL-6 levels were evaluated using enzyme-linked immunosorbent assay in 20 KD patients and controls. Changes in hemoglobin, plasma iron levels, and total iron binding capacity (TIBC were also measured in patients with KD. Hemoglobin, iron levels, and TIBC were lower (p < 0.001, p = 0.009, and p < 0.001, respectively while plasma IL-6 and hepcidin levels (both p < 0.001 were higher in patients with KD than in the controls prior to IVIG administration. Moreover, plasma hepcidin levels were positively and significantly correlated with urine hepcidin levels (p < 0.001 prior to IVIG administration. After IVIG treatment, plasma hepcidin and hemoglobin levels significantly decreased (both p < 0.001. Of particular note was a subsequent gradual increase in hemoglobin levels during the three weeks after IVIG treatment; nevertheless, the hemoglobin levels stayed lower in KD patients than in the controls (p = 0.045. These findings provide a longitudinal study of hemoglobin changes and among the first evidence that hepcidin induces transient anemia and hypoferremia during KD’s acute inflammatory phase.

  13. Prognostic value of anemia for patients with cervical cancer treated with irradiation

    International Nuclear Information System (INIS)

    Grigiene, R.; Aleknavicius, E.; Kurtinaitis, J.

    2005-01-01

    The objective of this study was to evaluate the prognostic value of anemia in uterine cervical carcinoma patients treated with irradiation. A total of 162 patients diagnosed with stage IIA-IIIB cervical carcinoma by the criteria of International Federation of Gynecology and Obstetrics and treated with irradiation were analyzed. Univariate and multivariate analyses using the Cox regression model were performed to determine statistical significance of some tumor-related factors. Patients were divided into two groups according to the hemoglobin level before treatment: 10 mm) assessed by computed tomography had impact on overall survival (p=0.008), disease-free survival (p=0.023) and relapse-free survival (p=0.028). Using multivariate analysis, the hemoglobin level before treatment was found to be an independent prognostic factor for overall survival (p=0.001), disease-free survival (p=0.040) and local relapse-free survival (p=0.013); Iymph node status assessed by computed tomography had impact on overall survival (p=0.030) and local relapse-free survival (p=0.038). Hemoglobin level before treatment is a significant prognostic factor for patients with uterine cervical carcinoma treated with irradiation. (author)

  14. Anemia after continuous-flow left ventricular assist device implantation: characteristics and implications.

    Science.gov (United States)

    Amione-Guerra, Javier; Cruz-Solbes, Ana S; Bhimaraj, Arvind; Trachtenberg, Barry H; Pingali, Sai R; Estep, Jerry D; Park, Myung H; Guha, Ashrith

    2017-09-15

    Anemia is common in patients with heart failure and is associated with adverse outcomes. Management of anemia in CF-LVAD patients is not well studied. Our purpose is to characterize and identify the etiology of anemia in CF-LVAD patients. Secondary objectives are to describe the effect of CF-LVAD on pre-existing anemia and assess its impact after CF-LVAD support. Cross-sectional study from January to July 2015 of ambulatory patients supported with a CF-LVAD for at least 6-months that presented with hemoglobin <12 g/dL and no recent gastrointestinal bleeding. Patients were classified as iron-deficient and non-iron-deficient and compared. Additionally, a retrospective analysis of 116 consecutive patients who underwent CF-LVAD from 2008 to 2013 with reported hemoglobin at 6 months as outpatients were divided into anemic or non-anemic and compared. In our cross-sectional cohort, iron deficiency was the most common cause of anemia. Notably, 49% of the iron-deficient patients were already on iron supplementation. In our retrospective cohort, 59% of the patients were anemic after 6 months of support. Anemic patients were older, had lower albumin, higher brain natriuretic peptide (BNP), worse renal function and New York Heart Association (NYHA) class. Anemia had a HR of 3.16 (95%CI 1.38-7.26) to predict a composite of 1-year death and HF readmissions, as well as HF-readmissions alone. The most common cause of anemia in our study was iron-deficiency; almost half of the patients were iron deficient despite treatment, suggesting that oral iron may not be sufficient to reverse anemia. Anemia regardless of etiology was associated with adverse outcomes.

  15. Fatores de risco para anemia em crianças de 6 a 12 meses no Brasil Risk factors for anemia among 6- to 12-month-old children in Brazil

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    Mônica Glória Neumann Spinelli

    2005-02-01

    Full Text Available OBJETIVO: Estimar a prevalência de anemia e investigar os fatores de risco a ela associados em lactentes brasileiros que recebem atendimento na rede básica de saúde. MÉTODO: Estudo transversal com 2 715 crianças entre 6 e 12 meses de idade, residentes em 12 municípios das cinco regiões do Brasil. As mães ou responsáveis responderam a um questionário para coleta de informações sobre a criança e sua alimentação. Foram medidos o peso e a altura para determinação do estado nutricional. Também foi feita a dosagem da concentração de hemoglobina com fotômetro portátil HemoCue, considerando-se como anemia o nível OBJECTIVE: To estimate the prevalence of anemia and to determine associated risk factors among infants receiving routine health care in public clinics in Brazil. METHOD: This cross-sectional study included 2 715 infants between 6 and 12 months old in 12 cities, in all five of the geographic regions of Brazil. Information regarding the child and its feeding habits was obtained from the mother or other caregiver, using a questionnaire. Nutritional status was determined based on height and weight measurements. The hemoglobin concentration was measured using the HemoCue portable hemoglobinometer. Anemia was defined as hemoglobin < 11 g/dL. The infants’ eating habits were assessed based on what they were eating around the time of the questionnaire interviews. The association between anemia and the different variables was evaluated through bivariate analysis, followed by multiple logistic regression using a hierarchical selection model. RESULTS: The prevalence of anemia for the entire group was 65.4%. Multiple regression analysis identified the following risk factors for anemia: living in the Southeastern Region of Brazil (odds ratio (OR = 1.57, 95% confidence interval (95% CI = 1.25- 1.99, maternal age < 20 years (OR = 1.58, 95% CI = 1.21-2.07, birthweight < 2 500 g (OR = 2.09, 95% CI = 1.48-2.95, not being breast-fed (OR

  16. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6–59 Months in the Democratic Republic of the Congo

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    Sarah Harvey-Leeson

    2016-02-01

    Full Text Available Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK and Kongo Central (KC. We determined hemoglobin (Hb, serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR, retinol binding protein (RBP, C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC, children 6–23 months (26% vs. 59% in SK; 25% vs. 42% in KC, and children 24–59 months (14% vs. 35% in SK; 23% vs. 44% in KC, respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC, children 6–23 months (51% vs. 14% in SK; 74% vs. 10% in KC, and children 24–59 months (23% vs. 4% in SK; 58% vs. 1% in KC. Regardless of indicator, iron deficiency anemia (IDA never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP deficiencies were all very low (<5%; RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC, children 6–23 months (23% in SK; 20% in KC, and children 24–59 months (25% in SK; 27% in KC. The rate of biochemical zinc deficiency among Congolese women and children requires attention.

  17. Hematological parameters and prevalence of anemia among free-living elderly in south Brazil

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    Vanessa Sgnaolin

    2013-01-01

    Full Text Available OBJECTIVE: The aims of this study were to analyze the hematological parameters, the prevalence of anemia and the association between anemia and socioeconomic conditions in an elderly community-based population. METHODS: A population-based study was performed as part of the Multidimensional Study of the Elderly in Porto Alegre, Brazil (EMIPOA. An initial total of 1058 community residents aged 60 years and older were interviewed. Of these, 392 agreed to have a physical evaluation and a blood sample was taken from each. The hematological parameters analyzed in the blood samples included the hemoglobin concentration, mean cell volume (MCV, mean corpuscular hemoglobin concentration (MCHC and red cell distribution width (RDW. The association between the variables and the diagnosis of anemia was assessed using the chi-squared test and a multiple logistic regression model. RESULTS: The overall prevalence of anemia was 12.8%. Anemia was present in 13.7% of women and in 10.4% of men. Normocytic normochromic anemia without anisocytosis was the most common type of anemia (46%. The assessment of erythrocyte morphology showed significant differences between anemic and non-anemic individuals (microcytosis = 12% vs. 1.5%, hypochromia = 40% vs. 8.8%, and anisocytosis = 26% vs. 7%. In the analysis of socioeconomic conditions, significant differences were found in respect to age and race. CONCLUSION: The prevalence of anemia increases with age and is associated with race, microcytosis, hypochromia and anisocytosis. Anemia is not a condition that should be associated only with the aging process, as it may be due to pathological conditions that occur most frequently in this age group. As a result, a diagnosis of anemia warrants adequate clinical attention.

  18. DAMPAK SUPLEMENTASI YODIUM PADA IBU ATAU BAYI TERHADAP STATUS YODIUM, STATUS GIZI DAN KADAR HEMOGLOBIN BAYI

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    Ance M. Dahro

    2012-11-01

    Full Text Available plementasi yodium pada ibu menyusui dan bayi di 2 kecamatan Magelang. Responden adalah ibu menyusui sebanyak 216 orang dan bayinya yang berumur 7-12 minggu dalam keadaan sehat. Responden dibagi ke dalam empat kelompok perlakuan yaitu I: ibu dan bayi diberi kapsul yodium; II: hanya ibu yang diberi kapsul yodium; III: hanya bayi yang diberi kapsul yodium; IV: ibu dan bayi sebagai pembanding. Yodium yang diberikan pada ibu menyusui dosis 200 mg, sedangkan untuk bayi dosis 100 mg. Dilihat dampaknya pada status yodium melalui pemeriksaan yodium dalam urin bayi pada hari ke 0, 1, 7, 60, 90 dan 180 dihitung dari hari pertama intervensi; kadar hemoglobin pada hari ke 180 dan status gizi bayi berdasarkan hasil pengukuran anthropometri pada hari ke 0, 90 dan 180. Dari hasil penelitian didapati median kadar yodium dalam urin bayi kelompok I, II dan III naik mencapai puncaknya pada hari pertama setelah pemberian kapsul yodium masing-masing yaitu 27450 ug/l, 15500 ug/l dan 26000 ug/l. Bila dibandingkan dengan awal pemeriksaan kenaikan ekskresi yodium dalam urin kelompok I, II dan III masing-masing adalah 283 kali, 152 kali dan 245 kali. Yodium dalam urin bayi kelompok I dibandingkan dengan kelompok II diasumsikan tidak sama pada setiap waktu pemeriksaan ternyata cenderung tidak terlalu berbeda. Yodium dalam urin bayi pada hri pertama kelompok II dan kelompok III yang bila dibandingkan dengan ekskresi yodium urin kelompok I menunjukkan bahwa ekskresi kadar yodium urin bayi makin tidak konsisten bila dosis suplemen makin tinggi. Ekskresi yodium dalam urin bayi yang mendapat yodium dosis hanya 100 mg ternyata jumlahnya cenderung sama dengan ekskresi yodium dalam urin ibu yang memperoleh dosis 200 mg, yang menunjukkan adanya perbedaan toleransi penyerapan yodium oleh tubuh bayi dan dewasa. Bayi yang hanya mendapat ASI saja (kelompok II ekskresi yodium dalam urinnya sudah menggambarkan kecukupan perolehan yodium pada bayi hingga hari ke 180. Pada akhir penelitian

  19. Prevalence of anemia in predialysis chronic kidney disease patients

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    FAM Shaheen

    2011-01-01

    Full Text Available To evaluate the prevalence of anemia in a large cohort that comprises patients in different stages of chronic kidney disease (CKD in the kingdom of Saudi Arabia (KSA, we conducted a multi-center cross-sectional study of a cohort of CKD patients who have not started dialysis. The study patients were recruited from the nephrology clinics in 11 different medical centers distributed all over the regions of the KSA. For the estimated glomerular filtration rate (GFR, we used the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI equation. There were 250 study patients who fulfilled the criteria for the study. The patients were stratified according to their GFR as follows: stage 1: 19 patients, stage 2: 35 patients, stage 3: 67 patients, stage 4: 68 patients, and stage 5: 61 patients. The composite of proteinuria and abnormal imaging in stages 1 and 2 was satisfied in 100% of the cases. The prevalence of anemia was elevated for the hemoglobin levels below 12 g/dL (the level at which the evaluation of anemia in CKD should be initiated in the different stages of CKD, that is, 42%, 33%, 48%, 71%, and 82% in the stages from 1 to 5, respectively. The prevalence was also elevated for the hemoglobin levels below 11 g/dL (the minimum hemoglobin level at which therapy should be initiated with erythropoietin, that is, 21%, 17%, 31%, 49%, and 72%, respectively for stages from 1 to 5. In conclusion, we found a large prevalence of anemia among the CKD population in Saudi Arabia, and the burden of patients who require treatment with erythropoietin is considerably large. However, the response to therapy will not require large doses according to the availability of long-acting erythropoiesis stimulating agents, which will render the therapy more convenient and less expensive.

  20. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study

    Science.gov (United States)

    Lebso, Meaza; Loha, Eskindir

    2017-01-01

    Background Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Methods Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration anemia. Results The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11–3.69), trimester second (AOR = 3.09, 95%CI: 1.41–6.79) and third (AOR = 3.68, 95% CI: 1.67–8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03–3.07) and six and above (AOR = 2.59, 95%CI: 1.37–4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02–2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37–7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34–5.39). Conclusion Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors. PMID:29228009

  1. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study.

    Science.gov (United States)

    Lebso, Meaza; Anato, Anchamo; Loha, Eskindir

    2017-01-01

    Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb) level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia. Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia. The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%). Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11-3.69), trimester second (AOR = 3.09, 95%CI: 1.41-6.79) and third (AOR = 3.68, 95% CI: 1.67-8.08), gravidity three to five (AOR = 1.78, 95% CI: 1.03-3.07) and six and above (AOR = 2.59, 95%CI: 1.37-4.92), not supplemented with iron (AOR = 1.72, 95% CI: 1.02-2.91), low dietary diversity score (AOR = 3.18, 95% CI: 1.37-7.37) and hookworm infection (AOR = 2.69, 95%CI: 1.34-5.39). Anemia has moderate public health significance in the area. Community-based interventions should be enhanced considering the identified associated factors.

  2. Hemoglobin levels and blood transfusion in patients with sepsis in Internal Medicine Departments.

    Science.gov (United States)

    Muady, Gassan Fuad; Bitterman, Haim; Laor, Arie; Vardi, Moshe; Urin, Vitally; Ghanem-Zoubi, Nesrin

    2016-10-13

    Acute reduction in hemoglobin levels is frequently seen during sepsis. Previous studies have focused on the management of anemia in patients with septic shock admitted to intensive care units (ICU's), including aggressive blood transfusion aiming to enhance tissue oxygenation. To study the changes in hemoglobin concentrations during the first week of sepsis in the setting of Internal Medicine (IM) units, and their correlation to survival. Observational prospective study. We recorded hemoglobin values upon admission and throughout the first week of hospital stay in a consecutive cohort of septic patients admitted to IM units at a community hospital, the patients were enrolled into a prospective registry. Data on blood transfusions was also collected, we examined the correlation between hemoglobin concentrations during the first week of sepsis and survival, the effect of blood transfusion was also assessed. Eight hundred and fifteen patients (815) with sepsis were enrolled between February 2008 to January 2009. More than 20 % of them had hemoglobin levels less than 10g/dL on admission, a rate that was doubled during the first week of sepsis. Overall, 68 (8.3 %) received blood transfusions, 14 of them (20.6 %) due to bleeding. Typically, blood transfusion was given to older patients with a higher rate of malignancy and lower hemoglobin levels. While hemoglobin concentration on admission had strong correlation with in-hospital mortality (O.R-0.83 [95 % C.I. 0.74-0.92], blood transfusion was not found to be an independent predicting factor for mortality. Anemia is very common in sepsis. While hemoglobin level on admission exhibit independent correlation with survival, blood transfusion do not.

  3. Distinct roles of urinary liver-type fatty acid-binding protein in non-diabetic patients with anemia.

    Directory of Open Access Journals (Sweden)

    Naohiko Imai

    Full Text Available Various stresses including ischemia are known to up-regulate renal L-FABP gene expression and increase the urinary excretion of L-FABP. In diabetic patients with anemia, the urinary excretion of L-FABP is significantly increased. We studied the clinical significance of urinary L-FABP and its relationship with anemia in non-diabetic patients.A total of 156 patients were studied in this retrospective cross-sectional analysis. The associations between anemia and urinary L-FABP levels, and the predictors of urinary L-FABP levels in non-diabetic patients were evaluated.Urinary L-FABP levels were significantly higher in patients with anemia compared to those in patients without anemia. Similarly, the urinary L-FABP levels were significantly higher in patients with albuminuria compared to those in patients without albuminuria. Urinary L-FABP levels correlated with urinary albumin-to-creatinine ratios, estimated glomerular filtration rates, body mass index, and hemoglobin levels. Multivariate linear regression analysis determined that hemoglobin levels (β = -0.249, P = 0.001 and urinary albumin-to-creatinine ratios (β = 0.349, P < 0.001 were significant predictors of urinary L-FABP levels.Urinary L-FABP is strongly associated with anemia in non-diabetic patients.

  4. Anemia management among hemodyalisis patients at the University Hospital in Puerto Rico.

    Science.gov (United States)

    Ocasio, Heana E; Diaz, Hector; Cangiano, José L; Báez, Rafael; Suárez, Erick

    2014-01-01

    End-stage renal disease is frequently complicated with anemia. Iron deficiency anemia occurs in most hemodialysis patients secondary to increased iron demand driven by the accelerated erythropoiesis that occurs when stimulating agents are administered as treatment of the anemia. The purpose of this study was to determine the prevalence of anemia and iron stores in patients undergoing hemodialysis at our unit; identify their treatment and effectiveness. Medical records of fifty-three patients undergoing ambulatory hemodialysis were evaluated for three months. Patient's hemoglobin, ferritin, iron, total iron binding capacity and percent transferrin saturation were recorded. 91% patients had arterial hypertension and 62% were diabetic. The prevalence of anemia was 34%, 57% and 47% during the three-month period respectively. Only 21% of the population had transferrin saturation less than 20% and none had ferritin below 200 ng/ml. Throughout the study, the majority of patients were managed with combination of iron and erythropoietin stimulating agents (ESAs). The prevalence of anemia remained elevated despite treatment with iron and ESAs. However, 56% of anemic patients throughout the three months showed an increase in hemoglobin levels by the end of the observation period. 53% of patients were treated with iron alone or with ESAs for the three consecutive month periods and only two had transferrin saturation less than 20%. In our population, ESAs low responsiveness is not related to iron deficiency but to the morbidity of their disease.

  5. Effects of separate delivery of zinc or zinc and vitamin A on hemoglobin response, growth, and diarrhea in young Peruvian children receiving iron therapy for anemia.

    Science.gov (United States)

    Alarcon, Karl; Kolsteren, Patrick W; Prada, Ana M; Chian, Ana M; Velarde, Ruth E; Pecho, Iris L; Hoeree, Tom F

    2004-11-01

    Anemia is the most prevalent nutritional deficiency in the world. Attempts to improve iron indexes are affected by deficiency of and interaction between other micronutrients. Our goal was to assess whether zinc added to iron treatment alone or with vitamin A improves iron indexes and affects diarrheal episodes. This was a randomized, placebo-controlled, double-blind trial conducted in Peru. Anemic children aged 6-35 mo were assigned to 3 treatment groups: ferrous sulfate (FS; n = 104), ferrous sulfate and zinc sulfate (FSZn; n = 109), and ferrous sulfate, zinc sulfate, and vitamin A (FSZnA; n = 110). Vitamin A or its placebo was supplied only once; iron and zinc were provided under supervision >/=1 h apart 6 d/wk for 18 wk. The prevalence of anemia was 42.97%. The increase in hemoglobin in the FS group (19.5 g/L) was significantly less than that in the other 2 groups (24.0 and 23.8 g/L in the FSZn and FSZnA groups, respectively). The increase in serum ferritin in the FS group (24.5 mug/L) was significantly less than that in the other 2 groups (33.0 and 30.8 mug/L in the FSZn and FSZnA groups, respectively). The median duration of diarrhea and the mean number of stools per day was significantly higher in the FS group than in other 2 groups (P < 0.005). Adding zinc to iron treatment increases hemoglobin response, improves iron indexes, and has positive effects on diarrhea. No additional effect of vitamin A was found.

  6. White Matter Damage Relates to Oxygen Saturation in Children With Sickle Cell Anemia Without Silent Cerebral Infarcts.

    Science.gov (United States)

    Kawadler, Jamie M; Kirkham, Fenella J; Clayden, Jonathan D; Hollocks, Matthew J; Seymour, Emma L; Edey, Rosanna; Telfer, Paul; Robins, Andrew; Wilkey, Olu; Barker, Simon; Cox, Tim C S; Clark, Chris A

    2015-07-01

    Sickle cell anemia is associated with compromised oxygen-carrying capability of hemoglobin and a high incidence of overt and silent stroke. However, in children with no evidence of cerebral infarction, there are changes in brain morphometry relative to healthy controls, which may be related to chronic anemia and oxygen desaturation. A whole-brain tract-based spatial statistics analysis was carried out in 25 children with sickle cell anemia with no evidence of abnormality on T2-weighted magnetic resonance imaging (13 male, age range: 8-18 years) and 14 age- and race-matched controls (7 male, age range: 10-19 years) to determine the extent of white matter injury. The hypotheses that white matter damage is related to daytime peripheral oxygen saturation and steady-state hemoglobin were tested. Fractional anisotropy was found to be significantly lower in patients in the subcortical white matter (corticospinal tract and cerebellum), whereas mean diffusivity and radial diffusivity were higher in patients in widespread areas. There was a significant negative relationship between radial diffusivity and oxygen saturation (Plevel negative relationship between radial diffusivity and hemoglobin (Pcell anemia, and provides for the first time direct evidence of a relationship between brain microstructure and markers of disease severity (eg, peripheral oxygen saturation and steady-state hemoglobin). This study suggests that diffusion tensor imaging metrics may serve as a biomarker for future trials of reducing hypoxic exposure. © 2015 American Heart Association, Inc.

  7. Pengaruh suplementasi taburia (sprinkle terhadap kadar hemoglobin balita gizi kurang usia 3-5 tahun di Kecamatan Lewimunding Kabupaten Majalengka

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    Teguh Akbar Budiana

    2016-12-01

    Full Text Available Background: Anemia is the most common nutritional problem found in the world, whichal sooccurred in under five children. Anemia is one of themain nutritional problems in Indonesia. Anemia treatment by iron (Fe supplementation the community level were not successfull yet. This research aimed to investigate the effect of sprinkle supplementation on hemoglobin level of malnourished children aged 3-5 years. Method: Randomized pretest - posttest control group design was implemented on 66 anemic malnourished children aged 3-5 years. Study was conducted in Lewimunding subdistrict. Subjects were divided into two groups, treatment and control groups. Sprinkle supplementation and nurition education were given to treatment group for 2 months, while control group were only recieved nutrition education. All subjects treated by 400 mg Albendazol before supplementation. Data were nutrient intake collected by 24 hour Recall method. Hb was measured by Cyamethaemoglobin. Data were analyzed by Mann-Whitney,  Independent Sample Test, Wilcoxon Signed Ranks, Paired Test and linear regression method. Result: There was no difference in energy, protein, iron, vitamin B6, vitamin B12 and vitamin C on both treatment and control groups. There is no difference in hemoglobin levels between the groups before supplementation (p=0.290. Hemoglobin increased on treatment group from (11.14±0.85 mg/dl to (12.31±0.55 mg/dl with p=0.001. Hemoglobin also increased from (10,95 ± 0,71 mg/dl to (11,81 ±0,53 mg/dl in the control group (p=0.001. Sprinkle  supplementation increased by hemoglobin level  0.69 mg/dl higher than the control group (p=0.001. Multivariate analysis that hemoglobin level increased by  0.66 mg/dl higher compared to the control group after controlled by initial hemoglobin. Conclusion: Sprinkle supplementation for two months increase hemoglobin level of anemic malnourished children.

  8. Glycine and Folate Ameliorate Models of Congenital Sideroblastic Anemia.

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    J Pedro Fernández-Murray

    2016-01-01

    Full Text Available Sideroblastic anemias are acquired or inherited anemias that result in a decreased ability to synthesize hemoglobin in red blood cells and result in the presence of iron deposits in the mitochondria of red blood cell precursors. A common subtype of congenital sideroblastic anemia is due to autosomal recessive mutations in the SLC25A38 gene. The current treatment for SLC25A38 congenital sideroblastic anemia is chronic blood transfusion coupled with iron chelation. The function of SLC25A38 is not known. Here we report that the SLC25A38 protein, and its yeast homolog Hem25, are mitochondrial glycine transporters required for the initiation of heme synthesis. To do so, we took advantage of the fact that mitochondrial glycine has several roles beyond the synthesis of heme, including the synthesis of folate derivatives through the glycine cleavage system. The data were consistent with Hem25 not being the sole mitochondrial glycine importer, and we identify a second SLC25 family member Ymc1, as a potential secondary mitochondrial glycine importer. Based on these findings, we observed that high levels of exogenous glycine, or 5-aminolevulinic acid (5-Ala a metabolite downstream of Hem25 in heme biosynthetic pathway, were able to restore heme levels to normal in yeast cells lacking Hem25 function. While neither glycine nor 5-Ala could ameliorate SLC25A38 congenital sideroblastic anemia in a zebrafish model, we determined that the addition of folate with glycine was able to restore hemoglobin levels. This difference is likely due to the fact that yeast can synthesize folate, whereas in zebrafish folate is an essential vitamin that must be obtained exogenously. Given the tolerability of glycine and folate in humans, this study points to a potential novel treatment for SLC25A38 congenital sideroblastic anemia.

  9. Hemoglobin levels and 30-day mortality in patients after myocardial infarction

    NARCIS (Netherlands)

    Lipsic, E; van der Horst, ICC; Voors, AA; van der Meer, P; Nijsten, MWN; van Gilst, WH; van Veldhuisen, DJ; Zijlstra, F

    2005-01-01

    Background: Anemia is an independent risk factor for cardiovascular (CV) outcomes in patients with coronary artery disease and heart failure. However, the effect of hemoglobin levels on short-term CV mortality in patients with acute myocardial infarction (MI) remains unclear. Methods: In a

  10. Severe anemia in Malawian children.

    Science.gov (United States)

    Calis, Job Cj; Phiri, Kamija S; Faragher, E Brian; Brabin, Bernard J; Bates, Imelda; Cuevas, Luis E; de Haan, Rob J; Phiri, Ajib I; Malange, Pelani; Khoka, Mirriam; Hulshof, Paul Jm; van Lieshout, Lisette; Beld, Marcel Ghm; Teo, Yik Y; Rockett, Kirk A; Richardson, Anna; Kwiatkowski, Dominic P; Molyneux, Malcolm E; van Hensbroek, Michaël Boele

    2016-09-01

    Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration, <5.0 g per deciliter) and 757 preschool children without severe anemia in urban and rural settings in Malawi. Causal factors previously associated with severe anemia were studied. The data were examined by multivariate analysis and structural equation modeling. Bacteremia (adjusted odds ratio, 5.3; 95% confidence interval [CI], 2.6 to 10.9), malaria (adjusted odds ratio, 2.3; 95% CI, 1.6 to 3.3), hookworm (adjusted odds ratio, 4.8; 95% CI, 2.0 to 11.8), human immunodeficiency virus infection (adjusted odds ratio, 2.0; 95% CI, 1.0 to 3.8), the G6PD -202/-376 genetic disorder (adjusted odds ratio, 2.4; 95% CI, 1.3 to 4.4), vitamin A deficiency (adjusted odds ratio, 2.8; 95% CI, 1.3 to 5.8), and vitamin B 12 deficiency (adjusted odds ratio, 2.2; 95% CI, 1.4 to 3.6) were associated with severe anemia. Folate deficiency, sickle cell disease, and laboratory signs of an abnormal inflammatory response were uncommon. Iron deficiency was not prevalent in case patients (adjusted odds ratio, 0.37; 95% CI, 0.22 to 0.60) and was negatively associated with bacteremia. Malaria was associated with severe anemia in the urban site (with seasonal transmission) but not in the rural site (where malaria was holoendemic). Seventy-six percent of hookworm infections were found in children under 2 years of age. There are multiple causes of severe anemia in Malawian preschool children, but folate and iron deficiencies are not prominent among them. Even in the presence of malaria parasites, additional or alternative causes of severe anemia should be considered.

  11. [Positive Distribution Rate of Coombs Test in Patients with Clinical Anemia and Blood Transfusion and Its Effect on Clinical Blood Transfusion].

    Science.gov (United States)

    Wu, Gang; Duan, Yu-Han

    2018-02-01

    To study the positive distribution rate of Coombs test in patients with clinical anemia and blood transfusion, and its effect on clinical blood transfusion. Seventy patients with hemoglobin level in the normal range were enrolled into control group, while 130 patients with anemia or blood transfusion who' s hemoglobin level was lower comfirmed by micro-column gel antihuman globin detection card and 70 surgical patients with anemia or blood transfusion who' s hemoglobin level was lower comfirmed by micro-column gel anti-human globin card were enrolled into anemia or blood transfusion (A or BT) group. And coomb' s test performed for all the patients, in which the positive patients in Department of Internal Medicine need to be re-typed. Among 70 surgical patients with anemia or blood transfusion, 14 cases were directly detected to be anti-human globine positive with detection rate 20%; among 130 internal medicine patients with anemia or blood transfusion, 54 cases were directly detected to be anti-human globine positive with detection rate 41.4%. Among 270 cases, the highest positive rate (66.7%) was observed in patients with 50-59 g/L of hemoglobin. According to type test, the samples of 54 patients with anemia in Department of Internal Medicine, who were directly selected to be anti-human globin positive, could be divided into anti-C3d(7 cases, accounting for 13.0%), anti-IgG(12 cases accounting for, 22.2%) and anti-C3d+anti-IgG(35 cases, accounting for 64.8%), while according to diseases, the anti-human globin positive ratio was high in tumor cancer, hephropathy and gastroenteropathy patients, and patients in intensive care unit, moreover the blood transfusion frequency of these patients was higher than that of patients with anti-human globin negative(Pblood transfusion, so as to ensure the effectiveness of blood transfusion.

  12. High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia.

    Science.gov (United States)

    Verhagen, Lilly M; Incani, Renzo N; Franco, Carolina R; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I; Hermans, Peter W M; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H; Pinelli, Elena

    2013-01-01

    Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic

  13. High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia.

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    Lilly M Verhagen

    Full Text Available Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children.This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score and acute (weight-for-height and Body Mass Index (BMI-for-age Z score in respectively children under 5 years of age and children aged 5 years and above malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism.Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18% while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37% and Trichuris trichiura (40% in both regions. The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%. Anemia prevalence was highest in the Amazon Region (24%. Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20.In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and

  14. Efficacy of iron-supplement bars to reduce anemia in urban Indian women: a cluster-randomized controlled trial.

    Science.gov (United States)

    Mehta, Rajvi; Platt, Alyssa C; Sun, Xizi; Desai, Mukesh; Clements, Dennis; Turner, Elizabeth L

    2017-03-01

    Background: India's high prevalence of iron-deficiency anemia has largely been attributed to the local diet consisting of nonheme iron, which has lower absorption than that of heme iron. Objective: We assessed the efficacy of the consumption of iron-supplement bars in raising hemoglobin concentrations and hematocrit percentages in anemic (hemoglobin concentration Indian women of reproductive age. Design: The Let's be Well Red study was a 90-d, pair-matched, cluster-randomized controlled trial. A total of 361 nonpregnant women (age 18-35 y) were recruited from 10 sites within Mumbai and Navi Mumbai, India. All participants received anemia education and a complete blood count (CBC). Random assignment of anemic participants to intervention and control arms occurred within 5 matched site-pairs. Intervention participants received 1 iron-supplement bar (containing 14 mg Fe)/d for 90 d, whereas control subjects received nothing. CBC tests were given at days 15, 45, and 90. Primary outcomes were 90-d changes from baseline in hemoglobin concentrations and hematocrit percentages. Linear mixed models and generalized estimating equations were used to model continuous and binary outcomes, respectively. Results: Of 179 anemic participants, 136 (76.0%) completed all follow-up assessments (65 intervention and 71 control participants). Baseline characteristics were comparable by arm. Mean hemoglobin and hematocrit increases after 90 d were greater for intervention than for control participants [1.4 g/dL (95% CI: 1.3, 1.6 g/dL) and 2.7% (95% CI: 2.2%, 3.2%), respectively]. The anemia prevalence at 90 d was lower for intervention (29.2%) than for control participants (98.6%) (OR: 0.007; 95% CI: 0.001, 0.04). Conclusions: The daily consumption of an iron-supplement bar leads to increased hemoglobin concentrations and hematocrit percentages and to a lower anemia prevalence in the target population with no reported side effects. This intervention is an attractive option to combat anemia

  15. Maternal hemoglobin in Peru: regional differences and its association with adverse perinatal outcomes

    OpenAIRE

    Gonzales, Gustavo F.; Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima, Perú. Unidad de Reproducción, Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia. Lima, Perú. Doctor en Medicina.; Tapia, Vilma; Unidad de Reproducción, Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia. Lima, Perú. Obstetríz.; Gasco, Manuel; Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima, Perú. Biólogo.; Carrillo, Carlos; Unidad de Reproducción, Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia. Lima, Perú. Doctor en Medicina.

    2011-01-01

    Objectives. To evaluate hemoglobin (Hb) levels in pregnant women from different geographical regions from Peru; to establish anemia and erythrocytocis rates and to establish the role of Hb on adverse perinatal outcomes using the Perinatal Information System (PIS) database of Peruvian Ministry of Health. Materials and methods. Data were obtained from 379,816 births of 43 maternity care units between 2000 and 2010. Anemia and erythrocytocis rates were determined in each geographical region as w...

  16. Iron-deficiency anemia and associated factors among preschool children in Diamantina, Minas Gerais, Brazil

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    Luciana Neri NOBRE

    Full Text Available ABSTRACT Objective: Study the prevalence of iron depletion and iron-deficiency anemia and their associated factors in preschool children. Methods: Cross-sectional study with five-year old preschool children from a birth cohort of the city of Diamantina, Minas Gerais state, Brazil. Socioeconomic, demographic, and dietary characteristics were obtained through a questionnaire administered to each child mother or guardian. Iron depletion (normal hemoglobin and low serum ferritin levels and iron-deficiency anemia (hemoglobin level than 11g/dL were detected after collecting 5mL of venous blood of preschool children. Poisson regression was used to identify the factors associated with iron depletion and iron-deficiency anemia. Results: A total of 228 preschool were evaluated, corresponding to 97.4% of the children from a cohort study followed-up up to the end of their first year of life. Iron depletion and iron-deficiency anemia were detected, respectively, in 15.9% and 18.9% of the preschool children evaluated. Iron depletion was not associated with any variable studied, while low maternal education level was associated with iron-deficiency anemia (PR=1.83; P=0.03. Conclusion: Iron-deficiency anemia is considered as a mild public health problem among 5-year old children in the city of Diamantina, Minas Gerais. Higher maternal education level was a protective factor against this deficiency, and therefore it is as an important marker for the occurrence of iron-deficiency anemia in the population studied.

  17. [The influencing factors of anemia for pregnant women between 2010-2012 in China].

    Science.gov (United States)

    Jiang, S; Pang, X H; Duan, Y F; Bi, Y; Wang, J; Yin, S A; Yang, L C; Yang, Z Y

    2018-01-06

    Objective: To investigate the prevalence of anemia and related risk factors for pregnant women in China. Method: Based on Chinese National Nutrition and Health Surveillance 2010-2012, a total of 3 501 pregnant women were investigated from 150 counties of 31 provinces, municipalities and autonomous regions in China, using a multi-stage stratified cluster randomization sampling method. General information of pregnant women, health status, and food intake during the gestation, was collected through a questionnaire investigation. 6 ml fasting venous blood was collected for the determination of hemoglobin concentration. Data were analyzed using multiple logistic regression to investigate the prevalence of anemia and the related influencing factors. Results: The 605 of 3 501 pregnant women had anemia. The prevalence of anemia was 17.2%; and mild anemia accounted for about 61.0% (369/605). Compared with the pregnant women living in the large cities, the OR (95% CI ) of those living in the poor rural areas was 1.46 (1.08-1.98). Compared with the pregnant women living in the south area of China, the OR (95% CI ) of those living in the north area of China was 1.39 (1.15-1.68); Compared with the pregnant women in the first trimester, the OR (95% CI ) of those in the second trimester and the third trimester were 1.79 (1.33-2.43) and 2.11 (1.56-2.85), respectively. The OR (95% CI ) of pregnant women who had used folic acid supplementation within the 6 months prior to gestation was 0.76 (0.63-0.93) compared with those who had not used. Conclusion: From 2010 to 2012, the epidemic characteristics of anemia was mild for the pregnant women in China, and pregnant women residential areas, periods of pregnancy and whether to take folic acid were related to anemia.

  18. Iron deficiency was not the major cause of anemia in rural women of reproductive age in Sidama zone, southern Ethiopia: A cross-sectional study.

    Science.gov (United States)

    Gebreegziabher, Tafere; Stoecker, Barbara J

    2017-01-01

    Anemia, which has many etiologies, is a moderate/severe public health problem in young children and women of reproductive age in many developing countries. The aim of this study was to investigate prevalence of iron deficiency, anemia, and iron deficiency anemia using multiple biomarkers and to evaluate their association with food insecurity and food consumption patterns in non-pregnant women from a rural area of southern Ethiopia. A cross-sectional study was conducted in 202 rural women of reproductive age in southern Ethiopia. Anthropometrics and socio-demographic data were collected. A venipuncture blood sample was analyzed for hemoglobin (Hb) and for biomarkers of iron status. Biomarkers were skewed and were log transformed before analysis. Mean, median, Pearson's correlations and ordinary least-squares regressions were calculated. Median (IQR) Hb was 138 (127, 151) g/L. Based on an altitude-adjusted (1708 m) cutoff of 125 g/L for Hb, 21.3% were anemic. Plasma ferritin was 1.0 g/L; four women (2%) had > 5 mg/L of C-reactive protein (CRP). Of the 43 women who were anemic, 23.3% (10 women) had depleted iron stores based on plasma ferritin. Three of these had elevated soluble transferrin receptors (sTfR). Hemoglobin (Hb) concentration was negatively correlated with sTfR (r = -0.24, p = 0.001), and positively correlated with ferritin (r = 0.17, p = 0.018), plasma iron (r = 0.15, p = 0.046), transferrin saturation (TfS) (r = 0.15, p = 0.04) and body iron (r = 0.14, p = 0.05). Overall prevalence of iron deficiency anemia was only 5%. Iron deficiency anemia was not prevalent in the study population, despite the fact that anemia would be classified as a moderate public health problem.

  19. The sociodemographic correlates of nutritional status of school adolescents in Jiangsu Province, China.

    Science.gov (United States)

    Shi, Zumin; Lien, Nanna; Kumar, Bernadette Nirmal; Dalen, Ingvild; Holmboe-Ottesen, Gerd

    2005-10-01

    The objective of this article was to describe the relationship between sociodemographic factors and nutritional status (body mass index [BMI], height for age, and anemia) in adolescents. In 2002, a cross-sectional study comprising 824 students aged 12 to 14 years from 8 schools in 2 prefectures in Jiangsu province of China had their height, weight, and hemoglobin level measured. Self-administered questionnaires were used to collect sociodemographic information. The prevalence of underweight was low in the overall sample (5.2%). The prevalence of stunting also was low (2.9%), and the differences between residential areas and sociodemographic groups were small. The percentage of overweight/obesity was higher among boys (17.9%) than girls (8.9%). Male students having fathers with a high educational level had the highest percentage of overweight and obesity (27.8%). Household socioeconomic status (SES) was associated positively with BMI. Family size, gender, and the father's level of education also were related to BMI. The percentage of anemia was somewhat higher among girls (23.4%) than boys (17.2%). Anemia coexisted with underweight. No urban/rural or SES differences in the percentage of students with anemia were observed in the sample, but differences between regions and schools were very significant. Undernutrition was not a problem in the research area. Nutritional status was associated with SES and region. Overnutrition and anemia in adolescents are important nutritional problems in Jiangsu, China. Intervention programs are needed to address these problems.

  20. Hemoglobin levels in normal Filipino pregnant women.

    Science.gov (United States)

    Kuizon, M D; Natera, M G; Ancheta, L P; Platon, T P; Reyes, G D; Macapinlac, M P

    1981-09-01

    The hemoglobin concentrations during pregnancy in Filipinos belonging to the upper income group, who were prescribed 105 mg elemental iron daily, and who had acceptable levels of transferrin saturation, were examined in an attempt to define normal levels. The hemoglobin concentrations for each trimester followed a Gaussian distribution. The hemoglobin values equal to the mean minus one standard deviation were 11.4 gm/dl for the first trimester and 10.4 gm/dl for the second and third trimesters. Using these values as the lower limits of normal, in one group of pregnant women the prevalence of anemia during the last two trimesters was found lower than that obtained when WHO levels for normal were used. Groups of women with hemoglobin of 10.4 to 10.9 gm/dl (classified anemic by WHO criteria but normal in the present study) and those with 11.0 gm/dl and above could not be distinguished on the basis of their serum ferritin levels nor on the degree of decrease in their hemoglobin concentration during pregnancy. Many subjects in both groups, however, had serum ferritin levels less than 12 ng/ml which indicate poor iron stores. It might be desirable in future studies to determine the hemoglobin cut-off point that will delineate subjects who are both non-anemic and adequate in iron stores using serum ferritin levels as criterion for the latter.

  1. Microfluidic approach of Sickled Cell Anemia

    Science.gov (United States)

    Abkarian, Manouk; Loiseau, Etienne; Massiera, Gladys

    2012-11-01

    Sickle Cell Anemia is a disorder of the microcirculation caused by a genetic point mutation that produces an altered hemoglobin protein called HbS. HbS self-assembles reversibly into long rope like fibers inside the red blood cells. The resulting distorded sickled red blood cells are believed to block the smallest capillaries of the tissues producing anemia. Despite the large amount of work that provided a thorough understanding of HbS polymerization in bulk as well as in intact red blood cells at rest, no consequent cellular scale approaches of the study of polymerization and its link to the capillary obstruction have been proposed in microflow, although the problem of obstruction is in essence a circulatory problem. Here, we use microfluidic channels, designed to mimic physiological conditions (flow velocity, oxygen concentration, hematocrit...) of the microcirculation to carry out a biomimetic study at the cellular scale of sickled cell vaso-occlusion. We show that flow geometry, oxygen concentration, white blood cells and free hemoglobin S are essential in the formation of original cell aggregates which could play a role in the vaso-occlusion events.

  2. [Prevalence of anemia in reproductive-age Mexican women].

    Science.gov (United States)

    Shamah-Levy, Teresa; Villalpando, Salvador; Mundo-Rosas, Verónica; De la Cruz-Góngora, Vanessa; Mejía-Rodríguez, Fabiola; Méndez Gómez-Humarán, Ignacio

    2013-01-01

    To update the prevalence of anemia and its trend in Mexican women of childbearing age over the past 13 years using information from the National Health and Nutrition Survey 2012 and 2006 (ENSANUT 2012 and ENSANUT 2006, respectively) and from the National Nutrition Survey 1999 (ENN 99). Data came from three national probabilistic surveys, representative at regional and rural / urban level. Hemoglobin (Hb) in women was measured using a HemoCue photometer and classified as anemia according to the WHO criteria. Frequencies and CI95% were estimated for each survey (ENSANUT 2012, ENSANUT 2006 and ENN 99) as well as percentage changes in anemia prevalence among pregnant and non-pregnant women in this survey sequence. The national prevalence of anemia in 2012 in non-pregnant women was 11.6% and in pregnant women was 17.9%. Between 1999 and 2012, a 10 percentage point (pp) decreasing in anemia prevalence was observed in the first ones and a 13.5 pp in the second ones. Although it has declined in the past 13 years, anemia in women of childbearing age remains as a serious public health problem. It is considered necessary to design strategies to prevent iron deficiency and for the early detection of anemia in women.

  3. Iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza Strip, Palestine

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    Mahmoud Mohammed Sirdah

    2014-04-01

    Full Text Available Background: iron deficiency anemia is the most common type of nutritional anemia; it has been recognized as an important health problem in Palestine. This study was conducted to estimate the prevalence and to identify possible risk factors of iron deficiency anemia among kindergarten children living in the marginalized areas of the Gaza Strip and to evaluate the effectiveness of supplementing oral iron formula in the anemic children. Methods: the study included 735 (384 male and 351 female kindergarten children. Data was collected by questionnaire interviews, anthropometric measurements, and complete blood count analysis. All iron deficient anemic children were treated using an oral iron formula (50 mg ferrous carbonate + 100 mg vitamin C /5 mL and the complete blood count was reassessed after three months. A univariate analysis and a multiple logistic regression model were constructed; crude and adjusted odds ratios (OR, and 95% confidence intervals (95% CI were calculated. Results: the overall prevalence of iron deficiency anemia was 33.5% with no significant differences between boys and girls. Significantly different prevalences of iron deficiency anemia were reported between different governorates of the Gaza Strip. Governorate, low education level of the parents and smoking are significant risk factors for children developing anemia. Significantly lower complete blood count parameters, except for WBC, were reported in anemic children. The oral iron treatment significantly improved hemoglobin concentrations, and normalized the iron deficiency marker. Conclusions: iron deficiency anemia is a serious health problem among children living in the marginalized areas of the Gaza Strip, which justifies the necessity for national intervention programs to improve the health status for the less fortunate development areas.

  4. High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and Creoles: Significant Associations WITH Intestinal Parasites and Anemia

    Science.gov (United States)

    Verhagen, Lilly M.; Incani, Renzo N.; Franco, Carolina R.; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I.; Hermans, Peter W. M.; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H.; Pinelli, Elena

    2013-01-01

    Background Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. Methods This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Results Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). Conclusions In rural populations in Venezuela helminthiasis and giardiasis were

  5. Development and validation of a noncontact spectroscopic device for hemoglobin estimation at point-of-care

    Science.gov (United States)

    Sarkar, Probir Kumar; Pal, Sanchari; Polley, Nabarun; Aich, Rajarshi; Adhikari, Aniruddha; Halder, Animesh; Chakrabarti, Subhananda; Chakrabarti, Prantar; Pal, Samir Kumar

    2017-05-01

    Anemia severely and adversely affects human health and socioeconomic development. Measuring hemoglobin with the minimal involvement of human and financial resources has always been challenging. We describe a translational spectroscopic technique for noncontact hemoglobin measurement at low-resource point-of-care settings in human subjects, independent of their skin color, age, and sex, by measuring the optical spectrum of the blood flowing in the vascular bed of the bulbar conjunctiva. We developed software on the LabVIEW platform for automatic data acquisition and interpretation by nonexperts. The device is calibrated by comparing the differential absorbance of light of wavelength 576 and 600 nm with the clinical hemoglobin level of the subject. Our proposed method is consistent with the results obtained using the current gold standard, the automated hematology analyzer. The proposed noncontact optical device for hemoglobin estimation is highly efficient, inexpensive, feasible, and extremely useful in low-resource point-of-care settings. The device output correlates with the different degrees of anemia with absolute and trending accuracy similar to those of widely used invasive methods. Moreover, the device can instantaneously transmit the generated report to a medical expert through e-mail, text messaging, or mobile apps.

  6. Serum phosphorus and association with anemia among a large diverse population with and without chronic kidney disease

    Science.gov (United States)

    Tran, Lac; Batech, Michael; Rhee, Connie M.; Streja, Elani; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.; Sim, John J.

    2016-01-01

    Background We hypothesized that phosphorus has an effect on anemia in both normal kidney function and early chronic kidney disease (CKD). We sought to determine whether higher phosphorus levels are associated with anemia in a large diverse population without CKD and early CKD. Methods This study is a historical population-based study within the Kaiser Permanente Southern California health system (1 January 1998 to 31 December 2013) among individuals aged 18 years and older with estimated glomerular filtration rate >30 mL/min/1.73 m2 and measurements of serum phosphorus, creatinine and hemoglobin. Individuals were excluded if they had secondary causes of anemia. Odds ratio (OR) estimated for moderate anemia defined as hemoglobin phosphorus levels ≥3.5 mg/dL were associated with both mild and moderate anemia. Moderate anemia OR (95% confidence interval) was 1.16 (1.04–1.29) for every 0.5 mg/dL phosphorus increase and 1.26 (1.07–1.48) in the highest versus middle phosphorus tertile. Additional independent anemia risk factors, including female sex, Asian race, diabetes, low albumin and low iron saturation, were observed, but did not alter the anemia–phosphorus association. Conclusions Higher phosphorus levels were associated with a greater likelihood for anemia in a population with early CKD and normal kidney function. Phosphorus may be a biomarker for anemia and may affect aspects of hematopoiesis. PMID:26254460

  7. [Prevalence of anemia and associated factors in elderly residing in peruvian households].

    Science.gov (United States)

    Tarqui-Mamani, Carolina; Sanchez-Abanto, José; Alvarez-Dongo, Doris; Espinoza-Oriundo, Paula; Jordan-Lechuga, Teresa

    2015-10-01

    To estimate the prevalence of anemia and associated factors in elderly residing in Peruvian households. the study deals with a cross-sectional design and was conducted in 2011. The sample was probabilistic, stratified and multistage independent in department of Peru. The required sample housing was 5792, we included 2172 elderly. We asked informed consent of all elderly. The anemia was defined as hemoglobin 23 to anemia was 23,3% (mild anemia 17.1%, moderate: severe 5,7% and 0,5%). The age 70 to 79 years (OR 1.5; CI 95%:1.1; 2.0),> 80 years (OR 2.1; CI 95%: 1.4; 3.0) and thinness (OR 1.7; CI 95%: 1.2, 2.3) associated with anemia. Ayacucho, Ancash, Lambayeque and Apurimac were the departments with the highest prevalence of anemia. Approximately one quarter of elderly were anemic, being more prevalent in the illiterate, rural and poor. Older age and thinness are associated with anemia in elderly Peruvians.

  8. Multivitamin and iron supplementation to prevent periconceptional anemia in rural tanzanian women: a randomized, controlled trial.

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    Nilupa S Gunaratna

    Full Text Available Women's nutritional status during conception and early pregnancy can influence maternal and infant outcomes. This study examined the efficacy of pre-pregnancy supplementation with iron and multivitamins to reduce the prevalence of anemia during the periconceptional period among rural Tanzanian women and adolescent girls.A double-blind, randomized controlled trial was conducted in which participants were individually randomized to receive daily oral supplements of folic acid alone, folic acid and iron, or folic acid, iron, and vitamins A, B-complex, C, and E at approximately single recommended dietary allowance (RDA doses for six months.Rural Rufiji District, Tanzania.Non-pregnant women and adolescent girls aged 15-29 years (n = 802.The study arms were comparable in demographic and socioeconomic characteristics, food security, nutritional status, pregnancy history, and compliance with the regimen (p>0.05. In total, 561 participants (70% completed the study and were included in the intention-to-treat analysis. Hemoglobin levels were not different across treatments (median: 11.1 g/dL, Q1-Q3: 10.0-12.4 g/dL, p = 0.65. However, compared with the folic acid arm (28%, there was a significant reduction in the risk of hypochromic microcytic anemia in the folic acid and iron arm (17%, RR: 0.61, 95% CI: 0.42-0.90, p = 0.01 and the folic acid, iron, and multivitamin arm (19%, RR: 0.66, 95% CI: 0.45-0.96, p = 0.03. Inverse probability of treatment weighting (IPTW to adjust for potential selection bias due to loss to follow-up did not materially change these results. The effect of the regimens was not modified by frequency of household meat consumption, baseline underweight status, parity, breastfeeding status, or level of compliance (in all cases, p for interaction>0.2.Daily oral supplementation with iron and folic acid among women and adolescents prior to pregnancy reduces risk of anemia. The potential benefits of supplementation on the risk of

  9. Alpha-thalassemia genetic testing: an important anemia diagnostic tool in patients of African heritage.

    Science.gov (United States)

    Dasanu, Constantin A

    2010-01-01

    Inherited alpha-thalassemia genotypes have been shown to have a rather high prevalence in some patient populations of African heritage. These genotypes lead to mild anemia with microcytic indices and a normal hemoglobin electrophoresis. In our outpatient department, we analyzed 54 consecutive patients of African descent with longstanding microcytic anemia, but no evidence of iron deficiency. We detected alpha-thalassemia gene deletions in 94 percent of these patients. Alpha-thalassemia genetic testing appears cost-effective in an otherwise unexplained, longstanding microcytic anemia in patients of African origin.

  10. Positive Association of Vitamin E Supplementation with Hemoglobin Levels in Mildly Anemic Healthy Pakistani Adults.

    Science.gov (United States)

    Jilani, Tanveer; Azam, Iqbal; Moiz, Bushra; Mehboobali, Naseema; Perwaiz Iqbal, Mohammad

    2015-01-01

    Hemoglobin levels slightly below the lower limit of normal are common in adults in the general population in developing countries. A few human studies have suggested the use of antioxidant vitamins in the correction of mild anemia. The objective of the present study was to investigate the association of vitamin E supplementation in mildly anemic healthy adults with post-supplemental blood hemoglobin levels in the general population of Karachi, Pakistan. In a single-blinded and placebo-controlled randomized trial, 124 mildly anemic subjects from the General Practitioners' Clinics and personnel of the Aga Khan University were randomized into intervention (n = 82) and control (n = 42) group. In the intervention group, each subject was given vitamin E (400 mg) everyday for a period of three months, while control group subjects received a placebo. Eighty six subjects completed the trial. Fasting venous blood was collected at baseline and after three months of supplementation. Hemoglobin levels and serum/plasma concentrations of vitamin E, vitamin B12, folate, ferritin, serum transferrin receptor (sTfR), glucose, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, creatinine, total-antioxidant-status and erythropoietin were measured and analyzed using repeated measures ANOVA and multiple linear regression. The adjusted regression coefficients (β) and standard error [SE(β)] of the significant predictors of post-supplemental hemoglobin levels were serum concentration of vitamin E (0.983[0.095]), gender (- 0.656[0.244]), sTfR (- 0.06[0.02]) and baseline hemoglobin levels (0.768[0.077]). The study showed a positive association between vitamin E supplementation and enhanced hemoglobin levels in mildly anemic adults.

  11. [Treatment and results of therapy in autoimmune hemolytic anemia].

    Science.gov (United States)

    Tasić, J; Macukanović, L; Pavlović, M; Koraćević, S; Govedarević, N; Kitić, Lj; Tijanić, I; Bakić, M

    1994-01-01

    Basic principles in the therapy of idiopathic autoimmune hemolytic anemia induced by warm antibody were glucocorticoides and splenectomy. Immunosupresive drugs, plasmaferesis and intravenous high doses gamma globulin therapy are also useful. In secundary autoimmune hemolytic anemia induced by warm antibody we treated basic illness. During the period of 1990-1992 we treated 21 patients with primary autoimmune hemolytic anemia and 6 patients with secondary /4 CLL and 2 Non-Hodgkin's lymphoma/. Complete remission we found as a normalisation of reticulocites and hemoglobin level respectively. Complete remission by corticoides we got in 14/21 patients, partial response in 2/21 respectively. Complete response by splenectomy we got in 2/3 splenoctomized patients (idiopathic type). For successful treatment secondary hemolytic anemias we treated primary diseases (CLL and malignant lymphoma) and we got in 4/6 patients complete remission. Our results were standard in both type of autoimmune hemolytic anaemias induced by warm antibody.

  12. Hypoproduction of erythropoietin contributes to anemia in chronic cadmium intoxication: clinical study on Itai-itai disease in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Horiguchi, Hyogo (Dept. of Public Health, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Teranishi, Hidetoyo (Dept. of Public Health, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Niiya, Kenji (Dept. of Clinical Lab. Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Aoshima, Keiko (Dept. of Public Health, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Katoh, Terutaka (Dept. of Public Health, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Sakuragawa, Nobuo (Dept. of Clinical Lab. Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan)); Kasuya, Minoru (Dept. of Public Health, Faculty of Medicine, Toyama Medical and Pharmaceutical Univ. (Japan))

    1994-10-01

    Itai-itai disease is a condition caused by longterm exposure of the inhabitants of Toyama prefecture, Japan, to cadmium intoxication. The characteristic clinical features of this disease include renal tubular dysfunction, osteomalacia, and anemia. In order to clarify the pathogenesis of the anemia, the red blood cell count, hemoglobin concentration, hematocrit, serum iron level, total iron-binding capacity, serum ferritin level, serum erythropoietin level, creatinine clearance, fractional excretion of [beta][sub 2]-microglobulin, and bone marrow morphology were determined in ten patients with Itai-itai disease. Low serum iron or ferritin levels were not observed, and bone marrow aspiration did not reveal any specific hematological disorders. A close relationship was observed between the decrease in the hemoglobin level and the progression of renal dysfunction. Low serum erythropoietin levels were detected despite the presence of severe anemia. These results suggest an important role of renal damage in the anemia which develops in Itai-itai disease. (orig.)

  13. Importância da reabsorção do ferro da hemorragia intestinal provocada pela ação dos vermes na progressão da anemia The importance of iron reabsorption in intestinal hemorrhage caused by worms in the course of anemia

    Directory of Open Access Journals (Sweden)

    Victorio Maspes

    1979-12-01

    Full Text Available Foram estudados 10 doentes, portadores de anemia ancilostomótica e de grande parasitose. Foram determinados alguns parâmetros hematológicos como dosagem de hemoglobina, contagem de hemácias, hematócrito, volume corpuscular médio, hemoglobina corpuscular média, ferro sérico e siderofilina. Foram estudados o volume da perda de sangue intestinal, o ferro perdido nesta hemorragia e eliminado nas fezes, e o ferro reaborvido da hemorragia intestinal. Conclui-se que a reabsorção do ferro da hemoglobina por dia no tubo digestivo é de suma importância no retardamento da instalação da anemia ferropriva, causada pela parasitose ancilostomótica.Ten patients presenting ancylostomotic anemia and a high rate of parasitosis were submitted to several hematologic determinations: hemoglobin level, erythrocyte count, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, serum iron level, and transferrin. In addition, measurements were made of the blood volume lost by intestinal bleeding, of iron loss through hemorrhage and in feus, and of iron reabsorption from intestinal bleeding. The main reason for the late appearance of iron deficiency anemia in ancylostomiasis is the high degree of dally iron absorption in the digestive tract, originating from hemoglobin breakdown.

  14. Chloroquine and its derivatives exacerbate B19V-associated anemia by promoting viral replication.

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    Claudia Bönsch

    Full Text Available BACKGROUND: An unexpectedly high seroprevalence and pathogenic potential of human parvovirus B19 (B19V have been observed in certain malaria-endemic countries in parallel with local use of chloroquine (CQ as first-line treatment for malaria. The aims of this study were to assess the effect of CQ and other common antimalarial drugs on B19V infection in vitro and the possible epidemiological consequences for children from Papua New Guinea (PNG. METHODOLOGY/PRINCIPAL FINDINGS: Viral RNA, DNA and proteins were analyzed in different cell types following infection with B19V in the presence of a range of antimalarial drugs. Relationships between B19V infection status, prior 4-aminoquinoline use and anemia were assessed in 200 PNG children <10 years of age participating in a case-control study of severe infections. In CQ-treated cells, the synthesis of viral RNA, DNA and proteins was significantly higher and occurred earlier than in control cells. CQ facilitates B19V infection by minimizing intracellular degradation of incoming particles. Only amodiaquine amongst other antimalarial drugs had a similar effect. B19V IgM seropositivity was more frequent in 111 children with severe anemia (hemoglobin <50 g/L than in 89 healthy controls (15.3% vs 3.4%; P = 0.008. In children who were either B19V IgM or PCR positive, 4-aminoquinoline use was associated with a significantly lower admission hemoglobin concentration. CONCLUSIONS/SIGNIFICANCE: Our data strongly suggest that 4-aminoquinoline drugs and their metabolites exacerbate B19V-associated anemia by promoting B19V replication. Consideration should be given for choosing a non-4-aminoquinoline drug to partner artemisinin compounds in combination antimalarial therapy.

  15. Socio-economic and demographic determinants of childhood anemia

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    Sankar Goswmai

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate socio-economic and demographic determinants of anemia among Indian children aged 6-59 months. METHODS: Statistical analysis was performed on the cross-sectional weighted sample of 40,885 children from 2005 to 2006 National Family Health Survey by using multinomial logistic regression to assess the significance of some risk factors in different degrees of child anemia. Anemia was diagnosed by World Health Organization (WHO cut-off points on hemoglobin level. Pearson's chi-squared test was applied to justify the associations of anemia with different categories of the study population. RESULTS: The prevalence of anemia was 69.5%; 26.2% mild, 40.4% moderate, and 2.9% severe anemia. Overall prevalence rate, along with mild and moderate cases, showed an increasing trend up to 2 years of age and then decreased. Rural children had a higher prevalence rate. Of 28 Indian states in the study, 10 states showed very high prevalence, the highest being Bihar (77.9%. Higher birth order, high index of poverty, low level of maternal education, mother's anemia, non-intake of iron supplements during pregnancy, and vegetarian mother increased the risks of all types of anemia among children (p < 0.05. Christian population was at lower risk; and Scheduled Caste, Scheduled Tribe, and Other Backward Class categories were at higher risk of anemia. CONCLUSION: The results suggest a need for proper planning and implementation of preventive measures to combat child anemia. Economically under-privileged groups, maternal nutrition and education, and birth control measures should be priorities in the programs.

  16. [Risk factors associated among anemia in pregnancy women of network public health of a capital of Brazil Northeastern].

    Science.gov (United States)

    De Oliveira, Alane Cabral Menezes; De Barros, Amanda Maria Rocha; Ferreira, Raphaela Costa

    2015-11-01

    To evaluate the factors associated with anemia among pregnant women receiving public health care in a capital city in Northeastern Brazil. This was a cross-sectional study conducted on a sample of 428 patients obtained on the basis of the estimated prevalence of anemia during pregnancy (50%), a 95% confidence interval (95%CI), an error of 5% and a sample loss of 20%. Pregnant women who lived in the city and were served by the municipal public health network were considered to be eligible for the study. Socioeconomic, lifestyle, clinical and anthropometric data and dietary iron intake were obtained, and capillary hemoglobin was determined. Anemia was identified as a hemoglobin level public health system of the city is a moderate public health problem, requiring the planning of effective measures for its control.

  17. The incidence of gastrointestinal pathology and subsequent anemia in young men presenting with iron deficiency without anemia.

    Science.gov (United States)

    Carter, Dan; Bardan, Eytan; Derazne, Estela; Tzur, Dorit; Avidan, Benjamin

    2016-10-01

    The etiology of iron deficiency (ID) without anemia in young men is unclear, and there are no evidence-based recommendations for the required gastrointestinal (GI) evaluation. The aims of this study were to examine the incidence of significant GI pathology and the development of anemia during the follow-up of young men presenting with ID, but without anemia. All young men (18-30 years) who served in the Israel Defense Forces during the years 2005-2013 and had at least a single laboratory test indicative of ID without anemia were followed until the diagnosis of significant GI pathology or discharge from military service. The study population included 2061 young men (mean age 20.7±1.8). During follow-up of 3150 person years, significant GI pathologies were diagnosed in 39 patients: inflammatory bowel disease in 25 (1.2%), celiac disease in 8 (0.4%), and peptic disease in 4 (0.1%). No cases of GI-related cancer were diagnosed. ID anemia developed during follow-up in 203 (9.8%). Lower baseline hemoglobin levels, lower ferritin levels, and younger age at diagnosis were more common among those who developed anemia. The development of anemia was a predisposing factor for the diagnosis of GI pathology (risk ratio=3.60, 95% confidence interval 1.34-8.32, P=0.012). Significant GI pathology is very uncommon in young men presenting with ID. Overt anemia developed in close to 10% of the study cohort. Therefore, we advise simple GI evaluation (celiac serology, C-reactive protein or fecal calprotectin, and urease breath test) as well as follow-up in this population.

  18. Risk Factors of anemia in head and neck cancer patients undergoing chemotherapy with high-dose cisplatin

    Directory of Open Access Journals (Sweden)

    Johan Kurnianda

    2008-12-01

    Full Text Available Cisplatin is well-known for its effectiveness against cancer, as well as its toxicity to human tissues. Of several documented side effects, anemia was reported to have significant association with decreased quality of life. This study was conducted to investigate development of cisplatin-induced anemia, and to identify independent factors contributing to anemia. Clinical data from head and neck cancer patients treated with high-dose cisplatin between December 2002 and December 2005 were obtained in this study. Incidence and risk factors of anemia were assessed in a model including age, sex, baseline hemoglobin level, baseline creatinine clearance, and occurrence of distant metastases. Multivariate logistic regression was used to define independent predictors of anemia. Among 86 eligible patients, 26 (30.2% developed anemia, defined as Hb level lower than 11 g/dL. Age > 55 years old (RR = 2.2, 95% CI, 1.2-4.0, female sex (RR = 2.0, 95% CI, 1.2-3.8, baseline Hb ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4 and baseline CrCl < 50 mL/min (RR = 2.9, 95% CI, 1.7-5.1 were significantly correlated with incidence of anemia (P < 0.05. In multivariate analysis, baseline Hb and baseline CrCl were identified as independent risk factors for anemia. However, considerable confounding was observed in baseline CrCl after stratified by age (aRR = 2.2, 95% CI, 1.1-4.7. Thus, baseline Hb level was the strongest predictor of anemia. The findings suggested that baseline Hb and CrCl were useful to recognize cisplatin-treated patients at risk for anemia who might benefits from preventive measures. (Med J Indones 2008; 17: 248-54Keywords: anemia, cisplatin, chemotherapy, hemoglobin, creatinine clearance

  19. A retrospective study of the risk factors for linezolid-induced thrombocytopenia and anemia.

    Science.gov (United States)

    Hanai, Yuki; Matsuo, Kazuhiro; Ogawa, Miki; Higashi, Ayaka; Kimura, Itsuki; Hirayama, Shinobu; Kosugi, Takayoshi; Nishizawa, Kenji; Yoshio, Takashi

    2016-08-01

    Myelosuppression is major treatment-related adverse events of linezolid therapy and result in treatment termination in some cases. We aimed to identify the risk factors for linezolid-induced thrombocytopenia and anemia. We retrospectively retrieved demographic and laboratory data from the medical records of 221 Japanese patients who were undergoing linezolid therapy. Thrombocytopenia and anemia were defined as an unexplained reduction of >30% in the patient's platelet count and hemoglobin level, respectively, from the baseline. Thrombocytopenia developed in 48.4% of patients, and anemia developed in 10.4% of patients during linezolid therapy. In multivariate analysis, creatinine clearance (adjusted odds ratio = 0.94 [0.92-0.95], P linezolid therapy (1.14 [1.07-1.21], P linezolid-induced thrombocytopenia. Patients with creatinine clearance rates of linezolid-induced thrombocytopenia. In addition, a high incidence of linezolid-induced thrombocytopenia was even detected among the patients that had received linezolid therapy for linezolid therapy (1.04 [1.01-1.07], P = 0.011) was shown to be a risk factor for anemia, and a high incidence of anemia was seen among the patients who received linezolid for >15 days. In conclusion, we recommend that among patients receiving linezolid therapy the platelet counts of those with risk factors for linezolid-induced thrombocytopenia should be monitored closely throughout treatment, and the hemoglobin levels of patients that receive linezolid for >15 days should be carefully monitored on a weekly basis to detect anemia. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Association of anemia with the risk of cardiovascular adverse events in overweight/obese patients

    DEFF Research Database (Denmark)

    Winther, S. A.; Finer, N.; Sharma, A. M.

    2014-01-01

    Objective:Anemia is associated with increased cardiovascular risks. Obesity may cause anemia in several ways, for example, by low-grade inflammation and relative iron deficit. The outcomes associated with anemia in overweight/obese patients at high cardiovascular risk are however not known....... Therefore, we investigated the cardiovascular prognosis in overweight/obese subjects with anemia.Methods:A total of 9 687 overweight/obese cardiovascular high-risk patients from the Sibutramine Cardiovascular OUTcomes trial were studied. Patients were stratified after baseline hemoglobin level and followed...... for the risks of primary event (comprising nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death) and all-cause mortality. Risk estimates (hazard ratios (HR) with 95% confidence intervals (CI)) were calculated using Cox regression models.Results:Anemia...

  1. Hemoglobin as an independent prognostic factor in the radiotherapy of head and neck tumors

    International Nuclear Information System (INIS)

    Schaefer, U.; Micke, O.; Mueller, S.B.; Schueller, P.; Willich, N.

    2003-01-01

    Purpose: The purpose of this study was to analyze the prognostic value of baseline hemoglobin levels before radiotherapy in patients with head and neck tumors. Patients and Methods: In a retrospective study with a median follow-up of 43 months, we analyzed the results of 214 patients irradiated for head and neck cancer between January 1, 1990 and January 1, 1998 (180 men and 34 women; median age 58 years). The treatment concept consisted in adjuvant radiotherapy in 58 patients, 77 patients received definitive radiochemotherapy, 42 patients definitive radiotherapy, and 37 patients reirradiation for in-field recurrence. Baseline hemoglobin values were divided in four groups of the same patient number (quartiles). Several known prognostic factors like sex, tumor stage, histologic grading, performance status, and treatment scheme were analyzed for their influence on overall and event-free survival and correlated with pretreatment hemoglobin values (Kaplan-Meier method). In addition, univariate und multivariate logistic regression analyses were carried out to evaluate the effect of baseline hemoglobin on response rates. Results: The median survival (event-free survival) of all patients amounted to 15 months (10 months). 25%, 50%, and 75% of patients had hemoglobin values < 11.2 g/dl, < 12.7 g/dl, and < 13.9 g/dl, respectively. In the univariate analysis, the following variables were significant prognostic factors for overall/event-free survival (log-rank test): treatment concept (p < 0.001/ p < 0.001), tumor stage (p < 0.001/p < 0.001), general condition (p < 0.001/p < 0.001), and pretreatment hemoglobin (p = 0.014/p = 0.05). Multivariate analysis (Cox) proved these parameters to be independent of each other. In addition, response rate after radiation showed a strong association between hemoglobin and local control probability (p = 0.02). Conclusion: In this retrospective analysis, baseline hemoglobin level was shown to be an independent significant prognostic factor in

  2. A Patient with Microcytic Anemia and Fever

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    Sacha Bhatia

    2006-01-01

    Full Text Available A 62-year-old man with a history of mechanical aortic valve insertion and ascending aorta replacement in 1997 presented to his family doctor in August 2004 with a two-week history of melena after recently returning from a six-month vacation in Mexico. The patient had no other abdominal complaints. He took warfarin but did not take nonsteroidal anti-inflammatory agents, acetylsalicylic acid or alcohol. The patient had no history of liver or peptic ulcer disease. He had lost 7 kg over the past month, but did not complain of fever or night sweats. On physical examination, vital signs were normal, the second heart sound was mechanical, and there were no abnormal findings. Laboratory investigations showed a borderline microcytic anemia (hemoglobin 76 g/L; mean corpuscular volume 79 fL; mean corpuscular hemoglobin concentration 323 g/L, a therapeutic international normalized ratio (2.6 and an elevated creatinine level (112 µmol/L. His stool was positive for occult blood, although the ferritin level was high (623 µg/L. Other routine blood work was normal. The patient was admitted to hospital for investigation of the anemia.

  3. Increased susceptibility of blood type O individuals to develop anemia in Plasmodium vivax infection.

    Science.gov (United States)

    Resende, Sarah Stela; Milagres, Vanessa Gonçalves; Chaves, Daniel Gonçalves; Fontes, Cor Jesus Fernandes; Carvalho, Luzia Helena; Sousa, Tais Nobrega; Brito, Cristiana Ferreira Alves de

    2017-06-01

    Plasmodium vivax has been reported to cause severe malaria, and one of the main resulting complications is anemia. Considering that P. vivax infects only young erythrocytes, anemia has been associated with the destruction of infected and non-infected erythrocytes. However, few studies have focused on understanding the relationship between the pathogenesis of P. vivax malaria and human genetic polymorphisms. Although ABO groups seem to influence the outcome of Plasmodium falciparum malaria, the association between P. vivax and ABO blood groups has been minimally investigated. Thus, we investigate the correlation between ABO blood groups and anemia induced by P. vivax infection. Five single nucleotide polymorphisms at the ABO gene were genotyped by PCR-RFLP and Real-Time PCR in P. vivax-infected subjects. The ABO blood types were associated with the hematological data of the patients. Our main finding was that type O infected-individuals showed lower levels of hemoglobin and hematocrit compared to type A-infected individuals. The correlation between ABO blood groups and hemoglobin levels remained significant when a multiple linear regression was applied with the possible confounding effects of clinical-epidemiologic variables taken into account. The finding that type O individuals have a higher frequency of anemia is a first step to understand the mechanisms involved in malaria anemia, which could be associated to increased destruction of type O erythrocytes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Transient Ischemic Attack Caused by Iron Deficiency Anemia

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    Ufuk Emre

    2006-02-01

    Full Text Available Transient Ischemic Attack Caused by Iron Deficiency Anemia Transient ischemic attacks are episodes of transient focal ischemia involving the brain or brainstem. They are commonly two to thirty minutes in duration and lasting less than 24 hours. Anemia of iron deficiency isn’t frequently cause for transient ischemic attack. It has been reported as a risk factor for childhood ischemic strokes. In the iron deficiency anemia, T‹A may develop as result of hypercoagulable state and increased viscosity that is caused by anemic hypoxia that is result of reduce hemoglobine level, seconder thrombosis and microcytose As iron deficiency anemia has been reported so rarely in adult patients with transient ischemic attacks as a cause, we aimed to discuss the clinical and outcome features of two cases with iron deficiency anemia and transient ischemic attacks in this study. Materials and methods: Routine neurologic examination, biochemical screen, serological tests, vasculitic markers, thyroid function tests, vitamin B 12 level, cranial imaging, vertebral carotid doppler USG examination was conducted in the two patients. Anemia of iron deficiency was found as the only risk factor for TIA and the two patients were treated with replacement of iron and antiagregan therapy. Neurological examination revealed no abnormality through the two years of follow-up. The iron deficiency anemia may be cause of many neurologic problems such a irritability, lethargy, headache, development retardation except from T‹A. In the iron deficiency anemia, early diagnosis and treatment is important

  5. [Chronic and severe anemia caused by Ancylostoma duodenale in Ecuador. Diagnosis by duodenoscopy].

    Science.gov (United States)

    Calvopiña, Manuel; Flores, Jessica; Guaman, Isabel; Lara, Gabriela; Abarca, Jeyson

    2017-10-01

    For 11 years, a 38-year-old male residing in a subtropical region of Ecuador, was repeatedly diagnosed with chronic anemia, and treated with blood transfusions in a hospital of province of Cotopaxi, Ecuador. He was transferred to Quito for severe anemia, having hemoglobin of 4 g/dL. Duodenoscopy was performed and adult nematodes, identified later as Ancylostoma duodenale, were observed. The patient was successfully treated with albendazole for five consecutive days and given blood transfusions. In the control visit at eight months, without anemia and no hookworm ova in the stool examined were found.

  6. The Relationship Between Preoperative Hemoglobin Concentration, Use of Hospital Resources, and Outcomes in Cardiac Surgery.

    Science.gov (United States)

    Hallward, George; Balani, Nikhail; McCorkell, Stuart; Roxburgh, James; Cornelius, Victoria

    2016-08-01

    Preoperative anemia is an established risk factor associated with adverse perioperative outcomes after cardiac surgery. However, limited information exists regarding the relationship between preoperative hemoglobin concentration and outcomes. The aim of this study was to investigate how outcomes are affected by preoperative hemoglobin concentration in a cohort of patients undergoing cardiac surgery. A retrospective, observational cohort study. A single-center tertiary referral hospital. The study comprised 1,972 adult patients undergoing elective and nonelective cardiac surgery. The independent relationship of preoperative hemoglobin concentration was explored on blood transfusion rates, return to the operating room for bleeding and/or cardiac tamponade, postoperative intensive care unit (ICU) and in-hospital length of stay, and mortality. The overall prevalence of anemia was 32% (629/1,972 patients). For every 1-unit increase in hemoglobin (g/dL), blood transfusion requirements were reduced by 11%, 8%, and 3% for red blood cell units, platelet pools, and fresh frozen plasma units, respectively (adjusted incident rate ratio 0.89 [95% CI 0.87-0.91], 0.92 [0.88-0.97], and 0.97 [0.96-0.99]). For each 1-unit increase in hemoglobin (g/dL), the probability (over time) of discharge from the ICU and hospital increased (adjusted hazard ratio estimates 1.04 [1.00-1.08] and 1.12 [1.12-1.16], respectively). A lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery. Each g/dL unit fall in preoperative hemoglobin concentration resulted in increased blood transfusion requirements and increased postoperative ICU and hospital length of stay. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Reticulocyte maturity indices in iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Muriel Wollmann

    2014-01-01

    Full Text Available Objective: The aim of this study was to analyze the reticulocyte maturity indices (low, medium, and high fluorescence ratios in iron deficient 1- to 6-year-old children, and identify the prevalence of iron deficiency anemia in this population. Methods: The present study included 39 subjects, divided into two groups: control subjects (n = 33, and subjects with iron deficiency anemia (n = 6. The results were analyzed by Student's t-test for comparison of means. Differences were considered significant when two-tailed p-value < 0.05. Results: Subjects with iron deficiency anemia presented increases in the proportion of mean (10.3 ± 4.7% vs. 6.0 ± 3.4%; p-value = 0.003, and high fluorescence reticulocytes (2.3 ± 0.87% vs. 0.9 ± 0.9%; p-value = 0.03 compared to the control group. The prevalence of anemia in this population was 15% (n = 6. Conclusion: The indices related to immaturity of reticulocytes are higher in the presence of iron deficiency, thus demonstrating a deficiency in the raw material to form hemoglobin and are, therefore, possible early markers of iron deficiency and anemia. We emphasize the need to standardize these indices for use in clinical practice and lab test results.

  8. Nutritional status survey of aplastic anemia patients--a single center experience in China.

    Science.gov (United States)

    Li, Xinli; Feng, Yanyan; Wang, Hongyan; Song, Meijuan; Jin, Jingjing; Cui, Zhenzhu; Zheng, Yizhou

    2016-05-01

    To analyze the nutritional status of aplastic anemia (AA) patients. The nutrition-related anthropometric indicators and blood biochemical index of 622 newly-diagnosed AA patients were retrospectively analyzed. Of the cohort of AA patients, body mass index of non-severe AA (NSAA) patients were higher than those of severe AA (SAA) (phemoglobin was correlated with lower serum albumin protein concentration (peducation for patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Enteroparasitoses, Anemia e Estado Nutricional em Grávidas Atendidas em Serviço Público de Saúde Intestinal Parasites, Anemia and Nutritional Status in Pregnant Women in a Public Health Care Unit

    Directory of Open Access Journals (Sweden)

    Ariani Impieri de Souza

    2002-05-01

    Full Text Available Objetivos: estimar a freqüência de enteroparasitoses em gestantes de pré-natal de baixo risco e sua associação com anemia, estado nutricional, escolaridade e saneamento (fossa sanitária no domicílio. Métodos: a partir de amostra de 316 gestantes que iniciaram o pré-natal de baixo risco do ambulatório de pré-natal do Instituto Materno Infantil de Pernambuco (IMIP no período de maio de 2000 a julho de 2001, determinaram-se, por meio de um desenho de corte transversal, as freqüências de enteroparasitoses (método Hoffman, em única amostra e de anemia (Hb Purpose: to determine the frequency of enteroparasitoses in a group of pregnant women undergoing low-risk antenatal care and their association with anemia, maternal nutritional status, schooling and the existence of a bathroom in the home. Methods: to a sample of pregnant women who had begun low-risk antenatal care at IMIP's Maternal Health Care Center between May 2000 and July 2001, a cross-sectional design was applied to determine the frequencies of enteroparasitoses (Hoffman method, in a single sample and anemia (Hb <11.0 g/dL, nutritional status (through BMI standardized for stage of pregnancy and social indicators (schooling and the existence of a bathroom in the home. Results: in a sample of 316 pregnant women, a rate of 37.4% enteroparasitosis was detected, of which 31.6% was infestation by a single parasite. The most commonly found parasite species were Entamoeba histolytica (13.3% and Ascaris lumbricoides (12.0%. Anemia was detected in 55.4% of the pregnant women, malnutrition in 25.0% and overweight or obesity in 24.1%. There was a statistically significant association between enteroparasitosis and schooling. However, no association of, enteroparasitosis, anemia, maternal nutritional status with the existence of a bathroom in the home was noted. Conclusions: The prevalence of enteroparasitoses and anemia is high, albeit without any association of the two conditions, while

  10. Associations of anemia persistency with medical expenditures in Medicare ESRD patients on dialysis

    Directory of Open Access Journals (Sweden)

    Jiannong Liu

    2009-04-01

    Full Text Available Jiannong Liu1, Haifeng Guo1, David Gilbertson1, Robert Foley1,2, Allan Collins1,21Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 2Department of Medicine, University of Minnesota, Minneapolis, MN, USAAbstract: Most end-stage renal disease (ESRD patients begin renal replacement therapy with hemoglobin levels below the recommended US National Kidney Foundation Dialysis Outcomes Quality Initiative Guidelines lower level of 110 g/L. Although most patients eventually reach this target, the time required varies substantially. This study aimed to determine whether length of time with below-target hemoglobin levels after dialysis initiation is associated with medical costs, and if so, whether intermediate factors underlie the associations. US patients initiating dialysis in 2002 were studied using the Centers for Medicare and Medicaid Services ESRD database. Anemia persistence (time in months with hemoglobin below 110 g/L was determined in a six-month entry period, and outcomes were assessed in the subsequent six-month follow-up period. The structural equation modeling technique was used to evaluate associations between persistent anemia and medical costs and to determine intermediate factors for these associations. The study included 28,985 patients. Mean per-patient-per-month medical cost was $6267 (standard deviation $5713 in the six-month follow-up period. Each additional month with hemoglobin below 110 g/L was associated with an 8.9% increment in medical cost. The increased cost was associated with increased erythropoietin use and blood transfusions, and increased rates of hospitalization and vascular access procedures in the follow-up period. Keywords: anemia persistency, end-stage renal disease, medical costs, structural equation modeling

  11. Iron-deficiency anemia in infancy and social emotional development in preschool-aged Chinese children.

    Science.gov (United States)

    Chang, Suying; Wang, Li; Wang, Yuying; Brouwer, Inge D; Kok, Frans J; Lozoff, Betsy; Chen, Chunming

    2011-04-01

    We aimed to compare affect and behavior of 3 groups of nonanemic 4-year-old children: children with iron-deficiency anemia (IDA) in infancy whose anemia was not corrected before 24 months (chronic IDA) (n = 27); children with IDA in infancy whose anemia was corrected before 24 months (corrected IDA) (n = 70); and children who were nonanemic in infancy and at 24 months (n = 64). Mother and child dyads were invited to a local clinic room. Children's social referencing, wariness, frustration-tolerance behavior, and affect were observed during a set of situations encountered in the laboratory, including free play, stranger approach, novel toy, and delay of gratification. The whole procedure was videotaped. The children's affective and behavioral displays were coded by using a time-sampling (5-second segments) code scheme. Iron status of children was determined on the basis of hemoglobin concentration measured with the cyanomethemoglobin method in blood samples obtained by fingerstick in infancy and at the ages of 24 months and 4 years. Children who had chronic IDA in infancy displayed less positive affect, less frustration tolerance, more passive behavior, and more physical self-soothing in the stranger approach and delay of gratification. In contrast, the behavior and affect of children whose anemia was corrected before the age of 24 months were comparable to those of children who were nonanemic throughout infancy. The results point to the potential benefits of preventing iron deficiency in infancy and treating it before it becomes chronic or severe.

  12. Anemia e desnutrição em escolares da rede pública do município de Osasco, São Paulo, Brasil Anemia and malnutrition in children at public schools in Osasco, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Lúcia R. Stefanini

    1995-09-01

    Full Text Available Com o objetivo de estimar a prevalência de anemia e conhecer o estado nutricional de escolares, foi realizado um estudo em uma amostra dos alunos ingressantes nas primeiras séries do primeiro grau das escolas públicas de Osasco, município integrante da Região Metropolitana de São Paulo. O diagnóstico de anemia foi feito através da dosagem da concentração de hemoglobina do sangue colhido por punção digital. O nível crítico utilizado para caracterizar a presença de anemia foi o estabelecido pela OMS. O estado nutricional foi avaliado utilizando os indicadores peso/idade e altura/idade expressos em escores Z e a população de referência do NCHS. A prevalência, de anemia encontrada foi de 51%n. Houve diferença nos níveis de prevalência quanto à localização geográfica das escolas, sendo maior (56,9% na Região Periférica do que na Região Central (41,7%. A presença de anemia também foi mais elevada em crianças cujos pais eram analfabetos. O risco de anemia foi superior entre as crianças que ingressaram no primeiro grau com idade superior a 8 anos. Não foi constatada presença significante de desnutrição aguda. Os resultados deste estudo destacam a anemia entre escolares como importante problema de Saúde Pública e ressaltam a urgência da implantação de programas de controle da anemia na população de escolares.The authors studied a sample of students entering the first grade in the Osasco public school system in order to determine both the prevalence of anemia and nutritional status. Osasco is part of the Greater São Paulo Metropolitan Area. Diagnosis of anemia was made through the hemoglobin concentration of blood from digital puncture. World Health Organization (WHO levels were used to define anemia. Nutritional Status assessment. was made through weight/age and height/age indices, using Z score distribution and the National Center for Health Statistics (NCHS reference levels. Prevalence of anemia was 51

  13. Utility of noninvasive transcutaneous measurement of postoperative hemoglobin in total joint arthroplasty patients.

    Science.gov (United States)

    Stoesz, Michael; Wood, Kristin; Clark, Wesley; Kwon, Young-Min; Freiberg, Andrew A

    2014-11-01

    This study prospectively evaluated the clinical utility of a noninvasive transcutaneous device for postoperative hemoglobin measurement in 100 total hip and knee arthroplasty patients. A protocol to measure hemoglobin noninvasively, prior to venipuncture, successfully avoided venipuncture in 73% of patients. In the remaining 27 patients, there were a total of 48 venipunctures performed during the postoperative hospitalization period due to reasons including transcutaneous hemoglobin measurement less than or equal to 9 g/dL (19), inability to obtain a transcutaneous hemoglobin measurement (8), clinical signs of anemia (3), and noncompliance with the study protocol (18). Such screening protocols may provide a convenient and cost-effective alternative to routine venipuncture for identifying patients at risk for blood transfusion after elective joint arthroplasty. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Optical wavelength selection for portable hemoglobin determination by near-infrared spectroscopy method

    Science.gov (United States)

    Tian, Han; Li, Ming; Wang, Yue; Sheng, Dinggao; Liu, Jun; Zhang, Linna

    2017-11-01

    Hemoglobin concentration is commonly used in clinical medicine to diagnose anemia, identify bleeding, and manage red blood cell transfusions. The golden standard method for determining hemoglobin concentration in blood requires reagent. Spectral methods were advantageous at fast and non-reagent measurement. However, model calibration with full spectrum is time-consuming. Moreover, it is necessary to use a few variables considering size and cost of instrumentation, especially for a portable biomedical instrument. This study presents different wavelength selection methods for optical wavelengths for total hemoglobin concentration determination in whole blood. The results showed that modelling using only two wavelengths combination (1143 nm, 1298 nm) can keep on the fine predictability with full spectrum. It appears that the proper selection of optical wavelengths can be more effective than using the whole spectra for determination hemoglobin in whole blood. We also discussed the influence of water absorptivity on the wavelength selection. This research provides valuable references for designing portable NIR instruments determining hemoglobin concentration, and may provide some experience for noninvasive hemoglobin measurement by NIR methods.

  15. The effect of maternal anemia on anthropometric measurements of newborns

    International Nuclear Information System (INIS)

    Telatar, Berrin; Comert, Serdar; Vitrinel, Ayca; Akin, Yasemin; Erginoz, Ethem

    2009-01-01

    To evaluate the relation between maternal prenatal hemoglobin concentration and neonatal anthropometric measurements. All pregnant women who gave birth at the Obstetrics Department of Dr. LK Kartal Training and Research Hospital, Istanbul, Turkey, from January 1, 2005 to December 31, 2006, and their newborns were included in this prospective, cross-sectional study. The newborns weight, height, head, and chest circumference were recorded. Mothers with hemoglobin concentration less than 11g/dl were evaluated as anemic. The anemic mothers were then grouped into 3 categories according to the corresponding hemoglobin concentration: mild (10.9-9.0g/dl), moderate (8.9-7.0 g/dl), and severe anemic (less than 7 g/dl). The anthropometric measurements of newborns from non-anemic and anemic mother groups were compared. Of the 3688 pregnant women, 1588 (43%) were found to be anemic. Among the anemic mothers, 1245 had mild (78.5%), 311 had moderate (19.5%), and 32 (2%) had severe anemia. The anthropometric measurements (height, weight, head and chest circumference) of newborns of anemic and non-anemic mother groups showed a statistically significant difference (p=0.036, p=0.044, p=0.013, and p=0.0002). There was a statistically significant difference in height, weight, and chest circumference of newborns of severe anemic and mild anemic mothers (p=0.017, p=0.008 and p=0.02). The height (1.1 cm), weight (260 g), head (0.42 cm), and chest (1 cm) circumference of neonates in the severe anemic group is less than the mild anemic group. Anemia during pregnancy affect the anthropometric measurements of a newborn. Severe anemia had significant negative effect on neonatal anthropometric measurements. (author)

  16. Postoperative anemia and early functional outcomes after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Bandholm, Thomas; Kurbegovic, Sorel

    2016-01-01

    BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative...... anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age. Mobility and Qol were assessed pre- and postoperatively by the 6-minute...... walk test (6MWT; primary outcome), the timed up-and-go test, and the FACT-anemia subscale. Twenty-four-hour mobility at home was assessed by activity monitoring on Days 1 to 6 after discharge. Hemoglobin (Hb) at discharge (HbD) and the Hb decrease from preoperatively (ΔHb) were compared to mobility...

  17. FAIRY: a randomized controlled patient-blind phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose (Ferinject®) to placebo in patients with acute isovolemic anemia after gastrectomy - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Reim, Daniel; Kim, Young-Woo; Nam, Byung Ho; Kim, Mi-Jung; Yook, Jeong Hwan; Park, Young Kyu; Roh, Sung Hoon; Yu, Wan Sik; Bae, Jae Moon

    2014-04-05

    Isovolemic anemia (decrease in hemoglobin concentration with normal or even increased blood volume) after gastric cancer surgery may negatively influence short- and long-term outcomes. Therefore correction of isovolemic postoperative anemia is supposed to be beneficial. This prospective randomized placebo-controlled multicenter trial is designed to evaluate the efficacy of ferric carboxymaltose administration with the primary end point of successful hemoglobin level increase by 2 g/dl at 12 weeks after randomization. Gastric cancer patients after oncologic resection and postoperative hemoglobin level ≥ 7 g/dl to hemoglobin level, hematology and quality of life assessment 3 and 12 weeks after randomization. Correction of isovolemic postoperative anemia in gastric cancer patients after oncologic resection is considered to be beneficial. Administration of ferric carboxymaltose is considered to be superior to placebo for anemia correction without the possible risks of red blood cell transfusion. Further, improved quality of life for patients with quick recovery of hemoglobin levels is expected. NCT01725789 (international: http://www.clinicaltrials.gov) and NCCCTS-12-644 (NCC, Korea).

  18. Major Burden of Severe Anemia from Non-Falciparum Malaria Species in Southern Papua: A Hospital-Based Surveillance Study

    Science.gov (United States)

    Douglas, Nicholas M.; Lampah, Daniel A.; Kenangalem, Enny; Simpson, Julie A.; Poespoprodjo, Jeanne R.; Sugiarto, Paulus; Anstey, Nicholas M.; Price, Ric N.

    2013-01-01

    Background The burden of anemia attributable to non-falciparum malarias in regions with Plasmodium co-endemicity is poorly documented. We compared the hematological profile of patients with and without malaria in southern Papua, Indonesia. Methods and Findings Clinical and laboratory data were linked for all patients presenting to a referral hospital between April 2004 and December 2012. Data were available on patient demographics, malaria diagnosis, hemoglobin concentration, and clinical outcome, but other potential causes of anemia could not be identified reliably. Of 922,120 patient episodes (837,989 as outpatients and 84,131 as inpatients), a total of 219,845 (23.8%) were associated with a hemoglobin measurement, of whom 67,696 (30.8%) had malaria. Patients with P. malariae infection had the lowest hemoglobin concentration (n = 1,608, mean = 8.93 [95% CI 8.81–9.06]), followed by those with mixed species infections (n = 8,645, mean = 9.22 [95% CI 9.16–9.28]), P. falciparum (n = 37,554, mean = 9.47 [95% CI 9.44–9.50]), and P. vivax (n = 19,858, mean = 9.53 [95% CI 9.49–9.57]); p-value for all comparisons anemia (hemoglobin anemia (adjusted odds ratio [AOR] 3.25 [95% CI 2.99–3.54]); AORs for severe anaemia associated with P. falciparum, P. vivax, and P. malariae were 2.11 (95% CI 2.00–2.23), 1.87 (95% CI 1.74–2.01), and 2.18 (95% CI 1.76–2.67), respectively, panemia was attributable to non-falciparum infections compared with 15.1% (95% CI 13.9%–16.3%) for P. falciparum monoinfections. Patients with severe anemia had an increased risk of death (AOR = 5.80 [95% CI 5.17–6.50]; panemia in early infancy, mixed P. vivax/P. falciparum infections are associated with a greater hematological impairment than either species alone, and in adulthood P. malariae, although rare, is associated with the lowest hemoglobin concentration. These findings highlight the public health importance of integrated genus-wide malaria

  19. The effect of oral iron with or without multiple micronutrients on hemoglobin concentration and hemoglobin response among nonpregnant Cambodian women of reproductive age: a 2 x 2 factorial, double-blind, randomized controlled supplementation trial.

    Science.gov (United States)

    Karakochuk, Crystal D; Barker, Mikaela K; Whitfield, Kyly C; Barr, Susan I; Vercauteren, Suzanne M; Devlin, Angela M; Hutcheon, Jennifer A; Houghton, Lisa A; Prak, Sophonneary; Hou, Kroeun; Chai, Tze Lin; Stormer, Ame; Ly, Sokhoing; Devenish, Robyn; Oberkanins, Christian; Pühringer, Helene; Harding, Kimberly B; De-Regil, Luz M; Kraemer, Klaus; Green, Tim J

    2017-07-01

    Background: Despite a high prevalence of anemia among nonpregnant Cambodian women, current reports suggest that iron deficiency (ID) prevalence is low. If true, iron supplementation will not be an effective anemia reduction strategy. Objective: We measured the effect of daily oral iron with or without multiple micronutrients (MMNs) on hemoglobin concentration in nonpregnant Cambodian women screened as anemic. Design: In this 2 × 2 factorial, double-blind, randomized trial, nonpregnant women (aged 18-45 y) with hemoglobin concentrations ≤117 g/L (capillary blood) were recruited from 26 villages in Kampong Chhnang province and randomly assigned to receive 12 wk of iron (60 mg; Fe group), MMNs (14 other micronutrients; MMN group), iron plus MMNs (Fe+MMN group), or placebo capsules. A 2 × 2 factorial intention-to-treat analysis with the use of a generalized mixed-effects model was used to assess the effects of iron and MMNs and the interaction between these factors. Results: In July 2015, 809 women were recruited and 760 (94%) completed the trial. Baseline anemia prevalence was 58% (venous blood). Mean (95% CI) hemoglobin concentrations at 12 wk in the Fe, MMN, Fe+MMN, and placebo groups were 121 (120, 121), 116 (116, 117), 123 (122, 123), and 116 (116, 117) g/L, with no iron × MMN interaction ( P = 0.66). Mean (95% CI) increases in hemoglobin were 5.6 g/L (3.8, 7.4 g/L) ( P < 0.001) among women who received iron ( n = 407) and 1.2 g/L (-0.6, 3.0 g/L) ( P = 0.18) among women who received MMNs ( n = 407). The predicted proportions (95% CIs) of women with a hemoglobin response (≥10 g/L at 12 wk) were 19% (14%, 24%), 9% (5%, 12%), 30% (24%, 35%), and 5% (2%, 9%) in the Fe, MMN, Fe+MMN, and placebo groups, respectively. Conclusions: Daily iron supplementation for 12 wk increased hemoglobin in nonpregnant Cambodian women; however, MMNs did not confer additional significant benefit. Overall, ∼24% of women who received iron responded after 12 wk; even fewer would be

  20. Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy.

    Science.gov (United States)

    Gyorkos, Theresa W; Gilbert, Nicolas L; Larocque, Renée; Casapía, Martín; Montresor, Antonio

    2012-01-01

    The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (light); 1,000-9,999 epg (moderate), and ≥ 10,000 epg (heavy)) were developed in the 1980s, when there were little epidemiological data available on dose-response relationships. This study was undertaken to determine a threshold for T. trichiura-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions. In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg) had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg). They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62) and 1.73 (95% CI: 1.09, 2.74), respectively. This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly.

  1. Comparative and quantitative determination of total hemoglobin concentration in normal and psoriatic patients

    International Nuclear Information System (INIS)

    Mahesar, S.M.; Dahot, M.U.; Khuhawar, M.Y.; Mahesar, H.U.

    2004-01-01

    The cyanmethaemoglobin technique is now recommended as the standard method by International Committee for Standardization in Hematology and British Standards Institution 1966. The hemoglobin is treated with reagent containing potassium ferricyanide, Potassium cyanide and potassium dihydrogen phosphate. The ferricyanide forms methamoglobin which is converted to cyanmethaemoglobin by the cyanide. The average values of hemoglobin, percent determined from the blood samples of normal and psoriatic (n=44) males and (n=35) females were 15.0, 12.7, 13.6 and 11.2 g/100ml. The decrease in hemoglobin concentration could be due to anemia resulting during the cell proliferation epidermis in inflammatory state and Keratolytic disorder which take place in psoriasis. (author)

  2. A study of anemia among adolescent girls in eastern part of Nepal

    Directory of Open Access Journals (Sweden)

    Piush Kanodia

    2016-03-01

    Full Text Available Background & Objectives: Anemia is a global health problem. About 40% of the world's population suffers from anemia and adolescence is one of the most vulnerable age group. Hence the objective of the study was to determine prevalence and distribution of anemia among adolescent girls in eastern part of Nepal.Materials & Methods: This cross sectional study was conducted in a Government School of Dharan over a period of one year. There were total 433 participants, whose clinical and demographic profile were recorded and analyzed. Hemoglobin estimation was done by using cyanmethaemoglobin method and anemia was defined as per WHO cut-off.Results: The overall prevalence of anemia was found to be 51.3%. Prevalence was significantly more in pre-menarche age and undernourished girls (p<0.05. However factors like diet (vegetarian/non-vegetarian, worm infestation and parental education did not have a significant impact on occurrence of anemia.Conclusion: Anemia is the major health problem among adolescent girls in eastern part Nepal with high prevalence rate and nutrition is one of the leading causative factors for anemia.JCMS Nepal. 2016;12(1:19-22.

  3. Consumo de leite de vaca e anemia na infância no Município de São Paulo Cow's milk consumption and childhood anemia in the city of São Paulo, southern Brazil

    Directory of Open Access Journals (Sweden)

    Renata Bertazzi Levy-Costa

    2004-12-01

    Full Text Available OBJETIVO: Avaliar a influência de consumo de leite de vaca sobre o risco de anemia em menores de cinco anos. MÉTODOS: Estudou-se amostra domiciliar de menores de cinco anos do Município de São Paulo (n=584 em 1995 e 1996. O diagnóstico de anemia (hemoglobina OBJECTIVE: To evaluate the influence of the consumption of cow's milk on the risk of anemia during childhood in the city of São Paulo. METHODS: We have studied a probabilistic sample (n=584 of underfive children living in the city of São Paulo, southeastern Brazil, between 1995 and 1996. Anemia (hemoglobin <11g/dl was diagnosed using capillary blood obtained by fingertip puncture. The cow's milk content and the density of heme and nonheme iron in the child's diet were obtained using 24-hour recall questionnaires. Multiple linear and logistic regression models were used to study the association between cow's milk content in the diet and hemoglobin concentration or risk of anemia, and included statistical control for potential confounders (age, sex, birthweight, presence of intestinal parasites, family income, and mother's schooling. RESULTS: The prevalence of anemia was 45.2% and the mean contribution of milk to the total caloric content of the children's diets was 22.0%. The association between milk consumption and risk of anemia remained significant, even after considering the dilutive effect of milk consumption on the density of iron in the diet, thus indicating a possible inhibitor effect of milk on the absorption of the iron present in the other foods ingested by the child. CONCLUSIONS: The relative participation of cow's milk in the child's diet showed a significant positive association with risk of anemia in children between ages six and 60 months, regardless of the density of iron in the diet.

  4. Effect of Pretreatment Anemia on Treatment Outcome of Concurrent Radiochemotherapy in Patients With Head and Neck Cancer

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    Fortin, Andre; Wang Changshu; Vigneault, Eric

    2008-01-01

    Purpose: To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer. Methods and Materials: The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin 140 g/L. Conclusions: Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy

  5. Effects of hydroxyurea on blood rheology in sickle cell anemia: A two-years follow-up study.

    Science.gov (United States)

    Lemonne, Nathalie; Möckesch, Berenike; Charlot, Keyne; Garnier, Yohann; Waltz, Xavier; Lamarre, Yann; Antoine-Jonville, Sophie; Etienne-Julan, Maryse; Hardy-Dessources, Marie-Dominique; Romana, Marc; Connes, Philippe

    2017-01-01

    The aim of the present study was to test the effects of hydroxyurea (HU) therapy on clinical, hematological and hemorheological parameters in adult patients with sickle cell anemia (SCA). Hematological and hemorheological parameters were measured in 28 SCA patients before HU therapy (i.e., baseline) and at 6, 12 and 24 months of treatment. RBC deformability was determined by ektacytometry at 30 Pa. RBC aggregation properties were investigated by light-backscatter method. Blood viscosity was measured at 225 s-1 by a cone-plate viscometer. The rates of vaso-occlusive crises and acute chest syndrome were lower at 1 and 2 years of HU therapy compared to baseline. The proportion of patients with leg ulcers tended to decrease after 2 years of treatment. Hemoglobin oxygen saturation improved with HU therapy. HU therapy induced a decrease of platelet and white blood cell counts and a rise in fetal hemoglobin level and mean cell volume. While hemoglobin concentrations increased under HU, blood viscosity remained unchanged all along the study. RBC deformability increased over baseline values at 6 months of HU therapy and continued to rise until the end of the follow-up period. In conclusion, the improvement in RBC deformability probably compensates the increase of hemoglobin on blood viscosity and participates to the improvement of the clinical status of patients.

  6. Anemia and iron deficiency in Mexican elderly population. Results from the Ensanut 2012

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    Alejandra Contreras-Manzano

    2015-09-01

    Full Text Available Objective. To describe de prevalence of iron deficiency (ID and anemia in a sample of Mexican elderly population from the National Health and Nutrition Survey (Ensanut 2012. Materials and methods. 1 920 subjects ≥60 years of age were included. Hemoglobin, serum concentrations of ferritin and CRP were measured. The risk for ID and anemia adjusted for potential confounders was assessed in logistic regression models. Results. The overall prevalence of anemia was 13.9%, 15.2% in males and 12.8% females. For ID,overall it was 4.2%, males 4.0% and females 4.3%. The greatest prevalence of ID was found in males and females over 80 years old (6.9 and 7.0%, respectively. ID was present in 1.5 of 10 Mexican elders with anemia. Conclusion. The prevalence of anemia was high in the elderly, however the prevalence of ID was low; there is a need to further investigate the causes of anemia in this age group.

  7. Anemia and iron deficiency in Mexican elderly population: Results from the Ensanut 2012.

    Science.gov (United States)

    Contreras-Manzano, Alejandra; Cruz, Vanessa de la; Villalpando, Salvador; Rebollar, Rosario; Shamah-Levy, Teresa

    2015-01-01

    To describe de prevalence of iron deficiency (ID) and anemia in a sample of Mexican elderly population from the National Health and Nutrition Survey (Ensanut) 2012. 1 920 subjects ≥60 years of age were included. Hemoglobin, serum concentrations of ferritin and CRP were measured. The risk for ID and anemia adjusted for potential confounders was assessed in logistic regression models. The overall prevalence of anemia was 13.9%, 15.2% in males and 12.8% females. For ID, overall it was 4.2%, males 4.0% and females 4.3%. The greatest prevalence of ID was found in males and females over 80 years old (6.9 and 7.0%, respectively). ID was present in 1.5 of 10 Mexican elders with anemia. The prevalence of anemia was high in the elderly, however the prevalence of ID was low; there is a need to further investigate the causes of anemia in this age group.

  8. Hemolytic anemia repressed hepcidin level without hepatocyte iron overload: lesson from Günther disease model.

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    Millot, Sarah; Delaby, Constance; Moulouel, Boualem; Lefebvre, Thibaud; Pilard, Nathalie; Ducrot, Nicolas; Ged, Cécile; Lettéron, Philippe; de Franceschi, Lucia; Deybach, Jean Charles; Beaumont, Carole; Gouya, Laurent; De Verneuil, Hubert; Lyoumi, Saïd; Puy, Hervé; Karim, Zoubida

    2017-02-01

    Hemolysis occurring in hematologic diseases is often associated with an iron loading anemia. This iron overload is the result of a massive outflow of hemoglobin into the bloodstream, but the mechanism of hemoglobin handling has not been fully elucidated. Here, in a congenital erythropoietic porphyria mouse model, we evaluate the impact of hemolysis and regenerative anemia on hepcidin synthesis and iron metabolism. Hemolysis was confirmed by a complete drop in haptoglobin, hemopexin and increased plasma lactate dehydrogenase, an increased red blood cell distribution width and osmotic fragility, a reduced half-life of red blood cells, and increased expression of heme oxygenase 1. The erythropoiesis-induced Fam132b was increased, hepcidin mRNA repressed, and transepithelial iron transport in isolated duodenal loops increased. Iron was mostly accumulated in liver and spleen macrophages but transferrin saturation remained within the normal range. The expression levels of hemoglobin-haptoglobin receptor CD163 and hemopexin receptor CD91 were drastically reduced in both liver and spleen, resulting in heme- and hemoglobin-derived iron elimination in urine. In the kidney, the megalin/cubilin endocytic complex, heme oxygenase 1 and the iron exporter ferroportin were induced, which is reminiscent of significant renal handling of hemoglobin-derived iron. Our results highlight ironbound hemoglobin urinary clearance mechanism and strongly suggest that, in addition to the sequestration of iron in macrophages, kidney may play a major role in protecting hepatocytes from iron overload in chronic hemolysis. Copyright© Ferrata Storti Foundation.

  9. Erythropoiesis in HIV-infected and uninfected Malawian children with severe anemia

    NARCIS (Netherlands)

    Calis, Job C. J.; Phiri, Kamija S.; Vet, Raymond J. W. M.; de Haan, Rob J.; Munthali, Francis; Kraaijenhagen, Robert J.; Hulshof, Paul J. M.; Molyneux, Malcolm E.; Brabin, Bernard J.; Boele van Hensbroek, Michaël; Bates, Imelda

    2010-01-01

    Anemia is common in HIV infection, but the pathophysiology is poorly understood. Bone marrow analysis in 329 severely anemic (hemoglobin <5 g/dl) Malawian children with (n = 40) and without (n = 289) HIV infection showed that HIV-infected children had fewer CD34(+) hematopoietic progenitors (median

  10. Severe anemia in 3 toddlers with gastric lactobezoar.

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    Klein-Franke, A; Kropshofer, G; Gassner, I; Meister, B; Salvador, C; Scholl-Bürgi, S; Mueller, T; Heinz-Erian, P

    2013-05-01

    Anemia in toddlers may result from many disorders including excessive feeding with cow's milk. Another sequel of age-inadequate cow's milk nutrition may be gastric lactobezoar (GLB), a dense lump of coagulated milk and mucus in the stomach. 3 toddlers presented with a history of excessive intake of full cream cow's milk, abdominal distension, vomiting, dehydration, fatigue, marked pallor and tachycardia. Diagnostic imaging revea-led large GLBs as the likely origin of the abdominal symptoms. Laboratory evaluation showed severe anemia with depleted iron stores and signs of protein catabolism. Non-cow's milk-induced causes of anemia including defects of erythropoiesis, hemoglobin structure, RBC-enzymes and blood coagulation, hemolysis, immune disorders, infection, inflammation, extraintestinal hemorrhage, nephropathy were - according to the available data - unlikely to cause the anemia in our patients. Thus their anemia is thought to be due to age-inadequate cow's milk nutrition leading to 1) low intake, decreased absorption/bioavailability and increased intestinal loss of iron, and 2) GLB which induced blood loss following mechanical irritation of the gastric mucosa and vomiting causing high gastric pH and decrease in duodenal iron absorption. The anemia in our patients is due to both exaggerated feeding with cow's milk and adverse effects of GLBs. This hypothesis is supported by the finding that, after erythrocyte transfusion, iron substitution, age-adapted nutrition and GLB-dissolution, the anemia did not recur. We propose to include GLB in the differential diagnosis of anemia in cow's milk fed small children. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Delivery of iron-fortified yoghurt, through a dairy value chain program, increases hemoglobin concentration among children 24 to 59 months old in Northern Senegal: A cluster-randomized control trial.

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    Le Port, Agnes; Bernard, Tanguy; Hidrobo, Melissa; Birba, Ousmane; Rawat, Rahul; Ruel, Marie T

    2017-01-01

    Innovative strategies are needed to enhance the nutritional impact of agriculture. Value chain approaches, which use supply chains to add value (usually economic) to products as they move from producers to consumers, can be used to increase access to nutritious foods and improve nutritional status. This study tested whether a dairy value chain could be used to distribute a micronutrient-fortified yoghurt (MNFY) (conditional upon the producer supplying a minimum amount of cow milk/day) to improve hemoglobin and reduce anemia among preschool children in a remote area in Northern Senegal. A cluster randomized control trial was used to compare 204 children (24 to 59 months of age at baseline) from households who received the MNFY coupled to a behavior change communication (BCC) campaign focusing on anemia prevention to 245 children from a control group (receiving BCC only) after one year. Randomization was done at the level of the family concession (households from the same family) (n = 321). Eligible households had a child of the target age and were willing to deliver milk to the dairy factory. Changes in anemia and hemoglobin between groups were assessed using mixed regression models. Anemia prevalence was very high at baseline (80%) and dropped to close to 60% at endline, with no differences between intervention groups. Hemoglobin increased by 0.55 g/dL, 95%CI (0.27; 0.84) more in the intervention compared to the control group after one year, in models that controlled for potentially confounding factors. The impact was greater (0.72 g/dL, 95%CI (0.34; 1.12)) for boys, compared to girls (0.38 g/dL, 95%CI (-0.03; 0.80)). The dairy value chain was a successful strategy to distribute MNFY among pastoralists in Northern Senegal, and increase Hb concentrations among their children. This study is one of the first proofs of concept showing that a nutrition-sensitive agriculture value chain approach can contribute to improved child nutrition in a remote pastoralist

  12. Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report

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    Sree Kumar Vaggu

    2016-01-01

    Full Text Available We report a case of a 17-year-old female patient who presented with sudden, painless, nonprogressive diminished vision in both eyes (best corrected visual acuity in right eye - 6/60 and left eye - 6/36. An ophthalmological evaluation revealed bilateral pale tarsal conjunctiva and bilateral macular hemorrhage. Hematological evaluation revealed the presence of megalocytic anemia (with hemoglobin - 4.9 g%. General examination showed severe pallor. On systemic examination, no abnormality was detected, confirmed by ultrasonography abdomen. Other causes of severe anemia have been ruled out. Intraocular pressure in both eyes was 12 mmHg. This case documents the rare occurrence of bilateral subinternal limiting membrane macular hemorrhage with megaloblastic anemia without thrombocytopenia and other retinal features of anemic retinopathy.

  13. Oxidant-antioxidant status in Egyptian children with sickle cell anemia: a single center based study.

    Science.gov (United States)

    El-Ghamrawy, Mona Kamal; Hanna, Wagdi Maurice; Abdel-Salam, Amina; El-Sonbaty, Marwa M; Youness, Eman R; Adel, Ahmed

    2014-01-01

    the present study was conducted to investigate the oxidant-antioxidant status in Egyptian children with sickle cell anemia. the serum levels of total antioxidant capacity (TAO), paraoxonase (PON), vitamin E, nitrite, and malondialdehyde (MDA) were measured in 40 steady state children with homozygous sickle cell anemia (24 males and 16 females) and 20 apparently healthy age- and gender-matched controls. mean serum TAO, PON, vitamin E, and nitrite levels were significantly lower in the group with sickle cell anemia, whereas mean serum MDA was significantly higher in these children compared to controls. No significant differences in mean levels of TAO, PON, nitrite, vitamin E, and MDA were found in sickle cell anemia patients receiving hydroxyurea when compared with those not receiving hydroxyurea. A significant negative correlation between serum nitrite and the occurrence of vaso-occlusive crises (VOC) was observed (r=-0.3, p=0.04). PON level was found to be positively correlated with patients' weight and BMI (r=-0.4, p=0.01; r=-0.7, panemia have chronic oxidative stress that may result in increased VOC, and decreased serum nitrite may be associated with increases in VOC frequency. A novel finding in this study is the decrease in PON level in these patients, which is an interesting subject for further research. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. Prevalence of anemia amongst overweight and obese children in NCT of Delhi

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    Umesh Kapil

    2014-09-01

    Full Text Available Introduction: Anemia amongst children has been associated with impaired cognitive functions, developmental delays, behavioral and learning disturbances. Young children from high-income groups could be also being affected from anemia. Objective: To assess the prevalence of anemia amongst overweight and obese children in the age group of 5-18 years residing in National Capital Territory (NCT of Delhi. Material and Methods: Total of 413 children was included in the present study. The hemoglobin (Hb estimation was done by cyanmethemoglobin method. Results: In the age group of 5-11 years, the prevalence of anemia amongst overweight and obese children was found to be 38.4% and 29.2%. And in the age group of 12-18 years, the prevalence of anemia amongst overweight and obese children was found to be 33.3% and 21.7%; respectively. Conclusion: The findings of the present study revealed that there is a high prevalence of anemia amongst overweight and obese children in the age group of 5-18 years in NCT, Delhi.

  15. The changes of red blood cell viscoelasticity and sports anemia in male 24-hr ultra-marathoners

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    Che-Hung Liu

    2018-05-01

    Full Text Available Background: In endurance sports, stress, dehydration and release of chemical factors have been associated with red blood cell (RBC alterations of structure and function, which may contribute to sports anemia, a well-observed phenomenon during long-distance running. Until now, the investigation of the changes of viscoelastic properties of RBC membrane, a decisive factor of RBC deformability to avoid hemolysis, is lacking, especially in an Oriental population. Methods: nineteen runners were prospectively recruited into our study. Hematological parameters were analyzed before and immediately after the 2015 Taipei 24H Ultra-Marathon Festival, Taiwan. Video particle tracking microrheology was used to determine viscoelastic properties of each RBC sample by calculating the dynamic elastic modulus G′(f and the viscous modulus G″(f at frequency f = 20 Hz. Results: Haptoglobin, RBC count, hemoglobin, hematocrit, mean cell hemoglobin, plasma free hemoglobin and unsaturated iron-binding capacity values of the recruited runners showed a statistically significant drop in the post-race values. Blood concentration of reticulocyte and ferritin were significantly higher at post-race compared with pre-race. 15 out of the 19 runners had a concurrent change in the elastic and the viscous moduli of their RBCs. Changes in the elastic and the viscous moduli were correlated with changes in the RBC count, hemoglobin and hematocrit. Conclusion: Viscoelasticity properties, the elastic modulus G′(f and the viscous modulus G″(f of RBCs are associated with endurance exercise-induced anemia. Keywords: Clinical sports medicine, Red blood cell, Sports anemia, Ultra-marathon, Viscoelastic properties

  16. Iron Deficiency and Anemia Predict Mortality in Patients with Tuberculosis123

    Science.gov (United States)

    Isanaka, Sheila; Mugusi, Ferdinand; Urassa, Willy; Willett, Walter C.; Bosch, Ronald J.; Villamor, Eduardo; Spiegelman, Donna; Duggan, Christopher; Fawzi, Wafaie W.

    2012-01-01

    Many studies have documented a high prevalence of anemia among tuberculosis (TB) patients and anemia at TB diagnosis has been associated with an increased risk of death. However, little is known about the factors contributing to the development of TB-associated anemia and their importance in TB disease progression. Data from a randomized clinical trial of micronutrient supplementation in patients with pulmonary TB in Tanzania were analyzed. Repeated measures of anemia with iron deficiency, anemia without iron deficiency, and iron deficiency without anemia were assessed as risk factors for treatment failure, TB recurrence, and mortality. The prevalence of anemia (hemoglobin iron deficiency (mean corpuscular volume , 80 fL). We found no evidence of an association between anemia (with or without iron deficiency) or iron deficiency without anemia at baseline and the risk of treatment failure at 1 mo after initiation. Anemia without iron deficiency was associated with an independent, 4-fold increased risk of TB recurrence [adjusted RR = 4.10 (95% CI = 1.88, 8.91); P Iron deficiency and anemia (with and without iron deficiency) were associated with a 2- to nearly 3-fold independent increase in the risk of death [adjusted RR for iron deficiency without anemia = 2.89 (95% CI = 1.53, 5.47); P = 0.001; anemia without iron deficiency = 2.72 (95% CI = 1.50, 4.93); P = 0.001; iron deficiency anemia = 2.13 (95% CI = 1.10, 4.11); P = 0.02]. Efforts to identify and address the conditions contributing to TB-associated anemia, including iron deficiency, could play an important role in reducing morbidity and mortality in areas heavily affected by TB. PMID:22190024

  17. Relationship between intensity of soil-transmitted helminth infections and anemia during pregnancy.

    Science.gov (United States)

    Larocque, Renee; Casapia, Martin; Gotuzzo, Eduardo; Gyorkos, Theresa W

    2005-10-01

    A direct relationship exists between the intensity of hookworm infection and blood loss. Other parasites may also contribute to blood loss. Our objective was to assess the relationship between the intensity of soil-transmitted helminth infections and anemia in pregnant women in a highly endemic area of Peru. Recruitment occurred between April and November 2003. Overall, 47.31% of 1,042 women had anemia (hemoglobin anemia. However, those infected with moderate and heavy intensities of hookworm infection (OR = 1.84; 95% CI: 1.06, 3.17) and those with moderate and heavy intensities of both hookworm and Trichuris infections (OR = 2.13; 95% CI: 1.10, 4.13) were more likely to suffer from anemia than women having no or light intensities. These results support routine anthelminthic treatment within prenatal care programs in highly endemic areas.

  18. ERYTHROPOIETIN TREATMENT FOR ANEMIA IN CHILDREN WITH CANCER – SINGLE CENTRE EXPERIENCES

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    Polona Mali

    2004-12-01

    Full Text Available Background. Anemia, a common complication during treatment of malignant disease in children, was frequently treated with red blood cell transfusions. Several studies have shown, that the introduction of recombinant human erythropoietin (rh EPO for treating anemia in patients has been effective in reducing the need for transfusions. Variable doses of EPO from 150 to 900 IU/kg body weight have been used usually three times weekly. Recently some studies showed equally effective once weekly administration of EPO with proposed doses for children of 450 to 600 IU/ kg body weight.Efficacy and safety of once weekly EPO therapy was tested in 8/10 children treated in our Unit for solid tumors and nonHodgkin’s lymphoma. In this article we would like to present our one year experience with EPO treatment.Patients and methods. Patients have subcutaneously received the EPO dose of 600 UI/ kg body weight once weekly. Hemoglobin response and transfusion needs before and during treatment with EPO were analyzed.Results. Response was seen in 7/8 of patient, with increased hemoglobin level and lower transfusion needs. Only one patient was poor responder at first, but responded perfect after twice weekly EPO application. No adverse reaction related to EPO therapy was observed.Conclusions. Our experience with treating anemia in pediatric cancer patients who undergo intensive and aggressive chemotherapy treatment regimens are good and promising. Once weekly dosage regimen is child friendly and acceptable way of treating anemia.

  19. Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia.

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    Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro

    2017-08-12

    School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children's nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein ( p < 0.05), calcium ( p < 0.05), and vitamin C ( p < 0.001) significantly increased, while that of fat significantly decreased ( p < 0.001). After the intervention, hemoglobin ( p < 0.05) and hematocrit ( p < 0.05) levels were significantly improved, thereby almost halving the rate of anemia. These changes were significantly larger in the baseline anemic group than the non-anemic group ( p < 0.01). BMI significantly increased in the baseline underweight/normal group ( p < 0.001) but not in the overweight/obese group. The school lunch intervention significantly improved nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren.

  20. Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy.

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    Theresa W Gyorkos

    Full Text Available The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (light; 1,000-9,999 epg (moderate, and ≥ 10,000 epg (heavy were developed in the 1980s, when there were little epidemiological data available on dose-response relationships. This study was undertaken to determine a threshold for T. trichiura-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions.In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg. They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62 and 1.73 (95% CI: 1.09, 2.74, respectively.This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly.

  1. The Effect of High-Flux Hemodialysis on Hemoglobin Concentrations in Patients with CKD: Results of the MINOXIS Study

    Science.gov (United States)

    Schneider, Andreas; Drechsler, Christiane; Krane, Vera; Krieter, Detlef H.; Scharnagl, Hubert; Schneider, Markus P.; Wanner, Christoph

    2012-01-01

    Summary Background and objectives Hemodialysis treatment induces markers of inflammation and oxidative stress, which could affect hemoglobin levels and the response to erythropoietin use. This study sought to determine whether high-flux dialysis would help improve markers of renal anemia, inflammation, and oxidative stress compared with low-flux dialysis. Design, settings, participants, & measurements In a prospective, controlled study, 221 patients undergoing maintenance hemodialysis and receiving darbepoetin-alfa treatment (mean age, 66 years; 55% male) from 19 centers were screened in a 20-week run-in period of low-flux hemodialysis with a synthetic dialysis membrane. Thereafter, 166 patients were enrolled and randomly assigned to receive a synthetic high-flux membrane or to continue on low-flux dialysis for 52 weeks. Data on myeloperoxidase, oxidized LDL, high-sensitivity C-reactive protein, and the Malnutrition Inflammation Score were collected at baseline and after 52 weeks; routine laboratory data, such as hemoglobin, ferritin, and albumin, and the use of darbepoetin-alfa, were also measured in the run-in period. Results After 52 weeks, the low-flux and the high-flux groups did not differ with respect to hemoglobin (mean ± SD, 11.7±0.9 g/dl versus 11.7±1.1 g/dl; P=0.62) or use of darbepoetin-alfa (mean dosage ± SD, 29.8±24.8 μg/wk versus 26.0±31.1 μg/wk; P=0.85). Markers of inflammation, oxidative stress, or nutritional status also did not differ between groups. Conclusion Over 1 year, high-flux dialysis had no superior effects on hemoglobin levels or markers of inflammation, oxidative stress, and nutritional status. These data do not support the hypothesis that enhanced convective toxin removal would improve patient outcome. PMID:22096040

  2. Pentoxifylline for Anemia in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

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    Davide Bolignano

    Full Text Available Pentoxifylline (PTX is a promising therapeutic approach for reducing inflammation and improving anemia associated to various systemic disorders. However, whether this agent may be helpful for anemia management also in CKD patients is still object of debate.Systematic review and meta-analysis.Adults with CKD (any KDOQI stage, including ESKD patients on regular dialysis and anemia (Hb<13 g/dL in men or < 12 g/dL in women.Cochrane CENTRAL, EMBASE, Ovid-MEDLINE and PubMed were searched for studies providing data on the effects of PTX on anemia parameters in CKD patients without design or follow-up restriction.PTX derivatives at any dose regimen.Hemoglobin, hematocrit, ESAs dosage and resistance (ERI, iron indexes (ferritin, serum iron, TIBC, transferrin and serum hepcidin and adverse events.We retrieved 11 studies (377 patients including seven randomized controlled trials (all comparing PTX to placebo or standard therapy one retrospective case-control study and three prospective uncontrolled studies. Overall, PTX increased hemoglobin in three uncontrolled studies but such improvement was not confirmed in a meta-analysis of seven studies (299 patients (MD 0.12 g/dL, 95% CI -0.22 to 0.47. Similarly, there were no conclusive effects of PTX on hematocrit, ESAs dose, ferritin and TSAT in pooled analyses. Data on serum iron, ERI, TIBC and hepcidin were based on single studies. No evidence of increased rate of adverse events was also noticed.Small sample size and limited number of studies. High heterogeneity among studies with respect to CKD and anemia severity, duration of intervention and responsiveness/current therapy with iron or ESAs.There is currently no conclusive evidence supporting the utility of pentoxifylline for improving anemia control in CKD patients. Future trials designed on hard, patient-centered outcomes with larger sample size and longer follow-up are advocated.

  3. Effect of hemoglobin and immunization status on energy metabolism of weanling pigs.

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    Gentry, J L; Swinkels, J W; Lindemann, M D; Schrama, J W

    1997-04-01

    We investigated the effect of (Hb) and immunization status on energy metabolism of newly weaned pigs. An additional focus of the study was to determine the development of circadian rhythms as evidenced by heat production patterns. Twenty-four 4-wk-old crossbred weanling barrows were placed into groups of three based on weight and litter origin, and the groups were allotted to one of four treatments. Treatments were arranged as a 2 x 2 factorial. The factors included 1) Hb status (low vs high) and 2) immunization status (antigen vs placebo). Hemoglobin status was obtained by injecting 3-d-old barrows with 100 (low) or 200 mg (high) of Fe. At 4 wk, initial blood Hb concentrations were 6.0 mM for the low group and 7.8 mM for the high group. Energy metabolism was measured using two weekly total energy and nitrogen balance collections. Energy intake and retention were higher (P Energy metabolism was not affected (P > .10) by immunization status, and heat production was not affected (P > .10) by either Hb or immunization status. Total heat production (HTOT) increased (P light period compared with the dark period over the total experimental period but a decrease (P dark period was approximately half of that measured during the light period. In conclusion, Hb status affected energy metabolism; pigs having a high Hb status had a higher energy retention. Immunization status had minimal effects on energy metabolism and heat production. Additionally, the diurnal circadian rhythm seen in older pigs had not been established by 2 wk after weaning.

  4. Prevalence and severity of anemia among pregnant women in primary health centers/Erbil City

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    Rushna Ghazi Abdulwahid

    2017-07-01

    Full Text Available Anemia in pregnancy is a major public health problem, especially in developing countries. Nutritional anemia is the most common type of anemia worldwide and mainly includes iron, folic acid, vitamin B12 and vitamin C deficiencies. Iron deficiency contributes to half of the burden of anemia globally. The objectives of this study were to find out the prevalence and severity of anemia among pregnant women. A descriptive study was conducted on 600 pregnant women, during the period October 2015 to November 2016 at four primary health care centers in Erbil city. Data gathered through interview with study sample and filling questionnaire format and reviewing their antenatal records. Blood hemoglobin level was measured to assess the severity of anemia. Chi-square test and regression were used to analyze the data. Prevalence of anemia was 46.2%, and 67.1% of the anemic women had mild anemia. There was a significant association of severity of anemia with wife education and occupation, smoking, the number of abortions and cesarean section, ante partum hemorrhage, taking tablets of iron and folic acid per month. The study concluded that prevalence of anemia considered high in Erbil city, the highest percentage had mild anemia.

  5. Prevalence of anemia and associated factors among pregnant women in Southern Ethiopia: A community based cross-sectional study.

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    Meaza Lebso

    Full Text Available Anemia is defined as a condition in which there is less than the normal hemoglobin (Hb level in the body. During pregnancy; iron deficiency is associated with multiple adverse outcomes for both mother and infant. Most of the studies conducted in Ethiopia on anemia during pregnancy were conducted at institution level and associated factors are not well studied and documented. Independent factors like, food security status, dietary diversity and intestinal parasites infection were considered by only a few of them. Hence, the aim of this study was to determine the prevalence of anemia and associated factors among pregnant women in Lemo District, Southern Ethiopia.Community based cross- sectional study was conducted from May-June 2015. Multistage sampling was used to include 507 study participants. Anaemia was diagnosed using HemoCue HB 301 and haemoglobin concentration <11 g/dl was classified as anaemic. Stool examinations were also done. Structured questionnaire was used as a tool to collect sociodemographic characteristics, individual dietary diversity and level of household food security data. Multivariate logistic regression model was employed to determine the effect of explanatory variables like level of education, level of household food security, dietary diversity, trimester of pregnancy, family planning before pregnancy, deworming, gravidity, iron intake in current pregnancy and soil transmitted helminthes on dependent variable anemia.The prevalence of anemia was 23.2% (95% CI: 19.5%-26.9%. Factors associated with anemia were: low socio-economic status (AOR = 2.03, 95% CI: 1.11-3.69, trimester second (AOR = 3.09, 95%CI: 1.41-6.79 and third (AOR = 3.68, 95% CI: 1.67-8.08, gravidity three to five (AOR = 1.78, 95% CI: 1.03-3.07 and six and above (AOR = 2.59, 95%CI: 1.37-4.92, not supplemented with iron (AOR = 1.72, 95% CI: 1.02-2.91, low dietary diversity score (AOR = 3.18, 95% CI: 1.37-7.37 and hookworm infection (AOR = 2.69, 95%CI: 1

  6. Severe late anemia of hemolytic disease of the newborn

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    Mitchell, Simon; James, Andrew

    1999-01-01

    Late anemia is a well-recognized complication of Rhesus hemolytic disease of the newborn (HDN). The incidence of Rhesus HDN is declining, with a tendency for more severely affected pregnancies to be managed in specialist centres. Consequently, many paediatric departments may see relatively few affected infants with comparatively mild disease, and the risk of late anemia in such cases may not always be appreciated. Two cases of infants born with evidence of Rhesus isoimmunization noted at birth and encountering no immediate problems other than mild hyperbilirubinemia are described. After an uneventful early neonatal course, both infants were discharged without follow-up and presented in the second to third weeks of life with severe, life-threatening anemia, leading to neurological sequelae in one case. The importance of close surveillance, including hemoglobin measurements, in all infants with Rhesus hemolytic disease, irrespective of initial severity, is reiterated. PMID:20212966

  7. Determinants of Stunting, Wasting, and Anemia in Guinean Preschool-Age Children: An Analysis of DHS Data From 1999, 2005, and 2012.

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    Woodruff, Bradley A; Wirth, James P; Ngnie-Teta, Ismael; Beaulière, Jean Max; Mamady, Daffe; Ayoya, Mohamed Ag; Rohner, Fabian

    2018-03-01

    Wasting, stunting, and anemia are persistent and important forms of malnutrition in preschool-age children in the less developed world, in particular the Republic of Guinea, which was the site of a large outbreak of Ebola virus disease in 2014 to 2015. We analyzed data from 3 Demographic and Health Surveys done in Guinea in 1999, 2005, and 2012 to identify possible determinants of wasting, stunting, and anemia. All analyses, both bivariate and multivariate, were carried out separately for each of 3 age groups: less than 6 months, 6 to 23 months, and 24 to 59 months. Variables found statistically significantly associated with stunting, wasting, or anemia in bivariate analysis were placed in an age-specific logistic regression model for that outcome. Overall, anthropometric indices were available for 9228 children and hemoglobin concentrations were available for 5681 children. Logistic regression found relatively few variables associated with nutrition outcomes in children younger than 6 months. More variables were associated with nutrition outcomes in children aged 6 to 23 months. Such variables measured a wide variety of conditions, including estimated birth size, child health and nutritional status, child caring practices, mother's nutritional and health status, and household water source and sanitation. A similarly broad range of variables was statistically significantly associated with one or more nutrition outcomes in children aged 24 to 59 months. Few of the standard infant and young child feeding indicators were associated with any nutrition outcome. Improvement in the nutritional status of young children in Guinea may require a broad range of nutrition and health interventions.

  8. Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years

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    Bárbara C.A. Saraiva

    2014-12-01

    Full Text Available OBJECTIVE: To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. METHODS: This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n = 692 that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion, anthropometric data (body mass index-for-age and height-for-age, and biochemical parameters (ferritin, hemoglobin, and retinol serum were collected. RESULTS: The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p < 0.001 and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p < 0.001 among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r = 0.597; p < 0.001 and hemoglobin vs. retinol serum (r = 0.770; p < 0.001. CONCLUSIONS: Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency.

  9. Age and body mass index-dependent relationship between correction of iron deficiency anemia and insulin resistance in non-diabetic premenopausal women

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    Ozdemir, A.; Sevnic, C.; Selamaet, U.; Kamaci, B.; Atalay, S.

    2007-01-01

    No prospective studies have evaluated the effects of correction of iron deficiency anemia on insulin resistance in non-diabetic premenopausal women with iron deficiency anemia. All patients were treated with oral iron preparations. Insulin resistance was calculated with the Homeostasis Model Assessment formula. All patients were dichotomized by the median for age and BMI to assess how the relationship between iron deficiency anemia and insulin resistance was affected by the age and BMI. Although the fasting glucose levels did not change meaningfully, statistically significant decreases were found in fasting insulin levels following anemia treatment both in the younger age ( = 40 years) and the high BMI (>-27Kg/m) subgroups. Post-treatment fasting insulin levels were positively correlated both with BMI (r=0.386, P=0.004) and post-treatment hemoglobin levels. (r=0.285, P=0.036). Regression analysis revealed that the factors affecting post-treatment insulin levels were BMI (P=0.001) and post-treatment hemoglobin levels (p=0.030). Our results show that following he correction of iron deficiency anemia, insulin levels and HOMA scores decrease in younger and lean non-diabetic premenopausal women. (author)

  10. Impact of Mean Cell Hemoglobin on Hb A1c-Defined Glycemia Status.

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    Rodriguez-Segade, Santiago; Garcia, Javier Rodriguez; García-López, José M; Gude, Francisco; Casanueva, Felipe F; Rs-Alonso, Santiago; Camiña, Félix

    2016-12-01

    Several hematological alterations are associated with altered hemoglobin A 1c (Hb A 1c ). However, there have been no reports of their influence on the rates of exceeding standard Hb A 1c thresholds by patients for whom Hb A 1c determination is requested in clinical practice. The initial data set included the first profiles (complete blood counts, Hb A 1c , fasting glucose, and renal and hepatic parameters) of all adult patients for whom such a profile was requested between 2008 and 2013 inclusive. After appropriate exclusions, 21844 patients remained in the study. Linear and logistic regression models were adjusted for demographic, hematological, and biochemical variables excluded from the predictors. Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) correlated negatively with Hb A 1c . Fasting glucose, MCH, and age emerged as predictors of Hb A 1c in a stepwise regression that discarded sex, hemoglobin, MCV, mean corpuscular hemoglobin concentration (MCHC), serum creatinine, and liver disease. Mean Hb A 1c in MCH interdecile intervals fell from 6.8% (51 mmol/mol) in the lowest (≤27.5 pg) to 6.0% (43 mmol/mol) in the highest (>32.5 pg), with similar results for MCV. After adjustment for fasting glucose and other correlates of Hb A 1c , a 1 pg increase in MCH reduced the odds of Hb A 1c -defined dysglycemia, diabetes and poor glycemia control by 10%-14%. For at least 25% of patients, low or high MCH or MCV levels are associated with increased risk of an erroneous Hb A 1c -based identification of glycemia status. Although causality has not been demonstrated, these parameters should be taken into account in interpreting Hb A 1c levels in clinical practice. © 2016 American Association for Clinical Chemistry.

  11. Community-led initiative for control of anemia among children 6 to 35 months of age and unmarried adolescent girls in rural Wardha, India.

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    Dongre, Amol R; Deshmukh, Pradeep R; Garg, Bishan S

    2011-12-01

    Studies in India have reported a high prevalence of nutritional anemia among children and adolescent girls. Nutritional anemia is associated with impaired mental, physical, and cognitive performance in children and is a significant risk factor for maternal mortality. To evaluate the effect of a community-led initiative for control of nutritional anemia among children 6 to 35 months of age and unmarried rural adolescent girls 12 to 19 years of age. This Participatory Action Research was done in 23 villages of the Primary Health Centre, Anji, in Wardha District of Maharashtra. In February and March 2008, needs assessment was undertaken by interviewing the mothers of 261 children and 260 adolescent girls. Hemoglobin levels of adolescent girls and children were measured with the use of the hemoglobin color scale. The girls were given weekly iron-folic acid tablets, and the children were given daily liquid iron prophylaxis for 100 days in a year through community participation. The adolescent girls and the mothers of the children and adolescent girls were also given nutritional education on the benefits and side effects of iron supplementation. In June and July 2008, follow-up assessment was performed by survey and force field analysis. There was a significant reduction in the prevalence of nutritional anemia from 73.8% to 54.6% among the adolescent girls and from 78.2% to 64.2% among the children. There was improvement in awareness of iron-rich food items among the adolescent girls and the mothers of the children. The benefits to girls, such as increase in appetite and reduction in scanty menses, tiredness, and weakness, acted as positive factors leading to better compliance with weekly iron supplementation. The benefits to children perceived by the mothers, such as increase in appetite, weight gain, reduction in irritability, and reduction in mud-eating behavior, acted as a dominant positive force and generated demand for iron syrup. The community-led initiative for

  12. The Folate-Vitamin B12 Interaction, Low Hemoglobin, and the Mortality Risk from Alzheimer's Disease.

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    Min, Jin-Young; Min, Kyoung-Bok

    2016-03-21

    Abnormal hemoglobin levels are a risk factor for Alzheimer's disease (AD). Although the mechanism underlying these associations is elusive, inadequate micronutrients, particularly folate and vitamin B12, may increase the risk for anemia, cognitive impairment, and AD. In this study, we investigated whether the nutritional status of folate and vitamin B12 is involved in the association between low hemoglobin levels and the risk of AD mortality. Data were obtained from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) and the NHANES (1999-2006) Linked Mortality File. A total of 4,688 participants aged ≥60 years with available baseline data were included in this study. We categorized three groups based on the quartiles of folate and vitamin B12 as follows: Group I (low folate and vitamin B12); Group II (high folate and low vitamin B12 or low folate and high vitamin B12); and Group III (high folate and vitamin B12). Of 4,688 participants, 49 subjects died due to AD. After adjusting for age, sex, ethnicity, education, smoking history, body mass index, the presence of diabetes or hypertension, and dietary intake of iron, significant increases in the AD mortality were observed in Quartile1 for hemoglobin (HR: 8.4, 95% CI: 1.4-50.8), and the overall risk of AD mortality was significantly reduced with increases in the quartile of hemoglobin (p for trend = 0.0200), in subjects with low levels of both folate and vitamin B12 at baseline. This association did not exist in subjects with at least one high level of folate and vitamin B12. Our finding shows the relationship between folate and vitamin B12 levels with respect to the association between hemoglobin levels and AD mortality.

  13. Diagnosis of anemia on CT scans of the thorax

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    Corcoran, H.L.; Cook, D.E.; Proto, A.V.

    1986-01-01

    Visualization of the interventricular septum on nonenhanced CT scans of the thorax of patients with anemia has been illustrated in the literature and explained in terms of a density differential between the cardiac musculature and the blood of anemic patients (blood with a low hemoglobin level). There are no data on the frequency of visualization of the walls of the cardiac chambers, the aorta and its branches, the superior and inferior venae cavae, the brachiocephalic veins, the azygos arch, and so forth. Experience with 50 patients is reported in terms of the foregoing. Findings are correlated with the severity of the anemia, thereby indicating how commonly one may encounter such an appearance

  14. Perceived Cause and Effect Relationship for Nutritional Anemia Among Adolescent Girls in Rural Puducherry

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    Mayura S

    2014-10-01

    Full Text Available Background & Objectives: The prevalence of nutritional anemia among adolescent girls is high (47.6% to 90% as previously reported in the different parts of North India. Since there are limited studies on nutritional anemia at the sub-district level in the Southern part of India, there is a need to know the extent of the problem among adolescent girls to plan context specific interventions. With this background, the present study was done with the objectives 1 To find the prevalence of nutritional anemia among adolescent girls 2 To ‘qualitatively’ explore their perceptions of the causes and effects of nutritional anemia. Methods: The study was undertaken in two wards of Kallitheerthalkuppam village, the field practice area of the Department of Community Medicine, SMVMCH, Puducherry. Mixed-methods design which includes quantitative (survey and qualitative (cause-effect diagram methods was used. A representative sample of 100 adolescent girls aged 12-19 years were the study participants. Data for quantitative (survey using a questionnaire and qualitative (cause-effect diagram methods were collected over the period of two months. Result: The prevalence of anemia among the study population was 58 per cent. In The cause and effect diagram exercise, girls linked deficiency of iron as the cause for tiredness, irregular menstrual cycles and low birth weight. They also linked deficiency of iron and the habit of not wearing footwear to tiredness, reduced intake of green leafy vegetables, and intestinal worm infections to giddiness and hookworm infections to peptic ulcer. Interpretation & Conclusions: The study found a gap between knowledge and practice as reflected in the cause and effect diagram. This result indicates the need to initiate an effective behavior change communication for improving the hemoglobin status of adolescent girls.

  15. Research Article. Comparative Analysis of Hepcidin-25 and Inflammatory Markers in Patients with Chronic Kidney Disease with and without Anemia

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    Căldăraru Carmen Denise

    2017-03-01

    Full Text Available Introduction: Hepcidin is a regulatory protein in iron metabolism; we do not know the role in chronic kidney disease anemia. Methods: 22 patients with CKD anemia and 15 patients with CKD without anemia were investigated. CKD anemia-inclusion criteria: over 18 years, hemoglobin ≤12 g/dl for women and ≤13 g/dl for men, no treatment for anemia 6 months before enrollment, glomerular filtration rate (eGFR <60 ml/min/1.73m2 and stable creatinine three months before enrollment. Exclusion criteria: infection, bleeding, malignancy, systemic or liver disease, immunosuppression, renal replacement therapy. CKD without anemia-inclusion criteria: over 18 years, no anemia or treatment for anemia, CKD with stable creatinine values three months before enrollment. Exclusion criteria: medical conditions known to have a role in the development of polycythemia. Hepcidin-25 and ferritin were measured by ELISA method. Erythropoietin (EPO, tumor necrosis factor (TNF-α, interleukin (IL-6 were evaluated using chemiluminescent enzyme immunometric assays. Unpaired T test, Pearson correlation and multiple regression were used for statistical analysis. Results: Hemoglobin values were significantly lower in anemia group. There were no differences in terms of eGFR, age, body mass index, serum hepcidin, erythropoietin, fibrinogen, IL-6, and TNF-α between CKD patients with and without anemia. Serum hepcidin correlated positively with ferritin (r=0.45 p<0.05, TNF-α (r=0.54, p<0.05 and negatively with erythropoietin (r=-0.51, p<0.05. Multiple linear regression analysis demonstrated that TNF-α is an independent predictor of serum hepcidin in our patients (p=0.003, R=0.71. Conclusion: We found no differences in serum hepcidin, erythropoietin and inflammatory markers in non-dialysis CKD patients with and without anemia.

  16. Assessment of iron status of Filipino pregnant women.

    Science.gov (United States)

    Kuizon, M D; Tajaon, R T; Madriaga, J R; Perlas, L A; Desnacido, J A

    1989-09-01

    Plasma ferritin (PF), erythrocyte protoporphyrin (EP) and hemoglobin (Hb) were used to assess the iron status of 158 Filipino pregnant women included as subjects in the third national nutrition survey conducted by the Food and Nutrition Research Institute in 1987. The prevalence of iron depletion was 39.9% based on PF (less than 12 ng/ml). Iron deficient erythropoiesis was present in 36.1% based on EP of greater than 28 micrograms/dl whole blood and 40.5% based on EP/Hb ratio of greater than 2.4. When the criterion of iron deficiency was that both PF and EP were abnormal, the prevalence of deficiency was lower and only 16.4%. Iron deficiency anemia was present in 14.6% based on Hb less than 11 g/dl in addition to abnormal PF and EP. Significantly lower mean values for PF were obtained in women on the 2nd and 3rd trimesters of pregnancy indicating decreasing iron stores and the need for iron therapy to prevent anemia during those periods. The iron status of 38 women who reported taking iron supplements was not significantly different from those who did not take supplements.

  17. Hemoglobin stability in patients with anemia, CKD, and type 2 diabetes: an analysis of the TREAT (Trial to Reduce Cardiovascular Events With Aranesp Therapy) placebo arm.

    Science.gov (United States)

    Skali, Hicham; Lin, Julie; Pfeffer, Marc A; Chen, Chao-Yin; Cooper, Mark E; McMurray, John J V; Nissenson, Allen R; Remuzzi, Giuseppe; Rossert, Jerome; Parfrey, Patrick S; Scott-Douglas, Nairne W; Singh, Ajay K; Toto, Robert; Uno, Hajime; Ivanovich, Peter

    2013-02-01

    Sparse data are available about the natural history of hemoglobin (Hb) level trends in contemporary patients with anemia, chronic kidney disease (CKD), and type 2 diabetes mellitus. We intended to describe Hb level trends over time with no or minimal administration of erythropoiesis-stimulating agents. Prospective clinical trial cohort. 2,019 individuals with type 2 diabetes, moderate anemia, and CKD from the placebo arm of the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) followed up for 2.3 years with an average of 32 monthly Hb level determinations per patient. Darbepoetin alfa was administered only if Hb level decreased to protocol-directed doses of darbepoetin alfa received due to an Hb level decrease to protocol-directed darbepoetin alfa. The other patients received 1 (16%), 2-4 (16%), or 5 or more (13%) doses of darbepoetin alfa. Those who received no darbepoetin alfa doses had higher baseline Hb levels, higher estimated glomerular filtration rates (eGFRs), less proteinuria, and lower ferritin and transferrin saturation values. On average, Hb levels were stable or increased in all groups. Compared with individuals who received no darbepoetin alfa, those who received 5 or more doses were more likely to receive intravenous iron therapy and blood transfusions and progress to renal replacement therapy, but were not at higher risk of death. The strongest predictors of requiring 5 or more doses of darbepoetin alfa were lower baseline Hb level, lower eGFR, and higher proteinuria level. Post hoc analysis of a clinical trial of a specific population with diabetes, anemia, and non-dialysis-dependent CKD. In the TREAT placebo arm, Hb levels were stable with no or minimal protocol-directed darbepoetin alfa during 2.3 years of follow-up. Most patients with moderate anemia, non-dialysis-dependent CKD, and type 2 diabetes are able to maintain a stable Hb level without implementing long-term erythropoiesis-stimulating agent therapy. Copyright © 2013

  18. Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women.

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    Rappaport, Aviva I; Whitfield, Kyly C; Chapman, Gwen E; Yada, Rickey Y; Kheang, Khin Meng; Louise, Jennie; Summerlee, Alastair J; Armstrong, Gavin R; Green, Timothy J

    2017-08-01

    Background: Anemia affects 45% of women of childbearing age in Cambodia. Iron supplementation is recommended in populations in which anemia prevalence is high. However, there are issues of cost, distribution, and adherence. A potential alternative is a reusable fish-shaped iron ingot, which, when added to the cooking pot, leaches iron into the fluid in which it is prepared. Objective: We sought to determine whether there was a difference in hemoglobin concentrations in rural Cambodian anemic women (aged 18-49 y) who cooked with the iron ingot or consumed a daily iron supplement compared with a control after 1 y. Design: In Preah Vihear, 340 women with mild or moderate anemia were randomly assigned to 1 ) an iron-ingot group, 2 ) an iron-supplement (18 mg/d) group, or 3 ) a nonplacebo control group. A venous blood sample was taken at baseline and at 6 and 12 mo. Blood was analyzed for hemoglobin, serum ferritin, and serum transferrin receptor. Hemoglobin electrophoresis was used to detect structural hemoglobin variants. Results: Anemia prevalence was 44% with the use of a portable hemoglobinometer during screening. At baseline, prevalence of iron deficiency was 9% on the basis of a low serum ferritin concentration. There was no significant difference in mean hemoglobin concentrations between the iron-ingot group (115 g/L; 95% CI: 113, 118 g/L; P = 0.850) or iron-supplement group (115 g/L; 95% CI: 113, 117 g/L; P = 0.998) compared with the control group (115 g/L; 95% CI: 113, 117 g/L) at 12 mo. Serum ferritin was significantly higher in the iron-supplement group (73 μg/L; 95% CI: 64, 82 μg/L; P = 0.002) than in the control group at 6 mo; however, this significance was not maintained at 12 mo (73 μg/L; 95% CI: 58, 91 μg/L; P = 0.176). Conclusions: Neither the iron ingot nor iron supplements increased hemoglobin concentrations in this population at 6 or 12 mo. We do not recommend the use of the fish-shaped iron ingot in Cambodia or in countries where the prevalence

  19. Prevalence of anemia among under-5 children in the Ghanaian population: estimates from the Ghana demographic and health survey.

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    Ewusie, Joycelyne E; Ahiadeke, Clement; Beyene, Joseph; Hamid, Jemila S

    2014-06-19

    Anemia in children continues to be a major public health challenge in most developing countries, particularly in Africa. Anemia in the early stages of life leads to severe negative consequences on the cognitive as well as the growth and development of children, which may persist even after treatment. We examine the prevalence of anemia in under-five children in the Ghanaian population to help inform and serve as a guide to health policies and possible interventions. Data from the 2008 Ghana Demographic and Health Survey (GDHS) was used. Data consists of health, demographic and socio-economic factors. Anemia status was determined using hemoglobin level, and prevalence of childhood anemia along with 95% confidence intervals was provided. We also examined the distribution of prevalence across different age and socio-demographic groups as well as the different regions and sub-regions in Ghana. The overall prevalence of anemia in under-five children in Ghana was 78.4% (N = 2168, 95% CI: 76.7-80.2), where 7.8% (N = 2168, 95% CI: 6.6-8.9) of the children had severe anemia, 48.0% (N = 2168, 95% CI: 45.9-50.2) moderate anemia and 22.6% (N = 2168, 95% CI: 20.8-24.4) had mild anemia. The highest prevalence regions were the Upper East, 88.9% (N = 158, 95% CI: 80.9-94.0), and Upper West 88.1% (N = 220, 95% CI: 76.4-94.6). The prevalence was also higher among children under 2 years of age, 85.1% (N = 781, 95% CI: 82.6-87.7) than children 2-5 years of age, 74.8% (N = 1387, 95% CI: 72.5-77.1). No significant difference in prevalence between boys and girls was observed. Given the high prevalence of childhood anemia observed in Ghana, particularly among those less than 2 years old, and given the negative consequences on their cognitive and behavioral development even in later years, there is an urgent need for effective and efficient public health interventions.

  20. Coexistence of Obesity and Anemia in Older Mexican Adults.

    Science.gov (United States)

    Samper-Ternent, Rafael; Michaels-Obregon, Alejandra; Wong, Rebeca

    2011-12-08

    INTRODUCTION: Developing countries in Latin America (LA) are experiencing rapid aging as a result of advances in medical interventions. This rapid aging has not occurred with comparable improvements in standards of living. Chronic conditions are becoming highly prevalent while exposure to infectious communicable diseases is very common. This unique situation where communicable and non-communicable diseases coexist in the presence of low socioeconomic status place countries in LA in a unique epidemiological situation. Mexico presents a very good example where the impact of this situation on health warrants further analysis. METHODS: We use data from the Mexican National Health and Nutrition Survey (ENSANut 2006), a cross-sectional study representative of all urban and rural areas of Mexico. A total of 5,605 adults older than 60 years of age with valid values for Body Mass Index and Hemoglobin were analyzed. We first included a descriptive analysis of the coexistence of anemia and obesity by age, gender and characteristics of the living environment. We reported the weighted percentages for each covariate by each of four nutritional condition categories (obese and anemic, only-obese, only-anemic, not obese and not anemic). We used multinomial logit regressions to determine the association of socioeconomic characteristics, health status and the living environment with the presence of the three nutritional condition categories. RESULTS: In the ENSANut cohort 10.3% of older adults are anemic, 25.0% are obese and 2.6% are both anemic and obese. Approximately 62% has neither anemia nor obesity. Within the 38% that fall in the three nutritional condition categories, the co-existence of obesity & anemia appears to be associated with metropolitan area residence, living alone, being male, having relatively high wealth, and reporting two or more chronic health conditions. Analyzing the effect of the covariates to distinguish between outcome categories, living environment, age

  1. Anemia ferropriva em crianças de 6 a 12 meses atendidas na rede pública de saúde do município de Viçosa, Minas Gerais Iron deficiency anemia in 6 to 12-month-old infants attended at the public health service of Viçosa, Minas Gerais, Brazil

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    Danielle Góes da SILVA

    2002-09-01

    Full Text Available Este estudo teve como objetivos verificar a prevalência de anemia em lactentes de 6 a 12 meses atendidos na rede pública de saúde do município de Viçosa, MG e analisar alguns possíveis fatores de risco. As informações foram obtidas através de questionário aplicado aos responsáveis pela criança e através da verificação de medidas antropométricas e da dosagem de hemoglobina por hemoglobinômetro portátil. No diagnóstico de anemia, utilizou-se o ponto de corte de 11 g/dL. A prevalência de anemia ferropriva nas 204 crianças estudadas foi 60,8%, e 55,6% dos casos de anemia eram graves. A média da hemoglobina foi 9,28±1,07 nos anêmicos e 12,07±0,89 mg/dL nos não-anêmicos. A baixa escolaridade paterna e a idade materna mostraram associação estatística com a anemia (pThis study aimed at verifying the prevalence of anemia in 6 to 12-month-old infantsattended at the public health service of the city of Viçosa, state of Minas Gerais, and analyzing some possible risk factors. Information was obtained through questionnaire applied to those responsible for the infants and through the verification of the anthropometric measures and the hemoglobin dosage by portable hemoglobinometer. In diagnosing anemia, a 11g/dL cutoff point was used. The prevalence of iron deficiency anemia in a total of 204 infants reached 60.8%, and 55.6% of the cases of anemia were serious. The hemoglobin average was 9.28±1.07 mg/dL in anemic infants, and 12.07± 0.89 mg/dL in non-anemic ones. The father's low school level and the mother's age showed statistical association with anemia (p<0.05. A high prevalence and severity of the anemia was found, emphasizing the need for prevention and control of this disease in the city of Viçosa.

  2. KEGEMUKAN, ANEMIA, DAN PRESTASI BELAJAR SISWA SEKOLAH DASAR DI KOTA BOGOR

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    Lilis Heryati

    2015-02-01

    Full Text Available ABSTRACTThe purpose of this study was to analyze the correlation between overweight, anemia, and academic achievement of elementary school students in Bogor District. The design of this study was a cross-sectional and it was conducted between March to July 2014, at Polisi 1 and At Taufiq elementary school. Total subjects were 100 students, consisting of 62 students (62% with normal nutritional status and 38 students (38% overnutrition (overweight and obese. Mann Whitney test, Independent sample t test, Spearman and Pearson correlation test were applied to analyze the variables tested. The results showed that there were a significantly different intake of energy, protein, and fat (p<0.05, but not for anemic status and academic achievement among normal nutritional status and overnutrition of the subjects. A significant correlation was found between energy intake and nutritional status (p<0.05, anemic status and the mean scores of science and Indonesian language subjects (p<0.05. However, there were no significant correlation among nutritional status with anemic status and academic achievement (p>0.05.Keywords: academic achievement, anemia, obesity, overweightABSTRAKTujuan penelitian ini adalah menganalisis hubungan antara kegemukan, anemia, dan prestasi belajar siswa sekolah dasar di Kota Bogor. Desain penelitian yang digunakan adalah cross sectional study, dilaksanakan pada bulan Maret sampai Juli 2014, di Sekolah Dasar Negeri (SDN Polisi 1 dan Sekolah Dasar Islam Terpadu (SDIT At Taufiq. Jumlah subjek penelitian adalah 100 siswa, terdiri atas 62 siswa normal dan 38 siswa kegemukan (overweight dan obes. Analisis statistik yang digunakan adalah uji beda Mann Whitney dan independent sample t test serta uji korelasi Spearman dan Pearson. Hasil penelitian menunjukkan bahwa antara subjek normal dan kegemukan terdapat perbedaan yang signifikan pada asupan energi, protein, dan lemak (p<0,05, namun tidak terdapat perbedaan yang signifikan pada status

  3. Musculoskeletal manifestations in sickle cell anemia

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    Reddy Ravikanth

    2017-01-01

    Full Text Available Sickle cell anemia is an inherited hemoglobin disorder characterized by substitution of glutamic acid by valine at the sixth position of the beta globin chain. The sequence of events leads to pain crisis. Ischemia of the tissues resulting from decreased blood flow is believed to occur in pain crisis. Repeated or prolonged sickling causes red cell death in the form of hemolytic anemia. The majority of hospital admissions are due to painful crisis. These patients are at increased risk for both osteomyelitis and infarction of the long bones. Magnetic resonance imaging has been shown to be helpful in the diagnosis of early osteomyelitis and its differentiation from infarction in sickle cell disease patients with acute bone crisis. Others findings include dactylitis, medullary infarcts, diploic space widening, fish mouth vertebrae, and avascular necrosis. We present a case series on the various musculoskeletal manifestations of sickle cell disease.

  4. Effects of thyroid status on glycated hemoglobin

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    Rana Bhattacharjee

    2017-01-01

    Full Text Available Introduction: Glycated hemoglobin (HbA1c can be altered in different conditions. We hypothesize that HbA1c levels may change due to altered thyroid status, possibly due to changes in red blood cell (RBC turnover. Objectives: The objective of this study was to determine the effects of altered thyroid status on HbA1c levels in individuals without diabetes, with overt hyper- and hypo-thyroidism, and if present, whether such changes in HbA1c are reversed after achieving euthyroid state. Methods: Euglycemic individuals with overt hypo- or hyper-thyroidism were selected. Age- and sex-matched controls were recruited. Baseline HbA1c and reticulocyte counts (for estimation of RBC turnover were estimated in all the patients and compared. Thereafter, stable euthyroidism was achieved in a randomly selected subgroup and HbA1c and reticulocyte count was reassessed. HbA1c values and reticulocyte counts were compared with baseline in both the groups. Results: Hb A1c in patients initially selected was found to be significantly higher in hypothyroid group. HbA1c values in hyperthyroid patients were not significantly different from controls. HbA1c reduction and rise in reticulocyte count were significant in hypothyroid group following treatment without significant change in glucose level. Hb A1c did not change significantly following treatment in hyperthyroid group. The reticulocyte count, however, decreased significantly. Conclusion: Baseline HbA1c levels were found to be significantly higher in hypothyroid patients, which reduced significantly after achievement of euthyroidism without any change in glucose levels. Significant baseline or posttreatment change was not observed in hyperthyroid patients. Our study suggests that we should be cautious while interpreting HbA1c data in patients with hypothyroidism.

  5. Prevalence of anemia in children 6-59 months old in the state of Pernambuco, Brazil

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    Mônica M. Osório

    2001-08-01

    Full Text Available Objective. To determine the prevalence of anemia in children 6-59 months old in Pernambuco, a state in northeastern Brazil, so as to help guide health and nutrition policies there. Methods. In 1997 a representative sample of 777 young children had their hemoglobin concentration measured. The sampling process was in three stages. First, 18 municipalities were randomly selected to represent the state and its three geographic areas (metropolitan region of Recife, urban interior, and rural interior. Next, using census lists, 45 census sectors were randomly chosen. Finally, 777 children aged 6-59 months old were selected. Blood was collected by venipuncture, and hemoglobin was measured with a portable hemoglobinometer. In the analysis, prevalence was weighted to reflect the census age distribution. Results. The prevalence of anemia among children 6-59 months old was 40.9% for the state as a whole. Prevalence in the metropolitan region of Recife was 39.6%, and it was 35.9% in the urban interior. The rural interior had the highest prevalence, 51.4%. Prevalence was twice as high in children aged 6-23 months as among those 24-59 months old, 61.8% vs. 31.0% (chi² = 77.9, P < 0.001. The mean hemoglobin concentrations in the younger and older age groups were 10.4 g/dL (standard deviation (SD = 1.5 and 11.4 g/dL (SD = 1.4, respectively. There was no statistically significant difference between the sexes in terms of prevalence. Conclusions. This is the first statewide assessment of anemia prevalence among young children in Brazil. Given the very high prevalence of anemia among the children studied in Pernambuco, especially those in the age group of 6-23 months, public health interventions are needed.

  6. Precursors of executive function in infants with sickle cell anemia.

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    Hogan, Alexandra M; Telfer, Paul T; Kirkham, Fenella J; de Haan, Michelle

    2013-10-01

    Executive dysfunction occurs in sickle cell anemia, but there are few early data. Infants with sickle cell anemia (n = 14) and controls (n = 14) performed the "A-not-B" and Object Retrieval search tasks, measuring precursors of executive function at 9 and 12 months. Significant group differences were not found. However, for the A-not-B task, 7 of 11 sickle cell anemia infants scored in the lower 2 performance categories at 9 months, but only 1 at 12 months (P = .024); controls obtained scores at 12 months that were statistically comparable to the scores they had already obtained at 9 months. On the Object Retrieval task, 9- and 12-month controls showed comparable scores, whereas infants with sickle cell anemia continued to improve (P = .027); at 9 months, those with lower hemoglobin oxygen saturation passed fewer trials (R s = 0.670, P = .024) and took longer to obtain the toy (R s = -0.664, P = .013). Subtle delays in acquiring developmental skills may underlie abnormal executive function in childhood.

  7. Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

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    Lee, Hye Bin; Park, Hee Chul; Park, Won [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

    2012-09-15

    Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

  8. Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

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    Lee, Hye Bin; Park, Hee Chul; Park, Won

    2012-01-01

    Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

  9. Anemia and Feeding Practices among Infants in Rural Shaanxi Province in China

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    Renfu Luo

    2014-12-01

    Full Text Available Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and to identify correlates of anemia. In April 2013, we randomly sampled 948 infants aged 6–11 months living in 351 villages across 174 townships in nationally-designated poverty counties in rural areas of southern Shaanxi Province, China. Infants were administered a finger prick blood test for hemoglobin (Hb. Anthropometric measurement and household survey of demographic characteristics and feeding practices were conducted in the survey. We found that 54.3% of 6–11 month old infants in poor rural China are anemic, and 24.3% of sample infants suffer from moderate or severe anemia. We find that children still breastfed over 6 months of age had lower Hb concentrations and higher anemia prevalence than their non-breastfeeding counterparts (p < 0.01, and that children who had ever been formula-fed had significantly higher Hb concentrations and lower anemia prevalence than their non-formula-fed counterparts (p < 0.01. The results suggest the importance of iron supplementation or home fortification while breastfeeding.

  10. Nutritional status and effect of seaweed chocolate on anemic adolescent girls

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    A. Thahira Banu

    2015-03-01

    Full Text Available The study was carried out to study the nutritional status, develop a product incorporating seaweed and assess its impact on anemic adolescent girls. Five hundred adolescent girls in the age group of 15–18 years were selected from a women's college at Kilakarai, Tamil Nadu, India as the target group to find the prevalence of anemia. Among the 500 subjects 100 with a hemoglobin level of 7–9 g/dL (moderate anemia were selected by purposive sampling technique for supplementation. Seaweed incorporated chocolate was formulated, standardized, tested for consumer acceptability and in vitro iron bioavailability and supplemented to the selected subjects. The result of the study indicates that seaweed chocolate developed obtained the highest score for overall acceptability, 56 mg of iron/100 g and 11.80 mg of bioavailable iron. The results were found to be promising as there was a significant increase in hemoglobin, TIBC, MCH, MCV, serum iron and serum ferritin levels in the selected subjects. Seaweeds are a less consumed natural resource but abundantly available in the coastal areas of India as they are rich source of nutrients and can be used as an effective therapeutic and nutrient adjunct.

  11. An algorithm using reticulocyte hemoglobin content (CHr) measurement in screening adolescents for iron deficiency.

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    Stoffman, Nava; Brugnara, Carlo; Woods, Elizabeth R

    2005-06-01

    To evaluate whether the use of an algorithm including reticulocyte hemoglobin content (CHr), a new hematologic parameter, in addition to the screening complete blood count (CBC), improves detection of iron deficiency and iron deficiency anemia in healthy adolescents. After initiation of an algorithm using CHr in addition to CBC results for identifying iron-deficient patients in a primary care hospital-based adolescent clinic, we reviewed results of all hematological tests performed in the clinic during an 8-month period. Electronic medical records were screened for health status and inclusion criteria. We determined the number of patients with low hematocrit values, low mean cell volume (MCV), and low CHr. To evaluate the impact of the protocol, we calculated the percentage of cases in which the CHr results suggested a management plan different from that which would have been formulated using the CBC results only. A total of 381 patients (mean age 16.8 +/- 3.1 years) were included in the study. Anemia was diagnosed by the Centers for Disease Control (CDC) guidelines in 63 patients (16.5%), low MCV in 170 patients (44.6%), and a low CHr in 80 (21%) patients. In 68% of anemia cases, a normal CHr suggested that iron deficiency was not the cause of the anemia. Although low MCV values were found in 38 (60.4%) of all anemic cases, mean MCV was significantly (p < 0.001) lower in the 19 cases with a low CHr as well. In 19% of 318 patients with a normal hematocrit (HCT), a low CHr suggested the need for treatment of early iron deficiency. In 103 (27%) cases, CHr suggested a different treatment plan from that which would have been formulated using the screening CBC only. The use of an algorithm including CHr to screen for iron deficiency anemia may increase the accuracy of diagnosis, enabling early detection and treatment of iron deficiency in adolescents without the need for additional costly iron studies.

  12. [Maternal hemoglobin in Peru: regional differences and its association with adverse perinatal outcomes].

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    Gonzales, Gustavo F; Tapia, Vilma; Gasco, Manuel; Carrillo, Carlos

    2011-01-01

    To evaluate hemoglobin (Hb) levels in pregnant women from different geographical regions from Peru; to establish anemia and erythrocytocis rates and to establish the role of Hb on adverse perinatal outcomes using the Perinatal Information System (PIS) database of Peruvian Ministry of Health. Data were obtained from 379,816 births of 43 maternity care units between 2000 and 2010. Anemia and erythrocytocis rates were determined in each geographical region as well as rates of adverse perinatal outcomes. To analyze data the STATA program (versión 10.0,Texas, USA) was used. The results were considered significant at panemia rate was higher in the coast (25.8%) and low forest (26.2%). Moderate/severe anemia rate in low forest was 2.6% and at the coast was 1.0%. In the highland, the highest rate of moderate/severe anemia was in the southern highlands (0.6%). The highest rate of erythrocytocis was found in the central highland (23.7%), 11.9% in the southern highland and 9.5% in the north highland. Severe anemia and erythrocytocis were associated with adverse perinatal outcomes. There are differences by Peruvian geographical region in anemia rates. In the central highlands were found the highest rates of erythrocytocis due to hypoxia effect in the high altitudes; however in the southern highlands, erythrocytocis was lower. Severe anemia and erythrocytosis were associated with increased adverse perinatal outcomes.

  13. Lactoferrin or ferrous salts for iron deficiency anemia in pregnancy: A meta-analysis of randomized trials.

    Science.gov (United States)

    Abu Hashim, Hatem; Foda, Osama; Ghayaty, Essam

    2017-12-01

    This systematic review and meta-analysis aimed to evaluate the efficacy of daily oral bovine lactoferrin versus daily oral ferrous iron preparations for treatment of iron deficiency anemia (IDA) during pregnancy. Searches were conducted on PubMed, ScienceDirect, ClinicalTrials.gov and CENTRAL databases from inception to February 2017 and the bibliographies of retrieved articles were screened. The PRISMA Statement was followed. Published English language randomized trials comparing lactoferrin with oral ferrous iron preparations in pregnant women with iron deficiency anemia were included. Quasi-randomized, non- randomized or studies including other known cause of anemia, gestational or pre-existent maternal diseases were excluded. Accordingly, 4 eligible trials (600 women) were analyzed. Primary outcome was change in hemoglobin level at 4 weeks of treatment. Secondary outcomes were; change in serum ferritin and iron, rates of gastrointestinal side effects, preterm birth, low birthweight, neonatal death and mean birthweight. Quality assessment was performed by the Cochrane risk of bias tool. Odds ratio and mean difference were used to integrate dichotomous and continuous outcomes respectively. Pooled estimates for change in hemoglobin levels at four weeks favored daily oral lactoferrin over daily oral ferrous sulphate (mean difference 0.77; 95% confidence interval [CI] 0.04-1.55; P=0.04, 4 trials, 600 women). However, after subgroup analysis (degree of anemia), no significant difference in hemoglobin levels were found between both groups in mild anemia (mean difference 0.80; 95% CI -0.21 to 1.82, 3 trials, 372 women), but a significant increase favoring lactoferrin was reported in moderate anemia (mean difference 0.68; 95% CI 0.53-0.83; P<0.00001, one trial, 228 women). Significantly less gastrointestinal side effects were reported with lactoferrin treatment. No significant differences existed with regard to other outcomes. In conclusion, for pregnant women with IDA

  14. The Influence of Malnutrition and Micronutrient Status on Anemic Risk in Children under 3 Years Old in Poor Areas in China

    Science.gov (United States)

    Wang, Jie; Wang, Hui; Chang, Suying; Zhao, Liyun; Fu, Ping; Yu, Wentao; Man, Qingqing; Scherpbier, Robert; Pan, Lili; Duan, Yifan; Yin, Shi-an

    2015-01-01

    Background Malnutrition and anemia affect large numbers of young children living in poor areas of China. Multi-micronutrient deficiencies may be related to the prevalence of anemia in different populations, and identifying the risk factors that render children susceptible to anemia is the first step in combating anemia effectively. Methods In this cross-sectional study, a total of 1370 children under 3 years old were selected based on probability proportional to size sampling principles from poor counties of China. Basic characteristics data were collected by questionnaire; then anthropometrics and hemoglobin were measured in the field and anemia prevalence evaluated. Venous blood was drawn from children aged 12–35 months (N = 553) to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children’s anemia. Results Among children aged 0–35 months, the prevalence of stunting, low body weight and wasting was 17.5%, 8.6% and 5.1%, respectively, and 25.6% of the children were affected by anemia, with more anemic infants and younger children than older children (P children aged 12–35 months affected by iron deficiency, vitamin D deficiency, folic acid deficiency and vitamin B12 deficiency, respectively. For children aged 0–11 months who were breastfed, the mothers’ anemic status was the only factor associated with the child’s anemia (OR = 2.6; 95% CI: 1.2–5.4, P children aged 12–35 months, multivariate logistic regression indicated that anemia was significantly associated with iron and vitamin B12 deficiency (OR = 5.3; 95% CI: 1.9–14.5, P anemia was higher in children under 2 years old and requires urgent intervention. An effective intervention strategy should include iron and vitamin B12 supplements, improving dietary diversity and controlling breastfeeding mothers' anemia. PMID:26488490

  15. Programa de prevención de anemia falciforme (III: La electroforesis de hemoglobina: indicación e interpretación

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    Marcos Raúl Martín Ruiz

    1996-04-01

    Full Text Available Se presenta una guía práctica para la indicación de electroforesis de hemoglobina, utilizada en el pesquisaje de hemoglobinas anormales en el Programa de Prevención de Anemia Falciforme, actualmente vigente en Cuba, así como la interpretación del fenotipo y el riesgo de tener hijos afectados con hemoglobinopatías SS y SC.A practical guide is presented for the indication of hemoglobin electrophoresis used in the screening of abnormal hemoglobins in the Programme for Prevention of Sickle Cell Anemia, standing in Cuba at present, as well as the interpretation of phenotype and the risk of having children with hemoglobinopathies SS or SC.

  16. The interrelationship between preoperative anemia and N-terminal pro-B-type natriuretic peptide: the effect on predicting postoperative cardiac outcome in vascular surgery patients.

    Science.gov (United States)

    Goei, Dustin; Flu, Willem-Jan; Hoeks, Sanne E; Galal, Wael; Dunkelgrun, Martin; Boersma, Eric; Kuijper, Ruud; van Kuijk, Jan-Peter; Winkel, Tamara A; Schouten, Olaf; Bax, Jeroen J; Poldermans, Don

    2009-11-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts adverse cardiac outcome in patients undergoing vascular surgery. However, several conditions might influence this prognostic value, including anemia. In this study, we evaluated whether anemia confounds the prognostic value of NT-proBNP for predicting cardiac events in patients undergoing vascular surgery. A detailed cardiac history, resting echocardiography, and hemoglobin and NT-proBNP levels were obtained in 666 patients before vascular surgery. Anemia was defined as serum hemoglobin value of NT-proBNP for the prediction of the composite end point. Multivariable regression analysis was used to assess the additional value of NT-proBNP for the prediction of postoperative cardiac events in nonanemic and anemic patients. Anemia was present in 206 patients (31%) before surgery. Hemoglobin level was inversely related with the NT-proBNP levels (beta coefficient = -2.242; P = 0.025). The optimal predictive cutoff value of NT-proBNP for predicting the composite cardiovascular outcome was 350 pg/mL. After adjustment for clinical cardiac risk factors, both anemia (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.07-2.99) and increased levels of NT-proBNP (OR 4.09; 95% CI: 2.19-7.64) remained independent predictors for postoperative cardiac events. However, increased levels of NT-proBNP were not predictive for the risk of adverse cardiac events in the subgroup of anemic patients (OR 2.16; 95% CI: 0.90-5.21). Both anemia and NT-proBNP are independently associated with an increased risk for postoperative cardiac events in patients undergoing vascular surgery. NT-proBNP has less predictive value in anemic patients.

  17. Placental share and hemoglobin level in relation to birth weight in twin anemia-polycythemia sequence.

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    Zhao, D; Slaghekke, F; Middeldorp, J M; Duan, T; Oepkes, D; Lopriore, E

    2014-12-01

    Twin anemia-polycythemia sequence (TAPS) is a newly described form of chronic twin transfusion. Previous observational studies noted a discordance between birth weight and individual placental share in TAPS. The purpose of this study was to investigate if fetal growth in monochorionic (MC) twins with TAPS is determined by placental share or by the net inter-twin blood transfusion. All consecutive MC twin placentas of live-born twin pairs with and without TAPS examined at our center between June 2002 and February 2014 were included in this study. Hemoglobin (Hb) levels and individual placental share were evaluated at birth and correlated with birth weight share. We excluded MC twin pregnancies with twin-twin transfusion syndrome. A total of 270 MC twin pregnancies (TAPS group, n = 20; control group without TAPS, n = 250) were included in this study. Donors with TAPS had a lower birth weight than recipients in 90% (18/20) of cases, but a larger placental share in 65% (13/20) of cases. In the TAPS group, birth weight share was positively correlated with Hb share at birth (P < 0.01) but not with placental share (P = 0.54). In the control group without TAPS, birth weight share was strongly correlated with placental share (P < 0.01) but not with Hb share (P = 0.14). A relatively larger placental share may enable the survival of the anemic twin in TAPS. In contrast with uncomplicated MC twins, fetal growth in MC twins with TAPS is determined primarily by the net inter-twin blood transfusion instead of placental share. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Fruit and vegetable consumption and anemia among adult non-pregnant women: Ghana Demographic and Health Survey.

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    Ghose, Bishwajit; Yaya, Sanni

    2018-01-01

    Anemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables. Regular consumption of F&V was shown to have protective effect against NCDs; however, evidence on this protective effect against micronutrient deficiency diseases are limited. (1) To measure the prevalence of anemia among adult non-pregnant women in Ghana, and (2) to investigate if there is any cross-sectional relationship between F&V consumption and anemia. This is a cross-sectional study based on data extracted from the Ghana Demographic and Health Survey, 2008. Subjects were 4,290 non-pregnant women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue ® hemoglobin-meter. Association between anemia and F&V consumption was assessed by multivariable regression methods. Findings indicate that well over half (57.9%) of the women were suffering from anemia of some level. The percentage of women consuming at least five servings of fruits and vegetables a day were 5.4% and 2.5% respectively. Results of multivariable analysis indicated that among urban women, consumption of 5 servings/day. The findings indicate that urban women who did not maintain WHO recommended level of F&V consumption bear a significantly higher likelihood of being moderate to severely anemic.

  19. A prescrição semanal de sulfato ferroso pode ser altamente efetiva para reduzir níveis endêmicos de anemia na infância Long-term preventive mass prescription of weekly doses of iron sulfate may be highly effective to reduce endemic child anemia

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    Carlos Augusto Monteiro

    2002-04-01

    important nutritional problems faced by developing countries. Well-controlled efficacy studies show that intermittent iron supplementation can improve children's iron status as well as the traditional daily schedule. This gives new impetus to controlling child anemia by weekly preventive iron supplementation. The objective of this study is to evaluate the effectiveness of long-term preventive provision of weekly doses of iron sulfate to all children from 6 to 59 months of age, in a child population in which anemia is highly prevalent. Children from both the intervention and control groups were selected from a random cross-sectional sample of the child population of the city of São Paulo, Brazil. Parents in the intervention group were visited in their homes and received nutrition education plus a solution of iron sulfate with the request to give it to their children once a week until a follow-up visit occurred in approximately six months. Parents in the control group received only nutrition education. The effect of the intervention was assessed by changes in hemoglobin concentration and the prevalence of anemia. Comparisons between the two groups were made based on an intention-to-treat approach, and all estimates were adjusted for initial hemoglobin concentration, initial age, total duration of follow-up and family income. The average hemoglobin gain due to the intervention was 4.0 g/l, with a fall of more than 50% in the prevalence of anemia among the children. The intervention was particularly effective in preventing declines in hemoglobin concentration during the first two years of life. This study demonstrates that long-term preventive weekly iron supplementation for preschool children significantly reduces the risk of anemia under conditions similar to those possible in routine public health programs.

  20. Niveles de hemoglobina en gestantes atendidas en establecimientos del Ministerio de Salud del Perú, 2011 Hemoglobin levels in pregnant women seen in health care centers of the peruvian ministry of health, 2011

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    Oscar Munares-García

    2012-09-01

    Full Text Available Objetivos. Determinar los niveles de hemoglobina y la prevalencia de anemia en gestantes atendidas en los establecimientos del Ministerio de Salud a nivel nacional. Materiales y métodos. Estudio transversal donde se analizó la base de datos del Sistema de Información del Estado Nutricional del Niño menor de 5 años y de la Gestante (SIEN. Se incluyó 287 691 registros de gestantes evaluadas en establecimientos del Ministerio de Salud del Perú en 2011, se analizaron los niveles de hemoglobina corregida a la altura, edad, edad gestacional, altitud a nivel del mar y prevalencia de anemia (leve, moderada y grave. Se aplicaron estadísticas descriptivas y chi cuadrado. Resultados. La prevalencia a nivel nacional de anemia en la gestante fue de 28,0% siendo anemia leve de 25,1%, moderada de 2,6% y grave de 0,2%. Los niveles de hemoglobina son mayores en mujeres con mayor edad y menores durante los primeros meses de gestación, la frecuencia de anemia decrece con la altitud. Asimismo, la prevalencia es mayor en departamentos de la sierra. Huancavelica fue el departamento con mayor prevalencia de anemia (53,6%, seguido de Puno con 51,0%. Conclusiones. Los niveles de hemoglobina son mayores conforme la edad materna es mayor, y menores conforme el trimestre de gestación y altitud. Huancavelica tiene la mayor prevalencia de anemia en gestantesObjectives. Determine hemoglobin levels and prevalence of anemia in pregnant women seen in health care centers of the Ministry of Health at national level. Materials and methods. Cross-cut study where the database of the Information System on the Nutritional Health of Children under 5 and Pregnant Women (SIEN were analyzed. 287 691 records of pregnant women examined at the health care centers of the Peruvian Ministry of Health in 2011 were included, hemoglobin levels corrected by height, age, gestational age, altitude and prevalence of anemia (light, moderate and serious were analyzed. Descriptive statistics and

  1. IS HEMOGLOBIN E GENE WIDELY SPREAD IN THE STATE OF MADHYA PRADESH IN CENTRAL INDIA? EVIDENCE FROM FIVE TYPICAL FAMILIES

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    R S Balgir

    2014-09-01

    Full Text Available Background: Red cell inherited hemoglobin anomalies are commonly encountered in the central region of India. These cause a public health concern due to high degree of morbidity, mortality, and fetal loss in the backward, underprivileged, and vulnerable people. Purpose: To report five typical families of hemoglobin E disorders identified for the first time in the state of Madhya Pradesh from central India. Methods: Out of a total of 445 couples/families (excluding the present study with 1526 persons (848 males and 678 females referred from a tertiary hospital in central India for investigations of anemia/hemoglobinopathies during the period from March 2010 to February 2014, we came across five typical rare couples/families of hemoglobin E disorders worthy of detailed investigations. Laboratory investigations were carried out following the standard procedures after cross checking for quality control from time to time. Results: For the first time, we have encountered nine cases of heterozygous hemoglobin E trait, two members with hemoglobin E-β-thalassemia (double heterozygosity, two cases of sickle cell-hemoglobin E disease (double heterozygosity, and none with homozygous hemoglobin E. Cases  of hemoglobin E trait, hemoglobin E-β-thalassemia, sickle cell-β-thalassemia and sickle cell-E disease showed moderate to severe anemia, and target cells, and reduced values of red cell indices like RBC, Hb level, HCT, MCV, MCH and MCHC, representing abnormal hematological profile and clinical manifestations before blood transfusion. Conclusions: Double heterozygosity for hemoglobinopathies such as occurrence of β-thalassemia mutation with structurally abnormal hemoglobins (Hb S and Hb E is a rare entity, but occurs with severe clinical manifestations only in those areas or communities where these are highly prevalent, testifying the migrations and genetic admixture. Distribution of hemoglobin E and β-thalassemia in different districts of Madhya Pradesh

  2. MRI evaluation of cranial bone marrow signal intensity and thickness in chronic anemia

    International Nuclear Information System (INIS)

    Yildirim, Tulin; Agildere, A. Muhtesem; Oguzkurt, Levent; Barutcu, Ozlem; Kizilkilic, Osman; Kocak, Rikkat; Alp Niron, Emin

    2005-01-01

    Background and purpose: The aim is to assess the magnetic resonance imaging (MRI) findings for cranial bone marrow (CBM) signal intensity and thickness in patients with chronic anemia and compared these with findings in healthy subjects. We also investigated the relationships between CBM changes and age, type of anemia (hemolytic versus non-hemolytic), and severity of anemia. Methods: We quantitatively evaluated CBM signal intensity and thickness on images from 40 patients with chronic anemia (20 with congenital hemolytic anemia (HA) and 20 with acquired anemia) and compared these to findings in 28 healthy subjects. The intensity of CBM relative to scalp, white matter (WM), gray matter (GM), and muscle intensity was also investigated in patients and subjects in the control group. The sensitivity and specificity of CBM hypointense to GM and CBM hypointense to WM as markers of anemia were evaluated. Relationships between age and CBM thickness/intensity, and between anemia severity (hemoglobin (Hb) level) and CBM thickness/intensity were evaluated. Results: Cranial bone marrow signal intensity was lower in the chronic anemia patients than in the controls (P 0.05 for both). There were no correlations between age and CBM intensity or thickness, or between anemia severity and CBM intensity or thickness. Conclusion: Patients with chronic anemia exhibit lower CBM signal intensity on MRI than healthy subjects. Patients with hemolytic anemia have thicker CBM than patients with non-hemolytic anemia or healthy individuals. Decreased CBM intensity may indicate that the patient has anemia, and increased CBM thickness may specifically point to hemolytic anemia. These MRI findings may signal the need for further evaluation for the clinician

  3. COMPARATIVE STUDY OF EFFICACY OF FERROUS SULPHATE AND CARBONYL IRON IN ANEMIA OF ANTENATAL WOMEN

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    Radhika

    2015-03-01

    Full Text Available Iron deficiency anemia is the most common and important public health problem all over the world in the risk group of antenatal women. Research is going on to improve the iron status of the pregnant women with different forms of iron available. In this regard, Carbonyl Iron is showing promising results in improving the red cell mass with better compliance. 120 antenatal women were recruited in this study. The study comprised of 6weeks for each patient. They were given Carbonyl Iron 100 mg/day and FeS04 100gm/day . Before and after treatment all the baseline and specific investigations were one. Results were tabulated, comparison and significance were tested by unpaired student ’s’ test and their 'p' value was calculated. Results were shown graphically also. Carbonyl Iron showed improvement in hemoglobin, PCV and better than ferrous Sulphate (P <0.001. Incidence of side effects were less with Carbonyl Iron than Ferrous Sulphate, better compliance was seen with Carbonyl Iron. In conclusion, the present study s howed that Carbonyl Iron had better efficacy and safety in the management of Iron deficiency anemia in antenatal women than ferrous Sulphate

  4. The ecology of anemia: Anemia prevalence and correlated factors in adult indigenous women in Argentina.

    Science.gov (United States)

    Goetz, Laura G; Valeggia, Claudia

    2017-05-06

    The Toba/Qom of Namqom are an indigenous community native to the Gran Chaco region of northern Argentina. Historically seminomadic foragers, the diet of peri-urban community members has rapidly changed from high-protein, high-fiber to hypercaloric, processed. This study aims to understand the impact of this nutritional transition on aspects of women's health by exploring the relationship between prevalence of anemia and current diet composition, place of birth, and reproductive history. We measured the capillary hemoglobin (Hb) levels of 153 adult women. Each participant was also given two interviews characterizing reproductive history and a 24-hour food recall. The average Hb level was 12.6 g/dL (range 5.8-15.7 g/dL). In our sample, 28% of participants were anemic and 31% were borderline anemic. Iron and vitamin C consumption were negatively associated with Hb levels. Body mass index was marginally associated with Hb levels. Being born in a peri-urban setting, a proxy for early Westernized diet was associated with higher risk of anemia, suggesting developmental experience may play a role. Pregnant and lactating women had lower Hb levels than menstruating and menopausal women. Age, height, parity, and age at first pregnancy were not found to be statistically significant predictors of anemia. Iron deficiency represents a serious health concern for women, particularly pregnant ones. Our results suggest that both past and current nutritional ecology variables may be associated with the risk of anemia. These findings inform public health interventions, since reproductive history may be more difficult to modify than current diet. © 2017 Wiley Periodicals, Inc.

  5. Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study.

    Science.gov (United States)

    Costa, Elisa Miranda; Azevedo, Juliana A P; Martins, Rafiza F M; Alves, Cláudia M C; Ribeiro, Cecília C C; Thomaz, Erika B A F

    2017-06-01

    The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.

  6. Prevention of hypoxic fetal complications in pregnant women with congenital heart disease and anemia

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    Iu. Davydova

    2016-06-01

    Full Text Available The aim of the study is — to develop a strategy of prevention of hypoxic fetal abnormalities in pregnant women with congenital heart disease, heart failure and iron deficiency anemia. Materials and methods. The study included 86 pregnant women with CHD and NYHA II–III. 68 women in the third trimester of pregnancy is diagnosed anemia (group I, 18 pregnant women with CHD, NYHA II–III without anemia (II group, the control group consisted of 24 pregnant women without cardiac disease, with physiological pregnancy. All pregnant with information registration consent studied the concentration of ferritin, hemoglobin level, morphological study of the placenta. All pregnant women were assigned to iron supplements, oral iron (III hydroxide polymaltose complex (Maltofer when hemoglobin levels above 95 g/l and the expected delivery date more than 40 days of starting treatment. When the hemoglobin level below 95 g/l of intravenously administered iron (III hydroxide sucrose complex (Venofer followed by transfer to oral iron (III. Results. In groups of pregnant I and II did not have perinatal losses, births in gestation less than 28 weeks, with a score Apgar at birth of less than 4 points. Pregnant women with cyanotic heart defects and the need for early delivery in less than 37 weeks are not included in the study. Also, there is a correlation between the degree of severity of anemia in women with CHD with HF and prematurity, and the presence of IUGR child birth asphyxia able to varying degrees (respectively, r=0.8, r=0.75 and r=0.85. Conclusions. Formation of fetoplacental unit in women with CHD on a background of heart failure occurs with complications associated with the presence of tissue hypoxia, as well as the possible impact on the process of oxidative stress. The development of iron deficiency anemia in this group is an additional risk factor for placental dysfunction, which is confirmed by morphometric and morphological studies of placentas

  7. Prevalencia de anemia ferropénica en escolares y adolescentes, Medellín, Colombia, 1999 Prevalence of iron-deficiency anemia in schoolchildren and adolescents, Medellín, Colombia, 1999

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    Gloria M. Agudelo

    2003-06-01

    urban area of the city of Medellín, Colombia, in the 1999­2000 school year and (2 to explore the associations that age group, sex, socioeconomic class, and intestinal parasitism show with iron-deficiency anemia and iron deficiency. METHODS: A cross-sectional study was carried out among 960 students from 6 to 18 years old who were selected by simple random sampling after stratified multistage sampling and clustering in public and private schools in districts of Medellín. Body iron content was evaluated by determining ferritin and hemoglobin levels, average corpuscular volume, and amplitude of the erythrocyte distribution; the presence of intestinal parasites was evaluated through stool analysis; nutritional status was evaluated by means of anthropometric measurements; and consumption of iron and vitamin C was evaluated using a semiquantitative questionnaire on food intake. In order to define the cases of iron-deficiency anemia and of iron deficiency we used the standard definitions of the World Health Organization, based on ferritin and hemoglobin values. We used nonparametric tests, with a significance level of 0.05, to examine the associations between age group, sex, socioeconomic class, and the presence of intestinal parasites on the one hand and the presence of anemia on the other hand. RESULTS: The prevalence of iron deficiency was 4.9%, and the prevalence of iron-deficiency anemia was 0.6%. The prevalence of both was higher among adolescent women (P < 0.05 than in the rest of the sample studied. No significant association was found between the presence of intestinal parasites and the presence of anemia. The average daily consumption of iron (± standard deviation was 5.5 mg (± 2.3 mg (32% ± 15% of the recommended dietary intake for the studied age group; the average contribution of serum iron in the diet was 0.7 mg (± 0.7 mg. Comparing the children who did and who did not have anemia, there were no significant differences in iron consumption and the type of

  8. Correlation of maternal factors and hemoglobin concentration during pregnancy Shiraz 2006

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    Marzieh Akbarzadeh

    2009-12-01

    Full Text Available Background: Anemia in pregnancy is a serious condition, contributing to maternal mortality, morbidity and fetal morbidity and its prevalence varies between 35-100% in developing countries. This investigation is conducted to survey the correlation of maternal factors and the changes in hemoglobin in pregnant women. Method: In this study, 108 healthy pregnant women with gestational age of 10 to 14 weeks, chosen by cluster random sampling were included. The women were followed in three visits: at the end of the first, second and third trimester. In addition, correlation of Hb concentration with maternal factors including BMI, age parity, hyperemesis, gestational age, pregnancy interval and weight gain was investigated. Results: There was no significant correlation between BMI, parity, pregnancy interval, severe nausea and vomiting and also maternal age with hemoglobin level during pregnancy. Moreover, Multiple regression models showed that adequate maternal weight gain (P<0.009 and high hemoglobin (p<0.0001 in the first trimester were positive predictors and late iron supplementation was negative predictor of hemoglobin in pregnancy (P<0.006. Conclusion: Our data demonstrated that adequate maternal weight gain, high hemoglobin in the first trimester and also late iron supplementation could be as predictors in clinical settings in this query.

  9. Anemia of chronic kidney disease: novel physiological approaches to therapy based on simulation of hypoxic response

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    K. A. Aitbaev

    2017-01-01

    Full Text Available Anemia is a modifiable risk factor for the progression of chronic kidney disease (CKD and is characterized by a  decrease in the hemoglobin level, the hematocrit, and the number of circulating red blood cells. In the pre-erythropoietin era blood transfusion was a  common practice for the adequate correction of anemia in patients with CKD. However, a  recombinant human erythropoietin, that was developed and implemented into a clinical practice three decades ago, made a revolution in the renal anemia treatment. Today the management of anemia is based on the use of exogenous erythropoiesis-stimulating agents, such as erythropoietin and its analogues, as well as an oral or parenteral administration of iron. Nevertheless, despite of the high efficacy in the majority of patients this approach has a  negative side. The hemoglobin excursions, increased risk of cardiovascular complications, as well as the development of iron deficiency and chronic inflammation become additional factors in the pathogenesis of anemia associated with the renal failure. In this regard, the development of effective and safe methods of anemia management in CKD is of immediate interest. New medications based mainly on physiological approach are developed. A pharmacological activation of hypoxia-inducible factor (HIF response is one of them. HIF is the main hormonal regulator of erythropoiesis that stimulates the production of endogenous erythropoietin. It is known that in patients with renal failure, the activation of this factor in response to hypoxia is compromised, resulting in a lack of erythropoietin production. This review covers the new mechanistic views on the hypoxic regulation of erythropoiesis and the production of erythropoietin by the kidneys, and presents the newly discovered interactions between the synthesis of erythropoietin, iron metabolism, and the chronic inflammation. Besides that, ongoing clinical trials of pharmacological HIF activators, such as

  10. Iron Status of Vegetarian Children: A Review of Literature.

    Science.gov (United States)

    Pawlak, Roman; Bell, Kami

    2017-01-01

    Iron is considered a nutrient of concern for vegetarians. In children, inadequate iron status may lead to anemia and poor growth. Thirteen original manuscripts met the inclusion criteria. Various biochemical markers of iron status, such as hemoglobin (Hb) and serum ferritin, were used. Seven of the 13 studies reported the prevalence of iron deficiency separately for vegetarians and non-vegetarians. Five out of 7 showed a higher prevalence of iron deficiency among the vegetarian participants, while the other 2 showed a higher prevalence of iron deficiency among non-vegetarians. A wide range of iron deficiency prevalence, from 4.3% of vegetarian participants in one study to 73% having ferritin vegetarian children varies considerably from one study to another. The wide variation in the prevalence of inadequate iron status was consistent for studies from industrial and developing countries. The physiological significance of low iron status among vegetarians reported in some studies is unknown. © 2017 S. Karger AG, Basel.

  11. Risk Factors for Anemia in Pregnancy: A Case Control Study

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    Rutuja Pundkar

    2017-12-01

    Full Text Available Background: Aim of the study was to find the risk factors leading to Anemia in pregnancy. The main objective was to study the various sociodemographic factors leading to anemia. And to assess the knowledge about anemia among study participants. Material and methods: The present Case control study was carried out at Primary Health Centre, to determine the risk factors leading to anemia in pregnancy. A total of 308 pregnant females were registered. Among them two groups were made, group I cases and group II controls. Each group had 50 cases each. Laboratory test were done and females having hemoglobin less than 11mg/dl were considered anemic. Anemic females were considered cases and females having Hb >11mg/dl were considered controls. Data analysis was done using SPSS software. Results: The overall mean haemoglobin (Hb was 11.55g/dL in controls, whereas it was seen that among the cases it was 9.58g/dL.It would seem that diet, family size, education, social class, gravida and parity are associated with anemia in pregnancy. Conclusion: After adjusting for all the possible covariates there seems to be significant association between Hb levels and age group, education level, family size, diet, gravida and parity.

  12. Simultaneous point-of-care detection of anemia and sickle cell disease in Tanzania: the RAPID study.

    Science.gov (United States)

    Smart, Luke R; Ambrose, Emmanuela E; Raphael, Kevin C; Hokororo, Adolfine; Kamugisha, Erasmus; Tyburski, Erika A; Lam, Wilbur A; Ware, Russell E; McGann, Patrick T

    2018-02-01

    Both anemia and sickle cell disease (SCD) are highly prevalent across sub-Saharan Africa, and limited resources exist to diagnose these conditions quickly and accurately. The development of simple, inexpensive, and accurate point-of-care (POC) assays represents an important advance for global hematology, one that could facilitate timely and life-saving medical interventions. In this prospective study, Robust Assays for Point-of-care Identification of Disease (RAPID), we simultaneously evaluated a POC immunoassay (Sickle SCAN™) to diagnose SCD and a first-generation POC color-based assay to detect anemia. Performed at Bugando Medical Center in Mwanza, Tanzania, RAPID tested 752 participants (age 1 day to 20 years) in four busy clinical locations. With minimally trained medical staff, the SCD POC assay diagnosed SCD with 98.1% sensitivity and 91.1% specificity. The hemoglobin POC assay had 83.2% sensitivity and 74.5% specificity for detection of severe anemia (Hb ≤ 7 g/dL). Interobserver agreement was excellent for both POC assays (r = 0.95-0.96). Results for the hemoglobin POC assay have informed the second-generation assay design to be more suitable for low-resource settings. RAPID provides practical feasibility data regarding two novel POC assays for the diagnosis of anemia and SCD in real-world field evaluations and documents the utility and potential impact of these POC assays for sub-Saharan Africa.

  13. SUPLEMENTASI BESI MINGGUAN MENINGKATKAN HEMOGLOBIN SAMA EFEKTIF DENGAN KOMBINASI MINGGUAN DAN HARIAN PADA REMAJA PUTRI

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    Yeti Sutanti

    2016-09-01

    Full Text Available ABSTRACTThe objective of this quasi experimental study was to analyze effectiveness of three iron supplementation on hemoglobin concentration of adolescent girls. Three intervention groups have received iron supplements (60 mg of iron elemental and 0.25 mg folic acid for 14 weeks in March-June 2015 in Tasikmalaya District. The groups received supplementation weekly (M, weekly and daily for ten days during menstruation period (M+Mens, and weekly and nutrition education (M+PG supplementation respectively. The result showed that the mean change of hemoglobin was not significantly different among the three groups (M+PG 0.63±1.16 g/dl, M+Mens 0.48±1.04 g/dl, and M 0.44±1.13 g/dl (p>0.05. Iron supplementation could reduce the prevalence of anaemia by 15.8% (M, 18.0% (M+Mens, and 4.9% (M+PG. Weekly iron supplementation was as effective as weekly and daily during menstruation period on hemoglobin change among adolescent girls. Iron supplementation in adolescent is better done intermittently (weekly with benefit addition the high compliance in supplement consumption.Keywords: adolescent, anaemia, hemoglobin, iron supplementationABSTRAKPenelitian kuasi eksperimental ini bertujuan untuk mengkaji perbedaan efektivitas tiga cara pemberian suplementasi besi terhadap perubahan kadar hemoglobin pada remaja putri. Tiga kelompok intervensi menerima suplemen besi (60 mg besi elemental dan 0,25 mg asam folat selama 14 minggu di Kabupaten Tasikmalaya pada bulan Maret-Juni 2015. Kelompok tersebut masing-masing menerima suplemen besi secara mingguan (M, mingguan dan setiap hari selama 10 hari menstruasi (M+Mens, serta mingguan disertai pendidikan gizi (M+PG. Hasil penelitian menunjukkan bahwa peningkatan kadar hemoglobin tidak berbeda nyata (p>0,05 pada semua kelompok perlakuan (M+PG 0,63±1,16 g/dl, M+Mens 0,48±1,04 g/dl, dan M 0,44±1,13 g/dl. Suplementasi besi dapat menurunkan prevalensi anemia masing-masing sebesar 15,8% (M, 18,0% (M+Mens dan 4,9% (M

  14. Artificial intelligence for optimal anemia management in end-stage renal disease.

    Science.gov (United States)

    Brier, Michael E; Gaweda, Adam E

    2016-08-01

    Computational intelligence for the prediction of hemoglobin to guide the selection of erythropoiesis-stimulating agent dose results in improved anemia management. The models used for the prediction result from the use of individual patient data and help to increase the number of hemoglobin observations within the target range. The benefits of using these modeling techniques appear to be a decrease in erythropoiesis-stimulating agent use and a decrease in the number of transfusions. This study confirms the results of previous smaller studies and suggests that additional beneficial results may be achieved. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  15. The treatment of tumors by the induction of anemia and irradiation in hyperbaric oxygen

    International Nuclear Information System (INIS)

    Sealy, R.; Jacobs, P.; Wood, L.; Levin, W.; Barry, L.; Boniaszczuk, J.; Blekkenhorst, G.

    1989-01-01

    Because increased effects have been achieved when murine tumors are irradiated after a period of hypoxia and because of anecdotal clinical experiences of an improved result after irradiation of previously anemic patients in hyperbaric oxygen, the relationship between irradiation and increased survival was investigated in seventy-two patients with advanced head and neck or cervical cancer. Anemia was achieved by means of a two-stage isovolemic venesection maintained for seventy-two hours, hemoglobin was returned to a normal level, and treatment in hyperbaric oxygen was started. Marked tumor shrinkage after the induction of anemia and before radiotherapy was seen and was probably disease, site, and hemoglobin level related. As a result, a possible new approach to cancer therapy is suggested. After completion of therapy, the 1-year disease-free survival for patients with head and neck and cervical cancer was not improved, but the 21-month survival for cervical cancer was improved. Further studies are strongly urged

  16. Vitamin A supplementation and childhood morbidity from diarrhea, fever, respiratory problems and anemia in sub-Saharan Africa

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    Gebremedhin S

    2017-07-01

    Full Text Available Samson Gebremedhin School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia Background: Systematic reviews consistently indicated that vitamin A supplementation (VAS (100,000–200,000 international unit [IU] semiannually to children aged 6–59 months substantially reduces all-cause child mortality. Yet, its effect on morbidity is inconsistent and its contribution to the reduction of anemia has not been sufficiently explored.Objective: The objective of this study was to assess the association between routine VAS (100,000 IU for children aged 6–11 months and 200,000 IU for children aged 1–5 years and the occurrence of common childhood illnesses (fever, diarrhea, acute respiratory infection [ARI] and anemia in preschool children in sub-Saharan Africa (SSA.Methods: The analysis was made based on the data of 28 demographic and health surveys (DHSs conducted in SSA since 2010. The data of 152,406 children were included. The VAS status in the preceding 6 months and the occurrence of the illnesses in the past 2 weeks were determined based on the information given by the caregivers. The hemoglobin level was determined using a portable photometer. Data were analyzed using mixed-effects logistic regression model. The outputs were provided using adjusted odds ratio (AOR with the respective 95% confidence intervals (CIs. The practical significance of the association was measured via Cohen’s effect size (d.Results: The coverage of VAS was 56.3% (95% CI: 56.1–56.5. VAS was modestly associated with increased odds of fever (AOR=1.12 [95% CI: 1.09–1.15], diarrhea (AOR=1.09 [95% CI: 1.05–1.13] and ARI (AOR=1.18 [95%: 1.12–1.24]. Conversely, in the supplemented children, the odds of anemia were reduced by 10.1% (95% CI: 7.0–13.1. All the associations translated into trivial effect sizes (d<0.2.Conclusion: VAS is associated with an inconsequential increase in the occurrence of common childhood ailments. Keywords

  17. Whole exome sequencing identifies novel genes for fetal hemoglobin response to hydroxyurea in children with sickle cell anemia.

    Science.gov (United States)

    Sheehan, Vivien A; Crosby, Jacy R; Sabo, Aniko; Mortier, Nicole A; Howard, Thad A; Muzny, Donna M; Dugan-Perez, Shannon; Aygun, Banu; Nottage, Kerri A; Boerwinkle, Eric; Gibbs, Richard A; Ware, Russell E; Flanagan, Jonathan M

    2014-01-01

    Hydroxyurea has proven efficacy in children and adults with sickle cell anemia (SCA), but with considerable inter-individual variability in the amount of fetal hemoglobin (HbF) produced. Sibling and twin studies indicate that some of that drug response variation is heritable. To test the hypothesis that genetic modifiers influence pharmacological induction of HbF, we investigated phenotype-genotype associations using whole exome sequencing of children with SCA treated prospectively with hydroxyurea to maximum tolerated dose (MTD). We analyzed 171 unrelated patients enrolled in two prospective clinical trials, all treated with dose escalation to MTD. We examined two MTD drug response phenotypes: HbF (final %HbF minus baseline %HbF), and final %HbF. Analyzing individual genetic variants, we identified multiple low frequency and common variants associated with HbF induction by hydroxyurea. A validation cohort of 130 pediatric sickle cell patients treated to MTD with hydroxyurea was genotyped for 13 non-synonymous variants with the strongest association with HbF response to hydroxyurea in the discovery cohort. A coding variant in Spalt-like transcription factor, or SALL2, was associated with higher final HbF in this second independent replication sample and SALL2 represents an outstanding novel candidate gene for further investigation. These findings may help focus future functional studies and provide new insights into the pharmacological HbF upregulation by hydroxyurea in patients with SCA.

  18. Potential Contribution of Iron Deficiency and Multiple Factors to Anemia among 6- to 72-Month-Old Children in the Kokang Area of Myanmar

    OpenAIRE

    Zhao, Ai; Gao, Hongchong; Li, Bo; Yu, Kai; Win, Naing Naing; Zhang, Yumei; Wang, Peiyu

    2015-01-01

    The prevalence of anemia among children in Myanmar has been reported to be among the highest in the world. This study was conducted to determine 1) the prevalence of anemia in preschool children and 2) risk factors associated with anemia. A total of 138 children aged from 6 to 72 months were recruited through cluster sampling from six villages in Kokang. Hemoglobin (Hb) concentration, blood trace elements, and anthropometric indicators were measured. Feces samples were collected to examine fo...

  19. Polimorfisme gen ferroportin (FPN1 -1355 G/C sebagai faktor risiko anemia defisiensi besi pada ibu hamil

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    Nor Istiqomah

    2013-04-01

    Full Text Available Background: According to WHO data, prevalence of anemia pregnancy in Indonesia is 44.3%, it’s higher than world prevalence (41.8%. Ferroportin (FPN1 is one of important iron exsporter for iron absorption, release, and recycle inside the body. The varian of FPN1-1355 G/C in promoter region, leads to increased of ferroportin expression and iron export, increased cellular iron needs, overexpression of soluble transferrin receptor (sTfR, decrease hemoglobin (Hb and erythrocyte indices that manifest to iron deficiency anemia (IDA. Objective: This research will study the frequency of FPN1-1355 G/C polymorphism as a risk factor of IDA in pregnant women in Indonesia. Method: The research design was a case and control study. Blood samples were taken from 26 pregnant women with anemia and 48 pregnant women without anemia. FPN1-1355G/C polymorphism were determined using PCR-RFLP method. sTfR and ferritin level were measured with ELISA. Hemoglobin, erythrocyte indices, and sTfR level were compared among genotype group, then statistically analyzed using independent sample t-test and one way ANOVA. Bivariat analysis of Pearson test was conducted to analyze correlation between level of blood Hb and ferritin in pregnant women (p0.05. The sTfR and hepcidin level in subjects carrying C allele were higher than subjects carrying only G allele (p<0.05. Conclusion: In this study the FPN1 gene promoter -1355 G/C polymorphism was not a risk factor for anemia, but it was a risk factor for iron deficiency anemia in pregnant women.

  20. Impact of Anemia on Platelet Reactivity and Ischemic and Bleeding Risk: From the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents Study.

    Science.gov (United States)

    Giustino, Gennaro; Kirtane, Ajay J; Baber, Usman; Généreux, Philippe; Witzenbichler, Bernhard; Neumann, Franz-Josef; Weisz, Giora; Maehara, Akiko; Rinaldi, Michael J; Metzger, Christopher; Henry, Timothy D; Cox, David A; Duffy, Peter L; Mazzaferri, Ernest L; Brodie, Bruce R; Stuckey, Thomas D; Gurbel, Paul A; Dangas, George D; Francese, Dominic P; Ozan, Ozgu; Mehran, Roxana; Stone, Gregg W

    2016-06-15

    Anemic patients remain at increased risk of ischemic and bleeding events. Whether the effects of hemoglobin levels on thrombotic and bleeding risk are independent of platelet reactivity on clopidogrel, however, remains unknown. Patients from the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents study were categorized by the presence of anemia at baseline, defined according the World Health Organization criteria. Platelet reactivity was measured with VerifyNow assay; high platelet reactivity (HPR) on clopidogrel was defined as platelet reactive units value >208. Of 8,413 patients included in the study cohort, 1,816 (21.6%) had anemia. HPR was more prevalent in patients with anemia (58.3% vs 38.4%; p <0.001), an association that persisted after multivariate adjustment (adjusted odds ratio: 2.04; 95% confidence interval [CI]: 1.82 to 2.29; p <0.0001). Patients with anemia had higher 2-year rates of major adverse cardiac events (9.5% vs 5.6%; p <0.0001), major bleeding (11.8% vs 7.7%; p <0.0001), and all-cause mortality (4.0% vs 1.4%; p <0.0001); however, after adjustment for baseline clinical confounders, including HPR, anemia was no longer significantly associated with major adverse cardiac events but was still independently associated with all-cause mortality (adjusted HR 1.61, 95% CI 1.23 to 2.12; p <0.0001) and major bleeding (adjusted HR 1.42, 95% CI 1.20 to 1.68; p <0.0001). The effect of HPR on clinical outcomes was uniform according to anemia status, without evidence of interaction. In conclusion, anemia independently correlated with HPR. After percutaneous coronary intervention with drug-eluting stents, anemia at baseline was significantly associated with higher 2-year hemorrhagic and mortality risk; conversely, its association with ischemic risk was attenuated after multivariate adjustment, including HPR. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

    Science.gov (United States)

    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet; Weiss, Günter

    2015-01-01

    Abstract Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients. The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement available, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD. Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library, and the websites of WHO, FDA, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004. A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia should be administered with a target to restore/replenish the iron stores and the hemoglobin level in a suitable way. However, in patients with IBD flares and inadequate responses to or side effects with oral preparations, intravenous iron supplementation is the therapy of choice. Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD, and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics. In conclusion, because many physicians are in doubt as to how to manage anemia and iron deficiency in IBD, there is a clear need for the implementation of evidence-based recommendations on this matter. Based on the data presented, oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency anemia unless such patients are intolerant or have an inadequate response, whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron. PMID:26061331

  2. Anemia and Iron Deficiency in Children With Potential Celiac Disease.

    Science.gov (United States)

    Repo, Marleena; Lindfors, Katri; Mäki, Markku; Huhtala, Heini; Laurila, Kaija; Lähdeaho, Marja-Leena; Saavalainen, Päivi; Kaukinen, Katri; Kurppa, Kalle

    2017-01-01

    Active screening for celiac disease frequently detects seropositive children with normal villous morphology (potential celiac disease). It remains unclear whether these subjects should be treated. We here investigated the prevalence of anemia and iron deficiency in children with potential and mucosal atrophy celiac disease. The prospective study involved 19 children with potential disease, 67 with partial or subtotal villous atrophy (P/SVA), and 16 with total villous atrophy (TVA). Twenty-three healthy children comprised the control group. The groups were compared for various clinical, histological, and laboratory parameters and hepcidin. The prevalence of abnormal parameters was as follows (controls, potential celiac disease, P/SVA, and TVA, respectively): anemia 0%, 15%, 22%, and 63%; low iron 5%, 0%, 14%, and 50%; increased transferrin receptor 1 5%, 16%, 20%, and 47%; low ferritin 0%, 21%, 35%, and 87%; and low transferrin saturation 10%, 11%, 41%, and 71%. One subject had low folate and none had low vitamin B12. The median values for hemoglobin, total iron, ferritin, and transferrin saturation were significantly lower and transferrin receptor 1 values higher in TVA group compared with other groups. After a median of 7 months on a gluten-free diet hemoglobin, total iron, ferritin, and albumin in children with P/SVA exceeded the baseline values in the potential celiac disease group. The development of anemia and iron deficiency in celiac disease is a continuum and may already be present in children with normal villous morphology, advocating an early diagnosis and possible dietary treatment of these patients.

  3. Clinical and Hematological Evaluation of Patients with Sickle Cell Anemia Before and After Four Years of Using Hydroxyurea

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    Ieda Maria Gonçalves Pacce Bispo

    2017-06-01

    Full Text Available Objective: Evaluating clinical and hematological-clinical parameters of patients with sickle cell anemia (SCA before and after four years of using hydroxyurea (HU.  Method: A retrospective cohort study implementing a quantitative, descriptive and analytical approach developed in two public teaching hospitals located in the Central-West region of Brazil, from November 2010 to October 2011. Data collection was performed through medical records of 32 patients with SCA to assess clinical and hematological parameters before and after HU treatment. The study was approved by the UFMS Ethics Committee under protocol number 1890/2010. Results: All of the 32 patients were homozygous with a mean age in the prescription of hydroxyurea of 19.72±7.58 years, an initial dose of 15.59±4.27 mg/kg/day, and 22.48±5.35 mg/kg/day in the fourth year of treatment. Regarding the use of HU, average values of some hematological parameters presented a significant difference in the fourth year compared to the mean values prior to HU use, such as fetal hemoglobin (14.49±7.52%, red blood cells (2.54±0.38x1012/L, hematocrit (25.30±4.03% and hemoglobin (9.22±3.34g/dL.  Conclusion: Treatment with hydroxyurea showed a significant increase in fetal hemoglobin levels, increased hemoglobin, hematocrit and average corpuscular hemoglobin concentration, with reduced episodes of pain, infection and acute chest syndrome in such a way as to reaffirm its efficiency in treating these patients. Keywords: Hemoglobin; Sickle Cell Anemia; Hydroxyurea.

  4. Estado nutricional e anemia ferropriva em gestantes: relação com o peso da criança ao nascer Nutritional status and iron-deficiency anemia in pregnant women: relationship with the weight of the child at birth

    Directory of Open Access Journals (Sweden)

    Daniela da Silva Rocha

    2005-08-01

    to obtain information on the mothers, and their hemoglobin levels were dosed using Hemocue, also registering the mothers' height and weight. Information on the newborns was obtained from the Birth Registries Information System. RESULTS: A total of 168 low-income, low-schooling level pregnant women were evaluated, 41.3% showing inadequate pre-gestational nutritional status, 25.7% being underweight and 17.4% overweight or obese. The majority of the pregnant women presented inadequate weight gain during pregnancy. The prevalence of total iron deficiency anemia was 21.4%, increasing with gestational age. The frequencies of low birth weight and insufficient birth weight were 8.9% and 28.6%, respectively. The anthropometrical variables (pre-gestational weight, height, pre-gestational Body Mass Index and total weight gain presented a statistically significant association with weight at birth. CONCLUSION: The mother's anthropometrical variables correlated with the weight at birth. No correlation was found between the nutritional iron status of the pregnant women and weight at birth.

  5. Malaria and Anemia among Children in a Low Resource Setting In Nigeria

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    AA Onifade

    2012-09-01

    Full Text Available Background: This study aimed at determining the prevalence of malaria and anemia among child­ren in rural community of Okada, Edo State Nigeria, as well as to assess the level of use of Insecti­cide treated bed nets and its impact on prevalence of malaria and anemia among study population. Methods: Thick blood films from 226 children with signs and symptoms of malaria in Okada commu­nity were stained and examined for presence of malaria parasites. Hemoglobin concentra­tion of all children was also determined using standard method. Result: A total of 185 (81.9% children were infected with malaria parasite. Malaria parasitaemia was significantly affected by age (P =0.003. A significantly higher number of positive cases of malaria and anemia was observed in rainy season as compared to dry season (P<0.05. The prevalence of anemia in children was 47.3%. Malaria was a risk factor for development of anemia in children (OR=2.551; 95% CI=1.227, 5.305; P=0.015. Use of insecticide treated bed nets was recorded in 11(4.9% of children studied, and did not significantly reduce the prevalence of malaria and anemia. However among malaria parasite infected children, its use significantly reduced the prevalence of anemia (OR=0.126; 95%CI = 0.015, 1.047; P= 0.031. Conclusion: Malaria and anemia among children was high malaria intervention progammes by rele­vant agencies is strongly advocated.

  6. Evaluation of nonsurgical periodontal therapy in chronic periodontitis patients with anemia by estimating hematological parameters and high-sensitivity C-reactive protein levels.

    Science.gov (United States)

    Musalaiah, S V V S; Anupama, M; Nagasree, M; Krishna, Ch Murali; Kumar, Aravind; Kumar, P Mohan

    2014-07-01

    Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high‑sensitivity C‑reactive protein (hs‑CRP) and can depress erythropoietin production leading to the development of anemia. The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia. This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy. The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes

  7. Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania

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    Kejo D

    2018-02-01

    Full Text Available Dyness Kejo,1 Pammla M Petrucka,1,2 Haikel Martin,1 Martin E Kimanya,1 Theobald CE Mosha3 1Department of Food Biotechnology and Nutritional Sciences, Nelson Mandela African Institution of Science and Technology (NM-AIST, Arusha, Tanzania; 2College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada; 3Department of Food Technology, Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania Abstract: Anemia is a global health problem affecting most developing countries. We examined the prevalence of anemia and its predictors among children under 5 years of age in Arusha District, Tanzania. Random sampling technique was used to identify 436 children aged 6–59 months. Anemia status was assessed by measuring hemoglobin concentration from blood sample obtained from a finger prick and HemoCue® Hb 201+ photometer. Demographic information and dietary intake data were collected using a standardized questionnaire. Anemia cut-off points were defined according to World Health Organization standards for children aged 6–59 months. Logistic regression using backward procedure was used to estimate odds ratios (ORs at 95% confidence intervals (CIs. Prevalence rate of anemia among under-fives was found to be 84.6% (n=369. Multivariable logistic regression identified the following predictors of anemia; low birth weight (adjusted OR (AOR: 2.1, 95% CI: 1.1–3.8, not consuming meat (AOR: 6.4, 95% CI: 3.2–12.9, not consuming vegetables (AOR: 2.1, 95% CI: 1.1–4.1, drinking milk (AOR: 2.5, 95% CI: 1.1–5.2, and drinking tea (AOR: 4.5, 95% CI: 1.5–13.7. It was concluded that low birth weight and dietary factors (ie, low or nonconsumption of iron-rich foods like meat, vegetables, and fruits were predictors of anemia among under-five children living in this rural setting. Community education on exclusive breastfeeding and introduction of complementary foods should be improved. Mothers and caretakers should be educated about

  8. Anemia among hospitalized children at a multispecialty hospital, Bangalore (Karnataka, India

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    Firdos Saba

    2014-01-01

    Full Text Available Background: Due to the limited availability of data related to anemia in hospitalized children, this research was conducted to study the occurrence, morphological patterns, distribution in different age groups, sex, and severity of anemia among children aged 6 months-12 years. Setting: Inpatients in department of pediatrics at a multispecialty hospital, Bangalore. Study Design: Descriptive cross sectional study from Oct, 2011 to Sep, 2012. Materials and Methods: Ethical clearance was obtained from the ethical committee of the hospital as per 1964 Declaration of Helsinki. Unrestricted random sampling method was used to select the study group consisting of 882 children between the age of 6 months and 12 years. After obtaining the consent, data were obtained and statistically analyzed using statistical tools like mean, median, standard deviation, and Chi-square test. Results: Out of 882 children selected, 642 (72.79% were anemic, out of which a majority of 629 (98% children suffered from nonhemoglobinopathies and a meagre 13 (2% suffered from hemoglobinopathies. Children in the age group of 6 months-1 year were most affected with nonhemoglobinopathies (33%. Moderate degree of anemia (hemoglobin = 7-9.9 g/dL was the commonest grade of anemia (80%, while microcytic hypochromic anemia was commonest morphological type of anemia (48%. Among hemoglobinopathies, thalassemia major was the most common (69%, that is 9 out of 13 patients. Conclusion: The occurrence of anemia among children aged between 6 months and 12 years is high and nonhemoglobinopathies predominate over the hemoglobinopathies.

  9. Intrauterine transfusion combined with partial exchange transfusion for twin anemia polycythemia sequence: modeling a novel technique

    NARCIS (Netherlands)

    Slaghekke, F.; van den Wijngaard, J. P. H. M.; Akkermans, J.; van Gemert, M. J. C.; Middeldorp, J. M.; Klumper, F. J.; Oepkes, D.; Lopriore, E.

    2015-01-01

    Twin anemia-polycythemia sequence (TAPS) is a newly described disease in monochorionic twin pregnancies, characterized by large inter-twin hemoglobin differences. Optimal management for TAPS is not clear. One of the possible treatment modalities is intrauterine blood transfusion (IUT) in the donor

  10. Fruit and vegetable consumption and anemia among adult non-pregnant women: Ghana Demographic and Health Survey

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    Bishwajit Ghose

    2018-02-01

    Full Text Available Background Anemia is the most widely prevalent form of micronutrient deficiency that affects over a quarter of the global population. Evidence suggests that the burden of anemia is higher in the developing countries with women of reproductive age and children being the most at-risk groups. The most common causes are believed to be malnutrition and low bioavailability of micronutrients, which usually result from poor dietary habits and inadequate intake of food rich in micronutrients such as fresh fruits and vegetables. Regular consumption of F&V was shown to have protective effect against NCDs; however, evidence on this protective effect against micronutrient deficiency diseases are limited. Objectives (1 To measure the prevalence of anemia among adult non-pregnant women in Ghana, and (2 to investigate if there is any cross-sectional relationship between F&V consumption and anemia. Methods This is a cross-sectional study based on data extracted from the Ghana Demographic and Health Survey, 2008. Subjects were 4,290 non-pregnant women aged between 15 and 49 years. Hemoglobin levels were measured by HemoCue® hemoglobin-meter. Association between anemia and F&V consumption was assessed by multivariable regression methods. Results Findings indicate that well over half (57.9% of the women were suffering from anemia of some level. The percentage of women consuming at least five servings of fruits and vegetables a day were 5.4% and 2.5% respectively. Results of multivariable analysis indicated that among urban women, consumption of 5 servings/day. Conclusion The findings indicate that urban women who did not maintain WHO recommended level of F&V consumption bear a significantly higher likelihood of being moderate to severely anemic.

  11. Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

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    Davis-Ajami ML

    2014-04-01

    Full Text Available Mary Lynn Davis-Ajami,1 Jun Wu,2 Katherine Downton,3 Emilie Ludeman,3 Virginia Noxon4 1Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA; 2South Carolina College of Pharmacy, University of South Carolina, Greenville, SC, USA; 3Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA; 4Department of Clinical Pharmacy and Outcomes Science, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA Abstract: Epoetin zeta was granted marketing authorization in October 2007 by the European Medicines Agency as a recombinant human erythropoietin erythropoiesis-stimulating agent to treat symptomatic anemia of renal origin in adult and pediatric patients on hemodialysis and adults on peritoneal dialysis, as well as for symptomatic renal anemia in adult patients with renal insufficiency not yet on dialysis. Currently, epoetin zeta can be administered either subcutaneously or intravenously to correct for hemoglobin concentrations ≤10 g/dL (6.2 mmol/L or with dose adjustment to maintain hemoglobin levels at desired levels not in excess of 12 g/dL (7.5 mmol/L. This review article focuses on epoetin zeta indications in chronic kidney disease, its use in managing anemia of renal origin, and discusses its pharmacology and clinical utility. Keywords: biosimilar, chronic kidney disease, epoetin alfa, erythropoiesis, renal anemia, Retacrit®

  12. Household Food Insecurity, Mother's Feeding Practices, and the Early Childhood's Iron Status.

    Science.gov (United States)

    Salarkia, Nahid; Neyestani, Tirang R; Omidvar, Nasrin; Zayeri, Farid

    2015-01-01

    Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6-24 months children. In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. We found no association between household food insecurity and the occurrence of anemia in the 6-24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children.

  13. ANEMIA PREVALANCE AND RELATED FACTORS IN PREGNANT WOMEN ADMITTED TO STATE HOSPITAL

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    Riza Citil

    2014-06-01

    Full Text Available Aim: This study was performed to determine the prevalance of anemia and related nutrition and other risk factors in pregnant women who admitted to the hospital for prenatal care. Material and Methods: This descriptive and cross-sectional study to receive prenatal care to the hospital admitted 311 women participated. The data on socio-demographic characteristics of pregnant women, pregnancy information and dietary habits using a questionnaire that was collected using face to face interviews. To determine anemia in pregnant women in the hospital laboratory records made during routine pregnancy examination hemoglobin (Hb values were used. Hb values of 0.05. Similarly, pregnancy, abortion and curettage with the numbers there is no significant difference between the prevalance of anemia (p> 0.05. Using iron-multivitamin preparations in pregnant women (32.9% than those using (20.4% were seen significantly more anemia, and anemia among pregnants who drank dark tea was more prevalent than pregnants who drank light tea and the difference was significant (33,9% vs 17,2% (p<0,05. Conclusion: As a conclusion, admitted to the hospital for routine prenatal care, anemia seen in one of every four pregnant women, and not taking iron-multivitamin preparations regularly and consumption of dark tea seemed to be related with gestational anemia. Thus, anemia should be diagnosed earlier in pregnant and iron and vitamin supplements must be started; and women must be informed about the risk factors of anemia by the health stuff. [J Contemp Med 2014; 4(2.000: 76-83

  14. FAIRY: a randomized controlled patient-blind phase III study to compare the efficacy and safety of intravenous ferric carboxymaltose (Ferinject®) to placebo in patients with acute isovolemic anemia after gastrectomy - study protocol for a randomized controlled trial

    OpenAIRE

    Reim, Daniel; Kim, Young-Woo; Nam, Byung Ho; Kim, Mi-Jung; Yook, Jeong Hwan; Park, Young Kyu; Roh, Sung Hoon; Yu, Wan Sik; Bae, Jae Moon

    2014-01-01

    Background Isovolemic anemia (decrease in hemoglobin concentration with normal or even increased blood volume) after gastric cancer surgery may negatively influence short- and long-term outcomes. Therefore correction of isovolemic postoperative anemia is supposed to be beneficial. This prospective randomized placebo-controlled multicenter trial is designed to evaluate the efficacy of ferric carboxymaltose administration with the primary end point of successful hemoglobin level increase by 2 g...

  15. Hypoxia-Inducible Factor and Its Role in the Management of Anemia in Chronic Kidney Disease

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    Joshua M. Kaplan

    2018-01-01

    Full Text Available Hypoxia-inducible factor (HIF plays a crucial role in the response to hypoxia at the cellular, tissue, and organism level. New agents under development to pharmacologically manipulate HIF may provide new and exciting possibilities in the treatment of anemia of chronic kidney disease (CKD as well as in multiple other disease states involving ischemia–reperfusion injury. This article provides an overview of recent studies describing current standards of care for patients with anemia in CKD and associated clinical issues, and those supporting the clinical potential for targeting HIF stabilization with HIF prolyl-hydroxylase inhibitors (HIF-PHI in these patients. Additionally, articles reporting the clinical potential for HIF-PHIs in ‘other’ putative therapeutic areas, the tissue and intracellular distribution of HIF- and prolyl-hydroxylase domain (PHD isoforms, and HIF isoforms targeted by the different PHDs, were identified. There is increasing uncertainty regarding the optimal treatment for anemia of CKD with poorer outcomes associated with treatment to higher hemoglobin targets, and the increasing use of iron and consequent risk of iron imbalance. Attainment and maintenance of more physiologic erythropoietin levels associated with HIF stabilization may improve the management of patients resistant to treatment with erythropoiesis-stimulating agents and improve outcomes at higher hemoglobin targets.

  16. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    International Nuclear Information System (INIS)

    Murakami, Ryusuke; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-01-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT

  17. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Ryusuke, E-mail: rywakana@nms.ac.jp; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-10-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.

  18. Anemia in kidney transplants without erythropoietic agents: levels of erythropoietin and iron parameters.

    Science.gov (United States)

    Florit, E A; Hadad, F; Rodriguez Cubillo, B; De la Flor, J C; Valga, F; Perez Flores, I; Calvo Romero, N; Valero San Cecilio, R; Barrientos Guzman, A; Sanchez Fructuoso, A

    2012-11-01

    To study the association between hemoglobin, endogenous erythropoietin (EPO) levels and ferric parameters in kidney recipients not treated with EPO-stimulating agents. Transverse study of 219 kidney transplant outpatients. The median time after transplantation was 54 months (P(25-75), 23-107). We assessed blood counts, ferric parameters, EPO levels, renal function (MDRD-4), and adjuvant treatment. We performed a linear regression analysis to predict hemoglobin. Median EPO values were 14.05 mUI/mL (P(25-75) = 10.2-19.7). Applying the formulas described by Beguin, kidney transplant recipients showed a low observed/expected ratio of erythropoietin and of transferrin. Considering anemia to be an hemoglobin of calculate hemoglobin was: hemoglobin = 11829-0909 log (EPG level) - 0455 (if female) + 0.010 0.013 transferrin + 0.013 creatinine clearance (r = .424, P < .001). Treatment with ACEI and/or ARBs seemed to produce a defect in the synthesis of EPO, while those treated with mTORi, a hyporesponsive state. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. SEVERE IMMUNE HEMOLYTIC ANEMIA AFTER LIVER TRANSPLANTATION

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    A. I. Sushkov

    2013-01-01

    Full Text Available Clinical case of successful treatment of severe immune hemolytic anemia after liver transplantation is represen- ted in this article. The cause of complication was so-called passenger lymphocyte syndrome (a type of graft- versus-host disease. Two plasmapheresis sessions and Ig (0.5 g/kg in combination with increased maintenance immunosuppression with a short course of oral methylprednisolone in a total dose of 150 mg during 12 days were effective. The patient was discharged from hospital 34 days after transplantation in a satisfactory condition with a stable hemoglobin level. 

  20. Treatment of anemia in chronic kidney disease: known, unknown, and both

    OpenAIRE

    Foley, Rob

    2011-01-01

    Robert N FoleyChronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USAAbstract: Erythropoiesis is a rapidly evolving research arena and several mechanistic insights show therapeutic promise. In contrast with the rapid advance of mechanistic science, optimal management of anemia in patients with chronic kidney disease remains a difficult and polarizing issue. Although several large hemoglobin target trials have been performed, optimal treatment targets rema...

  1. Neonatal erythropoiesis and subsequent anemia in HIV-positive and HIV-negative Zimbabwean babies during the first year of life: a longitudinal study

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    Malaba Lucie C

    2006-01-01

    Full Text Available Abstract Background Anemia is common in HIV infection and independently associated with disease progression and mortality. The pathophysiology of HIV-related anemia is not well understood especially in infancy. Methods We conducted a longitudinal cohort study nested within the Zimbabwe Vitamin A for Mothers and Babies Project. We measured hemoglobin, erythropoietin (EPO, serum transferrin receptor (TfR and serum ferritin at 6 weeks, 3 and 6 months of age and hemoglobin at 9 and 12 months in 3 groups of randomly selected infants: 136 born to HIV-negative mothers, and 99 born to HIV-positive mothers and who were infected themselves by 6 weeks of age, and 324 born to HIV-positive mothers but who did not become infected in the 6 months following birth. Results At one year of age, HIV-positive infants were 5.26 (adjusted odds ratio, P Conclusion HIV strongly increases anemia risk and confounds interpretation of hematologic indicators in infants. Among HIV-infected infants, the EPO response to anemia is attenuated near the time of infection in the first weeks of life, but normalizes by 6 months.

  2. Temporal trend of anemia among reproductive-aged women in India.

    Science.gov (United States)

    Bharati, Susmita; Pal, Manoranjan; Som, Suparna; Bharati, Premananda

    2015-03-01

    Anemia is one of the major leading nutritional deficiencies in India, and the most vulnerable groups are preschool and adolescent children and pregnant and lactating women. The main objective of the study is to determine the temporal trend of anemia among reproductive-aged women of age 15-49 years. The study uses data from second and third rounds of the National Family Health Surveys (NFHS-2, 1998-1999, and NFHS-3, 2005-2006), conducted by the International Institute for Population Sciences. The dependent variable was the status of anemia of women. The determining variables were type of residence, age group, religion and castes, educational status, marital status, and household standard of living index. Anemia was most prevalent in the east zone for both the periods. The changes at the all India level were not much, but the north-east zone improved very well, whereas the south zone deteriorated drastically. The occurrence of severely anemic women in India varied between 1% and 2%. The highest prevalence rates were observed among women who were 15 to 24 years of age, illiterate, from non-Christian scheduled tribes (STs), unmarried, and whose standard of living was low. Rates of anemia have increased over time except in the case of Buddhists, Parsees, Jains, and the STs. From the viewpoint of our study, illiteracy and low standard of living may be the main causes of anemia among women in India. It is also necessary to take appropriate steps to curb anemia in women in their early adulthood. © 2012 APJPH.

  3. [Anemia and nutritional status of infants from two to five months of age treated in facilities of the Ministry of Health of Peru, 2012].

    Science.gov (United States)

    Gómez-Guizado, Guillermo; Munares-García, Oscar

    2014-01-01

    Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry of Health of Peru's 25 regions were analyzed. Descriptive statistics and logistic regression techniques were used for data analysis. 10.2% (95% CI 9.5-10.9) of the infants had anemia, with frequency differences by month of age (panemia were: age of 4 months (OR 1.2; 95% CI 1.0-1.5), age of 5 months (OR 1.4; 95% CI 1.2-1.6), obesity (OR 0.7; 95% CI 0.5-1.0) and chronic malnutrition (OR 1.3; 95% CI 1.0-1.6). The presence of anemia and chronic malnutrition before 6 months of age was evidenced, as well as that the probability of anemia increases with age and is associated with some components of nutritional status.

  4. Treatment of β-Thalassemia/Hemoglobin E with Antioxidant Cocktails Results in Decreased Oxidative Stress, Increased Hemoglobin Concentration, and Improvement of the Hypercoagulable State

    Directory of Open Access Journals (Sweden)

    Orn-uma Yanpanitch

    2015-01-01

    Full Text Available Studies on the antioxidant treatment for thalassemia have reported variable outcomes. However, treatment of thalassemia with a combination of hydrophobic and hydrophilic antioxidants and an iron chelator has not been studied. This study investigated the effects of antioxidant cocktails for the treatment of β-thalassemia/hemoglobin E (HbE, which is the most common form of β-thalassemia in Southeast Asia. Sixty patients were divided into two groups receiving N-acetylcysteine, deferiprone, and either curcuminoids (CUR or vitamin E (Vit-E, and their hematological parameters, iron load, oxidative stress, and blood coagulation potential were evaluated. Patients were classified as responders if they showed the improvements of the markers of iron load and oxidative stress, otherwise as nonresponders. During treatment, the responders in both groups had significantly decreased iron load, oxidative stress, and coagulation potential and significantly increased antioxidant capacity and hemoglobin concentration. The significantly maximum increase (P<0.01 in hemoglobin concentration was 11% at month 4 in CUR group responders and 10% at month 10 in Vit-E group responders. In conclusion, the two antioxidant cocktails can improve anemia, iron overload, oxidative stress, and hypercoagulable state in β-thalassemia/HbE.

  5. Anemia e renda per capita familiar de crianças freqüentadoras da creche do Centro Educacional Unificado Cidade Dutra, no Município de São Paulo Anemia and per capita income in children enrolled in a childhood education center in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Teresinha Stumpf Souto

    2007-06-01

    Full Text Available OBJETIVO: Avaliar a freqüência de anemia de acordo com a renda familiar per capita de crianças matriculadas no Centro de Educação Infantil (CEI do Centro Educacional Unificado (CEU Cidade Dutra, no Município de São Paulo, São Paulo, em 2004. MÉTODOS: Estudo transversal, com 190 crianças de 11 a 57 meses de idade distribuídas em duas faixas de renda familiar per capita ( 1 salário mínimo. Foram consideradas anêmicas as crianças com taxa de hemoglobina OBJECTIVE: To evaluate the frequency of anemia according to family per capita income in children enrolled in a day care center in São Paulo, Brazil, in 2004. METHODS: This cross-sectional study enrolled 190 children aged 11 to 57 months divided into two groups of per capita income ( 1 minimum wage. Hemoglobin level was evaluated in capillary blood (finger-stick test using a Hemocue® portable photometer. Anemia was considered when hemoglobin level was below 11g/dL. The results were analyzed using chi-square and Kruskal-Wallis tests. RESULTS: Anemia was found in 31.6% of the investigated children, with a higher proportion in younger children. The frequency of anemia was, respectively, 72.7%, 41.2%, 19.7% and 15.4% in children aged 11-23 months age, 24-35 months, 36-47 months, and 48-57 months. Among children of families with low per capita income, the frequency of anemia was 36.7%. In families earning more than one minimum wage per capita per month, there were 22.9% of children with anemia. CONCLUSIONS: At the day care center, the frequency of anemia was higher among children aged 11-23 months, especially when the family per capita income was less than one minimum wage per month.

  6. The Karnataka Anemia Project 2--design and evaluation of a community-based parental intervention to improve childhood anemia cure rates: study protocol for a cluster randomized controlled trial.

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    Shet, Arun S; Zwarenstein, Merrick; Mascarenhas, Maya; Risbud, Arvind; Atkins, Salla; Klar, Neil; Galanti, Maria Rosaria

    2015-12-30

    Childhood anemia is highly prevalent worldwide. Improving the hemoglobin level of preschool age children could yield substantial benefits in cognitive and psychosocial development and overall health. While evidence-based recommendations for reducing childhood anemia in high anemia prevalence countries are available, there is no experimental evidence of community centered education and counseling programs, as a route to improved acceptance of iron supplements, demonstrating beneficial effects on anemia outcomes. We report on the evaluation protocol of a complex educational intervention led by the community lay health worker (LHW) and delivered to mothers of 12-59-month-old anemic children living in and visiting village day care centers in a large district of southern India. The study is designed as a cluster randomized controlled trial. The intervention is based on the social cognitive theory and aims to promote among mothers, anemia awareness, dietary modifications to increase iron intake in the child, and recognition of the need for enhanced adherence to supplemental iron in the anemic child. From 270 eligible villages in the study area, a sample of 60 villages will be randomized to intervention [n = 30] or to treatment as usual [n = 30] of the study. LHWs in the intervention arm will be trained to administer the following intervention components to mothers of anemic children: 1] monthly distribution of Iron and folic acid (IFA) supplements to mothers of anemic children, and 2] five monthly counseling sessions of mothers of anemic children covering: a] anemia awareness education b] IFA adherence counseling and assessment, c] dietary modification to improve iron intake, and d] hygiene and sanitation. LHWs in the control arm will distribute IFA to mothers of anemic children as in the intervention arm but will not provide monthly education and counseling support. The primary outcome is the difference between the two experimental groups in anemia cure rates of

  7. Effect of dietary habits on prevalence of anemia in pregnant women of Delhi.

    Science.gov (United States)

    Sharma, Jai Bhagwan; Soni, Dimple; Murthy, Nandagudi Srinivasa; Malhotra, Monika

    2003-04-01

    To see the effect of various dietary habits, such as a vegetarian diet or various types of meat, on the prevalence of anemia in pregnant women. A study was carried out in Delhi to determine the effect of different dietary habits on prevalence of anemia during pregnancy by questioning the women during pregnancy regarding their dietary habits (vegetarian diet, jhatka or halal meat) and assessing their hemoglobin levels. The data was compiled and chi2 test was employed for understanding the associations between the effect of food habits on prevalence of anemia. Mean age was 26.5 years. Most women were in the second (26%) or third trimester (63.2%) of pregnancy. Prevalence of anemia was found to be very high. Of 1150 women, 96% were anemic (89.8% mildly anemic, 5.3% severely anemic). Anemia was seen in 96.18% cases in vegetarian women, 95.3% in halal meat eaters, and 96.2% in jhatka meat eaters (not significant). Although the percentage of women with halal meat eaters and vegetarians, the difference was not statistically significant. There is very high prevalence of anemia during pregnancy in Delhi, probably due to very low frequency of meat eating in India. Different types of dietary habits had no effect on the prevalence of anemia in pregnant Indian women.

  8. Factors associated with anemia among Sri Lankan primary school children in rural North Central Province.

    Science.gov (United States)

    Amarasinghe, Gayani Shashikala; Naottunna, Naotunna Palliya Guruge Chamidri Randika; Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika

    2017-03-27

    Despite interventions, childhood anemia is still a major public health problem in low and middle income countries. Purpose of the present study is to determine factors associated with anemia among rural primary school children in Sri Lanka, a country undergoing rapid socioeconomic changes. Multi stage cluster sampling was used to select 100 rural schools in NCP and a maximum of 50 children aged 60-131 months were enrolled from each school. Self-administered questionnaires were sent to parents. Anthropometric measurements and blood samples were obtained by trained investigators. Blood reports were analyzed in a commercial laboratory with external quality control measures. Total of 4412 children were included in the analysis. A Multiple regression was performed for hemoglobin. Only 4.2% of the change in hemoglobin could be explained by the model. District (p > 0.001), age (p > 0.001), timing of warm treatment(p = 0.026) and BMI for age (p = 0.002) uniquely contributed 1.12%, 1.19%, 0.13% and 0.26% to change in hemoglobin level respectively whereas, sex, monthly family income and frequency of meat and green leaf consumption didn't contribute significantly. Peripheral blood film analyses were available for 146 anemic children. Blood film was reported as normal in 19.9% while evidence of iron deficiency (18.5%), early iron deficiency (32.5%) and thalassemia trait with iron deficiency (29.5%) were reported in the rest. Serum ferritin level was available for 417 children with hemoglobin less than 12 g/dl. Mean ferritin level was 63.7 microgram/l. Only 0.5% had depleted iron stores. A multiple regression was performed for serum ferritin and R 2 was 0.123 (p nutrition of younger children in Sri Lanka, studying weather behaviors are related to anemia in primary school children is important. Possible etiologies including but not limited to nutritional deficiencies need to be studied further.

  9. Perbandingan Zat Besi dengan dan Tanpa Vitamin C terhadap Kadar Hemoglobin Wanita Usia Subur

    Directory of Open Access Journals (Sweden)

    Tuti Anggriani Utama

    2013-03-01

    Full Text Available Anemia pada wanita pekerja masih merupakan masalah kesehatan yang dapat menurunkan produktivitas kerja. Penelitian ini bertujuan untuk membandingkan zat besi dengan dan tanpa vitamin C terhadap kadar hemoglobin. Jenis penelitian yang digunakan yaitu Quasy Experimental dengan Pre Test and Post Test Control Group Design. Populasi penelitian berjumlah 600 orang dan sampel berjumlah 60 orang. Teknik pengambilan sampel random sampling. Pengumpulan data dilakukan dengan cara pengamatan, wawancara, pemeriksaan hemoglobin, dan data sekunder. Pada kelompok perlakuan diberi tablet zat besi dan dVitamin C, pada kelompok kontrol hanya diberi tablet zat besi. Intervensi yang dilakukan adalah pemberian tablet zat besi dengan dan tanpa vitamin C, satu kapsul perminggu.Nilai rata-rata kadar hemoglobin pada kelompok kontrol pada sebelum intervensi yaitu 9,15 gram/dL dan setelah intervensi meningkat menjadi 10,19 gram/dL. Pada kelompok perlakuan rata-rata kadar hemoglobin sebelum intervensi sebesar 9,5 gram/dL dan meningkat menjadi 11,44 gram/dL sesudah inter- vensi. Hasil uji T berpasangan menunjukkan perbedaan yang signifikan pada nilai mean kadar hemoglobin pada kelompok kontrol dan perlakuan (nilai p = 0,000. Penelitian ini diharapkan dapat digunakan sebagai salah satu masukan perencanaan dan evaluasi program gizi yang dapat dilakukan dalam rangka meningkatkan pola hidup sehat wanita pekerja di PT Sarana Mandiri Mukti Kepahiang. Anemia in women workers, remains a health problem that can reduce work productivity. The study aimed to compare iron with and without vitamin C to hemoglobin levels. Quasy experimental research was conducted with pre test and post test control group design. Study population were of 600 people and 60 people as sample with random sampling technique. Data was collected through observations, interviews, examination of hemoglobin and secondary data. In the treatment group were given iron and plus Vitamin C, in the control group were given

  10. Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

    Science.gov (United States)

    McClung, James P; Murray-Kolb, Laura E

    2013-01-01

    Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

  11. Delta-He, Ret-He and a New Diagnostic Plot for Differential Diagnosis and Therapy Monitoring of Patients Suffering from Various Disease-Specific Types of Anemia.

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    Weimann, Andreas; Cremer, Malte; Hernáiz-Driever, Pablo; Zimmermann, Mathias

    2016-01-01

    The present study was aimed to prove the usefulness of a new diagnostic plot (Hema-Plot), illustrating the relationship between the hemoglobin content of reticulocytes (Ret-He) as a marker of functional iron deficiency and the difference between the reticulocyte and erythrocyte hemoglobin content (Delta-He) as a marker of an impaired hemoglobinization of newly formed reticulocytes occurring during inflammatory processes, to differentiate between various disease-specific types of anemia. A complete blood and reticulocyte count was performed on routine EDTA blood samples from 345 patients with and without various disease-specific types of anemia using the Sysmex XN-9000 hematology analyzer: blood healthy newborns (n = 23), blood healthy adults (n = 31), patients suffering from anemia of chronic disease (ACD) due to diverse oncological, chronic inflammatory, or autoimmune diseases (total n = 138) with (n = 65) and without therapy (n = 73), patients with thalassemia and/or hemoglobinopathy (n = 18), patients with iron deficiency anemia (IDA) (n = 35), patients with a combination of ACD and IDA (n = 17), as well as patients suffering from sepsis (total n = 83) with (n = 32) and without therapy (n = 51). The results for Ret-He, Delta-He, and C-reactive protein (CRP) were statistically compared (Mann-Whitney U Test) between the particular patient groups and the diagnostic plots were drawn. Delta-Hemoglobin showed a statistically significant difference between blood healthy newborns and blood healthy adults (p ≤ 0.05), while Ret-He and C-reactive protein did not. In addition, of all three biomarkers only Delta-He showed a statistically significant difference (p ≤ 0.05) between the ACD/IDA and IDA cohort. Delta-He, Ret-He, and CRP showed a statistically significant difference between patient cohorts with and without therapy suffering from ACD, ACD/IDA, and sepsis before and after medical therapy (p ≤ 0.05). The Hema-Plot illustrated the dynamic character of Ret-He and

  12. Autoimmune gastritis: relationships with anemia and Helicobacter pylori status.

    Science.gov (United States)

    Villanacci, Vincenzo; Casella, Giovanni; Lanzarotto, Francesco; Di Bella, Camillo; Sidoni, Angelo; Cadei, Moris; Salviato, Tiziana; Dore, Maria Pina; Bassotti, Gabrio

    Autoimmune gastritis (AIG) is a gastric pathologic condition affecting the mucosa of the fundus and the body and eventually leading to hypo-achlorhydria. We report our clinical and pathological experience with AIG. Data from patients with a diagnosis of AIG seen in the period January 2002-December 2012 were retrieved. Only patients with complete sets of biopsies were analyzed. Data from 138 patients were available for analysis. Pernicious anemia was present in 25% of patients, iron deficiency anemia was found in 29.7% of patients, hypothyroidism in 23% of patients, type 1 diabetes in 7.9% of patients, and vitiligo in 2.8% of patients. Parietal cell antibodies were positive in 65% of patients, and no patient had serology positive for celiac disease. All gastric biopsies showed glandular atrophy associated with enterochromaffin-like (ECL)-cells hyperplasia, features limited to the mucosa of the fundus and body, and focal glandular intestinal metaplasia. Helicobacter pylori was negative in all cases. AIG was strongly associated with anemia; atrophy, intestinal metaplasia and ECL hyperplasia in the gastric fundus and body are hallmarks of this condition.

  13. Association between iron deficiency anemia and blood level in egyptian children

    International Nuclear Information System (INIS)

    Nassar, E.M.; Moawad, A.T.; Abd Alla, A.M.

    2003-01-01

    The relationship between iron deficiency and blood lead levels was investigated in a cross-sectional study of 200 children of both sexes, aged 6-12 years with mean of 7.8 +- 2.6 years. They were randomly selected from governmental primary school located near a highly contaminated industrial area. Blood samples were collected for measuring blood lead levels, serum iron serum ferritin, hemoglobin, mean corpuscular volume (MCV) and total iron binding capacity (TIBC) and other hematological indices. According to iron status, children were classified into non-anemic healthy controls(n=37),iron depleted children(n=58)and children with iron deficiency anemia (n=105).Iron deficiency is defined when MCV 10 / dl were significantly lower than those for children with blood lead levels < 10 /dl. Comparison of blood lead concentrations between boys and girls revealed highly significant increase in blood lead level in boys than girls. A strong negative correlation was detected between blood lead levels and serum iron in all subjects. However, such correlation vanished between blood lead concentration and serum ferritin,so, it could be concluded from the present study that the blood lead levels were changed according to changes in iron status. Improving iron status, along with reducing exposure to environmental contamination with lead, may help in reducing blood lead levels among most children especially those living in contaminated environment

  14. Prognostic Factors Affecting Locally Recurrent Rectal Cancer and Clinical Significance of Hemoglobin

    International Nuclear Information System (INIS)

    Rades, Dirk; Kuhn, Hildegard; Schultze, Juergen; Homann, Nils; Brandenburg, Bernd; Schulte, Rainer; Krull, Andreas; Schild, Steven E.; Dunst, Juergen

    2008-01-01

    Purpose: To investigate potential prognostic factors, including hemoglobin levels before and during radiotherapy, for associations with survival and local control in patients with unirradiated locally recurrent rectal cancer. Patients and Methods: Ten potential prognostic factors were investigated in 94 patients receiving radiotherapy for recurrent rectal cancer: age (≤68 vs. ≥69 years), gender, Eastern Cooperative Oncology Group performance status (0-1 vs. 2-3), American Joint Committee on Cancer (AJCC) stage (≤II vs. III vs. IV), grading (G1-2 vs. G3), surgery, administration of chemotherapy, radiation dose (equivalent dose in 2-Gy fractions: ≤50 vs. >50 Gy), and hemoglobin levels before (<12 vs. ≥12 g/dL) and during (majority of levels: <12 vs. ≥12 g/dL) radiotherapy. Multivariate analyses were performed, including hemoglobin levels, either before or during radiotherapy (not both) because these are confounding variables. Results: Improved survival was associated with better performance status (p < 0.001), lower AJCC stage (p = 0.023), surgery (p = 0.011), chemotherapy (p = 0.003), and hemoglobin levels ≥12 g/dL both before (p = 0.031) and during (p < 0.001) radiotherapy. On multivariate analyses, performance status, AJCC stage, and hemoglobin levels during radiotherapy maintained significance. Improved local control was associated with better performance status (p = 0.040), lower AJCC stage (p = 0.010), lower grading (p = 0.012), surgery (p < 0.001), chemotherapy (p < 0.001), and hemoglobin levels ≥12 g/dL before (p < 0.001) and during (p < 0.001) radiotherapy. On multivariate analyses, chemotherapy, grading, and hemoglobin levels before and during radiotherapy remained significant. Subgroup analyses of the patients having surgery demonstrated the extent of resection to be significantly associated with local control (p = 0.011) but not with survival (p = 0.45). Conclusion: Predictors for outcome in patients who received radiotherapy for locally

  15. Faktor Risiko yang Berhubungan dengan Kejadian Anemia pada Remaja Putri

    Directory of Open Access Journals (Sweden)

    Mahmut Jaelani

    2017-11-01

    Full Text Available Teenage girls are one of the groups who are prone to anemia. Anemia in teenage girls is still a big public health problem because the prevalence is still ≥20% that is equal to 21,7%. This study aimed to examine the dominant factors associated with the incidence of anemia and determinants in teenage girls in MTsN 02 Kota Bengkulu with a cross-sectional design. The population was all female adolescents in MTsN 02 Kota Bengkulu and the sample was taken by using simple random sampling as much as 100 respondents taken from class VII and class VIII. The results showed that the anemia was 33.0% and there was a relationship between menstrual period (p=0,028, nutritional status (p=0,000, breakfast habits (p=0,000, iron intake (p=0,000, intake protein (p=0,017, consumption pattern of iron absorption inhibitor (p=0,045 and there was no significant correlation between maternal education level (p=0,265 with incidence of anemia in Young women at MTsN 02 Kota Bengkulu. Variable nutritional status is the most dominant associated anemia in young women.

  16. Anemia em gestantes brasileiras antes e após a fortificação das farinhas com ferro Anemia en gestantes brasileñas antes y después de la fortificación de harinas con hierro Anemia in Brazilian pregnant women before and after flour fortification with iron

    Directory of Open Access Journals (Sweden)

    Elizabeth Fujimori

    2011-12-01

    Full Text Available OBJETIVO: Comparar prevalência de anemia e valores de hemoglobina (Hb em gestantes brasileiras, antes e após a fortificação das farinhas com ferro. MÉTODOS: Estudo de avaliação de painéis repetidos, desenvolvido em serviços públicos de saúde de municípios das cinco regiões brasileiras. Dados retrospectivos foram obtidos de 12.119 prontuários de gestantes distribuídas em dois grupos: antes da fortificação, com parto anterior a junho de 2004, e após a fortificação, com última menstruação após junho de 2005. Anemia foi definida como Hb OBJETIVO: Comparar prevalencia de anemia y valores de hemoglobina (Hb en gestantes brasileñas, antes y después de la fortificación de las harinas con hierro. MÉTODOS: Estudio de evaluación de paneles repetidos, desarrollado en servicios públicos de salud de municipios de las cinco regiones brasileñas. Datos retrospectivos se obtuvieron de 12.119 prontuarios de gestantes distribuidas en dos grupos: antes de la fortificación, con parto anterior a junio de 2004, y posterior a la fortificación, con última menstruación después de junio 2005. Anemia fue definida como HbOBJECTIVE: To compare prevalence of anemia and hemoglobin (Hb levels in Brazilian pregnant women before and after flour fortification with iron. METHODS: A repeated cross-sectional panel study of public health care centers of municipalities in the five Brazilian regions was conducted. Retrospective data were obtained from 12,119 medical records of pregnant women distributed in two groups: before fortification (delivery prior to June 2004 and after fortification (date of last period after June 2005. Anemia was defined as Hb<11.0 g/dl. Hb levels according to gestational age were assessed using two references from the literature. Statistical analysis was carried out using chi-squared tests, Student's t tests, and logistic regression, with a significance level of 5%. RESULTS: In the total sample, prevalence of anemia fell from

  17. [Prevalence and factors associated with anemia in pregnant women attending the General Hospital in Douala].

    Science.gov (United States)

    Tchente, Charlotte Nguefack; Tsakeu, Eveline Ngouadjeu Dongho; Nguea, Arlette Géraldine; Njamen, Théophile Nana; Ekane, Gregory Halle; Priso, Eugene Belley

    2016-01-01

    Anemia is a public health problem, prevalent among children and women of childbearing age. Our study aims to determine the prevalence and factors associated with anemia in pregnant women at Douala General Hospital. We conducted a cross sectional study from July 2012 to July 2013. All consenting pregnant women attending antenatal consultation and having undergone complete blood count (CBC) were included in the study. Sociodemographic characteristics, individual's obstetrical history and the results of the CBC were recorded on a pre tested data collection sheet. Anemia was defined according to the WHO criteria. After some descriptive statistics, we performed a bivariate analysis using the Chi-square test and Fisher exact probability test in order to determine the factors associated with anemia. P value prevalence was 39,8%. The average age was 29,89±4,835 years. The mean hemoglobin level was 10.93 ± 1.23. Normochromic normocytic anemia (53,3%) was prevalent. Anaemia was severe in 2,4% of cases. Anemia in pregnancy was significantly associated with a personal history of chronic diseases (P = 0.02) and of anemia in a previous pregnancy (P = 0.003). Anemia was more frequently observed during the 3rd trimester (P = 0.04) and breastfeeding played a protective role (P = 0.02). The prevalence of anemia during pregnancy remains high. A better management of chronic diseases in pregnant women and of postpartum follow-up is necessary to treat anemia before a subsequent pregnancy.

  18. Bariatric Surgery in Adolescents: Is Routine Nutrient Supplementation Sufficient to Avoid Anemia Following Bariatric Surgery?

    Science.gov (United States)

    Goldberg, Hanna R; Chin, Vivian L; Zitsman, Jeffrey L; Zhang, Chengchen; Williams, Kristen M; Oberfield, Sharon; Fennoy, Ilene

    2017-08-01

    Anemia following bariatric surgery is a known complication. To prevent nutrient deficiencies, adolescents require multivitamin/mineral supplementation following bariatric surgery. The purpose of this study was to investigate if routine multivitamin/mineral supplementation is sufficient to prevent anemia in adolescents undergoing bariatric surgery, particularly sleeve gastrectomy (SG), a procedure that may induce nutrient malabsorption. We conducted a retrospective review of pediatric patients who underwent SG (34 patients) and laparoscopic adjustable gastric banding (LAGB) (141 patients) (January 2006 through December 2013). We examined anemia marker levels (iron, ferritin, folate, B 12 , hemoglobin, and hematocrit) at first visit and 3, 6, and 12 months postsurgery by repeated-measures analysis adjusting for weight loss. Following SG, folate levels decreased 3 and 6 months postsurgery but returned to baseline levels at 12 months. Furthermore, the SG group demonstrated lower folate levels compared with LAGB at 3 and 6 months. B 12 levels decreased 6 months post-SG but returned to baseline at 12 months. Following LAGB, B 12 levels decreased 12 months postsurgery compared with baseline. Ferritin levels decreased 3 months post-LAGB but returned to baseline levels at 6 months. There were no changes within groups or differences between groups in iron, hemoglobin, or hematocrit. While anemia did not occur in any patients while on recommended routine supplementation, folate levels were significantly reduced following SG and were lower in SG compared with LAGB patients. Additional folate supplementation seemed to improve folate levels, which highlights the importance of ongoing surveillance by primary care providers and the need for additional folate supplementation following SG.

  19. Prevalence of celiac disease in nutritional anemia at a tertiary care center.

    Science.gov (United States)

    Kavimandan, Amit; Sharma, Meenakshi; Verma, Anil K; Das, Prasenjit; Mishra, Prabhash; Sinha, Sanjeev; Mohan, Anant; Sreenivas, V; Datta Gupta, Siddhartha; Makharia, Govind K

    2014-03-01

    While anemia occurs in 80 % to 90 % of patients with celiac disease (CD), it may be the sole manifestation of CD. The prevalence of CD in Indian patients with nutritional anemia is not known. Adolescent and adult patients presenting with nutritional anemia were prospectively screened for CD using IgA anti-tissue transglutaminase antibody (anti-tTG Ab) followed, if positive, by upper gastrointestinal endoscopy and duodenal biopsy. Ninety-six patients [mean ± SD age 32.1 ± 13.1 years and median duration of anemia 11 months (range 1 to 144 months)] were screened. Of these patients, 80 had iron deficiency anemia, 11 had megaloblastic anemia, and 5 had dimorphic anemia. Seventy-three patients were on hematinics and 36.4 % had received blood transfusions. Nineteen had a history of chronic diarrhea and the mean ± SD duration of diarrhea in them was 9.7 ± 35.8 months. IgA anti-tTG Ab was positive in 13 patients, of whom 12 agreed to undergo duodenal biopsy. Ten patients had villous atrophy (Marsh grade 3a in three, 3b in one, and 3c in six) and two did not. Thus, 10 patients with nutritional anemia (iron deficiency 9, vitamin B12 deficiency 1) were diagnosed to have CD. On multivariate logistic regression, age, duration of symptoms, and presence of diarrhea were found to be the predictors of CD. All the patients with CD were put on gluten-free diet and with iron and vitamin supplementations and showed a significant improvement in hemoglobin concentration. CD screening should be included in the work up of otherwise unexplained nutritional anemia.

  20. Factors associated with anemia in children under three years of age in Perú: analysis of the Encuesta Demográfica y de Salud Familiar, ENDES, 2007-2013.

    Science.gov (United States)

    Velásquez-Hurtado, José Enrique; Rodríguez, Yuleika; Gonzáles, Marco; Astete-Robilliard, Laura; Loyola-Romaní, Jessica; Vigo, Walter Eduardo; Rosas-Aguirre, Ángel Martín

    2016-06-03

    Despite the reduction of poverty in Perú, the prevalence of anemia in the country remains high.  To identify socio-demographic, child and maternal-child care factors associated with anemia in children between 6 and 35 months in Perú.  We conducted an analytical and descriptive study that included registered data from the national survey on demography and family health, 2007-2013, on children between 6 and 35 months old, including the measurement of blood hemoglobin. Anemia was confirmed by hemoglobin-altitude corrected values below 11 mg/dl. We used multivariate logistic regression models to assess potential associated factors for anemiaAnemia prevalence was high (47.9%). Twelve factors were independently associated with anemia in children: Socio-demographic factors such as living outside Lima and Callao, in a low socioeconomic household, and having an adolescent mother with low education level; child-related factors as being male, younger than 24 months of age, and having fever in the previous two weeks, and maternal-child care factors such as lack of prenatal control in the first trimester of pregnancy, lack or short period of iron supplementation during pregnancy, house delivery, anemia detection at the moment of the survey, and lack of intestinal anti-parasite preventive treatment in the child.  The analysis of survey data provided valuable information about factors associated with anemia in children between 6 and 35 months, which can be used to increase the coverage and effectiveness of maternal-child care practices.

  1. Falls in nursing home residents receiving pharmacotherapy for anemia

    Directory of Open Access Journals (Sweden)

    Reardon G

    2012-10-01

    Full Text Available Gregory Reardon,1 Naushira Pandya,2 Robert A Bailey31Informagenics, LLC and The Ohio State University College of Pharmacy, Columbus, OH, USA; 2Department of Geriatrics, Nova Southeastern University College of Osteopathic Medicine, Ft Lauderdale, FL, USA; 3Janssen Scientific Affairs, LLC, Horsham, PA, USAPurpose: Falls are common among nursing home residents and have potentially severe consequences, including fracture and other trauma. Recent evidence suggests anemia may be independently related to these falls. This study explores the relationship between the use of anemia-related pharmacotherapies and falls among nursing home residents.Methods: Forty nursing homes in the United States provided data for analysis. All incidents of falls over the 6-month post-index follow-up period were used to identify the outcomes of falls (≥1 fall and recurrent falls (>1 fall. Logistic regression was used to analyze the relationship between falls and recurrent falls with each of the anemia pharmacotherapies after adjusting for potential confounders.Results: A total of 632 residents were eligible for analysis. More than half (57% of residents were identified as anemic (hemoglobin < 12 g/dL females, or <13 g/dL males. Of anemic residents, 50% had been treated with one or more therapies (14% used vitamin B12, 10% folic acid, 38% iron, 0.3% darbepoetin alfa [DARB], and 1.3% epoetin alfa [EPO]. Rates of falls/recurrent falls were 33%/18% for those receiving vitamin B12, 40%/16% for folic acid, 27%/14% for iron, 38%/8% for DARB, 18%/2% for EPO, and 22%/11% for those receiving no therapy. In the adjusted models, use of EPO or DARB was associated with significantly lower odds of recurrent falls (odds ratio = 0.06; P = 0.001. Other significant covariates included psychoactive medication use, age 75–84 years, age 85+ years, worsened balance score, and chronic kidney disease (P < 0.05 for all.Conclusion: Only half of the anemic residents were found to be using anemia

  2. Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: Iron deficiency anemia working group consensus report

    Science.gov (United States)

    Api, Olus; Breyman, Christian; Çetiner, Mustafa; Demir, Cansun; Ecder, Tevfik

    2015-01-01

    According to the World Health Organization (WHO), anemia is the most common disease, affecting >1.5 billion people worldwide. Furthermore, iron deficiency anemia (IDA) accounts for 50% of cases of anemia. IDA is common during pregnancy and the postpartum period, and can lead to serious maternal and fetal complications. The aim of this report was to present the experiences of a multidisciplinary expert group, and to establish reference guidelines for the optimal diagnosis and treatment of IDA during pregnancy and the postpartum period. Studies and guidelines on the diagnosis and treatment of IDA published in Turkish and international journals were reviewed. Conclusive recommendations were made by an expert panel aiming for a scientific consensus. Measurement of serum ferritin has the highest sensitivity and specificity for diagnosis of IDA unless there is a concurrent inflammatory condition. The lower threshold value for hemoglobin (Hb) in pregnant women is anemia. Oral iron therapy is given as the first-line treatment for IDA. Although current data are limited, intravenous (IV) iron therapy is an alternative therapeutic option in patients who do not respond to oral iron therapy, have adverse reactions, do not comply with oral iron treatment, have a very low Hb concentration, and require rapid iron repletion. IV iron preparations can be safely used for the treatment of IDA during pregnancy and the postpartum period, and are more beneficial than oral iron preparations in specific indications. PMID:28913064

  3. Anemia Offers Stronger Protection Than Sickle Cell Trait Against the Erythrocytic Stage of Falciparum Malaria and This Protection Is Reversed by Iron Supplementation.

    Science.gov (United States)

    Goheen, M M; Wegmüller, R; Bah, A; Darboe, B; Danso, E; Affara, M; Gardner, D; Patel, J C; Prentice, A M; Cerami, C

    2016-12-01

    Iron deficiency causes long-term adverse consequences for children and is the most common nutritional deficiency worldwide. Observational studies suggest that iron deficiency anemia protects against Plasmodium falciparum malaria and several intervention trials have indicated that iron supplementation increases malaria risk through unknown mechanism(s). This poses a major challenge for health policy. We investigated how anemia inhibits blood stage malaria infection and how iron supplementation abrogates this protection. This observational cohort study occurred in a malaria-endemic region where sickle-cell trait is also common. We studied fresh RBCs from anemic children (135 children; age 6-24months; hemoglobin Anemia substantially reduced the invasion and growth of both laboratory and field strains of P. falciparum in vitro (~10% growth reduction per standard deviation shift in hemoglobin). The population level impact against erythrocytic stage malaria was 15.9% from anemia compared to 3.5% for sickle-cell trait. Parasite growth was 2.4 fold higher after 49days of iron supplementation relative to baseline (panemia protects African children against falciparum malaria, an effect that is substantially greater than the protection offered by sickle-cell trait. Iron supplementation completely reversed the observed protection and hence should be accompanied by malaria prophylaxis. Lower hemoglobin levels typically seen in populations of African descent may reflect past genetic selection by malaria. National Institute of Child Health and Development, Bill and Melinda Gates Foundation, UK Medical Research Council (MRC) and Department for International Development (DFID) under the MRC/DFID Concordat. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  4. Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years.

    Science.gov (United States)

    Saraiva, Bárbara C A; Soares, Michele C C; Santos, Luana C dos; Pereira, Simone C L; Horta, Paula M

    2014-01-01

    To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n=692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, piron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, pdeficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r=0.597; pAnemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. [Prevalence of anemia in Mexican children and adolescents: Results from three national surveys].

    Science.gov (United States)

    de la Cruz-Góngora, Vanessa; Villalpando, Salvador; Mundo-Rosas, Verónica; Shamah-Levy, Teresa

    2013-01-01

    To describe the prevalence of anemia in Mexican children and adolescents from ENSANUT 2012. Data had the power to make distinctions at the national, regional and rural/urban dwelling. Hemoglobin was measured by Hemocue. Descriptions were made by adjusted frequencies and 95%CI. Confounders were tested in a logistic regression models. The prevalence of anemia in 2012 was: in children 1-4 y, 23.3%; 5-11y, 10.1%, and 12-19 y, 5.6%. The prevalence in female adolescents was 7.7% and 3.6% in males. Reductions in the prevalence of anemia from 1999 was 8.3pp in <5y, 5.1pp in children 5-11y and 3.6pp from 2006 in adolescents. Despite the decrease in the prevalence of anemia in children 1-4 y in the last 13 years, it still is of great concern. There is a need of awareness among social and medical communities about this, to extend the distribution of micronutrient supplements in children <3y, and to promote nutritional education to incentive mothers to provide foods rich in iron.

  6. Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Yuan, Wenzhen; Li Yumin; Yang Kehu; Ma Bin; Guan Quanlin; Wang, Donghai; Yang, Lijuan

    2010-06-01

    Helicobacter pylori (H. pylori) infection and iron deficiency anemia are prevalent in disadvantaged populations worldwide. The benefit of H. pylori eradiation for iron deficiency anemia has been extensively studied, but data are still equivocal. A search in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing anti-H. pylori plus oral iron to oral iron alone for the iron deficiency patients in whom H. pylori was positive were selected for meta-analysis. Reviev Manager 5.0 software was used for the performance of meta-analysis. Sixteen randomized controlled trials totaling 956 patients were included. The meta-analysis showed that the difference from baseline to endpoint of hemoglobin (Hb), serum iron (SI), and serum ferritin (SF) was statistically significantly different between anti-H. pylori treatment plus oral iron and oral iron alone (SMD, Hb 1.48; 95% CI, 0.96, 2.00; p infection could be effective in improving anemia and iron statue in IDA patients infected by H. pylori, particularly in patients with moderate or severe anemia.

  7. Anemia prevalence and treatment practice in patients with non-myeloid tumors receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Merlini L

    2013-08-01

    Full Text Available Laura Merlini,1 Giacomo Cartenì,2 Stefano Iacobelli,3 Caterina Stelitano,4 Mario Airoldi,5 Peter Balcke,6 Felix Keil,7 Ferdinand Haslbauer,8 Laura Belton,9 Beatriz Pujol10 1Department of Medical Oncology, Ospedale Civile S, Bortolo, Vicenza, 2Department of OncoHematology, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", Napoli, 3Department of Medical Oncology, Ospedale Clinicizzato SS Annunziata, Chieti, 4Department of Hematology, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria, 5Department of Medical Oncology, Azienda Ospedaliero Universitaria Le Molinette, Torino, Italy; 61st Medical Department, General Hospital St Pölten and Karl Landsteiner Institute of Oncology, St Pölten, 73rd Medical Department (Hematology and Oncology, Hanusch Krankenhaus der Wiener Gebietskrankenkasse, Vienna, 8Department of Oncology, Landeskrankenhaus Vöcklabruck, Vöcklabruck, Austria; 9Contract biostatistician, Amgen Ltd, Uxbridge, UK; 10Research and Development Haematology/Oncology, Amgen Europe, Zug, Switzerland Purpose: To describe the prevalence and management of anemia in cancer patients. Methods: This cross-sectional, observational survey was conducted in Italy and Austria. Centers prespecified one day, during a 4-month enrollment window, to report specific data collected during normal clinical practice for patients with non-myeloid tumors attending for chemotherapy (±radiotherapy treatment. The primary endpoint was the prevalence of anemia as determined using a prespecified algorithm: hemoglobin (Hb ≤10 g/dL on/within 3 days prior to visit; ongoing anemia treatment; physician diagnosis of anemia, together with ≥1 anemia symptom. Results: Between November 18, 2010 and March 18, 2011, data for 1412 patients were collected (Italy n = 1130; Austria n = 282. Most patients (n = 1136; 80% had solid tumors; 809 (57% had received ≤ 3 chemotherapy cycles. The prevalence of anemia was 32% (95% confidence interval: 29.4%–34

  8. Effect of 2,3-diphosphoglycerate on oxygen affinity of blood in sickle cell anemia

    Science.gov (United States)

    Charache, Samuel; Grisolia, Santiago; Fiedler, Adam J.; Hellegers, Andre E.

    1970-01-01

    Blood of patients with sickle cell anemia (SS) exhibits decreased affinity for oxygen, although the oxygen affinity of hemoglobin S is the same as that of hemoglobin A. SS red cells contain more 2,3-diphosphoglycerate (DPG) than normal erythrocytes. The oxygen affinity of hemolyzed red cells is decreased by added DPG, and hemolysates prepared from SS red cells do not differ from normal hemolysates in this regard. Reduction of oxygen affinity to the levels found in intact SS red cells required DPG concentrations in excess of those found in most SS patients. The same was true of oxygen affinity of patients with pyruvate kinase deficiency. Other organic phosphates, as well as inorganic ions, are known to alter the oxygen affinity of dilute solutions of hemoglobin. These substances, the state of aggregation of hemoglobin molecules, and cytoarchitectural factors probably play roles in determining oxygen affinity of both normal and SS red cells. PMID:5443181

  9. Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India.

    Science.gov (United States)

    Bora, Reeta; Sable, Corey; Wolfson, Julian; Boro, Kanta; Rao, Raghavendra

    2014-06-01

    To determine the prevalence of anemia in pregnant women and characterize its effect on neonatal outcome in Northeast India. Four hundred and seventy mothers and their newborn infants during a one month period were included. The association between maternal hemoglobin (Hb) at delivery and neonatal outcomes were determined. Anemia (Hb < 110 g/L) was present in 421 (89.6%) mothers with 35 (8.3%) having severe anemia(Hb < 70 g/L). After adjusting for maternal and neonatal variables, each 10 g/L decrease in maternal Hb was associated with 0.18 week decrease in gestational length (p = 0.003) and 21 g decrease in birth weight (p = 0.093). Severe maternal anemia was associated with 0.63 week (95% CI, 0.03-1.23week) shorter gestation, 481 g (95% CI, 305-658 g) lower birth weight and 89% increased risk of small-for-gestation (OR 1.89, 95% CI, 1.25-2.86)in the offspring, compared with those born to mothers without anemia (p < 0.001). Maternal anemia was highly prevalentin this population. Lower gestational age and birth weight, and increased risk of small-for-gestation were associated with maternal anemia, especially when maternal Hb was <80 g/L. Maternal anemia needs urgent attention to improve neonatal outcome in this population.

  10. Family structure and child anemia in Mexico.

    Science.gov (United States)

    Schmeer, Kammi K

    2013-10-01

    Utilizing longitudinal data from the nationally-representative Mexico Family Life Survey, this study assesses the association between family structure and iron-deficient anemia among children ages 3-12 in Mexico. The longitudinal models (n = 4649), which control for baseline anemia status and allow for consideration of family structure transitions, suggest that children living in stable-cohabiting and single-mother families and those who have recently experienced a parental union dissolution have higher odds of anemia than those in stable-married, father-present family structures. Interaction effects indicate that unmarried family contexts have stronger associations with anemia in older children (over age five); and, that the negative effects of parental union dissolution are exacerbated in poorer households. Resident maternal grandparents have a significant beneficial effect on child anemia independent of parental family structure. These results highlight the importance of family structure for child micronutrient deficiencies and suggest that understanding social processes within households may be critical to preventing child anemia in Mexico. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Nutritional status and its correlates in Equatorial Guinean preschool children: results from a nationally representative survey.

    Science.gov (United States)

    Custodio, Estefanía; Descalzo, Miguel Angel; Roche, Jesús; Sánchez, Ignacio; Molina, Laura; Lwanga, Magdalena; Bernis, Cristina; Villamor, Eduardo; Baylin, Ana

    2008-03-01

    In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. The overall prevalence of stunting (hemoglobin hemoglobin education, should be undertaken.

  12. Functional and anatomical evidence of cerebral tissue hypoxia in young sickle cell anemia mice.

    Science.gov (United States)

    Cahill, Lindsay S; Gazdzinski, Lisa M; Tsui, Albert Ky; Zhou, Yu-Qing; Portnoy, Sharon; Liu, Elaine; Mazer, C David; Hare, Gregory Mt; Kassner, Andrea; Sled, John G

    2017-03-01

    Cerebral ischemia is a significant source of morbidity in children with sickle cell anemia; however, the mechanism of injury is poorly understood. Increased cerebral blood flow and low hemoglobin levels in children with sickle cell anemia are associated with increased stroke risk, suggesting that anemia-induced tissue hypoxia may be an important factor contributing to subsequent morbidity. To better understand the pathophysiology of brain injury, brain physiology and morphology were characterized in a transgenic mouse model, the Townes sickle cell model. Relative to age-matched controls, sickle cell anemia mice demonstrated: (1) decreased brain tissue pO 2 and increased expression of hypoxia signaling protein in the perivascular regions of the cerebral cortex; (2) elevated basal cerebral blood flow , consistent with adaptation to anemia-induced tissue hypoxia; (3) significant reduction in cerebrovascular blood flow reactivity to a hypercapnic challenge; (4) increased diameter of the carotid artery; and (5) significant volume changes in white and gray matter regions in the brain, as assessed by ex vivo magnetic resonance imaging. Collectively, these findings support the hypothesis that brain tissue hypoxia contributes to adaptive physiological and anatomic changes in Townes sickle cell mice. These findings may help define the pathophysiology for stroke in children with sickle cell anemia.

  13. Reticulocyte hemoglobin content (MCHr) in the detection of iron deficiency.

    Science.gov (United States)

    Urrechaga Igartua, Eloísa; Hoffmann, Johannes J M L; Izquierdo-Álvarez, Silvia; Escanero, Jesús F

    2017-09-01

    Blood hemoglobin (Hb) concentration within the reference interval does not exclude iron deficiency (ID): individuals with normal stores lose iron during a long period before their Hb falls below of the level that is defined as anemia. The process entails a decrease of storage iron, shown by serum ferritin below reference range, followed by iron depletion, eventually leading to iron restricted erythropoiesis; consequence of an imbalance between erythropoietic iron requirements and too low supply is a reduction of Hb synthesis in reticulocytes. We study the potential utility of mean reticulocyte hemoglobin content (MCHr), reported by CELL-DYN Sapphire (Abbott Diagnostics) analyzer, in the detection of ID in non-anemic adults. 207 patients with Hb within the reference range were enrolled. ID was defined as Hb>120g/L (women), >130g/L (men) and serum ferritin iron deficient adults. Copyright © 2016 Elsevier GmbH. All rights reserved.

  14. Recovery from anemia in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation--prevalence, predictors and clinical outcome

    DEFF Research Database (Denmark)

    De Backer, Ole; Arnous, Samer; Lønborg, Jacob

    2014-01-01

    INTRODUCTION: Preoperative anemia is common in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and has been linked to a poorer outcome--including a higher 1-year mortality. The aim of this study was to investigate the impact of successful TAVI...... on baseline anemia. METHODS: A total of 253 patients who survived at least 1 year following TAVI were included in this study. The prevalence, predictors and clinical outcome of hemoglobin (Hb)-recovery were assessed. RESULTS: The prevalence of baseline anemia was 49% (n = 124)--recovery from anemia occurred......-recovery, while blood transfusion (OR 0.31, P = 0.038) and chronic kidney disease (CKD, OR 0.33, P = 0.043) were identified as negative predictors at, respectively, one and two years after TAVI. When compared to patients without baseline anemia, those anemic patients with Hb-recovery had a similar functional...

  15. Treatment of anemia in chronic kidney disease: known, unknown, and both

    Directory of Open Access Journals (Sweden)

    Foley RN

    2011-08-01

    Full Text Available Robert N FoleyChronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USAAbstract: Erythropoiesis is a rapidly evolving research arena and several mechanistic insights show therapeutic promise. In contrast with the rapid advance of mechanistic science, optimal management of anemia in patients with chronic kidney disease remains a difficult and polarizing issue. Although several large hemoglobin target trials have been performed, optimal treatment targets remain elusive, because none of the large trials to date have unequivocally identified differences in primary outcome rates or death rates, and because other reported outcomes indicate the potential for harm (rates of stroke, early requirement for dialysis, and vascular access thrombosis and benefit (reductions in transfusion requirements and fatigue.Keywords: hemoglobin, erythropoietin, oxygen-sensing, target trial, methodology

  16. Anemia e marcadores séricos da deficiência de ferro em grávidas atendidas na rede pública municipal de Manaus, Amazonas, Brasil Anemia and serum markers of iron deficiency in pregnant women attended by Public Health Service in Manaus, Amazonas, Brazil

    Directory of Open Access Journals (Sweden)

    Carolina Marinho da Costa

    2009-01-01

    Full Text Available O presente estudo teve como objetivo avaliar a anemia em grávidas, associando os resultados da dosagem de hemoglobina e hematócrito com a análise de marcadores do perfil sérico do ferro. Participaram do estudo 92 grávidas que estavam realizando pré-natal em unidades de atendimento à saúde no Município de Manaus, Amazonas, Brasil. Foi aplicado um formulário para obtenção dos dados antropométricos e informações sobre estilo de vida, além de serem realizadas dosagens dos níveis séricos de ferro, capacidade latente de ligação do ferro (CLLF, capacidade total de ligação do ferro (CTLF, índice de saturação da transferrina (IST, transferrina, ferritina e níveis sanguíneos de hemoglobina e hematócrito por metodologia automatizada utilizando kits comerciais disponíveis. Foram encontradas 26,1% de grávidas com níveis de hemoglobina abaixo de 11 g/dL. Observou-se que 17,4% das grávidas com níveis normais de hemoglobina apresentavam níveis inadequados de ferro sérico e 9,8% apresentavam níveis baixos de ferritina sérica. Os níveis de ferritina e de hemoglobina apresentaram diferença significativa entre os trimestres de gestação (p This study aimed to evaluate anemia in pregnant women, comparing results of hemoglobin and hemotocrit dosages with analysis of iron serum status markers. 92 pregnant women, in pre-natal attendance in Public Health Service of Manaus, Amazonas, Brazil, participated in this study. A questionnaire was used to access anthropometric data and life style information. Serum levels of iron, latent iron binding capacity (LIBC, total iron binding capacity (TIBC, transferrin saturation (TS, transferrin, ferritin, and blood levels of hemoglobin and hematocrit were measured by automated methods, using commercially available kits. The study showed that 26.1% of the pregnant women had hemoglobin levels below 11 g/dL. Also, of the pregnant women with normal levels of hemoglobin, 17.4% showed inadequate iron

  17. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome

    International Nuclear Information System (INIS)

    Bhide, Shreerang A.; Ahmed, Merina; Rengarajan, Vijayan; Powell, Ceri; Miah, Aisha; Newbold, Kate; Nutting, Christopher M.; Harrington, Kevin J.

    2009-01-01

    Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS, and OS were also significantly better for patients with nadir Hb level >12 vs. 4. Conclusion: Our study seems to suggest that blood transfusion during radical treatment for SCCHN might be detrimental. Further research should be undertaken into the complex interactions among tumor hypoxia, anemia, and the treatment of anemia before making treatment recommendations

  18. Anemia and iron deficiency in gastrointestinal and liver conditions

    Science.gov (United States)

    Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

    2016-01-01

    Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice. PMID:27672287

  19. Anemia and iron deficiency in gastrointestinal and liver conditions.

    Science.gov (United States)

    Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

    2016-09-21

    Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice.

  20. Safety and Efficacy of PDpoetin for Management of Anemia in Patients with end Stage Renal Disease on Maintenance Hemodialysis: Results from a Phase IV Clinical Trial.

    Science.gov (United States)

    Javidan, Abbas Norouzi; Shahbazian, Heshmatollah; Emami, Amirhossein; Yekaninejad, Mir Saeed; Emami-Razavi, Hassan; Farhadkhani, Masoumeh; Ahmadzadeh, Ahmad; Gorjipour, Fazel

    2014-08-26

    Recombinant human erythropoietin (rHuEPO) is available for correcting anemia. PDpoetin, a new brand of rHuEPO, has been certified by Food and Drug Department of Ministry of Health and Medical Education of Iran for clinical use in patients with chronic kidney disease. We conducted this post-marketing survey to further evaluate the safety and efficacy of PDpoetin for management of anemia in patients on maintenance hemodialysis. Patients from 4 centers in Iran were enrolled for this multicenter, open-label, uncontrolled phase IV clinical trial. Changes in blood chemistry, hemoglobin and hematocrit levels, renal function, and other characteristics of the patients were recorded for 4 months; 501 of the patients recruited, completed this study. Mean age of the patients was 50.9 (±16.2) years. 48.7% of patients were female. Mean of the hemoglobin value in all of the 4 centers was 9.29 (±1.43) g/dL at beginning of the study and reached 10.96 (±2.23) g/dL after 4 months and showed significant increase overall (Pcase of immunological reactions to PDpoetin was observed. Our study, therefore, showed that PDpoetin has significantly raised the level of hemoglobin in the hemodialysis patients (about 1.7±0.6 g/dL). Anemia were successfully corrected in 49% of patients under study. Use of this biosimilar was shown to be safe and effective for the maintenance of hemoglobin in patients on maintenance hemodialysis.

  1. Sun-dried cowpeas and amaranth leaves recipe improves β-carotene and retinol levels in serum and hemoglobin concentration among preschool children.

    Science.gov (United States)

    Nawiri, Mildred P; Nyambaka, Hudson; Murungi, Jane I

    2013-03-01

    Vitamin A deficiency (VAD) and anemia are major challenges among children and expecting and lactating mothers in developing countries. Intervention with locally available dark green leafy vegetables (DGLV) is more sustainable to eradicate VAD, being cost-effective and readily adaptable to local communities. DGLV contain high levels of iron and β-carotene (BC) and therefore useful in fighting VAD and anemia. Since DGLVs are season-dependent sun-drying enables their availability during low seasons. However, their contribution to the bioavailability of BC and the improvement of hemoglobin are not well understood. The study therefore investigated the effect of consuming cooked recipe consisting of sun-dried amaranth and cowpea leaves on the levels of BC, retinol, and hemoglobin in preschool children from Machakos District, a semiarid region in Kenya. Vegetables were purchased from local vegetable market, with some sun-dried in an open shade. Levels of BC and retinol in serum and BC in fresh and processed vegetables were determined by a HPLC method and hemoglobin using a portable Hemocue Analyzer. All-trans-BC levels in uncooked fresh cowpea and amaranth leaves were 806.0 μg/g and 599.0 μg/g dry matter, respectively, while the dehydration and cooking processes retained the β-carotene levels at over 60 %. Consumption of the dehydrated vegetables significantly improved both serum BC and retinol levels (p < 0.05), while the baseline hemoglobin levels improved by 4.6 %. The study has shown that intervention with locally available sun-dried vegetables improves the bioavailability of BC, retinol, and hemoglobin levels among preschool children.

  2. Effects of Secondary Hyperparathyroidism Treatment on Improvement in Anemia: Results from the MBD-5D Study.

    Directory of Open Access Journals (Sweden)

    Motoko Tanaka

    Full Text Available Anemia is an important prognostic factor in hemodialysis patients. It has been reported that parathyroidectomy ameliorates anemia and reduces the requirement of postoperative erythropoiesis-stimulating agents. The objective of this study was to assess the effect of cinacalcet, which is considered as a pharmacological parathyroidectomy, on anemia in hemodialysis patients.We used data from a prospective cohort of Japanese hemodialysis patients with secondary hyperparathyroidism; the criteria were: intact parathyroid hormone concentrations ≥ 180 pg/mL or use of an intravenous or oral vitamin D receptor activator. All patients were cinacalcet-naïve at study enrollment. The main outcome measure was achievement of the target hemoglobin level (≥10.0 g/dL, which was measured repeatedly every 6 months. Cinacalcet exposure was defined as cumulative time since initiation. Both conventional longitudinal models and marginal structural models were adjusted for confounding factors.Among 3,201 cinacalcet-naïve individuals at baseline, cinacalcet was initiated in 1,337 individuals during the follow up. Cinacalcet users were slightly younger; included more patients with chronic glomerulonephritis and fewer with diabetes; were more likely to have a history of parathyroidectomy; and were more often on activated vitamin D agents, phosphate binders, and iron supplements. After adjusting for both time-invariant and time-varying potential confounders, including demographics, comorbidities, comedications, and laboratory values, each additional 6-month duration on cinacalcet was associated with a 1.1-fold increase in the odds of achieving the target hemoglobin level.Cinacalcet may improve anemia in chronic hemodialysis patients with secondary hyperparathyroidism, possibly through pathways both within and outside the parathyroid hormone pathways. Further investigations are warranted to delineate the roles of cinacalcet not only in the management of chronic kidney

  3. Molecular analysis and association with clinical and laboratory manifestations in children with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Roberta Faria Camilo-Araújo

    2014-10-01

    Full Text Available Objectives: To analyze the frequency of βS-globin haplotypes and alpha-thalassemia, and their influence on clinical manifestations and the hematological profile of children with sickle cell anemia. Method: The frequency of βS-globin haplotypes and alpha-thalassemia and any association with clinical and laboratorial manifestations were determined in 117 sickle cell anemia children aged 3–71 months. The confirmation of hemoglobin SS and determination of the haplotypes were achieved by polymerase chain reaction-restriction fragment length polymorphism, and alpha-thalassemia genotyping was by multiplex polymerase chain reaction (single-tube multiplex-polymerase chain reaction. Results: The genotype distribution of haplotypes was 43 (36.7% Central African Republic/Benin, 41 (35.0% Central African Republic/Central African Republic, 20 (17.0% Rare/atypical, and 13 (11.1% Benin/Benin. The frequency of the α3.7 deletion was 1.71% as homozygous (−α3.7/−α3.7 and 11.9% as heterozygous (−α3.7/αα. The only significant association in respect to haplotypes was related to the mean corpuscular volume. The presence of alpha-thalassemia was significantly associated to decreases in mean corpuscular volume, mean corpuscular hemoglobin and reticulocyte count and to an increase in the red blood cell count. There were no significant associations of βS-globin haplotypes and alpha-thalassemia with clinical manifestations. Conclusions: In the study population, the frequency of alpha-thalassemia was similar to published data in Brazil with the Central African Republic haplotype being the most common, followed by the Benin haplotype. βS-globin haplotypes and interaction between alpha-thalassemia and sickle cell anemia did not influence fetal hemoglobin concentrations or the number of clinical manifestations.

  4. Relationship between maternal hemoglobin and perinatal outcome

    International Nuclear Information System (INIS)

    Bakhtiar, U.J.; Khan, Y.; Nisar, R.

    2007-01-01

    To Study the Relationship between Maternal Hemoglobin and Perinatal outcome in a cohort of 860 pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome. All Singleton pregnancies delivering at Pakistan Railway Hospital Rawalpindi from January 2004 to December 2005 that fulfilled the required criteria were included. Out of the 860 patients, 402 were anemic (<11gm/dl) and 458 were non anemic. Perinatal outcome included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low apgr scores and intrauterine fetal deaths. Risk of preterm and Low birth weight among anemic women was 3.4 and 1.8 times more than non anaemic women. The neonates of anemic woman also had 1.7 times increased risk of having low apgr scores at 1 min. Among anemic women there was 2.2 times greater risk of intrauterine fetal death than the non-anemic women. Regular antenatal care from first trimester has a vital role in assessing and managing maternal anemia timely and it directly affects the perinatal outcome. The patients with anemia have also higher risk of having low birth weight, preterm births and intra uterine fetal death. (author)

  5. Influence of peripheral blood hemoglobin concentration on the result of radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    He Beiwa; Zhang Guofen; Zhao Yutian; Wang Zhenwu; Xu Min; Hu Yulin

    2002-01-01

    Objective: To determine the influence of peripheral blood hemoglobin concentration on the radiotherapy result of nasopharyngeal carcinoma (NPC). Methods: From January 1989 to December 1998, 304 patients with pathologically confirmed NPC received radical radiation. There were 209 males and 95 females. The ages ranged from 16 to 77 years with a median of 42. All patients were irradiated by 60 Co or 6 MV external beam with a total dose of 64 - 76 Gy for the primary tumor and 46 - 77 Gy for the cervical lymph nodes. The peripheral blood hemoglobin concentration for all patients was measured before, during and after radiotherapy. These patients were divided into three groups according to the peripheral blood hemoglobin concentration before radiotherapy: anemia ( 160 g/L), and into two groups according to the change in the peripheral blood hemoglobin concentration during radiotherapy as increased and decreased groups. Results: All patients were followed with a follow-up rate of 90.5%. The peripheral blood hemoglobin concentration had a significant effect on the survival of NPC patients. Its decrease or increase during radiotherapy affected the survival and local control rates of NPC patients. Conclusions: The change of peripheral hemoglobin concentration affecting the oxygen content in the blood, can influence the local control and survival rates of NPC patients. Increase results in higher survival

  6. Clinical Outcomes of Splenectomy in Children: Report of the Splenectomy in Congenital Hemolytic Anemia (SICHA) Registry

    Science.gov (United States)

    Rice, Henry E; Englum, Brian R; Rothman, Jennifer; Leonard, Sarah; Reiter, Audra; Thornburg, Courtney; Brindle, Mary; Wright, Nicola; Heeney, Matthew M; Smithers, Charles; Brown, Rebeccah L; Kalfa, Theodosia; Langer, Jacob C; Cada, Michaela; Oldham, Keith T; Scott, J Paul; St. Peter, Shawn; Sharma, Mukta; Davidoff, Andrew M.; Nottage, Kerri; Bernabe, Kathryn; Wilson, David B; Dutta, Sanjeev; Glader, Bertil; Crary, Shelley E; Dassinger, Melvin S; Dunbar, Levette; Islam, Saleem; Kumar, Manjusha; Rescorla, Fred; Bruch, Steve; Campbell, Andrew; Austin, Mary; Sidonio, Robert; Blakely, Martin L

    2014-01-01

    The outcomes of children with congenital hemolytic anemia (CHA) undergoing total splenectomy (TS) or partial splenectomy (PS) remain unclear. In this study, we collected data from 100 children with CHA who underwent TS or PS from 2005–2013 at 16 sites in the Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium using a patient registry. We analyzed demographics and baseline clinical status, operative details, and outcomes at 4, 24, and 52 weeks after surgery. Results were summarized as hematologic outcomes, short-term adverse events (AEs) (≤ 30 days after surgery), and long-term AEs (31–365 days after surgery). For children with hereditary spherocytosis, after surgery there was an increase in hemoglobin (baseline 10.1 ± 1.8 gm/dl, 52 week 12.8 ± 1.6 gm/dl; mean ± SD), decrease in reticulocyte and bilirubin as well as control of symptoms. Children with sickle cell disease had control of clinical symptoms after surgery, but had no change in hematologic parameters. There was an 11% rate of short-term AEs and 11% rate of long-term AEs. As we accumulate more subjects and longer follow-up, use of a patient registry should enhance our capacity for clinical trials and engage all stakeholders in the decision-making process. PMID:25382665

  7. [Effects of a lipid-based nutrient supplement on hemoglobin levels and anthropometric indicators in children from five districts in Huánuco Peru].

    Science.gov (United States)

    Vargas-Vásquez, Alejandro; Bado, Ricardo; Alcázar, Lorena; Aquino, Oscar; Rodríguez, Amelia; Novalbos, José Pedro

    2015-01-01

    Objectives . To determine the effect of consumption of a lipid-based nutrient supplement (LNS) on hemoglobin levels, anemia and anthropometric indicators in children aged six to eleven months old in five districts in the province of Ambo in the region of Huanuco, Peru. A pre-experimental, pre-post study was performed. The study population included children aged six to eleven months old in 19 health facilities in five districts with very high vulnerability to chronic malnutrition in the province of Ambo, Huanuco. Data from 147 children who received the lipid-based nutrient supplement (LNS) from six to eleven months old were obtained. The mean hemoglobin significantly increased by 0.67 g/dL (panemia dropped by 27 percentage points (panemia in children under twelve months, which might constitute an effective alternative to prevent and control childhood anemia.

  8. Effect of treatment with single total-dose intravenous iron versus daily oral iron(III-hydroxide polymaltose on moderate puerperal iron-deficiency anemia

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2017-05-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 Fausta Chioma Emegoakor,1 Euzebus Chinonye Ezugwu,1 Lucky Osaheni Lawani,2 Leonard Ogbonna Ajah,1 Jude Anazoeze Madu,3 Hyginus Uzo Ezegwui,1 Frank Okechukwu Ezugwu4 1Department of Obstetrics and Gynaecology, University of Nigeria, Enugu Campus, 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, 3Department of Haematology, University of Nigeria, Nsukka, 4Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University, Enugu, Nigeria Background: Iron-deficiency anemia is the most common nutritional cause of anemia in pregnancy and is often responsible for puerperal anemia. Puerperal anemia can impair postpartum maternal and neonatal well-being. Objective: To determine the effect of treatment of moderate puerperal iron-deficiency anemia using a single intravenous total-dose iron dextran versus daily single dose oral iron(III-hydroxide polymaltose. Methodology: A randomized controlled study in which postpartum women with moderate iron-deficiency anemia were randomized into treatment with either a single total-dose intravenous iron dextran or with daily single doses of oral iron(III-hydroxide polymaltose tablets for 6 weeks. Effects on hemoglobin concentration using either method were compared at 6 weeks postpartum. Analysis was per protocol using SPSS version 17 for windows. P-values ≤0.05 were considered significant. Results: Two hundred eighty-four women were recruited for the study: 142 women received single total dose intravenous infusion of iron dextran while 142 received daily oral iron(III-hydroxide polymaltose tablets. Approximately 84.0% (237/282 completed the study and were analyzed including 81% (115/142 of those randomized to injectable iron therapy compared to 85.9% (122/142 of those randomized to oral treatment. The proportions of women who had attained hemoglobin concentration of at least 10 g/dL by the 6 weeks postpartum visit did not differ

  9. Management of Anemia in Patients with Inflammatory Bowel Disease (IBD).

    Science.gov (United States)

    Patel, Dhruvan; Trivedi, Chinmay; Khan, Nabeel

    2018-03-01

    therapy with iron supplementation whereas IV administration of iron is recommended in patients with clinically active IBD, or for patients who are previously intolerant to oral iron, with hemoglobin levels below 10 g/dL, and in patients who need erythropoiesis-stimulating agents (ESAs). As the recurrence of anemia is common after resolution, the monitoring for recurrent anemia is equally important during the course of therapy.

  10. [Evaluation of the impact of multiple micronutrient powders on children anemia in three Andean regiones in Peru].

    Science.gov (United States)

    Munayco, César V; Ulloa-Rea, María E; Medina-Osis, José; Lozano-Revollar, Carmen R; Tejada, Violeta; Castro-Salazar, Consuelo; Munarriz-Villafuerte, José; de Bustos, Cecilia; Arias, Lena

    2013-04-01

    The aim of this research was to determine the impact of the strategy of multi-micronutrient supplementation (MMN) on the childhood anemia in three Andean regions of Peru. A sentinel surveillance system was established in 29 health centers of Andahuaylas, Ayacucho and Huancavelica (Peru) to monitor a cohort of children of 6 to 35 months of age whom been received MMM for a period of 12 months. Data regarding hemoglobin levels were gathered at the beginning and at the end of the research; they included consumption of MMN, and other data from clinical records and from growth and development charts. Between the child who completed the supplementation, the prevalence of anemia decreased from 70.2% to 36.6% (p value anemia at the beginning of the supplementation got cured. This research shows that supplementation with MMN could be a valuable strategy to fight anemia.

  11. The Virtual Anemia Trial: An Assessment of Model‐Based In Silico Clinical Trials of Anemia Treatment Algorithms in Patients With Hemodialysis

    Science.gov (United States)

    Topping, Alice; Kappel, Franz; Thijssen, Stephan; Kotanko, Peter

    2018-01-01

    In silico approaches have been proposed as a novel strategy to increase the repertoire of clinical trial designs. Realistic simulations of clinical trials can provide valuable information regarding safety and limitations of treatment protocols and have been shown to assist in the cost‐effective planning of clinical studies. In this report, we present a blueprint for the stepwise integration of internal, external, and ecological validity considerations in virtual clinical trials (VCTs). We exemplify this approach in the context of a model‐based in silico clinical trial aimed at anemia treatment in patients undergoing hemodialysis (HD). Hemoglobin levels and subsequent anemia treatment were simulated on a per patient level over the course of a year and compared to real‐life clinical data of 79,426 patients undergoing HD. The novel strategies presented here, aimed to improve external and ecological validity of a VCT, significantly increased the predictive power of the discussed in silico trial. PMID:29368434

  12. Hemoglobin concentrations in 358 apparently healthy 80-year-old Danish men and women. Should the reference interval be adjusted for age?

    DEFF Research Database (Denmark)

    Milman, N.; Pedersen, Agnes Nadelmann; Ovesen, Lars

    2008-01-01

    Background and aims: In elderly Danes, reference intervals for hemoglobin (Hb) concentrations are derived from younger population groups. The aim was to examine reference intervals for Hb and cut-off limits for anemia by application of criteria for normality to a representative population of 80...

  13. Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia

    Science.gov (United States)

    Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro

    2017-01-01

    School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children’s nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein (p nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren. PMID:28805668

  14. Anemia, malaria and hookworm infections in a Vietnamese ethnic minority

    NARCIS (Netherlands)

    Le Hung, Q.; de Vries, Peter J.; Giao, Phan T.; Binh, Tran Q.; Nam, Nguyen V.; Kager, Piet A.

    2005-01-01

    The aim of this study was to determine the prevalence of anemia and evaluate the relationship of malaria and helminth infections on anemia status in Phan Tien village, a mountainous ethnic minority community in southern Vietnam. This longitudinal study was performed from April 1997 to 2000 by

  15. Anemia prevalence and treatment practice in patients with non-myeloid tumors receiving chemotherapy

    International Nuclear Information System (INIS)

    Merlini, Laura; Cartenì, Giacomo; Iacobelli, Stefano; Stelitano, Caterina; Airoldi, Mario; Balcke, Peter; Keil, Felix; Haslbauer, Ferdinand; Belton, Laura; Pujol, Beatriz

    2013-01-01

    To describe the prevalence and management of anemia in cancer patients. This cross-sectional, observational survey was conducted in Italy and Austria. Centers prespecified one day, during a 4-month enrollment window, to report specific data collected during normal clinical practice for patients with non-myeloid tumors attending for chemotherapy (±radiotherapy) treatment. The primary endpoint was the prevalence of anemia as determined using a prespecified algorithm: hemoglobin (Hb) ≤10 g/dL on/within 3 days prior to visit; ongoing anemia treatment; physician diagnosis of anemia, together with ≥1 anemia symptom. Between November 18, 2010 and March 18, 2011, data for 1412 patients were collected (Italy n = 1130; Austria n = 282). Most patients (n = 1136; 80%) had solid tumors; 809 (57%) had received ≤3 chemotherapy cycles. The prevalence of anemia was 32% (95% confidence interval: 29.4%–34.2%); 196 patients (14%) were deemed anemic based on Hb ≤10 g/dL, 131 (9%) on ongoing anemia treatment, and 121 (9%) on physician diagnosis/anemia symptom. Overall, 1153 patients (82%) had Hb data; mean (standard deviation [SD]) Hb levels were 11.7 (1.7) g/dL. In total, 456 patients (32%) had anemia symptoms: fatigue (n = 392; 28%), depression (n = 122; 9%), and dyspnea (n = 107; 8%) were most common. Fifty-one patients (4%) had had their current chemotherapy cycle delayed due to anemia. On visit day, or ≤28 days prior, 91 (6%), 188 (13%), and 81 patients (6%) had evidence of whole blood/red blood cell transfusion, erythropoiesis-stimulating agent use, or iron use, respectively. On the prespecified study day, one-third of patients with non-myeloid tumors undergoing chemotherapy were found to be anemic and 13% had evidence of erythropoiesis-stimulating agent use then or in the 28 days prior

  16. Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Abel Gebre

    2015-01-01

    Full Text Available Background. Anemia affects the lives of more than 2 billion people globally, accounting for over 30% of the world’s population. Anemia is a global public health problem occurring at all stages of the life cycle but the burden of the problem is higher in pregnant women particularly in developing countries. The aim of this study was to determine the prevalence of anemia and associated factors among pregnant women attending antenatal clinics in north western zone of Tigray, northern Ethiopia. Methods. A facility based cross-sectional study was employed. A systematic random sampling procedure was employed to select 714 pregnant women who were attending antenatal clinics in health facilities found in the study area from April to May 2014. The data was entered and analyzed using Epi-info version 3.5.1 and SPSS version 20.0 statistical software, respectively. Logistic regression analysis was used to identify factors associated with anemia among the study participants. All tests were two-sided and p value < 0.05 was considered statistically significant. Results. The overall prevalence of anemia (hemoglobin < 11 g/dL among the pregnant women was 36.1% (95% CI = 32.7%–39.7% of which 58.5% were mildly, 35.7% moderately, and 5.8% severely anemic. In pregnant women, rural residence (AOR = 1.75, 95% CI = 1.01–3.04, no education/being illiterate (AOR = 1.56, 95% CI = 1.03–2.37, absence of iron supplementation during pregnancy (AOR = 2.76, 95% CI = 1.92–5.37, and meal frequency of less than two times per day (AOR = 2.28, 95% CI = 1.06–4.91 were the independent predictors for increased anemia among the pregnant women. Conclusions. Anemia was found to be moderate public health problem in the study area. Residence, educational status, iron supplementation during pregnancy, and meal frequency per day were statistically associated with anemia among the pregnant women. Awareness creation and nutrition education on the importance of taking iron

  17. ASUPAN PROTEIN NABATI DAN KEJADIAN ANEMIA WANITA USIA SUBUR VEGAN

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    Fajar Ari Nugroho

    2016-04-01

    Full Text Available ABSTRACTThe purpose of this study was to determined the role of vegetable protein intake and anaemia incidence among vegan reproductive aged women. This study was observational research with cross-sectional study design. Sixty-five subjects were selected by simple random sampling method. Data collection for intake was done by 24-hours recall technique, and haemoglobin levels was measured by cyanmethemogloblin method. The results showed that 26.1% from 31-anaemia vegan subjects classified as less vegetable protein intake individuals, and 43% from 34-non anaemia vegan subjects known as enough vegetable protein intake individuals. Chi-square test authenticate that there was a significant relationship between the vegetable protein intakes with anaemia incidence among vegan reproductive aged women (p=0.002. The conclusion showed that vegetable protein intake has a role to the risk of anaemia incidence among vegan reproductive aged women.Keywords: anaemia, reproductive aged women, vegan, vegetable proteinABSTRAKTujuan penelitian ini adalah mengetahui peran asupan protein nabati terhadap kejadian anemia pada wanita usia subur (WUS vegan. Penelitian yang dilakukan adalah penelitian observasional dengan desain cross sectional. Sebanyak 65 subjek WUS dipilih menggunakan metode simple random sampling. Pengambilan data asupan dilakukan menggunakan metode 24-hours recall, sedangkan kadar hemoglobin dianalisis menggunakan metode cyanmethemoglobin. Hasil penelitian menunjukkan 31 WUS vegan yang anemia sebesar 26,1% diantaranya menunjukkan memiliki asupan protein kurang, sedangkan 34 WUS vegan yang tidak anemia (43%, memiliki asupan protein nabati cukup. Analisis chi square menunjukkan bahwa terdapat hubungan yang signifikan antara asupan protein nabati dengan kejadian anemia (p=0,002. Kesimpulan penelitian ini adalah asupan protein nabati berperan terhadap risiko anemia pada WUS vegan.Kata kunci: anemia, protein nabati, vegan, WUS

  18. Anemia management: development of a rapid-access anemia and intravenous iron service

    Directory of Open Access Journals (Sweden)

    Radia D

    2013-08-01

    Full Text Available Deepti Radia,1 Ibrahim Momoh,2 Richard Dillon,1 Yvonne Francis,1 Laura Cameron,1 Toni-Lee Fagg,1 Hannah Overland,1 Susan Robinson,1 Claire N Harrison11Haematology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK; 2Bupa Home Healthcare, Harlow, UKAbstract: This article describes the initiation and evolution of the Rapid-Access Anemia Clinic (RAAC at Guy's and St Thomas' Hospitals, London, UK. This clinic was set up to provide diagnosis and treatment, and to coordinate investigative procedures, where necessary, into the underlying causes of anemia. Initially piloted with anemic preoperative orthopedic patients, the clinic now treats a wide range of conditions, deriving from both internal and external referrals. Treatment includes dietary advice, supplementation with iron, vitamin B12 and folate, and blood transfusion. Most patients at the RAAC need iron replacement, the majority of which require intravenous (IV iron. Therefore the first-line IV iron-administration protocol is carefully considered to ensure viability of the service and patient satisfaction. Four IV irons available in the UK are discussed, with explanation of the benefits and drawbacks of each product and the reasoning behind the IV iron choice at different stages of the RAAC's development. Costs to the service, affected by IV iron price and administration regimen, are considered, as well as the product's contraindications. Finally, the authors reflect on the success of the RAAC and how it has improved patients' quality-of-treatment experience, in addition to benefiting the hospital and National Health Service in achieving specific health-care mandates and directives. Drawing from the authors' experiences, recommendations are given to assist others in setting up and providing a successful rapid-access anemia service or similar facility.Keywords: hemoglobin, iron deficiency, ferric carboxymaltose, iron sucrose, iron dextran, iron isomaltoside

  19. Avaliação da eficácia do uso intravenoso de sacarato de hidróxido de ferro III no tratamento de pacientes adultos com anemia ferropriva Evaluation of the efficacy of intravenous iron III-hydroxide saccharate for treating adult patients with iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Rodolfo D. Cançado

    2007-06-01

    Full Text Available O objetivo desse estudo foi avaliar a eficácia do uso intravenoso de sacarato de hidróxido de ferro III no tratamento de pacientes adultos com anemia ferropriva. No período de janeiro de 2003 a dezembro de 2005, estudamos cinqüenta pacientes com anemia ferropriva que apresentaram intolerância e/ou resposta inadequada ao tratamento com ferro por via oral e/ou valor de hemoglobina inferior a 7,0 g/dL. Os principais exames laboratoriais realizados foram: hemograma completo, contagem de reticulócitos, ferro sérico, capacidade total de ligação de ferro e ferritina sérica. Os pacientes receberam uma dose semanal de 200 mg de sacarato de hidróxido de ferro III diluído em 250 mL de soro fisiológico a 0,9%, administrado por via intravenosa em trinta minutos. O tratamento foi realizado até a obtenção do valor de hemoglobina igual ou maior que 12,0 g/dL para mulheres e 13,0 g/dL para homens, ou até a administração da dose total de ferro parenteral recomendada para cada paciente. A idade mediana dos cinqüenta pacientes estudados foi de 45 anos, variando entre 28 e 76 anos; quarenta (80,0% eram do sexo feminino. A causa mais comum de anemia ferropriva no sexo feminino foi sangramento uterino anormal observado em 25/40 pacientes (62,5% e, no sexo masculino, gastrectomia parcial em 7/10 (70,0%. Vinte e quatro (48,0% pacientes foram incluídos nesse estudo por falta de resposta à terapia com ferro oral, 22 (44,0% por intolerância ao ferro oral e quatro (8,0% por hemoglobina The objective of this study was to evaluate the efficacy of intravenous iron III-hydroxide saccharate to treat adult patients with iron deficiency anemia. Between January 2003 and December 2005 we studied 50 patients with iron deficiency anemia who presented intolerance or inadequate response to oral iron therapy, or hemoglobin level < 7 g/dL. The main laboratory tests performed were: complete blood cell count, reticulocyte count, serum iron, total iron-binding capacity

  20. Intrahepatic and adrenal hemorrhage as a rare cause of neonatal anemia.

    Science.gov (United States)

    Akin, Mustafa Ali; Coban, Dilek; Doganay, Selim; Durak, Zehra; Kurtoglu, Selim

    2011-05-01

    Vaginal delivery of the macrosomic fetus may result in hemorrhage of intra-abdominal organs. Mostly affected organs are the liver and adrenal glands. Hemorrhage of liver is usually occurs as a subcapsular hemorrhage and it is clinically presented an abdominal mass without symptoms of anemia. But intraparenchymal hemorrhage of liver is very rare and there is no sign of abdominal mass. However, in contrast to subcapsular hemorrhage, symptoms of anemia are rapidly developed in newborns. A macrosomic newborn by vaginal delivery at term. Within 6 h after delivery, the patient showed pallor without tachycardia and hypotension. In laboratory studies, hemoglobin level failed from 14 g/dL to 10 g/dL within 6 h. Physical examination revealed no signs of abdominal mass. Intraparenchymal hemorrhage in the sixth segment of liver and right adrenal hemorrhage were detected on the ultrasonographic scan. Hepatic function tests were normal in the whole follow-up period, and hemorrhage resolved within two weeks. Following months after discharge, adrenal hemorrhage also resolved without any complication. Hepatic hemorrhages, causing hemorrhagic anemia in neonates, usually occur in subcapsular form. Intraparenchymal hepatic hemorrhage should especially be considered in those newborns, which are rapidly developed symptoms of anemia without any abdominal mass.

  1. Socio-economic and demographic determinants of childhood anemia

    Directory of Open Access Journals (Sweden)

    Sankar Goswmai

    2015-09-01

    Full Text Available Objective: To evaluate socio-economic and demographic determinants of anemia among Indian children aged 6–59 months. Methods: Statistical analysis was performed on the cross-sectional weighted sample of 40,885 children from 2005 to 2006 National Family Health Survey by using multinomial logistic regression to assess the significance of some risk factors in different degrees of child anemia. Anemia was diagnosed by World Health Organization (WHO cut-off points on hemoglobin level. Pearson's chi-squared test was applied to justify the associations of anemia with different categories of the study population. Results: The prevalence of anemia was 69.5%; 26.2% mild, 40.4% moderate, and 2.9% severe anemia. Overall prevalence rate, along with mild and moderate cases, showed an increasing trend up to 2 years of age and then decreased. Rural children had a higher prevalence rate. Of 28 Indian states in the study, 10 states showed very high prevalence, the highest being Bihar (77.9%. Higher birth order, high index of poverty, low level of maternal education, mother's anemia, non-intake of iron supplements during pregnancy, and vegetarian mother increased the risks of all types of anemia among children (p < 0.05. Christian population was at lower risk; and Scheduled Caste, Scheduled Tribe, and Other Backward Class categories were at higher risk of anemia. Conclusion: The results suggest a need for proper planning and implementation of preventive measures to combat child anemia. Economically under-privileged groups, maternal nutrition and education, and birth control measures should be priorities in the programs. Resumo: Objetivo: Avaliar os fatores socioeconômicos e demográficos determinantes de anemia em crianças indianas com idade de 6 a 59 meses. Métodos: A análise estatística foi realizada na amostra transversal ponderada de 40885 crianças da Pesquisa Nacional de Saúde da Família de 2005–2006, Governo da Índia, utilizando a técnica de

  2. Extracellular histones induce erythrocyte fragility and anemia.

    Science.gov (United States)

    Kordbacheh, Farzaneh; O'Meara, Connor H; Coupland, Lucy A; Lelliott, Patrick M; Parish, Christopher R

    2017-12-28

    Extracellular histones have been shown to play an important pathogenic role in many diseases, primarily through their cytotoxicity toward nucleated cells and their ability to promote platelet activation with resultant thrombosis and thrombocytopenia. In contrast, little is known about the effect of extracellular histones on erythrocyte function. We demonstrate in this study that histones promote erythrocyte aggregation, sedimentation, and using a novel in vitro shear stress model, we show that histones induce erythrocyte fragility and lysis in a concentration-dependent manner. Furthermore, histones impair erythrocyte deformability based on reduced passage of erythrocytes through an artificial spleen. These in vitro results were mirrored in vivo with the injection of histones inducing anemia within minutes of administration, with a concomitant increase in splenic hemoglobin content. Thrombocytopenia and leukopenia were also observed. These findings suggest that histones binding to erythrocytes may contribute to the elevated erythrocyte sedimentation rates observed in inflammatory conditions. Furthermore, histone-induced increases in red blood cell lysis and splenic clearance may be a significant factor in the unexplained anemias seen in critically ill patients. © 2017 by The American Society of Hematology.

  3. Left ventricular hypertrophy in children, adolescents and young adults with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Gustavo Baptista de Almeida Faro

    2015-10-01

    Full Text Available OBJECTIVE: The aims of this study were to estimate the frequency of left ventricular hypertrophy and to identify variables associated with this condition in under 25-year-old patients with sickle cell anemia.METHODS: A cross-sectional study was performed of children, adolescents and young adults with sickle cell anemia submitted to a transthoracic Doppler echocardiography. The mass of the left ventricle was determined by the formula of Devereux et al. with correction for height, and the percentile curves of gender and age were applied. Individuals with rheumatic and congenital heart disease were excluded. The patients were divided into two groups according to the presence or absence of left ventricular hypertrophy and compared according to clinical, echocardiographic and laboratory variables.RESULTS: A total of 37.6% of the patients had left ventricular hypertrophy in this sample. There was no difference between the groups of patients with and without hypertrophy according to pathological history or clinical characteristics, except possibly for the use of hydroxyurea, more often used in the group without left ventricular hypertrophy. Patients with left ventricular hypertrophy presented larger left atria and lower hemoglobin and hematocrit levels, reticulocyte index and a higher albumin:creatinine ratio in urine.CONCLUSION: Left ventricular hypertrophy was observed in more than one-third of the young patients with sickle cell anemia with this finding being inversely correlated to the hemoglobin and hematocrit levels, and reticulocyte index and directly associated to a higher albumin/creatinine ratio. It is possible that hydroxyurea had had a protective effect on the development of left ventricular hypertrophy.

  4. A case of iron deficiency anemia with co-existing Hb Fontainebleau.

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    Abhishek HL Purohit

    2014-06-01

    Full Text Available Hb Fontainebleaue is a rare alpha chain variant in the Indian population which generates an unknown peak on hemoglobin HPLC study and does cause diagnostic difficulty to those who are not acquainted with this entity. We present a case of Hb Fontainebleau, an eighteen year old patient who presented with symptoms related to anemia to our department and unknown peak observed in HPLC plots lead us to family study and molecular characterization for this case.

  5. Food intake and nutritional status of preschool from maroon communities of the state Alagoas, Brazil

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    Fernanda Maria de B. Leite

    2013-12-01

    Full Text Available OBJECTIVE: To assess the dietary intake and the nutritional status of children from Alagoas maroon communities. METHODS: Cross-sectional study involving 724 children (12-60 months from 39 Alagoas maroon communities. The nutritional status was investigated by anthropometric, biochemical (hemoglobin and food consumption indicators. RESULTS: The prevalence of anemia, stunting and obesity were, respectively, 48.0, 9.7 and 6.0%. The children had a monotonous eating pattern and a considerable prevalence of inadequate intake of zinc (17.0%, folate (18.1%, iron (20.2% and vitamins A (29.7% and C (34.3%. Compared to the other socioeconomic classes, the E class children had lower average consumption (p<0.05 for energy, carbohydrate, vitamins A and C, folate, iron, zinc and phosphorus. CONCLUSIONS: Anemia is a serious Public Health problem. The prevalence of chronic malnutrition and obesity were similar to those observed for the children in the State as a whole, where a nutritional transition process is occuring. There was a high prevalence of inadequate food intake risk for zinc, folate, iron and vitamins A and C, suggesting the need for nutritional education actions.

  6. Is methemoglobin an inert bystander, biomarker or a mediator of oxidative stress—The example of anemia?

    Directory of Open Access Journals (Sweden)

    Gregory M.T. Hare

    2013-01-01

    Full Text Available Acute anemia increases the risk for perioperative morbidity and mortality in critically ill patients who experience blood loss and fluid resuscitation (hemodilution. Animal models of acute anemia suggest that neuronal nitric oxide synthase (nNOS-derived nitric oxide (NO is adaptive and protects against anemia-induced mortality. During acute anemia, we have observed a small but consistent increase in methemoglobin (MetHb levels that is inversely proportional to the acute reduction in Hb observed during hemodilution in animals and humans. We hypothesize that this increase in MetHb may be a biomarker of anemia-induced tissue hypoxia. The increase in MetHb may occur by at least two mechanisms: (1 direct hemoglobin oxidation by increased nNOS-derived NO within the perivascular tissue and (2 by increased deoxyhemoglobin (DeoxyHb nitrite reductase activity within the vascular compartment. Both mechanisms reflect a potential increase in NO signaling from the tissue and vascular compartments during anemia. These responses are thought to be adaptive; as deletion of nNOS results in increased mortality in a model of acute anemia. Finally, it is possible that prolonged activation of these mechanisms may lead to maladaptive changes in redox signaling. We hypothesize, increased MetHb in the vascular compartment during acute anemia may reflect activation of adaptive mechanisms which augment NO signaling. Understanding the link between anemia, MetHb and its treatments (transfusion of stored blood may help us to develop novel treatment strategies to reduce the risk of anemia-induced morbidity and mortality.

  7. Dietary Composition Influences Incidence of Helicobacter pylori-Induced Iron Deficiency Anemia and Gastric Ulceration

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    Beckett, Amber C.; Piazuelo, M. Blanca; Noto, Jennifer M.; Peek, Richard M.; Washington, M. Kay; Algood, Holly M. Scott

    2016-01-01

    Epidemiologic studies have provided conflicting data regarding an association between Helicobacter pylori infection and iron deficiency anemia (IDA) in humans. Here, a Mongolian gerbil model was used to investigate a potential role of H. pylori infection, as well as a possible role of diet, in H. pylori-associated IDA. Mongolian gerbils (either H. pylori infected or uninfected) received a normal diet or one of three diets associated with increased H. pylori virulence: high-salt, low-iron, or a combination of a high-salt and low-iron diet. In an analysis of all infected animals compared to uninfected animals (independent of diet), H. pylori-infected gerbils had significantly lower hemoglobin values than their uninfected counterparts at 16 weeks postinfection (P Anemia was associated with the presence of gastric ulceration but not gastric cancer. Infected gerbils consuming diets with a high salt content developed gastric ulcers significantly more frequently than gerbils consuming a normal-salt diet, and the lowest hemoglobin levels were in infected gerbils consuming a high-salt/low-iron diet. These data indicate that H. pylori infection can cause IDA and that the composition of the diet influences the incidence and severity of H. pylori-induced IDA. PMID:27620719

  8. Hubungan Anemia dengan Kejadian Bayi Berat Lahir Rendah pada Kehamilan Aterm di RSUD Achmad Darwis Suliki

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    Maryam Syifaurrahmah Syifaurrahmah

    2016-08-01

    Full Text Available AbstrakAnemia pada ibu hamil adalah kondisi ibu dengan kadar hemoglobin (Hb dalam darah <11,0 g%. Masalah yang dihadapi oleh pemerintah Indonesia adalah tingginya prevalensi anemia pada ibu hamil yang merupakan masalah kesehatan utama yang berhubungan dengan kejadian bayi berat lahir rendah (BBLR. Bayi berat lahir rendah memiliki efek jangka pendek maupun panjang terhadap bayi tersebut dengan tingkat morbiditas dan mortalitas yang tinggi. Penelitian ini menggunakan desain retrospektif observasional dengan mengumpulkan data rekam medis ibu hamil aterm yang melahirkan di RSUD Achmad Darwis Suliki Kabupaten Lima Puluh Kota periode Januari – Desember 2013. Dari 73 sampel ibu hamil aterm anemia dan tidak anemia didapatkan nilai rerata berat bayi pada ibu hamil aterm anemia adalah 2722 gram dan rerata berat badan bayi pada ibu hamil aterm tanpa anemia adalah 2967 gram. Hasil analisis bivariat dengan uji Chi Square didapatkan  nilai p:0,047 (p<0,05 dengan rasio prevalensi sebesar 1,7. Disimpulkan bahwa terdapat hubungan bermakna antara anemia pada ibu hamil aterm dengan berat bayi lahir rendah di RSUD Suliki Kabupaten Lima Puluh KotaKata kunci: Anemia, hamil aterm, BBLR. AbstractAnaemia in pregnancy is a condition where hemoglobin concentration in blood <11.0 gr%. Indonesia government has an  issue about the high prevalence of anaemia in pregnancy which is the main issue correlates to the low birth baby weight. Low birth baby weight has a short and long term effects with high risk of morbidity and mortality. This analytic research with observational retrospective design obtaining datas from medical records of aterm pregnant mother who gave a birth in RSUD Achmad Darwis Suliki Kabupaten Lima Puluh Kota in a period from January – Desember 2013. From 73 samples of aterm pregnant mother who had anaemia and non anaemia, known mean of baby weight in normal aterm pregnant mothers who had anaemia is 2722 gram and mean of baby weight from aterm pregnant

  9. Prevalence of Malaria and Anemia among Pregnant Women Attending a Traditional Birth Home in Benin City, Nigeria

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    Bankole Henry Oladeinde

    2012-05-01

    Full Text Available Objectives: To determine the prevalence of malaria and anemia among pregnant women attending a traditional birth center as well as the effect of herbal remedies, gravidity, age, educational background and malaria prevention methods on their prevalence.Methods: Blood specimens were collected from 119 pregnant women attending a Traditional Birth Home in Benin City, Nigeria. Malaria parasitemia was diagnosed by microscopy while anemia was defined as hemoglobin concentration <11 g/dL.Results: The prevalence of malaria infection was (OR=4.35 95% CI=1.213, 15.600; p=0.016 higher among primigravidae (92.1%. Pregnant women (38.5% with tertiary level of education had significantly lower prevalence of malaria infection (p=0.002. Malaria significantly affected the prevalence of anemia (p<0.05. Anemia was associated with consumption of herbal remedies (OR=2.973; 95% CI=1.206, 7.330; p=0.017. The prevalence of malaria parasitemia and anemia were not affected by malaria prevention methods used by the participants.Conclusion: The overall prevalence of malaria infection and anemia observed in this study were 78.9% and 46.2%, respectively. Higher prevalence of malaria infection was associated with primigravidae and lower prevalence with tertiary education of subjects. Anemia was associated with consumption of herbal remedies. There is urgent need to control the prevalence of malaria and anemia among pregnant women attending traditional birth homes.

  10. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease: A Systematic Review.

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    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet; Weiss, Günter

    2015-06-01

    Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients. The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement available, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD. Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library, and the websites of WHO, FDA, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004. A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia should be administered with a target to restore/replenish the iron stores and the hemoglobin level in a suitable way. However, in patients with IBD flares and inadequate responses to or side effects with oral preparations, intravenous iron supplementation is the therapy of choice. Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD, and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics. In conclusion, because many physicians are in doubt as to how to manage anemia and iron deficiency in IBD, there is a clear need for the implementation of evidence-based recommendations on this matter. Based on the data presented, oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency anemia unless such patients are intolerant or have an inadequate response, whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron.

  11. Treatment of renal anemia: Erythropoiesis stimulating agents and beyond

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    Patrick Biggar

    2017-09-01

    Full Text Available Anemia, complicating the course of chronic kidney disease, is a significant parameter, whether interpreted as subjective impairment or an objective prognostic marker. Renal anemia is predominantly due to relative erythropoietin (EPO deficiency. EPO inhibits apoptosis of erythrocyte precursors. Studies using EPO substitution have shown that increasing hemoglobin (Hb levels up to 10-11 g/dL is associated with clinical improvement. However, it has not been unequivocally proven that further intensification of erythropoiesis stimulating agent (ESA therapy actually leads to a comprehensive benefit for the patient, especially as ESAs are potentially associated with increased cerebro-cardiovascular events. Recently, new developments offer interesting options not only via stimulating erythropoeisis but also by employing additional mechanisms. The inhibition of activin, a member of the transforming growth factor superfamily, has the potential to correct anemia by stimulating liberation of mature erythrocyte forms and also to mitigate disturbed mineral and bone metabolism as well. Hypoxia-inducible factor prolyl hydroxylase inhibitors also show pleiotropic effects, which are at the focus of present research and have the potential of reducing mortality. However, conventional ESAs offer an extensive body of safety evidence, against which the newer substances should be measured. Carbamylated EPO is devoid of Hb augmenting effects whilst exerting promising tissue protective properties. Additionally, the role of hepcidin antagonists is discussed. An innovative new hemodialysis blood tube system, reducing blood contact with air, conveys a totally different and innocuous option to improve renal anemia by reducing mechanical hemolysis.

  12. Survival of rats subjected to acute anemia at different levels of erythrocyte 2,3-diphosphoglycerate.

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    Arturson, G; Westman, M

    1975-12-01

    An experimental procedure was worked out in which rats were subjected to an exchange of erythrocytes, followed by acute anemia by means of hemodilution. One group of rats received erythrocytes with a high concentration of 2,3-diphosphoglycerate (DPG), and the other group was given erythrocytes with a low DPG concentration. The survival rate was equal in the two groups. Irrespective of DPG concentration, the rats whose hemoglobin concentration reached the lowest level died. The rats that died were also more acidotic than the others. The results indicate that the hemoglobin concentration and the pH value were more important determinants for survival than the DPG concentrations.

  13. The effects of anemia in pregnancy on the mode of delivery and newborn

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    Necmi Arslan

    2014-03-01

    Full Text Available Objective: The aim of this study is to evaluate the effects of anemia in pregnancy on the mode of delivery and new-born. Methods: Between June and October 2009, 307 pregnant women were evaluated in terms of hemoglobin (Hb and hematocrit (Hct values, and delivery mode retrospectively. And also, the first and fifth minute Apgar scores, birth weight, and the values of Hb, Hct, and bilirubin, which obtained from the cord blood of neonates, were analyzed. Pregnant women were divided into two groups and classified as: hemoglobin value under 11.1 g / dl as anemic and the others as non-anemic group. In addition, the anemic group were divided into three group in terms of hemoglobin value, as follows: Group 1: 10.1 -11 mg/dl, group 2: 9.1 - 10 mg/dl, and group 3: <9 mg/dl. Results: In the study, 146 pregnants were anemic, while the 161 were non-anemic. The rate of low birth weight neonates was significantly higher in anemic pregnant women (p=0.029. The values of Hb (p=0.026 and Htc (p=0.006 were found to be lower in the anemic pregnant’ neonates. The incidence of low birth weight was significant increased when the maternal Hb value was smaller than 10g/dl (62.5% sensitivity, 74.7% specificity. Conclusion: It is observed that the low birth weight and the low values of Hb and Hct were more common in anemic pregnant neonates. Therefore, anemia should be screened and treated during the pregnancy due to the potential negative consequences.

  14. Underlying factors associated with anemia in Amazonian children: a population-based, cross-sectional study.

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    Marly A Cardoso

    Full Text Available BACKGROUND: Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey. METHODOLOGY: We obtained venous blood samples from 1111 children aged 6 months to 10 years living in the frontier town of Acrelândia, northwest Brazil, to estimate the prevalence of anemia and iron deficiency by measuring hemoglobin, erythrocyte indices, ferritin, soluble transferrin receptor, and C-reactive protein concentrations. Children were simultaneously screened for vitamin A, vitamin B(12, and folate deficiencies; intestinal parasite infections; glucose-6-phosphate dehydrogenase deficiency; and sickle cell trait carriage. Multiple Poisson regression and adjusted prevalence ratios (aPR were used to describe associations between anemia and the independent variables. PRINCIPAL FINDINGS: The prevalence of anemia, iron deficiency, and iron-deficiency anemia were 13.6%, 45.4%, and 10.3%, respectively. Children whose families were in the highest income quartile, compared with the lowest, had a lower risk of anemia (aPR, 0.60; 95%CI, 0.37-0.98. Child age (2 pregnancies, 2.01; 1.40-2.87 were positively associated with anemia. Other associated correlates were iron deficiency (2.1; 1.4-3.0, vitamin B(12 (1.4; 1.0-2.2, and folate (2.0; 1.3-3.1 deficiencies, and C-reactive protein concentrations (>5 mg/L, 1.5; 1.1-2.2. CONCLUSIONS: Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia.

  15. The Placenta in Twin-to-Twin Transfusion Syndrome and Twin Anemia Polycythemia Sequence.

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    Couck, Isabel; Lewi, Liesbeth

    2016-06-01

    Twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are complications unique to monochorionic twin pregnancies and their shared circulation. Both are the result of the transfusion imbalance in the intertwin circulation. TTTS is characterized by an amniotic fluid discordance, whereas in TAPS, there is a severe discordance in hemoglobin levels. The article gives an overview of the typical features of TTTS and TAPS placentas.

  16. Epoetin alfa 40000 U once weekly and intravenous iron supply in solid tumor patients: early increase of hemoglobin level during chemotherapy

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    Lalle, M.; Antimi, M.; Pistillucci, G.; D'Aprile, M.

    2005-01-01

    The objective of this observational study was the early evaluation of the impact, a week after the first administration of epoetin alfa 40000 U once weekly and i.v. dose of 62.5 mg sodium ferric gluconate for seven days in improving hemoglobin levels in cancer patients affected by mild/moderate or severe anemia during chemotherapy. Twenty patients affected by solid tumors who received epoetin alfa 40000 U once weekly and daily i.v. sodium ferric gluconate for one week were evaluated: 90% of the patients showed hemoglobin increase, with a median level of hemoglobin increase of 0.73 g/L from baseline, and 50% of them showing a hemoglobin increase > 1 gr/L. The treatment was well tolerated and no adverse event was observed. The early increase of hemoglobin level from baseline is interesting and suggestive for the possibility of achieving an adequate hemoglobin level with a short-term treatment. It is still necessary to further explore the real need of iron supplementation to maintain adequate erythropoiesis prior and during epoetin therapy

  17. Prevalence of Iron Deficiency and Iron Deficiency Anemia in High-School Girl Students of Yazd

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    M Noori Shadkam

    2009-07-01

    Full Text Available Introduction: It is generally assumed that 50% of the cases of anemia are due to iron deficiency. The most severe consequence of iron depletion is iron deficiency anemia (IDA, and it is still considered the most common nutrition deficiency worldwide. The main risk factors for IDA include: inadequate iron intake, impaired absorption or transport, physiologic losses associated with chronological or reproductive age, or acute or chronic blood loss, parasite infections such as hookworms, acute and chronic infections, including malaria, cancer, tuberculosis, HIV and other micronutrient deficiencies, including vitamins A and B12, folate, riboflavin, and copper deficiency. Methods: This work as a cross-sectional study was done in 2007-2008 in Yazd. Two hundred girls who participated in the study were selected randomly from eight girl high schools. Five ml venous blood was collected for determination of serum ferritin and cell blood count (CBC. Serum ferritin was determined by using ECLIA method and CBC by cell counter SYSMEX KX21N. Iron deficiency was defined as having serum ferritin values below 12 μ/l. Anemia was defined as having Hemoglobin levels below12 g/dl. Iron-deficiency anemia was considered to be the combination of both. Results: The3 mean ageyears and body mass index (kg/m2 were 15.19±0.7years and 21.5±4.2, respectively. Distribution in the 14, 15 and 16 years and more age groups were 13, 58.5 and 28.5 percent, respectively. Mean of Hemoglobin(g/dl, Hematocrit(%, MCV (fl, MCH (pg, MCHC (g/dl and ferritin(μ/l were 12.8±0.9, 38.9±3.0, 80.7±4.3, 26.6±1.8, 33.2±3.6 and 23±18.2, respectively. Of the total, 13.5% were anemic, 68% of which had Iron Deficiency Anemia (9.3% of the total. Iron deficiency was present in 34.7% of the population under study. Conclusion: According to world health organization criteria, anemia is a mild public health problem in this region, but iron deficiency is a significant problem and suitable measures for

  18. Clinical Course of Homozygous Hemoglobin Constant Spring in Pediatric Patients.

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    Komvilaisak, Patcharee; Jetsrisuparb, Arunee; Fucharoen, Goonnapa; Komwilaisak, Ratana; Jirapradittha, Junya; Kiatchoosakun, Pakaphan

    2018-04-17

    Hemoglobin (Hb) Constant Spring is an alpha-globin gene variant due to a mutation of the stop codon resulting in the elongation of the encoded polypeptide from 141 to 172 amino acid residues. Patients with homozygous Hb Constant Spring are usually mildly anemic. We retrospectively describe clinical manifestations, diagnosis, laboratory investigations, treatment, and associated findings in pediatric patients with homozygous Hb Constant Spring followed-up at Srinagarind Hospital. Sixteen pediatric cases (5 males and 11 females) were diagnosed in utero (N=6) or postnatal (n=10). Eleven cases were diagnosed with homozygous Hb Constant Spring, 4 with homozygous Hb Constant Spring with heterozygous Hb E, and 1 with homozygous Hb Constant Spring with homozygous Hb E. Three cases were delivered preterm. Six patients had low birth weights. Clinical manifestations included fetal anemia in 6 cases, hepatomegaly in 1 case, hepatosplenomegaly in 2 cases, splenomegaly in 1 case. Twelve cases exhibited early neonatal jaundice, 9 of which required phototherapy. Six cases received red cell transfusions; 1 (3), >1 (3). After the first few months of life, almost all patients had mild microcytic hypochromic anemia and an increased reticulocyte count with a wide red cell distribution (RDW), but no longer required red cell transfusion. At 1 to 2 years of age, some patients still had mild microcytic hypochromic anemia and some had normocytic hypochromic anemia with Hb around 10 g/dL, increased reticulocyte count and wide RDW. Associated findings included hypothyroidism (2), congenital heart diseases (4), genitourinary abnormalities (3), gastrointestinal abnormalities (2), and developmental delay (1). Pediatric patients with homozygous Hb Constant Spring developed severe anemia in utero and up to the age of 2 to 3 months postnatal, requiring blood transfusions. Subsequently, their anemia was mild with no evidence of hepatosplenomegaly. Their Hb level was above 9 g/dL with hypochromic

  19. Anemia em crianças indígenas da etnia Karapotó Anemia in indigenous children of Karapotó ethnic backgrounds

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    Janaína Ferro Pereira

    2012-12-01

    Full Text Available OBJETIVOS: identificar a prevalência e fatores associados à anemia em crianças indígenas Karapotó. MÉTODOS: estudo transversal em que foi realizada dosagem de hemoglobina com fotômetro portátil Hemocue, coletadas medidas de peso e estatura e dados socioeconômicos de 99 crianças de 6 a 59 meses da etnia karapotó. Foi analisada a associação entre a prevalência de anemia e variáveis referentes às crianças, às mães e às famílias utilizando teste qui-quadrado ou teste exato de Fisher. RESULTADOS: a prevalência de anemia nas crianças foi de 57,6%, as prevalências de baixa estatura para idade, baixo peso para estatura e baixo peso para idade entre as crianças foram de 15,6%, 3,0% e 2,0%, respectivamente. A ocorrência de anemia associou-se à menor idade da criança, a um menor tempo de estudo materno, a um maior número de membros da família, à menor posse de itens de consumo e à moradia fora da aldeia (desaldeados. CONSLUSÕES: os resultados evidenciam que a anemia é um grave problema de saúde entre as crianças Karapotó, principalmente naquelas desaldeadas, coexistindo com problemas como sobrepeso e déficit estatural.OBJECTIVES: to identify the prevalence and factors associated with anemia in children of Karapotó ethnic backgrounds. METHODS: a cross-sectional study of hemoglobin dosage levels using a portable Hemocue photometer to collect measurements of weight and height along with socioeconomic data for 99 children between 6 and 59 months of age, all of Karapotó ethnicity. The association between the prevalence of anemia and variables related to children, mothers and families were analyzed, using chi-square tests or Fisher Exact Tests. RESULTS: the prevalence of anemia in the children was 57.6%, the prevalences of low height for age range, low weight-to-height ratios and low weight for age range in the children were 15.6%, 3.0% and 2.0% respectively. The occurrence of anemia was associated with younger children

  20. Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome

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    Bhide, Shreerang A; Ahmed, Merina [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Rengarajan, Vijayan; Powell, Ceri; Miah, Aisha; Newbold, Kate [Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Nutting, Christopher M [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Harrington, Kevin J [Institute of Cancer Research, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom); Head and Neck Unit, Royal Marsden National Health Service Foundation Trust Hospital, London (United Kingdom)], E-mail: kevinh@icr.ac.uk

    2009-02-01

    Purpose: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell cancer of the head and neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. Methods and Materials: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. Results: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), and OS (58% vs. 42% p = 0.005) were significantly better for patients who did not have a transfusion vs. those who did. The LRC, RFS, DSS, and OS were also significantly better for patients with nadir Hb level >12 vs. <12 g/dL and NOUT 1-4 vs. >4. Conclusion: Our study seems to suggest that blood transfusion during radical treatment for SCCHN might be detrimental. Further research should be undertaken into the complex interactions among tumor hypoxia, anemia, and the treatment of anemia before making treatment recommendations.