Effect of Deferoxamine on Post-Transfusion Iron, Inflammation, and In Vitro Microbial Growth in a Canine Hemorrhagic Shock Model: A Randomized Controlled Blinded Pilot Study.

Red blood cell (RBC) transfusion is associated with recipient inflammation and infection, which may be triggered by excessive circulating iron. Iron chelation following transfusion may reduce these risks. The aim of this study was to evaluate the effect of deferoxamine on circulating iron and inflammation biomarkers over time and in vitro growth of Escherichia coli (E. coli) following RBC transfusion in dogs with atraumatic hemorrhage. Anesthetized dogs were subject to atraumatic hemorrhage and transfusion of RBCs, then randomized to receive either deferoxamine or saline placebo of equivalent volume (n = 10 per group) in a blinded fashion. Blood was sampled before hemorrhage and then 2, 4, and 6 h later. Following hemorrhage and RBC transfusion, free iron increased in all dogs over time (both p < 0.001). Inflammation biomarkers interleukin-6 (IL6), CXC motif chemokine-8 (CXCL8), interleukin-10 (IL10), and keratinocyte-derived chemokine (KC) increased in all dogs over time (all p < 0.001). Logarithmic growth of E. coli clones within blood collected 6 h post-transfusion was not different between groups. Only total iron-binding capacity was different between groups over time, being significantly increased in the deferoxamine group at 2 and 4 h post-transfusion (both p < 0.001). In summary, while free iron and inflammation biomarkers increased post-RBC transfusion, deferoxamine administration did not impact circulating free iron, inflammation biomarkers, or in vitro growth of E. coli when compared with placebo.

Molecular Detection and Epidemiological Features of Selected Bacterial, Viral, and Parasitic Enteropathogens in Stool Specimens from Children with Acute Diarrhea in Thi-Qar Governorate, Iraq.

Knowledge of etiology causes of diarrheal illness is essential for development and implementation of public health measures to prevent and control this disease syndrome. There are few published studies examining diarrhea in children aged <5 years in Iraq. This study aims to investigate the occurrences and epidemiology of selected bacterial (Salmonella spp. and Campylobacter spp.), viral (adenovirus, norovirus GI and GII, and astrovirus), and parasitic (Entamoeba spp. and Giardia spp.) agents in stool samples from 155 child diarrheal cases enrolled between March and August 2017, in a hospital-based cross-sectional study in Thi-Qar, southeastern Iraq. Using molecular techniques and sequence-based characterization, adenovirus was the most frequently detected enteropathogen (53/155 (34.2%)), followed by Salmonella spp. (23/155 (14.8%)), Entamoeba spp. (21/155 (13.5%)), and Campylobacter spp. (17/155 (10.9%)). Mixed infection with Salmonella spp. and Campylobacter spp. was evident, and the same was revealed between various enteric viruses, particularly adenovirus and norovirus. The most frequent co-infection pattern was between adenovirus and Campylobacter spp., in seven cases (7/155 (4.5%)). Whole-genome sequencing-derived typing data for Salmonella isolates (n = 23) revealed that sequence type 49 was the most prevalent in this sample set (15/23 (65.2%)). To the best of our knowledge, this study provides the first report on detection and identification of floR, blaCARB-2, and mphA antimicrobial resistance genes in Salmonella isolated from children in the Middle East region. Logistic regression analysis pointed to few enteropathogen-specific correlations between child age, household water source, and breastfeeding patterns in relation to the outcome of detection of individual enteropathogens. This study presents the first published molecular investigation of multiple enteropathogens among children <5 years of age in Iraq. Our data provide supporting evidence for planning of childhood diarrhea management programs. It is important to build on this study and develop future longitudinal case-control research in order to elaborate the epidemiology of enteropathogens in childhood diarrhea in Iraq.

A Correlational Study of Spiritual Well-being and Depression in the Adult Cancer Patient.

Depression in adult cancer patients has been widely studied, along with spiritual effects of traumatic events and even spiritual growth after a diagnosis of cancer. There has been limited research determining a direct correlation between spiritual well-being and depression in adult cancer patients. The purpose of this research study was to examine the relationship between spiritual well-being and depression in adult cancer patients. This was a descriptive correlational study using 59 patients older than 18 years from an outpatient cancer center. The researchers hypothesized that patients with a low spiritual well-being score would be more likely to have a high depressive symptom score, thus providing support for a correlation between cancer patient's spiritual well-being and risk of depression. Implications of this study lead to evidence for better screening processes for cancer patients regarding spiritual well-being.

Blood Arsenic and Cadmium Concentrations in End-Stage Renal Disease Patients who were on Maintenance Haemodialysis.

BACKGROUND: In India, there is a rising burden of chronic diseases like hypertension and diabetes. It has been estimated that 25-40% of these patients are likely to develop chronic kidney disease (CKD), with a significant percentage requiring renal replacement therapy. Haemodialysis is the most common method which is used to treat advanced and permanent kidney failure. Derangements in the metabolism of several toxic and trace elements such as antimony, arsenic cadmium, molybdenum, nickel, and selenium have been reported for several decades in patients with chronically reduced renal functions. Overall, the available literature suggests that the blood levels of some elements such as cadmium, chromium, fluorine, iodine, lead, or vanadium are high in end-stage renal disease (ESRD). AIM AND OBJECTIVES: Our aim was to study the levels of blood arsenic and cadmium in ESRD patients who were on maintenance haemodialysis (MHD), and to study whether there was any relationship between their concentrations and the duration of the MHD. METHODS: The blood lead levels were determined in 50 healthy subjects with normal renal functions and in 50 patients with ESRD, who were on MHD. None of them had any history of smoking or any industrial exposure. RESULTS: The results of the study revealed that the blood arsenic and cadmium concentrations were higher in the ESRD patients who were on MHD than in the healthy adults. The blood arsenic and cadmium concentrations were found to increase with the duration of the MHD. CONCLUSION: The mild increase in the blood arsenic and cadmium concentrations, with an increase in the duration of the MHD in the study population, may be viewed in the wider context, that a prolonged exposure to arsenic and cadmium, even at low levels, may result in renal damage and/or progression of an already existing CKD.

Blood Lead in End-Stage Renal Disease (ESRD) Patients who were on Maintainence Haemodialysis.

BACKGROUND: In India, there is rising burden of chronic diseases like hypertension and diabetes. It has been estimated that 25-40% of these patients are likely to develop CKD, with a significant percentage requiring renal replacement therapy. Haemodialysis is the most common method which is used to treat advanced and permanent kidney failure. The derangements in the metabolism of several toxic and trace elements such as antimony, arsenic, cadmium, molybdenum, nickel, and selenium have been reported for several decades in patients with chronically reduced renal function. Overall, the available literature suggests that the blood levels of some elements such as cadmium, chromium, fluorine, iodine, lead and vanadium are high in ESRD. AIM AND OBJECTIVES: Our aim was to study the levels of blood lead in the End-Stage Renal Disease (ESRD) patients who were on Maintenance Haemodialysis (MHD), and to study whether there was any relationship between the blood lead concentration and the duration of MHD. METHODS: The blood lead level was determined in 50 healthy subjects with normal renal function and in 50 patients with ESRD who were on MHD. None of them had a history of smoking or any industrial exposure. RESULTS: The results of this study revealed that the blood lead level was higher in the ESRD patients who were on MHD than in the healthy adults. The blood lead concentration was found to increase with the duration of the MHD. CONCLUSION: The mild increase in the blood lead level with an increase in the duration of MHD in the study population, may be viewed in the wider context that the prolonged exposure to lead, even at low levels may result in CKD by causing interstitial nephritis, hypertension, hyperuricaemia, an increased incidence of hypertension, cerebrovascular disease and cardiovascular disease or the progression of an already existing CKD.