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1.
BMC Pregnancy Childbirth ; 22(1): 710, 2022 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-36115950

RESUMO

BACKGROUND: Prenatal prescription of standard iron supplements to prevent iron deficiency appears not to be appropriate for all women and their children, as some women may be at risk of iron deficiency and others at risk of iron excess early in pregnancy. The present study aimed to assess whether prenatal iron supplementation adapted to the needs of each pregnant woman affects their child's neurodevelopment. METHODS: Follow-up of a community-based RCT involving 503 mother-child pairs. Non-anaemic pregnant women recruited in Tarragona (Spain) early in pregnancy were prescribed a daily iron dose based on their initial haemoglobin levels: Stratum 1 (Hb = 110-130 g/L, 80 or 40 mg/d of iron) and Stratum 2 (Hb > 130 g/L, 40 or 20 mg/d of iron). Women receiving 40 mg/d were considered the control group in each Strata. The child's neurodevelopment was assessed at 40 days of age using the Bayley Scales of Infant Development-III (BSID-III). Adjusted multiple regression models were used. RESULTS: Multiple regression analyses showed no association between the intervention and control group within each Strata on the BSID-III scores on any of the developmental scales in children, including cognitive, language, and motor development: Stratum 1 (ß 1.46, 95%CI -2.15, 5.07; ß 1.30, 95%CI -1.99, 4.59; and ß 2.04, 95%CI -3.88, 7.96, respectively) and Stratum 2 (ß -4.04, 95%CI -7.27, 0.80; ß -0.36, 95%CI -3.47, 2.75; and ß -3.76, 95%CI -9.30, 1.78, respectively). CONCLUSIONS: In non-anaemic women in early pregnancy, no differences were found in the cognitive, language and motor development of children at 40 days of age between the dose of iron tested in each case -adjusted to initial Hb levels- compared to the dose of the control group. Further studies are guaranteed to confirm our findings. TRIAL REGISTRATION: The ECLIPSES study was registered at www.clinicaltrialsregister.eu as EudraCT number 2012-005,480-28.


Assuntos
Anemia Ferropriva , Complicações Hematológicas na Gravidez , Anemia Ferropriva/prevenção & controle , Suplementos Nutricionais , Feminino , Seguimentos , Hemoglobinas/análise , Humanos , Ferro , Gravidez , Complicações Hematológicas na Gravidez/prevenção & controle , Vitaminas
2.
Trials ; 23(1): 763, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076211

RESUMO

BACKGROUND: Anaemia in pregnancy is highly prevalent in African countries. High-dose oral iron is the current recommended treatment for pregnancy-related iron deficiency anaemia (IDA) in Nigeria and other African countries. This oral regimen is often poorly tolerated and has several side effects. Parenteral iron preparations are now available for the treatment of IDA in pregnancy but not widely used in Africa. The IVON trial is investigating the comparative effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate standard-of-care for pregnancy-related IDA in Nigeria. We will also measure the implementation outcomes of acceptability, feasibility, fidelity, and cost-effectiveness for intravenous ferric carboxymaltose. METHODS: This is an open-label randomised controlled trial with a hybrid type 1 effectiveness-implementation design, conducted at 10 health facilities in Kano (Northern) and Lagos (Southern) states in Nigeria. A total of 1056 pregnant women at 20-32 weeks' gestational age with moderate or severe anaemia (Hb < 10g/dl) will be randomised 1:1 into two groups. The interventional treatment is one 1000-mg dose of intravenous ferric carboxymaltose at enrolment; the control treatment is thrice daily oral ferrous sulphate (195 mg elemental iron daily), from enrolment till 6 weeks postpartum. Primary outcome measures are (1) the prevalence of maternal anaemia at 36 weeks and (2) infant preterm birth (<37 weeks' gestation) and will be analysed by intention-to-treat. Maternal full blood count and iron panel will be assayed at 4 weeks post-enrolment, 36 weeks' gestation, delivery, and 6 weeks postpartum. Implementation outcomes of acceptability, feasibility, fidelity, and cost will be assessed with structured questionnaires, key informant interviews, and focus group discussions. DISCUSSION: The IVON trial could provide both effectiveness and implementation evidence to guide policy for integration and uptake of intravenous iron for treating anaemia in pregnancy in Nigeria and similar resource-limited, high-burden settings. If found effective, further studies exploring different intravenous iron doses are planned. TRIAL REGISTRATION: ISRCTN registry ISRCTN63484804 . Registered on 10 December 2020 Clinicaltrials.gov NCT04976179 . Registered on 26 July 2021 The current protocol version is version 2.1 (080/080/2021).


Assuntos
Anemia Ferropriva , Anemia , Deficiências de Ferro , Nascimento Prematuro , Anemia/diagnóstico , Anemia/tratamento farmacológico , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/tratamento farmacológico , Feminino , Compostos Férricos/efeitos adversos , Humanos , Recém-Nascido , Ferro , Nigéria/epidemiologia , Gravidez , Gestantes , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Nutrients ; 14(17)2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-36079734

RESUMO

Iron is an indispensable nutrient for life. A lack of it leads to iron deficiency anaemia (IDA), which currently affects about 1.2 billion people worldwide. The primary means of IDA treatment is oral or parenteral iron supplementation. This can be burdened with numerous side effects such as oxidative stress, systemic and local-intestinal inflammation, dysbiosis, carcinogenic processes and gastrointestinal adverse events. Therefore, this review aimed to provide insight into the physiological mechanisms of iron management and investigate the state of knowledge of the relationship between iron supplementation, inflammatory status and changes in gut microbiota milieu in diseases typically complicated with IDA and considered as having an inflammatory background such as in inflammatory bowel disease, colorectal cancer or obesity. Understanding the precise mechanisms critical to iron metabolism and the awareness of serious adverse effects associated with iron supplementation may lead to the provision of better IDA treatment. Well-planned research, specific to each patient category and disease, is needed to find measures and methods to optimise iron treatment and reduce adverse effects.


Assuntos
Anemia Ferropriva , Microbioma Gastrointestinal , Deficiências de Ferro , Anemia Ferropriva/complicações , Anemia Ferropriva/tratamento farmacológico , Humanos , Inflamação/complicações , Ferro
4.
Nutrients ; 14(17)2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36079755

RESUMO

Maternal infections, nutrient deficiencies, and inflammation (MINDI) co-exist in lactating indigenous women in Panama, but their impact on maternal iron status and infant growth is unknown. For this secondary analysis of cross-sectional data of lactating mothers from our MINDI cohort, we investigated associations of MINDI variables with maternal anemia, elevated serum transferrin receptor (sTfR), low serum iron, hepcidin, ferritin, and infant weight-for-age (WAZ), length-for-age (LAZ), and head-circumference-for-age (HCAZ) Z-scores in 99 mother-infant dyads. A bootstrapping resampling procedure preselected covariates for inclusion in multivariable regressions models from chronic maternal infections and nutritional status [folate, vitamins A, D, retinol-binding protein (RBP), insulin-growth factor-1 (IGF-1)] and inflammation [C-reactive protein (CRP), cytokines, platelet indices] indicators. Anemia was prevalent (53.5%) but underestimated due to widespread low plasma volume (<2.2 L, 79.9%) and was associated with indicators of malnutrition [lower IGF-1, body mass index (BMI), vitamin D, and intake of green/leafy vegetables], but not inflammation. Higher CRP was associated with lower serum iron, and higher hepcidin and ferritin, whereas maternal platelets were associated with lower HCAZ (ß = -0.22), WAZ (ß = -0.17), and LAZ (ß = -0.17). Higher LAZ was also associated with maternal serum vitamin D (ß = 0.23), whereas maternal iron supplementation lowered LAZ (ß = -0.22). Assessment of iron status in this MINDI cohort is complex and supplementation strategies must consider consequences for both the mother and the infant.


Assuntos
Anemia Ferropriva , Anemia , Desnutrição , Anemia Ferropriva/epidemiologia , Antropometria , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Ferritinas , Hepcidinas , Humanos , Lactente , Inflamação , Fator de Crescimento Insulin-Like I/metabolismo , Ferro , Lactação , Nutrientes , Vitamina D
7.
Br J Hosp Med (Lond) ; 83(8): 1-3, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-36066297

RESUMO

Anaemia affects a third of surgical patients and is associated with increased morbidity and mortality. Iron deficiency is the most common cause of anaemia and can be absolute or functional. Patients may require treatment with oral or intravenous iron.


Assuntos
Anemia Ferropriva , Anemia , Deficiências de Ferro , Administração Intravenosa , Anemia/etiologia , Anemia/terapia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Humanos , Ferro/uso terapêutico
8.
BMJ Paediatr Open ; 6(1)2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-36053597

RESUMO

BACKGROUND: Iron-deficiency anaemia disproportionately affects children in low-income and middle-income areas; Western China is a prime example. Given the health risks associated with childhood anaemia and the large heterogeneity of published studies on this subject, we conducted a systematic review of the evidence regarding anaemia prevalence and associated factors in children under 5 years in Western China. METHODS: We searched for all relevant studies on the prevalence of iron deficiency anaemia in children under 5 years in Western China, obtaining research between 1 January 2011 and 30 June 2021, in English and Chinese from Medline, Embase, PubMed, Web of Science, CNKI, WanFang Data and VIP. Two reviewers independently screened titles and abstracts; three reviewed full texts of relevant articles for data extraction and performed quality assessments. The median prevalence was calculated on unweighted pooling, stratified by region, sex, age and ethnic group. Associated factors and a linear trend chart were conducted to identify trends and research highlights. RESULTS: Among the 55 articles included, most were cross-sectional studies (39, 70.91%). The prevalence of anaemia in children under 5 years in Western China ranged from 3.69% to 75.74% (median 42.54% (IQR 25.62%-52.56%)); the highest levels were in Qinghai province: 59.10%-75.74% (median 67.80% (IQR 64.70%-72.75%)); the highest levels were reported in the subgroup of children aged 6-12 months (median 50.09% (IQR 34.35%-59.04%)). Regional contexts, individual sociodemographic characteristics and feeding behaviours, and nutritional programme interventions were factors associated with anaemia prevalence. CONCLUSION: The prevalence of anaemia in children under 5 years in Western China is concerningly high. For this multiethnic and economically underdeveloped region, more high-quality and prospective studies are needed to inform evidence based and targeted preventive strategies to decrease the high prevalence of anaemia among young children.


Assuntos
Anemia Ferropriva , Anemia , Anemia/epidemiologia , Anemia Ferropriva/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Comportamento Alimentar , Humanos , Prevalência
9.
Nutrients ; 14(15)2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35956390

RESUMO

Iron deficiency is a significant comorbidity of heart failure (HF), defined as the inability of the myocardium to provide sufficient blood flow. However, iron deficiency remains insufficiently detected. Iron-deficiency anemia, defined as a decrease in hemoglobin caused by iron deficiency, is a late consequence of iron deficiency, and the symptoms of iron deficiency, which are not specific, are often confused with those of HF or comorbidities. HF patients with iron deficiency are often rehospitalized and present reduced survival. The correction of iron deficiency in HF patients is associated with improved functional capacity, quality of life, and rehospitalization rates. Because of the inflammation associated with chronic HF, which complicates the picture of nutritional deficiency, only the parenteral route can bypass the tissue sequestration of iron and the inhibition of intestinal iron absorption. Given the negative impact of iron deficiency on HF progression, the frequency and financial implications of rehospitalizations due to decompensation episodes, and the efficacy of this supplementation, screening for this frequent comorbidity should be part of routine testing in all HF patients. Indeed, recent European guidelines recommend screening for iron deficiency (serum ferritin and transferrin saturation coefficient) in all patients with suspected HF, regular iron parameters assessment in all patients with HF, and intravenous iron supplementation in symptomatic patients with proven deficiency. We thus aim to summarize all currently available data regarding this common and easily improvable comorbidity.


Assuntos
Anemia Ferropriva , Insuficiência Cardíaca , Deficiências de Ferro , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etiologia , Doença Crônica , Comorbidade , Compostos Férricos , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Ferro , Maltose , Qualidade de Vida
10.
Medicine (Baltimore) ; 101(33): e30116, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35984149

RESUMO

Patients with isolated leukopenia pose difficulties in diagnosis because there is no related guideline in the literature. In this study, our aim was to evaluate the clinical and laboratory associations of isolated, nonspecific (not related to neutropenia) leukopenia. In this retrospective data review study, patients who were admitted to Hacettepe University Hematology Outpatient Clinic between 2014 and 2019 due to leukopenia were evaluated. The patients with anemia (other than iron deficiency) or thrombocytopenia were excluded. Clinical and laboratory data and the final diagnoses (if present) of the remaining cases and especially of those without neutropenia (the most difficult group to diagnose) were evaluated. One hundred sixty-nine patients were included in the study. One hundred forty-four (85.2%) patients were female and 25 (14.8%) were male. One hundred ten of them had 1500/µL or higher neutrophil count. In these nonneutropenic cases, the etiological factors contributing to leukopenia were as follows: iron deficiency anemia (21.8%), other autoimmune/autoinflammatory diseases (17.3%), autoimmune thyroid disease (21.8%), autoimmune laboratory tests (2.7%), drugs (12.7%), infection (5.5%), hematopoietic disorder (2.7%), hypersplenism (2.7%), radiotherapy sequel (1.8%), and B12 deficiency (1.8%). No etiology was recognized in 44 patients. On the other hand, the etiological factors in patients with neutrophil count <1500/µL were as follows; iron deficiency anemia (10.2%), other autoimmune/autoinflammatory diseases (17%), autoimmune thyroid disease (5.1%), autoimmune laboratory tests (8.5%), drugs (8.5%), infection (6.8%), hematopoietic disorder (11.9%), hypersplenism (1.7%), radiotherapy sequel (1.7%), and B12 deficiency (1.7%). No etiology was recognized in 25 patients. Physicians ordered bone marrow examination more frequently in patients with neutropenia. If isolated antinuclear antibody positivity was also considered in favor of autoimmunity, 91/169 (53.8%) cases had an autoimmune diagnosis or laboratory finding. In the present study, the most frequent reasons of isolated leukopenia in nonneutropenic patients are found as iron deficiency anemia, other autoimmune/autoinflammatory diseases, and autoimmune thyroid disease. In neutropenic patients, the most frequent reasons of isolated leukopenia are found as iron deficiency anemia, autoimmune/autoinflammatory diseases, and hematopoietic disorders. Therefore, autoimmunity is detected as an important factor leading to isolated leukopenia.


Assuntos
Anemia Ferropriva , Anemia , Doenças Autoimunes , Doenças Hereditárias Autoinflamatórias , Hiperesplenismo , Leucopenia , Neutropenia , Trombocitopenia , Doenças da Glândula Tireoide , Anemia/complicações , Anemia Ferropriva/complicações , Doenças Autoimunes/complicações , Feminino , Doenças Hereditárias Autoinflamatórias/complicações , Humanos , Hiperesplenismo/complicações , Leucopenia/etiologia , Masculino , Neutropenia/complicações , Estudos Retrospectivos , Trombocitopenia/complicações , Doenças da Glândula Tireoide/complicações
11.
J Health Popul Nutr ; 41(1): 32, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927693

RESUMO

BACKGROUND: Anaemia in pregnancy is the leading cause of maternal morbidity and mortality and poor birth outcomes in low- and middle-income countries. The most common cause of anaemia during pregnancy is acute blood loss and iron deficiency due to physiological changes and increasing demand for iron on the mother and growing foetus. Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anaemia during pregnancy. The mother's knowledge of anaemia and the benefit of iron-folic acid is crucial in reducing the magnitude of anaemia due to iron deficiency. In Woldia town, despite the efforts made to reduce iron deficiency anaemia during pregnancy, information on pregnant mother knowledge on anaemia and the benefit of iron-folic acid and its associated factors are scarce. METHODS: A facility-based cross-sectional study design was conducted, on 414 pregnant mothers attending antenatal care in Woldia town, Northern Ethiopia. Systematic random sampling methods were used to select study participants. The data were entered into Epi-data version 4.2 and analysed using SPSS version 24. Bivariable and multivariable analysis was done to see the association between the dependent variable and independent variables. RESULTS: This study revealed that 54.1% and 57.7% of pregnant women had good knowledge of anaemia and the benefit of iron-folic acid, respectively. Maternal education status (AOR = 2.19, 95% CI 1.32-3.64), good knowledge of iron-folic acid (AOR = 5.85, 95% CI 3.60-9.50) and residence (AOR = 5.43, 95% CI 2.36-12.51) were statistically associated with pregnant mothers knowledge on anaemia. Obtained counselling on the benefit of iron-folic acid (AOR = 2.04, 95% CI 1.11-3.75), having four or more antenatal care visit (AOR = 3.12, 95% CI 1.38-7.07) and good knowledge of anaemia (AOR = 5.88, 95% CI 3.63-9.50) was statistically associated with pregnant mothers knowledge on the benefit of iron-folic acid. CONCLUSIONS: Promoting frequent antenatal care visits and giving counselling on the benefit of iron-folic acid and cause, prevention and treatment of anaemia were essential strategies to raise knowledge of pregnant mother on anaemia and the benefit of iron-folic acid.


Assuntos
Anemia Ferropriva , Anemia , Deficiências de Ferro , Anemia/prevenção & controle , Anemia Ferropriva/prevenção & controle , Estudos Transversais , Suplementos Nutricionais , Etiópia , Feminino , Ácido Fólico/uso terapêutico , Humanos , Ferro/uso terapêutico , Mães , Gravidez , Cuidado Pré-Natal
12.
Adv Ther ; 39(10): 4678-4691, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35947351

RESUMO

INTRODUCTION: Intravenous (IV) iron is the preferred treatment for patients with iron deficiency anemia (IDA) who require rapid replenishment of iron stores or in whom oral iron is not tolerated or effective. Data from two large-scale randomized controlled trials (RCTs) have recently been published reporting the incidence of adjudicated cardiovascular events after ferric derisomaltose (FDI) and iron sucrose (IS). The objective was to calculate the relative incidence of cardiovascular events with FDI and IS, and to conduct an indirect comparison with ferric carboxymaltose (FCM) based on previously published studies of cardiovascular risk. METHODS: RCTs reporting the incidence of blindly adjudicated cardiovascular events in IDA patients treated with IV iron were identified by systematic literature review (SLR). Pairwise random effects meta-analyses of FDI versus IS, and FCM versus IS were conducted for the pre-specified adjudicated composite cardiovascular endpoint of: death due to any cause, nonfatal myocardial infarction, nonfatal stroke, unstable angina requiring hospitalization, congestive heart failure, arrhythmia, and protocol-defined hypertensive and hypotensive events. Analyses were also conducted for the composite endpoint excluding blood pressure events. Meta-analysis results were combined in an adjusted indirect comparison to provide an indirect estimate of cardiovascular risk with FDI versus FCM. RESULTS: The SLR retrieved 694 unique articles, of which four were RCTs reporting the incidence of the composite cardiovascular endpoint; two studies comparing FCM (N = 1529) with IS (N = 1505), and two studies comparing FDI (N = 2008) with IS (N = 1000). The odds ratios of the composite CV endpoint were 0.59 (95% confidence interval: 0.39-0.90) for FDI versus IS, 1.12 (95% CI 0.90-1.40) for FCM versus IS, and the indirect OR for FDI versus FCM was 0.53 (95% CI 0.33-0.85). CONCLUSIONS: Pooling data from four large-scale RCTs suggested that FDI was associated with significantly lower incidence of cardiovascular adverse events compared to both FCM and IS.


Assuntos
Anemia Ferropriva , Doenças Cardiovasculares , Compostos Férricos , Óxido de Ferro Sacarado , Anemia Ferropriva/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Dissacarídeos , Compostos Férricos/efeitos adversos , Óxido de Ferro Sacarado/efeitos adversos , Insuficiência Cardíaca , Humanos , Incidência , Ferro , Maltose/análogos & derivados , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Sheng Li Xue Bao ; 74(4): 639-647, 2022 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-35993215

RESUMO

Anemia of chronic disease (ACD), complicated by various chronic inflammatory diseases, is the second most prevalent type of anemia after iron deficiency anemia in the world. ACD significantly reduces the life quality of patients with chronic diseases, and represents an independent poor prognostic factor in certain chronic diseases. A large body of studies has demonstrated that most of anemia is related to abnormal iron metabolism. In the past decade, hepcidin, as a key factor in regulating iron metabolism, has attracted enormous attention due to its important role in the pathogenesis of ACD. This article reviews the research progress on the role and underlying regulatory mechanisms of hepcidin in ACD. We also discuss the potential of hepcidin as an effective therapeutic target for ACD treatment, in order to provide a new maneuver for improving the quality of ACD patients' life.


Assuntos
Anemia Ferropriva , Anemia , Anemia Ferropriva/complicações , Anemia Ferropriva/metabolismo , Anemia Ferropriva/patologia , Doença Crônica , Hepcidinas , Humanos , Ferro/metabolismo
14.
Ann Intern Med ; 175(8): JC95, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35914266

RESUMO

SOURCE CITATION: Dave CV, Brittenham GM, Carson JL, et al. Risks for anaphylaxis with intravenous iron formulations: a retrospective cohort study. Ann Intern Med. 2022;175:656-64. 35344378.


Assuntos
Anafilaxia , Anemia Ferropriva , Idoso , Anafilaxia/induzido quimicamente , Dextranos , Óxido de Ferro Sacarado/efeitos adversos , Óxido Ferroso-Férrico/efeitos adversos , Humanos , Ferro/efeitos adversos , Complexo Ferro-Dextran/efeitos adversos , Estudos Retrospectivos
15.
Int J Mol Sci ; 23(15)2022 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-35955421

RESUMO

Hypertension is an important public health challenge, affecting up to 30-50% of adults worldwide. Several epidemiological studies indicate that high blood pressure originates in fetal life-the so-called programming effect or developmental origin of hypertension. Iron-deficiency anemia has become one of the most prevalent nutritional problems globally. Previous animal experiments have shown that prenatal iron-deficiency anemia adversely affects offspring hypertension. However, the underlying mechanism remains unclear. We used a maternal low-iron diet Sprague Dawley rat model to study changes in blood pressure, the renal renin-angiotensin system, oxidative stress, inflammation, and sodium transporters in adult male offspring. Our study revealed that 16-week-old male offspring born to mothers with low dietary iron throughout pregnancy and the lactation period had (1) higher blood pressure, (2) increased renal cortex angiotensin II receptor type 1 and angiotensin-converting enzyme abundance, (3) decreased renal cortex angiotensin II receptor type 2 and MAS abundance, and (4) increased renal 8-hydroxy-2'-deoxyguanosine and interleukin-6 abundance. Improving the iron status of pregnant mothers could influence the development of hypertension in their offspring.


Assuntos
Anemia Ferropriva , Hipertensão , Deficiências de Ferro , Efeitos Tardios da Exposição Pré-Natal , Anemia Ferropriva/metabolismo , Animais , Pressão Sanguínea , Feminino , Hipertensão/metabolismo , Ferro/metabolismo , Ferro na Dieta/metabolismo , Rim/metabolismo , Lactação , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Estresse Oxidativo , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores de Angiotensina/metabolismo , Sistema Renina-Angiotensina
16.
Sci Rep ; 12(1): 13978, 2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-35978001

RESUMO

Anemia and iron deficiency (ID) are common in patients with heart failure (HF) and intravenous (IV) administration of iron to patients hospitalized for decompensated HF with ID improves outcome. The diagnosis of ID in routine practice is based on serum ferritin and transferrin saturation (TSAT) but both have limitations; alternatives should be considered. Reticulocyte hemoglobin equivalent (Ret-He) reflects iron content in reticulocytes but its clinical utility in patients with HF remains uncertain. We prospectively enrolled 142 patients hospitalized for decompensated HF. Sixty five percent had ID as defined in current international guidelines. Ret-He was directly correlated with serum iron and ferritin concentrations and with TSAT. There was a poor relationship between quartile of Ret-He and HF hospitalization or death but increases or decreases in Ret-He between admission and discharge were associated with a worse outcome. The clinical utility of Ret-He for identifying ID and predicting response to IV iron and prognosis for patients with HF requires further investigation.


Assuntos
Anemia Ferropriva , Insuficiência Cardíaca , Deficiências de Ferro , Anemia Ferropriva/diagnóstico , Ferritinas , Insuficiência Cardíaca/diagnóstico , Hemoglobinas/análise , Humanos , Ferro , Curva ROC , Reticulócitos
17.
Perm J ; 26(2): 138-143, 2022 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-35933679

RESUMO

Introduction Osler-Weber-Rendu syndrome, or hereditary hemorrhagic telangiectasia, is a rare genetic disease that causes recurrent epistaxis and anemia. Numerous bleeding vascular malformations can be found throughout the body. Case presentation A 75-year-old woman presented to her hematologist with recurrent epistaxis, iron deficiency anemia, menorrhagia, and hypothyroidism. Her mother had similar nosebleeds, and physical examination revealed small vascular malformations on the conjunctiva, oropharynx, tongue, lip, and palate. Heavy epistaxis occurred several times per week. Multiple nasal and gastrointestinal endoscopic procedures were performed. She received over 100 iron infusions and multiple blood transfusions. Overall treatment involved integrated care with multiple medical specialties. Conclusion Hereditary hemorrhagic telangiectasia and other complex diseases are best treated with a multidisciplinary approach within an integrated health care setting.


Assuntos
Anemia Ferropriva , Anemia , Telangiectasia Hemorrágica Hereditária , Idoso , Transfusão de Sangue , Epistaxe/diagnóstico , Epistaxe/etiologia , Epistaxe/terapia , Feminino , Humanos , Telangiectasia Hemorrágica Hereditária/complicações , Telangiectasia Hemorrágica Hereditária/diagnóstico
18.
BMC Public Health ; 22(1): 1478, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922790

RESUMO

BACKGROUND: Anemia is a significant public health challenge that affects the population of all nations. Anemia among adolescents emerged as an alarming public health issue as it harms an individual's physical capacity and cognitive and work performance. The study aims to determine the effect of changes in individual and household level factors on the prevalence of anemia among adolescent boys and girls. METHOD: The study utilized data from two waves of the "Understanding the lives of adolescent and young adults" (UDAYA) survey, conducted in Bihar and Uttar Pradesh during 2015-16 (wave-1) and 2018-19 (wave-2). The sample size for the present study was 4216 and 5974 unmarried adolescent boys and girls aged 10-19 years in both waves. We performed descriptive analysis to observe the characteristics of adolescents during 2015-16. Further, changes in selected independent variables from wave-1 to wave-2 were examined using the proportion test. Moreover, random-effect regression models were employed to examine the association of changes in individual and household level factors with anemia prevalence among adolescents. RESULTS: The prevalence of anemia decreased over time among adolescent boys (33 to 30%), whereas it increased among adolescent girls (59 to 63%). The results from the random-effect model show that adolescent boys who used shared toilets were more anemic than those who used a private restroom [ß:0.05, 95% CI:(0.01, 0.08)]. Moreover, underweight [ß:0.05, CI:(0.01, 0.09)] and thin [ß:0.04, CI:(0.00, 0.07)] adolescent boys were more likely to be anemic compared to their normal counterparts. Additionally, boys who belonged to the poorest [ß:0.08, CI:(0.02, 0.14)] households had a higher risk of anemia than the richest household. CONCLUSION: The anemia prevalence was higher among adolescents aged 10-19 years in Uttar Pradesh and Bihar. This study has filled an information gap by providing state-level representative estimates indicating underweight status and thinness as the common factors behind the anemia prevalence among adolescent boys than in girls. Iron deficiency anemia is the most prevalent in certain age groups in India. Hence, Anemia prevention efforts and iron-folic acid (IFA) supplementation programs are currently being strengthened in India, targeting the high-risk population.


Assuntos
Anemia Ferropriva , Anemia , Adolescente , Anemia/epidemiologia , Anemia Ferropriva/epidemiologia , Feminino , Ácido Fólico , Humanos , Masculino , Prevalência , Magreza/epidemiologia , Adulto Jovem
20.
Isr Med Assoc J ; 24(8): 497-502, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35972006

RESUMO

BACKGROUND: One of the main causes of iron deficiency anemia (IDA) is chronic gastrointestinal blood loss. The use of video capsule endoscopy (VCE) after negative bidirectional endoscopy in patients with IDA is controversial. OBJECTIVES: To evaluate the effect of VCE in the management and long-term outcomes of IDA patients. METHODS: A retrospective case-control study was performed on all patients with IDA undergoing VCE over a 5-year period. We compared those with positive findings on VCE to those with normal findings. All participants previously underwent a negative bidirectional endoscopy. RESULTS: We performed 199 VCE examinations; median follow-up time was 4 years (IQR 2-5). Positive findings were identified in 66 patients (diagnostic yield 33.2%). Double balloon enteroscopy or push enteroscopy was performed in eight patients (18.6%); only one was therapeutic. The main therapy in both groups was iron supplementation. There were no significant differences in iron treatment before and after VCE in each group and between groups. Anemia improved in both groups. There was no difference in the level of hemoglobin change between the groups during each year of follow-up compared to the baseline level prior to VCE. Anemia resolved in 15 patients (35%) in the positive VCE group and in 19 (45%) in the negative VCE group (P = 0.33). CONCLUSIONS: Positive findings on VCE led to subsequent endoscopic interventions only in a small percentage of patients with IDA. Anemia improved and resolved equally whether or not there were VCE findings. The main intervention that appears to help IDA is iron supplementation.


Assuntos
Anemia Ferropriva , Endoscopia por Cápsula , Deficiências de Ferro , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/etiologia , Endoscopia por Cápsula/efeitos adversos , Estudos de Casos e Controles , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Intestino Delgado , Ferro , Estudos Retrospectivos
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