Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.568
Filtrar
2.
Monaldi Arch Chest Dis ; 90(1)2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32124586

RESUMO

Iron deficiency (ID) is recognized as an important comorbidity in patients undergoing cardiac surgery; however, it still remains under-diagnosed and under-treated in clinical practice. This study aims at comparing efficacy and the effects on exercise capacity of intravenous ferric carboxymaltose (FCM) versus ferric gluconate (FG) in patients with ID anemia (IDA) resulting from cardiac surgery. We retrospectively analyzed data from our records of in-hospital patients with IDA after cardiac surgery undergoing cardiac rehabilitation. Group I was treated with FG, group II with FCM. Efficacy measures included changes (baseline vs discharge) in hemoglobin (Hb) and in distance traveled at six-minutes walking test (6MWT). Data from 74 in-patients (mean age 67.5±10.4 years, 43% women) were analyzed. At discharge, patients treated with FCM showed higher levels of Hb (11.1±1.2g/dl vs 10.2±1.1 g/dl; p=0.001), greater distance traveled at 6MWT (279.2±108.8 meters vs 236.3±72.7 meters; p=0.048), and lower in-hospital rehabilitation length of stay (20.3±7 vs 25.3±11.7 days; p=0.043) as compared to FG group. At multivariate analysis, the most powerful predictors of Hb increase >1 g/dl at discharge were transferrin levels (p=0.019) and treatment with FCM (p<0.001). FCM replacement therapy and iron serum levels were the most powerful predictors of 6MWT distance improvement (>100 meters) at discharge (p=0.13 and p=0.003, respectively). In patients with IDA following cardiac surgery, intravenous FCM is effective in restoring Hb levels and in improving exercise capacity after cardiac surgery.


Assuntos
Anemia Ferropriva/tratamento farmacológico , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Tolerância ao Exercício , Compostos Férricos/uso terapêutico , Hematínicos/uso terapêutico , Maltose/análogos & derivados , Idoso , Anemia Ferropriva/etiologia , Feminino , Humanos , Infusões Intravenosas , Masculino , Maltose/uso terapêutico , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
3.
PLoS One ; 15(2): e0218695, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32097440

RESUMO

BACKGROUND: Severe anaemia is a major cause of morbidity and mortality in HIV-infected adults living in resource-limited countries. Comprehensive data on the aetiology are lacking but are needed to improve outcomes. METHODS: HIV-infected adults with severe (haemoglobin ≤70g/l) or very severe anaemia (haemoglobin ≤ 50 g/l) were recruited at Queen Elizabeth Central Hospital, Blantyre, Malawi. Fifteen potential causes and associations with anaemia severity and mortality were explored. RESULTS: 199 patients were enrolled: 42.2% had very severe anaemia and 45.7% were on ART. More than two potential causes for anaemia were present in 94% of the patients including iron deficiency (55.3%), underweight (BMI<20: 49.7%), TB infection (41.2%) and unsuppressed HIV infection (viral load >1000 copies/ml) (73.9%). EBV/CMV co-infection (16.5%) was associated with very severe anaemia (OR 2.8 95% CI 1.1-6.9). Overall mortality was high (53%; 100/199) with a median time to death of 17.5 days (IQR 6-55) days. Death was associated with folate deficiency (HR 2.2; 95% CI 1.2-3.8) and end stage renal disease (HR 3.2; 95% CI 1.6-6.2). CONCLUSION: Mortality among severely anaemic HIV-infected adults is strikingly high. Clinicians should be aware of the urgent need for a multifactorial approach including starting or optimising HIV treatment, considering TB treatment, nutritional support and optimising renal management.


Assuntos
Anemia Ferropriva/etiologia , Infecções por HIV/complicações , Infecções por Herpesviridae/complicações , Desnutrição/complicações , Mortalidade , Tuberculose/complicações , Adulto , Anemia Ferropriva/complicações , Anemia Ferropriva/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por Herpesviridae/epidemiologia , Humanos , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Tuberculose/epidemiologia
5.
Chemosphere ; 243: 125428, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31995880

RESUMO

Toxic elements exposure disturbs the homeostasis of essential elements in organisms, but the mechanism remains elusive. In this study, we demonstrated that Drosophila melanogaster exposed to Lead (Pb, a pervasive environmental threat to human health) exhibited various health defects, including retarded development, decreased survival rate, impaired mobility and reduced egg production. These phenotypes could be significantly modulated by either intervention of dietary iron levels or altering expression of genes involved in iron metabolism. Further study revealed that Pb exposure leads to systemic iron deficiency. Strikingly, reactive oxygen species (ROS) clearance significantly increased iron uptake by restoring the expression of iron metabolism genes in the midgut and subsequently attenuated Pb toxicity. This study highlights the role of ROS in Pb induced iron dyshomeostasis and provides unique insights into understanding the mechanism of Pb toxicity and suggests ideal ways to attenuate Pb toxicity by iron supplementation therapy or ROS clearance.


Assuntos
Anemia Ferropriva/etiologia , Drosophila melanogaster/metabolismo , Chumbo/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Anemia Ferropriva/induzido quimicamente , Animais , Dieta , Drosophila melanogaster/efeitos dos fármacos , Homeostase , Humanos , Ferro/metabolismo , Chumbo/metabolismo , Espécies Reativas de Oxigênio/metabolismo
7.
Turk J Pediatr ; 61(1): 102-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559729

RESUMO

Mantadakis E, Zikidou P, Tsouvala E, Thomaidis S, Chatzimichael A. Severe iron deficiency anemia and anasarca edema due to excessive cow`s milk intake. Turk J Pediatr 2019; 61: 102-106. The authors describe a 13-month-old girl who presented with progressively worsening anasarca edema that developed over the last three weeks along with increasing fatigue. Over the last several months she was consuming progressively increasing amounts of fresh cow`s milk. Laboratory examinations on admission showed severe microcytic and hypochromic anemia (hemoglobin 3.8 g/dl) and hypoferritenemia indicative of iron deficiency, while urinalyses showed no proteinuria. The child was transfused with 13ml/kg packed red blood cells and approximately 2g/kg intravenous albumin. On the second and fourth hospital days, she received 100 mg of iron sucrose intravenously that she tolerated well. Eight months after the described events, she is healthy with normal hemoglobin for age, while she has no laboratory evidence of cow`s milk protein allergy. Pediatricians should be aware of the association of severe iron deficiency anemia (IDA) and anasarca edema, and should screen infants in their practice for anemia at the age of 12 months or sooner, if risk factors are present.


Assuntos
Anemia Ferropriva/etiologia , Edema/etiologia , Leite/efeitos adversos , Anemia Ferropriva/diagnóstico , Animais , Fadiga/etiologia , Feminino , Humanos , Lactente
8.
Nutrients ; 11(9)2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31480641

RESUMO

: Dietary iron deficiency (ID) is the first nutritional deficiency in the world, in terms of disability adjusted life years (DALY). This nutritional deficiency may lead to anemia, especially among children, adolescents, and adult women. The aim of this study was to build an original probabilistic model to quantitatively assess the ID, the iron deficiency anemia (IDA) and the subsequent health burden in France expressed in DALY, per age class and gender. The model considered the distribution of absorbed iron intake, the iron requirement distribution established by the European Food Safety Authority and the iron status in France. Uncertainty due to lack of data and variability due to biological diversity were taken into account and separated using a second-order Monte Carlo procedure. A total of 1290 (95% CI = 1230-1350) IDA cases corresponding to 16 (95% CI = 11-20) DALY were estimated per 100,000 individuals per year. The major contributors to IDA burden were menstruating females aged from 25 to 44 years old. Then, a consumption scenario was built with ground beef as intake, an increase in red meat consumption to 100 g/d would not eliminate entirely the IDA burden. The quantitative methodology applied here for France could be reused for other populations.


Assuntos
Anemia Ferropriva/epidemiologia , Ferro na Dieta/análise , Modelos Estatísticos , Adolescente , Adulto , Anemia Ferropriva/etiologia , Criança , Efeitos Psicossociais da Doença , Feminino , França/epidemiologia , Humanos , Masculino , Estado Nutricional , Prevalência , Fatores de Risco
10.
BMJ Case Rep ; 12(9)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31519723

RESUMO

Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described. We report the case of 38-year-old woman who became pregnant shortly after insertion of the IUCD 6 years prior to presentation. She delivered vaginally and 'expulsion' of the device was assumed. Some 4 years later, she had another IUCD inserted and remained asymptomatic till she recently presented with iron-deficiency anaemia. As part of the investigation, diagnostic colonoscopy was performed. Surprisingly, the old IUCD was found penetrating into the midrectum. Uneventful endoscopic removal was performed and she remained well at 3-month follow-up. Migrating IUCD remains asymptomatic and may be discovered accidentally during routine investigation for some other symptoms.


Assuntos
Anemia Ferropriva/etiologia , Migração de Dispositivo Intrauterino/efeitos adversos , Dispositivos Intrauterinos/efeitos adversos , Reto/diagnóstico por imagem , Adulto , Anemia Ferropriva/diagnóstico , Colonoscopia/métodos , Endoscopia/métodos , Feminino , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Achados Incidentais , Resultado do Tratamento
11.
J Vet Intern Med ; 33(5): 1964-1969, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31381197

RESUMO

BACKGROUND: Video capsule endoscopy (VCE) is a noninvasive imaging modality that can identify mucosal lesions not detected with traditional endoscopy or abdominal sonography. In people, VCE is used in diagnostic and management protocols of various gastrointestinal (GI) disorders, particularly in GI bleeding of obscure origin or unexplained iron deficiency anemia (IDA). OBJECTIVE: To evaluate the utility of VCE in the identification of mucosal lesions in dogs with evidence of GI hemorrhage. ANIMALS: Sixteen client-owned dogs that underwent VCE. METHODS: Retrospective case-control study. Medical records were reviewed to include dogs with microcytosis, low normal mean corpuscular volume, or clinical GI bleeding that received VCE. RESULTS: Median age of dogs was 8.7 years (range, 8 months to 15 years) with a median weight of 21.7 kg (range, 6.9-62.5 kg). Abdominal ultrasound (16), abdominal radiography (4), and abdominal CT (1) did not identify a cause for GI blood loss. Gastric mucosal lesions were identified by VCE in 15 of 16 dogs and small intestinal lesions in 12 of 14 dogs, with 2 capsules remaining in the stomach. Endoscopy was performed in 2 dogs before VCE; 1 dog had additional small intestinal lesions identified through the use of VCE. CONCLUSIONS AND CLINICAL IMPORTANCE: Video capsule endoscopy is a minimally invasive diagnostic tool that can identify GI lesions in dogs presenting with microcytosis with or without GI hemorrhage when ultrasonography is inconclusive; however, the majority of lesions identified would have been apparent with conventional endoscopy.


Assuntos
Endoscopia por Cápsula/veterinária , Doenças do Cão/diagnóstico por imagem , Índices de Eritrócitos/veterinária , Hemorragia Gastrointestinal/veterinária , Anemia Ferropriva/etiologia , Animais , Endoscopia por Cápsula/métodos , Estudos de Casos e Controles , Cães , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Trato Gastrointestinal/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Masculino , Estudos Retrospectivos
13.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31413181

RESUMO

Scurvy is a rare disease in developed nations. In the field of pediatrics, it primarily is seen in children with developmental and behavioral issues, malabsorptive processes, or diseases involving dysphagia. We present the case of an otherwise developmentally appropriate 4-year-old boy who developed scurvy after gradual self-restriction of his diet. He initially presented with a limp and a rash and was subsequently found to have anemia and hematuria. A serum vitamin C level was undetectable, and after review of the MRI of his lower extremities, the clinical findings supported a diagnosis of scurvy. Although scurvy is rare in developed nations, this diagnosis should be considered in a patient with the clinical constellation of lower-extremity pain or arthralgias, a nonblanching rash, easy bleeding or bruising, fatigue, and anemia. This case highlights the importance of carefully assessing a child's dietary and developmental status at well-child visits, which can help avoid a more invasive workup.


Assuntos
Dieta/efeitos adversos , Escorbuto/etiologia , Anemia Ferropriva/etiologia , Ácido Ascórbico/sangue , Pré-Escolar , Exantema/etiologia , Hematúria/etiologia , Humanos , Extremidade Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Escorbuto/diagnóstico por imagem , Deficiência de Vitamina D/etiologia
14.
Int J Mol Sci ; 20(17)2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31461904

RESUMO

In patients with chronic kidney disease (CKD), adverse outcomes such as systemic inflammation and anemia are contributing pathologies which increase the risks for cardiovascular mortality. Amongst these complications, abnormalities in mineral metabolism and the metabolic milieu are associated with chronic inflammation and iron dysregulation, and fibroblast growth factor 23 (FGF23) is a risk factor in this context. FGF23 is a bone-derived hormone that is essential for regulating vitamin D and phosphate homeostasis. In the early stages of CKD, serum FGF23 levels rise 1000-fold above normal values in an attempt to maintain normal phosphate levels. Despite this compensatory action, clinical CKD studies have demonstrated powerful and dose-dependent associations between FGF23 levels and higher risks for mortality. A prospective pathomechanism coupling elevated serum FGF23 levels with CKD-associated anemia and cardiovascular injury is its strong association with chronic inflammation. In this review, we will examine the current experimental and clinical evidence regarding the role of FGF23 in renal physiology as well as in the pathophysiology of CKD with an emphasis on chronic inflammation and anemia.


Assuntos
Anemia Ferropriva/metabolismo , Fatores de Crescimento de Fibroblastos/metabolismo , Insuficiência Renal Crônica/metabolismo , Anemia Ferropriva/etiologia , Anemia Ferropriva/patologia , Animais , Hepcidinas/metabolismo , Humanos , Inflamação/metabolismo , Ferro/metabolismo , Receptores de Fatores de Crescimento de Fibroblastos/metabolismo , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/patologia
15.
BMJ Case Rep ; 12(7)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31371333

RESUMO

A 73-year-old man with an 8-week history of angina underwent an exercise tolerance test at the rapid access clinic, which indicated inducible ischaemia and he was subsequently referred for angiogram. His angiogram demonstrated no coronary pathology. It was later discovered that bloods taken on the day of the procedure showed a haemoglobin of 54 g/L (130-180 g/L). His haemoglobin used to book the angiogram 3 months before was 143 g/L. Following angiogram, a mass was identified in the right iliac fossa and CT scan confirmed a caecal tumour. The patient ultimately underwent a curative right hemicolectomy as an outpatient. The case is a reminder of the importance of basic preangiogram investigations, in particularly a full blood count, to rule-out angina secondary to anaemia through a low haemoglobin. Most importantly, it also questions when the appropriate time is for these investigations to be carried out, prior to coronary angiography.


Assuntos
Anemia Ferropriva/diagnóstico , Angina Pectoris/diagnóstico , Neoplasias do Ceco/diagnóstico , Idoso , Anemia Ferropriva/etiologia , Angina Pectoris/etiologia , Neoplasias do Ceco/complicações , Diagnóstico Diferencial , Humanos , Masculino
17.
Dtsch Med Wochenschr ; 144(14): 969-977, 2019 07.
Artigo em Alemão | MEDLINE | ID: mdl-31311047

RESUMO

In recent years, considerable progress has been made in the detection and treatment of iron deficiency. The results are also relevant for many specialist areas and, in particular, for patients with chronic inflammatory diseases. In daily practice, iron deficiency is often neither identified nor consistently treated.An iron deficiency can - even before anaemia occurs - reduce the quality of life and influence the course of the underlying disease. In patients with chronic diseases , the iron status should be monitored regularly. Especially, the currently available oral iron preparations for these patients are inefficient, because of the limitated tolerability and, furthermore, because of restricted enteral iron uptake due to inflammation. For this reason, various guidelines recommend intravenous iron substitution.


Assuntos
Anemia Ferropriva , Doença Crônica , Inflamação , Ferro , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Humanos , Inflamação/complicações , Inflamação/fisiopatologia , Ferro/administração & dosagem , Ferro/uso terapêutico , Qualidade de Vida
18.
Pak J Pharm Sci ; 32(3): 1091-1095, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31278724

RESUMO

Iron deficiency anemia (IDA) is one of the foremost health issues among women of reproductive age. The study highlights to assess the level of awareness about the causes, symptoms, prevention and treatment of IDA among women of reproductive age in district Bahawalpur, province Punjab, Pakistan. A randomized study was conducted by using a self-designed standardized questionnaire disseminated to the hostels of female residents and homes in the immediate vicinity of Islamia University Bahawalpur. Females aged 18-45 years without any previous history of medical or gynecological problems were enlisted. A total number of 200 women were surveyed for awareness of iron deficiency anemia. Seventy three percent (73%) of women (n=146) were aware of the term IDA with the highest proportion of women falling in the age bracket 20-35 years. Most (66.9%) of the women were aware of the fact that their diet contains iron and its importance in health. It is concluded that, in reproductive age women the IDA can be prevented and treated through proper guidance and awareness through education.


Assuntos
Anemia Ferropriva , Conhecimentos, Atitudes e Prática em Saúde , Ferro na Dieta/administração & dosagem , Adolescente , Adulto , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/terapia , Dieta , Suplementos Nutricionais , Escolaridade , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão , Gravidez , Inquéritos e Questionários , Adulto Jovem
19.
N Z Med J ; 132(1499): 72-75, 2019 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-31352477

RESUMO

Iron-induced hypophosphatemia represents an increasingly recognised complication of iron infusion. A 34-year-old woman presented for surgical management of her colorectal cancer. Post-operative blood tests revealed severe hypophosphatemia, resistant to oral phosphate supplementation and large volumes of intravenous phosphate replacement. Further questioning and biochemical investigation led to the recognition of iron-induced hypophosphatemia as a contributory cause, secondary to iron infusion administered as part of pre-operative optimisation. Early consideration, diagnosis and management of this complication has the potential to reduce fluid burden associated with intravenous phosphate supplementation and optimise post-operative care.


Assuntos
Cirurgia Colorretal , Hipofosfatemia/induzido quimicamente , Ferro/efeitos adversos , Adulto , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Calcitriol/uso terapêutico , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Feminino , Humanos , Hipofosfatemia/tratamento farmacológico , Ferro/uso terapêutico , Vitamina D/análogos & derivados , Vitamina D/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA