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1.
Ren Fail ; 44(1): 1112-1122, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35912897

RESUMO

BACKGROUND: Hyperphosphatemia and anemia, which are common complications of chronic kidney disease (CKD), can independently contribute to cardiovascular events. Several previous studies have found that the iron-based phosphate binder, ferric citrate (FC), could be beneficial to both hyperphosphatemia and anemia. METHODS: Relevant literature from PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials (CCRCT) and MEDLINE databases were searched up to 21 February 2022, in order to conduct a meta-analysis to investigate the efficacy, safety and economic benefits of ferric citrate treatment in CKD patients with hyperphosphatemia and anemia. The meta-analysis was conducted independently by two reviewers using the RevMan software (version 5.3). RESULTS: In total, this study included 16 randomized clinical trials (RCT) involving 1754 participants. The meta-analysis showed that ferric citrate could significantly reduce the serum phosphorus in CKD patients compared to the placebo control groups (MD -1.76 mg/dL, 95% CI (-2.78, -0.75); p = 0.0007). In contrast, the difference between ferric citrate treatment and active controls, such as non-iron-based phosphate binders, sevelamer, calcium carbonate, lanthanum carbonate and sodium ferrous citrate, was not statistically significant (MD - 0.09 mg/dL, 95% CI (-0.35, 0.17); p = 0.51). However, ferric citrate could effectively improve hemoglobin levels when compared to the active drug (MD 0.43 g/dL, 95% CI (0.04, 0.82); p = 0.03) and placebo groups (MD 0.39 g/dL, 95% CI (0.04, 0.73); p = 0.03). According to eight studies, ferric citrate was found to be cost-effective treatment in comparison to control drugs. Most of the adverse events (AE) following ferric citrate treatment were mild at most. CONCLUSION: Collectively, our review suggests that iron-based phosphate binder, ferric citrate is an effective and safe treatment option for CKD patients with hyperphosphatemia and anemia. More importantly, this alternative treatment may also less expensive. Nevertheless, more scientific studies are warranted to validate our findings.


Assuntos
Anemia , Hiperfosfatemia , Insuficiência Renal Crônica , Anemia/tratamento farmacológico , Anemia/etiologia , Compostos Férricos/uso terapêutico , Humanos , Hiperfosfatemia/tratamento farmacológico , Hiperfosfatemia/etiologia , Fosfatos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
BMC Public Health ; 22(1): 1478, 2022 Aug 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
3.
J Health Popul Nutr ; 41(1): 32, 2022 Aug 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
4.
J Extra Corpor Technol ; 54(2): 123-127, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928331

RESUMO

Laboratory testing is a helpful tool for clinicians, but can be costly and harmful to patients. A quality improvement project was initiated to reduce laboratory testing for patients receiving extracorporeal membrane oxygenation (ECMO) in a pediatric intensive care unit (PICU) at a tertiary care center. Preliminary data was gathered to demonstrate preimplementation practice, cost, and patient need for packed red blood cell (pRBC) transfusions. A new protocol was created by an interprofessional team based on best practice and benchmarking with high-performing organizations. The project was evaluated using two comparison groups, pre- and postimplementation for anyone receiving ECMO therapy in the PICU. The average laboratory tests per ECMO day decreased by 52% (128.4 vs. 61.1), cost per case decreased by 14.7%, pRBC transfusions decreased from 100% to 85%, length of stay (LOS) decreased by 8 days, and mortality rates decreased by 9.5%. The revised pediatric ECMO laboratory testing guidelines were successfully implemented and reduced laboratory cost without adverse effects on mortality rates or LOS.


Assuntos
Anemia , Oxigenação por Membrana Extracorpórea , Criança , Transfusão de Eritrócitos , Oxigenação por Membrana Extracorpórea/métodos , Humanos , Unidades de Terapia Intensiva Pediátrica , Estudos Retrospectivos
5.
J Med Life ; 15(6): 867-870, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928351

RESUMO

Snakebites have been reported to induce hematological complications. Thrombocytopenia usually occurs secondary to disseminated intravascular coagulation (DIC) and coagulopathy induced by the snake bite. However, thrombocytopenia can develop after the snake bite, even in the absence of significant coagulopathy. We reported the case of a 36-year-old Jordanian male patient who was bitten by Arabian Macrovipera Lebetina Obtusa (Levantine viper), which developed venom-induced severe thrombocytopenia without coagulopathy. A progressive drop in platelet count was observed during his admission. His condition improved after anti-venom therapy, and he was discharged after 4 weeks of treatment for a full recovery. This case supports that snake venom can produce severe thrombocytopenia without significant coagulopathy, which can be treated successfully with anti-venom and the best supportive care.


Assuntos
Anemia , Coagulação Intravascular Disseminada , Mordeduras de Serpentes , Trombocitopenia , Viperidae , Adulto , Anemia/complicações , Animais , Antivenenos/uso terapêutico , Coagulação Intravascular Disseminada/induzido quimicamente , Coagulação Intravascular Disseminada/complicações , Humanos , Masculino , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/terapia , Trombocitopenia/complicações
6.
Sci Rep ; 12(1): 11498, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35798952

RESUMO

Malaria and anaemia are common diseases that affect children, particularly in Africa. Studies on the risk associated with these diseases and their synergy are scanty. This work aims to study the spatial pattern of malaria and anaemia in Nigeria and adjust for their risk factors using separate models for malaria and anaemia. This study used Bayesian spatial models within the Integrated Nested Laplace Approach (INLA) to establish the relationship between malaria and anaemia. We also adjust for risk factors of malaria and anaemia and map the estimated relative risks of these diseases to identify regions with a relatively high risk of the diseases under consideration. We used data obtained from the Nigeria malaria indicator survey (NMIS) of 2010 and 2015. The spatial variability distribution of both diseases was investigated using the convolution model, Conditional Auto-Regressive (CAR) model, generalized linear mixed model (GLMM) and generalized linear model (GLM) for each year. The convolution and generalized linear mixed models (GLMM) showed the least Deviance Information Criteria (DIC) in 2010 for malaria and anaemia, respectively. The Conditional Auto-Regressive (CAR) and convolution models had the least DIC in 2015 for malaria and anaemia, respectively. This study revealed that children in rural areas had strong and significant odds of malaria and anaemia infection [2010; malaria: AOR = 1.348, 95% CI = (1.117, 1.627), anaemia: AOR = 1.455, 95% CI = (1.201, 1.7623). 2015; malaria: AOR = 1.889, 95% CI = (1.568, 2.277), anaemia: AOR = 1.440, 95% CI = (1.205, 1.719)]. Controlling the prevalence of malaria and anaemia in Nigeria requires the identification of a child's location and proper confrontation of some socio-economic factors which may lead to the reduction of childhood malaria and anaemia infection.


Assuntos
Anemia , Malária , Anemia/etiologia , Teorema de Bayes , Criança , Estudos Transversais , Dacarbazina , Humanos , Malária/complicações , Malária/epidemiologia , Nigéria/epidemiologia , Prevalência , Fatores de Risco
7.
Sci Rep ; 12(1): 11911, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831434

RESUMO

Despite interest in the clinical implications of soluble transferrin receptor (sTfR), previous studies on the association of sTfR with mortality in the general population are lacking. Therefore, we analysed the association between sTfR and all-cause mortality in the general United States adult population. We conducted a prospective cohort study using National Health and Nutrition Examination Survey data from 2003 to 2010. A total of 5403 premenopausal nonpregnant females were analysed in this study. The mean age was 34.2 years (range 20.0-49.9 years). Participants were divided into log(sTfR) tertiles. The primary outcome was all-cause mortality. The secondary outcome was chronic kidney disease (CKD) development (composite of estimated glomerular filtration rate < 60 ml/min/1.73 m2 and/or random urine albumin-to-creatinine ratio ≥ 30 mg/g). During a median 8.7 years of follow-up, 103 (1.9%) participants died. Compared with the reference group (log(sTfR) 0.45-0.57), the highest tertile of log(sTfR) was associated with all-cause mortality (log(sTfR) > 0.57, hazard ratio [HR] 1.77 [95% CI 1.05-2.98]) in a multivariable hazards model including covariates such as haemoglobin and ferritin. Patients in the highest tertile of log(sTfR) also had an increased risk of CKD relative to those in the reference tertile. High sTfR was associated with all-cause mortality and CKD regardless of anaemia and iron storage status.


Assuntos
Anemia Ferropriva , Anemia , Insuficiência Renal Crônica , Adulto , Anemia/diagnóstico , Anemia Ferropriva/diagnóstico , Feminino , Humanos , Ferro/metabolismo , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estudos Prospectivos , Receptores da Transferrina , Transferrina , Adulto Jovem
8.
Int J Mol Sci ; 23(13)2022 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-35806011

RESUMO

Lead (Pb) is a common metal, which can be toxic to the human body via the pollution of water or food, and can cause anemia and other diseases. However, what happens before hemolysis and anemia caused by Pb poisoning is unclear. Here, we demonstrated Pb can cause procoagulant activity of erythroid cells leading to thrombosis before hemolysis. In freshly isolated human erythroid cells, we observed that Pb resulted in hemolysis in both concentration- and time-dependent manners, but that no lysis occurred in Pb-exposed erythroid cells (≤20 µM for 1 h). Pb treatment did not cause shape changes at up to 0.5 h incubation but at 1 h incubation echinocyte and echino-spherocyte shape changes were observed, indicating that Pb can exaggerate a concentration- and time-dependent trend of shape changes in erythroid cells. After Pb treatment, ROS-independent eryptosis was shown with no increase of reactive oxygen species (ROS), but with an increase of [Ca2+]i and caspase 3 activity. With a thrombosis mouse model, we observed increased thrombus by Pb treatment (0 or 25 mg/kg). In brief, prior to hemolysis, we demonstrated Pb can cause ROS-independent but [Ca2+]i-dependent eryptosis, which might provoke thrombosis.


Assuntos
Anemia , Eriptose , Trombose , Animais , Cálcio , Eritrócitos , Hemólise , Chumbo/toxicidade , Camundongos , Fosfatidilserinas , Espécies Reativas de Oxigênio , Trombose/etiologia
9.
Nutrients ; 14(13)2022 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-35807821

RESUMO

Hypertension during pregnancy may increase the risk of anemia in the offspring. However, few studies have investigated the effects of elevated blood pressure during the preconception period on childhood anemia. This large population-based birth cohort study was performed to determine whether abnormal preconception blood pressure has long-term consequences for childhood health. Data were obtained from the China-US Collaborative Project for Neural Tube Defect Prevention. The study consisted of 40,638 women with singleton live births who were registered in a monitoring system before pregnancy in southern China during the period 1993-1996. Children were assessed by hemoglobin measurement at approximately 53 months of age. The incidences of childhood anemia were 19.80% in the hypertension group and 16.07% in the non-hypertension group. Compared with the non-hypertension group, the hypertension group had an increased risk of childhood anemia (adjusted risk ratio (RR): 1.25; 95% confidence interval (CI): 1.11-1.41). After categorization according to blood pressure, combined systolic and diastolic hypertension was associated with a significantly increased risk of childhood anemia, compared with normotension (adjusted RR: 1.37; 95% CI: 1.16-1.63). Compared with women who had normal blood pressure, the adjusted RRs for childhood anemia were 1.20 (95% CI: 1.13-1.28), 1.26 (95% CI: 1.08-1.47), and 1.38 (95% CI: 1.14-1.67) among women with prehypertension, stage-1 hypertension, and stage-2 hypertension, respectively. Our results suggest a linear association between prepregnancy hypertension and the risk of childhood anemia in the Chinese population. Interventions targeting preconception blood pressure may have a positive effect on childhood health.


Assuntos
Anemia , Hipertensão , Anemia/epidemiologia , Coorte de Nascimento , Pressão Sanguínea/fisiologia , Criança , Pré-Escolar , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Hipertensão/epidemiologia , Gravidez , Fatores de Risco
10.
Nutrients ; 14(13)2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35807875

RESUMO

Background: Anaemia is a condition characterised by a decrease in the concentration of haemoglobin (Hb) in the blood. Anaemia suffers under five years children about 47.4% and 67.6% worldwide and developing countries including Ethiopia, respectively. The aim of this study was to assess the prevalence rate and the associated socio-economic, geographic and demographic factors of anaemia status of under five years children in Ethiopia. Methods: The data for this study were obtained from the 2011 Ethiopia National Malaria Indicator Survey (EMIS 2011). A sample of 4356 under five years age children was obtained from three regional states of Ethiopia. Based on haemoglobin level, child anaemia status was ordered and takes an ordinal value as no anaemia, mild anaemia, moderate anaemia and severe anaemia, respectively. Ordinal logistic regression model, specifically the proportional odds model was used by considering with and without survey design features. Results: Of the 4356 complete cases, 2190 (50.28%) were male and 1966 (49.72%) were female children under five years old. The children overall mean (SD) age was 2.68 (1.21) years. It was observed that both the mean ages and their variabilities in the regions are approximately equal to the overall mean and variability. It was also observed that in Amhara, Oromiya and SNNP regions 72.28%, 67.99% and 73.63% of the children, respectively had no anaemia; 15.93%, 13.47% and 13.56% of the children, respectively had mild anaemia; 10.99%, 15.61% and 11.33% of the children, respectively had moderate anaemia; and only 0.81%, 2.93% and 1.49% had severe anaemia, respectively. The prevalence of severe child anaemia status was higher in Oromiya region compared to Amhara and SNNP regions, respectively. Our result indicates that age, use of mosquito net, malaria RDT outcome, type of toilet facility, household wealth index, region and median altitude were significantly related to child anaemia status. However, it was observed that some covariates were model dependent, for example household wealth index and type of toilet facility were not significant when considering survey features. Conclusions: Anaemia burden remains high particularly in developing countries. Controlling the burden of anaemia necessitates the formulation of integrated interventions which prioritise the highest risk groups including children under five years. The statistical model used in this paper identified individual, household and cluster level risk factors of child anaemia. The identified risk factors for example not having improved toilet facility in the dwelling where a child lived as well as poorest household wealth index suggest the policymakers should target to focus more on children from poor community. Further, the strong association between malaria infection and anaemia suggests that malaria preventative methods such as vector control methods namely, long-lasting insecticidal nets (LLINs) and indoor residual spraying of households with insecticides and including case diagnostic testing and treatment may be the most effective ways to reduce infections associated with anaemia. Such collective assessment approach may lead to more effective public health strategies and could have important policy implications for health promotion and for the reduction of health disparities.


Assuntos
Anemia , Malária , Anemia/complicações , Anemia/etiologia , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Humanos , Malária/complicações , Malária/epidemiologia , Masculino , Mosquiteiros , Prevalência , Fatores de Risco
11.
BMC Public Health ; 22(1): 1320, 2022 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-35810292

RESUMO

BACKGROUND: Anaemia occurs in children when the haemoglobin level in the blood is less than the normal (11 g/dL), the consequence is the decrease of oxygen quantity in the tissues. It is a prevalent public health problem in many low-income countries, including Madagascar, and data on risk factors are lacking. We used existing data collected within the pathophysiology of environmental enteric dysfunction (EED) in Madagascar and the Central African Republic project (AFRIBIOTA project) conducted in underprivileged neighbourhoods of Antananarivo to investigate the factors associated with anaemia in children 24 to 59 months of age. METHODS: Children included in the AFRIBIOTA project in Antananarivo for whom data on haemoglobin and ferritin concentrations were available were included in the study. Logistic regression modelling was performed to identify factors associated with anaemia. RESULTS: Of the 414 children included in this data analysis, 24.4% were found to suffer from anaemia. We found that older children (adjusted OR: 0.95; 95% CI: 0.93-0.98) were less likely to have anaemia. Those with iron deficiency (adjusted OR: 6.1; 95% CI: 3.4-11.1) and those with a high level of faecal calprotectin (adjusted OR: 2.5; 95% CI: 1.4-4.4) were more likely to have anaemia than controls. CONCLUSIONS: To reduce anaemia in the children in this underprivileged area, more emphasis should be given to national strategies that improve children's dietary quality and micronutrient intake. Furthermore, existing measures should be broadened to include measures to reduce infectious disease burden.


Assuntos
Anemia Ferropriva , Anemia , Deficiências de Ferro , Adolescente , Anemia/epidemiologia , Anemia Ferropriva/epidemiologia , Criança , Pré-Escolar , Ferritinas , Humanos , Madagáscar/epidemiologia , Pobreza , Prevalência
12.
Sci Rep ; 12(1): 12127, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35840620

RESUMO

Transfusion-associated circulatory overload (TACO) is the leading cause of transfusion related morbidity and mortality. The only treatment is empirical use of furosemide. Our aim was to investigate if furosemide can prevent TACO. A randomized controlled trial was performed using a previously validated two-hit rat model for TACO. Volume incompliance was induced (first hit) in anemic, anesthetized Lewis rats. Rats were randomized to placebo, low-dose (5 mg kg-1) or high-dose (15 mg kg-1) furosemide-administered prior to transfusion (second-hit) and divided over two doses. Primary outcome was change in left-ventricular end-diastolic pressure (∆LVEDP) pre- compared to post-transfusion. Secondary outcomes included changes in preload, afterload, contractility and systemic vascular resistance, as well as pulmonary outcomes. Furosemide treated animals had a significantly lower ∆LVEDP compared to placebo (p = 0.041), a dose-response effect was observed. ∆LVEDP in placebo was median + 8.7 mmHg (IQR 5.9-11), + 3.9 (2.8-5.6) in the low-dose and 1.9 (- 0.6 to 5.6) in the high-dose group. The effect of furosemide became apparent after 15 min. While urine output was significantly higher in furosemide treated animals (p = 0.03), there were no significant changes in preload, afterload, contractility or systemic vascular resistance. Furosemide rapidly and dose-dependently decreases the rise in hydrostatic pulmonary pressure following transfusion, essential for preventing TACO.


Assuntos
Anemia , Reação Transfusional , Anemia/complicações , Animais , Transfusão de Sangue , Furosemida/uso terapêutico , Ratos , Ratos Endogâmicos Lew , Reação Transfusional/etiologia
14.
Am J Case Rep ; 23: e936445, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35871772

RESUMO

BACKGROUND Pure red cell aplasia (PRCA) is an uncommon syndrome characterized by ineffective erythropoiesis and severe anemia. Among immunodeficient patients, including those with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), persistent parvovirus-B19 can cause PRCA. We report a rare case of an Australian man with parvovirus-B19 mediated PRCA secondary to a new diagnosis of HIV-1/AIDS. The case highlights the importance of early treatment initiation with anti-retroviral drugs and pooled immunoglobulins to enable marrow recovery and long-term disease remission. CASE REPORT A 64-year-old man residing in rural Indonesia presented with severe anemia. Apart from 8 kg of unintentional weight loss, he denied any occult bleeding, diatheses, or constitutional symptoms. His bloodwork revealed a normocytic, normochromic anemia (Hb 81 g/L) with profound reticulocytopenia (9.5×109/L). Parvovirus-B19 serology and polymerase chain reaction testing confirmed active viremia. Lymphopenia and an undetectable CD4 T-lymphocyte count (<1%) were also noted; HIV-1 was subsequently diagnosed. Bone marrow sampling later confirmed features consistent with parvovirus-B19-driven PRCA secondary to HIV-1/AIDS. The patient received 1 g/kg intravenous immunoglobulin for two days and initiated anti-retroviral HIV therapy. Rapid reticulocytosis with slow incrementation of his hemoglobin were observed over one month. At three years following his diagnosis, he remains in remission. CONCLUSIONS Severe, isolated anemia in immunodeficient patients, particularly those with HIV-1/AIDS, should prompt consideration of parvovirus-B19-mediated PRCA. Depletion of CD4-T-lymphocyte populations enables the establishment of parvovirus-B19 reservoirs within erythroid progenitors, thereby hampering physiological erythropoiesis. Long-term remission can be achieved with the rapid institution of intravenous immunoglobulin and anti-retroviral HIV therapies.


Assuntos
Síndrome de Imunodeficiência Adquirida , Anemia , Doença Enxerto-Hospedeiro , Infecções por HIV , HIV-1 , Infecções por Parvoviridae , Parvovirus B19 Humano , Parvovirus , Aplasia Pura de Série Vermelha , Síndrome de Imunodeficiência Adquirida/complicações , Idoso , Anemia/etiologia , Austrália , Doença Enxerto-Hospedeiro/complicações , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Pessoa de Meia-Idade , Infecções por Parvoviridae/complicações , Infecções por Parvoviridae/diagnóstico , Aplasia Pura de Série Vermelha/diagnóstico , Aplasia Pura de Série Vermelha/tratamento farmacológico , Aplasia Pura de Série Vermelha/etiologia
15.
Comput Intell Neurosci ; 2022: 3627688, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35875776

RESUMO

Previous evidence has shown that preoperative hemoglobin is related to poor prognosis after primary total knee arthroplasty. Reviewing cohort research was conducted at the third-level academic medical center in Singapore and involved 2,676 patients. Population statistics, complications, preoperative hemoglobin (Hb) levels, length of hospital stay (LOS), and readmission information of thirty days were obtained. Anemia was defined based on the World Health Organization (WHO). LOS extension was with the definition as no less than six days with >1/75 LOS corresponding to the data. According to the study requirements, we finally collected 2273 patients. We plotted the relationship between hemoglobin levels and length of stay. We analyzed 2273 patients, with 140 cases of Hb ≤ 11.0 g/dL, 831 cases of Hb 11.0-12.9 g/dL, and the other 1320 cases of Hb ≥ 13.0 g/dL. The mean age of patients with prolonged LOS (68.4 ± 8.2 years) was higher than that of patients with familiar LOS (65.9 ± 8.0 years). In addition, patients with extended LOS had higher ASA-PS values, a history of cerebrovascular accidents (CVA), diabetes mellitus (DM), and ischemic heart disease (IHD) (P < 0.001), repeated surgery within 30 days, HB, and operative time (min) (P < 0.01). Variables independently related to increased risk of extended LOS included general anesthesia (GA) (adjusted OR (aOR) 1.4, P=0.005, P=0.005), CVA (aOR 3.0, P < 0.001), DM (aOR 1.4, P=0.032), and HB < 11 g/dL. Variables increased LOS included HB ≥ 13 g/dL (aOR 0.4, P < 0.001) and Hb 11.0-12.9 g/dL (aOR 0.5, P=0.001). Hb was 14 g/dL, and LOS decreased by at least 0.24 days for each 1 g increase in preoperative Hb before the inflection point (95%CI 0.12 to 0.36, P=0.0001). Anemia is familiar in patients receiving elective total knee arthroplasty (TKA) in Singapore. Thus, this study describes that the preoperative hemoglobin was associated with length of stay. We found that on the left where HB was 14, length of stay decreased with increased hemoglobin values. We recommend preoperative correction of anemia to determine the diagnosis.


Assuntos
Anemia , Artroplastia do Joelho , Idoso , Anemia/complicações , Anemia/epidemiologia , Artroplastia do Joelho/efeitos adversos , Hemoglobinas/análise , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Pan Afr Med J ; 41: 310, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35855036

RESUMO

Introduction: the aim was to investigate the demographic characteristics, primary colonoscopy findings, main indications, and feature of colorectal cancer (CRC) patients at Mnazi Mmoja Referral Hospital in the Zanzibar Archipelago, Tanzania. Methods: between December 2013 and October 2021, a total of 448 eligible participants were finally enrolled in present cross-sectional study. Demographic information and primary colonoscopy findings of each participant were retrieved. Results: among all enrolled subjects, 205 (45.80%) are females, remaining 243 (54.20%) are males. The median age of present cross-sectional study was 47 years old (ranging from 8 to 90 years). The main presenting indications included diarrhea (22.54%), abdominal pain (21.21%), hematochezia (18.53%), difficult defecation (16.96%), mucoid stool (10.49%), and anemia (8.70%). The common identified colonoscopy findings comprised colitis (28.57%), colonic polyps (25.22%), CRC (17.63%), inflammatory bowel disease (IBD) (13.52%), hemorrhoids (4.24%), and colonic diverticulum (4.02%), respectively. Unconditional logistic regression analyses demonstrated the elder group had significant higher risk of CRC (OR, 1.03; 95% CI, 1.01-1.03, P< 0.001), meanwhile a significant higher possibility of suffering hematochezia (OR, 2.29; 95% CI, 1.32-3.99, P=0.003) and anemia (OR, 2.96; 95% CI, 1.46-6.00, p= 0.003) in CRC group. Conclusion: the present study demonstrated that colitis, colonic polyps, CRC, and IBD are the most common colonoscopy diagnoses in Zanzibar. The indication of hematochezia or anemia showed a statistically higher risk of CRC.


Assuntos
Anemia , Colite , Pólipos do Colo , Neoplasias Colorretais , Doenças Inflamatórias Intestinais , Idoso , Anemia/epidemiologia , Colite/diagnóstico , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Estudos Transversais , Feminino , Hemorragia Gastrointestinal , Humanos , Masculino , Pessoa de Meia-Idade , Tanzânia/epidemiologia
17.
Niger J Clin Pract ; 25(7): 1102-1106, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35859472

RESUMO

Background: Colorectal cancer (CRC) is the second most frequently diagnosed cancer in women and the third in men. Anaemia is a common condition in patients with CRC. Aim: In this study, we aimed to retrospectively analyse the relationship between preoperative anaemia (POA) and postoperative complications in patients with colorectal cancer (CRC) that underwent elective surgery. Patients and Methods: The data of patients who underwent elective curative surgery for CRC between January 2015 and December 2020 and had pathologically-proven cancer were evaluated retrospectively. We examined the effect of demographic characteristics of patients, preoperative haemoglobin, cancer localization (colon/rectum), American Society of Anaesthesiologist (ASA) classification, preoperative co-morbidity, surgical method (laparoscopic/open), stoma status, tumor stage, presence of preoperative anaemia on surgical site infection, pulmonary complications, renal complications, anastomotic leaks, and need for intensive care and re-operation in the postoperative period. Results: Of the 352 patients who underwent curative resection for CRC, 177 (50.3%) were diagnosed with POA. The median haemoglobin value was 10.7 g/dl in POA patients while it was 13.6 g/dl in the non-POA group. Regarding the localization of tumor, the patients with tumors on the right colon were more statistically significant in terms of POA (p < 0.05). Patients with POA had a higher rate of hypertension and coronary artery disease compared to patients without POA (p < 0.05). In patients with POA, surgical site infection and need for intensive care were statistically significant in the postoperative period compared to patients without POA (p < 0.05, P < 0.01, respectively). However, there was no significant difference between the two groups regarding pulmonary complications, renal complications, anastomotic leaks, and need for re-operation in the postoperative period. Conclusion: We believe that POA should be corrected prior to surgery to reduce not only the need for intensive care but also surgical site infection in patients undergoing elective curative surgery for CRC.


Assuntos
Anemia , Neoplasias Colorretais , Fístula Anastomótica , Anemia/complicações , Anemia/epidemiologia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/cirurgia , Feminino , Hemoglobinas , Humanos , Masculino , Período Pós-Operatório , Estudos Retrospectivos , Infecção da Ferida Cirúrgica
18.
Indian J Public Health ; 66(2): 182-186, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35859502

RESUMO

Background: Anemia is a major public health issue throughout the world. Nutritional deficiencies in terms of iron, B12 (cobalamin) and B9 (folate) are the main causes of anemia in the absence of genetic abnormalities and chronic diseases in many countries. Lactating mothers are susceptible to anemia because of maternal iron depletion during lactation as well as blood loss during childbirth. Objective: The present study examines the prevalence of anemia among the lactating (cases) and nonpregnant-nonlactating (control) married Tangkhul women of Ukhrul district. Materials and Methods: A community-based cross-sectional study was conducted among 400 individuals (lactating: 150; nonpregnant-nonlactating women: 250) from 11 villages of the Ukhrul district in Manipur. A pretested schedule, which included height, weight, and socio-demographic parameters were used. Body mass index = weight (in kg)/height (in metre2) was computed of each subject and categorized. Hemoglobin concentration was measured using Sahli's method. Statistical methods namely Chi-square (χ2) test and binary logistic regression were applied. Results: The prevalence of anemia was higher in the lactating women (62.0%) than nonpregnant-nonlactating women (56.8%). Odds ratio (OR) of multivariate logistic regression analysis indicated that anemia was significantly associated in both cases and control with low literacy level (OR = 5.03 and 3.71), low income (OR = 2.51 and 3.56), cultivator (OR = 6.20 and 3.86), and multigravida >4 (OR = 5.25 and 2.67), respectively. Conclusion: Dietary practices play an important role in causing anemia. Low literacy level, low income, cultivator, and high gravidity were identified as the associated risk factors of anemia.


Assuntos
Anemia , Lactação , Anemia/epidemiologia , Anemia/etiologia , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Ferro , Prevalência , Fatores de Risco
19.
Pan Afr Med J ; 41: 334, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35865846

RESUMO

Introduction: thrombocytopenia is a common hematological disorder during pregnancy next to anemia. Pregnant women with thrombocytopenia have complications of excessive bleeding during or after childbirth, cesarean section incision site oozing, stillbirth and neonatal thrombocytopenia. Findings on the magnitude of thrombocytopenia among pregnant women were inconsistent. Therefore, this review aimed to estimate the pooled prevalence of thrombocytopenia among pregnant women in Africa. Methods: this systematic review and meta-analysis were performed based on PRISMA guidelines. The databases (PubMed, PubMed Central, Hinari, Science Direct, Pop line, Google Scholar, and African Journals Online) were searched to identify relevant studies. Data were analyzed using STATA 11 statistical software. A random-effect model was fitted to estimate the pooled prevalence of thrombocytopenia. I2 test statistics were done to test the heterogeneity of included studies. Funnel plots analysis and Egger weighted regression tests were done to detect publication bias. Results: of the total 1,517 articles retrieved, 15 articles which involved 8,380 pregnant women were eligible for meta-analysis. The overall pooled prevalence of thrombocytopenia among pregnant women in Africa was 10.23% (95% confidence interval (CI): 7.44, 13.02%). Its level of severity showed that, 77.95% (I2=43.1%), 15.62% (I2=53.4%), and 5.60 (I2=0.0%) of pregnant women had mild, moderate and severe thrombocytopenia, respectively. The highest prevalence of thrombocytopenia was occurred in the third trimester of pregnancy (54.05% (95% CI: 29.48, 78.61)). Conclusion: this systematic review and meta-analysis showed that the pooled prevalence of thrombocytopenia among pregnant women in Africa was found to be relatively higher compared with the globe. Therefore, routine screening and follow-up programs are needed to identify pregnant women with thrombocytopenia and provide them with the necessary interventions.


Assuntos
Anemia , Trombocitopenia , África/epidemiologia , Cesárea , Etiópia , Feminino , Humanos , Recém-Nascido , Gravidez , Gestantes , Prevalência , Trombocitopenia/epidemiologia
20.
Indian J Med Res ; 155(1): 43-48, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35859427

RESUMO

Background & objectives: Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by the elevated secretion of the parathormone (PTH). The aim of this study was to evaluate the haematological manifestations of PHPT in patients with normal renal functions who were treated surgically for parathyroid adenomas. Methods: In this retrospective cross-sectional study, 134 patients with normal renal functions who underwent parathyroidectomies for PHPT were included. The haematological manifestations were evaluated in the total study cohort and in the two groups of different calcium (Ca) levels (Group 1 ≤11.2 mg/dl and Group 2 >11.2 mg/dl). Results: The overall prevalence of anaemia, leucopenia and thrombocytopenia was 20.1, 6.7 and 6.0 per cent, respectively. Normocytic anaemia was present in 19 (14.2%) patients. There were no significant differences in the prevalence of anaemia, leucopenia and thrombocytopenia between the two groups. There were no correlations between the PTH levels and the leukocyte, haemoglobin or platelet values. Six to 12 months after the parathyroidectomy (PTX), 35.7 per cent of the patients with anaemia, 85.7 per cent of the patients with leucopenia and 100 per cent of the patients with thrombocytopenia had recovered. Interpretation & conclusions: In the present study, anaemia was seen with a variable frequency in PHPT, but there was no relationship between anaemia and high PTH or Ca levels. The development of anaemia can be seen regardless of the PTH levels in PHPT patients with normal renal functions. High-resolution rates after PTX indicate a possible association between PHPT and thrombocytopenia or leucopenia, although their prevalence is low in PHPT.


Assuntos
Anemia , Hiperparatireoidismo Primário , Trombocitopenia , Anemia/epidemiologia , Anemia/etiologia , Cálcio , Estudos Transversais , Humanos , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/epidemiologia , Hiperparatireoidismo Primário/cirurgia , Hormônio Paratireóideo , Paratireoidectomia , Estudos Retrospectivos , Trombocitopenia/complicações , Trombocitopenia/epidemiologia
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