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1.
Int J Mol Sci ; 22(11)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064290

RESUMO

Inositol 1,4,5-triphosphate receptor-associated cGMP kinase substrate 1 (IRAG1) is a substrate protein of the NO/cGMP-signaling pathway and forms a ternary complex with the cGMP-dependent protein kinase Iß (PKGIß) and the inositol triphosphate receptor I (IP3R-I). Functional studies about IRAG1 exhibited that IRAG1 is specifically phosphorylated by the PKGIß, regulating cGMP-mediated IP3-dependent Ca2+-release. IRAG1 is widely distributed in murine tissues, e.g., in large amounts in smooth muscle-containing tissues and platelets, but also in lower amounts, e.g., in the spleen. The NO/cGMP/PKGI signaling pathway is important in several organ systems. A loss of PKGI causes gastrointestinal disorders, anemia and splenomegaly. Due to the similar tissue distribution of the PKGIß to IRAG1, we investigated the pathophysiological functions of IRAG1 in this context. Global IRAG1-KO mice developed gastrointestinal bleeding, anemia-associated splenomegaly and iron deficiency. Additionally, Irag1-deficiency altered the protein levels of some cGMP/PKGI signaling proteins-particularly a strong decrease in the PKGIß-in the colon, spleen and stomach but did not change mRNA-expression of the corresponding genes. The present work showed that a loss of IRAG1 and the PKGIß/IRAG1 signaling has a crucial function in the development of gastrointestinal disorders and anemia-associated splenomegaly. Furthermore, global Irag1-deficient mice are possible in vivo model to investigate PKGIß protein functions.


Assuntos
Anemia/metabolismo , Proteína Quinase Dependente de GMP Cíclico Tipo I/metabolismo , Transdução de Sinais/fisiologia , Esplenomegalia/metabolismo , Animais , Cálcio/metabolismo , Colo/metabolismo , GMP Cíclico/metabolismo , Feminino , Receptores de Inositol 1,4,5-Trifosfato/metabolismo , Masculino , Camundongos , Camundongos Knockout , Músculo Liso Vascular/metabolismo , Fosforilação/fisiologia , RNA Mensageiro/metabolismo , Baço/metabolismo , Estômago
2.
BMC Infect Dis ; 21(1): 507, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059017

RESUMO

BACKGROUND: Hematological abnormalities are common features in falciparum malaria but vary among different populations across countries. Therefore, we compared hematological indices and abnormalities between Plasmodium falciparum-infected patients and malaria-negative subjects in Kosti city of the White Nile State, Sudan. METHODS: A comparative, cross-sectional study was conducted at the Clinical Laboratory Unit of Kosti Teaching Hospital from June to December 2018. A total of 392 participants (192 P. falciparum-infected patients and 200 malaria-negative subjects) were recruited in the study. Hematological indices of hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets were measured, and their median values were statistically compared. RESULTS: The majority of P. falciparum-infected patients (67.6%) showed a low-level parasitemia. The median values of Hb concentration, RBC count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were significantly lower in P. falciparum-infected patients, while the median red cell distribution width (RDW) was significantly higher in the patients compared to malaria-negative subjects. Anemia, low MCV, low MCH, low MCHC and high RDW were significantly associated with falciparum malaria, but parasitemia level was not significantly associated with anemia severity. The median total WBC count was non-significantly higher in P. falciparum-infected patients, with neutropenia being significantly associated with falciparum malaria. The median platelet count was significantly lower in P. falciparum-infected patients, with thrombocytopenia being significantly associated with falciparum malaria. CONCLUSIONS: Falciparum malaria among patients in Kosti city of the White Nile State, Sudan is predominantly of low-level parasitemia. It is significantly associated with anemia, low MCV, low MCH, low MCHC, high RDW, thrombocytopenia and neutropenia. However, parasitemia level is not a significant predictor of anemia severity. On the other hand, leucopenia is not useful to predict falciparum malaria. Further large-scale studies in community and healthcare settings and inclusion of patients with complicated or severe malaria and those with high parasite densities are recommended.


Assuntos
Malária Falciparum/sangue , Adolescente , Adulto , Anemia/sangue , Anemia/parasitologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Testes Hematológicos , Humanos , Lactente , Leucopenia/sangue , Leucopenia/parasitologia , Malária Falciparum/parasitologia , Masculino , Pessoa de Meia-Idade , Parasitemia/sangue , Parasitemia/parasitologia , Plasmodium falciparum , Trombocitopenia/sangue , Trombocitopenia/parasitologia , Adulto Jovem
3.
Wei Sheng Yan Jiu ; 50(3): 366-371, 2021 May.
Artigo em Chinês | MEDLINE | ID: mdl-34074357

RESUMO

OBJECTIVE: To observe the effect of 6-23 months infants by Yingyangbao(YYB) intervention in impoverished areas of Henan Province. METHODS: A multi-stage random sampling method was used to select infants aged 6-23 months from 51 project counties in Henan Province from September to November 2019. Physical anthropometric measurement and hemoglobin detection were performed, and face-to-face questionnaires surveyed with caregivers of the children. Children in 12 regions covered by YYB were defined as intervention group, and controls were selected from the baseline survey of children in 39 regions not covered by YYB according to the 1∶1 matching principle. The analysis between YYB and control groups were analyzed by χ~2 or t test. χ~2 test for trend to compare trend of children health status. RESULTS: A total of 7738 subjects were selected in the study, including 3869 in the intervention group and 3869 in the control group. The average length, weight and hemoglobin level of YYB group were 1. 1 cm, 0. 67 kg and 3. 8 g/L, respectively, which were higher than that of the control group. The anemia rate, underweight rate, stunting rate and wasting rate in intervention group were 13.1%, 1.7%, 2.1% and 1.9%, respectively, significantly lower than control group. Compared with the control group, the two-week prevalence of fever and diarrhea in the intervention group decreased by 5. 6% and 7. 2%, respectively. In addition, nutrition knowledge score of the parents, minimum dietary diversity rate, minimum meal frequency rate and minimum acceptable diet rate of intervention group were 62. 4%, 71. 1%, 73. 7% and 55. 8%, respectively, significantly better than that of control group. From 2015 to 2019, the anemia rate, underweight rate, stunting rate of children in regions covered by YYB showed a downward trend. CONCLUSION: YYB can effectively improve the nutrition, physical development and health status of 6-24 months infants. Through the implementation of the project, the knowledge and skills of scientific feeding in impoverished regions were significantly improved.


Assuntos
Anemia , Suplementos Nutricionais , Anemia/epidemiologia , Criança , China/epidemiologia , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Estado Nutricional , Prevalência , População Rural
4.
Wei Sheng Yan Jiu ; 50(3): 377-381, 2021 May.
Artigo em Chinês | MEDLINE | ID: mdl-34074359

RESUMO

OBJECTIVE: To describe the hemoglobin and prevalence of anemia among 6-23 months infants at different elevations in poor rural areas in China. METHODS: The monitoring data in the year 2018 from the Children Nutrition Improvement Project in Poor Areas of China was used for the analysis, which covered 19 provinces and 42 938 infants of 6-23 months. Hemoglobin was tested by Hemoque method with blood drop from finger tips. The altitude of the residence regions was divided into eight parts. Analysis of variance was used to compare the mean values among the altitude groups, and chi-square test was used to compare the prevalence of anaemia. RESULTS: The data from 42 938 6-23 months infants was under analysis, among them 22 207(51.7%)were boys and 20 731(48.4%)girls. 27 208(63.4%)infants and children were located in the areas under 1000 meters whose average hemoglobin was 11.8 g/dL and the prevalence of anemia was 18.7%. There were 15 730(36.6%)infants living in areas higher than 1000 meters. The anemia rate ranged from 31.3% to 83.6% in all aged groups when altitude& gt; 2500 m that were noticeable higher than that of lower altitude regions. With the increase of altitude, the adjusted anemic rate showed an obvious upward trend. 6-11 months infants showed higher anemia rate compared with other groups. CONCLUSION: The incidence of anemia among children aged 6 to 23 months in poor areas of China is severe, among which infants living at an altitude of more than 2500 meters have a higher prevalence of anemia.


Assuntos
Altitude , Anemia , Pobreza , Anemia/epidemiologia , China/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Lactente , Masculino , Prevalência , População Rural
5.
Rinsho Ketsueki ; 62(5): 371-377, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34108317

RESUMO

Anemia is a significant complication of chronic kidney disease (CKD), caused by erythropoietin deficiency and reduced iron availability. Erythropoiesis-stimulating agents have been used with iron supplementation to treat anemia; however, they are associated with some problems. Hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) is a promising new class of oral therapy for the treatment of anemia associated with CKD. HIF-PHI inhibits HIF-prolyl hydroxylase enzymes and results in the HIF-α accumulation, which leads to increased expression of HIF-responsive genes, including erythropoietin and vascular endothelial growth factor (VEGF). HIF stimulates endogenous erythropoietin production and also reduces circulating hepcidin concentrations, resulting in improved anemia. Many clinical trials demonstrate that HIF-PHI improves anemia in patients with CKD and on dialysis. In addition to treating anemia, HIF-PHI may have multiple potential effects. Several animal experiments show that HIF-PHI protects against ischemic kidney damage that progresses to CKD and also improves metabolic disorders and ameliorates cardiovascular complications. In contrast, malignant tumor and retinopathy should be carefully evaluated due to theoretical concerns that HIF stabilization may result in increased VEGF protein expression. Some adverse events such as shunt occlusion reported in large clinical trials also need attention and warrant further investigations.


Assuntos
Anemia , Eritropoetina , Inibidores de Prolil-Hidrolase , Insuficiência Renal Crônica , Anemia/tratamento farmacológico , Anemia/etiologia , Animais , Eritropoetina/uso terapêutico , Humanos , Hipóxia , Prolina Dioxigenases do Fator Induzível por Hipóxia , Inibidores de Prolil-Hidrolase/uso terapêutico , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular
6.
Kardiologiia ; 61(4): 39-45, 2021 May 04.
Artigo em Inglês, Inglês | MEDLINE | ID: mdl-33998407

RESUMO

Aim      To study the effects of pre- and postoperative anemia on the risk and the structure of internal organ dysfunction in patients undergoing surgery for acquired heart diseases (AHD).Material and methods  This was a retrospective cohort study including 610 primarily operated patients with AHD. A comparative analysis of the incidence and the structure of internal organ dysfunction was performed, and the likelihood of intraoperative hemotransfusion was determined for patients with preoperative anemia (Hb <130 g/l) and without it. The incidence and the nature of internal organ damage were compared in patients with postoperative Hb < 90 g/l and 90-130 g/l.Results The presence of postoperative anemia detected in 45 % of patients at two days after the surgery 6-fold increased the risk of acute heart failure (odds ratio [OR], 5.75; 95 % confidence interval [CI], 1.23-26.84; р=0.016), 4-fold increased the risk of multiorgan failure (MOF) (OR, 4.2; 95 % CI, 1.16-15.64; р=0.03), and 5-fold increased the likelihood of hemotransfusion (OR, 4.74; 95 % CI, 3.12-7.19; р<0.0001). Severe and moderate anemia (Hb <90 g/l) was observed in 11.2 % of patients, which presence 6-fold increased the risk of brain dysfunction (OR, 5.72; 95 % CI, 2.17-15.06; р=0.001) and MOF (OR, 5.97; 95 % CI, 1.94-18.35; р=0.004) compared to patients with Hb 90-130 g/l.Conclusion      In patients with AHD, postoperative anemia increases the risk of circulatory decompensation at two days after the surgery and of MOF and also increases the likelihood of intraoperative hemotransfusion; postoperative anemia with Hb <90 g/l increases the risk of brain damage and MOF.


Assuntos
Anemia , Insuficiência de Múltiplos Órgãos , Anemia/epidemiologia , Anemia/etiologia , Valvas Cardíacas , Humanos , Insuficiência de Múltiplos Órgãos/epidemiologia , Insuficiência de Múltiplos Órgãos/etiologia , Estudos Retrospectivos , Fatores de Risco
7.
J Int Med Res ; 49(5): 3000605211012231, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34018838

RESUMO

OBJECTIVE: In the present study, we aimed to investigate the relationship between serum vitamin D3 concentration and anaemia in patients with chronic kidney disease (CKD) in China, to assist understanding of the effects of vitamin D treatment in such patients. METHODS: A total of 225 patients with CKD were enrolled and a range of laboratory parameters were measured. The participants were allocated to three groups, according to their serum 25-hydroxyvitamin D3 concentration: a severe deficiency group, a deficiency group, and a sufficiency group. The prevalences of anaemia in the three groups were assessed, and the factors associated with anaemia in patients with CKD were analysed using logistic regression. RESULTS: The prevalences of anaemia were 79.5% in the severe deficiency group, 63.5% in the deficiency group, and 48.0% in the sufficiency group. The prevalence of anaemia gradually increased with the severity of vitamin D3 deficiency. The prevalences of anaemia in participants with stages 1 to 5 CKD were 21.1%, 30.4%, 39.5%, 78.7%, and 94.6%, respectively. CONCLUSION: Vitamin D3 deficiency may increase the risk of anaemia in patients with CKD.


Assuntos
Anemia , Insuficiência Renal Crônica , Deficiência de Vitamina D , Anemia/epidemiologia , China/epidemiologia , Colecalciferol , Estudos Transversais , Humanos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
8.
BMC Geriatr ; 21(1): 329, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34030664

RESUMO

BACKGROUND AND OBJECTIVES: The present study aimed to investigate the relation between anemia and hemoglobin (Hgb) concentration, physical performance, and cognitive function in a large sample of Iranian elderly population. METHODS: Data were collected from Bushehr elderly health (BEH) program. A total of 3000 persons aged ≥60 years were selected through multistage random sampling. Hemoglobin values lower than 12 and 13 g/dL were considered as anemia for women and men, respectively. The cognitive function was measured using the Mini-cog test and Category fluency test (CFT), and the physical function was measured using handgrip strength (muscle strength), Relative handgrip strength (RHGS), and 4.57-m usual gait speed. Univariate and adjusted multivariate logistic regression and linear regression with Stata MP (version 15) were run, and a p-value of < 0.05 was used as statistically significant for all analyses. RESULTS: Among participants, 7.43% were anemic, and 115 (51.57%) simultaneously had anemia and cognitive disorder. There were significant associations between red blood cell count (RBC), hemoglobin (Hgb), platelet count (PLT), and hematocrit percentage (HCT) with cognitive impairment. Additionally, Hgb concentration was significantly associated with all physical measures (Mean handgrip, Relative handgrip, and usual gait speed) and late recall (mini-cog) among the whole participants. This association remained statistically significant after considering multi-cofounders. In contrast, after stratifying the participants by gender, the association between Hgb concentration and usual gait speed was decreased in both men and women; moreover, Hgb association with cognitive measures (category fluency test and late recall) was no longer significant (all p-values > 0.05). CONCLUSION: There was a cross-sectional and significant association between anemia and functional variables (e.g., Relative and mean handgrip) in Iranian elderly population, whereas Semantic memory, Late recall, and walking were more affected by gender.


Assuntos
Anemia , Força da Mão , Idoso , Anemia/diagnóstico , Anemia/epidemiologia , Cognição , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Desempenho Físico Funcional
9.
Nihon Yakurigaku Zasshi ; 156(3): 187-197, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33952849

RESUMO

Roxadustat (Evrenzo® tablet) is an oral hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor. Roxadustat has been approved for the treatment of renal anemia in patients on dialysis in September 2019 in Japan. By inhibiting HIF-PH, roxadustat suppresses the degradation of HIF-α, a subunit of the heterodimeric transcription factor HIF, leading to its accumulation and activation of the HIF pathway. Similar to activation of the HIF pathway in response to hypoxia, the production of endogenous erythropoietin is increased and erythropoiesis is stimulated. Moreover, roxadustat stimulates erythropoiesis efficiently by improving iron bioavailability. The efficacy and mechanism of action of roxadustat have been detailed in non-clinical pharmacology studies. Rat models of anemia demonstrated efficacy of roxadustat in correcting anemia and changes in gene expression leading to increased iron bioavailability. Four phase 3 clinical studies in Japan clearly demonstrated the efficacy of roxadustat in patients with renal anemia on dialysis. Roxadustat showed an acceptable safety profile, and the incidences and types of adverse events and serious adverse events reported in the clinical studies were similar with those predicted to occur in these patient population. Since roxadustat is an oral drug, concerns present with erythropoiesis-stimulating agents (ESAs) such as the risk of infection to the medical staff due to accidental needle-stick, pain during ESA injection in patients and burden on patients to visit a hospital, can be avoided or reduced. In November 2020, roxadustat has also been approved for the treatment of renal anemia in patients not on dialysis (data not shown in this article).


Assuntos
Anemia , Insuficiência Renal Crônica , Anemia/tratamento farmacológico , Anemia/etiologia , Animais , Glicina/análogos & derivados , Humanos , Isoquinolinas , Japão , Ratos , Insuficiência Renal Crônica/tratamento farmacológico , Comprimidos
10.
Curr Opin Anaesthesiol ; 34(3): 352-356, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33935184

RESUMO

PURPOSE OF REVIEW: In the past years, patient blood management (PBM) has evolved to improve patient's care and safety. Anemia is one of the most common medical diseases in the world and is an independent risk factor for morbidity and mortality. Iron deficiency is the main cause for anemia and constitutes a potentially preventable condition with a great impact on surgical outcome. However, preoperative anemia management is not yet established in most hospitals. Changing workflows and re-thinking is challenging. Numerous published studies confirmed the positive effect of preoperative anemia diagnosis and treatment recently. RECENT FINDINGS: Iron supplementation in iron-deficient anemic (IDA) patients reduce the need for allogenic blood transfusion thereby improving perioperative outcome. SUMMARY: Since the introduction of PBM programs, important movements towards early detection and therapy of preoperative anemia have been observed. However, preoperative anemia management is not implemented on a large scale as many healthcare professionals are not aware of the most recent findings in the field. Preoperative anemia management, particularly iron supplementation in IDA patients, has proven to be highly effective and has a tremendous effect on patient safety and outcome.


Assuntos
Anemia , Anemia/diagnóstico , Anemia/epidemiologia , Anemia/etiologia , Transfusão de Sangue , Humanos , Ferro , Cuidados Pré-Operatórios , Fatores de Risco
11.
BMC Infect Dis ; 21(1): 477, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034666

RESUMO

BACKGROUND: School-aged children (SAC) are a high-risk demographic group for infectious diseases and malnutrition. The objective of this study was to assess the burden and the effect of Plasmodium falciparum and Schistosoma haematobium infections on the haematological indices in SAC and the confounding influence of malnutrition on the outcomes. METHODS: This cross-sectional study was conducted in SAC 4-14 years old living in Ikata, Bafia and Mile 14-Likoko in Muyuka, Cameroon. Anthropometric measures of malnutrition were obtained and blood samples collected were used for detection of malaria parasites by Giemsa-stained blood films using light microscopy and complete blood count analysis using an automated haematology analyser. Urine samples collected were used to detect micro haematuria with the aid of reagent strips and the eggs of S. haematobium by urine filtration technique. Multiple linear regression model was used to examine influence of independent variables on haematological parameters. RESULTS: Out of the 606 SAC examined, the prevalence of single infections with Plasmodium or S. haematobium and co-infection with both parasites was 16.2, 16.3 and 8.3%, respectively. Overall, malaria parasite (MP), urogenital schistosomiasis, malnutrition, anaemia, haematuria, microcytosis and thrombocytopenia was prevalent in 24.4, 24.6, 25.9, 74.4, 12.2, 45.4 and 11.1% of SAC, respectively. A significant linear decline (P = 0.023) in prevalence of P. falciparum infection with the severity of stunting was observed. Factors that significantly influenced haematological parameters included haemoglobin: age, stunting and MP; haematocrit: age and MP; white blood cell count: age; red blood cell count; age and MP; lymphocyte counts: stunting; mean cell volume: age; mean cell haemoglobin: age and stunting; mean cell haemoglobin concentration: sex, stunting and red cell distribution width-coefficient of variation: sex, age and stunting. CONCLUSIONS: Malnutrition, Plasmodium and S. haematobium infections are common while anaemia is a severe public health problem in Muyuka, Cameroon. The interaction between haematological parameters with malaria parasites as well as linear growth index was negative and other interactions indicate systemic inflammation. While findings provide contextual intervention targets to ensure the judicious use of the limited resources, there is need for regular monitoring and proper treatment to improve the health of the underserved population.


Assuntos
Coinfecção/sangue , Coinfecção/epidemiologia , Malária Falciparum/sangue , Malária Falciparum/epidemiologia , Desnutrição/epidemiologia , Plasmodium falciparum/isolamento & purificação , Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/sangue , Esquistossomose Urinária/epidemiologia , Adolescente , Anemia/epidemiologia , Animais , Camarões/epidemiologia , Criança , Pré-Escolar , Coinfecção/parasitologia , Estudos Transversais , Contagem de Eritrócitos , Índices de Eritrócitos , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Contagem de Linfócitos , Malária Falciparum/parasitologia , Masculino , Prevalência , Esquistossomose Urinária/parasitologia , Instituições Acadêmicas
12.
BMC Res Notes ; 14(1): 167, 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947454

RESUMO

OBJECTIVE: Hospital data are a useful resource for studying pregnancy complications, including bleeding-related conditions, however, the reliability of these data is unclear. This study aims to examine reliability of reporting of bleeding-related conditions, including anaemia, obstetric haemorrhage and blood disorders, and procedures, such as blood transfusion and hysterectomy, in coded hospital records compared with obstetric data from two large tertiary hospitals in New South Wales. RESULTS: There were 36,051 births between 2011 and 2015 included in the analysis. Anaemia and blood disorders were poorly reported in the hospital data, with sensitivity ranging from 2.5% to 24.8% (positive predictive value (PPV) 12.0-82.6%). Reporting of postpartum haemorrhage, transfusion and hysterectomy showed high sensitivity (82.8-96.0%, PPV 78.0-89.6%) while moderate consistency with the obstetric data was observed for other types of obstetric haemorrhage (sensitivity: 41.9-65.1%, PPV: 50.0-56.8%) and placental complications (sensitivity: 68.2-81.3%, PPV: 20.3-72.3%). Our findings suggest that hospital data may be a reliable source of information on postpartum haemorrhage, transfusion and hysterectomy. However, they highlight the need for caution for studies of anaemia and blood disorders, given high rates of uncoded and 'false' cases, and suggest that other sources of data should be sought where possible.


Assuntos
Anemia , Hemorragia Pós-Parto , Anemia/diagnóstico , Anemia/epidemiologia , Austrália , Feminino , Hospitais , Humanos , New South Wales/epidemiologia , Hemorragia Pós-Parto/diagnóstico , Hemorragia Pós-Parto/epidemiologia , Gravidez , Reprodutibilidade dos Testes
13.
Ann Palliat Med ; 10(4): 4736-4746, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33966423

RESUMO

BACKGROUND: Chronic kidney disease is a global public health problem, anemia is the most common complication of chronic kidney disease. Roxadustat is a new drug that can be used to treat renal anemia by oral administration. METHODS: We conducted a comprehensive computerized search of the China Knowledge Network (CNKI), VIP (VIP), Wanfang, China Biomedical (CBM), PubMed, Embase, and the Cochrane Library databases. We collected clinical randomized controlled trials (RCTs) published on roxadustat in the treatment of anemia of kidney disease. According to the inclusion and exclusion criteria, the included studies were subject to screening and quality evaluation, and RevMan 5.3 software was used for meta-analysis. RESULTS: A total of 7 RCTs involving 997 patients with anemia of kidney disease were included. The results of meta-analysis showed that compared with the treatment effect of the erythropoietin (EPO) group, in the roxadustat group there were significant increases in the amount of hemoglobin [mean difference (MD) =11.70, 95% confidence interval (CI): 0.41 to 22.99, P=0.04], hemoglobin overall response rate [odds ratio (OR) =1.97, 95% CI: 1.7 to 3.33, P=0.01], serum iron [standardized mean difference (SMD) =0.39, 95% CI: 0.23 to 0.55, P<0.00001], transferrin saturation (MD =6.09, 95% CI: 5.36 to 6.82, P<0.0001), transferrin (MD =0.36, 95% CI: 0.28 to 0.44, P<0.00001], total iron binding capacity (SMD =0.63, 95% CI: 0.47 to 0.79, P<0.00001) and significantly reduced hepcidin (MD =-29.04, 95% CI: -51.61 to -6.47, P=0.01). There was no significant difference in adverse reactions between groups (OR =1.06, 95% CI: 0.30 to 3.74, P=0.93). DISCUSSION: Roxadustat can effectively improve the anemia status of patients with CKD without increasing adverse reactions. Due to limitations of the number and quality of the included studies, further verification is required through the multi-center, large sample-sized, and high-quality RCTs in the future.


Assuntos
Anemia , Isoquinolinas , Anemia/tratamento farmacológico , Anemia/etiologia , China , Glicina/análogos & derivados , Humanos
14.
Rinsho Ketsueki ; 62(4): 267-269, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33967151

RESUMO

We report the case of a patient with lead poisoning caused by a dietary supplement. A 40-year-old man was referred to us due to intermittent upper abdominal pain and normocytic anemia. His hemoglobin level was 9.3 g/dl, with basophilic stippling in 2.8% of red blood cells. Bone marrow aspirate smear showed ringed sideroblasts that represented 19% of the erythroblasts. The patient reported the use of an unauthorized, Indian-manufactured dietary supplement and was diagnosed with lead poisoning based on a significantly high blood lead level. The dietary supplement was discontinued, and he was successfully treated with lead chelation therapy, and his hemoglobin level normalized within 2 months.


Assuntos
Anemia , Intoxicação por Chumbo , Adulto , Terapia por Quelação , Suplementos Nutricionais , Humanos , Chumbo , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/tratamento farmacológico , Intoxicação por Chumbo/etiologia , Masculino
15.
BMJ Open ; 11(5): e045609, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33986056

RESUMO

BACKGROUND: Preventing infantile anaemia and ensuring optimal growth and development during early childhood, particularly in resource-constrained settings, represent an ongoing public health challenge. Current responses are aligned to treatment-based solutions, instead of determining the roles of its inter-related causes. This project aims to assess and understand the complex interplay of eco-bio-social-political factors that determine infantile anaemia to inform policy, research design and prevention practices. METHODS: This is a longitudinal birth cohort study including four components: (1) biological, will assess known blood markers of iron homeostasis and anaemia and stool microbiota to identify and genetically analyse the participants' flora; (2) ecological, will assess and map pollutants in air, water and soil and evaluate features of nutrition and perceived food security; (3) social, which will use different qualitative research methodologies to explore key stakeholders and informants' perceptions related to nutritional, environmental and anaemia topics, participant observations and a participatory approach and (4) a political analysis, to identify and assess the impact of policies, guidelines and programmes at all levels for infantile anaemia in the three regions. Finally, we will also explore the role of social determinants and demographic variables longitudinally for all study participants. This project aims to contribute to the evidence of the inter-related causal factors of infantile anaemia, addressing the complexity of influencing factors from diverse methodological angles. We will assess infantile anaemia in three regions of Peru, including newborns and their mothers as participants, from childbirth until their first year of age. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Research Ethics Committee of the Instituto Nacional de Salud del Niño (Lima, Peru), CIEI-043-2019. An additional opinion has been granted by the Ethical Committee of Queen Mary University of London (London, UK). Dissemination across stakeholders is taking part as a continues part of the research process.


Assuntos
Anemia , Anemia/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Crescimento e Desenvolvimento , Homeostase , Humanos , Lactente , Recém-Nascido , Ferro , Londres , Peru
16.
Pan Afr Med J ; 38: 229, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34046134

RESUMO

Introduction: in Cameroon patients with multidrug/rifampicin resistant pulmonary tuberculosis (MDR/RR-PTB) are treated with a 9-11 month standardised shorter treatment regimen. Despite its effectiveness, factors associated with the occurrence of an unfavourable treatment outcome in this group of patients are not known. Determine the incidence and identify factors associated with an unfavourable treatment outcome among patients with rifampicin resistant pulmonary tuberculosis (RR-PTB) in Yaoundé. Methods: we conducted a retrospective record review of all consecutive patients with bacteriologically confirmed RR-PTB followed up at the specialised MDR/RR-TB treatment centre of the Jamot Hospital in Yaoundé (JHY) from January 2013 to November 2019. A patient was classified as having an unfavourable outcome if he/she had treatment failure, died or was lost to follow-up during the course of treatment. Results: a total of 242 RR-PTB patients with a mean age of 35.59 ± 12.02 years including 144 (59.5%) males were registered. Forty-nine (49) of the 242 patients had an unfavourable treatment outcome giving a cumulative incidence of 20.20% (95% confidence interval (95% CI): 15.40-25.90%). Multivariable analysis revealed that patients with an unfavourable outcome were more likely to be males (odds ratio (OR): 2.94; 95% CI: 1.24-7.00, p= 0.015), HIV infected (OR: 2.67; 95% CI: 1.17-6.06, p = 0.019), and have a baseline haemoglobin level ≤ 10g/dl (OR: 2.87; 95% CI: 1.25-6.58, p = 0.013). Conclusion: the rate of an unfavourable treatment outcome among patients with RR-PTB at the specialised MDR/RR-TB treatment centre of the JHY is relatively high. The male sex, HIV infection and moderate to severe anaemia are independent factors associated with an unfavourable treatment outcome.


Assuntos
Antituberculosos/administração & dosagem , Rifampina/administração & dosagem , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Anemia/epidemiologia , Camarões/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rifampina/farmacologia , Fatores de Risco , Fatores Sexuais , Falha de Tratamento , Resultado do Tratamento , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
17.
Intern Med J ; 51(5): 797-801, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34047020

RESUMO

A strong anti-hepcidin activity has been observed in heparins. Mean hepcidin levels were significantly reduced compared to baseline, following the first day of unfractionated heparin administration in critically patients. Heparin displayed a strong independent negative association with hepcidin. These results may lead to future treatment methods of forms of anaemia characterised by hepcidin excess, common among the critically ill.


Assuntos
Anemia , Heparina , Anemia/tratamento farmacológico , Estado Terminal , Hepcidinas , Humanos
18.
Dimens Crit Care Nurs ; 40(4): 204-209, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34033439

RESUMO

BACKGROUND: A low hemoglobin level, commonly referred to as anemia, is frequently encountered in the acute care setting among patients with different comorbidities. It is essential that clinicians understand the pathophysiology of anemia to develop a practical differential diagnosis of the cause of the low hemoglobin level. A systematic approach should be used when determining the diagnosis to provide the correct treatment for the patient. OBJECTIVE: This article highlights the equal importance of the patient's history and laboratory values in arriving at the correct diagnosis of low hemoglobin level. The approach to diagnosis is described along with an algorithm to enable the clinician to quickly and effectively diagnose their patients. DISCUSSION: The differential diagnosis of low hemoglobin level is extensive, and some may be overlooked if an organized approach is not taken. For unstable patients, the diagnosis is usually clearer to the clinician. However, for a stable patient, the diagnosis may be difficult to obtain owing to the many causes of low hemoglobin level. The algorithm allows for easier navigation of the diagnostic process.


Assuntos
Anemia , Algoritmos , Anemia/diagnóstico , Diagnóstico Diferencial , Hemoglobinas , Humanos
20.
Gan To Kagaku Ryoho ; 48(3): 363-365, 2021 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-33790158

RESUMO

A 61-year-old woman, who consulted another doctor with chief complaints of epigastric pain, nausea, anorexia, palpitation, and shortness of breath since a month was referred to our hospital for diagnosis and treatment. She was diagnosed with advanced gastric cancer. She was also found to have severe anemia(hemoglobin 1.8 g/dL)and malnutrition. With adequate precautions to prevent development of heart failure and refeeding syndrome, the patient was treated for anemia with blood transfusion and intravenous iron injection; and for malnutrition with intravenous hyperalimentation and enteral nutrition. The patient underwent distal gastrectomy 17 days after admission. Histological examination revealed a type 3 moderately differentiated tubular adenocarcinoma>solid type of poorly differentiated adenocarcinoma>mucinous adenocarcinoma corresponding to pT4a, pN3a, pStage ⅢB, respectively. The postoperative course was good and adjuvant chemotherapy was started 22 days after surgery. However, the patient died approximately 15 months after surgery due to metastases of gastric cancer to the lymph nodes.


Assuntos
Adenocarcinoma , Anemia , Neoplasias Gástricas , Adenocarcinoma/cirurgia , Anemia/etiologia , Anemia/terapia , Feminino , Gastrectomia , Gastroenterostomia , Hemoglobinas , Humanos , Pessoa de Meia-Idade , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia
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