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1.
BMC Infect Dis ; 21(1): 674, 2021 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-34247585

RESUMO

BACKGROUND: Anemia, which is a condition with reduced healthy red blood cells, is reported to be closely related to the development of infectious diseases. We aimed to investigate the association between history of anemia and 12-year mortality rate due to infections, and compare it with that among non-anemic individuals. METHODS: Data from the National Health Insurance Service Health Screening Cohort were used in this population-based cohort study. Adults who underwent standardized medical examination between and 2002-2003 were included, and the mortality rate due to infection between 2004 and 2015 was analyzed. Individuals were considered to have a history of anemia if the serum hemoglobin level in 2002-2003 was < 12 g/dL for women and < 13 g/dL for men. The severity of anemia at that time was categorized as mild (12 g/dL > hemoglobin ≥11 g/dL in women and 13 g/dL > hemoglobin ≥11 g/dL in men), moderate (hemoglobin 8-10.9 g/dL), or severe (hemoglobin < 8 g/dL). Propensity score (PS) matching and Cox regression analysis were used as statistical methods. RESULTS: Overall, 512,905 individuals were included in this study. The mean age of the participants was 54.5 years old (range: 40-98), and 49,042 (9.6%) individuals were classified in the anemic group, which comprised of 36,383 (7.1%), 11,787 (2.3%), and 872 (0.2%) participants in the mild, moderate, and severe sub-groups, respectively. After PS matching, 49,039 individuals in each group were included in the analysis. The risk of mortality due to infection in the anemic group was 1.77-fold higher (hazard ratio [HR]: 1.77, 95% confidence interval [CI]: 1.52-2.60; P < 0.001) than that in the non-anemic group. In the subgroup analysis, the mild and moderate anemia groups had 1.38-fold (HR: 1.38, 95% CI: 1.23 to 1.55; P < 0.001) and 2.02-fold (HR: 2.02, 95% CI: 1.62 to 2.50; P < 0.001) risk of mortality due to infection compared to that of the non-anemic group, respectively. The severe anemia group did not have a significantly different risk of mortality due to infection (P = 0.448). CONCLUSIONS: History of anemia was associated with increased mortality rate due to infection at 12-year follow-up.


Assuntos
Anemia/complicações , Infecções/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Hemoglobinas/análise , Humanos , Infecções/etiologia , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Modelos de Riscos Proporcionais , República da Coreia , Fatores de Tempo
2.
Nutrients ; 13(5)2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-34066873

RESUMO

To evaluate whether women with anaemia or high haemoglobin (Hb) in early pregnancy would be at higher risk of miscarriage, this population-based cohort study involved 9453 women whose pregnancies were monitored at primary care centres between 2007 and 2012. The computerised clinical histories were used to collect: Hb measurements (up to 14 weeks of gestation), miscarriage before or by 24 weeks of gestation, and other maternal characteristics. The relation between anaemia (Hb < 110 g/L), normal Hb (110-140 g/L, reference), and high Hb concentrations (≥140 g/L) with miscarriage were expressed as adjusted OR with 95%CI. Restricted cubic spline models were applied to evaluate the dose-response relationships. A total of 520 (5.5%) women were recorded as having a miscarriage. The rate of miscarriage in anaemia, normal Hb, and high Hb concentrations was 8.4%, 5.1%, and 10.2%, respectively. Compared with women with normal Hb at the first trimester, the multivariable-adjusted OR for miscarriage was 2.11 (95%CI, 1.38-3.21) for women with anaemia and 1.83 (95%CI, 1.29-2.58) for women with high Hb. Hb concentrations showed a U-shaped association with miscarriage, with the lowest incidence among women with Hb of 120-130 g/L. These data highlight the importance of considering anaemia and high Hb levels in early pregnancy as harmful indicators for miscarriage.


Assuntos
Aborto Espontâneo/epidemiologia , Anemia/epidemiologia , Hemoglobinas/análise , Complicações Hematológicas na Gravidez/epidemiologia , Primeiro Trimestre da Gravidez/sangue , Aborto Espontâneo/etiologia , Adulto , Anemia/complicações , Estudos de Coortes , Feminino , Humanos , Incidência , Razão de Chances , Gravidez , Complicações Hematológicas na Gravidez/etiologia , Fatores de Risco
3.
Lancet Haematol ; 8(7): e503-e512, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34171281

RESUMO

BACKGROUND: Numerous iron preparations are available for the treatment of iron deficiency anaemia in pregnancy. We aimed to provide a summary of the effectiveness and safety of iron preparations used in this setting. METHODS: We did a systematic review and network meta-analysis of randomised trials. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, trial registers, and grey literature for trials published in any language from Jan 1, 2011, to Feb 28, 2021. We included trials including pregnant women with iron deficiency anaemia and evaluating iron preparations, irrespective of administration route, with at least 60 mg of elemental iron, in comparison with another iron or non-iron preparation. Three authors independently selected studies, extracted data, and did a risk of bias assessment using the Cochrane tool (version 1.0). The primary outcome was the effectiveness of iron preparations, evaluated by changes in haemoglobin concentration at 4 weeks from baseline. The secondary outcomes were change in serum ferritin concentration at 4 weeks from baseline and treatment-related severe and non-severe adverse events. We did random-effects pairwise and network meta-analyses. Side-effects were reported descriptively for each trial. This study is registered with PROSPERO, CRD42018100822. FINDINGS: Among 3037 records screened, 128 full-text articles were further assessed for eligibility. Of the 53 eligible trials (reporting on 9145 women), 30 (15 interventions; 3243 women) contributed data to the network meta-analysis for haemoglobin and 15 (nine interventions; 1396 women) for serum ferritin. The risk of bias varied across the trials contributing to network meta-analysis, with 22 of 30 trials in the network meta-analysis for haemoglobin judged to have a high or medium global risk of bias. Compared with oral ferrous sulfate, intravenous iron sucrose improved both haemoglobin (mean difference 7·17 g/L, 95% CI 2·62-11·73; seven trials) and serum ferritin (mean difference 49·66 µg/L, 13·63-85·69; four trials), and intravenous ferric carboxymaltose improved haemoglobin (mean difference 8·52 g/L, 0·51-16·53; one trial). The evidence for other interventions compared with ferrous sulfate was insufficient. The most common side-effects with oral iron preparations were gastrointestinal effects (nausea, vomiting, and altered bowel movements). Side-effects were less common with parenteral iron preparations, although these included local pain, skin irratation, and, on rare occasions, allergic reactions. INTERPRETATION: Iron preparations for treatment of iron deficiency anaemia in pregnancy vary in effectiveness, with good evidence of benefit for intravenous iron sucrose and some evidence for intravenous ferric carboxymaltose. Clinicians and policy makers should consider the effectiveness of individual preparations before administration, to ensure effective treatment. FUNDING: None.


Assuntos
Anemia Ferropriva/tratamento farmacológico , Compostos Férricos/uso terapêutico , Óxido de Ferro Sacarado/uso terapêutico , Compostos Ferrosos/uso terapêutico , Maltose/análogos & derivados , Feminino , Compostos Férricos/efeitos adversos , Óxido de Ferro Sacarado/efeitos adversos , Ferritinas/sangue , Compostos Ferrosos/efeitos adversos , Hemoglobinas/análise , Humanos , Maltose/efeitos adversos , Maltose/uso terapêutico , Náusea/etiologia , Gravidez
4.
Medicine (Baltimore) ; 100(26): e26565, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190197

RESUMO

BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic agent used to reduce bleeding in major surgical procedures. This study evaluates the efficacy and safety of the systemic and topical intra-articular administration of TXA in total hip arthroplasty (THA). METHODS: Patients (N = 123) scheduled for primary unilateral THA were divided into 3 treatment groups: control group; TXA, systemic, repeated 1 g bolus; TXA, topically intra-articularly, 2 g in 50 mL saline. Primary readouts used were intra- and postoperative bleeding, transfusion requirement, postoperative hemoglobin levels and complications. RESULTS: Both systemic and topical intra-articular TXA administrations decreased bleeding and transfusion requirements. Topical intra-articular use of TXA led to the reduction in intraoperative and postoperative bleeding and affected hemoglobin levels compared with control. Systemic administration of TXA led to a significant reduction of postoperative bleeding and transfusion rate compared with control and was not different in efficacy and complication incidence when compared to topical administration of TXA. CONCLUSIONS: The use of TXA to reduce blood loss and transfusion requirements in THA is an effective and safe concept in practice. The dose of 2 g TXA topically intra-articularly and a repeated bolus of 1 g TXA systematic led to lower intra- and postoperative bleeding and a significantly lower transfusion rate than the control group. Topical intra-articular TXA administration could be a reasonable alternative in high-risk patients.


Assuntos
Artroplastia de Quadril , Hemorragia Pós-Operatória/prevenção & controle , Ácido Tranexâmico , Administração Intravenosa/métodos , Idoso , Antifibrinolíticos/administração & dosagem , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Transfusão de Sangue/estatística & dados numéricos , Monitoramento de Medicamentos , Feminino , Hemoglobinas/análise , Humanos , Injeções Intra-Articulares/métodos , Masculino , Hemorragia Pós-Operatória/sangue , Risco Ajustado/métodos , Eslováquia , Ácido Tranexâmico/administração & dosagem , Ácido Tranexâmico/efeitos adversos , Resultado do Tratamento
5.
Animal ; 15(7): 100256, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34098521

RESUMO

The current preventive treatment for iron deficiency in pigs is inefficient, resulting in a high prevalence of iron-deficient or anemic postweaned pigs. The aim of this study was to develop and characterize edible toys (ETs) to be used as oral iron supplements, and to assess their effect on feeding behavior and iron status of postweaned pigs. Three types of ETs, varying in sweetness, were produced by ionic gelation, using whey, sodium alginate, ferrous sulfate and atomized bovine erythrocytes. ET control (ETC) was developed without sweetener, ET1 contained 15% w/v sucrose and ET2 contained 0.03% w/v of Sucram (98% sodium saccharin, 1% neosperidine dihydrocalcone and 1% maltol). ETs were mainly composed of carbohydrates and protein, with a similar concentration of iron (2.2-2.7 mg/g). The ETs were offered to 24 postweaned pigs to measure acceptability and preference. The animals preferred ETC and ET2 over ET1. To assess the nutritional benefit of the ETs, 24 postweaned pigs were distributed into three groups: ETC (without iron), ETC-Fe (ETC with iron) and ET2-Fe (with iron and Sucram). Iron-loaded ET (ETC-Fe and ET2-Fe) significantly increased the concentration of red blood cells (from 6.1 to 7.5·106 x mm3 for ETC-Fe and from 6.2 to 7.8 for ET2-Fe), hematocrit (from 32.8 to 37.9% for ETC-Fe and from 32.3 to 35.1 for ET2-Fe), serum iron (from 28.6 to 120.6 µmol/L for ETC-Fe and from 34.9 to 145.4 for ET2-Fe) and serum ferritin (from 7.8 to 18.5 µg/L for ETC-Fe and from 8.1 to 20.2 for ET2-Fe). In conclusion, the ETs developed in this study were accepted by the pigs and provided adequate iron to improve the iron status of postweaned pigs.


Assuntos
Anemia Ferropriva , Doenças dos Bovinos , Doenças dos Suínos , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/veterinária , Animais , Bovinos , Comportamento Alimentar , Hematócrito/veterinária , Hemoglobinas/análise , Ferro , Suínos
6.
Eur J Pediatr ; 180(8): 2609-2618, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34101010

RESUMO

Iron deficiency anemia (IDA) is common among children with cerebral palsy (CP), and studies on the efficacy of lactoferrin (Lf) in the treatment of IDA are limited. This study aimed to compare the efficacy of Lf with that of iron hydroxide polymaltose complex (IPC) in the treatment of IDA in children with CP. This randomized controlled study, conducted at Alexandria University Children's Hospital, enrolled 70 children aged 1-10 years with CP and IDA; 35 children randomly received IPC, whereas the other 35 received Lf. Four children withdrew from the study; thus, only 66 children were analyzed (32 in the IPC group and 34 in the Lf group). At baseline, the hemoglobin level and other blood parameters were similar between the two intervention groups. After four weeks of treatment, both the IPC and Lf groups showed significant improvements in hemoglobin (Hb), serum ferritin (SF), serum iron, total iron-binding capacity, mean corpuscular volume, and mean corpuscular hemoglobin from baseline. Upon comparing the two treatment groups, adjusted mean Hb and SF changes in the Lf group were significantly higher than that of the IPC group (p =0.001and p= 0.033, respectively), and constipation was less likely to occur in the Lf group than the IPC group (p = 0.049 ).Conclusion: Lactoferrin is effective and superior to IPC as an oral iron replacement therapy in children with CP and IDA, as it has fewer side effects. What is Known: • Lactoferrin (LF) is a natural glycoprotein capable of treating iron deficiency anemia (IDA). • Studies on the efficacy of Lf in the treatment of IDA in children with cerebral palsy (CP) are limited. What is New? • This trial compared the efficacy of Lf and iron hydroxide polymaltose complex (IPC) as treatments of IDA in children with CP. • Lf is effective and even better than IPC as a treatment of IDA in children with CP, as it has fewer side effects.


Assuntos
Anemia Ferropriva , Paralisia Cerebral , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/tratamento farmacológico , Criança , Compostos Férricos , Hemoglobinas/análise , Humanos , Lactoferrina
7.
J Zoo Wildl Med ; 52(2): 737-741, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34130420

RESUMO

Hematologic reference values can be used to help monitor the health of birds kept in captivity for conservation and management purposes. The reference intervals for hematologic analysis in clinically healthy, captive red-and-green macaws (n = 42) were determined and evaluated as to whether they varied with sex. Males showed higher hemoglobin values than females. This report defines hematologic reference intervals of captive, healthy red-and-green macaws kept under similar conditions.


Assuntos
Proteínas Sanguíneas/análise , Contagem de Eritrócitos/veterinária , Hemoglobinas/análise , Contagem de Leucócitos/veterinária , Papagaios/sangue , Animais , Feminino , Masculino , Valores de Referência , Fatores Sexuais
8.
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
9.
BMC Womens Health ; 21(1): 256, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34167528

RESUMO

BACKGROUND: Iron deficiency anemia disrupts the concentration of adolescent girls; reduces their academic achievement, productivity, and physical strength, and increases the risk of infection. This research aim was to evaluate the effectiveness of the PRECEDE model nutrition education on iron deficiency anemia among female students of Fasa City, Fars Province, Iran. METHODS: This quasi-experimental study was done on 160 students (80 experimental and 80 control groups) who were selected using a random sampling method in Fasa City, Fars Province, Iran, in 2018-2019. The educational intervention included six sessions based PRECEDE model for 45 or 50 min. A scale of this study consisted of two parts; demographic information, and PRECEDE constructs were used to determine the nutritional behaviors status concluding preventing iron deficiency anemia and hemoglobin, hematocrit, and ferritin blood level in two (before and 4 months after intervention) times. RESULTS: In the experimental group of the students the mean age was 13.85 + 1.72 years and in the controlled group was 13.60 + 1.81 years. Moreover, there was no significant difference in the PRECEDE constructs, and nutritional behaviors preventing iron deficiency anemia before the intervention in two groups of study. However, the experimental group showed a significant increase 4 months after the intervention. Also, there was no significant difference in the mean score of hemoglobin, hematocrit, and ferritin blood level between the two groups before the intervention. However, in ferritin level, a significant increase was shown in 4 months after the intervention in the experiential group. CONCLUSIONS: Based on results, the nutrition intervention education base on PRECEDE model has a positive effect to improve iron deficiency anemia preventive behaviors in female students.


Assuntos
Anemia Ferropriva , Adolescente , Anemia Ferropriva/prevenção & controle , Criança , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hemoglobinas/análise , Humanos , Irã (Geográfico) , Estudantes
10.
Analyst ; 146(13): 4290-4302, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34105523

RESUMO

Over the past seven years Matrix Assisted Laser Desorption Ionisation Mass Spectrometry Profiling (MALDI MSP) and Imaging (MALDI MSI) have proven to be feasible tools for the detection of blood and its provenance in stains and fingermarks. However, whilst this capability as a confirmatory test addresses the primary questions at the scene of a violent crime, additional intelligence recoverable from blood can also prove important for investigations. A DNA profile is the most obvious and important example of such intelligence; however, it is not always suitable for identification purposes, depending on quantity, age and environmental conditions. Proteins are much more stable and determining the presence of haemoglobin variants in blood recovered at a crime scene may provide associative and possibly corroborating evidence on the presence of an individual at a particular location. This evidence gains more incriminatory value, the lower the incidence of the variant in a certain geographical area or population and may contribute to narrowing down the pool of suspects. In this study, a MALDI based mass spectrometric method has been developed and tested on six haemoglobin variants for their fast and reliable identification and mapping in blood fingermarks.


Assuntos
Corantes , Testes Hematológicos , Hemoglobinas/análise , Hemoglobinas/genética , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Coloração e Rotulagem
11.
Ars pharm ; 62(2): 182-189, abr.-jun. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-202444

RESUMO

INTRODUCTION: India carries the highest burden of anemia, particularly in children and women. Children at the growing stage are at the risk of nutrition depletion, hence anemia. Fewer data are available on the prevalence of anemia in growing children of age 10-14 years. It is important to intervene early and track this group. The objective of the present study was to estimate the prevalence of anemia and its correlation to age, gender and body mass index in children of rural area of Ghaziabad, Uttar Pradesh, India. METHOD: Total 600 children of 5-13 years age group were included in this study. A detailed questionnaire was used to collect the health details of the children and socioeconomic status of the parents. Hemoglobin was determined by the calibrated Hemoglobin analyzer. Body mass index values were calculated based on the measurements of weight and height of the children. RESULTS: Prevalence of anemia as per WHO standards in these children was 57.67%. Results of the study population reveal that anemia in this region is more prevalent in girls (68%) when compared to boys (47.3%). However, association between body mass index and hemoglobin was not statistically significant in the present study. CONCLUSIONS: Our results suggest that increased prevalence of anemia in the children of rural area is associated with multiple nutrient deficiencies. Nutritional interventions, evaluation of predisposing risk factors and increased coverage of supplementation programme are recommended measures that can be adopted to control anemia in children


INTRODUCCIÓN: India soporta la mayor carga de anemia, especialmente en niños y mujeres. Hay menos datos disponibles sobre la prevalencia de anemia en niños en crecimiento de 10 a 14 años. Es importante intervenir temprano y rastrear a este grupo. El objetivo del presente estudio fue estimar la prevalencia de anemia y su correlación con la edad, sexo e índice de masa corporal en niños del área rural de Ghaziabad, Uttar Pradesh, India. MÉTODO: Se incluyó un total de 600 niños de entre 5 y 13 años. Se utilizó un cuestionario detallado para recopilar datos de salud de los niños y el estado socioeconómico de los padres. Se midió peso talla y se calculó el índice de masa corporal. Se midió la hemoglobina mediante analizador calibrado. RESULTADOS: La prevalencia de anemia según los estándares de la OMS en estos niños fue de 57,67%. Los resultados revelan que la anemia en esta región es más prevalente en las niñas (68%) en comparación con los niños (47,3%). Sin embargo, la asociación entre el índice de masa corporal y la hemoglobina no fue estadísticamente significativa en el presente estudio. CONCLUSIONES: Nuestros resultados sugieren que el aumento de la prevalencia de anemia en los niños del área rural está asociado con múltiples deficiencias de nutrientes. Las intervenciones nutricionales, la evaluación de los factores de riesgo predisponentes y una mayor cobertura del programa de suplementación son medidas recomendadas que se pueden adoptar para controlar la anemia en los niños


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Anemia/epidemiologia , População Rural/estatística & dados numéricos , Estudos Transversais , Prevalência , Fatores Socioeconômicos , Desnutrição/epidemiologia , Índice de Massa Corporal , Hemoglobinas/análise , Distribuição por Idade e Sexo , Índice de Gravidade de Doença , Índia/epidemiologia , Comportamento Alimentar
12.
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
13.
Curr Opin Anaesthesiol ; 34(4): 530-536, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34039847

RESUMO

PURPOSE OF REVIEW: Severe bleeding events, which require blood transfusions, are a challenge faced by many critical care physicians on a daily basis. Current transfusion guidelines generally recommend rather strict transfusion thresholds and strategies, which can appear opposing to a patient in need for urgent transfusion at first sight. Moreover, applied guidelines are lacking evidence and specificity for the typical ICU patient population and its comorbidities. Transfusion decisions, which are pivotal for clinical outcome, are often unsatisfactorily based on hemoglobin levels only. RECENT FINDINGS: Recent publications generally support previous studies that a strict transfusion regimen is superior to a liberal one for the majority of cases. Newly developed and easily feasible techniques are currently in clinical trials and have the potential to become a valuable supplementation to hemoglobin-guided decision-making. In addition to the choice of the ideal transfusion strategy, physiological status and comorbidities were found to have a major impact on the outcome of severe bleedings in the ICU. SUMMARY: The body of evidence for ICU-specific transfusion guidelines is scarce. Critical care physicians should properly evaluate their patient's comorbidities and consider extended point-of-care testing for transfusion decisions in indistinct anemic situations. A strict transfusion strategy should, however, be applied whenever possible.


Assuntos
Anemia , Transfusão de Eritrócitos , Hemoglobinas/análise , Hemorragia/etiologia , Hemorragia/terapia , Humanos , Unidades de Terapia Intensiva
14.
Ann Clin Lab Sci ; 51(2): 213-219, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33941561

RESUMO

OBJECTIVE: Patients with warm autoimmune hemolytic anemia (WAIHA) present with anemia that is highly heterogeneous, and often have macrocytic anemia with inappropriately elevated mean corpuscular volume (MCV). The goal of this retrospectivecase study is to elucidate the characteristics of anemia in patients with idiopathic WAIHA. PROCEDURES: The hematological parameters were analyzed by automated hematology analyzers in 19 consecutive patients with idiopathic WAIHA. Thecontent of hemoglobin (Hb) in the reticulocytes was assessed as reticulocyte Hb equivalent (RET-He). Relevant laboratory data and medical records were retrospectively studied. RESULTS: The median MCV was 102.7 fL and ten patients had macrocytic anemia with MCV above 100 fL. There was a significant correlation between the percentage of reticulocytes and MCV. The median RET-He value was 35.9 pg, and the reticulocytes of patients with higher MCV had higher RET-He. There was a significant correlation between red cell volume distribution width (RDW) andMCV, while the association between RDW and RET-He was not significant. Red blood cell agglutination was not seen in any of the patients. Relative folate deficiency was implied to contribute to the increased Hb content in the reticulocytes of WAIHA patients. CONCLUSION: Reticulocytes in WAIHA patients often contain more Hb than normal reticulocytes and become inappropriately large, possibly due to relative folate deficiency. Elevated MCV in WAIHA patients is due to the increase in both the number and the Hb content of reticulocytes.


Assuntos
Anemia Hemolítica Autoimune/metabolismo , Anemia Macrocítica/diagnóstico , Reticulócitos/química , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/diagnóstico , Anemia Hemolítica Autoimune/fisiopatologia , Anemia Macrocítica/metabolismo , Índices de Eritrócitos/fisiologia , Feminino , Hemoglobinas/análise , Hemoglobinas/química , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
Stem Cell Reports ; 16(5): 1165-1181, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: covidwho-1225410

RESUMO

SARS-CoV-2 infection is associated with lower blood oxygen levels, even in patients without hypoxia requiring hospitalization. This discordance illustrates the need for a more unifying explanation as to whether SARS-CoV-2 directly or indirectly affects erythropoiesis. Here, we show significantly enriched CD71+ erythroid precursors/progenitors in the blood circulation of COVID-19 patients. We found that these cells have distinctive immunosuppressive properties. In agreement, we observed a strong negative correlation between the frequency of these cells with T and B cell proportions in COVID-19 patients. The expansion of these CD71+ erythroid precursors/progenitors was negatively correlated with the hemoglobin levels. A subpopulation of abundant erythroid cells, CD45+ CD71+ cells, co-express ACE2, TMPRSS2, CD147, and CD26, and these can be infected with SARS-CoV-2. In turn, pre-treatment of erythroid cells with dexamethasone significantly diminished ACE2/TMPRSS2 expression and subsequently reduced their infectivity with SARS-CoV-2. This provides a novel insight into the impact of SARS-CoV-2 on erythropoiesis and hypoxia seen in COVID-19 patients.


Assuntos
Imunidade Adaptativa/imunologia , COVID-19/patologia , Células Precursoras Eritroides/virologia , Eritropoese/fisiologia , Hemoglobinas/análise , Oxigênio/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Enzima de Conversão de Angiotensina 2/metabolismo , Animais , Linfócitos B/citologia , Linfócitos B/imunologia , COVID-19/imunologia , Dexametasona/farmacologia , Células Precursoras Eritroides/imunologia , Feminino , Humanos , Contagem de Linfócitos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , SARS-CoV-2/imunologia , Serina Endopeptidases/metabolismo , Linfócitos T/citologia , Linfócitos T/imunologia , Adulto Jovem
16.
Eur J Med Res ; 26(1): 45, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: covidwho-1229005

RESUMO

BACKGROUND: Hematological comparison of coronavirus disease (COVID-19) and other viral pneumonias can provide insights into COVID-19 treatment. METHODS: In this retrospective case-control single-center study, we compared the data of 126 patients with viral pneumonia during different outbreaks [severe acute respiratory syndrome (SARS) in 2003, influenza A (H1N1) in 2009, human adenovirus type 7 in 2018, and COVID-19 in 2020]. RESULTS: One of the COVID-19 characteristics was a continuous decline in the hemoglobin level. The neutrophil count was related to the aggravation of COVID-19 and SARS. Thrombocytopenia occurred in patients with SARS and severe COVID-19 even at the recovery stage. Lymphocytes were related to the entire course of adenovirus infection, recovery of COVID-19, and disease development of SARS. CONCLUSIONS: Dynamic changes in hematological counts could provide a reference for the pathogenesis and prognosis of pneumonia caused by respiratory viruses in clinics.


Assuntos
Infecções por Adenovirus Humanos/sangue , COVID-19/sangue , Influenza Humana/sangue , Pneumonia Viral/sangue , Síndrome Respiratória Aguda Grave/sangue , Infecções por Adenovirus Humanos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/patologia , Estudos de Casos e Controles , Feminino , Hemoglobinas/análise , Humanos , Influenza Humana/patologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Pneumonia Viral/patologia , Estudos Retrospectivos , SARS-CoV-2/imunologia , Síndrome Respiratória Aguda Grave/patologia , Trombocitopenia/patologia , Adulto Jovem
17.
Chin Med J (Engl) ; 134(11): 1335-1344, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34039863

RESUMO

BACKGROUND: Fecal immunochemical tests (FITs) are the most widely used non-invasive tests in colorectal cancer (CRC) screening. However, evidence about the direct comparison of the test performance of the self-administered qualitative a laboratory-based quantitative FITs in a CRC screening setting is sparse. METHODS: Based on a CRC screening trial (TARGET-C), we included 3144 pre-colonoscopy fecal samples, including 24 CRCs, 230 advanced adenomas, 622 non-advanced adenomas, and 2268 participants without significant findings at colonoscopy. Three self-administered qualitative FITs (Pupu tube) with positivity thresholds of 8.0, 14.4, or 20.8 µg hemoglobin (Hb)/g preset by the manufacturer and one laboratory-based quantitative FIT (OC-Sensor) with a positivity threshold of 20 µg Hb/g recommended by the manufacturer were tested by trained staff in the central laboratory. The diagnostic performance of the FITs for detecting colorectal neoplasms was compared in the different scenarios using the preset and adjusted thresholds (for the quantitative FIT). RESULTS: At the thresholds preset by the manufacturers, apart from the qualitative FIT-3, significantly higher sensitivities for detecting advanced adenoma were observed for the qualitative FIT-1 (33.9% [95% CI: 28.7-39.4%]) and qualitative FIT-2 (22.2% [95% CI: 17.7-27.2%]) compared to the quantitative FIT (11.7% [95% CI: 8.4-15.8%]), while at a cost of significantly lower specificities. However, such difference was not observed for detecting CRC. For scenarios of adjusting the positivity thresholds of the quantitative FIT to yield comparable specificity or comparable positivity rate to the three qualitative FITs accordingly, there were no significant differences in terms of sensitivity, specificity, positive/negative predictive values and positive/negative likelihood ratios for detecting CRC or advanced adenoma between the two types of FITs, which was further evidenced in ROC analysis. CONCLUSIONS: Although the self-administered qualitative and the laboratory-based quantitative FITs had varied test performance at the positivity thresholds preset by the manufacturer, such heterogeneity could be overcome by adjusting thresholds to yield comparable specificities or positivity rates. Future CRC screening programs should select appropriate types of FITs and define the thresholds based on the targeted specificities and manageable positivity rates.


Assuntos
Neoplasias Colorretais , Laboratórios , Colonoscopia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Fezes , Hemoglobinas/análise , Humanos , Sangue Oculto , Sensibilidade e Especificidade
18.
Lancet Haematol ; 8(6): e462-e466, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34048684

RESUMO

In haematology, as in all of medicine, the use of reference intervals for laboratory variables is essential to define disease states and inform treatment decisions. There are many haematological variables, including haemoglobin, mean corpuscular volume, absolute neutrophil count, and iron indices, that are often reported to be different on the basis of a person's race or ethnicity. Although there are many haematological conditions with a genetic basis, such that it is appropriate to consider ancestry in the diagnostic algorithm, defining pathology on the basis of a social construct such as race is unacceptable. The inclusion of separate thresholds or simple statements that so-called normal values vary by race further validates the common misperception that there are physiological differences between Black and white patients. These statements might have downstream effects on diagnostic and treatment decisions that exacerbate existing racial health disparities. In this Viewpoint, we argued for the removal of race-based reference intervals across haematology.


Assuntos
Testes Hematológicos/normas , Hemoglobinas/normas , Anemia Ferropriva/diagnóstico , Grupos Étnicos , Hemoglobinas/análise , Humanos , Laboratórios/normas , Valores de Referência
19.
Medicine (Baltimore) ; 100(20): e24571, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011020

RESUMO

INTRODUCTION: Iron deficiency anemia (IDA) is common among obstetric and gynecologic patients. This systematic review aimed to assess the comparative efficacy and safety of commonly used intravenous (IV) iron formulations, ferric carboxymaltose (FCM), and iron sucrose (IS) in the treatment of IDA in obstetric and gynecologic patients. METHODS: We systematically searched PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for eligible randomized controlled trials (RCTs) comparing IV iron replacement using FCM and IS up to October 2019. The primary outcome was to compare the efficacy of FCM and IS, assessed by measuring serum hemoglobin (Hb) and ferritin levels before and after iron replacement. The secondary outcome was to compare the safety of FCM and IS, assessed by the incidence of adverse events during iron replacement. The meta-analysis was performed using RevMan 5.3. RESULTS: We identified 9 RCTs with 910 patients (FCM group, n = 456; IS group, n = 454). Before iron replacement, FCM and IS group patients had similar baseline Hb (mean difference [MD], 0.04 g/dL; 95% confidence interval [CI], -0.07 to 015; I2 = 0%; P = 0.48) and ferritin levels (MD, -0.42 ng/mL; 95% CI, -1.61 to 0.78; I2 = 45%; P = 0.49). Following iron replacement, patients who received FCM had higher Hb (MD, 0.67; 95% CI, 0.25-1.08; I2 = 92%; P = 0.002) and ferritin levels (MD, 24.41; 95% CI, 12.06-36.76; I2 = 75%; P = 0.0001) than patients who received IS. FCM group showed a lower incidence of adverse events following iron replacement than IS group (risk ratio, 0.53; 95% CI, 0.35-0.80; I2 = 0%; P = 0.003). Serious adverse events were not reported in any group. CONCLUSION: FCM group showed better efficacy in increasing Hb and ferritin levels and a favorable safety profile with fewer adverse events compared with IS group for IDA treatment among obstetric and gynecologic patients. However, this meta-analysis was limited by the small number of RCTs and high heterogeneity. TRIAL REGISTRATION: The review was prospectively registered with the International Prospective Registry of Systematic Reviews (https://www.crd.york.ac.uk/prospero/, registration number CRD42019148905).


Assuntos
Anemia Ferropriva/tratamento farmacológico , Compostos Férricos/administração & dosagem , Óxido de Ferro Sacarado/administração & dosagem , Hematínicos/administração & dosagem , Maltose/análogos & derivados , Complicações Hematológicas na Gravidez/tratamento farmacológico , Administração Intravenosa , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/etiologia , Feminino , Compostos Férricos/efeitos adversos , Óxido de Ferro Sacarado/efeitos adversos , Ferritinas/sangue , Hematínicos/efeitos adversos , Hemoglobinas/análise , Humanos , Maltose/administração & dosagem , Maltose/efeitos adversos , Gravidez , Complicações Hematológicas na Gravidez/sangue , Complicações Hematológicas na Gravidez/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
20.
Clin Chim Acta ; 519: 193-197, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33939955

RESUMO

BACKGROUND: Hemoglobin fractionation by capillary zone electrophoresis (CE) is becoming a popular method for the identification of hemoglobin variants that can cause hemoglobinopathies. The goal of this study was to compare the performance of capillary electrophoresis using Sebia Capillarys 2 Flex Piercing system (CE-S) with high-pressure liquid chromatography (HPLC) using Primus Ultra2 Resolution Variants System (HPLC-P) as a primary method in hemoglobinopathy work-up. METHODS: A total of 306 blood specimens submitted for evaluation of hemoglobinopathies were studied using HPLC-P and CE-S. RESULTS: The reference ranges for Hb A, A2 and F agreed well between methods. All common variants containing Hb S and Hb C were detected by both methods. Quantification of Hb A2 with HPLC-P required a correction in the presence of Hb S, while quantification of Hb A2 was slightly overestimated by CE-S in the presence of Hb C. Of 41 samples containing other variants, 2 were not identified by HPLC-P and 3 were not identified by CE-S. CONCLUSION: CE-S provides comparable information to that obtained by HPLC-P and it is a reliable primary method for the evaluation of hemoglobin variants.


Assuntos
Hemoglobinopatias , Hemoglobinas Anormais , Cromatografia Líquida de Alta Pressão , Eletroforese Capilar , Hemoglobina A Glicada/análise , Testes Hematológicos , Hemoglobinopatias/diagnóstico , Hemoglobinopatias/genética , Hemoglobinas/análise , Hemoglobinas Anormais/análise , Humanos
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