Erythropoiesis-Stimulating Properties of Anthocyanin-Containing Complex from Sorbus aucuparia L. in Cytostatic Anemic Syndrome in Mice with Lewis Lung Carcinoma.

The results of studying the effect of the anthocyanin-containing complex from Sorbus aucuparia L. on the main indicators of erythropoiesis in the blood and bone marrow of mice with Lewis lung carcinoma against the background of doxorubicin administration were presented. It was shown that administration of the anthocyanin-containing complex from S. aucuparia L. to animals with the tumor prevented the development of anemic syndrome by promoting regeneration of the erythropoiesis after its depletion caused by single administration of a cytostatic agent.

[ASSESSMENT OF NOSOLOGICAL STRUCTURE ASSOCIATED WITH ANEMIC SYNDROME].

The anemic syndrome at the stage of primary health care delivery on an outpatient basis is a risk factor for an unfavorable outcome in patients with chronic somatic diseases, primarily cardiovascular and oncological pathologies. In order to understand the true prevalence of anemia among outpatients it is necessary to improve the registration of patients with this disease. Aim: to analyze the features of managing patients with anemia in the primary health care system using a computerized patient monitoring system. The study included 1498 patients aged 18 to 80 who were under dispensary observation by family physicians. For the analysis of the medical records, a computer program developed by the authors "Monitoring system for patients with anemic syndrome" was used. The structure of morbidity in two selected areas of the outpatient department in the context of the main classes of diseases of ICD-10 is analyzed. According to the analysis of the medical records carried out using the program developed by us, anemia was recorded in 208 patients (13.89%), while in the analysis using the computer register according to the WHO criteria, 500 people had anemic syndrome (33.38%), which indicates the underdiagnosis of this pathological condition and the need to direct the efforts of healthcare organizers to the early revealing of patients with anemia.

Erythropoesis-Stimulating Properties of Anthocyanin-Containing Complexes in Cytostatic Anemic Syndrome.

We studied the effect of an anthocyanin-containing complex from Sorbus aucuparia L. on the main indicators of erythropoiesis in the blood and bone marrow of mice against the background of doxorubicin treatment. It was shown that administration of an anthocyanincontaining complex from S. aucuparia L. prevented the development of anemic syndrome by stimulating regeneration of the erythroid lineage of hematopoiesis after its devastation by single administration of the cytostatic.

LEVEL OF HEPCIDINE IN PATIENTS WITH ANKYLOSING SPONDYLITIS, ASSOCIATION WITH ANEMIA AND THE SEVERITY OF THE DISEASE.

OBJECTIVE: The aim: To assess the level of hepcidin in patients with AS, to determine its connection to the disease and various forms of anemia. PATIENTS AND METHODS: Materials and methods: 118 patients with ankylosing spondylitis were examined and hematological, biochemical, immunologic indicators of the general parameters of hematopoiesis and ferrokinetics, plasma levels of CRP, IL-6 and hepcidin were determined. RESULTS: Results: It was found that high levels of hepcidin are found in 25% of patients with AS, 50% are limiting and only 25% are optimal. The serum levels of hepcidin in patients with AS are independent of the age, sex, and duration of the disease, but are closely associated with the activity (ESR, CRP, IL-6, BASDAI, and ASDAS levels) of the disease. Close pathogenetic connection of hepcidin with the formation of anemic syndrome was established. Patients with ACD were characterized by the highest levels of hepcidin. CONCLUSION: Conclusions: Hepcidin plays an important role in the pathogenesis of ACD in patients with AS and can be used as a diagnostic marker for differential diagnosis.

Anemia in patients with ankylosing spondylitis, association with the activity of the inflammatory process and the severity of the disease.

OBJECTIVE: The aim: To estimate the prevalence of anemia in patients with ankylosing spondylitis, major pathogenetic variants and their relationship with the activity of the inflammatoryprocess and the severity of the disease. PATIENTS AND METHODS: Materials and methods: 118 patients with ankylosing spondylitis participated in the study, which performed hematologic, biochemical, immunological studies with general haemopoiesis and ferrokinetics parameters, plasma levels of CRP and IL-6. RESULTS: Results: It was found that in Ukrainian population of patients with ankylosing spondylitis, 28.8% of patients has anemic syndrome. The anemia spectrum is represented by ACD (44.1%), ACD with iron deficiency (29.4%) and IDA (23.5%). It is shown that the severity of anemic syndrome increases with the increase of the stage of activity of the inflammatory process. The presence and severity of anemia are closely related to the severe course of the disease, evaluated by the BASDAI and ASDAS index, and laboratory markers of inflammation CRP and IL-6 of serum. CONCLUSION: Conclusions: The obtained data is promising for the search of effective means of correction of anemic syndrome in patients with ankylosing spondylitis.

[Characterization of anemic syndrome in cancer patients with sepsis in the early postoperative period.]

A study of the main indicators of red blood (RBC, HGB, HCT, MCV, MCH) and the concentration of EPO, sTfR in 9 cancer patients with anemic syndrome (AS) against sepsis was carried out. Among them, patients with chronic disease anemia (ACh), with normocytic, normochromic characteristics of red blood cells and low hematocrit predominated. In 2 patients, microcytosis and erythrocyte hypochromia were noted, the concentration of sTfR was significantly higher than normal (0.9 ± 0.07 µg / ml), amounted to 2.7 µg / ml in one of them and 1.9 µg / ml in the other, which testified to t iron deficiency erythropoiesis (IDE) on the background of the ACh,. In 7 patients with ACh without IDE, sTfR values were within the normal range (0.1-1.2) µg / ml, the median was 0.5 µg/ml. In all patients with sepsis, the production of EPO was inadequate for the severity of the AS, to a lesser extent in patients with IDE. The average EPO production in the group was 19.4 ± 5.1 (7.7-52.8) mU / ml, median = 12.1 mE / ml. Further studies of EPO, sTfR are planned in order to determine their role in therapeutic tactics in the correction of AS in cancer patients with sepsis.

Síndrome cardio-renal anémico / Cardio-renal anemia syndrome

Las interacciones entre el corazón y el riñón se han convertido en un área de considerable interés, dada la interdependencia de los mismos. Esto motivó la definición y conceptualización del síndrome cardio-renal anémico, que incluye interacciones bidireccionales, donde alteraciones, tanto agudas como crónicas de cualquier órgano, pueden afectar indistintamente la función renal o la ventricular. El tratamiento, involucra el bloqueo del eje renina angiotensina aldosterona y durante una descompensación aguda es válido el soporte dialítico para control de la volemia. La anemia, es multifactorial, se debe tratar de manera oportuna con hierro endovenoso y eritropoyetina recombinante, reduciendo al mínimo el soporte transfusional. El manejo, la definición y el pronóstico del síndrome cardio-renal anémico aún sigue siendo controversial y es un reto para el internista moderno (Acta Med Colomb 2011; 36: 141-144).

The interactions between the heart and the kidney have become an area of considerable interest, given their interdependence. This led to the definition and conceptualization of cardio-renal anemic syndrome, which includes a bidirectional interaction: acute or chronic injuries of any organ indiscriminately affect renal or ventricular function. Treatment involves blocking the rennin-angiotensin-aldosterone axis and, during acute decompensation, dialytic support for volemic control. Anemia is due to multiple causesand must be treated promptly with intravenous iron and recombinant erythropoietin, to minimize the need for transfusions. Management, definition and prognosis of cardio-renal anemic syndrome are still controversial and represent a challenge for the modern internist (Acta Med Colomb 2011; 36: 141-144).

¿Qué hacer cuando la anemia se interpone en la insuficiencia cardíaca crónica? / What to do when anemia stands in chronic heart failure? / ¿O que fazer quando chega a anemia na insuficiência cardíaca crà´nica?

Desde hace muchos años conocemos las consecuencias fisiopatológicas de la anemia en el aparato cardiovascular. Estudios multicéntricos demostraron que es un factor de riesgo independiente de mortalidad y morbilidad en insuficiencia cardíaca crónica, por lo que su corrección mejora la sobrevida de estos pacientes. Tiene una prevalencia elevada, en algunas series, cercana al 60%. Las causas de anemia en pacientes con insuficiencia cardíaca crónica son numerosas y muchas veces se asocian como formas etiológicas mixtas, por lo cual resulta difícil llegar a su diagnóstico y luego encontrar el tratamiento específico. Los recursos terapéuticos disponibles son la transfusión, el hierro endovenoso y la eritropoyetina con sus derivados; todos ellos con potenciales efectos indeseados. No está claramente definido el umbral mínimo de hemoglobina donde se incrementa la mortalidad o el punto donde deberíamos comenzar a actuar. Tampoco está definido hasta donde llevar los niveles de hemoglobina para evitar los efectos indeseados de la terapéutica. Por todos estos motivos, la anemia es un verdadero problema para el cardiólogo. Si bien actualmente, podemos delimitar algunas pautas como: descartar causas frecuentes de anemia (pérdidas gastrointestinales), evaluar los depósitos de hierro y el uso de eritropoyetina en un selecto grupo de pacientes, todavía no existe consenso en las guías de insuficiencia cardíaca.

For many years we have known the pathophysiological consequences of anemia in the cardiovascular system. Multicenter studies showed that it is an independent risk factor of mortality and morbidity in chronic heart failure, so its correction improves survival in these patients. It has a high prevalence, in some series approaches 60%. The causes of anemia in patients with chronic heart failure are numerous and are often associated as mixed aetiological forms; these makes difficult our reach to a diagnosis and then find the specific treatment. Therapeutic resources available are transfusion, intravenous iron and erythropoietin with its derivatives; all with potential unwanted effects. It is not clearly defined the minimum threshold of hemoglobin where increases mortality or the point where we should start working. And it is not defined how far carrying hemoglobin levels to avoid unwanted effects of therapy. For all these reasons, anemia is a real problem for the cardiologist. While we can now define some guidelines like: rule out common causes of anemia (gastrointestinal losses), evaluate iron deposits and use erythropoietin in a select group of patients, there is still no consensus on the heart failure guidelines.

Por muitos anos nós sabemos as conseqà»ências fisiopatológicas da anemia no sistema cardiovascular. Estudos multicêntricos mostraram que é um fator de risco independente de mortalidade e morbidade em insuficiência cardíaca crà´nica, por isso a sua correção melhora a sobrevida destes pacientes. Ele tem uma alta prevalência, em algumas séries chega aos 60%. As causas da anemia em pacientes com insuficiência cardíaca crà´nica são numerosas e estão freqà»entemente associadas como formas etiológicas mistas, o que torna difícil chegar a um diagnóstico e, em seguida, encontrar o tratamento específico. Os recursos terapêuticos disponíveis são: transfusão, ferro endovenoso e eritropoietina com seus derivados, todos com potenciais efeitos indesejáveis. Não está claramente definido o limite mínimo de hemoglobina, onde aumenta a mortalidade ou o ponto onde devemos comeà§ar a trabalhar. Também não é definida, na medida do aumento dos níveis de hemoglobina para evitar os efeitos indesejáveis da terapia. Por todas estas razàµes, a anemia é um problema real para o cardiologista. Enquanto nós podemos agora definir algumas diretrizes como: excluir causas comuns de anemia (perdas gastrointestinais), avaliar os depósitos de ferro e eritropoietina uso em um grupo seleto de pacientes, ainda não há consenso sobre as orientações da insuficiência cardíaca.