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Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 3-year-old Tanzanian female presented with severe hemolytic anemia of unknown etiology, necessitating multiple red blood cell transfusions. The patient was found to have glucose-6-phosphate dehydrogenase (G6PD) deficiency A- and a heterozygous Piezo-type mechanosensitive ion channel component 1 (PIEZO1) mutation (2744A>G, N915S). This case identifies a novel PIEZO1 mutation implicated in erythrocyte channelopathies occurring in conjunction with an X-linked enzymopathy in a female patient. This underscores the importance of keeping X-linked disorders in the differential diagnosis of hemolytic anemia in females, as well as presents the possibility for novel coexisting mutations to augment the phenotype. [ABSTRACT FROM AUTHOR]

Introduction: Post-partum anemia remains a public health problem. Adolescent women are at high risk of post-partum anemia due to both prepartum anemia and anemia caused by acute hemorrhage during delivery. The aim of our study is to assess the prevalence of postpartum anemia and associated factors among adolescent mothers in Kisangani, Democratic Republic of Congo. Method: This was a prospective multicenter cross-sectional study conducted over a seven-month period, from February 1 to August 31, 2024, among postpartum adolescent girls in five health facilities in the city of Kisangani. Results: The prevalence of postpartum anemia in adolescent girls was 71,4%. The second adolescence (15-19 years) accounted for 88,9% of patients; 66,7% had secondary education, half (50%) were single and 95,2% were unemployed. However, none of these showed a statistically significant association. Among obstetrical data, prepartam anemia, soft issue lesions, delivery pathologies and number of prenatal visits were significantly associated with postpartum anemia. In multivariate logistic regression, teenage mothers with prepartum anemia were 7 times more likely to develop postpartum anemia than those without anemia (AOR=7,08; 2,79 -- 19,6). Conclusion: The prevalence of postpartum anemia is very high in adolescent girls. Prepartum anemia is more signoificantly associated with postpartum anemia in adolescent girls. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dans une démarche constante d’amélioration des pratiques médicales, depuis la loi du 4 Mars 2004, en France, les professionnels de santé, qu’ils soient du domaine médical ou paramédical, participent au développement des évaluations des pratiques professionnelles (EPP). L’EPP est un outil incontournable pour améliorer la qualité des soins et garantir la sécurité du patient. Cette évaluation peut être individuelle ou collective. Elle vise à cibler un ou différents thèmes afin de corriger les écarts entre les soins prodigués aux patients par rapport à un référentiel de soins et de prise en charge. Nous effectuons les EPP, de manière constante depuis 2012, essentiellement portée sur l’anémie et la nutrition des patients en dialyse péritonéale. Au travers de ce travail, nous souhaitons montrer l’intérêt de la réalisation des EPP dans le suivi des patients en dialyse péritonéale.

In addition to the burden of infectious diseases, practitioners working in sub-Saharan Africa are more and more highlighting conditions that were considered rare or non-existent in their context. In fact, Biermer's disease (BD) is increasingly reported on non-Caucasians populations, with unusual and confusing presentations. To overcome diagnostic delays which could darken the prognosis, a reference framework of good clinical practices was initiated by an inclusive approach involving experts on Internal medicine, Hematogy, Neurology and Gastroenterology. They work in different universities and countries, but have overcome this border in order to collaborate and make a didactic reminder of this so subtle disease. The objective is to contribute to its popularization while understanding the conditions that may be similar. We aim to present the summary of the referential derived from their work. [ABSTRACT FROM AUTHOR]

Background: Reticulocytes are red blood cell precursors with an average lifespan of 1-2 days. Reticulocyte hemoglobin equivalent (Ret-He) is an early marker of iron deficiency (ID) erythropoiesis and reflects real-time information regarding the synthesis of young erythrocytes in the bone marrow. The objective of this study is to determine the diagnostic utility of Ret-He in patients having microcytic hypochromic anemia in comparison with serum ferritin and iron studies. Objectives: The objective of this study is to determine the diagnostic utility of the Ret-He parameter in patients having microcytic hypochromic anemia in comparison with the serum ferritin, iron studies and its role in routine hematological screening for nutritional deficiency anemia like ID. Design and Settings: The design involves observational study. Materials and Methods: A hospital-based observational study was carried out in a referral hospital. Hematological parameters were processed using Sysmex XN1000 (Sysmex Corporation, Kobe, Japan) analyzer and were compared with Serum iron studies using biochemistry analyzer (VITROS® 250 Chemistry System) from 201 participants who presented with microcytic hypochromic anemia. Main Outcome and Measures: Relationship of Ret-He parameter and its diagnostic utility for screening of iron-deficient states. Sample Size: The sample size was 201. Results: When serum ferritin is taken as "the gold standard" to detect ID, with Ret-He cutoff of 27.15 pg/cell, we found a statistically significant positive correlation between Ret-He and serum ferritin (P < 0.001). We found a sensitivity of 57.37% and specificity of 75.95% with area under the curve of 0.681, positive predictive value of 100%, negative predictive value of 3.8%, and accuracy of 62.19% for Ret-He in detecting ID anemia (IDA). Also found a statistically significant negative correlation between Ret-He and total iron binding capacity (P < 0.001). There was no statistical correlation between Ret-He and serum iron levels in our study. Conclusions: The present study suggests Ret-He is one of the better and more reliable hematological parameters indicating ID and, when used along with biochemical parameters like serum ferritin, can give valuable inputs in a better screening and diagnosis of IDA; hence proper treatment is possible. Limitations: The multicentric study is required to standardize Ret-He reference values, and follow-up to therapy of the subjects was not done. Additional hemoglobin variant analysis data would have been favorable to the study. [ABSTRACT FROM AUTHOR]

Non-regenerative normocytic normochromic anemia is frequently observed in patients with chronic kidney disease (CKD) and becomes a common finding in the advanced stages of the disease (stages 3 and 4 according to the International Renal Interest Society), negatively affecting the quality of life in dogs. In both humans and dogs with CKD, anemia has multiple causes, with the main one being erythropoietic hypoproliferation, resulting from a relative insufficiency of erythropoietin (EPO) production by the kidneys. Additional contributing factors include functional iron deficiency, nutritional imbalances caused by hyporexia or anorexia, and gastrointestinal bleeding, whether visible or occult. [ABSTRACT FROM AUTHOR]

One-fourth of the global population suffer from anemia, with iron deficiency being the main reason; it affects both sexes almost equally, with a slight preponderance of women being afflicted. Anemia can be caused by a wide range of conditions and circumstances, and it can present both orally and systemically. Reduced red blood cell count and/or hemoglobin concentration, or disruption in their function, which finally results in reduced oxygen delivery to tissues, are all defining characteristics of anemia. Anemia is linked to decreased well-being, poor cognitive function, and persistent fatigue. The orofacial signs and symptoms include magenta tongue, midfacial overgrowth, angular stomatitis, atrophic glossitis, paresthesia/anesthesia of the mental nerve, dysphagia, osteosclerosis, and conjunctiva and facial pallor. Common orofacial manifestations also include conjunctival hemorrhage, nose bleeding, spontaneous and posttraumatic gingival hemorrhage, and persistent post-extraction bleeding. Patients with anemia require multidisciplinary care. Consequently, the dentist must have a solid awareness of this disorder, with a focus on warning indicators, dental management, and appropriate communication with the patient’s physician. [ABSTRACT FROM AUTHOR]

A better understanding of risks associated with allogeneic blood transfusions along with a growing population of patients seeking surgical care without the use of blood transfusion has led to the development of complex clinical strategies, intending to minimize blood loss, conserve autologous blood, enhance hematopoiesis, and augment tolerance of anemia. Advances in surgical technique, current technology, knowledge, and perioperative management significantly contributed to the fact that successful treatment without transfusion is a realistic option but it does require a concerted patient-centered effort from the multidisciplinary team. In this review, we discuss effective bloodless strategies in the setting of perioperative management, acute blood loss, trauma, and postpartum hemorrhage. Additionally, the valuable experience gained from bloodless care has paved the way to develop the concept of Patient Blood Management as a standard care to benefit all patients, and not only those for whom blood is not an option. [ABSTRACT FROM AUTHOR]

Anemia in pregnancy is a recognized risk factor for complications in both the fetus and the mother, such as preterm birth, low birth weight, placental abruption, preeclampsia, and postpartum hemorrhage. The most common type is iron deficiency anemia, which accounts for approximately 90% of all anemias detected during pregnancy. The delivery of an anemic woman is classified as high-risk. Every pregnant woman should proactively take 30 mg of elemental iron daily to meet the needs of pregnancy (approximately twice the dose for non-pregnant women). This amount is difficult to obtain, even with a varied diet. The quantity of elemental iron stated in medications does not correspond to its biological availability. The first therapeutic test for anemic women should be oral iron administration. If there is an increase in hemoglobin levels after 4 weeks, it indicates an iron deficiency. Women with confirmed iron deficiency anemia should take 30–60 mg of elemental iron daily. If oral supplements are insufficient, intravenous iron preparations should be considered. Symptomatic pregnant women, with severe anemia (<75 g/l), in the late stage of pregnancy (after the 34th week), or with insufficient response to iron supplementation should be examined by a specialist – an internal medicine doctor, to rule out other causes of anemia. After normalizing hemoglobin levels, supplementation should continue for another 3 months or at least until the 6th week postpartum. Women with a postpartum hemoglobin level <105 g/l should take 30–60 mg of elemental iron daily for 3 months. Parenteral iron administration is the treatment of choice for women with confirmed iron deficiency who have not responded adequately to oral administration or who have not tolerated it (especially pregnant women in the 2nd and 3rd trimesters). Oral and intravenous preparations have a proven effect in treating iron deficiency anemia compared to placebo. Intravenous preparations have a faster onset of action than oral ones and do not require as much patient‘s compliance. Older types of intravenous preparations were more associated with severe complications caused by severe allergic reactions. Blood transfusions should be reserved for women with rapid major blood loss with hemodynamic consequences, at risk of further bleeding, or showing signs of cardiovascular complications. [ABSTRACT FROM AUTHOR]

Autoimmune hemolytic anemia (IMHA) is one of the leading causes of anemia in dogs and cats. This type of anemia can occur in animals of all ages, but is more common in young and middle-aged adult dogs and cats. In secondary IMHA, a trigger is often suspected because of a temporal association with the administration of certain drugs or a preexisting disease, but establishing a causal link is frequently difficult. While both forms of IMHA affect dogs and cats, the primary form is more common in dogs and the secondary form is more common in cats. [ABSTRACT FROM AUTHOR]

One of the key aspects to enhance the suitability for surgery in elective arthroplasty is the optimization of hemoglobin concentration. In this randomized controlled trial, we investigated the efficacy of an oral iron supplement and its impact on blood management practices. A total of 60 older adults undergoing elective hip or knee surgery were randomized to follow a month and a half of supplementation with a water-soluble powder containing iron and vitamins. We monitored iron homeostasis and the use of blood resources. The trial was completed by 58 subjects. We observed a significant inter-group change in hemoglobin and its mean corpuscular concentration (P < 0.05), vitamin B6, B9 (P < 0.001), and B12 (P < 0.05). Albeit not statistically significant, fewer patients in the intervention group had hemoglobin over the threshold for blood unit request before (11 vs. 14) or transfusion evaluation after surgery (1 vs. 6), or actually received a blood transfusion (1 vs. 3). The extent of preoperative iron deficiency and hematocrit were predictive for postoperative blood units (AUC = 0.9). Iron homeostasis improved in the intervention group, while the changes in the control group were consistent with the depletion of iron reserves. The iron-based formulation enriched with vitamins was safe but showed a slight impact on blood management practices. The potential of optimizing patient blood management encourages the planning of large-scale studies, possibly combining a diet therapy to promote the consumption of foods rich in iron long before the operation. [ABSTRACT FROM AUTHOR]

La drépanocytose, maladie génétique la plus fréquente en France, est non seulement une maladie de l'hémoglobine, mais aussi une maladie vasculaire associée à des phénomènes inflammatoires. La douleur est au premier plan. Elle est devenue une maladie chronique émaillée de complications aiguës. Le dépistage néonatal a permis d'améliorer de manière très significative la mortalité et la morbidité grâce aux mesures préventives (antibioprophylaxie, vaccinations, dépistage de la vasculopathie cérébrale), à l'éducation thérapeutique et à la prise en charge psychologique débutées dès l'âge de 2 mois. Dès l'annonce, la prise en charge doit être multidisciplinaire et en réseau de soins. Dans les formes sévères, l'intensification thérapeutique par hydroxycarbamide, des transfusions régulières et/ou une greffe de moelle en ont transformé le pronostic. Les principales complications aiguës (crise vaso-occlusive, syndrome thoracique aigu, anémie brutale, infection sévère, accident vasculaire cérébral) peuvent survenir de manière imprévisible chez l'enfant et mettre en jeu le pronostic vital. Elles nécessitent un diagnostic et une prise en charge thérapeutique urgents. À l'avenir, un des challenges sera de repérer très précocement les patients à risque de développer une maladie sévère afin qu'ils puissent bénéficier d'une intensification thérapeutique précoce, et de pouvoir prévenir l'apparition des complications organiques chroniques chez l'adulte. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Romanian Journal of Veterinary Medicine & Pharmacology is the property of Innovation in Health Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The causes of anemia in cirrhosis are multiple and interrelated. Among the corpuscular anomalies, acanthocytosis is the most frequently erythrocytic deformation found, mainly in cases of severe decompensation. It is responsible for hemolytic anemia by destruction of red blood cells and splenic sequestration of deformed erythrocytes. Its presence correlates with the severity of cirrhosis and is associated with significant short-term mortality. Liver transplantation is the only treatment allowing the disappearance of acanthocytosis and the improvement of the prognosis of these patients. [ABSTRACT FROM AUTHOR]

Background. Myeloproliferative disorders define a vast and heteregenous group of neoplastic entities, characterized by malignant proliferation of blood cells. These may affect multiple tissues, some of these malignancies involving organs in which there is lymphoid tissue. Case report. A 81-year-old female patient was admitted to the Department of Internal Medicine with moderate-to-intense spontaneous pain in the left hypochondrial and in the left abdominal flank, associated with generalized fatigue and loss of appetite. According to the personal medical history, the patient is known with type II diabetes mellitus, being under treatment with oral antidiabetics (metformin 1000 mg), and arterial hypertension under treatment with candesartan. Upon admission, the physical examination revealed cutaneous and mucosal pallor and marked physical weakness. Abdominal palpation revealed pain in the left hypochondrial and in the left abdominal flank, associated with firm and massive splenomegaly, descending towards the umbilicus. Abdominal ultrasound confirmed massive splenomegaly, associated with moderate hepatomegaly. Blood analysis revealed several modifications, indicative of hypochromic normocytic anemia, associated with lymphocytosis, thrombocytopenia and neutropenia. C-reactive protein (CRP) serum levels were in normal range upon admission. All of these modifications suggested a possible leukemogenous or lymphoid malignancy, which resulted in the patient's transfer towards the Department of Hematology, for further investigations. Conclusions. Massive splenomegaly, associated with anemia and thrombocytopenia in elderly patients, should always indicate a leukemogenous or lymphoid malignancy and a thorough differential diagnosis and collaboration between internists and hematologists is required. [ABSTRACT FROM AUTHOR]

L'érythroblastopénie est une anémie rare caractérisée par une réticulocytopénie profonde causée par une réduction marquée des érythroblastes médullaires, sans anomalie des autres lignées sanguines. L'anémie de Blackfan-Diamond est une ribosomopathie héréditaire responsable d'une érythroblastopénie génétique. Parmi les érythroblastopénies acquises, on distingue les formes primaires des formes secondaires : infection à Parvovirus B19, thymome, lymphoproliférations, maladies autoimmunes (lupus), médicamenteuses. La physiopathologie de l'érythroblastopénie est imparfaitement comprise : elle fait intervenir à la fois des mécanismes humoraux et des mécanismes cellulaires médiés par les lymphocytes T. Dans les formes liées au Parvovirus B19, le traitement repose sur les immunoglobulines polyvalentes. La thymectomie en cas de thymome est indispensable mais ne permet d'obtenir une rémission que dans quelques cas. La stratégie thérapeutique repose sur des avis d'experts : la corticothérapie seule est rarement suffisante, et l'ajout d'un immunosuppresseur est guidé par la présence d'une pathologie sous-jacente. La ciclosporine A est le traitement ayant montré la meilleure efficacité en ciblant un taux résiduel entre 150 et 250 ng/mL. En cas de leucémie à grands lymphocytes à grains, l'alternative est le cyclophosphamide. Le sirolimus semble être une option prometteuse en particulier dans les cas réfractaires. L'objectif thérapeutique est l'obtention d'une indépendance transfusionnelle, voire d'une normalisation de l'hémoglobine. En cas de transfusions massives (> 20 culots globulaires), il est indispensable de rechercher une surcharge martiale afin de proposer une chélation adaptée. Dans le but d'améliorer les connaissances sur cette maladie, une cohorte nationale rétrospective et prospective (EPIC-F) a été mise en place. Pure red cell aplasia (PRCA) is a rare anemia characterised by profound reticulocytopenia caused by a marked reduction in bone marrow erythroblasts, without abnormalities in other blood lineages. Blackfan-Diamond anemia is an inherited ribosomopathy responsible for a hereditary form of PRCA. Acquired PRCA are separated in primary and secondary forms, including Parvovirus B19 infection, thymoma, lymphoproliferative disorders, autoimmune diseases (lupus) and drug-induced PRCA. The pathophysiology of PRCA is not fully understood and involves both humoral and T lymphocyte autoreactive cells. In Parvovirus B19-related PRCA, treatment is based on polyvalent immunoglobulins. Thymectomy for thymoma is mandatory but results in prolonged remission in a limited number of cases. The therapeutic strategy is based on expert opinion: corticosteroids in monotherapy provide few sustained responses. The choice of an additional immunosuppressant drug is guided by the presence of an underlying disease. In most cases, cyclosporine A is the first choice providing the best response rate but requires a concentration monitoring (150 to 250 ng/mL). The second choice is cyclophosphamide in large granular lymphocyte leukaemia. Sirolimus (mTOR inhibitor) seems to be a promising option especially in refractory cases. Transfusion independence is the main objective. If the patient receives numerous red blood cell transfusions (> 20 packs), iron overload assessment is crucial to initiate an iron chelation. A retrospective and prospective national cohort (EPIC-F) has been set up and is now available to include each case of PRCA to improve the knowledge of this disease and to optimize the therapeutic strategy. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Iron deficiency anemia is the most common form of anemia in pregnancy, occurring in approximately 30-40% of cases. The causes of the occurrence and maintenance of iron deficiency in pregnancy are represented by the perpetuation of a pattern characterized by the occurrence of heavy menstrual bleeding during puberty, precarious and insufficient nutritional intake and, finally, the occurrence of pregnancy with increased iron requirements. The diagnosis of iron deficiency anemia is established based on the decrease in hemoglobin and ferritin levels, with a cut-off value established at 11 g/dL in the case of hemoglobin. Effects on the mother range from asthenia, difficulty concentrating to thyroid disorders or postpartum depression. Maternal-fetal consequences, such as postpartum hemorrhages, low birth weight and premature birth, are significantly reduced by adequate supplementation with iron preparations, orally or intravenously, during pregnancy. Thus, a correct and complete follow-up of the pregnant woman includes, according to the guidelines, the hemoglobin dosage when the patient is taken into account, with the repetition of its dosage at 28 weeks of pregnancy. In Romania, the guidelines recommend ferritin dosing in cases at risk of developing iron deficiency anemia (adolescent girls, twin pregnancies, pregnancies less than a year apart). The choice is oral supplementation in order to prevent the onset of anemia, with the mention of adverse effects of frequent gastrointestinal cause. There is the possibility of parenteral administration in case of severe iron deficiency anemia (Hb<7 g/dL) preoperatively or before the time of birth, or in case of intolerance to oral therapy. Despite all the measures implemented in recent years, the prevalence of anemia continues to be high, a fact that requires a better prevention and education campaigns, especially in countries with low socioeconomic status. [ABSTRACT FROM AUTHOR]

Un spectru larg de comorbidități a fost asociat cu boala Parkinson, care afectează mai mult de 7 milioane de oameni la nivel mondial. Dovezi emergente indică faptul că bolile cronice, inclusiv diabetul zaharat, depresia, anemia și cancerul, pot fi implicate în patogeneza și progresia BP.Studii epidemiologice recente sugerează că unele dintre aceste comorbidități pot crește riscul de BP și pot preceda apariția simptomelor motorii. Cu toate acestea, mecanismele care stau la baza apariției acestor comorbidități rămân a fi evazive.

We present here a case of documented paraprosthetic valvular leak following TAVI treated medically initially. This led to a poorly tolerated hemolytic anemia. We were able to correct this paraprosthetic valvular leak by a postdilation of the TAVI valve with a good result and uncomplicated follow-up. [ABSTRACT FROM AUTHOR]

Introduction: The diagnosis of pulmonary embolism associated with anemia is rare. There should be a high index of suspicion for venous thromboembolism in anemic patients. Objective: We aimed to review published data about anemia and thrombosis, its pathophysiology, and its role in patient outcomes. Materials and Methods: MEDLINE/PubMed database, Google Scholar, ScienceDirect, were searched to identify the most relevant data on identify anemia as a risk factor for venous thromboembolism. Results: The thromboprophylaxis of anemic patients with risk factors for thrombosis has proven to be effective. VTE patients with anemia have a higher risk of adverse events. Treatment of Fe deficiency reduced blood coagulability. Fe deficiency is common in patients with idiopathic pulmonary hypertension (PH). Conclusion: Anemia produces a poor prognosis. Hemoglobin levels can be used to assess the risk of thrombosis. Hypoxia, alteration of mitochondrial function and inflammation, are all involved in Fe manipulation and the occurrence of PH. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is an inflammatory, chronic and systemic disease that primarily affects the synovial joints. Anemia is a common extra-articular manifestation in the absence of an effective treatment. The main mechanisms involved include shortening the lifespan of erythrocytes, inadequate bone marrow and abnormalities in iron metabolism. Eighty-eight patients over 18 years with definite diagnosis of rheumatoid were included in this study. The prevalence, respectively the characteristics of anemia were analyzed, together with demographic data, the type of symptoms, the type of comorbidities, the hematological indices and treatments. The mean age of the study population was 65.31 ± 12.57 years. Treat to target was achieved in one third of the patients (36.4%). The prevalence of anemia was 55% with higher prevalence in males (57%) than females (50%). Anemia was associated with higher disease activity (p=0.036). Out of the anemic patients, 7.14% had megaloblastic anemia, 40.48% had anemia of chronic disease and 21.43% suffered from iron deficiency anemia. Microcytic normochromic and normocytic hypochromic patterns can have mixed causes, belonging to both iron-pathophysiological processes and chronic inflammation. The prevalence of anemia at the 1-year check-up was 29.44% and the percentage of patients who achieved treat-to-target goals increased from 36.40% to 40.90%. The majority (48.80%) did not prove to have anemia neither at admission nor at follow-up. The results of the study suggest that anemic patients tend to have a higher level of RA activity, therefore screening for anemic syndrome should be part of the management of these patients, in an effort to establish the best therapeutic conduct. [ABSTRACT FROM AUTHOR]

Anemia is a common clinical problem in daily clinical practice. Anemia could be the only expression of a subclinical celiac disease. Iron deficiency is the most important background of this anemia. Sometimes, iron deficiency anemia with no identifiable cause can be the only sign of an undiagnosed celiac disease. The pathogenic mechanism of anemia in gluten-sensitive enteropathy deserves consideration for a proper and faster diagnosis, especially in cases with atypical presentation – iron deficiency anemia. [ABSTRACT FROM AUTHOR]

Au cours de l'insuffisance rénale chronique, l'anémie et la malnutrition couplées à l'inflammation sont fréquentes et considérées comme des facteurs de morbi-mortalité. Le lien entre ces deux facteurs a longuement été décrit dans la littérature, mettant en avant une association de la malnutrition avec la carence en fer, considérée elle-même comme l'une des causes de l'anémie chez les patients en insuffisance rénale chronique (non dialysés et hémodialysés). Notre étude a pour objectif de connaître la prévalence de ces deux facteurs dans une population d'insuffisance rénale chronique (non dialysés et hémodialysés) d'Alger, et de mettre en évidence les possibles associations entre eux. Il s'agit d'une étude multicentrique, transversale et descriptive, réalisée sur une période de 6 mois (août 2018 à janvier 2019). L'anémie et la malnutrition ont été évaluées par divers outils biologiques et clinico-biologiques tels que le score de malnutrition et d'inflammation et les critères de l' International Society of Renal Nutrition and Metabolism. Les tests statistiques ont été réalisés avec le logiciel R studio® en considérant p < 0,05 comme valeur statistiquement significative. Nous avons inclus 209 patients en insuffisance rénale chronique (90 non dialysés et 119 hémodialysés). La médiane d'âge était de 70 ans (IQR = 16) pour les non-dialysés et de 56 ans (IQR = 16,5) pour les hémodialysés. La prévalence de l'anémie était de 66,66 % (n = 60) chez les non-dialysés et de 70,58 % (n = 84) chez les hémodialysés. Celle de l'anémie par carence en fer absolue était plus élevée chez les non-dialysés (48,33 % ; n = 29), alors que la carence fonctionnelle était plus élevée chez les hémodialysés (34,52 % ; n = 29). La prévalence de la malnutrition par le score de malnutrition et d'inflammation était relativement faible. Seule la carence en fer fonctionnelle était associée à la malnutrition. La prévalence de l'anémie été plus importante chez les patients en insuffisance rénale chronique (non-dialysés et hémodialysés) algérois, contrairement à la malnutrition qui reste associée à l'anémie avec carence en fer fonctionnelle. In chronic kidney disease, anemia and malnutrition coupled with inflammation as malnutrition-inflammation complex syndrom are common and considered as morbidity-mortality factors. The link between these two factors has been described at length in the literature highlighting an association of malnutrition with iron deficiency considered itself as one of the causes of anemia in chronic kidney disease (non-dialysis and hemodialysis). Our study aims to know the prevalence of these two factors in a population of chronic kidney disease (non-dialysis and hemodialysis) of Algiers and to highlight the possible associations between them. This is a multicentre, cross-sectional and descriptive study carried out over a period of 6 months (August 2018 to January 2019). Anemia and malnutrition were assessed by various biological and clinical tools such as the malnutrition inflammation score and the International Society of Renal Nutrition and Metabolism criteria. Statistical tests were performed on the R studio software, considering P < 0.05 as a statistically significant value. Two hundred and nine patients on chronic kidney disease were included (90 non dialysis and 119 hemodialysis). The median age was 70 (IQR = 16) for non dialysis and 56 (IQR = 16.5) for hemodialysis. The prevalence of anemia was 66.66% (n = 60) in non dialysis and 70.58% (n = 84) in hemodialysis. Absolute iron deficiency anemia was higher in non dialysis (48.33%; n = 29) while functional iron deficiency anemia was higher in hemodialysis (34.52%; n = 29). The prevalence of malnutrition by malnutrition inflammation score was relatively low. Only functional iron deficiency anemia was associated with malnutrition. The prevalence of anemia was higher in Algerian chronic kidney disease (non-dialysis and hemodialysis) unlike malnutrition which remains associated with functional iron deficiency anemia. [ABSTRACT FROM AUTHOR]

Anemia is common in pediatrics, especially in toddlers; it is often secondary to iron deficiency. In developing countries, it can be associated with other factors such as malnutrition, infections, malaria, in addition to poor socio-economic conditions. We report a case of a 12-year-old adolescent boy of Malagasy origin, living in mainland France since 2016, who presented with severe anemia. Despite an extensive etiological assessment, the only aetiology found was a parasitic co-infection with Trichuris trichuria and Giardia intestinalis; he was successfully treated with a red blood cells transfusion and anti-parasitic agents. Anemia from parasitic causes is rare in metropolitan France, we hereby discuss its pathophysiology while drawing the attention of clinicians to this unusual presentation, especially in immigrant children. [ABSTRACT FROM AUTHOR]

Hematinic deficiency irrespective of anemia is not uncommon in patients with heart failure. We studied the prevalence, distribution, and etiology of anemia in patients with heart failure with reduced ejection fraction (HFrEF) and compared it with non-anemic patients. Congestive heart failure (CHF) was diagnosed by modified Framingham criteria and ejection fraction (EF) <40%. Iron deficiency (ID) anemia was defined as serum ferritin level <100 ng/ml (absolute) or 100-300 ng/ml with transferrin saturation <20% (functional). Vitamin B12 and folate deficiency were defined as <200pg/ml and <4ng/ml respectively. 688 patients with HFrEF were studied with an overall mean age of 57.2±13.8 years, and males outnumbering females (62.3% vs. 37.7%). Coronary artery disease (44.2%), dilated cardiomyopathy (46.8%), and valvular heart disease (6.7%) were major causes of CHF.Anemia was found in 63.9% of patients. Vit B12 deficiency, and folate deficiency were found in 107 (15.55%), and 54 (7.85%) subjects, respectively. Absolute ID was detected in 186 (42.27%) patients with anemia and 84 (33.87%) patients without anemia, while functional ID was present in 80 (18.18%) patients with anemia and 29 (11.69%) patients without anemia. Vitamin B12 deficiency was noted in 70 (15.9%) patients with anemia and 37 (14.9%) patients without anemia, while folate deficiency was noted in 31 (7.04%) patients with anemia and 23 (9.2%) patients without anemia. Hematinic deficiency among the study population was distributed equally among patients irrespective of EF, NYHA class, socioeconomic class diet pattern. The study shows that hematinic deficiency was seen even in non-anemic patients irrespective of diet pattern. Supplementation could be a strong strategy to improve outcomes in these patients of heart failure irrespective of anemia and should be evaluated in prospective studies. [ABSTRACT FROM AUTHOR]

La carence martiale est fréquente et associée à une morbidité importante chez les patients insuffisants rénaux chroniques non dialysés. Nous avons réalisé une étude nationale, multicentrique, observationnelle et transversale afin d'évaluer la prévalence de la carence martiale et les pratiques de dépistage de la carence martiale dans cette population. Vingt-cinq centres de néphrologie de France métropolitaine ont participé à cette étude. Au cours d'une période d'inclusion de 4 semaines, tous les patients insuffisants rénaux chroniques non dialysés adultes remplissant les critères d'inclusion (débit de filtration glomérulaire estimé > 15 mL/min/1,73 m2) et d'exclusion, et ayant fourni un consentement, ont été inclus. Les investigateurs réalisaient un bilan sanguin (concentration d'hémoglobine, dosage du fer sérique, ferritinémie et coefficient de saturation de la transferrine) et remplissaient un questionnaire sur leurs pratiques de dépistage de la carence martiale. Le critère de jugement principal était la prévalence de la carence martiale (ferritinémie < 100 μg/L et/ou coefficient de saturation de la transferrine < 20 %). Parmi les critères de jugement secondaires, figuraient la prévalence de la carence martiale absolue (ferritinémie < 100 μg/L et coefficient de saturation de la transferrine < 20 %) et de la carence martiale fonctionnelle (ferritinémie ≥ 100 μg/L et coefficient de saturation de la transferrine < 20 %), la prévalence de la carence martiale en fonction de la concentration d'hémoglobine et du stade de la maladie rénale chronique, la proportion de centres réalisant un bilan martial systématique, ainsi que l'utilisation éventuelle d'une supplémentation martiale. Au total, 1211 patients insuffisants rénaux chroniques non dialysés ont été inclus dans l'analyse. La prévalence de la carence martiale s'élevait à 47,1 %. La proportion de patients présentant une carence martiale absolue et fonctionnelle était respectivement de 13,4 % et 17,1 %. Sur les 25 centres participant, 12 déclaraient pratiquer un bilan martial systématique chez les patients insuffisants rénaux chroniques non dialysés. Dans cette étude observationnelle, la prévalence de la carence martiale était particulièrement élevée chez les patients insuffisants rénaux chroniques non dialysés. Moins de la moitié des centres participant déclarait pratiquer un bilan martial systématique dans cette population. Iron deficiency is common and associated with worse outcomes in patients with non-dialysis chronic kidney disease. We performed a national, multicentre, observational and transversal study to assess the prevalence of iron deficiency as well as current iron deficiency screening practices in this population. A total of 25 nephrology centres in France participated in the study. All adult non-dialysis chronic kidney disease patients who met the inclusion (GFR > 15 mL/min/1.73 m2) and exclusion criteria and provided consent were systematically recruited over a 4-week inclusion period. Investigators were asked to perform a blood test (hemoglobin concentration, serum iron, serum ferritin and transferrin saturation) and to complete a questionnaire about their iron status monitoring practices. The primary objective was to assess the prevalence of iron deficiency (serum ferritin < 100 μg/L and/or transferrin saturation < 20%). Secondary objectives were to evaluate the prevalence of absolute iron deficiency (serum ferritin < 100 μg/L and transferrin saturation < 20%) and functional iron deficiency (serum ferritin ≥ 100 μg/L and transferrin saturation < 20%), the prevalence of iron deficiency according to haemoglobin concentration and chronic kidney disease stage, the proportion of centres that perform routine evaluation of iron status and the number of patients receiving iron supplementation. A total of 1211 patients with non-dialysis chronic kidney disease were included in the analysis. The overall prevalence of iron deficiency was 47.1%. The rates of absolute iron deficiency and functional iron deficiency and anaemia were 13.4% and 17.1%, respectively. Among the 25 participating centres, 12 reported routine assessment of iron status in non-dialysis chronic kidney disease patients. In this observational study, a high prevalence of iron deficiency was observed among non-dialysis chronic kidney disease patients. Less than half of participating centres reported routine assessment of iron status. [ABSTRACT FROM AUTHOR]

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La drépanocytose, maladie génétique la plus fréquente en France, est non seulement une maladie de l'hémoglobine, mais aussi une maladie vasculaire associée à des phénomènes inflammatoires. La douleur est au premier plan. Elle est devenue une maladie chronique émaillée de complications aiguës. Le dépistage néonatal a permis d'améliorer de manière très significative la mortalité et la morbidité grâce aux mesures préventives (antibioprophylaxie, vaccinations, dépistage de la vasculopathie cérébrale), à l'éducation thérapeutique et à la prise en charge psychologique débutées dès l'âge de 2 mois. Dès l'annonce, la prise en charge doit être multidisciplinaire et en réseau de soins. Dans les formes sévères, l'intensification thérapeutique par hydroxycarbamide, des transfusions régulières et/ou une greffe de moelle en ont transformé le pronostic. Les principales complications aiguës (crise vaso-occlusive, syndrome thoracique aigu, anémie brutale, infection sévère, accident vasculaire cérébral) peuvent survenir de manière imprévisible chez l'enfant et mettre en jeu le pronostic vital. Elles nécessitent un diagnostic et une prise en charge thérapeutique urgents. À l'avenir, un des challenges sera de repérer très précocement les patients à risque de développer une maladie sévère afin qu'ils puissent bénéficier d'une intensification thérapeutique précoce, et de pouvoir prévenir l'apparition des complications organiques chroniques chez l'adulte. [ABSTRACT FROM AUTHOR]

Copyright of Remedia is the property of Medical Tribune CZ, s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hematuric syndrome in pets is a common pathology with complex etiology: kidney stones, bladder stones, inflammation of the bladder and, last but not least, neoplasms of the components of the urinary tract. Cases of hematuric syndrome with neoplastic causes in different segments of the urinary tract will be presented in this study to describe the diversity of clinical expression and the incidence of this pathology with intricate etiopathogenesis. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The aim of this study was to evaluate the prevalence of anemia among blood donors at Lomé national blood transfusion center (NBTC) and to identify criteria for controlling hemoglobin level in blood donation candidates. Methods: We determined the hemoglobin level using HemoCue® 201+. To identify the hemoglobin level control criteria, the judgment parameters were the proportion of anemic donors based on the number of blood donations in the last 12 months and the staining of the conjunctiva. One parameter is considered "critical" and used as a control criterion when more than 30% of donors meeting this parameter are anemic. Results: A total of 1 291 blood donor candidates, predominantly male (89.70%), were included in this study. The prevalence of anemia was 28.12%. This prevalence was 38.71% among women who made 2 donations and 32.27% among men who made 3 donations and who came for a new donation in the year. Anemia was observed in 59.45% of men and 51.56% of women who had slightly colored conjunctiva. Conclusion: The prevalence of anemia was high among blood donors at NBTC Lomé. Hemoglobin control is indicated in blood donation candidates with conjunctiva judged to be slightly colored and / or on their 2nd donation (female) and 3rd blood donation (male) within 12 months. [ABSTRACT FROM AUTHOR]

Objectives: Optimal oncologic care includes successful prevention and management of the adverse effects of cancer and its treatment. This review explored the most efficient evidence-based strategies in supportive care. Material and Methods: Our search identified recent original articles published between 2018 and 2020. Discussion: We examined currently available evidence about the optimal strategies of palliative care. Conclusions: Supportive care needs a holistic approach and appropriate interventions to prevent pain and to meliorate the quality of life. [ABSTRACT FROM AUTHOR]

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Anemia is a frequent condition in burn patients due to a mixture of blood loss and chronic inflammation. Transfusions increase the probability of serious infections and reduce overall survival, especially when unrelated to perioperative blood loss. Once the surgical phase in burn patients is completed, the role of parenteral iron administration in the reduction of subsequent transfusions is not well established. Burn patients subjected to at least two surgeries and presenting progressive anemia after concluding the surgical phase, without major symptoms, were selected (n=12). Those patients with confirmed iron deficiency were treated with intravenous (i.v.) ferric carboxymaltose (n=8). Subsequently, these patients were compared with a group of 18 control patients selected from our historical database (n=1375), matching controls by age (±5 years), sex, and TBSA burn (±6%). The objective was to verify if i.v. iron administration reduced the need for blood transfusions after the surgical phase. The analysis concluded that none of the cases treated required transfusions compared to 44% of the controls. There were no side effects related to the i.v. iron infusion. This result suggests that i.v. iron supplementation with ferric carboxymaltose could be an alternative in anemic patients without major symptoms once the surgical phase is completed. Iron deficiency should be assessed and i.v. supplementation must be administered if required in burn patients showing progressive anemia. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs. La supplémentation en fer par voie parentérale est l'option préférée pour traiter efficacement la carence martiale chez les patients présentant une anémie ferriprive. Le fer saccharose et similaires (FS) et le carboxymaltose ferrique (CMF) sont les principales préparations de fer injectable pour le traitement de l'anémie ferriprive. Le risque de réaction anaphylactique associé à ces produits limite l'administration du fer injectable au milieu hospitalier. Les objectifs de l'étude étaient, d'une part, d'évaluer les pratiques d'utilisation du fer par voie parentérale par les médecins anesthésistes chez des patients présentant une carence martiale et une anémie ferriprive en chirurgie orthopédique ou gynécologique dans des établissements de santé français et, d'autre part, d'en déduire l'impact sur les coûts de prise en charge par les établissements. Méthodes. Nous avons utilisé dans cette étude la méthodologie validée des vignettes cliniques représentant quatre situations cliniques fictives pour le FS ou le CMF. Les principaux paramètres d'intérêt étaient : patients d'orthopédie ou de gynécologie, hospitalisation complète/préopératoire ou hospitalisation de jour/postopératoire et documentation de la dose de fer par perfusion, de la dose totale de fer, du nombre de perfusions et de la durée des soins infirmiers associés. Résultats et discussion. Sur 94 médecins participants actifs, 40 indiquent utiliser plus fréquemment le FS dans leur pratique courante et 54 choisissent le CMF. Au vu des simulations, les choix thérapeutiques faits par les médecins ont conduit à 134 cas d'anémie ferriprive traités par FS et 242 cas traités par CMF. Le nombre moyen de perfusions était plus faible avec le CMF (1,3 ± 0,5) qu'avec le FS (2,1 ± 0,7). La durée de soins infirmiers estimée était de 72,5 ± 170,3 minutes et 73,4 ± 186,5 minutes avec le CMF et de 86,1 ± 51,5 minutes et 94,8 ± 65,6 minutes avec le FS pour l'hospitalisation complète et l'hospitalisation de jour respectivement. Conclusion. Par rapport au FS, l'utilisation du CMF pourrait simplifier l'organisation de la prise en charge des patients en raison du nombre plus faible de perfusions, des hospitalisations plus courtes et de la moindre mobilisation des professionnels de santé. En considérant les coûts de transport et les coûts administratifs, le coût total du traitement de l'anémie ferriprive par le CMF pourrait être inférieur à celui du FS. What is known? Parenteral iron-replacement therapy (IRT) is the preferred option to treat efficiently iron deficiency (ID) in ID anemia (IDA) patients. Iron sucrose (IS/ISS) and ferric carboxy maltose (FCM) are the main available injectable iron preparations for the treatment of IDA. Due to reports of anaphylactic reactions, the prescription and the administration of injectable irons is now restricted to the hospital to ensure safety monitoring. Study objectives were, on the one hand, to assess the use of parenteral IRT by anesthesiologists in orthopedic or gynecological surgery patients with ID/IDA, and, on the other hand, to deduce the impact of the costs of management in the French hospital setting. Methods. We used the validated methodology of case-vignettes with four different fictive clinical cases built by randomization of clinical parameters. Key parameters of interest were: context of orthopedics or gynecology and patient situation, either inpatient stay/pre-surgery or outpatient stay/post-surgery. The selection of either IS/ISS or FCM was left to participant's decision and the iron administration was documented: iron dose per infusion, the total iron dose, number of infusions and nursing time required for each infusion. Results. Of 94 active participating physicians, 40 use IS/ISS more frequently in their routine practice and 54 choose FCM. In view of the simulations, the therapeutic choices made by the doctors led to 134 cases of IDA treated with IS/ISS and 242 cases treated with FCM. Mean number of infusions was lower with FCM (1.3 ± 0.5) than with IS/ISS (2.1 ± 0.7). The estimated nursing time spent by infusion: 72.5 ± 170.3 minutes for an inpatient stay and 73.4 ± 186.5 minutes for an outpatient stay with FCM and 86.1 ± 51.5 minutes and 94.8 ± 65.6 minutes with IS/ISS for inpatient and outpatient stay, respectively. Conclusion. Compared to IS/ISS, the use of FCM could result in an organizational simplification patient management due to reduced number of infusions, hospitalization duration and health professionals mobilization. Considering transportation costs and administrative costs, the total cost of treating IDA with FCM might be lower than that of IS/ISS. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common nutrient deficiency in the world, affecting roughly 40% of women in nonindustrialized countries. Iron is the essential element in hemoglobin, the major carrier of blood oxygen and oxidative metabolism that supports physical and cognitive performance. The relationship between iron and physical work capacity suggests that iron deficient individuals could experience reduced work output. Participants were 138 experienced tea pluckers aged 18--55 years from the Panighatta Tea Estate in Darjeeling District of northern West Bengal, India. Hemoglobin, serum ferritin, and soluble transferrin receptor were measured from venous blood. Energy expenditure was estimated from accelerometry and heart rate, and plucking productivity was measured as amount of tea plucked during the morning work session when temperature and rainfall conditions are optimal. At a given level of energy expenditure, iron deficient, anemic, and iron deficient anemic women plucked less tea during a 3-h period. The results warrant further research as to whether interventions providing supplemental iron might improve worker productivity and work efficiency. Further study should examine evidence of economic incentives for policies and programs targeting nutritional deficiencies. Novelty * Anemia predicts up to 2.02 kg (9.1%) less tea plucked per 3 h, or 4.0% lower wage per 3 h, compared with nonanemic women, controlling for physical effort. * An increase of 1.0 g/L in hemoglobin concentration predicts 0.71 kg (3.3%) more tea plucked over 3 h. * An increase of 1.0 g/L in hemoglobin concentration predicts a 1.6% wage increase. [ABSTRACT FROM AUTHOR]