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Background Studies of the impact of increased hemoglobin on spontaneous intracerebral hemorrhage (ICH) are limited. The present study aimed to explore the effect of increased hemoglobin on ICH. Methods A retrospective single-center study using medical records from a database processed by univariate and multivariate analyses was performed in the People’s Hospital of Tibet Autonomous Region in Lhasa, Tibet, China. Results The mean hemoglobin level in 211 patients with ICH was 165.03 ± 34.12 g/l, and a median hematoma volume was 18.5 ml. Eighty-eight (41.7%) patients had large hematomas (supratentorial hematoma ≥ 30 ml; infratentorial hematoma ≥ 10 ml). No differences in ICH risk factors between the groups with different hemoglobin levels were detected. Increased hemoglobin was independently associated with large hematomas [odds ratio (OR) 1.013, P = 0.023]. Increased hemoglobin was independently associated with ICH with subarachnoid hemorrhage (OR 1.014, P = 0.016), which was more pronounced in men (OR 1.027, P = 0.002). Increased hemoglobin was independently associated with basal ganglia hemorrhage and lobar hemorrhage in men (OR 0.986, P = 0.022; OR 1.013, P = 0.044, respectively) but not in women (P > 0.1). Conclusions Increased hemoglobin was independently associated with large hemorrhage volume. Increased hemoglobin was independently associated with lobar hemorrhage in men and ICH with subarachnoid hemorrhage, which was more pronounced in men. Additional studies are needed to confirm our findings and explore potential mechanisms.

AIM: The study aims to determine the effect of Moringa oleifera teabags on increased Hemoglobin (Hb) in adolescent girls. METHODS: The research method used in this research was a pre-post-test one group design, a research design to determine the cause and effect or effect of an intervention. The treatment was carried out by giving M. oleifera teabags 2 times. Specifically, one sachet (3 g) in the morning and one sachet (3 g) in the afternoon, dipped in 250 ml hot water, and added two teaspoons granulated sugar. The treatment was given for 30 days. RESULTS: An increase in the average of Hb (mean) before the intervention was 10.71 g/dl. After 15 days of the intervention, it was 11.03 g/dl. Subsequently, after 30 days of intervention, the average Hb value (mean) was 11.63 g/dl, then the p-value ≤ α, which was 0.000 (p < 0.05), and these results indicated a significant difference between Hb before and after the intervention. CONCLUSION: There was a significant difference between Hb before and after the intervention, meaning that there was an effect of Moringa leaf teabags on the increase in Hb in adolescent females.

Hemoglobin is the red pigment-protein contained in red blood cells. The function of hemoglobin is to transport oxygen from the lungs and in the bloodstream to be carried to the tissues. Hemoglobin can increase by increasing the intake of iron in the body. One way to increase hemoglobin can be done by giving method Infused Water Dates. Infused water is a drink consisting of plain water with fresh fruit added and soaking or settling together for a certain time. The making of infused water is carried out by soaking for a period of 0 to 12 hours, so that the infused water becomes a liquid medium that carries more nutrients than ordinary water and will be more easily absorbed by cells and distributed throughout the body (Sidauruk, 2018 ). In several studies, it is stated that dates can increase hemoglobin levels in the blood. Where dates contain iron, vitamin A, vitamin C, protein to form red blood cells. With the method, Infused Water the date palm water becomes alkaline so that it can accelerate the absorption process in the body. The purpose of this study was to determine the effectiveness of dates infused water provision to increase hemoglobin levels of midwifery adolescent girls at Medan Health Polytechnic in 2020. This research was quasi-experimental study using the One Group Pretest-Posttest Without Control Design approach. The sample in this study were 20 respondents of midwifery adolescent girls from Medan Health Polytechnic, using the technique of purposive sampling. The statistical test used wa the Wilcoxon Signed Rank Test because the data was not normal. The results of the Wilcoxon Signed Rank Test obtained the value of P-Value = 0.001. So it can be concluded that the date infused water is effective in increasing hemoglobin levels of midwifery adolescent girls at Medan Health Polytechnic in 2020. Keywords: Dates Infused Water, Increased Hemoglobin Levels, Girls Adolescent

A large world population resides at moderate altitude. In the Valley of Mexico (2,240 m above sea level), its inhabitants, breathe approximately 29% more on average and have 10% increased hemoglobin concentrations compared to sea level residents, among other differences. These compensations reduce but not eliminate the impact of altitude hypoxemia. The objective of the manuscript is to review and describe the information available on health and disease at moderate altitudes, mainly with data in Spanish language from Latin-American countries. Young adults in Mexico City have an SaO2 between 92% and 94% versus 97% at sea level, frequently decreasing below 90% during sleep and intense exercise. It is likely that among the population living at this altitude, lung growth, and development during pregnancy and infancy are enhanced, and that after residing for several tens of thousands of years, more important adaptations in oxygen transport and utilization have developed, but we are not certain about it. For patients with respiratory diseases, residing at moderate altitudes implies increased hypoxemia and clinical deterioration, unless supplementary oxygen is prescribed or patients move to sea level. Hyperventilation increases exposure of residents to air pollutants compared to those living in cities with similar concentrations of pollutants, although at sea level. Humans evolved at sea level and lack the best-known adaptations to reside at moderate or high altitudes. Residents of moderate altitudes breathe deeply the city´s air with all its pollutants, and more often require supplementary oxygen.

An experimental study was conducted to assess the effectiveness of vitis vinifera soak on hemoglobin level among anemic students in selected colleges at Vellore. Quantitative evaluative approach was used for this study and the researcher adopted a true experimental research design. The sample was conducted among 60 anemic students in selected colleges at Vellore, in which 30 were in experimental group and 30 were in control group. The sample was selected by using Probability simple random sampling technique with lottery method. The researcher adopted Kristen M. Swanson theory as a conceptual framework. There are six different hypothesis were tested in this study. The Structured interview schedule was used to collect the demographic and clinical variable. Sahli’s hemoglobinometer was used to assess the hemoglobin level. Experimental group received intervention of vitis vinifera soak for 21 days in the morning and control group advised to follow daily routine and no intervention is given. In both groups, on 22nd day the researcher was conducted post test by using same tool. The data were analyzed using both descriptive and inferential statistics. The study revealed that the mean post test score in control group was 9.29 where as in experimental group the mean post test score was 9.82, the mean difference was 0.53. The obtained ‘t’ value was 2.24 which was statistically significant (P

Anemia is a condition where the hemoglobin (Hb) level is lower than 12 g/dL. Teenagers are the most susceptible group experiencing a decrease in hemoglobin, especially teenage girls because they get menstruate so that they lose a lot of iron every month. It causes them become easily tired, drowsiness, dizziness, rapid concentration loss, then clearly inhibits the learning process and achievement. Natural ingredients as an alternative to increase Hb which is easily obtained and cultivated are Moringa oleifera L. leaves since they contain protein, vitamin C, and iron. This study aims to evaluate an increase of hemoglobin levels and the knowledge of anemia after giving education and capsules of moringa leaves powder. This is true experimental study with pre and posttest design. The respondents were female students with anemia which were divided to the intervention groups (getting education and kelor) and control groups (getting education and placebo). It was carried out for 30 days. The results showed that education and Moringa leaf powder capsules significantly increased hemoglobin levels by 1.76 ±0.80 g/dL, while the increase in the education group was 0.72 ± 0.97 g/dL. It can be concluded that the education and Moringa leaf powder capsules can significantly increase the knowledge of anemia and Hb levels.

Hemoglobin is a protein-rich substance bezi, Have affinity (power team) against oxygen and with oxygen it forms a oxihemoglobin in red blood cells. The goal in this research is to know the influence of banana fruit mas to increased hemoglobin on pregnant women trimester III in BPM Ny "B" Ngasem Regency Kediri Year 2017. In this research method using alphabets experiment and approach Pre alphabets experiment with Purposive Sampling. This research was conducted in BPM Ny "B" Ngasem Regency Kediri Year 2017. Instruments in use are sheets of observation, data analysis with the iji Wlcoxon Signed Rank. Results of research of banana fruit mas on pregnant women this trimester III that the magnitude of the value of ρ is less than the value of 0.000 α = 0.05 (0.000 < 0.05) so that H0 is rejected and the H1 is accepted means there is influence of hemoglobin levels before and after the given bananas mas against peningktan the levels of haemoglobin in pregnant women Trimester III in BPM Ny. " B “ Ngasem Regency Kediri year 2017. With this expected to consume fruit banana mas on pregnant women may help lower III trimester anemia with practical.

Therapeutic agents that increase the Hb affinity for oxygen (O(2)) could, in theory, lead to decreased O(2) release from Hb and impose a hypoxic risk to tissues. In this study, GBT1118, an allosteric modifier of Hb affinity for O(2), was used to assess the impact of increasing Hb affinity for O(2) on brain tissue oxygenation, blood pressure, heart rate, O(2) delivery, and tolerance to hypoxia in Townes transgenic sickle cell disease (SCD) mice. Brain oxygenation and O(2) delivery were studied during normoxia and severe hypoxic challenges. Chronic treatment with GBT1118 increased Hb affinity for O(2), reducing the Po(2) for 50% HbO(2) saturation (P50) in SCD mice from 31 mmHg to 18 mmHg. This treatment significantly reduced anemia, increasing hematocrit by 33%, improved cardiac output (CO), and O(2) delivery and extraction. Chronically increasing Hb affinity for O(2) with GBT1118 preserved cortical O(2) tension during normoxia, improved cortical O(2) tension during hypoxia, and increased tolerance to severe hypoxia in SCD mice. Independent of hematological changes induced by chronic treatment, a single dose of GBT1118 significantly improved tolerance to hypoxia, highlighting the benefits of increasing Hb affinity for O(2) and consequently reducing sickling of RBCs in blood during hypoxia in SCD. NEW & NOTEWORTHY Chronic pharmacologically increased hemoglobin affinity for oxygen in sickle cell disease mice alleviated hematological consequences of sickle cell disease, increasing RBC half-life, hematocrit, and hemoglobin concentration, while also decreasing reticulocyte count. Additionally, chronically increased hemoglobin affinity for oxygen significantly improved survival as well as cortical tissue oxygenation in sickle cell disease mice during hypoxia, suggesting that oxygen delivery and utilization is improved by increased hemoglobin affinity for oxygen.

Introduction: The objective of the present study was to describe the experience of the Blood and Tissues Bank of Aragon with the Reveos® Automated Blood Processing System and Mirasol® Pathogen Reduction Technology (PRT) System, comparing retrospectively routine quality data obtained in two different observation periods. Methods: Comparing quality data encompassing 6,525 blood components from the period 2007–2012, when the semi-automated buffy coat method was used in routine, with 6,553 quality data from the period 2014–2019, when the Reveos system and subsequently the Mirasol system were implemented in routine. Results: Moving from buffy coat to Reveos led to decreased discard rates of whole blood units (1.2 to 0.1%), increased hemoglobin content (48.1 ± 7.6 to 55.4 ± 6.6 g/unit), and hematocrit (58.9 ± 6.5% to 60.0 ± 4.9%) in red blood cell concentrates. Platelet concentrates (PCs) in both periods had similar yields (3.5 ×1011). Whereas in the earlier period, PCs resulted from pooling 5 buffy coats, in the second period 25% of PCs were prepared from 4 interim platelet units. The mean level of factor VIII in plasma was significantly higher with Reveos (92.8 vs. 97.3 IU). Mirasol PRT treatment of PCs reduced expiry rates to 1.2% in 2019. One septic transmission was reported with a non-PRT treated PCs, but none with PRT-treated PCs. Conclusion: Automation contributed to standardization, efficiency, and improvement of blood processing. Released resources enabled the effortless implementation of PRT. The combination of both technologies guaranteed the self-sufficiency and improvement of blood safety.

Objective: Increased hemoglobin (HGB) has been described as an adaptive response to hypoxia in high altitude. This study aimed to investigate whether increased HGB level had a role in the development of albuminuria in Tibetan male patients with type 2 diabetes (T2D). Methods: This cross-sectional, hospital-based study utilized data from 653 Tibetan male patients with T2D from 2018-2020. Patients were divided into two groups based on HGB level (group 1: 12.0 ≤ HGB Results: Clinical characteristics of subjects was showed in Table 1. Albuminuria was confirmed in 140 (21.4%) patients. In multiple logistic regression analysis, patients with higher HGB level showed an odds ratio of 1.28 (95% CI: 0.90-1.83; P=0.167) for albuminuria compared to those with lower HGB level. After adjusted age, duration of T2D, BMI, LDL-C, HbA1c and the presence of hypertension, patients with higher HGB level were at a 1.50-fold (95% CI: 1.01-2.27; P=0.046) higher prevalence of albuminuria. Conclusions: Our finding indicate that higher HGB level was independently associated with increased presence of albuminuria in Tibetan male patients with T2D. Disclosure C. Zhang: None.

Objective: Rapid glomerular filtration rate (GFR) decline, increased hemoglobin A1c (HbA1c) and hyperfiltration were risk factors for renal function decline. We aimed to explore the effect of HbA1c decline on short-term GFR decline in patients with type 2 diabetes (T2D). Methods: A total of 3920 patients were enrolled if they had 2-3 times HbA1c and eGFR test in 12 months. Of them, 16.7%, 29.4%, 12.5%, 14.1% and 27.3 had relatively stable (RS:- 3.49~3.49), rapid decline (RD:> - 10.00), modest decline (MD:- 10.00~3.50), modest increase (3.50~10.00) and rapidly increase (>10.00) of eGFR (mL/min/1.73 m2) respectively. The final analysis comprised 2295 patients in group RS, RD and MD. Results: Multinomial logistic regression analysis showed HbA1c decline of ≥-3.10% [OR:2.251 (95%CI: 1.316~3.850)], -3.00~-2.10% [OR: 1.962 (95%CI: 1.160~3.316)], -2.00~-1.10% [OR:1.592 (95%CI: 1.089~2.329)], stage G1 (eGFR≥90) [OR: 4.111 (95%CI: 3.043~5.552)] and stage A3 UACR [OR: 1.819 (95%CI: 1.070~3.093)] were major risk factors for GFR RD. No significant risk factors were found to be related with GFR MD (Table). Conclusions: High proportion of patients with T2D experienced short term eGFR RD or RI. Decline of HbA1c (≥-1.10%) and being at stage G1 or A3 were risk factors for eGFR RD. The eGFR accompanied by HbA1c decline may indicate the real renal function. Disclosure L. An: None. L. Ji: None.

Objective: Increased hemoglobin (HGB) has been described as an adaptive response to hypoxia in high altitude. This study aimed to investigate whether increased HGB level had a role in the development of diabetic retinopathy (DR) in Tibetan male patients with type 2 diabetes (T2D). Methods: This cross-sectional, hospital-based study utilized data from 653 Tibetan male patients with T2D from 2018-2020. Patients were divided into two groups based on HGB level (group 1: 12.0 ≤ HGB Results: DR was confirmed in 140 (21.4%) patients. Clinical characteristics of subjects was showed in Table 1. There was an inverse relationship between HGB level and the prevalence of DR in multiple linear regression analysis. A 14% decrease in prevalence of DR was found with a 1.0-g/dL increment in HGB level (95% CI: 0.75-0.98). Multiple logistic regression analysis conformed patients with higher HGB level showed an odds ratio of 0.50 (95% CI, 0.31-0.86) for DR after adjusted age, duration of T2D, smoke, LDL-C, HbA1c and presence of chronic kidney disease compared to those with lower HGB level. Conclusions: Our finding indicate that higher HGB level was associated with reduced presence of DR in Tibetan male patients with T2D. Disclosure C. Zhang: None.

Significance In diving birds like penguins, physiologic considerations suggest that increased hemoglobin (Hb)-O2 affinity may improve pulmonary O2 extraction and enhance dive capacity. We integrated experimental tests on whole-blood and native Hbs of penguins with protein engineering experiments on reconstructed ancestral Hbs. The experiments involving ancestral protein resurrection enabled us to test for evolved changes in Hb function in the stem lineage of penguins after divergence from their closest nondiving relatives. We demonstrate that penguins evolved an increased Hb-O2 affinity in conjunction with a greatly augmented Bohr effect (i.e., reduction in Hb-O2 affinity at low pH) that should maximize pulmonary O2 extraction without compromising O2 delivery at systemic capillaries., Dive capacities of air-breathing vertebrates are dictated by onboard O2 stores, suggesting that physiologic specialization of diving birds such as penguins may have involved adaptive changes in convective O2 transport. It has been hypothesized that increased hemoglobin (Hb)-O2 affinity improves pulmonary O2 extraction and enhances the capacity for breath-hold diving. To investigate evolved changes in Hb function associated with the aquatic specialization of penguins, we integrated comparative measurements of whole-blood and purified native Hb with protein engineering experiments based on site-directed mutagenesis. We reconstructed and resurrected ancestral Hb representing the common ancestor of penguins and the more ancient ancestor shared by penguins and their closest nondiving relatives (order Procellariiformes, which includes albatrosses, shearwaters, petrels, and storm petrels). These two ancestors bracket the phylogenetic interval in which penguin-specific changes in Hb function would have evolved. The experiments revealed that penguins evolved a derived increase in Hb-O2 affinity and a greatly augmented Bohr effect (i.e., reduced Hb-O2 affinity at low pH). Although an increased Hb-O2 affinity reduces the gradient for O2 diffusion from systemic capillaries to metabolizing cells, this can be compensated by a concomitant enhancement of the Bohr effect, thereby promoting O2 unloading in acidified tissues. We suggest that the evolved increase in Hb-O2 affinity in combination with the augmented Bohr effect maximizes both O2 extraction from the lungs and O2 unloading from the blood, allowing penguins to fully utilize their onboard O2 stores and maximize underwater foraging time.

BACKGROUND AND AIMS High hemoglobin A1c (HbAlc) level is associated with increased cardiovascular disease risk and thromboembolic events [1]. The study sought to explored the association between HbAlc and left atrial appendage flow velocity (LAAV) among non-valvular atrial fibrillation (AF) patients. METHODS AND RESULTS A total of 249 consecutive non-valvular AF patients who underwent transesophageal echocardiography (TEE) were divided into two subgroups according to the median of LAAV level (

Simple Summary Currently, all pigs raised on intensive farms develop iron-deficiency anemia if they do not receive supplemental iron at birth. Weaning diets commonly contain high concentrations of iron, and the effect on the copper and zinc contents in pork is unknown. In this exploratory work, we determined the effect of excessive oral iron supplementation on the contents of these microminerals in pork. Surprisingly, we found that high iron doses of 3000 ppm reduced the zinc content of pork by 32–55%. Abstract The aim of this work was to determine in an exploratory manner the effect of excessive iron supplementation on iron, zinc, and copper contents in pork and pork offal. Pigs averaging 50 days in age and 15 ± 1.3 kg body weight were allocated to a control group (500 ppm dietary Fe) and a supplemental group (3000 ppm dietary Fe). After an iron supplementation period of 60 days, blood samples were analyzed to determine iron biomarkers, serum copper, and zinc contents. Animals were slaughtered to assess total iron, non-heme iron, heme iron, zinc, and copper contents in samples of nine meat cuts and some offal. Iron supplementation improved the iron status in pigs with increased hemoglobin and hematocrit, but did not affect serum levels of iron, zinc, and copper. Iron supplementation did not affect the heme and non-heme iron contents of the different meat cuts. Zinc contents decreased by 32–55% in meat cuts, where iron content increased in the liver, spleen, kidneys, and pancreas. No differences of zinc and copper were observed in offal samples. High concentrations of iron supplementation reduce zinc content in pork.

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. Although it has been reported that some COVID-19 patients showed elevated liver biochemistries, there are few studies regarding clinical features and prognosis of these patients. In this multicenter, retrospective study, we collected data on laboratory-confirmed COVID-19 patients from three hospitals in Wuhan, China, who died or were discharged between February 1, 2020, and February 20, 2020. The data on demographics, comorbidities, clinical symptoms, laboratory examinations on admission, complications, treatment, and outcome were collected. A total of 482 patients were enrolled in this study. Of those, 142 (29.5%) patients showed abnormal liver biochemistries on admission, and patients with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) accounted for 67.6%, 69.0%, and 16.2%, respectively. Those with abnormal liver biochemistries showed higher percentages of severe cases and comorbidities and were more likely to have dyspnea, chest distress or pain, and increased hemoglobin (Hb) on admission. Higher rates of complications and mortality and worse recovery when discharged were observed in patients with abnormal AST or TBIL. The multivariable regression analysis showed that chest distress or pain (odds ratio [OR], 1.765; P = 0.018), dyspnea (OR, 2.495; P = 0.001), elevated C-reactive protein [CRP] level (OR, 1.007; P = 0.008), elevated white blood count (WBC) (OR, 1.139; P = 0.013), and elevated Hb concentration (OR, 1.024; P = 0.001) were independent factors associated with elevated liver biochemistries in COVID-19 patients. Conclusion: Elevated liver biochemistries were common in COVID-19 patients. Patients with hypoxia or severe inflammation are more likely to experience increased liver biochemistries on admission. Those with abnormal AST or TBIL on admission are more likely to suffer from severe complications and death.

Negative endoscopic retrograde cholangiopancreatography (ERCP) for suspected common bile duct stones (CBDS) may be associated with significant morbidity and should be avoided. Between 2010 and 2018, 85 patients who have undergone negative ERCP for suspected CBDS were retrospectively evaluated and compared with 318 patients with positive findings. Predictors for negative ERCP were assessed. Patients with negative ERCP were younger; had increased levels of serum amylase, alanine transaminase, and lactate dehydrogenase; and increased hemoglobin. Even though preprocedure computed tomography (CT) or ultrasonography demonstrating CBDS were highly predictive of positive findings on ERCP, of the 212 patients with CBDS on computed tomography or ultrasonography, 17 (8%) eventually had a negative ERCP, suggesting spontaneous stone passage. An increased serum amylase level was the only predictor for negative ERCP in multivariate analysis, including in patients with preprocedure CBDS on imaging. The data suggest that assessing serum amylase may assist in avoiding unnecessary examinations.

Dive capacities of air-breathing vertebrates are dictated by onboard O2stores, suggesting that physiological specializations of diving birds like penguins may have involved adaptive changes in convective O2transport. It has been hypothesized that increased hemoglobin (Hb)-O2affinity improves pulmonary O2extraction and enhance capacities for breath-hold diving. To investigate evolved changes in Hb function associated with the aquatic specialization of penguins, we integrated comparative measurements of whole-blood and purified native Hbs with protein engineering experiments based on site-directed mutagenesis. We reconstructed and resurrected ancestral Hbs representing the common ancestor of penguins and the more ancient ancestor shared by penguins and their closest nondiving relatives (order Procellariiformes, which includes albatrosses, shearwaters, petrels, and storm petrels). These two ancestors bracket the phylogenetic interval in which penguin-specific changes in Hb function would have evolved. The experiments revealed that penguins evolved a derived increase in Hb-O2affinity and a greatly augmented Bohr effect (reduced Hb-O2affinity at low pH). Although an increased Hb-O2affinity reduces the gradient for O2diffusion from systemic capillaries to metabolizing cells, this can be compensated by a concomitant enhancement of the Bohr effect, thereby promoting O2unloading in acidified tissues. We suggest that the evolved increase in Hb-O2affinity in combination with the augmented Bohr effect maximizes both O2extraction from the lungs and O2unloading from the blood, allowing penguins to fully utilize their onboard O2stores and maximize underwater foraging time.

The Asiatic toad (Bufo gargarizans) belonging to the family of Bufonidae (Anura: Amphibia) is successfully residing on the Qinghai–Tibetan Plateau (QTP). To investigate whether the oxygen delivery undergoes adaptive adjustments to high-altitude environments in Asian toads inhabiting the QTP (Zoige County, 3446 m), choosing low-altitude populations (Chengdu City, 500 m) as control, we measured hematological traits, O2 affinities of whole blood, Hb-O2 affinities of purified Hbs, their sensitivities to temperature, and allosteric effectors (H+, Cl− and ATP). Our results showed that high-altitude Asiatic toads possessed significantly increased hemoglobin concentration, hematocrit, and red blood cell count, but significantly decreased erythrocyte volume compared with low-altitude toads. The whole blood and purified Hbs of high-altitude Asiatic toads both exhibited significantly higher O2 affinities compared with low-altitude toads. Substantially increased intrinsic Hb-O2 affinities of high-altitude Asiatic toads Hbs are likely to be the main reason for its elevated Hb-O2 affinities given the anionic cofactor sensitivities of high- and low-altitude toads were similar. The Hbs of high-altitude toads were also characterized by distinctly strong Bohr effects at the low temperature and low-temperature sensitivities. The adaptive adjustments of hematological traits could enhance the blood–O2 carrying capacity of high-altitude Asiatic toads. The increased Hb-O2 affinities could safeguard the pulmonary O2 uploading under hypoxia. The strong Bohr effects at the low temperature could help the release of O2 in metabolic tissues and cold limbs, while low-temperature sensitivity could minimize the effect of temperature fluctuation on the Hb–O2 affinity.

Environmental stressors, such as heat or altitude, elicit dissimilar physiological adaptations to endurance training programs. Whether these differences (i.e., increased hemoglobin mass vs plasma volume) differentially influence performance is debated. We review data in support of our novel hypothesis, which proposes altitude as the preferred environmental training stimulus for elite endurance athletes preparing to compete in temperate, sea-level climates (5°C-18°C).

The management of anemia of chronic kidney disease (CKD) is often challenging. In particular, for patients with underlying inflammation, comorbid type 2 diabetes or cancer, those hospitalized, and recipients of a kidney transplant, the management of anemia may be suboptimal. Responsiveness to iron and/or erythropoiesis-stimulating agents, the mainstay of current therapy, may be reduced and the risk of adverse reactions to treatment is increased in these difficult-to-manage patients with anemia of CKD. This review discusses the unique patient and disease characteristics leading to complications and suboptimal treatment response. New treatment options in clinical development, such as hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) inhibitors, may be particularly useful for difficult-to-treat patients. In clinical studies, HIF-PH inhibitors provided increased hemoglobin levels and improved iron utilization in anemic patients with non–dialysis-dependent and dialysis-dependent CKD, and preliminary data suggest that HIF-PH inhibitors may be equally effective in patients with or without underlying inflammation. The availability of new treatment options, including HIF-PH inhibitors, may improve treatment outcomes in difficult-to-manage patients with anemia of CKD.

Background: There remains equivocal evidence in terms of glucose-6-phosphate dehydrogenase (G6PD) and malaria occurrence. A case-control study was performed to assess protective relationship of G6PD and other lifestyle factors with malaria. Methods: One-hundred twenty six medical professionals were randomly selected from a tertiary care clinical institute. Along with demographic and lifestyle details, subjects were interviewed about their history of occurrence of malaria at all in previous 10 years. Their hematological, biochemical, and metabolic profile was assessed clinically as well as by investigations. The analysis was carried out with two groups: (1) those who were subjected with malaria at least once in past 10 years (Malaria Ever Group); (2) those who never encountered malaria (Malaria Never Group). Results: Out of 126, 65 subjects were in Malaria Ever Group and 61were in Malaria Never Group. There was no difference in lifestyle measures, hematological, and biochemical parameters. Mean G6PD levels were found similar in both the groups. Of 61 subjects in “malaria-never” group, 1 had deficient (1.1 unit/gm of Hb), 9 had low normal (between 2.5 and 10 units/gm of Hb), 48 had normal (10.1–20.5 units/gm of Hb), and 3 had higher than normal (>20.5 units/gm of Hb) G6PD levels. In comparison, 65 participants from “malaria ever” group, none was deficient, 6 had low normal, 58 had normal, and none had higher than normal G6PD levels. HPLC-based hemoglobin analysis showed significant higher number of participants in “malaria-never” group having altered hemoglobin. 12 participants had increased hemoglobin A2 levels, of which 10 were in “Malaria Occurrence Never” group; of them 6 could be diagnosed having hemoglobinopathy of specified variety. 3 of these 10 participants of “malaria-never” group had low G6PD levels also. Conclusion: Malaria Protection Hypothesis was not found to be true as per our findings, but there were subtle hints that G6PD protection with or without change in hemoglobin alteration maybe operable.

Background. Anemia in pregnant women is currently a national problem of maternal and child health in Indonesia. Based on Riskesdas data in 2013, the prevalence of pregnant women with anemia in Indonesia was 37.1%, namely pregnant women with Hb levels of less than 11.0 grams/dl, with almost the same proportion in urban areas (36.4%) and rural (37.8%). The program of giving at least 90 iron tablets during pregnancy is an important component in efforts to prevent iron deficiency anemia. However, the absorption of non-heme iron can be increased by consuming vitamin C from fruits, vegetables, or other food factors that facilitate absorption. One of them is the local wisdom of Pekalongan Regency, namely sweet potato leaf which is used as a vegetable. The purpose of this study was to determine maternal hemoglobin levels before and after being given the treatment of boiling sweet potato leaves and iron tablets. Methods. This research is a pre-post experiment research (mini-research) with a sample of 4 people who will be assessed and assessed for hemoglobin levels before and after treatment. Results. The result shows that the treatment of 100 grams of sweet potato leaves decoction for 10 days can increase hemoglobin levels in each respondent at R1 1.7 gr%, R2 2.1, R3 2.2, and R4 2.7 gr%. Conclusion. Further research is needed to prove the stronger benefits of sweet potato leaf decoction in helping to increase Hb levels of pregnant women by increasing the number of samples and testing hematocrit levels in the blood.

[Image: see text] We report herein the design and synthesis of a series of orally active, liver-targeted hypoxia-inducible factor prolyl hydroxylase (HIF-PHD) inhibitors for the treatment of anemia. In order to mitigate the concerns for potential systemic side effects, we pursued liver-targeted HIF-PHD inhibitors relying on uptake via organic anion transporting polypeptides (OATPs). Starting from a systemic HIF-PHD inhibitor (1), medicinal chemistry efforts directed toward reducing permeability and, at the same time, maintaining oral absorption led to the synthesis of an array of structurally diverse hydroxypyridone analogues. Compound 28a was chosen for further profiling, because of its excellent in vitro profile and liver selectivity. This compound significantly increased hemoglobin levels in rats, following chronic QD oral administration, and displayed selectivity over systemic effects.

Background: Delayed cord clamping (DCC) and umbilical cord milking (UCM), the methods used to increase placental blood transfusion to the newborn are associated with increased hemoglobin levels after birth, improved iron stores after several months of life, and greater myelination in early developing brain. Evidence suggests that clamping the umbilical cord in all births should be delayed for at least one minute. UCM also appears to be safe especially in a cesarean section scenario, where waiting too long to delay the cord clamping may not be feasible. Well-appearing late preterm …

The study was conducted on adolescent girls who had anemic clinical signs and supplemented raagi Laddu , drumstick leaf powder and iron tablets for four months for improvement of hemoglobin under on farm testing for three years and one year front line demonstration at Krishi Vigyan Kendra, Rudrur, Nizamabad district Telangana state. The results revealed that there was no improvement in hemoglobin level for treatment normal diet only, for second treatment the hemoglobin level of the adolescent girls was below normal hemoglobin level but on an average 0.36 mg/dl increased hemoglobin levels was observed after four months intervention. Other symptoms are proscribed and slight upgrading in weights of adolescent girls 3 (17%) were in normal weight and 15 (83%) in under weight. Adolescent girls had improved their mean hemoglobin level from 8.9 mg/dl to 9.5 mg/dl but their hemoglobin level was lower than the normal hemoglobin level. Though their BMI showed they were in underweight but the average BMI increased from 16 to 16.7 after four months.

Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE). This study investigated the associations of ScO2 and ΔSaO2-ScO2 with SaO2 and Hb and verified the normal range of ScO2 in children with CHD.Children undergoing cardiac catheterization for CHD were enrolled in a calibration and validation study of the FORE-SIGHT NIRS monitor. Two pairs of simultaneous arterial and jugular bulb samples were drawn for co-oximetry, calculation of a reference ScO2 (REF CX), and estimation of COE. Pearson correlation and linear regression were used to determine relationships between O2 saturation parameters and Hb. Data were also analyzed according to diagnostic group defined as acyanotic (SaO2 ≥ 90%) and cyanotic (SaO290%).Of 65 children studied, acceptable jugular bulb samples (SjbO2 absolute difference between samples ≤10%) were obtained in 57 (88%). The ΔSaO2-SjbO2, ΔSaO2-ScO2, and ΔSaO2-REF CX were positively correlated with SaO2 and negatively correlated with Hb (all P.001). Although by diagnostic group ScO2 differed statistically (P = .002), values in the cyanotic patients were within the range considered normal (69% ± 6%). COE estimated by the difference between arterial and jugular bulb O2 content (ΔCaO2-CjbO2, mL O2/100 mL) was not different for cyanotic and acyanotic patients (P = .10), but estimates using ΔSaO2-SjbO2, ΔSaO2-ScO2, or ΔSaO2-ScO2/SaO2 were significantly different between the cyanotic and acyanotic children (P.001).Children with adequately compensated chronic hypoxemia appear to have ScO2 values within the normal range. The ΔSaO2-ScO2 is inversely related to Hb, with the implication that in the presence of reduced Hb, particularly if coupled with a decreased cardiac output, the ScO2 can fall to values associated with brain injury in laboratory studies.

Hemoconcentration (HC) is associated with reduced mortality, whereas hyponatremia (HN) has been associated with an increased risk of adverse outcomes in patients with acute decompensated heart failure (ADHF). We sought to determine if the presence of HN influences the beneficial prognostic value of HC in ADHF patients.We analyzed 2046 ADHF patients from the Korean Heart Failure Registry. We defined HC as an increased hemoglobin level from admission to discharge, and HN as sodium135mmol/L at admission. Our primary composite endpoint was all-cause mortality and/or HF re-hospitalization.Overall, HC occurred in 889 (43.5%) patients and HN was observed in 418 patients (20.4%). HC offered higher 2-year event-free survival in patients without HN (73.2% vs. 63.1% for no-HC, log-rank p0.001), but not in patients with HN (54.2% vs. 58.7% for no-HC, log-rank p=0.879, p for interaction=0.003). In a multiple Cox proportional hazard analysis, HC without HN conferred a significant event-free survival benefit (hazard ratio: 0.703, 95% confidence interval 0.542-0.912, p=0.008) over no-HC with HN.Only HC occurring in ADHF without HN was associated with improved clinical outcomes. These results provide further support for the importance of HN as a challenging therapeutic target in ADHF patients.

Purpose Increased hemoglobin A1C was reported to be a predictor of angiographically detected CAV. Our study examined the impact of glycemic control on myocardial blood flow (MBF) measured by 13N-ammonia positron emission tomography (PET) in transplant recipients. Methods We reviewed the records of patients who had heart transplant in the past 5 years at our center, and who had regadenoson-stress 13N-ammonia PET imaging. Three PET flow parameters were measured: stress MBF, myocardial flow reserve (MFR), and coronary vascular resistance (CVR = systolic blood pressure / stress MBF). Age, time from heart transplant to PET imaging, cold ischemia time during transplant, history of ≥ 2R cellular rejection, cholesterol level and A1C within 3 months of PET were recorded as potential risk factors. Correlations between PET and potential risk factors were analyzed (Pearson and Spearman's rank). Mann-Whitney test was used to compare PET flow between patients with A1C Results 57 patients (median age 57.6 years, 73% men) were identified. Median time from transplant to PET imaging was 25 months. Median stress MBF was 2.8 (2.3-3.2) ml/min/g, CVR was 46.7 (39.1-54.0) mmHg/ml/min/g, and MFR was 3.0 (2.6-3.6). A1C (median 6.4%) correlated significantly with stress MBF: r -0.395 (P 0.006), and with CVR: r 0.392 (P 0.006). Time from transplant to PET imaging showed weaker correlation with stress MBF: r -0.284 (p 0.032) and CVR: r 0.279 (p 0.035). Patients with A1C Conclusion Time from heart transplant and A1C level significantly correlated with MBF by 13N-ammonia PET. Patients with high HbA1C level had significantly lower MBF, suggesting that glycemic control may have an important role in prevention of CAV.

In children under 5, a hemoglobin (Hb) cutoff of 11 g/dL is recommended by the World Health Organization to define anemia, yet few studies have examined whether this cut point accurately coincides with negative functional consequences. This systematic review and meta-analysis of iron intervention and observational studies aimed to clarify the consequences of low Hb concentration in children under age 5 years on growth, development, and chronic disease (functional outcomes) across the full range of Hb values. A literature search returned 5049 studies; of these, 56 intervention and 20 observational studies fit the inclusion criteria. Among iron supplementation trials, a metaregression indicated significant associations between intervention effects on Hb and their effects on motor and mental development. For each 1 standard deviation (SD) increase in Hb, motor scores increased by 0.28 SD and mental scores increased by 0.24 SD. Iron supplementation trials among children with lower Hb concentrations at baseline showed stronger associations between their effects on Hb and their effects on mental development (P-interaction = 0.008). Heterogeneity among observational studies precluded calculation of pooled associations between Hb and functional outcomes. Available evidence was not able to establish an inflection point at which decreasing Hb begins to be associated with negative functional outcomes. Future research is needed to examine associations of Hb with growth and development in populations with varying levels of Hb, inflammation, and in different ages and settings.

Pain (nociceptive) input caudal to a spinal contusion injury can undermine long-term recovery and increase tissue loss (secondary injury). Prior work suggests that nociceptive stimulation has this effect because it fosters the breakdown of the blood-spinal cord barrier (BSCB) at the site of injury, allowing blood to infiltrate the tissue. The present study examined whether these effects impact tissue rostral and caudal to the site of injury. In addition, the study evaluated whether cutting communication with the brain, by means of a rostral transection, affects the development of hemorrhage. Eighteen hours after rats received a lower thoracic (T11–12) contusion injury, half underwent a spinal transection at T2. Noxious electrical stimulation (shock) was applied 6 h later. Cellular assays showed that, in non-transected rats, nociceptive stimulation increased hemoglobin content, activated pro-inflammatory cytokines and engaged signals related to cell death at the site of injury. These effects were not observed in transected animals. In the next experiment, the spinal transection was performed at the time of contusion injury. Nociceptive stimulation was applied 24 h later and tissue was sectioned for microscopy. In non-transected rats, nociceptive stimulation increased the area of hemorrhage and this effect was blocked by spinal transection. These findings imply that the adverse effect of noxious stimulation depends upon spared ascending fibers and the activation of rostral (brain) systems. If true, stimulation should induce less hemorrhage after a severe contusion injury that blocks transmission to the brain. To test this, rats were given a mild, moderate, or severe, injury and electrical stimulation was applied 24 h later. Histological analyses of longitudinal sections showed that nociceptive stimulation triggered less hemorrhage after a severe contusion injury. The results suggest that brain-dependent processes drive pain-induced hemorrhage after spinal cord injury (SCI).

The present study incorporated beetroot pomace powder in biscuit preparation at concentrations of 5–20%. Biscuits' chemical composition, and sensory were evaluated. A feeding experiment was conducted using three groups (n = 3); control and anemic (An+) groups fed a standard diet, and anemic group fed 90% standard-diet and 10% biscuit containing 15% pomace (AnB). Anemia induced by injecting rats with phenylhydrazine (40 mg/kg) for two consecutive days. Hematological and biochemical blood parameters were determined at days 3, 14, and 28. An enhancement in protein, fiber, calcium, phosphorus, and iron was observed in the biscuit by increasing the pomace. Consuming biscuits containing 15% pomace increased hemoglobin, RBCs, and antioxidant enzymes in (AnB) rats after 28 days. The minor kidney and liver dysfunction in the anemic groups were recovered in (AnB) after 28 days. Consequently, incorporation beet pomace in biscuit revealed a promising role in anemia treatment and oxidative stress managing.

Background : Anemia is a global phenomenon involving developing countries. Fifty percent of anemia cases is caused by iron deficiency. Indonesia is a tropical country that is rich in various kinds of marine plants and still not used optimally.Sargassum sp is one of high iron contains seaweed but still less utilized. Objectives: the aim of this study was to analyze the influence of Sargassum sp on hemoglobin and serum ferritin level. Methods : a simple randomized with pre and posttest control group design was used in this study. Sixteen Wistar male rats were divided into 2 groups (1) control (2) treatment and fed with Sargassum sp 0,49 g for 14 days. During the treatment pre and post hemoglobin and serum ferritin was measured. Results : : iron level in Sargassum sp was 122,37mg/g and Pb level was 0,00009%. In the treatment group hemoglobin level was significantly increased 5,24 mg/dl (p0,05). Conclusion : sargassum sp increased hemoglobin level on anemic wistar rat but not in serum ferritin significantly.

Liver transplantation is especially challenging in patients who are Jehovah's Witnesses because their religious beliefs prohibit the receipt of blood products. We present two cases of living donor liver transplantation performed in adult Jehovah's Witnesses in South Korea without the use of blood products. In the first case, preoperative erythropoiesisstimulation therapy increased hemoglobin levels from 8.1 to 13.1 g/dl after 9 weeks. In the second case, hemoglobin levels increased from 7.4 to 10.8 g/dl after 6 months of erythropoiesis-stimulation therapy. With the combination of acute normovolemic hemodilution, intraoperative cell salvage, and use of transfusion alternatives, liver transplantation was successfully performed without transfusion of blood products.

Background: Trichuriasis is a soil transmitted helminth that causes anemia and growth disturbance in children. This study aimed to compare hemoglobin concentration before and after Trichuriasis treatment with albendazole among primary school children.Subjects and Method: This was an experimental study with before and after quasi experiment design. This study was conducted at Medan Tembung Primary School, Medan, North Sumatera, from March to June, 2015. A total of 63 children were selected for this study. Blood sample was taken for hemoglobin concentration examination before and after the administration of albendazole. The treatment consisted of 400 mg albendazole that was administered in single dose 0nce a day for 3 days, both for single and mixed infection.Results: The prevalence of Trichuriasis among the school children under study was 33.3% (126/ 378), which was consisted of 37 children with single infection and 26 children with mixed infection. Albendazole increased hemoglobin concentration with mean= 11.88 g/dl; SD=1.26 before treatment and mean=12.53 g/dl; SD= 1.37 after treatment, among children with single infection, and it was statistically significant (p= 0.002). Albendazole increased hemoglobin concentration with mean= 11.69 g/dl; SD=1.04 before treatment and mean=12.36 g/dl; SD= 1.06 after treatment, among children with mixed infection, and it was statistically significant (p= 0.001).Conclusion: Albendazole is effective in increasing hemoglobin concentration among school children with anemia that is caused by Trichuriasis infection. Keywords: helminthiasis, trichuriasis, hemoglobin, anemia, albendazole, school childrenCorrespondence: Novreka Pratiwi Sipayung. Department Parasitology, Faculty of Medicine, HKBP Nommensen University, Medan. Email: ega_efq@yahoo.com. Mobile: 085261145049.Indonesian Journal of Medicine (2016), 1(4): 201-208https://doi.org/10.26911/theijmed.2017.02.01.08

To determine the value of recombinant interferon-alfa (rIFNα) in the treatment of polycythemia vera (PV) and essential thrombocythemia (ET) based on its biological activities and phase 2 clinical studies, pending completion of phase 3 trials; to determine importance of the Internet in patient decision-making in treatment selection.The value of rIFNα in PV and ET is based upon its biological effects on PV stem cells and megakaryocyte proliferation. Single-arm trials are useful for life-threatening diseases when there are relatively few patients to evaluate endpoints, such as rIFNα treatment of PV and ET. Proper diagnostic criteria are mandatory; for PV, the current World Health Organization criteria emphasizing increased hemoglobin values exclude approximately one-third of eligible patients. Importance of these data: Single-arm studies in diseases exemplified by rIFNα in PV require updated diagnostic criteria for research and for clinical practice. The influence of the Internet on patient decisions for treatment is noteworthy.The biologic basis for selecting therapy is exemplified by rIFNα in treating PV and ET. Current single-arm studies of rIFNα in PV and ET are relevant and acceptable. The importance of the Internet in patient decision-making is important.

In contrast to Andean natives, high-altitude Tibetans present with a lower hemoglobin concentration that correlates with reproductive success and exercise capacity. Decades of physiological and genomic research have assumed that the lower hemoglobin concentration in Himalayan natives results from a blunted erythropoietic response to hypoxia (i.e., no increase in total hemoglobin mass). In contrast, herein we test the hypothesis that the lower hemoglobin concentration is the result of greater plasma volume, rather than an absence of increased hemoglobin production. We assessed hemoglobin mass, plasma volume and blood volume in lowlanders at sea level, lowlanders acclimatized to high altitude, Himalayan Sherpa, and Andean Quechua, and explored the functional relevance of volumetric hematological measures to exercise capacity. Hemoglobin mass was highest in Andeans, but also was elevated in Sherpa compared with lowlanders. Sherpa demonstrated a larger plasma volume than Andeans, resulting in a comparable total blood volume at a lower hemoglobin concentration. Hemoglobin mass was positively related to exercise capacity in lowlanders at sea level and in Sherpa at high altitude, but not in Andean natives. Collectively, our findings demonstrate a unique adaptation in Sherpa that reorientates attention away from hemoglobin concentration and toward a paradigm where hemoglobin mass and plasma volume may represent phenotypes with adaptive significance at high altitude.

Objetivo: Analizar los efectos clínicos de la hidroxiurea, demostrada como la única terapia modificadora de la anemia falciforme. Método: El presente estudio es de carácter observacional y descriptivo. Población: 210 pacientes con anemia falciforme bajo terapia con hidroxiurea. Muestra: muestreo no probabilístico por conveniencia, constituida por los pacientes de la población que cumplían con los criterios de inclusión (92 pacientes). Resultados: De los pacientes estudiados (100%); el 87% fueron falcémicos HbSS, que empezaron su terapia entre los 3 y 9 años (60%), con un número promedio de cinco seguimientos en 1-2 años de terapia. Se observó una reducción importante (51%) (p

Venous thromboembolism prophylaxis in the general trauma population is well established. However, risk of increased intracranial hemorrhage in traumatic brain injury (TBI) population is of concern. The aim for this study is to identify a reproducible model of mild traumatic brain injury (mTBI), evaluated by clinical and histological markers and test the hypothesis that enoxaparin increases the risk of spontaneous brain hemorrhage.40 male Sprague Dawley rats were randomly assigned to 5 groups: group 1 (sham) with no TBI along with 4 groups comparing mTBI with and without pharmacological intervention using enoxaparin at 24 h and 72 h respectively. Mild traumatic brain injury was induced using a weight drop apparatus, with a clinical endpoint of time to right (TTR), along with histological and spectrophotometer analysis for qualitative hemorrhage.There is a statistically significant difference between group 1 (sham) and all other groups with a mean longer time to right of 64 s (p = 0.005) in the mTBI groups. There was a statistically significant difference between group 1 (sham) and all other groups with an increase of 6 g/dL hemoglobin (p 0.001) in the mTBI groups with no difference in hemorrhage between groups that were treated with enoxaparin.The weight drop apparatus is a reproducible model for mTBI that has correlations with clinical and qualitative data. This model was able to produce clinical signs of concussion, as reflected by longer TTR and increased hemoglobin in the mTBI groups. Upon further analysis, there wasno increase in hemorrhage in the pharmacological intervention groups with enoxaparin.

This study aims to determine the ability of extracts of edible mushroom to increase hemoglobin rabbit. The method used is by using a photometer Cyanmethemoglobin C-206 Biochemyistri. Observations made with three times the measurement of hemoglobin, the measurement of the initial Hb, after induced, and after treatment. Extract of mushroom with a concentration of 2%, 4%, and 6% w/v to increase hemoglobin in test animals rabbits respectively 11.8%, 35.54%, and 79.32%. Extract with a concentration of 6% w/v had no significantly different effect with the provision of suspension ferosi sulfate 0.117% w/v, namely 86.9%. Analysis results obtained by the method ANAVA Fhitung > Ftabel at α = 0.05 and α = 0.01 with the value of each 275.52 > 275.52 3.48 and > 5.99, which means the results obtained that there are significant significant differences in the effects of each treatment.

The aim of the study was to determine the impact of triploidization on hematological and blood gas parameters in Siberian sturgeon, Acipenser baerii Brandt. The study material was comprised of juvenile Siberian sturgeon specimens with total body lengths of 22.3 ± 2.9 cm and mean body weights of 75.3 ± 40.7 g. Triploidization was confirmed to result in significant changes in the hematological profile of Siberian sturgeon. In comparison to the diploid group, the fish with higher levels of ploidy exhibited lower erythrocyte counts, increased hemoglobin concentration, and increased values of mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. A significant decrease in the percentage share of lymphocytes and an increase in the percentage share of granulocytes in the peripheral blood were also observed, which indicate disturbances in the immune response (particularly in the adaptive immune system) and greater susceptibility to stress. Triploidization did not, however, cause significant differences in the blood gas profile. CORRESPONDING AUTHOR: M. Rozynski [+] Department of Aquaculture Inland Fisheries Institute in Olsztyn Oczapowskiego 10, 10-719 Olsztyn, Poland Tel. +48 89 5241071; e-mail: maciej.rozynski@infish.com.pl K. Demska-Zakeś, D. Fopp-Bayat Department of Ichthyology University of Warmia and Mazury in Olsztyn, Poland

Aims: The objective was to study the care of hospitalized patients with diabetes mellitus and coexisting cancer. Patients & methods: Hospitalized patients with a new solid organ malignancy and diabetes were retrospectively analyzed. Multivariable generalized estimating equation models evaluated associations between cancer type and hyperglycemia (glucose >180 mg/dl). Results: Among 443 patients with 914 hospitalizations, cancer types included prostatic, liver, lung, kidney, pancreatic, bladder, breast, colorectal and gynecologic. Increased hemoglobin A1c (β = 2.72; p < 0.01), mean glucose within 24 h after admission (β = 0.27; p < 0.01) and insulin administration (β = 10.16; p < 0.01) were significantly associated with hyperglycemia. No association existed between cancer type and hyperglycemia frequency (p = 0.79). Conclusion: Inpatient hyperglycemia management is not associated with type of solid organ malignancy.

Objective: Evaluating clinical and hematological-clinical parameters of patients with sickle cell anemia (SCA) before and after four years of using hydroxyurea (HU). Method: A retrospective cohort study implementing a quantitative, descriptive and analytical approach developed in two public teaching hospitals located in the Central-West region of Brazil, from November 2010 to October 2011. Data collection was performed through medical records of 32 patients with SCA to assess clinical and hematological parameters before and after HU treatment. The study was approved by the UFMS Ethics Committee under protocol number 1890/2010. Results: All of the 32 patients were homozygous with a mean age in the prescription of hydroxyurea of 19.72±7.58 years, an initial dose of 15.59±4.27 mg/kg/day, and 22.48±5.35 mg/kg/day in the fourth year of treatment. Regarding the use of HU, average values of some hematological parameters presented a significant difference in the fourth year compared to the mean values prior to HU use, such as fetal hemoglobin (14.49±7.52%), red blood cells (2.54±0.38x1012/L), hematocrit (25.30±4.03%) and hemoglobin (9.22±3.34g/dL). Conclusion: Treatment with hydroxyurea showed a significant increase in fetal hemoglobin levels, increased hemoglobin, hematocrit and average corpuscular hemoglobin concentration, with reduced episodes of pain, infection and acute chest syndrome in such a way as to reaffirm its efficiency in treating these patients. Keywords: Hemoglobin; Sickle Cell Anemia; Hydroxyurea.

Background According to WHO definition approximately 15% of all patients with rheumatoid arthritis (RA) suffer from anemia (hemoglobin Objectives The 6th interim analysis of the non-interventional ICHIBAN study (NCT01194401) evaluated the occurrence of inflammatory anemia, characterized the patient population with anemia, and observed the response during intravenous Tocilizumab therapy (TCZ i.v.). Patients were subgrouped according to their anemic/non-anemic status at baseline. Methods Since 2010 the ICHIBAN study collects clinical data of the routine use of TCZ i.v. in RA patients. The observation period for each patient is up to two years. At the due date of the current interim analysis (Dec 10, 2015) 2999 patients were enrolled. 902 patients have completed the maximal 104 weeks observation period (Group W104). Results At baseline, the proportion of patients with anemia (acc. to WHO definition) was 21.4% (men) and 22.0% (women) in the group W104. On comparison, RA patients with anemia showed, amongst others, increased inflammation parameters, a higher disease activity and higher rates of comorbidities. Already after 4 weeks with TCZ i.v. the proportion of patients with anemia improved to 12.1% (men) and 12.7% (women). After 104 weeks therapy the proportion of patients with anemia reduced further to 7.4% (men) and 8.4% (women). The relevant response parameters and laboratory values are shown in Table 1. Despite the higher disease activity at baseline for anemic patients, the benefit was comparable for patients with and without anemia. DAS28-ESR values decreased on average by 2.9 (women) and 3.1 (men) in RA patients with anemia and by 2.7 (women) and 2.8 (men) in RA patients without, resulting in similar disease scores at the end of the observational period. The effectiveness of TCZ i.v. was also confirmed by patient reported outcomes (PROs) via visual analogue scales (VAS). In particular, a reduction of the intensity of pain (>50%) and a reduction of fatigue (>38%) was observed (Table 1). Conclusions At start of therapy, approximately one out of five patients documented in ICHIBAN showed anemia according to the WHO definition. During TCZ i.v. therapy a noticeable decrease in the rate of anemia and improved hemoglobin values were observed. These effects can already be seen after four weeks of treatment and continue up to the end of this study (i.e. 2 years). Despite the higher burden of disease at baseline in RA patients with anemia, TCZ i.v. therapy resulted in good clinical response rates and PROs. Acknowledgements We would like to thank all patients, their families, the investigators and the nurses who participated in this trial. This research was funded by Roche Pharma AG, Germany, and Chugai Pharma Europe Ltd., Germany. Support for third-party writing assistance for this abstract presentation was provided by Roche and Chugai and performed by Ecron Acunova GmbH, Germany. Disclosure of Interest C. Specker Grant/research support from: Chugai, DRFZ, Consultant for: Abbvie, Janssen, Chugai, MSD, Novartis, UCB, Lilly, Boehringer, Speakers bureau: Abbvie, Celgene, Chugai, Euroimmun, MSD, Pfizer, UCB, H. Kellner: None declared, P. Kastner: None declared, C. Volberg: None declared, V. Braunewell: None declared, I. Schwarze: None declared, M. Aringer: None declared, M. Sieburg: None declared, M. Hofmann Employee of: Chugai Pharma Europe Ltd., Zweigniederlassung Deutschland, J. Flacke Employee of: Roche Pharma AG, Germany, H.-P. Tony Consultant for: Roche Pharma, Abbvie, BMS, Chugai, Janssen, Novartis, Pfizer, Sanofi, Lilly, MSD, Astra-Zeneca, G. Fliedner: None declared

We compared the effect of xymedon (100 mg/kg) and Mexidol (50 mg/kg) on morphometric parameters of erythrocytes and oxygen-transporting function of hemoglobin in rats with Walker-256 carcinoma treated with docetaxel (15 mg/kg once intraperitoneally on day 11 after tumor cells transplantation). Xymedon and Mexidol were injected intramuscularly for 10 days starting from day 11 of the experiment. The studied parameters were evaluated on experimental days 14 and 22. Similar to Mexidol, xymedon prevented changes in the erythrocyte geometric parameters induced by docetaxel and neoplastic process, but increased hemoglobin packing density in erythrocytes (by 32%) more effectively than Mexidol. Optimization of oxygen-transporting function of hemoglobin and normalization of its structural and functional parameters changed by docetaxel treatment (content of oxyhemoglobin, hemoglobin affinity for oxygen and its ability to bind and release oxygen, intensity of symmetric and asymmetric vibrations of pyrrole rings) in rats receiving xymedon took longer time than in case of Mexidol treatment, but the effects were similar.

Introduction: Fluid intake was reported to reduce migraine attacks. This may be due to its effect on hemoconcentration. Hemoconcentration may manifest itself by increasing in the hemoglobin and platelet-related values. This study aimed to reveal hemoconcentration by evaluating complete blood cell counts in attack-free periods of pediatric patients with migraine. Materials and Methods: Consecutive children with migraine (n = 70) and tension-type headache (TTH) (n = 65) were compared with the control groups. Control 1 (n = 70) and control 2 (n = 60) groups consisted of age- and gender-matched patients, respectively. Control 2 group patients had gastrointestinal symptoms leading to fluid loss, which may have caused hemoconcentration. To evaluate hemoglobin and platelets together, the M1-value was created by multiplying hemoglobin level by plateletcrit. Results: The M1-value was higher in the migraine group than in control 1 and TTH groups (P = 0.017 and 0.034) and the hemoglobin and hematocrit levels were also higher in the migraine group than in control 2 group (P = 0.013 and 0.012). Female patients with migraine had higher hemoglobin levels as compared to the female patients in control group 1 (P = 0.041). Male patients with migraine had higher M1-values than the male patients in control group 1 (P = 0.034). In the subgroup of migraine with aura (n = 10), folic acid was significantly lower than the other patients with migraine (P = 0.02). Conclusion: This study suggests that migraine may be accompanied with hemoconcentration in children.

Aim The aim of the study was to analyse the reason of elevated hemoglobin concentration in childhood. Background Elevated hemoglobin concentration is a rare abnormality during childhood. There are disorders of hereditary or acquired hyperproliferations of red cells or pseudo high hemoglobin conditions. Materials and methods We present 3 asymptomatic children in whom high hemoglobin concentration was diagnosed by a family doctor. Results Given that the iron concentration was elevated, genetic testing for HFE mutation was carried out. Conclusion Patients presented with HFE mutation might have an increased hemoglobin production.

A 71-year-old male smoker was referred to our hospital because of increased hemoglobin and hematocrit. At initial consultation, his hemoglobin and hematocrit levels were 21.8 g/dl and 64.8%, respectively. Other laboratory data and his cardiopulmonary functions were almost normal, and JAK2 V617F mutation was negative. He had smoked about 25 cigarettes per day for 50 years until the age of 70, when he switched from conventional smoking to electronic cigarettes (e-cigarettes). We requested that he quit e-cigarette use. Thereafter, his hemoglobin and hematocrit gradually decreased and normalized. Here, we report the first case of e-cigarette-induced polycythemia.