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Hemoglobin Levels (hemoglobin + level)

Distribution by Scientific Domains

Medical Sciences	91%
Life Sciences	4%
2 Other Domains	5%

Distribution within Medical Sciences

Oncology & Radiotherapy	26%
Hematology	18%
Gastroenterology	6%
Geriatric Medicine	4%
12 Other Subdomains	46%

Selected Abstracts

Glycated Hemoglobin Levels and Intellectual Activity in an Aged Population

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2005
Hidenori Amano MHSc
Objectives: To examine the association between glycated hemoglobin (GHb) and aspects of daily activities in an elderly population. Design: Cross-sectional population-based survey. Setting: Nangai village, an agricultural community with a population of about 5,000 located in Akita prefecture in the north of Japan. Participants: Nine hundred thirty-five people aged 65 and older. Measurements: GHb percentages, self-reported measures of activities of daily living (ADLs) and instrumental activities of daily living (IADLs), intellectual activity (IA), and social role (SR). Results: An exploratory analysis indicated that nondiabetic subjects in the lowest tertile of GHb tend to have lower IA than those in the middle tertile, if they were aged 70 and older. No consistent association appeared between GHb and ADLs, IADLs, or SR. Linear and logistic regression analyses, controlling for other risk factors, indicated significantly lower IA scores in the low and high GHb tertiles (P<.001 and P=.04, respectively) than in the middle in nondiabetic subjects aged 70 and older and without stroke history or IADL impairments. The value of GHb related to the maximal IA score was 5.0% to 5.2% as the middle tertile; or 5.2%, assuming a logistic regression model including a squared term with GHb as a continuous variable. A similar relationship was observed in the whole nondiabetic sample aged 70 and older but not in the younger counterpart. Conclusion: There is an inverted U-shaped relationship between GHb and intellectual activity in older people without diabetes mellitus. One possible interpretation is that suboptimal blood glucose could contribute to intellectual inactivity in older people. [source]

Concomitant radiochemotherapy in primary inoperable advanced head and neck cancer with 5-fluorouracil and mitomycin-C

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2004
Hans Christiansen MD
Abstract Background. The purpose of this study was to evaluate the efficacy and toxicity of radiotherapy and concomitant 5-fluorouracil (5-FU) and mitomycin-C infusion in inoperable head and neck cancer. Methods. Seventy-six patients (86% men, 14% women), mean age 57 years, with primary inoperable head and neck cancer were treated with 70 Gy plus simultaneous intravenous chemotherapy with 5-FU (600 mg/m2/d, days 1 to 5) and mitomycin-C (10 mg/m2, day 5 plus 36). Results. After a mean follow-up of 13 months, 31 patients were alive. Complete response (CR) was seen in 63%. The 1- and 2-year overall survival rates were 67.7% and 39.5%, and locoregional control rates were 51.7% and 35.6%. Pretreatment hemoglobin <13.9 g/dL was associated with lower locoregional control rates (p = .03). Therapy was well tolerated (grade 3 mucositis in 21%, grade 4 in 1%, grade 3 leukopenia in 11%). Conclusions. Our radiochemotherapy regimen offers a curative option for this group of patients with a poor prognosis. Hemoglobin levels before therapy have an influence on prognosis. © 2004 Wiley Periodicals, Inc. Head Neck26: 845,853, 2004 [source]

Anemia and cognitive performance in hospitalized older patients: results from the GIFA study

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2006
Valentina Zamboni
Abstract Background Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons. Method Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia. Results Mean age of the sample (n,=,13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p,<,0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR,=,0.96, 95%CI,=,0.94,0.99, p,=,0.004, and OR,=,1.32, 95%CI,=,1.18,1.48, p,<,0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend,<,0.001). Conclusion Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Mitigating stress effects during transportation of matrinxã (Brycon amazonicus Günther, 1869; Characidae) through the application of calcium sulfate

JOURNAL OF APPLIED ICHTHYOLOGY, Issue 2 2009
F. Bendhack
Summary This study verified the effects of CaSO4 on physiological responses of the tropical fish matrinxãBrycon amazonicus (200.2 ± 51.1 g) in water containing CaSO4 after a 4-h transportation at concentrations of: 0, 75, 150, and 300 mg L,1. Blood samples were collected prior to transportation (initial levels), immediately after packaging, at arrival, and 24 h and 96 h after transportation (recovery). Cortisol levels increased after packaging (118.2 ± 14.2 ng ml,1), and decreased slightly after transportation in water containing CaSO4 (106.8 ± 14.1), but remained higher than initial levels (21.0 ± 2.6 ng ml,1). Fish kept at 150 mg L,1 CaSO4 reached the pre-transportation levels at 24 h of recovery. Blood glucose increased after transportation in all treatments (8.2 ± 0.2 mmol L,1) and declined after full recovery to values below initial levels (4.8 ± 0.1 mmol L,1). Chloride levels did not change in CaSO4 treatments; serum sodium concentrations decreased after packaging and after transportation. Serum calcium levels did not differ among treatments, but decreased after packaging and increased at 96 h of recovery. Hematocrit and the number of red blood cells were higher in all treatments after packaging and arrival, except in fish exposed to 300 mg L,1 CaSO4. Mean corpuscular volume increased in 75 mg L,1 CaSO4, which reached the higher VCM after transportation. Hemoglobin levels increased only after transportation, regardless of calcium sulfate levels. Handling before transportation and transportation itself were both stressful to fish; calcium sulfate at concentrations tested in the present work had a moderate influence in the reduction of stress responses. [source]

Prognostic factors in the nonsurgical treatment of esophageal carcinoma with radiotherapy or radiochemotherapy

CANCER, Issue 8 2005
The importance of pretreatment hemoglobin levels
Abstract BACKGROUND The current study was performed to evaluate prognostic factors for overall survival (OS), distant metastasis (DM), and local failure (LF) in patients with Stage II/III esophageal carcinoma. METHODS The following potential prognostic factors were retrospectively investigated in 124 patients treated with radiotherapy (RT) alone or with radiochemotherapy: age, gender, performance status, tumor location, tumor length, histology, histologic grade, T classification, N classification, International Union Against Cancer stage, chemotherapy, RT dose, and pre-RT hemoglobin level. RESULTS Using univariate analysis (Kaplan,Meier method), pre-RT hemoglobin level, RT dose, tumor length, chemotherapy, and performance status were significantly associated with OS. Hemoglobin levels of 12.1,14.0 g/dL were associated with the best OS, followed by , 14.1 g/dL and , 12.0 g/dL. DM was significantly influenced by tumor length, RT dose, N classification, and performance status. LF was significantly influenced by pre-RT hemoglobin level, RT dose, and tumor length. Using multivariate analysis (Cox proportional hazard model), pre-RT hemoglobin maintained significance for OS (P < 0.001) and LF (P < 0.001), RT dose for OS (P = 0.001), DM (P = 0.031), and LF (P < 0.001), tumor length for OS (P = 0.003), DM (P = 0.017), and LF (P = 0.033), and chemotherapy for OS (P = 0.027). N classification was of borderline significance for DM (P = 0.054). Performance status lost significance for OS (P = 0.73) and LF (P = 0.22). CONCLUSIONS The strongest predictors for outcome in Stage II/III esophageal carcinoma were RT dose, tumor length, pre-RT hemoglobin level, and chemotherapy. The pre-RT hemoglobin level was an independent prognostic factor significantly associated with OS and LF. A hemoglobin level of 12.1,14 g/dL resulted in a better prognosis than hemoglobin levels , 14 g/dL and , 12 g/dL. Cancer 2005. © 2005 American Cancer Society. [source]

Impact of hemoglobin level on survival in definitive chemoradiotherapy for T4/M1 lymph node esophageal cancer

DISEASES OF THE ESOPHAGUS, Issue 3 2008
S. Zenda
SUMMARY., We retrospectively investigated the impact of the pre-chemoradiotherapy hemoglobin level (pre-CRT Hb level) for T4 and/or M1 lymph node (LYM) squamous cell carcinoma of the esophagus. Chemotherapy consisted of protracted infusion with 5-fluorouracil (5-FU) at 400 mg/m2/day on days 1,5 and 8,12, combined with cisplatin at 40 mg/m2/day on days 1 and 8, repeated twice at a 5-week interval. Concurrent radiation therapy was started on day 1 and delivered at 2 Gy/day for five days a week for a total radiation dose of 60 Gy, with a two-week break after a cumulative dose of 30 Gy. Several factors considered to be related with treatment outcome were evaluated by univariate and multivariate analysis. A total of 48 patients with T4/M1 LYM (lymphocyte) esophageal cancer treated with chemoradiotherapy (CRT) between September 2002 and April 2005 were enrolled. The complete response rate to this regimen was 44% and median survival time was 13.6 months, with a median follow-up period of 26.8 months. Median pre-CRT Hb level was 13.5 (10.4,15.3) g/dL. The CR rate in patients with a pre-CRT Hb level of 13 g/dL or less was only 24% but it was 60% in those with a level that was more than 13 g/dL (P=0.01). As for survival, anovarevealed that a pre-CRT Hb of 13 g/dL or less was a significant prognostic factor with a hazard ratio of 0.45 (95% confidence interval [CI]); 0.21,0.97, P=0.04), while on manova, including performance status, tumor size, TNM stage and pre-CRT Hb level, a pre-CRT Hb level of 13 g/dL or less was the only significant prognostic factor, with a hazard ratio of 0.35 (95% CI; 0.13,0.90, P=0.03). In conclusion, the pre-CRT Hb level may be an important determinant of outcome in patients with T4/M1 LYM squamous cell carcinoma of the esophagus. [source]

Association of non-alcoholic steatohepatitis (NASH) with chronic neutrophilic leukemia

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2004
Chikashi Yoshida
Abstract: A 54-yr-old female having chronic neutrophilic leukemia (CNL) associated with severe liver injury is presented. Physical examination on admission showed severe jaundice, hepatosplenomegaly, massive ascites, and pretibial edema. Complete blood count showed a hemoglobin level of 9.1 g/dL, platelet count of 25.8 × 104/,L, and white blood cell count of 36.6 × 103/,L with 89.7% neutrophils. Blood chemistry showed hyperbilirubinemia (21.9 mg/dL) with normal transaminase levels. There was no abnormality in serum cholesterol, triglyceride, or glucose levels. Neutrophil alkaline phosphatase activity was significantly elevated. Bone marrow aspiration showed myeloid hyperplasia with normal karyotype. Rearrangement of the bcr/abl was not detected by either polymerase chain reaction or fluorescence in situ hybridization. Human androgen receptor gene assay (HUMARA) of the bone marrow cells showed clonal proliferation of neutrophils. The patient was diagnosed as having CNL. To evaluate the pathogenesis of the liver injury, a needle biopsy was performed, which showed steatohepatitis with infiltration of neutrophils. As the patient had no history of alcohol abuse, a diagnosis of non-alcoholic steatohepatitis (NASH) was made. Assuming that the infiltration of abnormal neutrophils into the liver contributed to the development of NASH, she was treated with cytoreductive chemotherapy (cytosine arabinoside: 100 mg/d, 1,3 doses/wk). With decreases in white blood cell counts, serum bilirubin levels decreased gradually to 1.5 mg/mL. A postchemotherapy liver biopsy specimen showed marked improvement of the fatty degenerative change. To our knowledge, this is the first report describing the development of NASH in a myeloproliferative disorder. We believe that the infiltration of leukemic cells contributed to the development of NASH in this patient. [source]

Concomitant low-dose cisplatin and three-dimensional conformal radiotherapy for locally advanced squamous cell carcinoma of the head and neck: Analysis of survival and toxicity,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 3 2006
Harold Lau MD
Abstract Background. Our center sought to implement a simple chemoradiotherapy schedule for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) with minimal toxicity to achieve rates of overall survival comparable to other schedules. Methods. The chemoradiotherapy schedule consisted of daily radiation to 70 Gy over 7 weeks with concurrent cisplatin 20 mg/m2 during days 1 to 4 of weeks 1 and 5. Acute and late toxicities were recorded according to the Radiation Therapy Oncology Group (RTOG) and common toxicity criteria (CTC) grading. The overall, disease-specific, and locoregional recurrence,free survival were calculated using the STATA statistics package. Possible factors influencing these endpoints were analyzed. Results. Fifty-seven patients were treated, and 56 patients were evaluable for follow-up. Median follow-up of alive patients was 16.1 months. There was an 82% complete response rate to chemoradiotherapy. The 2-year Kaplan,Meier overall, disease-specific, and locoregional recurrence,free survival rates were 62%, 67%, and 63%. Acute grade 3 and 4 radiation toxicity was noted in 61% and 2%, respectively. Grade 3 or 4 hematologic toxicity was noted in 7% of patients. Factors influencing overall survival included: Karnofsky performance status, receiving more than 50% of planned chemotherapy, age, and initial hemoglobin level. Conclusion. This regimen is tolerable and achieves overall survival and locoregional control rates comparable to other chemoradiotherapy schedules. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

Impact of Helicobacter pylori on the Development of Vitamin B12 Deficiency in the Absence of Gastric Atrophy

HELICOBACTER, Issue 6 2002
Ender Serin
Abstract Background. Cobalamin (vitamin B12) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B12. Materials and Methods. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pylori -infected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed. Results. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B12 level (p < .01) on univariate analysis. Only H. pylori density was significantly associated with B12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status (p < .001). Conclusion. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with nonulcer dyspepsia and minimal or no gastric atrophy. [source]

Erythropoietin for the treatment of anemia associated with hematological malignancy

HEMATOLOGICAL ONCOLOGY, Issue 1 2001
T. J. Littlewood
Abstract Anemia is common in patients with hematological malignancy. Most patients will have their anemia attributed to the anemia of chronic disease. The anemia of chronic disease is caused by cytokine mediated suppression of erythropoiesis and low serum erythropoietin levels are found in the majority of patients with cancer. Many of these anemic patients will be symptomatic with fatigue. Data from many studies indicates that treatment of anemic patients with erythropoietin will increase their hemoglobin concentration, decrease transfusion need and also improve their quality of life. A recent study also suggests that improving the hemoglobin level may improve the patients' prognosis but this finding needs to be confirmed. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Chronic lymphocytic leukemia presenting as cutaneous and bone involvement

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2001
Maria P. Stefanidou MD
An 84-year-old man had a 3-year history of a progressive, painless, papulonodular eruption, that was particularly prominent on the face and extremities. Physical examination revealed firm, bluish-red nodules and plaques, located on the tip of the nose, the cheeks, ears, and distal digits. Skin lesions produced a leonine facies (Fig. 1), deformities of the fingers and toes, finger clubbing, and onyxis. An identical lesion was seen on a postoperational scar on the left cheek. The mucous membranes were spared. The patient had anterior and posterior cervical and bilateral axillary lymphadenopathy and splenomegaly. Figure 1. Leonine facies On admission, the peripheral blood count revealed 260,000/mm3 leukocytes (lymphocytes 97%, neutrophils 2%, and monocytes 1%), a hemoglobin level of 9.5 g/dL, and platelet count of 100,000/mm3. Hypogammaglobulinemia with reduction of immunoglobulin G (IgG) and IgM was found. Radiography of the fingers showed multiple osteolytic lesions of the phalanges and phalangette destruction of the left median finger (Fig. 2a,b). Computed tomography of the chest and abdomen revealed bilateral axillary, mediastinal, and para-aortic lymphadenopathy and spleen enlargement. Figure 2. X-Ray of the hands: (a) ,multiple osteolytic lesions of the phalanges and (b) ,partial destruction of the left median phalangette Skin biopsy specimens from the ear and finger lesions showed a massive nonepidermal leukemic infiltration in the papillary and reticular dermis, with a grenz zone consisting of small lymphocytes (Fig. 3). Figure 3. Skin biopsy (hematoxylin and eosin, ×,250). Massive leukemic infiltration consisting of small lymphocytes. Subepidermally, a grenz zone of connective tissue is noted Biopsy of the enlarged cervical lymph node showed a diffuse infiltration with lymphocytes. Tissue biopsy from a finger lytic lesion revealed infiltration of bone trabecular and fibrous tissue with a dense population of small- and medium-sized lymphocytes. Immunohistochemical study of cutaneous and bone lesions showed that the infiltrate in both biopsies consisted mainly of B lymphocytes (CD20+, CD45R+, CD45Ro,, OPD4,). Peripheral blood smear had a B-cell phenotype (CD19 98%, CD20 97%, CD23 99%, CD25 40%, CD5 90%, HLA-DR 100%). Bone marrow smear and immunophenotyping surface marker analysis found a diffuse pattern of B-lymphocytic infiltration. A diagnosis of B-cell chronic lymphocytic leukemia stage C (Binet staging system), with specific cutaneous and bone lesions, was established. The patient received chemotherapy with chlorambucil and methylprednisolone, which resulted in improvement of the hematologic profile. Two years later, the cutaneous lesions showed partial remission. [source]

Prodromal myeloproliferative neoplasms: The 2008 WHO classification,

AMERICAN JOURNAL OF HEMATOLOGY, Issue 1 2010
Hans Michael Kvasnicka
The concept of prodromal chronic myeloproliferative neoplasms has been endorsed by the WHO classification implicating a stepwise evolution of disease. Histology of the bone marrow (BM) and borderline to mildly expressed clinical features play a pivotal role for diagnosing prefibrotic-early primary myelofibrosis. By lowering the platelet count for essential thrombocythemia and regarding BM morphology, early manifestations are tackled. Pre-polycythemic stages of polycythemia vera with a low hemoglobin level at onset are diagnosed by positive JAK2V617F mutation status, a low erythropoietin value, and characteristic BM features. The revised WHO classification incorporates hematological, morphological, and moleculargenetic parameters to generate a consensus-based working diagnosis. Am. J. Hematol., 2010. © 2009 Wiley-Liss, Inc. [source]

Prognostic factors and treatment outcome in childhood hodgkin disease,

PEDIATRIC BLOOD & CANCER, Issue 5 2005
Aynur Oguz MD
Abstract Background The goals of this study included: (1) Identification of factors prognostic for event-free survival (EFS) and overall survival (OS), and (2) Definition of risk groups for risk adapted therapy in children with Hodgkin disease (HD). Procedure From 1991 to 2003, 69 children with newly diagnosed, untreated biopsy-proven stage I,IV HD were treated with chemotherapy (CT) and low-dose involved field radiotherapy (LD-IFRT). The relationship of pretreatment factors to EFS and OS was analyzed by univariate and multivariate analysis. Results The 5-year EFS and OS for all patients were 90.77% and 96.22%, respectively with a median follow-up of 73 months (3,137 months). Male to female ratio was 3:1 and 21 children (32.3%) were less than 7 years of age. Mixed cellularity was the predominant histologic subtype (38.5%). Factors associated with inferior EFS by univariate analysis were extranodal disease, hemoglobin level <11 g/dl, number of involved lymph node regions and stage. By multivariate analysis only stage IV disease was significant. Conclusion Our study confirms that excellent results are achievable with combined modality therapy in childhood HD. In order to use risk-adapted therapy in children with HD, clinical prognostic factors should be validated with large, multicentered prospective clinical studies. © 2005 Wiley-Liss, Inc. [source]

Evaluation of 80 children with prolonged fever

PEDIATRICS INTERNATIONAL, Issue 5 2003
Ozgur Cogulu
Abstract Background:,Several studies have been published regarding the etiology and evaluation of a child with prolonged fever, however, the reasons for the prolonged fever have changed during the years. The present study aims to determine the causes of prolonged fever, to investigate the relationship of fever using some basic laboratory tests, and to establish guidelines for the approach in those children. Methods:,The charts of 80 out of 17 490 hospitalized children who were seen between 1996 and 2001 with prolonged fever of longer than 2 weeks and unknown origin were reviewed in the university hospital of Izmir, Turkey. Their charts were evaluated in respect of age, sex, growth curves, educational level of their families, the duration and the magnitude of fever, causes of fever, and basic laboratory investigations such as white blood cell, blood smear, hemoglobin, erythrocyte sedimentation rate, and C-reactive protein. Results:,Forty-four (55.00%) were boys and 36 (45.00%) were girls. Forty-four children (55.00%) were aged between 1 month and 2 years, 21 (26.25%) were aged 3,6 years, seven (8.75%) were aged 7,10 years, and eight (10.00%) were older than 10 years. The mean age was 3.87 ± 4.17 years (range 3 months,17 years). Forty-six children (57.50%) had a prolonged fever that had lasted from 15,30 days, 18 (22.50%) from 31,60 days, and 16 (20.00%) had fever lasting more than 60 days. Final diagnosis had been reached in 70 of the 80 children (87.50%). The most common causes were infection (47/80), followed by immune deficiency (6/80), collagen tissue disorder (5/80), neoplasia (2/80), and miscellaneous (10/80) such as central fever in three, diabetes insipidus in two, familial Mediterranean fever in two, Kawasaki disease, foreign body in the respiratory system, and Crohn disease in one patient each. Among the laboratory tests white blood cell count, hemoglobin level and blood smear distribution of infection group were statistically significant. Conclusions:,The most common cause of fever of unknown origin remains infection. The proportion of collagen tissue disorders and neoplasia have been found to be decreased. Unusual reasons such as diabetes insipidus and foreign body in the respiratory system in the miscellaneous group have been detected. Age plays important role in the diagnosis of prolonged fever, while some basic laboratory tests might give clues in the evaluation and may suggest a diagnosis. [source]

Coronary risks after high-dose ,-globulin in children with Kawasaki disease

PEDIATRICS INTERNATIONAL, Issue 5 2000
Yoshiyuki Morikawa
Abstract Objectives: The goals of the present study were to develop a predictive coronary risk scoring system after intravenous ,-globulin (IVGG) therapy of any dose for the different preparations currently used in the treatment of children with Kawasaki disease and to determine the predictive value of the system. The previously reported scoring systems were based on treatment with high-dose IVGG therapy at limited doses and were determined using investigative methods. Methods: Four hundred and fifty-one patients were randomized into one of three groups and received either i.v. polyethylene glycol-treated human immunoglobulin at a dose of either 200 (n=147) or 400 mg/kg per day (n=152) or freeze-dried sulfonated human immunoglobulin at 200 mg/kg per day (n=152) for 5 consecutive days. We documented 31 cases of coronary abnormalities (CA). Univariate and multivariate logistic regression was performed using 49 clinical variables and the resulting predictive model was validated. Results: The duration of fever (odds (1 day)/odds (, 5 days)=0.158; 95% confidence interval (CI) 0.0385,0.648), hemoglobin (odds (Q1=10.3)/odds (Q3=11.6) = 3.97; 95% CI 1.92,8.20), IgG (odds (Q1=1900)/odds (Q3=2658)=2.72, 95% CI 1.18,6.25) and IgA (odds (Q1=72)/odds (Q3=160) =0.415; 95% CI 0.253,0.680) levels after completion of ,-globulin infusion were independent predictors. The model is quasi-cross validated and has acceptable sensitivity and selectivity. The estimated risk and observed occurence of CA coincide. Conclusions: Determinants of the risk of CA after IVGG therapy are a longer duration of fever, a lower IgG level, a higher IgA level and a lower hemoglobin level after IVGG infusion. This model is applicable for IVGG doses from 1 to 2 g/kg and for at least two different ,-globulin preparations. [source]

A scoring system for the classification of ,-thalassemia/Hb E disease severity

AMERICAN JOURNAL OF HEMATOLOGY, Issue 6 2008
Orapan Sripichai
,-Thalassemia intermediate patients show a remarkable clinical heterogeneity. We examined the phenotypic diversity of 950 ,-thalassemia/Hb E patients in an attempt to construct a system for classifying disease severity. A novel scoring system based on six independent parameters, hemoglobin level, age at disease presentation, age at receiving first blood transfusion, requirement for transfusion, spleen size, and growth and development, was able to separate patients into three distinctive severity categories: mild, moderate, and severe courses. This system, therefore, can increase the accuracy of studies of genotype,phenotype interactions and facilitate decisions for appropriate patient management. Am. J. Hematol. 2008. © 2008 Wiley-Liss, Inc. [source]

Hypertriglyceridemia presenting as "pink blood" and elevated hemoglobin level

AMERICAN JOURNAL OF HEMATOLOGY, Issue 3 2008
Donald E. Tsai
No abstract is available for this article. [source]

Does being an orphan decrease the nutritional status of Luo children?

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2009
Amy M. Zidron
The HIV/AIDS pandemic is creating a generation of orphaned children in Africa. The number of orphans will continue to increase long after the HIV/AIDS crisis has peaked; therefore, it is important to determine how best to assist these children. Current studies investigating the impact of orphanhood have conflicting results and conclusions. Several studies report that orphans are at a disadvantage and are more likely to suffer from malnutrition, whereas other studies report no difference between the nutritional status of orphans and nonorphans. Four hundred eleven Luo children (mean age 9 ± 1 years) were recruited to participate in a study investigating the impact of orphanhood on nutritional status. Participants underwent an interview, anthropometric measurements, testing for anemia, a clinical history, and a physical exam. Anthropometric variables and hemoglobin level were compared across groups using a t -test. The reference population used for comparison of anthropometric variables is the 2000 CDC growth reference data. All analyses were gender specific, and the effect of length of orphanhood was also investigated. The data presented here suggest that there is no significant difference between the nutritional status of orphaned and nonorphaned Luo children. This study supports research indicating there is little, if any, difference in nutritional indicators between orphans and nonorphans. Orphans may live in households with higher socioeconomic statuses than nonorphans. Luo orphans may not be at higher risk for poor nutritional status than nonorphans; therefore, interventions targeted at this age group should include both orphaned and nonorphaned children. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source]

Preconception Health Status of Iraqi Women After Trade Embargo

PUBLIC HEALTH NURSING, Issue 4 2008
Wafa Abdul Karim Abbas
ABSTRACT Objectives: To describe the preconception health status of Iraqi women in 2001 following the trade embargo imposed on Iraq beginning in 1991 and only partially removed in 1996. Design: A descriptive cross-sectional prevalence study. Sample: 500 Iraqi women at a premarital clinic in Baghdad in 2001. Measurements: Women were surveyed for age, area of residence, menstrual history, household crowding, consanguinity, and a family history of congenital problems. Clinical findings regarding height, weight, and hemoglobin level were included in the data. Results: Almost one third of the women were below the age of 20 and the majority were between 20 and 25 years of age. More than half of the women in this study had an intermediate-level education or less and lived in very crowded housing. Most of the women were anemic and reported a delay in menarche, suggesting malnutrition. Most of the women were planning consanguineous unions even though many reported congenital conditions in their family of origin. Conclusions: Young Iraqi women who endured embargo needed, and continue to need, aggressive preventive health services to recoup health gains lost during the 1990s and to address prevention of common congenital disorders. [source]

Randomized phase 2 study of subcutaneous amifostine versus epoetin-, given 3 times weekly during concurrent chemotherapy and hyperfractionated radiotherapy for limited-disease small cell lung cancer

CANCER, Issue 7 2008
Hye-Suk Han MD
Abstract BACKGROUND. The purpose of the current study was to investigate the role of amifostine and epoetin-, in reducing severe toxicities during concurrent chemo-hyperfractionated radiotherapy (CCRT) for limited disease small cell lung cancer (LD-SCLC). METHODS. Seventy-six patients with LD-SCLC were enrolled. The treatment schedule was consisted of two 28-day cycles of cisplatin at a dose of 30 mg/m2 (Days 1 and 8) and irinotecan at a dose of 60 mg/m2 (Days 1, 8, and 15) followed by two 21-day cycles of cisplatin at a dose of 60 mg/m2 (Day 1) and etoposide at a dose of 100 mg/m2 (Days 1-3) with concurrent twice-daily thoracic radiotherapy for a total of 45 grays. Patients were randomly assigned at registration to either amifostine at a dose of 500 mg or epoetin-, at a dose of 10,000 IU subcutaneously 3 times weekly (n = 36 patients and 40 patients, respectively). Fifteen of 36 patients assigned to the amifostine arm did not receive amifostine because of a lack of supply. RESULTS. Amifostine treatment was associated with higher febrile neutropenia (P = .003) and grade 2 or 3 nausea (according to the National Cancer Institute Common Toxicity Criteria [version 3.0]) (P = .03). It also demonstrated a trend toward higher grade 4 leukopenia (P = .05). Grade 3 esophagitis was reported in 30% of patients treated with amifostine and 9% of patients treated with epoetin-, (P = .059). Epoetin-, treatment was associated with less grade 2 or 3 anemia (P = .031) and lower decreases in hemoglobin level during CCRT (P = .016). The median survival times for both treatment arms were comparable (22.6 months in the amifostine arm vs 25.6 months in the epoetin-, arm; P = .447). CONCLUSIONS. Although amifostine administered 3 times weekly during CCRT did not significantly reduce severe toxicities, epoetin-, was effective in preventing severe anemia during CCRT in patients with LD-SCLC. Other radioprotective strategies to minimize severe toxicities should be investigated Cancer 2008. © 2008 American Cancer Society. [source]

Prognostic factors in the nonsurgical treatment of esophageal carcinoma with radiotherapy or radiochemotherapy

,-Globin gene cluster haplotypes and HbF levels are not the only modulators of sickle cell disease in Lebanon

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2003
A. Inati
Abstract: Sickle cell disease (SCD) is an inherited autosomal recessive disorder of the , -globin chain. Despite the fact that all subjects with SCD have the same single base pair mutation, the severity of the clinical and hematological manifestations is extremely variable. This study examined for the first time in Lebanon the correlation between the clinical manifestation of SCD and the , -globin gene haplotypes. The haplotypes of 50 patients diagnosed with SCD were determined using polymerase chain reaction amplification of fragments containing nine polymorphic restriction sites around and within the ,,G,,A,,,,,,,, -globin gene complex. Most reported haplotypes were found in our population with the Benin haplotype as the most prevalent one. When the patients were divided according to their HbF levels into three groups (Group A: HbF < 5%, Group B: HbF between 5 and 15%, and Group C: HbF > 15%), surprisingly, the highest levels of HbF were associated with the most severe clinical cases. Our findings suggest that fetal hemoglobin levels are important but not the only parameters that affect the severity of the disease. In addition, the high levels of HbF in patients with CAR haplotypes did not seem to ameliorate the severity of symptoms, suggesting that genetic factors other than haplotypes are the major determinants of increased HbF levels in Lebanon. [source]

Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: VI.

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2005
Maubin in Myanmar
Background: The objective of the present study is to compare the findings of comprehensive geriatric assessments of community-dwelling elderly in Maubin township, Myanmar with those in Japan. Methods: A cross-sectional, study was undertaken of community-dwelling people aged 60 years and over who were living in downtown Maubin and two rural villages near Maubin city, and 411 people aged 65 years and over who were living in Sonobe, Kyoto, Japan. They were examined using a common comprehensive geriatric assessment tool, which included interviews regarding activities of daily living (ADL), medical and social history, quality of life (QOL) and the 15-item Geriatric Depression Scale. Anthropometric, neurobehavioral and blood chemical examinations were also conducted. Using anova and Post Hoc Scheffe's F -test, findings from the three groups were compared. Results: Scores of basic ADL, instrumental self-maintenance, intellectual activities, social roles, QOL, Tokyo Metropolitan Institute of Gerontology Index of Competence, body mass index, total cholesterol levels, blood hemoglobin levels and HDL levels were lower in Myanmar's elderly subjects than in Japanese ones. There was no significant difference in prevalence of depression. Mean blood pressure measurements and rates of subjects with systolic pressure > 140 mmHg or diastolic pressure > 90 mmHg and prevalence of stroke were higher in downtown Maubin than in Japan. The atherogenic index was higher in Myanmar's elderly than in Japanese. Conclusion: In Myanmar subjects had lower ADL and QOL scores than Japanese elderly. Of particular note is the higher prevalence of anemia and subjects with history of stroke in Myanmar than in Japan. Further study is needed to detect the cause of high prevalence of stroke in Myanmar. [source]

Resource settings have a major influence on the outcome of maintenance hemodialysis patients in South India

HEMODIALYSIS INTERNATIONAL, Issue 2 2010
ABRAHAM Georgi
Abstract Chronic kidney disease is reaching epidemic proportions and the number of patients on renal replacement therapy (RRT) is increasing worldwide and also in developing countries. To meet the challenge of providing RRT, a few charity organizations provide hemodialysis units for underprivileged patients, as the private hospitals are unaffordable for the majority. There is a paucity of information on the outcome of dialysis in these patients. Here, we describe the outcome of hemodialysis patients comparing the middle- and upper-class income group with the lower class income group. A retrospective analysis was carried out in 558 CKD patients initiated on maintenance hemodialysis in two different dialysis facilities. Group A (n=247) included those who belonged to the lowermost socioeconomic status and were undergoing dialysis in two nonprofit, charity (TANKER)-run dialysis units, and Group B (n=311) was undergoing dialysis in a nonprofit hospital setting where no subsidy was given. Those patients of a low socioeconomic status, especially those who are diabetics, have a higher death rate (Group A-38.1%, Group B-4.2%) and loss to follow-up (Group A-25.9%, Group B-0.3%) compared with those who are in the middle- and high-income group. Higher EPO use and hence higher hemoglobin levels (Group A-6.4±1.2, Group B-8.9±1.5 P<0.001) were observed in those who were in the middle and the higher income group. Lower serum phosphorus level was observed in the low-socioeconomic group (Group A-4.7±1.5, Group B-5.5±1.9, P<0.001). Patients belonging to the middle and higher socioeconomic group undergo more transplantations compared with the lower socioeconomic group (Group A-2.4%, Group B-65.6%). [source]

Modification of cardiovascular risk in hemodialysis patients: An evidence-based review

HEMODIALYSIS INTERNATIONAL, Issue 1 2007
David W. JOHNSON
Abstract Cardiovascular disease accounts for 40% to 50% of deaths in dialysis populations. Overall, the risk of cardiac mortality is 10-fold to 20-fold greater in dialysis patients than in age and sex-matched controls without chronic kidney disease. The aim of this paper is to review critically the evidence that cardiac outcomes in dialysis patients are modified by cardiovascular risk factor interventions. There is limited, but as yet inconclusive controlled trial evidence that cardiovascular outcomes in dialysis populations may be improved by antioxidants (vitamin E or acetylcysteine), ensuring that hemoglobin levels do not exceed 120 g/L (especially in the setting of known cardiovascular disease), prescribing carvedilol in the setting of dilated cardiomyopathy, and by using cinacalcet in uncontrolled secondary hyperparathyroidism. Similarly, there are a number of negative controlled trials, which have demonstrated that statins, high-dose folic acid, angiotensin-converting enzyme inhibitors, multiple risk factor intervention via multidisciplinary clinics, and high-dose or high-flux dialysis are ineffective in preventing cardiovascular disease. Although none of these studies could be considered conclusive, the negative trials to date should raise significant concerns about the heavy reliance of current clinical practice guidelines on extrapolation of findings from cardiovascular intervention trials in the general population. It may be that cardiovascular disease in dialysis populations is less amenable to intervention, either because of the advanced stage of chronic kidney disease or because the pathogenesis of cardiovascular disease in dialysis patients is different from that in the general population. Large, well-conducted, multicenter randomized-controlled trials in this area are urgently required. [source]

Impaired intestinal iron absorption in Crohn's disease correlates with disease activity and markers of inflammation

INFLAMMATORY BOWEL DISEASES, Issue 12 2006
Gaith Semrin MD
Abstract Background: Anemia in patients with Crohn's disease (CD) is a common problem of multifactorial origin, including blood loss, malabsorption of iron, and anemia of inflammation. Anemia of inflammation is caused by the effects of inflammatory cytokines [predominantly interleukin-6 (IL-6)] on iron transport in enterocytes and macrophages. We sought to elucidate alterations in iron absorption in pediatric patients with active and inactive CD. Methods: Nineteen subjects with CD (8 female, 11 male patients) were recruited between April 2003 and June 2004. After an overnight fast, serum iron and hemoglobin levels, serum markers of inflammation [IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate], and a urine sample for hepcidin assay were obtained at 8 am. Ferrous sulfate (1 mg/kg) was administered orally, followed by determination of serum iron concentrations hourly for 4 hours after the ingestion of iron. An area under the curve for iron absorption was calculated for each patient data set. Results: There was a strong inverse correlation between the area under the curve and IL-6 (P = 0.002) and area under the curve and CRP levels (P = 0.04). Similarly, the difference between baseline and 2-hour serum iron level (,[Fe]2hr) correlated with IL-6 (P = 0.008) and CRP (P = 0.045). When cutoff values for IL-6 (>5 pg/mL) and CRP (>1.0 mg/dL) were used, urine hepcidin levels also positively correlated with IL-6 and CRP levels (P = 0.003 and 0.007, respectively). Conclusions: Subjects with active CD have impaired oral iron absorption and elevated IL-6 levels compared with subjects with inactive disease. These findings suggest that oral iron may be of limited benefit to these patients. Future study is needed to define the molecular basis for impaired iron absorption. [source]

Anemia and cognitive performance in hospitalized older patients: results from the GIFA study

A 3-year analysis of plateletpheresis donor deferral pattern in a tertiary health care institute: Assessing the current donor selection criteria in Indian scenario

JOURNAL OF CLINICAL APHERESIS, Issue 4 2008
Rashmi Tondon
Abstract Introduction: This study reports the frequency and nature of plateletpheresis deferrals and evaluates donors with low platelet count and hemoglobin levels so as to assess the possibility of reentry without hampering donor safety. Materials and methods: Three-year retrospective data of plateletpheresis deferral was collected. Data from actual procedures was also reviewed to analyze the safety of performing plateletpheresis in donors with low hemoglobin and platelet values. Results: Four hundred sixteen donors were deferred for various reasons among 1,515 screened (27.5%), of which 69.7% deferrals were because of low platelet count (55.8%) and less hemoglobin levels. Among the low platelet count donor group, 20.3% had a count between 141 and 149 × 109/L and 41.8% below 120 × 109/L. Of the 14% donors deferred for low hemoglobin, 62.1% had values in the range of 11.5,12.4 g/dL with normal mean corpuscular volume and red cell distribution width in most (86.2%) of them. Expected blood loss in each procedure varied between 20 and 30 mL, whereas RBC contamination in the product varied from 0 to 1.6 mL in 538 procedures. There were 176 donations with predonation platelet count <180 × 109/L (32.7%). None of the 14 procedures performed on donors with platelet count of 150 × 109/L showed evidence of thrombocytopenia or donor reaction. Conclusion: Lowering the cut-off value for plateletpheresis from 12.5 g/dL to 11.5 g/dL has no deleterious effect on donor safety as the blood loss is minimal. One-fifth deferrals can be reconsidered if the criteria of plateletpheresis donor selection are relaxed for hemoglobin and platelet count. J. Clin. Apheresis, 2008. © 2008 Wiley-Liss, Inc. [source]

Helicobacter pylori infection detected by 14C-Urea breath test is associated with iron deficiency anemia in pregnant women

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2008
s Mulayim
Abstract Aims:, To determine whether there is a relationship between Helicobacter pylori (H. pylori) infection, iron deficiency anemia and thrombocytopenia in pregnant women. Methods:, Hemoglobin and ferritin levels and platelet counts of pregnant women were measured during the third trimester. H. pylori infection was determined using a 14C-urea breath test (14C-UBT) after delivery. Statistical analyses were determined with a Mann,Whitney U -test and the ,2 test. Statistical significance was determined with a P -value less than .05. Results:, Seventy-two of 117 women had positive results on the 14C-UBT. Overall, 27 of 117 pregnant women had anemia (23.1%), and all them were in the H. pylori -positive group; 18 of 27 (66.7%) had iron deficiency anemia. Median hemoglobin levels and neonatal body weights were 12.0 g/dL vs 12.0 g/dL and 3320.0 grams vs 3520.0 grams in the H. pylori -positive and negative groups, respectively. Serum hemoglobin and ferritin levels and neonatal body weight were found to be lower in the anemic group compared with the non-anemic group among H. pylori -infected women (P = 0.0001, P = 0.02, P = 0.008, respectively). There were no statistically significant differences with regard to gestational thrombocytopenia between the H. pylori -positive and H. pylori -negative groups (P = 0.532). Conclusions:, Our study indicates that there is a strong relationship between H. pylori infection and iron deficiency anemia in women with uncomplicated pregnancy. However, an association between H. pylori infection and thrombocytopenia was not found. [source]

Glycoengineering: The effect of glycosylation on the properties of therapeutic proteins

JOURNAL OF PHARMACEUTICAL SCIENCES, Issue 8 2005
Angus M. Sinclair
Abstract Therapeutic proteins have revolutionized the treatment of many diseases but low activity or rapid clearance limits their utility. New approaches have been taken to design drugs with enhanced in vivo activity and half-life to reduce injection frequency, increase convenience, and improve patient compliance. One recently used approach is glycoengineering, changing protein-associated carbohydrate to alter pharmacokinetic properties of proteins. This technology has been applied to erythropoietin and resulted in the discovery of darbepoetin alfa (DA), a hyperglycosylated analogue of erythropoietin that contains two additional N-linked carbohydrates, a threefold increase in serum half-life and increased in vivo activity compared to recombinant human erythropoietin (rHuEPO). The increased serum half-life allows for less frequent dosing to maintain target hemoglobin levels in anemic patients. Carbohydrates on DA and other molecules can also increase molecular stability, solubility, increase in vivo biological activity, and reduce immunogenicity. These properties are discussed. © 2005 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 94:1626,1635, 2005 [source]