Anemia In Males Research Articles

The prevalence of neonatal anemia in Al Baha, Saudi Arabia: A retrospective observational study

Abstract Background Neonatal anemia contributes to the global burden of anemia, a crucial public health concern. It is primarily associated with mild to severe neurological impairment, which may result in perinatal mortality and morbidity. This study aimed to determine the prevalence of anemia and its association with sex and age in newborns at Al-Baha, Saudi Arabia. A retrospective observational study was performed using the R-studio/r-base coding tool. The analysis included the mean, standard deviation, median, interquartile range, correlation matrix, and logistic regression. The overall prevalence of neonatal anemia was 25.36% (n = 140). The mean±SD of hemoglobin (Hgb) (g/dl) was significantly different between anemic and nonanemic neonates, with values of 9.36 ± 1.04 and 15.74 ± 3.35 (P < 0.0001). The prevalence of neonatal anemia in males and females was 29.8% and 20.5%, respectively. Among males, the neonatal anemia Severity was 14.4% (mild anemia) and 6.1% (moderate anemia), while among females, it was 20.1% (mild anemia) and 9.7% (moderate anemia). In female neonates, the prevalence of microcytic, normocytic, and macrocytic anemia was 6.08%, 62.36%, and 31.56%, respectively. In contrast, the prevalence rate of microcytic, normocytic, and macrocytic anemia among male neonates, was 8.3%, 54.4%, and 29.07%, respectively. In females, only normocytic iron deficiency anemia was observed (55%), whereas the prevalence of normocytic iron deficiency anemia and microcytic iron deficiency anemia in males was 69% and 31%, respectively. Overall, iron deficiency anemia affected 65% of males. Compared with neonates aged 0-90 days, neonates aged 90-180 days have ~0.4 times more likelihood of developing neonatal anemia. Female sex is one of the risk factors associated with anemia. Further investigation and implementation of preventive measures are crucial to address the prevalence and severity of neonatal anemia.

Enhancement of Anemia Detection by Correlating Computed Tomography Findings of Abdominal Aorta and Inferior Vena Cava With Laboratory Investigations.

Anemia affects approximately a quarter of the global population, and improved detection may reduce the associated morbidity and mortality. This study investigated correlations between the results of laboratory hematological determinations of hemoglobin levels and attenuation values measured in the lumina of the abdominal aorta and inferior vena cava (IVC) via unenhanced computed tomography (CT) with the aim of expanding diagnostic options for anemia. The data of 423 patients who underwent abdominal unenhanced CT examinations and laboratory examinations at a tertiary hospital were retrospectively evaluated. CT data were collected using a standard abdominal protocol without contrast. The 151 patients who met the inclusion criteria were categorized by hemoglobin values as follows: <8 (severe anemia), 8-10.9 (moderate anemia), 10.9-12 (mild anemia in females), 10.9-13 (mild anemia in males), and >13 g/dL (non-anemic). The mean CT attenuation values in the aorta and IVC were 37.7 and 36.1 Hounsfield units (HU), respectively. A regression analysis performed to evaluate the correlation and predictability of hemoglobin-based aortic and IVC density yielded a coefficient of determination, R2: 0.42 (F ratio: 149.23, p < 0.0001). The highest contribution in the dependent variable (hemoglobin) was reported to IVC density, showing a significant positive correlation between hemoglobin and IVC density. Our study results demonstrate significant correlations between the densities of the aorta, IVC, and hemoglobin value. Accordingly, radiologists and clinicians can use these readily available values to facilitate diagnosis and patient care.

Germline GATA1s-generating mutations predispose to leukemia with acquired trisomy 21 and Down syndrome-like phenotype

AbstractIndividuals with Down syndrome are at increased risk of myeloid leukemia in early childhood, which is associated with acquisition of GATA1 mutations that generate a short GATA1 isoform called GATA1s. Germline GATA1s-generating mutations result in congenital anemia in males. We report on 2 unrelated families that harbor germline GATA1s-generating mutations in which several members developed acute megakaryoblastic leukemia in early childhood. All evaluable leukemias had acquired trisomy 21 or tetrasomy 21. The leukemia characteristics overlapped with those of myeloid leukemia associated with Down syndrome, including age of onset at younger than 4 years, unique immunophenotype, complex karyotype, gene expression patterns, and drug sensitivity. These findings demonstrate that the combination of trisomy 21 and GATA1s-generating mutations results in a unique myeloid leukemia independent of whether the GATA1 mutation or trisomy 21 is the primary or secondary event and suggest that there is a unique functional cooperation between GATA1s and trisomy 21 in leukemogenesis. The family histories also indicate that germline GATA1s-generating mutations should be included among those associated with familial predisposition for myelodysplastic syndrome and leukemia.

Sex-Related Differences in the Prevalence and Prognostic Value of the Academic Research Consortium for High Bleeding Risk Criteria.

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Study on Genetic and Non-Genetic Anemia Poverty Types and Their Relationship with Residential Areas

Anemia is the most common pathological condition in hematology. There are more than 400 types of anemia, can be divided into three main types: anemia caused by blood loss as in people with ulcers and hemorrhoids, during menstruation, at birth and anemia caused by dysfunction in the production of erythrocytes that occurs due to red blood cell damage this is called hemolytic anemia, and iron deficiency anemia is the most common type of anemia at all. Through the results obtained from the Al-Hussein Teaching Hospital in the holy province of Karbala for the year 2018, found 152 cases, of which cases were males by (60.53%) and (60) cases were females by (39.47%). Thus, the incidence of females is lower than that of males. The number and percentage of anemia for each age group shows that the highest age group is (21-30 years) with (43) and (28.3%). The lowest age group was (+60) with (8) and (5.27%), the number of males infected (6) by (3.94%) and the number of females (2) by (1.31%). Types of anemia recorded in the research were hereditary and non- hereditary (other types)—hereditary number (14) by (9.21%). Types of hereditary anemia recorded were Thalassemia and Sickle by number and percentage respectively (9) and (5) by (5.92%) and (3.28%), The number and percentage of males and females of the two species, respectively, males (4) and (2) by (2.63%) and (1.31%), females with (5) and (3) by (3.28%) and (1.98%), The rate of hereditary anemia in males is higher than in females. Non-hereditary anemia was (138) by (90.79%), which is higher than hereditary anemia. The types of non-hereditary anemia recorded are six types (nutritional, hemorrhagic, inflammatory, tumor, immune and renal failure). In the residential sectors, the highest incidence was recorded in the center sector (90), (59.22%), while the lowest incidence rate was in the AL-huor sector (10), (6.57%). We concluded from the study that the incidence of males is higher than females and that the higher incidence was in the AL-center sector, which increased the disease in urban areas and less in rural areas.

Morphological pattern based analysis of anemia in paediatric age group

Introduction: Anemia is a global public health problem and is a significant contributor to the global health disease. It is more prevalent among low socioeconomic groups. Young children are more vulnerable to the effects of anemia since it retards the physical and mental growth and development. Material and Methods: Hospital based prospective cross sectional study was undertaken for a period of 3 months. 200 cases were included for the study with hemoglobin less than 12g% and age group ranging from 6 months to 5 years. Results: Maximum numbers of the patients were in the range of 6 months to 1 year. Proportions of anemia in males was 58% when compared to females 42%. Microcytic hypochromic anemia was the commonest type of anemia. Of 200 children with anemia studied, 102 children had Microcytic Hypochromic Anemia, 41 children had Normocytic Normochromic Anemia, 38 children had Normocytic Hypochromic Anemia,15 children had Dimorphic Anemia and 4 children had Macrocytic Anemia. Conclusion: Study of patterns of anemia is essential to direct the investigation since it reflects the underlying etiopathological factors. The Peripheral smear study with automated hemogram is beneficial and sufficient for diagnosis and morphological sub typing of anemia for the Paediatric population. Keywords: Anemia, Children, Dimorphic, Hypochromic, Microcytic.

Anaemia and associated socio-demographic factors among workers of a sugar factory in South India

Background: Anaemia is the most under-recognized cause of bewildering morbidity interfering with the overall capacity and productivity of individuals, especially, in case of the workers of various factories and industries. It is worthwhile to understand and gauge the magnitude of this problem and various factors including those of nutritional, influencing the anaemia status among the workers. Objectives: To determine the prevalence of anaemia and study the associations between anaemia and the various socio-demographic factors among the workers of a sugar factory. Methodology: A cross-sectional study was done among all the workers of a sugar factory in Tamil Nadu. Altogether, 281 sugar factory workers were studied after taking informed consent. The data was collected using a questionnaire and venous blood was used for measurement of haemoglobin levels. Statistical analysis was performed using SPSS version 16. Results: Among the 281 workers of the factory 260 were males while 21 were females. The prevalence of anaemia among males was 18.5% while among females it was 52.4% and a single lady had severe anaemia. Lower income, older age, duration of work experience and underweight were significantly associated with anaemia in males. Conclusions: Regular monitoring of anaemia status necessary as it can insidiously give rise to adverse impact on productivity by the workers and steps may be undertaken to rule out or rule in that the severe anaemia was not an “ice-berg” phenomenon. Simple but cost-effective preventive strategies need to be undertaken to elevate their nutritional status such as gooseberry juice and or cereal based fermented foods may be included in their menu along with the generic iron medication. Socio-economic status may also be addressed by implementing the government policies effectively. Some management techniques may be taught to workers to efficiently manage their limited resources.

Thrombocytosis in Iron Deficiency Anemia

Background: Thrombocytosis can be a result of a reactive process such as acute blood loss, infections, iron deficiency anemia (IDA) or a clonal disorder such as Essential Thrombocythemia. The challenge of correctly identifying the etiology of thrombocytosis in an individual patient becomes particularly essential when the clinician is confronted with decisions regarding further workup, follow up as well as preventing future complications such as thrombotic events. Prior data linking iron deficiency anemia and thrombocytosis has been concluded from studies with small sample size, and to a large part, this association is based on anecdotal evidence. Our study examines the association between IDA and platelet counts and to the best of our knowledge is the largest study to do so.Methods: We performed a retrospective chart review of patients seen at our outpatient clinic from 1st January to 31st December 2017. We defined Iron deficiency as serum ferritin <30 mcg/dl, anemia in males as hemoglobin (Hb) <13.1 g/dl, anemia in females as Hb <11.7g/dl and thrombocytosis as platelet count >450,000/ul. Patient demographics, as well as hematological data, were collected and compared between three groups: Iron deficiency anemia, Iron deficiency without anemia, and control. We defined controls as subjects with neither iron deficiency nor anemia. Bivariate analysis using the Chi-square test for categorical variables, and a One-Way ANOVA for continuous variables were used to determine the association between the three groups of interest and the covariates. The relationship between platelet counts and other hematological parameters was evaluated using Pearson's correlation test.Results: Of the 4896 subjects included in our study, 1225 (25.02%) had iron deficiency anemia, 699 (14.28%) had iron deficiency without anemia, and 2972 (60.70%) were controls. The mean age of the cohort was 55.8 (SD = 18.31) years, and 73.9% of the subjects were females. In the IDA group, the mean hemoglobin was 10.21 (SD = 1.39) g/dl, the mean platelet count was 319.24 (SD = 106.92) k/uL, and 127 (10.37%) subjects had thrombocytosis whereas 1098 (89.63%) had normal platelet counts. When compared to the control group, 32 (1.08%) subjects had thrombocytosis, and 2940 ( 98.92%) had normal platelet counts. The difference in numbers of subjects with thrombocytosis between iron deficiency anemia, iron deficiency without anemia and control group was statistically significant as indicated by P<0.001 on the Chi-Square test. Furthermore, we found an inverse relationship between platelet count and ferritin as well as hemoglobin level with a p < 0.0001 across all groups.Conclusions: Our study demonstrated a significant association between iron deficiency anemia and thrombocytosis when compared to the control group however at a lower frequency than seen in the previously published studies. Further studies are needed to study causality and to elucidate the mechanism by which iron deficiency anemia leads to thrombocytosis. DisclosuresNo relevant conflicts of interest to declare.

Clinico-epidemiological profile of nutritional anaemia and its impact on developmental outcome in children aged 6 months to 5 years

Background: Anemia is a global public health problem and is a significant contributor to the global health disease. Young children are more vulnerable to the effects of anemia since it retards the physical and mental growth and development. Objective of this study was clinico-epidemiological profile of nutritional anemia and its impact on developmental outcome in children aged 6 months to 5 years.Methods: The study was a prospective observational study. A total of 100 patients with hemoglobin &lt;11g/dl admitted in our hospital were included in the study. Detailed clinical history with developmental assessment was elicited and thorough clinical examination was performed. Complete haemogram with Peripheral smears of these patients were examined. Bone marrow examination was done where ever possible.Results: Maximum numbers of the patients were in the range of 3 to 4 year. Proportions of anemia in males were 68% when compared to females (32%). Iron deficiency anemia (IDA) was the most common in males. The correlation between anemia and developmental delay was 7.9% in iron deficiency anemia and 87.5% in megaloblastic anemia (MBA) which was highly significantt.Conclusions: Anemia poses a biggest challenge in the improvement of primary health care particularly in young children since it is associated with delay in psychomotor development and increased morbidity and mortality. Initial screening and subsequent diagnostic tests enable early diagnosis and appropriate management.

A study of anemia in human immunodeficiency virus patients: Estimating the prevalence, analyzing the causative effect of nutritional deficiencies, and correlating the degree of severity with CD4 cell counts

Background: Anemia is a common complication of human immunodeficiency virus (HIV) infection. The role of iron, Vitamin B12, and folate deficiencies, which are otherwise most common causes of anemia, is not well-established in HIV patients. Several studies in India have shown that severe immunodeficiency is associated with higher grade of anemia, but correlation of CD4 cell counts with severity of anemia is not well-documented. Aims: The aims of the present study were: To estimate the point prevalence of anemia in HIV patients, to analyze the causative role of iron, Vitamin B12, and folate deficiencies in anemic HIV patients, and correlating the degree of severity of anemia with CD4 cell counts. Materials and Methods: This study was a cross-sectional study. The study group enrolled 103 consecutive HIV patients attending medical emergency, medical outpatient department, medical wards, and anti-retroviral therapy (ART) center at a tertiary care medical center in North India. Study participation consisted of a single visit during which relevant data, including medical history, current medications, CD4 T-lymphocyte count, complete hemogram with red blood cell indices, peripheral smear picture, iron studies, serum Vitamin B12, serum folate and bone marrow studies, were recorded on a case report form. Anemia was classified according to the World Health Organization criteria. Data analysis was carried out using Microsoft Excel and Statistical Package for the Social Sciences software. Results: 86.4% (89/103) patients were found to be anemic. There was no significant difference in prevalence of anemia in ART-naive patients from those who were on ART (P > 0.05). Pearson's correlation had shown a highly significant positive correlation of hemoglobin and CD4 cell counts in male patients (r = 0.418) as well as female patients (r = 0.565). Normocytic normochromic was the most common type of anemia in males (46%) as well as females (42%). Significant iron deficiency (P = 0.022) was observed in 42.85% of the patients having microcytic hypochromic anemia. Significant Vitamin B12 and folate deficiencies were observed in patients having macrocytic anemia (47.05%, P = 0.003 and 35.29%, P = 0.012, respectively). Conclusions: This study shows that anemia is highly prevalent in HIV patients and severity of anemia increases with decrease in CD4 cell counts. Nutritional deficiencies play a significant role in causing anemia in these patients.

Study of anemia in geriatric population: a hospital based study in Marathwada region, Maharashtra, India

Background: In geriatric population, anemia is not only the common problem, but it may present as severe complications in this group compared with anemia in younger group. According to WHO criteria, level of hemoglobin less than 13 gm% in case of males and less than 12 gm% in females are considered as anemia.The main objective of the study was to study the various pattern of anemia in the geriatric population.Methods: The study was carried out at JIIU’s IIMSR Medical College and Noor Hospital, Badnapur, Jalna, Maharashtra, India from January 2014 to June 2015. Total number of patients taken for the study are 550 (&gt;60 years) who attending geriatric and clinical OPD at Noor Hospital, Badnapur. Detailed haematological examination was carried out in each patient.Results: Out of 550 cases, 369 (67.09%) patients were found to be anemic. Proportions of anemia in males was 64.74% and in females 70.58%. On peripheral smear examination normocytic being the commonest and constituting 78.86%.Conclusions: Diagnosis of anemia in geriatric age group, and further to know its pattern, which thus helps in etiological diagnosis of anemia which ultimately helps in the treatment.

Insulin-Like Growth Factor-1 and Anemia in Older Subjects: The Inchianti Study

Recent studies indicate a role for the age-related decline of anabolic hormones, especially testosterone, in the onset of "anemia of aging." Some of testosterone's erythropoietic activities are mediated by insulin-like growth factor (IGF)-1, which also seems to have independent erythropoietic effects. However, the associations among IGF-1, anemia, and hemoglobin (Hb) have not been adequately investigated in older populations. We used data from a representative sample of 953 subjects ≥65 years who participated in the InCHIANTI (Invecchiare in Chianti) Study and were not on growth hormone (GH) or erythropoietin therapy and were not diagnosed with hematologic malignancies or other cancers. Anemia was defined according to the World Health Organization (WHO) criteria by Hb level ≤13 g/dL in males and ≤12 g/dL in females. Backward multiple regression analyses including age, IGF binding protein (IGFBP)-3, testosterone, comorbidities, inflammatory markers, and anemia-related measures were used to address the relationship between IGF-1 and Hb and between IGF-1 and anemia in both sexes. We found that 46/410 (11.2%) males and 71/543 (13.0%) females were defined as anemic. After adjustment for age, anemic males (100 ± 54 vs. 130 ± 56, P<.001) and females (89.1 ± 48 vs. 110 ± 52, P = .001) exhibited lower IGF-1 levels than their nonanemic counterparts. IGF-1 levels were independently and negatively associated with anemia in males (β ± SE = -0.0005 ± 0.0002, P = .04) but not in females (β ± SE = -0.0002 ± 0.0002, P = .40). In both males (β ± SE = 0.002 ± 0.001, P = .03) and females (β ± SE = 0.002 ± 0.0009, P = .03), IGF-1 levels were independently and positively associated with Hb levels. In older males but not in females, IGF-1 levels are negatively associated with anemia. IGF-1 levels are independent and positive determinants of Hb concentration in both sexes.

The association between symptoms and bladder or renal tract cancer in primary care: a systematic review.

Appropriate selection for further investigation of patients presenting in primary care with symptoms that may indicate cancer is key to early diagnosis. To quantify the risk of urinary tract cancer in patients presenting in primary care with symptoms that may indicate bladder or renal cancer. Systematic review of studies relating to bladder or renal cancer in primary care. Databases searched were MEDLINE, PreMEDLINE, Embase, the Cochrane Library, Web of Science (SCI and SSCI), and ISI Proceedings from 1980 to August 2014, and PsycINFO (1980-2012) and BioMed Central (inception to 2012) for retrospective, prospective, or case-control diagnostic accuracy studies of symptomatic patients presenting to primary care with one or more symptoms for whom follow-up data were available. The target conditions were bladder or renal cancer. The studies were appraised using the QUADAS-2 tool. Eleven studies with 3 451 675 patients were included. The positive predictive value (PPV) from meta-analysis of visible haematuria was 5.1% in adult patients. It increased with age and was higher in males. The PPVs of other single symptoms were very low, with the highest non-haematuria PPV being 1.4% for anaemia in males. Fewer data were available on the PPVs of symptom combinations. Generally, these data showed that, with the exception of symptom combinations including haematuria, these were very low. The only high-risk feature of bladder/renal cancer in primary care was visible haematuria, and this clearly warrants investigation. However, not all patients with one of these cancers experience haematuria, so a policy restricting investigation to patients with haematuria will inevitably delay the diagnosis in some patients.

Reply to Son et al.

We thank Son et al. [1] for their interest in our article [2] and for the points they raised. The authors bring up an issue that is both important and controversial, i.e. the impact of gender on outcomes after aortic valve surgery as well as the possible differential effect of anaemia in males versus females. Female gender has been included as a factor in many risk-scoring systems including the EuroSCORE [3]. However, several studies have found that female gender is not a risk factor for poor outcomes after aortic valve surgery. Fuchs et al. [4] studied the gender differences of patients undergoing aortic valve replacement (AVR) for isolated severe aortic stenosis and found that although women referred to AVR are older and more symptomatic, gender did not impact on operative and long-term mortality. In the oldest age group of 79 years and older, women even have a better outcome, presumably due to a longer mean life expectancy. However, it is important to differentiate the effect of gender as a confounder (affecting the relationship between anaemia and outcomes) and as an effect modifier (having a differential effect of anaemia on outcomes based on gender). In order for gender to be a significant confounder, it would have to be associated with either the exposure (anaemia) or outcomes (mortality and morbidity). In our study, we did not find gender to be significantly associated with either variable, and therefore, by definition, gender was not a significant confounder of the relationship between anaemia and outcomes. Furthermore, addition of gender to our multivariable model did not significantly change the effect of anaemia on outcomes. The threshold effect of anaemia on outcomes was observed for the entire cohort and was similar between males and females. Son et al. [1] also propose the notion that females may have a better tolerance to haemodilution than males. Our study was not designed to answer this question, but there is a lack of convincing evidence supporting this phenomenon in the literature. In our study, the impact of anaemia on outcomes was observed equally in males and females [2]. Son et al. [1] also propose that concomitant coronary artery bypass grafting surgery (CABG) surgery may be a confounder. Similar to gender, concomitant CABG was equally distributed within our exposure groups and addition of this variable to our model did not impact on the relationship between exposure and outcomes, suggesting that it was not a significant confounder in our population.

Impact of Preoperative Anemia on Oncologic Outcomes of Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy

We evaluated the impact of preoperative anemia on oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. A total of 282 patients with upper tract urothelial carcinoma underwent radical nephroureterectomy. Preoperatively measured hemoglobin values were stratified into normal and anemia based on the WHO classification of 13 gm/dl or less and 12 or less considered anemia in males and females, respectively. We performed sensitivity analysis based on contemporary anemia classifications adjusted for the impact of age, gender and race with anemia considered a hemoglobin value of 13.7 gm/dl or less and 13.2 or less in white males younger than 60 and 60 years old or older, respectively, and 12.2 gm/dl or less in white females of all ages. Univariable and multivariable Cox regression analyses were done to assess the effects of anemia on oncologic outcomes. Median preoperative hemoglobin was 13.2 gm/dl (IQR 11.7, 14.3). A total of 112 patients (39.7%) were anemic by the WHO classification vs 129 (45.7%) by the contemporary classification. Anemia was associated with lymph node metastasis, lymphovascular invasion, sessile tumor architecture, tumor necrosis, advanced age and a higher ECOG (Eastern Cooperative Oncology Group) performance score using the WHO and/or the contemporary definition (p ≤0.044). At a median 30-month followup anemia was associated with decreased recurrence-free (p ≤0.008) and cancer specific (p <0.001) survival on Kaplan-Meier analyses. On multivariable analysis adjusted for standard clinicopathological factors anemia remained an independent predictor of disease recurrence (HR 1.76, 95% CI 1.17-2.63 and 1.89, 95% CI 1.26-2.86) and cancer specific mortality (HR 1.88, 95% CI 1.15-3.08 and 2.04, 95% CI 1.21-3.45) by the WHO and contemporary classifications, respectively. Preoperative anemia is an independent predictor of disease recurrence and cancer specific mortality. It is associated with aggressive tumor features in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. Hemoglobin is a promising marker for patient counseling and risk stratification for additional treatment decision making.

Is Obesity a Risk Factor for Anemia?

Purpose: Obesity is a chronic inflammatory condition. Inflammation and infection can predispose to anemia. Hepcidin an adipokine is suggested to affect iron metabolism and cause inflammatory related anemia. We evaluated the association between body mass index (BMI) and anemia using 2005-2006 National Health and Nutritional Examination Survey (NHANES) raw database. Methods: Subjects were all males aged 18 years and above. They were divided into four groups of BMI as proposed by the World Health Organization. Group I, BMI less than 25; Group II, BMI 25-30; Group III, BMI 30-35; Group IV, BMI more than 35. BMI < 25 was used as a control and p-values were calculated in relation to the control. Anemia in males is defined per the WHO criteria (Hg<13 g/dL). We analyzed the relationship between BMI, hemoglobin, hematocrit and mean corpuscular volume (MCV) using STATA/SE 10.0. Results: Complete raw data for 2242 of the 2511 male patients was included in the analysis. Sampling weights were not taken into account when summarizing the data. The patient characteristics along with anemia percentages are provided in Table 1. The groups did not differ with respect to age, hemoglobin, hematocrit and MCV. The group with BMI > 35 had higher percentage prevalence of anemia. However, it was not statistically significant.Table 1: Patient characteristics and anemia prevelanceConclusion: Despite the relationship between inflammatory conditions and anemia, we failed to find a statistically significant relationship between obesity and anemia.

A hematologist's view of unexplained iron deficiency anemia in males: Impact of Helicobacter pylori eradication

Background and objectives Helicobacter pylori infection with, or without coexisting autoimmune gastritis has been implicated in several recent studies as an important cause of IDA in patients with unexplained iron deficiency anemia (IDA). However, the role of H. pylori in the causation of IDA is still unsettled as the vast majority of reported patients were premenopausal women in whom menstrual blood loss was likely the dominant factor determining IDA. Design and methods Prospective study of 44 consecutive male IDA patients referred for hematologic evaluation. Following standard endoscopic studies, all patients were screened for non-bleeding GI conditions including celiac disease, autoimmune gastritis and H. pylori gastritis. All subject with H. pylori infection were offered triple therapy for H. pylori eradication. Results Only 15 patients had a likely source of blood loss identified. The 29 males with “unexplained” IDA were distinguished by their younger age (36 ± 20 vs. 57 ± 17 years p < 0.001), poor initial response to oral iron treatment, and high prevalence of H. pylori infection (25 of 29 vs. 5 of 15 p < 0.0001) with (10) or without (15) coexistent autoimmune gastritis. Three had celiac disease. Following H. pylori eradication, all patients achieved normal hemoglobin levels with follow-up periods ranging from 4 to 69 months (38 ± 15 months mean ± 1SD). This was accompanied by a significant decrease in H. pylori IgG antibodies and serum gastrin. Sixteen patients discontinued iron treatment, maintaining normal hemoglobin and ferritin and may be considered cured. Remarkably, 4 of the 16 achieved normal hemoglobin without ever having received oral iron after H. pylori eradication. Interpretation and conclusions The favorable long-term clinical results of H. pylori eradication offer strong evidence for a cause-and-effect relation between H. pylori and IDA. Recognition of the respective roles of H. pylori and autoimmune gastritis in the pathogenesis of iron deficiency may have a strong impact on the clinical management of unexplained and refractory iron deficiency anemia.

Characteristics of Lifestyle and Health Status of Workers in Small-Scale Enterprises in Japan

This study was conducted to clarify the characteristics of small-scale enterprises (SSEs) with fewer than 50 workers, which employ 62.2% of all Japanese workers. Subjects were 71,183 workers employed at 1,761 workplaces in Tochigi, Japan, in 2002. Frequencies of abnormal lifestyle and health check-up data were described according to the category of the enterprise. Adjusted odds ratios (ORs) of the abnormal findings were calculated by logistic regression analysis. Dose-response relationships were calculated by trend tests. The frequency of abnormal findings was higher in SSEs than in other categories of enterprises. The ORs of work intensity, alcohol consumption, current smoker, and the Brinkmann index were higher in SSEs than in large-scale enterprises (LSEs) and were also significant in trend tests. The ORs of audiometry, hypertension, glucose in urine and ECG in males and females, BMI, liver function, lipid metabolism, and blood sugar in females, chest X-ray, and anemia in males were higher in SSEs. Audiometry, hypertension, anemia, ECG in both males and females; chest X-ray, and glucose in urine in males, and liver function, lipid metabolism and blood sugar in females showed significant results in trend tests. Overall health and healthy lifestyle in SSEs were worse than in LSEs.

A new mutation of the ALAS2 gene in a large family with X-linked sideroblastic anemia

X-linked sideroblastic anemia is a genetic disorder characterized by a hypochromic microcytic anemia of variable intensity with the presence of ring sideroblasts in the bone marrow of the patients. Two different mutations have been reported in the ALAS2 gene in patients with this disease. We have studied a large kindred with a pyridoxine-sensitive form of X-linked sideroblastic anemia. Sequencing amplified cDNA of the proband revealed a guanine-to-adenine change at nucleotide 871 of the coding sequence (exon 7 of the gene). This results in a glycine to serine substitution that is responsible for a marked decrease in the enzymatic activity of the mutated protein. A polymerase chain reaction assay demonstrated the presence of the same mutation in three affected males and two female carriers in the kindred. The carrier status was excluded in eight females at risk. Early detection of the mutant allele in family members may thus be important for the prevention of anemia in males and of iron overload both in affected males and carrier females.

Anaemia is a major public health problem in Tanzania

In Tanzania health workers surveyed 10037 adults (=or> 15 years old) in rural villages in the Morogoro Rural District (a poor rural area) Kilimanjaro region of Hai District (the most wealthy rural area in the study) Mara region (a poor rural area) and in the urban areas of Manzese and Kimara in Dar es Salaam to determine the prevalence of anemia in adults. The prevalence of anemia in males (hemoglobin [Hb] < 13 g/dl) and in females (Hb < 12 g/dl) varied from 29.8% in Kilimanjaro to 79.9% in Mara and 25.8% in Kilimanjaro to 80.5% in Morogoro respectively. Anemia was always more prevalent in Morogoro and Mara than in Kilimanjaro or Dar es Salaam. When the researchers used Hb levels of less than 11 g/dl for males and less than 10 g/dl prevalence ranged from 3.1% in Kilimanjaro to 26.3% in Morogoro for men and 2.1% in Kilimanjaro to 26.8% in Morogoro for women. Mean Hb levels were 13.2 g/dl in Kilimanjaro 11.9 g/dl in Dar es Salaam 11.1 g/dl in Morogoro and 11.1 g/dl in Mara. The 5537 nonpregnant women had a consistently higher mean Hb level than did the 257 pregnant women (11.7 g/dl vs. 10 g/dl). Men in the older age groups had a higher prevalence of anemia in all areas except Mara than did younger men especially 65-year-old and older men. Age was not a factor in women however. Mean prevalence of anemia in males and females in the poorer rural areas was much higher than mean prevalence of anemia in males and females in other East African countries. Since anemia reduces maximum oxygen transport the high levels of anemia in Tanzania may impede work performance. Further anemia contributes to poor health also reducing work performance. These findings show that anemia is a major public health problem in Tanzania.