Hemoglobin Concentration Research Articles

Non-invasive point-of-care optical technique for continuous invivo assessment of microcirculatory function: Application to a preclinical model of early sepsis.

Increased amplitude of peripheral vasomotion is a potential early marker of sepsis-related microcirculatory impairment; however, previous reports relied on clinically unsuitable invasive techniques. Hyperspectral near-infrared spectroscopy (hsNIRS) and diffuse correlation spectroscopy (DCS) are non-invasive, bedside techniques that can be paired to continuously monitor tissue hemoglobin content (HbT), oxygenation (StO2), and perfusion (rBF) to detect vasomotion as low-frequency microhemodynamic oscillations. While previous studies have primarily focused on the peripheral microcirculation, cerebral injury is also a common occurrence in sepsis and hsNIRS-DCS could be used to assess cerebral microcirculatory function. This work aimed to use a hybrid hsNIRS-DCS system to continuously monitor changes in the peripheral and cerebral microcirculation in a rat model of early sepsis. It was hypothesized that the skeletal muscle would be a more sensitive early indicator of sepsis-related changes in microhemodynamics than the brain. Control animals received saline while the experimental group received fecal slurry to induce sepsis. Subsequently, hsNIRS-DCS measurements were acquired from the skeletal muscle and brain for 6 h. Peripheral rBF rapidly decreased in septic animals, but there were no significant changes in peripheral HbT or StO2, nor cerebral HbT, rBF, or StO2. The power of low-frequency peripheral oscillations in all parameters (i.e., HbT, StO2, and rBF) as well as cerebral HbT oscillations were elevated in septic animals during the final 4 h. These findings suggest that in the early stages of sepsis, while vital organs like the brain are partly protected, changes in peripheral perfusion and vasomotor activity can be detected using hsNIRS-DCS. Future work will apply the technique to ICU patients.

Functionalized Iron Oxide Nanoparticles for Both Dual-Modal Imaging and Erythropoiesis.

Cancer-related anemia (CRA), a complication of cancer, is considered the primary cause of high mortality for cancer patients. Safe and effective theranostics are desirable for realizing the high diagnostic accuracy of tumors and ameliorating CRA in the clinic. However, the available theranostics do not support dual-modal imaging and the amelioration of CRA at the same time. In this study, we synthesized functionalized iron oxide nanoparticles (Fe3O4 NPs) modified with protoporphyrin IX (PPIX) and folic acid (FA) by a one-step modification strategy (Fe3O4@NH-PPIX&FA NPs) or a step-by-step strategy (Fe3O4@NH-PPIX-FA NPs), aiming at both magnetic resonance imaging/fluorescence imaging (MRI/FI) and erythropoiesis. Fe3O4@NH-PPIX-FA NPs displayed better ability of MRI/FI than Fe3O4@NH-PPIX&FA NPs and had an efficient tumor targeting of 45 min after tail vein injection owing to the reduction of the steric effect and extension of FA groups. Fe3O4@NH-PPIX-FA NPs exhibited satisfactory erythropoiesis with up to 20% elevation of red blood cell (RBC) counts and hemoglobin concentrations in mice with CRA, which provided a safe alternative to RBC transfusions, especially for patients needing recurrent RBC transfusions. With excellent performance in both dual-modal imaging and erythropoiesis, Fe3O4@NH-PPIX-FA NPs could be a powerful tool for the theranostics of cancer patients with anemia.

TOXICOLOGICAL IMPACT OF DICLOFENAC SODIUM: HEMATOLOGICAL, BIOCHEMICAL AND HISTOPATHOLOGICAL CHANGES IN MALE RATS

Background: Long-term administration of diclofenac sodium can lead to harmful effects on body tissues, causing cellular injuries that include changes in kidney function and contributing to the development of immune mechanisms against kidney tissues. This study aimed to evaluate the toxic effects of diclofenac sodium on hematological and biochemical parameters, as well as histopathological changes in the kidneys of experimental animals. Methods: Forty male Albino-Aster mice were divided into four groups: control and three groups administered diclofenac sodium orally at doses of 20.5, 45 and 56.25 mg/kg body weight for 20 days. Blood samples were collected for hematological and biochemical analyses and kidney tissues were examined histopathologically. Results: Diclofenac sodium administration caused a significant decrease in red blood cells, hemoglobin, packed cell volume, mean corpuscular volume and mean corpuscular hemoglobin concentration, as well as a significant increase in platelets and total white blood cells. Serum alkaline phosphatase, aspartate aminotransferase and alanine aminotransferase were significantly elevated. Histopathological examination revealed congestion, inflammation, glomerular abnormalities, tubular necrosis and vascular changes in the kidney tissues, with the severity increasing with higher doses. Conclusion: Diclofenac sodium administration at different doses can cause significant alterations in hematological and biochemical parameters, as well as histopathological changes in the kidneys of male rats, indicating potential adverse effects on animal tissues. Caution is recommended in the clinical use of diclofenac sodium and the lowest effective dose and duration should be used to achieve the desired therapeutic effect.

Effect of age on lung adaptation to high-altitude hypoxia in Tibetan sheep

After prolonged adaptation to high-altitude environments, Tibetan sheep have developed a robust capacity to withstand hypobaric hypoxia. Compared to low-altitude sheep, various organs and tissues in Tibetan sheep have undergone significant adaptive remodeling, particularly in the lungs. However, whether lambs and adult Tibetan sheep exhibit similar adaptations to high-altitude hypoxia remains unclear. In this study, we selected six lambs (4 months old) and six adult (3 years old) female Tibetan sheep to assess their blood gas indicators, observe lung microstructures, and measure the expression levels of key proteins in the lungs. The results indicated that adult sheep exhibited higher hemoglobin concentrations and finer, denser pulmonary vasculature, which enhanced their oxygen-carrying capacity and increased the surface area available for blood gas exchange, resulting in improved oxygen transfer capacity. Conversely, lambs demonstrated larger lungs relative to their body weight and greater pulmonary vascular volumes, which increased relative pulmonary ventilation and blood flow, thereby enhancing oxygen uptake. These findings suggested that Tibetan sheep employ different adaptation strategies to high-altitude hypoxia at various life stages.

Grazing sheep on pastures with tansy ragwort (Senecio jacobaea L.) – results of a two-year study on ingested pyrrolizidine alkaloids and transfer into animal organs

Tansy ragwort (Senecio jacobaea L.) growing in animal pasture may pose a risk to humans due to the potential transfer of pyrrolizidine alkaloids (PAs) into food of animal origin. Here, we investigated what amount of PAs corresponds to the amount of ragwort consumed by sheep on a pasture and whether the ingested PAs are transferred into edible tissue. From 2020 to 2021, a field study was conducted with 70 sheep grazing on a pasture (stocking density of 12 sheep/hectare) with considerable quantities of tansy ragwort. After slaughter, blood samples were taken for analysis of liver enzyme activities and haemoglobin concentration. Samples of ruminal fluid, liver and diaphragm pillar were analysed for PAs. The amount of ingested ragwort was determined by counting missing plant parts and calculating their weight using reference material. The mean daily intake of ragwort per sheep ranged from 0.16 kg to 4.89 kg fresh matter and corresponded to PA doses from 0.3 to 40.9 mg/kg body weight with no effect on the liver enzyme activities. The PA concentrations in the animal tissue were between the limit of detection and a maximum of 8.0 µg/kg in the liver and 2.5 µg/kg in muscle. These data suggest that the risk is negligible of exposure to PAs through consumption of meat or liver.

Mining Hypertension Predictors using Decision Tree: Baseline Data of Kharameh Cohort Study

Introduction: Hypertension is a serious chronic disease and an important risk factor for many health problems. This study aimed to investigate the factors associated with hypertension using a decision-tree algorithm. Methods: Methods: This cross-sectional study was conducted through the census in Kharameh City between 2014 and 2017. The study included 2510 hypertensive and 7840 non-hypertensive individuals. To create the decision tree, 70% of the cases were randomly allocated to the training dataset. In comparison, the remaining 30% were used as the testing dataset for the performance evaluation of the decision tree. Two models were assessed. In the first model (model I), 15 variables including age, gender, body mass index (BMI), years of education, occupation status, marital status, family history of hypertension, physical activity, total energy, number of meals, salt, oil type, drug use, alcohol use, and smoke entered into the model. in the second model (model II) 16 variables including age, gender, BMI and Blood factors as Hematocrit (HCT), Mean corpuscular hemoglobin concentration (MCHC), Platelet Count (PLT), Fasting blood sugar (FBS), Blood Urea Nitrogen (BUN), creatinine (Cr), triglycerides (TG), cholesterol (CHOL), Alkaline phosphatase (ALP), High-density lipoprotein (HDL), Gamma-glutamyl transpeptidase (GGT), low-density lipoproteins (LDL) and Urinary specific gravity (SG) were considered. A confusion matrix was used to measure the performance of the decision tree. Additionally, accuracy, sensitivity, specificity, and the receiver operating characteristics (ROC) curve were determined to compare the models. Results: For the model I, the accuracy, sensitivity, specificity and AUC value were 79.2%(77.8-80.6), 82.4%(80.1-84.5), 78.24%(76.4-80), and 0.80%(0.79-0.82), respectively. For model II, the corresponding values were 79.5%(78.2-80.8), 81.0%(78.3-83.6)79.0%(77.5-80.5)and 0.80%(0.79-0.81), respectively. Confusion matrix of model I showed that of the 1188 cases with hypertension in the training data set, 979 cases were classified correctly and, for model II of the 2812 non-hypertension cases, 2222 cases were classified correctly. Conclusion: We have suggested a decision tree model to identify the risk factors associated with hypertension. This model can be useful for early screening and improving preventive and curative health services in health promotion

An Overview on Iron Deficiency Anaemia

"Anaemia’’ is defined as a collection of disorders caused by erythropoietin tissues' incapacity to maintain normal haemoglobin concentration due to insufficient availability of one or more nutrients, which lowers the amount of haemoglobin in circulation overall. It can be brought on by a poor vegetarian diet, iron malabsorption, hookworm infections, profuse bleeding during menstruation, or childbirth.Low birth weight, decreased immunological function, poor cognitive development, behavioural issues, decreased job ability, and maternal mortality are among the negative outcomes of anaemia. The most popular and sensitive initial diagnostic test for IDA is serum ferritin. The most effective methods of treating iron deficiency anaemia include dietary variety, supplementation, fortification of staple foods, and nutrition education. Keywords: Anaemia, iron deficiency, micronutrient deficiency, nutritional anaemia

Anemia-associated smaller brain volume and sex differences: a cross-sectional study of magnetic resonance imaging in brain health checkups

IntroductionAnemia is a risk factor for dementia development. However, few studies have examined the relationship between brain volume and anemia. This study aimed to analyze the association between anemia and brain volume using magnetic resonance imaging data from brain health checkups.MethodParticipants underwent brain health checkups between January 2015 and March 2022. Blood samples were collected to measure hemoglobin concentrations and mean corpuscular volumes. The modified Mini-Mental State Examination (MMSE) was used to evaluate cognitive function. Magnetic resonance images were analyzed using voxel-based Morphometry to evaluate the overall patterns of brain volume. After extracting the principal components (PCs) from PC analysis, we investigated their association with MMSE scores and anemia.ResultsThis study included 1,029 participants and identified principal components, representing smaller volume in the frontal lobe (PC1), and smaller volume in the limbic system to the temporal lobe (PC2). A higher PC2 score was significantly associated with a lower MMSE score. Male participants with anemia had smaller bilateral PC1 volumes and left hippocampal volumes, and female participants with anemia had smaller bilateral PC2 volumes and hippocampus volumes.DiscussionPC2 may represent the extent of disease affecting limbic system volume, such as Alzheimer’s disease. Our results suggest that anemia may be associated with smaller volumes in the limbic system, especially in women. Further studies are required to determine which type of anemia is more strongly correlated with smaller brain volumes.

Evaluation of the Immunological and Hematological parameters of Systemic Lupus Erythematosus in Iraqi Women

Systemic lupus erythematosus is an autoimmune disease involving several systems, mainly affects young adult women, and causes a significant deterioration in quality of life. Different environmental aspects are known to facilitate the development of lupus in predisposed individuals. Hemoglobin concentration (HB), granulocyte level, hemoglobin level, saturation (ESR), and platelets (PLT) were among the clinical blood indicators that were found to be associated with the beginning of SLE in adults and teenagers. Blood PLT levels in both SLE patients were significantly lower than in the G1 control group (P< 0.001). When compared to the control group, G1, the two SLE patient groups (G2 & G3) had noticeably higher ESRs (P < 0.01). The study employed many immunological markers, such as C-reactive protein (CRP), antinuclear antibody (ANA), Anti-double stranded DNA (Anti-dsDNA), complement components C3 and C4 levels. Serum CRP levels were significantly higher in G2 and G3 SLE patients (P<0.001) than in the G1 control group. Research revealed that two SLE patient groups (G2 & G3) had blood levels of ANA and Anti-double stranded DNA (Anti-dsDNA) that were considerably higher than those of the control group (G1).

Characteristics and Risk Factors for Postoperative Bleeding Following Endoscopic Resection of Esophageal Squamous Neoplasms.

Reports on postoperative bleeding after esophageal endoscopic resection are limited. This study aimed to identify the clinical characteristics and risk factors for postoperative bleeding following endoscopic resection of esophageal neoplasms. This single-center, retrospective study included consecutive patients who underwent endoscopic resection for esophageal squamous cell carcinoma or squamous intraepithelial neoplasm between January 2018 and December 2022. We investigated the incidence, timing, severity, and risk factors for postoperative bleeding. Of 1288 patients, 1062 (82%) underwent endoscopic submucosal dissection, and 226 (18%) underwent endoscopic mucosal resection. Postoperative bleeding occurred in seven (0.5%) patients (95% confidence interval [CI] 0.2-1.1%; median postoperative day 8 [range, 4-17 days]). In these seven patients, hemoglobin concentration decreased by a median of 3.0g/dL (range, 1.6-6.8g/dL). Antithrombotic agent use, resection wound circumference, and specimen size were significantly associated with postoperative bleeding (P < 0.001, P = 0.002, and P = 0.024, respectively). Among 43 patients who received direct oral anticoagulants (DOACs), postoperative bleeding occurred in four (9%) patients (95% CI 2.6-22.1%). DOACs were significantly associated with postoperative bleeding even after propensity score matching (4/40 [10%] vs. 0/80 [0%], respectively; P = 0.011). The overall bleeding rate following esophageal endoscopic resection was 0.5%, with a delayed onset, leading to anemia. DOACs emerged as the most significant risk factor for postoperative bleeding.

Multicenter, prospective, single-arm clinical study to investigate the efficacy and safety of Zoladex (Goserelin acetate) 10.8 mg prior to surgery in Chinese premenopausal women with symptomatic uterine fibroids

Objectives To assess the effect and safety of Zoladex (Goserelin acetate) 10.8 mg in patients with uterine fibroids. Methods Fifty-three patients received Goserelin acetate 10.8 mg once and surgery was conducted at 12 weeks ± 7 days after drug injection. All assessments form baseline to week12/before surgery were carried out: fibroids volume, uterine volume, serum hormone (E2, FSH, LH), hemoglobin concentration, uterine arterial resistance index (UA-RI), fibroid arterial RI (FA-RI) and improvements of symptoms (Uterine Fibroid Symptom and Quality of Life (UFS-QOL) and Health-Related Quality of Life (HRQL) scores). Adverse events (AEs) were recorded to evaluate the safety. Results After 12 weeks of treatment, the volume of uterine fibroids was significantly smaller than before (249.19 ± 297.04 vs. 195.77 ± 418.27 cm3, p < 0.0001). The volume of the uterus was also smaller than before (372.02 vs. 263.58 cm3, p < 0.0001). Serum levels of E2, FSH, and LH showed significant decreasing trend (61.13 pmol/L, 5.23 IU/L and 4.75 IU/L respectively, p < 0.0001) and hemoglobin levels were increased significantly (108.30 ± 26.28 VS. 134.90 ± 9.21g/L, p < 0.0001). Left and right UA-RI showed slight increase of 0.04 and 0.02 respectively from baseline without significance. Mean FA-RI showed slight decrease of 0.03 from baseline (p = 0.22). Patient symptoms were alleviated after treatment. In addition, AEs occurred in 81.1% of enrolled patients and all AEs were well tolerably. Conclusions Goserelin acetate 10.8 mg pretreatment can effectively reduce the volume of uterine fibroids and uterus, lower estrogen levels and improve anemia symptoms. It could also improve the quality of life of patients, showing good safety and tolerance. This pretreatment was effective, safe, and generally well tolerated.

Evaluation of Some Haemorheologic Parameters amongst Automotive Spray Painters in Port Harcourt, Nigeria

Background/Objectives: Automotive Spray-Painters are at a higher risk of exposure to hazardous chemicals such as polycyclic aromatic hydrocarbons – benzene inclusive, and heavy metals which may cause adverse health outcomes. The aim of the study was to evaluate effect of exposure to spray paints on some haemorheological parameters in individuals involved in automotive spray painting within Port Harcourt Metropolis. Method: This case control study recruited 52 participants: 30 automotive spray-painters and 22 controls. The study was carried out in Port Harcourt Metropolis, Nigeria. Venous blood samples were drawn from the participants (age 20 to 65 years) and examined for packed cell volume, erythrocyte sedimentation rate, fibrinogen and haemoglobin. Semi-structured questionnaire was used to obtain information from participants. Result: Participants from painting occupation had significantly higher ESR (p = 0.0450) as a result of increase in number of years in Automotive Spray-Painting. Increased ESR may be an indication of inflammation in the body. There was no statistical significance between Automotive Spray-Painters and control subjects when values of haemoglobin concentration, packed cell volume, fibrinogen concentration and erythrocyte concentration was compared in Automotive Spay-Painters, however, their values were increased than that control subjects at p&lt;0.05. Conclusion: The study revealed that prolonged inhalation of benzene and other aromatic toxic compounds in paints caused slight increase in haemorheological parameters (PCV, HB, ESR and fibrinogen) of Automotive Spray-Painters due to exposure to paint fumes, a risk factor for inflammation of vital organs, venous thrombosis and thromboembolism; and predisposes Spray-Painters to many health disorders which can affect their lungs, heart, blood vessels, and ultimately the transport of oxygen to the brain.

Changes in glucose variability and diabetes control in children and young adults with type 1 diabetes on routine continuous glucose monitoring and continuous subcutaneous insulin therapy following a switch to hybrid closed-loop therapy (MiniMed 780G) – retrospective study

IntroductionAdvanced hybrid closed loop (AHCL) insulin delivery systems offer considerable benefits to individuals with type 1 diabetes (T1D) in terms of glucose control and quality of life. With increasing numbers of regular users, real-life long-term data on long-term AHCL effectiveness become available.Material and methodsThis was a single-centre retrospective study. We included children and young adults (age 5–25 years ) with established T1D (≥ 3 m) who started MiniMed780G therapy between January 2021 and April 2022. We excluded those naïve to continuous glucose monitoring (CGM) or insulin pumps, as well as those without good-quality baseline CGM data. Included patients were followed for 12 months, with CGM and pump data retrieved from 14-day periods before transition and 3, 6, 9, and 12 months following the start of automode. Clinical data (body weight, height, glycated haemoglobin concentration) were recorded from the most recent outpatient visits.ResultsAmong 81 patients who started AHCL therapy, 46 met the criteria for analysis (mean age 11.5 ±4.4 years, diabetes duration 4.4 ±3.6 years, mean glycated haemoglobin 7.0 ±1.0%). Over the year following transition, we noted a significant improvement in time in target range 70–180 mg/dl (TIR, baseline: 69.1 ±12.0% to 12 m: 76.9 ±8.5%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and time in tight range 70–140 mg/dl (baseline: 45.3 ±14.2% to 12 m: 53.3 ±10.4%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Time below target range 70 mg/dl (TBR70 mg/dl) decreased significantly for 24-hour records (&lt;i&gt;p&lt;/i&gt; = 0.0020). Importantly, those improvements were not accompanied by an increase in daily dose of insulin or body mass index.ConclusionsA prolonged 12-month-long observation in a routine care setting demonstrates that for young CGM- and pump users with T1D, switch AHCL offers sustained benefits in glucose variability.

Design and simulation of a highly sensitive photonic crystal fiber sensor for malaria detection

This research focuses on developing an innovative optical sensor utilizing photonic crystal fiber with a unique cladding structure. The photonic crystal fiber’s cladding consists of four layers of circular air holes, with two of them filled with hemoglobin. This arrangement renders the photonic crystal fiber sensitive to changes in hemoglobin concentration, primarily investigating its impact on chromatic dispersion – the wavelength-dependent refractive index variation. The study analyzes two specific wavelengths, 1.2 µm and 1.4 µm, finding high sensitivity at 1.2 µm, calculated to be 0.232 ps/(nm·km)/(g/L). The potential application lies in malaria diagnosis through non-invasive blood sample analysis. We selected the refractive index of an infected red blood cell at the ring stage, setting it at n = 1.395. Our proposed sensor demonstrates outstanding performance in diagnosing malaria at an HGB concentration of 38 g/L at 1.2 µm and at an HGB concentration of 40 g/L at 1.4 µm. By monitoring hemoglobin concentration changes, this photonic crystal fiber-based sensor offers a promising method for early and accurate malaria detection, thus potentially improving global healthcare.

Associations between blood markers of glucose metabolism and characteristics of circulating lymphocytes

AimsThe pathophysiology of diabetes is not fully understood; recent research indicates close relations with immunological alterations. Therefore, the aim of this study was to investigate the associations between markers of glucose metabolism and characteristics of blood lymphocytes in a population-based cohort. MethodsThe analysis was based on data from 219 non-diabetic participants of the MEGA study in Augsburg, Germany, who were recruited between 2018 and 2021. The majority of participants were examined two different times with a time lag of 9 months. Fasting venous blood samples were taken and oral glucose tolerance tests (OGTT) were performed at both visits. Immune cells were analyzed from fresh blood using flow cytometry. The associations between fasting blood glucose levels, glucose levels at 2 hours after oral glucose bolus and glycated hemoglobin (HbA1c) concentrations and the quantity of different lymphocyte subsets were analyzed using linear mixed regression models with random intercept. P values were FDR-adjusted. ResultsHbA1c was negatively associated with the marginal zone B cells (IgD+ CD27+ B cells). Fasting glucose was positively associated with natural killer (NK) cells and 2-hour OGTT glucose was positively associated with NKT cells. Finally, HbA1c showed significantly negative associations with the CD57-PD1-NKT cell subset. ConclusionMarkers of glucose metabolism showed significant associations with B cell, NK cell and NKT cell subsets, which clearly indicates a relation between glucose metabolism and the adaptive immune system.

Safety and efficacy of mitapivat in sickle cell disease (RISE UP): results from the phase 2 portion of a global, double-blind, randomised, placebo-controlled trial

Sickle cell disease, a debilitating, inherited haemolytic anaemia with premature morbidity and mortality, affects millions globally. Mitapivat, a first-in-class, oral, allosteric activator of pyruvate kinase, improves red blood cell survival by increasing ATP and diminishes sickling by decreasing 2,3-diphosphoglycerate. We aimed to evaluate the efficacy and safety of mitapivat in patients with sickle cell disease. We report results from the phase 2, 12-week, double-blind period of RISE UP, a global, phase 2/3, double-blind, randomised, placebo-controlled trial. The phase 2 part of the study was conducted at 32 clinical study sites across 13 countries. Patients aged 16 years or older with a confirmed diagnosis of sickle cell disease (any genotype), baseline haemoglobin of 5·5-10·5 g/dL (inclusive), and two to ten sickle cell pain crises within 12 months before providing informed consent, were randomly assigned 1:1:1 to receive oral mitapivat 50 mg, 100 mg, or placebo twice daily, in this portion of the study which is now complete. Randomisation was performed using a permuted-block method and concealed with an interactive response system; patients, investigators, and individuals assessing outcomes were masked to treatment assignment. Primary efficacy and safety endpoints were haemoglobin response (≥1·0 g/dL increase from baseline in average haemoglobin concentration from week 10 through week 12), and type, severity, and relationship to study drug of adverse and serious adverse events. Efficacy and safety endpoints were evaluated in the full analysis set (all randomly assigned patients) and safety analysis set (all patients who received at least one dose of study drug), respectively. This study is registered with ClinicalTrials.gov as part of an ongoing phase 2/3 study (NCT05031780). Between Jan 19, 2022, and April 25, 2023, 79 patients were randomly assigned (51 [65%] female, 28 [35%] male; 46 [58%] Black or African American, 26 [33%] White, five [6%] multiracial, two [3%] Asian); 26 received mitapivat 50 mg, 26 received mitapivat 100 mg, and 27 received placebo, twice daily. Both treatment groups showed a statistically significant haemoglobin response rate versus placebo (12 [46%] of 26 patients in the mitapivat 50 mg group and 13 [50%] of 26 patients in the mitapivat 100 mg group, versus one [4%] of 27 patients in the placebo group; two-sided p=0·0003 and p=0·0001, respectively). Mitapivat was generally well tolerated. Serious adverse events were reported in two (8%) of 26 patients in the mitapivat 50 mg group, four (15%) of 26 patients in the mitapivat 100 mg group, and three (11%) of 27 patients in the placebo group; grade 3 or worse adverse events occurred in three (12%), five (19%), and two (7%) patients, respectively. No serious or grade 3 or worse adverse events were considered treatment related and there were no treatment-related deaths. The most common grade 3 or worse adverse events were infections and infestations, and included one patient in the placebo group with an infected skin ulcer, one patient in the mitapivat 50 mg group with meningitis and one with pelvic inflammatory disease, and one patient each with malaria, pneumonia, and tonsillitis in the mitapivat 100 mg group. Mitapivat, through its dual effect of increasing ATP and decreasing 2,3-diphosphoglycerate, could provide clinical benefit to patients with sickle cell disease. These results support continued evaluation of mitapivat in the phase 3 portion of the study. Agios Pharmaceuticals.

Enhancing diagnostic accuracy for iron deficiency in pregnant women through mean reticulocyte volume.

Women are more prone to iron deficiency (ID) anemia when pregnant. The diagnostic use of mean reticulocyte volume (MRV) in identifying ID anemia during pregnancy has not been thoroughly investigated. The objective of this study is to evaluate the effectiveness of MRV in diagnosing ID in pregnant women. Firstly, MRV of 20 healthy female volunteers (healthy group) was measured on specific days for one month. Subsequently, clinical data from 724 pregnant women were thoroughly examined. These women were divided into two groups: 282 with ID (research group) and 442 without ID (control group). Parameters such as MRV, reticulocyte hemoglobin equivalent (RHE), red blood cell volume distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), reticulocyte count (RET), MRV/MCV ratio, and serum ferritin (SF) were analyzed and compared. MRV remained consistent over a period of one month for 20 healthy individuals. In addition, there were significant differences in MRV, RHE, RDW-SD, MCV, MCH, MCHC, HCT, RET, and MRV/MCV between the research group and control group. The receiver operating characteristic (ROC) analysis showed that the areas under the curve (AUCs) for these measures were as follow: 0.840, 0.837, 0.676, 0.654, 0.639, 0.602, 0.571, 0.550, and 0.816, respectively. Ultimately, there was a substantial disparity in MRV prior to and following therapy with oral iron treatments. In healthy women, MRV remains stable and is a reliable ID marker, which can be used to assess oral iron treatment effectiveness during pregnancy.

Maternal hair lead and cytokine pro-inflammatory effects in preterm birth

This case-control study analyzed the lead (Pb), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) levels in pregnant women with preterm birth (PTB) in Central Java, Indonesia. Hair samples from 72 pregnant women were collected non-invasively. The prenatal exposure to Pb was determined with the total reflection X-ray fluorescence (TXRF) method. Serum IL-6 and TNF-α were examined using enzyme-linked immunosorbent assays (ELISA). The Pb concentration in hair was slightly higher in women with PTB than those without PTB; however, this difference was not statistically significant. An elevated hair Pb level was not associated with increased PTB risk (OR 24.69, 95% CI 0.93–653.82, p&amp;gt;0.05). A serum TNF-α level ≥27 pg/ml, a serum IL-6 level ≥9 pg/ml, and the spouse’s smoking frequency were significantly associated with increased PTB risk (TNF-α OR 42.25, 95% CI 5.26–339.61; IL-6 OR 22.33, 95% CI 3.12–158.54; spouse’s smoking frequency OR 1.28, 95% CI 1.09–1.5), while the maternal hemoglobin concentration significantly decreased PTB risk (OR 0.43, 95% CI 0.2–0.927). This study demonstrates that maternal hair Pb concentration has no significant relationship with PTB. Serum TNF-α, IL-6, and the spouse’s smoking frequency potentially increased PTB risk, while the maternal hemoglobin level is a protective factor.

Hepatotoxic Effects of Gaseous Sulfur Dioxide (SO₂), Nitrogen Dioxide (NO₂), and Their Mixture on Sea Bass (Centropristis striata): Hematological, Biochemical and Genotoxic Studies

This study meticulously explores the intricate hepatotoxic effects stemming from acute exposure to gaseous sulfur dioxide (SO2), nitrogen dioxide (NO2), and their amalgamation on sea bass (Centropristis striata). Employing a comprehensive approach involving hematological, cytotoxic, and histochemical analyses, the research provides crucial insights into the potential adverse impacts of these pollutants on fish health. The examination specifically focuses on the effects of SO2+NO2 on hematological, histochemical, and serum biochemical parameters in Centropristis striata. Treatment groups, subjected to LC30, LC50, and LC90 acute exposure of gaseous SO2, NO2, and SO2+NO2, alongside a control group, underwent evaluation of parameters such as red and white blood cells, hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, acid phosphatase, lactate dehydrogenase, total protein, albumin, serum creatinine, and blood urea. At the 96th hour, RBC values decreased, and WBC values increased in all experimental conditions compared to the control group (p&gt;0.05). MCV and MCH increased with the concentration of gaseous pollutants and exposure time (p&gt;0.05). Hematological parameter variations underscore disruptions in blood composition and immune responses. Simultaneously, alterations in serum biochemical parameters suggest potential impairments in liver and kidney functions, along with disturbances in lipid metabolism. Significant declines in albumin levels, indicating potential liver dysfunction or inflammation due to SO2 and NO2 exposures, were observed at all experimental conditions, while decreased globulin levels suggest immunosuppressive effects from combined pollutants. A substantial increase in the albumin/globulin ratio further signals an imbalance indicative of potential liver dysfunction or inflammation. Varied responses in liver enzyme levels (SGPT/ALT, SGOT/AST, ALP) underscore potential liver damage or injury (p&lt; 0.05). These findings deepen our understanding of environmental impacts on aquatic ecosystems, emphasizing the need for ongoing efforts to ensure the health and sustainability of fish populations in polluted environments.

Relationship of Iron Deficiency, Anemia and Combination of Iron Deficiency With Anemia With Severity of Manifestations of Chronic Heart Failure. Additional Analysis of the Study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)".

Aim To evaluate the role of iron deficiency (ID) identified by various criteria, anemia, and the combination of ID and anemia in determining the severity of the clinical course of chronic heart failure (CHF) in a retrospective analysis of data from 498 patients who participated in the ID-CHF-RF Russian multicenter program.Material and methods ID was diagnosed by the following three criteria established by the European Society of Cardiology (ESC) and the Russian Society of Cardiology (RSC): 1) ferritin concentration &lt;100 μg/l or ferritin concentration 100-299 μg/l in combination with a decreased transferrin saturation (TS) &lt;20%; 2) ID criteria that showed a high sensitivity and specificity when compared with bone marrow morphology (BMM): TS ≤19.8% or serum iron (SI) ≤13 μmol/l; and 3) a composite index including a ferritin concentration &lt;100 μg/l in combination with TS &lt;20% and SI ≤13 μmol/l. The presence of anemia was defined as a hemoglobin concentration of less than 12.0 g/dl in women and less than 13.0 g/dl in men according to the criteria of the World Health Organization.Results Concomitant anemia was detected in 40.3% of patients with CHF; in 85.1% of cases, anemia was combined with the SI concentration below normal. CHF patients with concomitant anemia were significantly older and had low levels of not only red blood cells and hemoglobin but also all parameters of iron metabolism, i.e., SI, ferritin concentration, and TS. The mean deviation of the red blood cell size, that characterizes the degree of anisocytosis, was significantly increased in patients with anemia, especially with a low SI. These patients had a higher CHF functional class, elevated levels of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) and walked a shorter distance in the 6-minute walk test, which reflects significantly more severe manifestations of CHF with concomitant anemia, particularly in combination with a low SI. The incidence of ID was 83.1% (including 23.3% in combination with anemia) according to the ESC/RSC criteria; 74.5% (including 43.3% with anemia) according to the BMM criteria; and 51.6% (including 51.7% with anemia) according to the composite index, which seems to be stricter compared to the first two criteria. Regardless of the assessment method (by total weighted average data), in ID combined with anemia, not only the hemoglobin concentration was significantly reduced but all three analyzed parameters of iron metabolism were also significantly reduced (SI 9.0 μmol/l vs. 10.4 μmol/l; ferritin 41 μg/l vs. 59 μg/l; TS 8.5% vs. 12.9%) compared to ID without anemia, respectively. The CHF severity and the NT-proBNP concentration were also maximum for the combination of ID and anemia, in contrast to ID without anemia, regardless of the ID criterion used. A more accurate comparison of the methods for determining ID in CHF in the context of their prognostic value will be obtained by analyzing the data of a two-year follow-up of patients in this study, which will be the subject of the next article.Conclusion This analysis suggests that the presence of concomitant ID without anemia or anemia without ID moderately affects the severity of clinical manifestations of CHF and may be rather markers than factors determining the course of the disease, and in this case, does not require special correction with iron medications. And only ID anemia (a combination of ID with anemia) in patients with CHF can be considered a condition requiring special correction (for example, with intravenous medication) in addition to optimal therapy for CHF. This conclusion does not change depending on the used criteria for ID and requires verification in new RCTs.