Decrease In Hemoglobin Concentration Research Articles

Biochemical and mineral status of the body of infertile boars with hypovitaminosis A

A leading role in the occurrence of infertility in male domestic animals is played by nutritional deficiency factors, in particular vitamin A deficiency, which contributes to the development of morphological and functional changes in the reproductive system. The aim of the work was to determine the effect of vitamin A (carotene) deficiency on the biochemical and mineral status of infertile boars, in particular, to establish changes in the main biochemical markers and assess the state of the antioxidant defence system and indicators of mineral homeostasis (Calcium, Phosphorus, Zinc, Copper, Manganese and Cobalt). In the experimental group of animals, a probably low level of vitamin A was noted (by 54.2 % lower than the control group, P ˂ 0.001) due to a significant increase in the content of thiobarbiturate acid-reactive compounds (by 2.32 times, P ˂ 0.001) and a decrease in the activity of catalase and superoxide dismutase (by 47.3 % and 28.8 %, respectively, P ˂ 0.001). A decrease in haemoglobin concentration by 14.3 % (Р ˂ 0.001), total protein by 11.6 % (Р ˂ 0.01), the number of erythrocytes by 9.3 % (Р ˂ 0.01) and acid capacity by 9.1 % (Р ˂ 0.05). These results demonstrate a general decrease in metabolic processes in the body of infertile boars with vitamin A deficiency. The reduced number of erythrocytes in the blood of boars of the experimental group was mainly due to antiradical and antihypoxic abilities. It should be noted that catalase activity and the content of reduced glutathione in erythrocytes were probably lower than the control indicators by 53.1 % and 16.3 % (Р ˂ 0.001), respectively. In addition, taking into account the reduced indicators of haemoglobin content and the number of erythrocytes, a negative dynamics of oxygen metabolism was established. This is also confirmed by a probable increase in the content of 2,3-diphosphoglycerate in erythrocytes (by 67.5 %, Р ˂ 0.001). Also, in boars of the experimental group, the content of Calcium was lower by 25.0 % (Р ˂ 0.001) than the control indicators, and the content of Phosphorus decreased by 12.6 % (Р ˂ 0.05). Similar changes were observed in the levels of Zinc and Copper (indicators were lower than the control by 52.0 % and 28.0 %, respectively, Р ˂ 0.001). Note that the Manganese content in the blood of experimental boars was reduced by 20.9 % (Р ˂ 0.05), while the Cobalt level was lower by 16.1 % (Р ˂ 0.05). The obtained results showed a significant effect of A-vitamin deficiency on the general antioxidant activity and mineral homeostasis in barren boars.

Detection of Blood Parasites in Fish

Fish are often infected with different blood protozoa of the genera Babesiosoma, Trypanosoma, and Hemogrigarina. These blood parasites match the genera which infect the blood of mammals. A total of 120 samples from five different fish species (Barbus grypus, Barbus sharpyi, Liza abu, Carasobarbus luteus, and Aspius vorax) were collected from the Khazar River in Ninevah Governorate, Iraq at weekly intervals during the period from April 2022 to October 2022 for the detection of blood parasites and hematological analysis. Thin and thick Giemsa stained blood smears revealed significant infection with Trypanosoma, Babes iosoma, and Haemogregarina which were recorded in 32%, 16%, and 8% of Carasobarbus luteus samples, respectively; 30%, 15%, and 10% of B. sharpyi samples, respectively; and 23.3%, 16.7%, and 6.7% of B. grypus samples, respectively. No infection with Trypanosoma or Babesiosoma were recorded in L. Abu, and no infection with Babesiosoma or Haemogregarina were recorded in A. vorax. Hematological parameters of blood samples from infected fish showed a significant decrease in hemoglobin concentration, total red blood cells, and stacked cell size along with a significant increase in the number of inflammatory cells including lymphocytes, eosinophils, and basophils. This is the first study to identify blood parasites in fishes and to monitor the changes of hematological parameters in blood samples of infected fishes from the waters of Mosul, Iraq.

Study of some epidemiological aspects and heamatological parameters associated with cutaneous leishmaniasis in Tikrit city

This study aimed to estimate the epidemiological prevalence of cutaneous Leishmaniasis, and it's distribution rate in Tikrit and affiliated towns and villages according to patients that attending Tikrit Teaching Hospital. This study recorded 531 cases of infections during the period from October 2011 till the end of September 2012. The results showed that the highest peak of infection was in December (35.59 %) , and infection in male was 50.66 % which was higher than female (49.34%). As well as the highest percentage of infection was represent in the age group under five years (47.65%). Also, the survey showed the higher percentage of infection was in the center of Tikrit city with 43.50 % and followed by towns and villages that affiliate to the city. This study also aimed to know the effect of cutaneous Leishmaniasis on some aspects of hematological parameters. In which the study recorded significant decrease in mean of packed cell volume (PCV) (36.57 ± 1.32، 34.73 ± 1.10) in males and females, respectively, compared with control (l(41.75 ± 1.45 ، 39.86 ± 1.10 in males and females, (respectively). Also, decrease in concentration of hemoglobin (Hb) (11.54 ± 0.41 , 10.97 ± 0.34) in both of males and females, respectively was recorded when they compared with control (13.13 ± 0.43 ، 12.56 ± 0.32 ) in male and females, (respectively). There are significant increased in the total count of white blood cells in both infected males and females (10750 ± 1251 , 9618 ± 935) was recorded when compared with control (6829 ± 655 , 9294 ± 1027 ) in male and females, (respectively).

Evaluation of subacute toxicity of a polyherbal nootropic formulation in Wistar albino rats

In ayurvedic system of traditional medicine, 'medhyarasayanas' — decoction of selected plants are used to improve intellect or cognition abilities. Here, we investigated one such polyherbal formulation (PHF) with ingredients Bacopa monniera, Glycyrrhiza glabra, Valeriana wallechii and Withania somnifera used as a facilitator of learning, retention and recall. We evaluated the safety of this PHF in animal models. We performed acute oral toxicity test using 2000 mg/kg of the formulation as per OECD guideline 423 and observed for toxicity over 14 days. Thereafter, we divided them into four groups of six animals each and administered Normal saline 5 mL/kg, The PHF (Wilmer®) @500, 1000 and 2000 mg/kg in the respective groups over 28 days. We observed no mortality or physical and behavioural abnormalities in both acute and subacute toxicity study. On the 28th day, animals were sacrificed, blood collected for estimation of haematological and biochemical parameters and histopathological examination of organs was performed. There was significant difference (P <0.05) in Mean ± SEM values of haemoglobin, total cholesterol, total protein, ALT, AST, ALP and serum creatinine in the test groups compared to control as analysed by One-way ANOVA followed by Tukey’s multiple comparison test. We observed steatosis and ballooning of hepatocytes, lymphocytic periglomerular infiltrate, eosinophilic hyaline casts and renal tubular coagulation necrosis in histopathology of test groups. Haematologic abnormalities (decrease in haemoglobin concentration), hepatotoxic, nephrotoxic and dyslipidemic effects of the tested PHF were seen in the rats in subacute toxicity study over 28 days, which could be due to the individual plant products, microbial contamination or heavy metals in the formulation in excess of regulatory limits. Hence, it needs further safety evaluation in animals and humans.

Studies on haematological changes in GI nematodes in cattle and buffalo in Udaipur, district (Rajasthan)

A study on prevalence of for gastrointestinal nematode in the infected and non-infected cattle and buffalo of Udaipur district (Rajasthan) from Sept. 2020 to January 2021 by haematological parameters such as haemoglobin (Hb), packed cell volume (PCV), erythrocyte sedimentation rate (ESR), total leucocyte Count (TLC) and differential leucocyte count (DLC). The highly significant decrease in haemoglobin concentration innematode infected and non-infected buffalo (8.65±0.2335 and 10.12±0.1077) and (8.63±0.2886 and 09.84±0.1411) in infected and in non-infected cattle, respectively. The packed cell volume showed highly significant decrease in nematode infected and non-infected buffalo (28.98±0.2101 and 32.94±0.2477) and (27.64±0.5337 and 30.65±0.3956) in infected and non-infected cattle, respectively. The highly significant decrease in erythrocyte sedimentation rate in nematode infected and non-infected buffalo (0.80±0.0245 and 1.00±0.0167) and in cattle was found to be in infected (0.63±0.0287) and in non-infected (0.97±0.0240), respectively.Total leukocyte count (TLC) value significant increase for infected and noninfected buffalo and cattle buffalo (8.53±0.2784 and 10.45±0.2538) and (8.36±0.2582 and 10.49±0.1689), respectively. In the infected buffalo neutrophils (32.96±0.3084), eosinophils (5.50±0.2049).Basophils (0), lymphocytes (62.36±0.2948) and monocytes (5.48±0.1831). However, in non-infected buffalo neutrophils (37.21±0.3701), eosinophils (4.60±0.2196), basophils (0), lymphocytes (57.21±0.2802) and monocytes (4.99±0.2094). Whereas, in infected cattle neutrophils (28.02±0.2914), eosinophils (5.74±0.1942) basophils (0), lymphocytes (67.48±0.2979) and monocytes (5.57±0.1547). However, in non-infected cattle neutrophils (32.15±0.3088), eosinophils (3.88±0.1836) basophils (0), lymphocytes (61.59±0.3475) and monocytes (5.23±0.1832).There is reduction in haemoglobin, packed cell volume and ESR in the GI nematode infected cattle and buffalo. In total leukocyte count in buffalo and cattle lymphocytes, eosinophils and monocyte showed increased in infected group.

РЕТИКУЛОЦИТАРНЫЕ И ЭРИТРОЦИТАРНЫЕ ИНДЕКСЫ В ОЦЕНКЕ АНЕМИЧЕСКОГО СИНДРОМА ПРИ ЮВЕНИЛЬНОМ ИДИОПАТИЧЕСКОМ АРТРИТЕ

The article presents the results of a study of erythrocyte and reticulocyte indi-ces in patients with juvenile idiopathic arthritis (JIA). The aim of the study was the possibility of early diagnosis of anemic syn-drome in patients with JIA based on the study of reticulocyte indices. Materials and methods. 118 patients with JIA at the age of 11 (6; 14) years underwent a general blood test with the determination of reticulocyte parameters. The comparison group included 30 healthy children. Results and conclusions. Revealed a significant decrease in hemoglobin (p = 0.001) less than 120 g/l in 22.9 % of patients with JIA. A statistically signif-icant difference from the comparison group was a decrease in the average concen-tration of hemoglobin in an erythrocyte (p = 0.03). An increase in the content of reticulocytes with a predominance of immature forms was found in 28.8 % of pa-tients with JIA. A decrease in the hemoglobin content in the reticulocyte and erythrocyte was detected in 28.8 and 44.9 % of cases. The systemic form of the disease affects erythropoiesis in the form of an increase in the content of reticulo-cytes with an increase in the content of immature forms (37.5 %), a decrease in the concentration of hemoglobin in the reticulocyte and erythrocyte (25 and 58.8 %).

Synergism of Azadirachta indica Seed and Nigella sativa on Plasmodium falciparum: Study on Wistar Rats

Aim: This study was carried out to determine the Phytochemical contents of Azadirachta indica seed and Nigella. sativa and their synergistic therapeutic effect on indices of clinical importance in malaria-induced male wistar rats.
 Study Design: The animals that were used for this study where divided into 4 groups of 6 rats each. All rats in the 3 test groups were inoculated with 0.2 ml blood parasitized with Plasmodium falciparum and observed for 3 days for manifestation of signs of malaria. Treatment with Azadirachta indica seed extract only, Nigella sativa extract only and a combination of Azadirachta indica seed and Nigella sativa extracts was conducted for a period of 14 days. Changes in weight of the rats and hematological parameters RBC, WBC,PCV and Hemoglobin were assessed before commencement of treatment and through the 14 day period.
 Place and Duration of Study: This study was conducted at the National Veterinary Research Institute (NVRI), Vom in collaboration with the Department of Biological Sciences Abubakar Tafawa Balewa University, Bauchi, Nigeria between March 2022 and May 2022. 
 Methodology: Azadirachta indica seed and Nigella sativa seeds were extracted with distilled water and the lethal doses (LD₅₀) were determined on the rats. Qualitative phytochemical screening of Azadirachta indica seed and Nigella sativa extracts was performed. Plasmodium infected rats were divided into 3 groups of 6 rats each and a normal control group which was left uninfected. Symptoms of malaria infection were observed three days after infection. The treatment was commenced on day 4 post-infection and was continued for a period of 14 days. Each plant extract and the mixture of both extracts were administered at 100, 200, and 300mg/kg body weight of the rats. After first 4 days, 7 days, and at 14 days of treatment each rat’s blood sample was taken for hematological analysis.
 Results: The plant extracts lethal dose (LD₅₀) was considered safe for Azadirachta indica seed at 5000mg/kg and 2000mg/kg for Nigella sativa respectively. Qualitative phytochemical screening revealed the presence of saponins, alkaloids, flavonoids, resins, glycosides, steroids in both Azadirachta indica seed extract and Nigella. sativa extract. Treatment with a mixture of both extracts showed a high restoration of red blood cell count with a significant (p>0.05) increase in RBC with a non-significant decrease in PCV and WBC. There was no significant decrease in hemoglobin concentration observed across all treatment groups at the end of the 14 day study.
 Conclusion; The combination of both Azadirachta indica seed and Nigella sativa is well tolerated and safe for Plasmodium parasites effects on wistar rats at concentration of 400mg/kg of body weight which showed highest values of restoration of RBC count as compared to the normal control group. Group A treated with only Nigella sativa also showed RBC count higher than that obtained in group B treated with only Azadirachta indica seed. PCV values compared with the normal control group showed an 8% increase at concentration of 400mg/kg at the end of the experiment in group C treated with the mixture of Azadirachta indica seed and Nigella sativa. At 200mg/kg concentration, the mixture of Azadirachta indica seed and Nigella. sativa gave a 25% increase in PCV values. This shows that the synergistic effect of Azadirachta indica seed and Nigella sativa has better therapeutic effects against Plasmodium parasites than either Nigella sativa or Azadirachta indica seed as a single therapy. This study provides a basis for the development of a cheaper plant-based antimalarial combination therapy.

Multicenter research of the dependence of skin graft engraftment and the concentration of blood hemoglobin, total serum protein and albumin

The Objective was to evaluate the effects of the concentration of blood hemoglobin, total serum protein and albumin on skin graft engraftment frequency.Methods and Materials. The study included 186 patients with full-thickness skin burn more than 5 % of total body surface area who were treated in five different burn departments of the Russian Federation. Depending on the readiness of the wounds, all performed surgical treatments were divided into four groups: 1) simultaneous skin graft after tangential necretomy; 2) simultaneous skin graft after radical necretomy; 3) skin graft for granulation wounds; 4) skin graft for a long time existing pathologically (hyper)granulation. Venous blood was taken from all the patients 12 hours before and 12–24 hours after skin graft. The concentration of blood hemoglobin, total serum protein and albumin was determined in the obtained samples. The evaluation of skin graft engraftment frequency was carried out by a combined method on the 7th day after skin graft. The data obtained were processed using descriptive and nonparametric statistics.Results. The concentration of total serum protein (p=0.001) and albumin (p=0.000) had a significant impact on the skin grafting results. This relationship was most pronounced during skin grafting on granulating wounds and after radical necretomy. The data obtained were identical for meshed and non-meshed skin grafts. Decrease in hemoglobin concentration did not lead to a degradation of skin grafts (p=0.068) in any of the study groups. According to the results of the laboratory parameters ranking, it was found that maintaining the concentration of total serum protein more than 6 g/dL allows 1.3 times to improve the results of skin grafting, and albumin concentrations more than 3.5 g/dL – 1.4.Conclusion. During the study, we were unable to confirm the existence of a relationship between the concentration of blood hemoglobin and the results of skin graft engraftment by any of the statistical analysis methods in any of the study groups. Accordingly, the inability to transfuse erythrocytes to a patient with anemia below 9–8 g/dL cannot be considered as an absolute contraindication for early surgical treatment of burned patients. Apparently, the concentration of total serum protein and albumin has a much greater effect on the skin grafting results. Trigger values of total serum protein can be recognized as 6 g/dL (albumin – 3.5 g/dL), which provides good results of engraftment in at least 90 % of operated patients.

Decreased Haemoglobin Level Measured at Admission Predicts Long Term Mortality after the First Episode of Acute Pulmonary Embolism.

Background: Decreased hemoglobin concentration was reported to predict long term prognosis in patients various cardiovascular diseases including congestive heart failure and coronary artery disease. We hypothesized that hemoglobin levels may be useful for post discharge prognostication after the first episode of acute pulmonary embolism. Therefore, the aim of the current study was to evaluate a potential prognostic value of a decreased hemoglobin levels measured at admission due to the first episode of acute PE for post discharge all cause mortality during at least 2 years follow up. Methods: This was a prospective, single-center, follow-up, observational, cohort study of consecutive survivors of the first PE episode. Patients were managed according to ESC current guidelines. After the discharge, all PE survivors were followed for at least 24 months in our outpatient clinic. Results: During 2 years follow-up from the group of 402 consecutive PE survivors 29 (7.2%) patients died. Non-survivors were older than survivors 81 years (40−93) vs. 63 years (18−97) p < 0.001 presented higher sPESI 2 (0−4) vs. 1 (0−5), p < 0.001 driven by a higher frequency of neoplasms (37.9% vs. 16.6%, p < 0.001); and had lower hemoglobin (Hb) level at admission 11.7 g/dL (6−14.8) vs. 13.1 g/dL (3.1−19.3), p < 0.001. Multivariable analysis showed that only Hb and age significantly predicted all cause post-discharge mortality. ROC analysis for all cause mortality showed AUC for hemoglobin 0.688 (95% CI 0.782−0.594), p < 0.001; and for age 0.735 (95% CI 0.651−0.819) p < 0.001. A group of 59 subjects with hemoglobin < 10.5 g/dL showed mortality rate of 16.9% (OR for mortality 4.19 (95% CI 1.82−9.65), p-value < 0.00, while among 79 patients with Hb > 14.3 g/dL only one death was detected. Interestingly, patients in age > 64 years hemoglobin levels < 13.2 g/dL compared to patients in the same age but with >13.2 g/dL showed OR 3.6 with 95% CI 1.3−10.1 p = 0.012 for death after the discharge. Conclusions: Lower haemoglobin measured in the acute phase especially in patients in age above 64 years showed significant impact on the prognosis and clinical outcomes in PE survivors.

Uterine Exteriorization Versus In Situ Repair in Cesarean Delivery: A Systematic Review and Meta-Analysis

(Can J Anesth/J Can Anesth. 2022;69:216–2123) Optimizing surgical technique is an important part of improving outcomes in cesarean delivery. It is unclear whether uterine exteriorization is associated with hemostasis benefits, and if there is a benefit, it is unclear if that outweighs the risks of nausea and vomiting. This review aimed to compare uterine exteriorization for cesarean delivery with in situ repair. The primary outcome of the study was intraoperative nausea and vomiting (IONV) and decrease in hemoglobin concentration.

Recipient-Specific Antibodies (RSA) in Mismatched Related Transplants May Induce Transplant-Associated Thrombotic Microangiopathy (TA-TMA)

HLA incompatibility increases the risk of transplant-related complications. Specifically, donor-specific antibodies (DSA) in mismatched related transplants (mm-HCT) increase the risk of graft failure. Less is known about the role of recipient-specific antibodies (RSA) detected in donors, as the immune status of the donor is not routinely examined before transplant with regard to anti-HLA antibodies. These antibodies may be transferred together with transplanted cells or produced by memory donor cells. We hypothesize that donor-derived RSA may induce immune-mediated complement activation in the classical pathway (CH50), leading to overproduction of membrane attack complex (MAC) and exacerbation of endothelial damage. Here we present preliminary epidemiological data regarding the presence of DSA and RSA, and the impact of RSA antibodies on transplant-related complications, especially transplant-associated thrombotic microangiopathy (TA-TMA) and acute graft-versus-host disease (aGvHD). Methods We prospectively analyzed the presence of anti-HLA antibodies in 20 pairs of donors and recipients qualified for mm-HCT. All recipients suffered from hematological malignancies and received a myeloablative conditioning regimen and immunosuppression consisting of post-transplant cyclophosphamide, tacrolimus, and mycophenolate mofetil. Patients’ and donors’ immunization status were tested with the solid phase method. Tests were carried out using a flow fluorometer across the screening range (Luminex Screen, One Lambda, USA). In the group of positive samples for anti-HLA class I and/or II antibodies, identification of the specificity of the HLA antibodies was performed (Luminex Single Antigen Beads, One Lambda, USA). Reagents enabling the determination of anti-HLA antibodies in the IgG class were used. All results were presented as mean fluorescence intensity (MFI) values. Monitoring of complement activation on days 30, 60, and 100 post-transplant was started after completing epidemiological data in the first 10 pairs. All patients were checked for TA-TMA and GvHD development during routine post-transplant visits. TA-TMA screening included TA-TMA triad: hypertension or kidney injury, LDH increase and decrease in number of platelets or refractoriness to transfusions, and additionally decrease in hemoglobin concentration, proteinuria, and clinical presentation with TA-TMA involved organ damage. Schistocytes as non-objective and nonrepeatable markers were excluded from diagnostic criteria. Results Anti-HLA antibodies were detected in 9/20 (45%) of recipients, and in 9/20 (45%) of the donors despite the lack of any transfusion history in donor group. Neither the presence of DSA nor RSA was affected by gender. RSAs were present more often in donors (7/9; 77%) than DSAs in recipients (2/9; 22%); p=0.052. Data summarizing MFI values and type of antibodies are presented in table 1. Laboratory diagnosis of TA-TMA met 12/20 (60%) patients, with a significant clinical presentation including severe hypertension (3) pericarditis (1), gastrointestinal (5), or neurological (6) impairment in 8/12 (66%). All patients with RSA (7/7; 100%) developed TA-TMA compared to no-RSA group (5/13; 38%) (p<0.01). TA-TMA-mediated organ damage was noticed more often in the RSA population (5/7; 71%) compared to the no-RSA group (3/13, 23%) (p<0.01); (Table 2). A trend for higher activation of CH50 and MAC in RSA compared to a no-RSA group was noted with a mean CH50 93 vs. 82 (p=0,16), and MAC 1428 vs. 1007 (p=0,24) respectively. A trend for higher maximum concentrations of tacrolimus 14 vs 10.7 (p=0.07) was observed in patients with TA-TMA. There was no impact of ABO incompatibility on TA-TMA development. During the time of observation 6 patients (30%) developed aGvHD - grades I, II, and III were diagnosed in 3, 1, and 2 patients respectively. Only 1 patient with RSA developed aGvHD. There was no correlation between RSA and GvHD occurrence (RSA 1/7, no-RSA 5/13, p=0.26) and between aGvHD and TA-TMA. CMV reactivation was documented in 13/20 (65%) patients, with no differences between the RSA and no-RSA groups (p=0.65). Conclusions RSAs occur surprisingly often in the donor population, irrespectively to the donor`s gender and the lack of transfusions history. The exact role of these antibodies is not fully understood; however, our data may suggest their impact on complement activation and TA-TMA induction. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Intraoperative cell salvage using swab wash and serial thromboelastography in elective abdominal aortic aneurysm surgery involving massive blood loss.

The loss of 50% blood volume is one accepted definition of massive haemorrhage, which ordinarily would trigger the massive transfusion protocol, involving the administration of high ratios of fresh frozen plasma and platelets to allogeneic red cells. We investigated 53 patients who experienced >50% blood loss during open elective abdominal aortic aneurysm surgery to assess allogeneic blood component usage and coagulopathy. Specialist patient blood management practitioners used a tailored cell salvage technique including swab wash to maximise blood return. We assessed the proportion of patients who did not require allogeneic blood components and develop evidence of coagulopathy by thromboelastography (TEG) parameters. Blood loss was 50%-174% (mean [SD] 68% [27%]) of blood volume. The mean (SD) intraoperative decrease in haemoglobin concentration, assessed by arterial blood gas analysis, was 5(13)g/l. No patient received allogeneic red cells intraoperatively. Four of the 53 (8%) patients received blood components in the first 24 h postoperatively at the anaesthetists' discretion. No patient had intraoperative TEG changes indicative of fibrinolysis or coagulopathy. The 30-day mortality was 2% (one of 53). Reduction of allogeneic transfusion is one aim of patient blood management techniques. We have demonstrated virtual avoidance of allogeneic blood product transfusion despite massive blood loss. These data show possible alternatives to the current massive transfusion protocols to the management of elective vascular surgical patients.

Clinical characteristics and risk factors of in-hospital gastrointestinal bleeding in patients with acute myocardial infarction.

BackgroundGastrointestinal bleeding (GIB) is one of the most serious complications of acute myocardial infarction (AMI) and is correlated with poor outcomes.ObjectiveTo evaluate the prevalence, risk factors and in-hospital mortality of GIB in patients with AMI.MethodsThis observational case-control study retrospectively enrolled consecutive patients with AMI from the Department of Cardiovascular Medicine and Cardiovascular Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to December 2020. GIB after AMI was identified by International Classification of Diseases (ICD) codes from inpatient medical settings and validated by medical record review. AMI patients without GIB were accordingly classified as the control group. Propensity score matching (PSM) was used to match with the GIB group and the control group. All anonymized clinical data were provided by the Biobank of the First Affiliated Hospital of Xi'an Jiaotong University.ResultsA total of 5,868 AMI patients were enrolled, 0.87% (51/5,868) of whom developed GIB after AMI. On the univariate analysis, history of diabetes, chronic kidney disease, Killip IV, a lower hemoglobin concentration, a higher serum level of creatinine, blood urea nitrogen and D-dimer were closely associated with the risk of GIB (P < 0.05). On the multivariable analysis, a lower hemoglobin concentration (OR: 0.93, 95% CI: 0.89–0.96, P < 0.001) was independently associated with the risk of GIB. Patients with GIB had a much higher in-hospital mortality rate than those without GIB (14.3 vs. 2.1%, P = 0.047). In-hospital mortality among patients with GIB after AMI appeared to be associated with a decreased hemoglobin concentration (OR: 0.93, 95% CI: 0.86–0.99, P = 0.045) and Killip IV (OR: 51.59, 95% CI: 2.65–1,005.30, P = 0.009).ConclusionThe history of diabetes, poor renal function and heart failure were associated with the high risk of GIB in patients experiencing AMI. The in-hospital mortality in patients with AMI complicating GIB was higher than that in patients without GIB and was associated with a decreased hemoglobin concentration and high Killip classification.

Can ten days of heat acclimation training improve temperate-condition rowing performance in national-level rowers?

This study investigated whether heat acclimation (HA) could improve rowing performance in temperate conditions in national-level rowers. Using a parallel-group design, eleven rowers (3 female, 8 male, age: 21±3 years, height: 182.3±6.8cm, mass: 79.2±9.0kg, [Formula: see text]: 61.4±5.1ml·kg·min-1) completed either a HA intervention (HEAT, n = 5) or acted as controls (CON, n = 6). The intervention replaced usual cross-training sessions and consisted of an hour of submaximal cycling or rowing ergometry in either 34±0°C for HEAT or 14±1°C for CON daily over two five-day blocks (10 sessions total), separated by 72h. Participants performed the '10+4' test that consists of 10-min submaximal rowing and a 4-min time-trial (TT) in temperate conditions (20±0°C) before and after the intervention. Heat acclimation following the 10-session intervention was evidenced by large significant (p<0.05) decreases in maximum tympanic temperature (d = -1.68) and rate of perceived exertion (RPE) (d = -2.26), and a large significant increase in sweat loss (d = 0.91). Large non-significant (p>0.05) decreases were seen in average tympanic temperature (d = -3.08) and average heart rate (d = -1.53) in HEAT from session 2 to session 10 of the intervention. Furthermore, a large significant increase was seen in plasma volume (d = 3.74), with large significant decreases in haemoglobin concentration (d = -1.78) and hematocrit (d = -12.9). Following the intervention, large non-significant increases in respiratory exchange ratio (d = 0.87) and blood lactate (d = 1.40) as well as a large non-significant decrease in RPE (d = -1.23) were seen in HEAT during the 10-min submaximal rowing. A large significant decrease in peak heart rate (d = -2.27), as well as a large non-significant decrease in relative [Formula: see text] (d = -0.90) and large non-significant increases in respiratory exchange ratio (d = 1.18), blood lactate concentration (d = 1.25) and power output (d = 0.96) were seen in HEAT during the 4-min TT. This study suggests that a 10-session HA intervention may elicit HA in national-level rowers, with potential to improve 4-min TT performance in temperate conditions.

Ulvan-Based Nanofibrous Patches Enhance Wound Healing of Skin Trauma Resulting from Cryosurgical Treatment of Keloids.

Keloids are skin fibroproliferative disorders, resulting from abnormal healing of deep cutaneous injuries. Cryosurgery, the most common treatment for keloids, causes skin traumas. Even though the clinical practice of cryosurgery has increased, effective wound healing therapy is still lacking. In this investigation, nonwoven nanofibrous patches composed of ulvan, a marine sulfated polysaccharide exhibiting anti-inflammatory and antioxidant activities, and polyethylene oxide (PEO) were fabricated through electrospinning and characterized. Their wound healing efficacy on skin traumas resulting from cryosurgical treatment of keloids was clinically tested and evaluated in comparison to a reference product. Twenty-four volunteer patients undergoing cryosurgery as a treatment of keloids were selected to apply either the ulvan/PEO patch or the reference product for 21 days. The ulvan/PEO patch, 21 days after cryosurgery, showed significant wound healing, elimination of skin inflammation, restoration of biophysical parameters similar to normal values and significant decrease in haemoglobin concentration, skin texture and volume, while no discomfort or adverse reaction was observed. In contrast, the reference product showed inferior performance in all evaluated parameters. The designed ulvan/PEO patch represents the first wound dressing to effectively heal skin trauma after cryosurgical treatment of keloids.

Effects of iron supplementation on microcytic and hypochromic red blood cells during the third trimester of pregnancy.

Mild anaemia often occurs in the third trimester of pregnancy. Particularly in the Hb range between 101-110 g/L it is difficult to determine whether the decreased haemoglobin concentration is physiological or pathological and whether supplementation is required. The aim of this study was to gain insight into the added value of measuring the percentages of microcytic RBCs (%MicroR) and hypochromic RBCs (%Hypo-He) for monitoring effects of iron supplementation in case of suspected iron-deficient erythropoiesis (IDE) in the third trimester of pregnancy. After assessing haematological parameters and zinc protoporphyrin/heme ratio as marker for IDE, subjects were classified into a group with symptoms of IDE (n=39) or without IDE (n=106). The subjects with IDE (n=39) were treated with iron supplementation. After 4 weeks effects of treatment were evaluated. In the group of pregnant women with IDE results of %MicroR and %Hypo-He were increased (p=<.001), compared to the group without haematological symptoms of IDE, whereas RET-He, RBC-He and delta-He were decreased (p=<.001). A significant positive correlation to increased values of %MicroR (r=.75, p=<.001) and %Hypo-He (r=.77, p=<.001) with ZPP was established. However, in the ZPP interval 75-100 μmol/mol heme a slight overlap was demonstrated between subjects with and without symptoms of IDE. After iron supplementation, %Hypo-He decreased (p=.002) while %MicroR remained stable. RET-He, delta-He and RDW-SD increased (p=<.001). The added value of %MicroR and %Hypo-He as a single marker for IDE is poor. However, combined interpretation of %MicroR, %Hypo-He, Ret-He and delta-He has added value in monitoring erythropoiesis during pregnancy.

Faktor-Faktor yang Mempengaruhi Kepatuhan Ibu Hamil dalam Mengkonsumsi Tablet Fe: Literature Review

Anemia in pregnant women is a condition where there is a lack of red blood cells or hemoglobin. A condition where in the first and third trimesters there is an increase in plasma volume in a greater proportion than the increase in erythrocytes, resulting in a decrease in hemoglobin concentration (Hb) which causes hemoglobin levels to fall below 11.0 g/dl or in the second trimester &lt; 10.5 g/dl. dl due to hemodilution. The purpose of this literature review study was to determine the factors that influence the compliance of pregnant women in consuming Fe tablets. This research method used a literature review method and uses databases such as Pubmed, Google Scholar and Health Profiles with a vulnerable publication period of the last 10 (ten) years. The results from several journals show that there were several factors that influence the compliance of pregnant women in consuming Fe tablets, namely knowledge, attitudes, family support, support from health workers, frequency of ANC visits, and age. Some of these factors show a significant relationship to the effect of pregnant women's compliance in consuming Fe tablets. Conclusion: the factors that influence the compliance of pregnant women in consuming Fe tablets are knowledge, attitudes, family support, support from health workers, frequency of ANC visits, and age.

Role of DOAC plasma concentration on perioperative blood loss and transfusion requirements in patients with hip fractures.

There is an ever-increasing number of hip fracture (HF) patients on direct oral anticoagulants (DOAC). The impact of DOAC plasma level prior to HF surgery on perioperative blood loss and transfusion requirements has not been investigated so far. In this retrospective study of HF patients on DOACs admitted to the AUVA Trauma Center Salzburg between February 2015 and December 2021. DOAC plasma levels were analysed prior to surgery. Patients were categorized into four DOAC groups: Group A < 30ng/mL, Group B 30-49ng/mL, Group C 50-79ng/mL, and Group D ≥ 80ng/mL. Haemoglobin concentration was measured upon admission, prior to surgery, after ICU/IMC admission, and on day 1 and 2 post-surgery. Difference in the blood loss via drains, transfusion requirements and time to surgery were compared. A total of 155 subjects fulfilled the predefined inclusion criteria. The median age of the predominantly female patients was 86 (80-90) years. Haemoglobin concentration in Group D was lower upon admissions but did not reach statistical significance. The decrease in haemoglobin concentration over the entire observation time was comparable between groups. Blood transfusion requirements were significantly higher in Group D compared to Group A and B (p = 0.0043). Time to surgery, intra- and postoperative blood loss via drains were not different among groups. No strong association between the DOAC plasma levels and perioperative blood loss was detected. Higher transfusion rates in patients with DOAC levels ≥ 80ng/mL were primarily related to lower admission haemoglobin levels. DOAC concentration measurement is feasible and expedites time to surgery.

Dietary administration of Bacillus subtilis , inulin and its synbiotic combination improves growth and mitigates stress in experimentally infected Pseudoplatystoma reticulatum

Juveniles of Pseudoplatystoma reticulatum (36.25 g and 19.32 cm) were randomly distributed in 16 tanks with 80 L of water. The fish were fed with diets containing probiotic (2%), prebiotic (0.5%), synbiotic (2% probiotic +0.5% prebiotic) and diet without additives (control). After 60 days of feeding, the fish were challenged with inoculation of the Aeromonas hydrophila (0.9 × 106 CFU/mL). Growth performance, physiological, immunological and haematological analyses were evaluated. Fish fed with probiotic, inulin and synbiotic diet showed greater (p = 0.018) weight gain when compared to control fish, and the condition factor was better (p < 0.001) in fish fed with probiotic. Cortisol concentrations increased in all treatments after challenge (p = 0.27), however, after A. hydrophila injection of 6 h, the cortisol levels increased significantly in fish that received control diet. The haematocrit (p < 0.001) and lymphocytes percentages (p < 0.001) decreased after A. hydrophila injection of 3 and 6 h, and neutrophils percentages increased (p < 0.001), without difference among treatments. The not supplemented and supplemented with prebiotic and synbiotic fish groups had decreased haemoglobin concentration (p = 0.01) at after 3 and 6 h. The juvenile catfish fed with probiotic (2% Bacillus subtilis), prebiotic (0.05% inulin) and the synbiotic combination for 60 days had better productive performance, ensuring greater weight gain and growth. The supplemented diets inhibited the cortisol increase when fish are challenged with A. hydrophila, but it does not inhibited the effects of the stress imposed by the bacterial infection.

Analysis of Selected Nutritional Parameters in Patients with HPV-Related and Non-HPV-Related Oropharyngeal Cancer before and after Radiotherapy Alone or Combined with Chemotherapy.

Simple SummaryThe aim of this study was to assess and compare the nutritional status (NS) of patients with HPV-related (HPV+) and non-HPV-related (HPV-) oropharyngeal cancer (OPC) before and after radiotherapy (RT) or chemoradiotherapy (CRT). The analysis included 127 patients with OPC who underwent radiotherapy (RT) alone, or in combination with chemotherapy (CRT). In both groups, a significant decrease in all analyzed nutritional parameters was noted after RT/CRT. Overall survival (OS) and disease-free survival (DFS) were significantly better in patients with a higher BMI in the HPV- group; DFS was significantly better in patients with total lymphocyte count (TLC) >1.28/mm3 in the HPV+ group. Higher NRS 2002 was an independent adverse prognostic factor for OS and DFS in HPV-, but not in the HPV+ group. Regardless of HPV status, patients with OPC can develop malnutrition during RT/CRT. Therefore, nutritional support during RT/CRT is required in patients with HPV- and HPV+ OPC.Background: Radiotherapy plays an essential role in the treatment of oropharyngeal carcinoma (OPC). The aim of this study was to assess and compare the nutritional status (NS) of patients with HPV-related (HPV+) and non-HPV-related (HPV-) OPC before and after radiotherapy (RT) or chemoradiotherapy (CRT). Methods: The analysis included 127 patients with OPC who underwent radiotherapy (RT) alone, or in combination with chemotherapy (CRT), in the I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (formalin-fixed, paraffin-embedded) tissue material and/or extracellular circulating HPV DNA. Basic anthropometric and biochemical parameters before and after RT/CRT were compared between the HPV- and HPV+ groups. The effect of NS on survival was also analyzed. Results: In both groups, a significant decrease in all analyzed nutritional parameters was noted after RT/CRT (p < 0.01). CRT caused significant weight loss and decreases in BMI, albumin, total lymphocyte count (TLC), and hemoglobin concentration, as well as an increase in the Nutritional Risk Score (NRS) 2002, in HPV- and HPV+ patients. A significant decrease in prealbumin levels after CRT was noted only in HPV+ patients. RT caused a significant decrease in hemoglobin concentration and TLC in HPV- patients. There were no significant differences regarding other nutritional parameters after RT in either group. RT did not have negative impact on body mass index (BMI), weight, NRS, CRP, Alb, Prealb, or PNI. Overall survival (OS) and disease-free survival (DFS) were significantly better in patients with a higher BMI in the HPV- group (OS, p = 0.011; DFS, p = 0.028); DFS was significantly better in patients with C-reactive protein (CRP) < 3.5 g/dL in the HPV- (p = 0.021) and HPV+ (p = 0.018) groups, and with total lymphocyte count (TLC) >1.28/mm3 in the HPV+ group (p = 0.014). Higher NRS 2002 was an independent adverse prognostic factor for OS and DFS in HPV-, but not in the HPV+ group. Kaplan–Meier analysis showed that both OS and DFS were significantly better in HPV- patients with lower NRS 2002 scores. However, this relationship was not observed in the HPV+ group. Conclusions: Regardless of HPV status, patients with OPC can develop malnutrition during RT/CRT. Therefore, nutritional support during RT/CRT is required in patients with HPV- and HPV+ OPC.