Blood Hemoglobin Concentration Research Articles

Increased blood reactive oxygen species and hepcidin in obstructive sleep apnea precludes expected erythrocytosis.

Obstructive sleep apnea (OSA) causes intermittent hypoxia during sleep. Hypoxia predictably initiates an increase in the blood hemoglobin concentration (Hb); yet in our analysis of 527 patients with OSA, >98% did not have an elevated Hb. To understand why patients with OSA do not develop secondary erythrocytosis due to intermittent hypoxia, we first hypothesized that erythrocytosis occurs in these patients, but is masked by a concomitant increase in plasma volume. However, we excluded that explanation by finding that the red cell mass was normal (measured by radionuclide labeling of erythrocytes and carbon monoxide inhalation). We next studied 45 patients with OSA before and after applying continuous positive airway pressure (CPAP). We found accelerated erythropoiesis in these patients (increased erythropoietin and reticulocytosis), but it was offset by neocytolysis (lysis of erythrocytes newly generated in hypoxia upon return to normoxia). Parameters of neocytolysis included increased reactive oxygen species from expanded reticulocytes' mitochondria. The antioxidant catalase was also downregulated in these cells from hypoxia-stimulated microRNA-21. In addition, inflammation-induced hepcidin limited iron availability for erythropoiesis. After CPAP, some of these intermediaries diminished but Hb did not change. We conclude that in OSA, the absence of significant increase in red cell mass is integral to the pathogenesis, and results from hemolysis via neocytolysis combined with inflammation-mediated suppression of erythropoiesis.

Combined use of handgrip strength and hemoglobin as markers of undernutrition in patients with stage 3–5 chronic kidney disease

Background and aimsThe early identification of undernourished patients with CKD could help instating appropriate nutritional intervention before the full development of the threatening condition known as Protein Energy Wasting (PEW). Handgrip strength (HGS) and blood hemoglobin (Hb) concentration are two parameters considered representative of nutritional status but not included among the criteria for PEW diagnosis. In the present work we investigated whether they could help identifying CKD patients at risk of undernutrition. Methods and resultsWe performed a two-step cluster analysis to classify a cohort of 71 stage 3–5 CKD patients, none of which with PEW, according to their Hb concentration and dominant-hand HGS. Two clusters were finely separated using this method. When we compared the two groups for main body composition and nutritional variables by using t-test statistics or Mann–Whitney test, as appropriate, we found significant differences in PhA, ECW/TBW, ASMI, serum iron. Then we stratified our population by gender and performed cluster analysis as well. PhA, ECW/TBW were still significantly different in the two clusters both in M and in F, while serum iron concentration only in males and ASMI only in females. ConclusionThese results suggest that either in male than in female Hb concentration and HGS may distinguish two subgroups of CKD patients with different nutritional status and disease severity. Patient belonging to either of these cluster can be easily identified by using the HGS/Hb ratio which represents the HGS normalized per gr Hb.

Safety and efficacy of waterjet debridement vs. conventional debridement in the treatment of extremely severe burns: A retrospective analysis

IntroductionPatients with extremely severe burns often require rapid wound closure with a tangential excision or escharectomy combined with a skin graft to reduce life-threatening complications such as infection. Traditional tangential excision surgery using the Watson or Humby knife does not allow accurate excision of necrotic tissue and often removes too much active tissue, which is detrimental to the rapid healing of the wound. Importantly, the Versajet hydrosurgical system, with its smaller handle, allows for more precise excision of necrotic burn tissue and preserves more active dermal tissue, positively affecting wound healing and scarring. This study compared the safety and efficacy of hydrosurgical combined with autologous skin grafting to conventional excision combined with autologous skin grafting in patients with extremely severe burn. MethodsInformation of sixty burn patients with total body surface area (TBSA) > 50 % treated at the first affiliated hospital of Anhui Medical University from January 2019 to August 2022 were analyzed. The patients were divided into a conventional debridement group (n = 37) and a hydrosurgical debridement group (n = 23) according to the approach used. The hydrosurgical debridement group and the conventional debridement group were compared from the difference between the duration of the first debridement surgery, wound healing time, the changes of red blood cells and hemoglobin concentration postoperative, total blood transfusion, hospitalization cost, skin grafting frequency, procalcitonin, wound bacterial culture, albumin and prealbumin. ResultsInformation on age, gender, weight, inhalation injury, hypovolemic shock, preoperative procalcitonin, preoperative albumin, preoperative prealbumin, the operation frequency (n ≥ 3), preoperative trauma culture and postoperative trauma culture were compared between both groups (P > 0.05). Operative time and wound healing time were significantly shorter in patients with hydrosurgical debridement combined with autologous skin grafting than those in the control group (P < 0.05), while hospitalization costs were not significantly different between the two groups (P > 0.05). The changes of red blood cells and hemoglobin concentration during the postoperative period in the hydrosurgical debridement group were less significantly than those in the conventional debridement group (P < 0.05). The total amount of red blood cells transfused during hospitalization was significantly lower in the hydrosurgical debridement group than that in the conventional debridement group (P < 0.05), but the total amount of fresh frozen plasma transfused during hospitalization was not statistically significant between the two groups (P > 0.05). Albumin on the third day after surgery and prealbumin on the first, third and fifth day after surgery improved more significantly than those in the control group(P < 0.05), however, there were no significant differences between the two groups in albumin on the first and fifth postoperative days (P > 0.05). The PCT level in the conventional debridement group was significantly higher than that in the hydrosurgical debridement group on the first, third and fifth days after surgery(P < 0.05). ConclusionThe hydrosurgical debridement group presented with shorter operative time, less blood loss during surgery, faster postoperative nutritional recovery, less postoperative inflammatory response and faster wounds healing, and did not increase the hospitalization cost, postoperative bacterial culture of the wounds and the number of skin grafting surgeries. In patients with extremely severe burn, hydrosurgical debridement combined with autologous skin grafting group is safer and more effective than those in the conventional debridement combined with autologous skin grafting group.

Tranexamic Acid Treatment Reduces Blood Loss After Elective and Semi-Urgent Reverse Total Shoulder Arthroplasty.

Post operative blood loss after reverse shoulder arthroplasty (RSA) is associated with the need for blood transfusion and prolonged hospital stay, among other complications. Tranexamic acid (TXA) reduces perioperative blood loss and is effective when delivered systemically or locally. We compared the effects of TXA on perioperative blood loss between elective and semi-urgent RSA. We retrospectively reviewed patients who underwent either elective or semi-urgent RSA for fracture repair, with and without TXA treatment. Demographics, clinical records, and laboratory results were collected and analyzed to compare peripheral blood hemoglobin concentrations before and after surgery, the need for blood transfusion, and length of hospital stay between the 2 groups. In a cohort of 158 patients, 91 (58%) underwent elective RSA. TXA was administered in 91 (58%) patients from the entire group. TXA administration was associated with a significant decrease in post operative hemoglobin concentration reduction in both the elective and fracture groups (P = .026 and P = .018, respectively), a significant decrease in post operative blood transfusion rates (P = .004 and P = .003, respectively), and a decrease in the need for prolonged hospitalization (P = .038 and P = .009, respectively). The local application of TXA during RSA yielded a significant reduction in perioperative blood loss. We showed a significant positive effect of local TXA administration during RSA that is comparable for both elective and semi-urgent patients. Due to the baseline characteristics of fracture patients, their clinical benefits may be more notable. The positive outcomes for surgical patients with the use of TXA during RSA can possibly cause future consideration in clinical practice.

Evaluation of the therapeutic potential of vomit seed (Strychnos nux-vomica) homeopathic treatment in acute acetaminophen-induced toxicity

Purpose: To investigate the effect of vomit seed homeopathic drugs (14CH and 30CH) on paracetamolinduced toxicity in rats.&#x0D; Methods: Thirty-two male Wistar rats were divided into 4 groups of 8 animals each (n = 8) and treated for 12 days. During the treatment period, group (G) one (G1) which constitutes the control group received filtered water, whereas groups two (G2), three (G3), and four (G4) were gavaged with a toxic dose of paracetamol 1/4 of LD50. Next, Strychnos nux-vomica (0.5 mg/kg) homeopathic dilutions of 14CH and 30CH were administered to G3 and G4, respectively. Hematological, biochemical, and antioxidant markers were assessed.&#x0D; Results: Homeopathic drug groups, namely G3 and G4, showed significant recovery in some hematological (red blood cells count and hemoglobin concentration; p &lt; 0.01) and biochemical parameters (urea, creatinine, glutamic transaminase, and alkaline phosphatase; p &lt; 0.001). The level of malondialdehyde significantly decreased while glutathione level significantly increased in treated rats.&#x0D; Conclusion: The antioxidant and anti-hemolytic properties of vomit seeds protect against paracetamolinduced acute toxicity in rats by reducing oxidative stress, hepatotoxicity, and nephrotoxicity in rats.

Prognostic Significance of Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) Score in Hepatocellular Carcinoma.

HALP score consisting of hemoglobin content, albumin content, lymphocyte count, and platelet count can comprehensively evaluate the inflammatory response and nutritional status. Many researchers have indicated that the HALP score is an effective predictor of the overall prognosis of various tumors. However, there is no relevant research to suggest whether the HALP score can predict the prognosis of patients with hepatocellular carcinoma (HCC). We retrospectively analyzed 273 HCC patients who underwent surgical resection. Hemoglobin content, albumin content, lymphocyte count, and platelet count in peripheral blood were measured for each patient. The relationship between the HALP score and overall survival (OS) was investigated. With a mean of 56.69 ± 1.25 months follow-up, the 1-, 3-, and 5-year OS was 98.9%, 76.9%, and 55.3% for all patients, respectively. HALP scores (HR=1.708, 95% CI=1.192-2.448, P=0.004) were significant independent risk factors of OS. The 1-, 3-, and 5-year OS were 99.3%, 84.3%, and 63.4% for patients with high HALP scores; and 98.6%, 69.8%, and 47.5% for patients with low HALP scores, respectively (P=0.018). In TNM I-II stage patients, compared with high HALP scores, low HALP scores have worse OS (P=0.039). In AFP positive patients, compared with high HALP scores, low HALP scores have worse OS (P=0.042). Our research showed the preoperative HALP score is an independent predictive factor of overall prognosis, and a low HALP score indicates a worse prognosis in HCC patients who underwent surgical resection.

Effect of Date Juice and Coconut Water on Hemoglobin (Hb) Levels in Anemia Gravidarum

Anemia is something condition where amount cell blood red or hemoglobin concentration in it more low from usually. Deep anemia pregnancy is condition mother with hemoglobin levels (Hemoglobin) in blood more low from 11 gr/dl. Knowing influence giving juice dates (Phoenix dactylifera .L ) and coconut water (Coconut water) against mother's hemoglobin ( Hb ) level pregnant with anemia trimester III at the health center babelan. This study use Quasi experiment with pretest- posttest with control group design. Taking sample done use technique purposive sampling amounted to 34 mothers third trimester of pregnancy consisting of 17 people group intervention and 17 person groups control. Instrument study is form sheet observation, informed consent, date juice drink and coconut water data analysis used descriptive statistics and paired t-test to know difference score before and after intervention. There is difference average rate hemoglobin pretest and posttest given juice dates Phoenix dactylifera .l ) and water coconut  (Coconut water) with paired t-test results obtained Value 0.000 (p &lt;0.05). There is influence gift juice dates (Phoenix dactylifera .l) and water coconut (Coconut water) to rate hemoglobin ( Hb ) mother pregnant with anemia trimester III at the health center babelan 2023. Expected drink dates (Phoenix dactylifera .l ) and water coconut (Coconut water).It can be one choice non-pharmacological drugs in increase hemoglobin level on mother pregnant trimester III.

Allometric scaling of metabolic rate and cardiorespiratory variables in aquatic and terrestrial mammals.

While basal metabolic rate (BMR) scales proportionally with body mass (Mb ), it remains unclear whether the relationship differs between mammals from aquatic and terrestrial habitats. We hypothesized that differences in BMR allometry would be reflected in similar differences in scaling of O2 delivery pathways through the cardiorespiratory system. We performed a comparative analysis of BMR across 63 mammalian species (20 aquatic, 43 terrestrial) with a Mb range from 10 kg to 5318 kg. Our results revealed elevated BMRs in small (>10 kg and <100 kg) aquatic mammals compared to small terrestrial mammals. The results demonstrated that minute ventilation, that is, tidal volume (VT )·breathing frequency (fR ), as well as cardiac output, that is, stroke volume·heart rate, do not differ between the two habitats. We found that the "aquatic breathing strategy", characterized by higher VT and lower fR resulting in a more effective gas exchange, and by elevated blood hemoglobin concentrations resulting in a higher volume of O2 for the same volume of blood, supported elevated metabolic requirements in aquatic mammals. The results from this study provide a possible explanation of how differences in gas exchange may serve energy demands in aquatic versus terrestrial mammals.

The effects of temperature and salinity on the blood chemistry and survival of juvenile Atlantic tarpon Megalops atlanticus.

Atlantic tarpon Megalops atlanticus are highly migratory sportfish that support recreational fisheries throughout their range. In US waters, juveniles can be found in coastal and estuarine habitats along the Gulf of Mexico and Atlantic seaboard, with temperature limiting their northern latitudinal distribution. Juveniles may overwinter in these areas during the first several years of life. Low temperatures are known to cause mortality in adults, but the challenges of temperature are less understood for juveniles. Furthermore, salinity, which can change dramatically in these habitats, may have a synergistic effect with temperature. To examine the physiological effects of temperature and salinity on juvenile tarpon, wild fish were acclimated to a range of conditions that potentially occur in the northern range of their estuarine habitats. The haematology of juvenile tarpon was examined in two salinity (≤2 and ≥30 ppt) and temperature (15 and 25°C) treatments, followed by a low-temperature tolerance test. After 2 weeks in treatment conditions, blood samples were analysed for haematocrit, pH, red blood cell concentration, haemoglobin content and plasma osmolality. Increased plasma osmolality was observed in fish at low temperature (15°C compared to 25°C) and at high salinity (≥30 ppt compared to ≤2 ppt). Blood pH was increased at 15°C compared to 25°C, with the highest pH at 15°C and low salinity. Haemoglobin, haematocrit and red blood cell concentration were higher at 25°C than 15°C, with haemoglobin lowest at 15°C and low salinity. For the low-temperature tolerance test, all fish were acclimated to 15°C for 2 weeks, then transferred to separate tanks where temperature was gradually decreased at 0.9 ± 0.1°C/h until fish lost equilibrium. Fish at low salinity lost equilibrium more rapidly (1 ppt, 12.65 ± 0.46°C) than fish at high salinity (30 ppt, 11.26 ± 0.14°C). The results indicate juvenile tarpon are susceptible to low temperature, which is exacerbated by low salinity, findings useful in the assessment of juvenile tarpon overwintering habitat.

Chronotropic incompetence and exercise capacity after cardiac surgery with left atrium incision

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Chronotropic incompetence (CI) is sometimes observed during exercise training of cardiac rehabilitation in patients who underwent cardiac surgery, however, little is known which factors affect to the incidence of CI and exercise capacity of those patients. Purpose Because the possibility exists that cardiac sympathetic nerves might be impaired by surgical procedure, moreover CI is sometimes observed in patients after mitral valve surgery, we hypothesized that the incidence of CI was higher in patients with left atrium incision (LAI) during surgical operation as compared with those without LAI. And if so, which factor determines the exercise capacity of patients after cardiac surgery with LAI. We thus aimed this study to elucidate the hypothesis with cardiopulmonary exercise testing (CPX). Methods We performed CPX in total 153 patients who had undergone elective cardiac operation (45 patients with LAI, age 60.5±11.0; 108 patients without LAI, age 62.0±11.7). We analyzed chronotropic response index (CRI), peak oxygen uptake (peak VO2/W), anaerobic threshold (AT), and peak oxygen pulse (peak VO2/HR) with CPX, echocardiography, and blood hemoglobin concentration (Hb). Results The value of CRI was significantly reduced in the patients with LAI as compared with those without LAI (with LAI 0.24±0.22 vs. without LAI; 0.44±0.18, p&amp;lt;0.001). Exercise capacity such as peak oxygen uptake (peak VO2), anaerobic threshold showed no significant difference between two groups. In patients with LAI, peak VO2 showed significant correlations between peak oxygen pulse (peak VO2/HR; r=0.36, p&amp;lt;0.05), Hb (r=0.40, p&amp;lt;0.01) and left atrium dimension (LAD) measured by echocardiography (r=-0.54, p&amp;lt;0.001). Conclusions The present study demonstrated that higher incidence of CI was shown in patients with LAI as compared with those without LAI. Moreover peak VO2 of patients with LAI showed significant correlations with peak VO2/HR, Hb and LAD. These results suggest that 1) left atrium incision impairs cardiac sympathetic nerves and causes CI, 2) peak VO2/HR and Hb which is essential element of oxygen pulse are important factors for exercise capacity in patients after LAI with CI. Left atrium enlargement may indicates pre-operative damages of left atrium, 3) LAD which may indicate left atrium function, also is an important factor of exercise capacity in those patients.

A Systematic Analysis of Biological, Sociodemographic, Psychosocial, and Lifestyle Factors Contributing to Work Ability Across the Working Life Span: Cross-sectional Study

As employees age, their physical and mental abilities decline and work ability decreases, enhancing the risk for long-term sick leave or even premature retirement. However, the relative impact of biological and environmental determinants on work ability with increasing age is poorly understood in terms of their complexity. Previous research has shown relationships between work ability and job and individual resources, as well as specific demographic and lifestyle-related variables. However, other potentially important predictors of work ability remain unexplored, such as personality traits and biological determinants, including cardiovascular, metabolic, immunological, and cognitive abilities or psychosocial factors. Our aim was to systematically evaluate a wide range of factors to extract the most crucial predictors of low and high work ability across the working life span. As part of the Dortmund Vital Study, 494 participants from different occupational sectors, aged between 20 and 69 years, completed the Work Ability Index (WAI) assessing employee's mental and physical resources. A total of 30 sociodemographic variables were grouped into 4 categories (social relationships, nutrition and stimulants, education and lifestyle, and work related), and 80 biological and environmental variables were grouped into 8 domains (anthropometric, cardiovascular, metabolic, immunologic, personality, cognitive, stress related, and quality of life) and have been related to the WAI. Using the analyses, we extracted important sociodemographic factors influencing work ability, such as education, social activities, or sleep quality, and identified age-dependent and age-independent determinants of work ability. Regression models explained up to 52% of the WAI variance. Negative predictors of work ability were chronological and immunological age, immunological inefficiency, BMI, neuroticism, psychosocial stress, emotional exhaustion, demands from work, daily cognitive failures, subclinical depression, and burnout symptoms. Positive predictors were maximum heart rate during ergometry, normal blood pressure, hemoglobin and monocyte concentration, weekly physical activity, commitment to the company, pressure to succeed, and good quality of life. The identified biological and environmental risk factors allowed us to evaluate work ability in its complexity. Policy makers, employers, and occupational safety and health personnel should consider the modifiable risk factors we identified to promote healthy aging at work through focused physical, dietary, cognitive, and stress-reduced preventive programs, in addition to well-balanced working conditions. This may also increase the quality of life, commitment to the job, and motivation to succeed, which are important factors to maintain or even enhance work ability in the aging workforce and to prevent early retirement. ClinicalTrials.gov NCT05155397; https://clinicaltrials.gov/ct2/show/NCT05155397. RR2-10.2196/32352.

Changes in blood pressure, oxygen saturation, hemoglobin concentration, and heart rate among low-altitude migrants living at high altitude (5380 m) for 360 days.

This article aimed to study the adjustment and adaptation of resting systolic blood pressure (SBP), diastolic blood pressure (DPB), oxygen saturation (SpO2 ), hemoglobin concentration ([Hb]), and heart rate (HR) in low-altitude migrants during a 1-year stay at high altitude. Our study enrolled 35 young migrants who were exposed to a hypoxia environment at 5380 m altitude on the Qinghai Tibetan Plateau between June 21, 2017, and June 16, 2018. We set 14-time points (the 1st-10th, 20th, 30th, 180th, and 360th day after arriving at 5380 m) for obtaining the measurements of resting SBP, DBP, HR, SpO2, and [Hb] and compared them with the control values recorded prior to migration. Variables with continuous data were summarized as means (SD). One-way repeated measures ANOVA without assuming sphericity was carried out to test whether the mean values (SBP, DBP, HR, SpO2 , and [Hb]) on different days were different significantly. Furthermore, Dunnett's multiple comparisons test was carried out to determine the time points whose values were significantly different from the control values. SBP and DBP were continually increasing within d1-3 and peaked on the 3rd day, then steadily declined from d3 to d30. SBP fell back to the control values on d10 (p > 0.05), and DBP fell back to the control values on d20 (p > 0.05). A significant decline occurred on d180 (p < 0.05). Both SBP and DBP were lower than the control values on d180 (p < 0.05), and this trend was maintained to d360. There were similar characteristics of HR and BP in the time course at HA. HR on d1-3 was increasing (p < 0.05) compared to the control values, after which it fell back to the control values on d180 (p > 0.05), and this trend was maintained to d360. SpO2 was the lowest on d1 and lower than the control value throughout the study at HA (p < 0.05). [Hb] increased after long-term exposure (180 and 360 days) to HA (p < 0.05). Our study continuously monitored lowlanders at 5380 m in Tibet, and is perhaps the only longitudinal study of migrants conducted at an altitude above 5000 m during a 1-year period. Our study provides new information on the adjustment and adaptation of [Hb], SpO2 , SBP, DBP, and HR in high-altitude plateau migrants during a 360-day stay at an altitude of 5380 m.

Effects of PAH Mixtures on Haematological, Hepatic and Oxidative Stress Biomarkers in Clarias gariepinus

Haematological, hepatic and oxidative stress parameters in juvenile Clarias gariepinus exposed to a combined ternary mixture of naphthalene, phenanthrene and benzo[a]pyrene were investigated under static-renewal bioassay conditions. The test organisms were exposed to two levels of treatments of the mixed compounds for a period of 35 days. Red blood cell (RBC) count, haemoglobin (Hb) concentration and haematocrit (Hct) were significantly lowered in exposed fish compared to the control. Significant decreases were also observed in mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). White blood cell (WBC) and platelet (PLT) counts were significantly raised in exposed organisms compared to the control. There were significant reductions in total plasma protein and bilirubin. While increases in superoxide dismutase (SOD) and catalase (CAT) were significant, that of glutahthione s-tranferase (GST) was not significant.

Normoxia exposure reduces hemoglobin concentration and gill size in a hypoxia-tolerant tropical freshwater fish

Hypoxia is a widespread environmental stressor that shapes fish physiology and morphology. Plasticity in traits that improve oxygen uptake and delivery or reduce oxygen requirements may be critical for fish to cope with fluctuating dissolved oxygen (DO) conditions in their natural habitat or adapt to new environments. In this study, we characterized a suite of morpho-physiological respiratory traits of a naturally hypoxia-acclimated weakly electric mormyrid fish, Petrocephalus degeni, and quantified their plasticity in response to long-term normoxia exposure. We captured P. degeni from a hypoxic swamp habitat (PO2 = 2.43 ± 1.85 kPa) surrounding Lake Nabugabo, Uganda, and acclimated them to normoxia (PO2 > 16 kPa) for up to 75 days. At various time points throughout normoxia exposure, we measured blood hemoglobin and lactate concentration, gill size, routine metabolic rate (RMR), regulation index (RI), and critical oxygen tension (Pcrit). We found that 62–75 days of normoxia exposure significantly reduced blood hemoglobin concentration (− 17%), gill filament length (− 14%), and hemibranch area (− 18%), whereas RMR, RI, Pcrit, and blood lactate showed no significant change. Our results support earlier findings that swamp-dwelling P. degeni are well adapted to life in chronic and severe hypoxia and indicate that they possess a limited capacity for phenotypic plasticity in response to a change in their DO environment.

A Risk-scoring Model for Predicting Post-recurrence Survival in Patients With Endometrial Carcinoma

AimsThe survival time of patients with recurrent endometrial carcinoma is generally short. However, considerable interindividual variation exists. We developed a risk-scoring model for predicting post-recurrence survival in patients with endometrial carcinoma. Materials and methodsPatients with endometrial carcinoma treated at a single institution between 2007 and 2013 were identified. Pearson chi-squared analyses were used to compute odds ratios for the associations between risk factors and short survival after cancer recurrence. The results for biochemical analyses represented values at diagnosis of disease recurrence or values at initial diagnosis for those patients who had a primary refractory disease. Logistic regression models were constructed for the identification of variables that independently predict short post-recurrence survival. The models were used to assign points based on odds ratios for risk factors and risk scores were derived. ResultsIn total, 236 patients with recurrent endometrial carcinoma were included in the study. Based on overall survival analysis, 12 months was selected as the cut-off for short post-recurrence survival. Factors associated with short post-recurrence survival were platelet count, serum CA125 concentration and progression-free survival. A risk-scoring model with an area under the receiver operating characteristic curve (AUC) of 0.782 (95% confidence interval 0.713–0.851) was developed in patients without missing data (n = 182). When patients with a primary refractory disease were excluded, age and blood haemoglobin concentration were identified as additional predictors of short post-recurrence survival. For this subpopulation (n = 152), a risk-scoring model with an AUC of 0.821 (95% confidence interval 0.750–0.892) was developed. ConclusionsWe report a risk-scoring model that shows acceptable to excellent accuracy in predicting post-recurrence survival in patients with endometrial carcinoma, with primary refractory diseases included or excluded. This model has potential applications in precision medicine in patients with endometrial carcinoma.

Experimental reduction in blood oxygen-carrying capacity alters foraging behaviour in a colonial waterbird.

Oxidative metabolism is a key component of organismal physiology and it is primarily determined by aerobic capacity, which depends on the capacity of blood to carry oxygen. However, experimental manipulations of blood oxygen-carrying capacity are scarcely implemented to test ecophysiological hypotheses in vertebrate populations. Here we combined an experimental manipulation of blood oxygen-carrying capacity with GPS-tracking to test if suboptimal (reduced) haematological performance affects foraging behaviour in a colonial waterbird, the black-headed gull Chroicocephalus ridibundus. First, a validation of phenylhydrazine (PHZ) treatment in gulls revealed 9-18% reduction in haematocrit and blood haemoglobin concentration (via oxidative denaturation and haemolysis of erythrocytes). Then, GPS-tracking of experimental (PHZ-treated) and control (saline-treated) gulls during the incubation period provided no support for reduced or suspended engagement in energetically costly activities (long-distance foraging trips) by experimental birds. Instead, we found evidence for fine-scale alterations in foraging behaviour of PHZ-treated individuals, which resulted in fewer foraging trips per unit time, but trips that were longer in duration and in distance compared to control birds. This suggests reduced foraging performance of experimental birds (e.g. lower capacity to find and collect food during trips) or evasion of social competition, although no differences in the total investment in foraging may also suggest compensatory physiological responses to haemolytic anaemia. Our study contributes to better understanding of physio-ecological nexus in non-diving colonial avian species. At the same time, it should be subject to further investigation, if behavioural effects of reduced aerobic capacity may have any implications for gull condition and reproductive performance.

Factors associated with anemia among pregnant women attended antenatal care: a health facility-based cross-sectional study.

A health facility-based cross-sectional study was conducted from 1 February 2020 to 2 March 2020 among 420 pregnant women. The data were collected by systematic random sampling technique, entered into a computer using EpiData 3.5, and analyzed using the Statistical Package of Social Sciences 23.0 version. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a P-value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables. The overall prevalence of anemia was 32.9% (95% CI: 28.6-37.4), and it was higher in rural than urban pregnant women (45 vs. 23%), respectively. In multivariable analysis women who are found in the age group of greater than or equal to 30 years (AOR=3.45, 95% CI=1.22-9.78), rural residency (AOR=3.51, 95% CI=1.92-6.42), low family income (AOR=3.10, 95% CI=1.19-8.08), multiparty (AOR=2.91, 95% CI=1.33-6.38), a short interpregnancy gap (AOR 3.32, 95% CI=1.69-6.53), not taking iron and folate (AOR=4.83, 95% CI=2.62-9.90), third trimester of pregnancy (AOR=3.21, 95% CI=1.25-8.25), poor minimum dietary diversity score (AOR=3.54, 95% CI=1.58-7.95), undernourished (AOR=4.9, 95% CI=2.19-7.64), poor knowledge of anemia (AOR=3.19, 95% CI=1.72-5.93), consumption of coffee always after meal per day (AOR=3.24, 95% CI=1.42-7.42), having a history of irregular menstruation, and antepartum hemorrhage were significantly associated with anemia in pregnant women. This study showed that the prevalence of anemia in pregnant women in this study area was a moderate public health problem. The author suggest emphasizing the education and counseling of women on the advantage of taking the supplemented iron and folic acid. Health care providers should have to advise women to stay for at least 2 years before the next pregnancy to reduce the risk of adverse maternal and infant outcomes. Awareness creation in the community on the utilization of insecticide-treated bed nets is also needed.

A study to assess the effect of maternal hemoglobin level on foetal outcome among antenatal mothers in selected maternity hospitals at Mangalore

In developing countries maternal anemia during pregnancy has been reported to increase the risk of unfavorable foetal outcome. According to the standard laid down by WHO, anemia in pregnancy is present when the hemoglobin concentration in the peripheral blood is 11gm\100ml or less. In India its prevalence has been found to be in the range of 50-90% in 3rd trimester of pregnancy according to different studies conducted in rural areas. Maternal anemia in pregnancy is commonly considered as risk factor for poor pregnancy outcome and can threaten the life of mother and foetus. However, the extent to which the maternal hemoglobin concentration affects the foetal weight and foetal outcome is still uncertain. In the present study the researcher will investigate the possible effects of abnormal maternal hemoglobin level on foetal outcome. Interpretation and Conclusion: The findings of the present study revealed that there is a relationship between maternal hemoglobin level and fetal outcome such as birth weight, color of the new born, muscle tone, pre term birth and gestational age of the new born. A review of previous studies done showed that the risks of preterm delivery and LBW increased in proportion to the severity of maternal anemia. A comprehensive community based intervention with iron supplementation, helminthes treatment and increase in knowledge regarding information, education and communication through effective strategies, to improve the hematological status of pregnant women in each trimester, is needed and there by reduces maternal and fetal mortality and morbidity.

Toxic effects of microplastic (polyethylene) exposure: Bioaccumulation, hematological parameters and antioxidant responses in crucian carp, Carassius carassius

The purpose of this study was to evaluate the toxic effects of polyethylene microplastics (PE-MPs) by measuring the bioaccumulation, hematological parameters, and antioxidant responses in crucian carp (Carassius Carassius) exposed to waterborne 22–71 μm PE-MPs. C. carassius (mean weight, 24.0 ± 2.1 g; mean length, 13.1 ± 1.2 cm) were exposed to PE-MPs at concentration of 0, 4, 8, 16, 32, and 64 mg/L for 2 weeks. The accumulation of PE-MPs in each tissue of C. carassius was significantly increased in proportion to the PE-MPs concentration; the highest accumulation was observed in the intestine, followed by the gills and liver. Hematological parameters, plasma components and antioxidants responses were significantly affected by PE-MPs in a concentration-dependent manner. Exposure to ≥32 mg/L PE-MPs induced a significant decrease in red blood cells (RBCs), hemoglobin (Hb) content, and hematocrit values. However, exposure to ≥32 mg/L PE-MPs induced oxidative stress in the liver, gill, and intestine of C. carassius, thereby resulting in a significant increase in the levels of superoxide dismutase (SOD), catalase (CAT), and glutathione S-transferase (GST) and a decrease in glutathione (GSH) levels. The effects of interaction between the PE-MPs and exposure periods showed no significant changes in bioaccumulation, hematological parameters, plasma components and antioxidant responses. These finding indicate that the exposure to ≥32 mg/L PE-MPs could cause a significant accumulation in specific tissues of C. carassius, resulting in changes in hematological parameters, plasma components, and antioxidant responses. However, the interaction between PE-MPs and exposure periods had no significant effects, thereby suggesting the lack of toxicological interactions between PE-MPs and exposure periods in C. carassius.

Nutritional Status, Anemia and Eating Behavior among Children with Elevated Blood Lead Levels in a Primary Health Care of Peru

Aim: Malnutrition, anemia, and lead exposure are important public health problems. Introduction: To assess nutritional status, anemia, and eating habits and their relationship to elevated blood lead levels in children. Materials and Methods: Descriptive study conducted with data from children evaluated in a district of Callao, Peru. The variables studied were: nutritional status, based on anthropometric measurements; anemia, determined by blood hemoglobin concentration; dietary habits, evaluated by the 24-hour dietary recall method and food consumption frequency; and blood lead, determined by LeadCare II analyzer. Results and Discussion: A total of 425 children participated, with a median age of 6 years (IQR=5; Q3=9, Q1=4), 52.2% (n=222) were female and 71.3% (n=303) had blood lead level (BLL) ≥5μg/dL. Among children with BLL ≥5 μg/dL, 11.6% (n=35) presented poor nutritional status, 9.9% (n=30) had anemia, and 63% (n=191) had inadequate eating habits. Of the children with inadequate eating habits, 17.4% (n=47) had poor nutritional status and 15.9% (n=43) had anemia, compared to children with adequate eating habits (p&lt;0.001). In children with BLL ≥5 μg/dL, the children's median hemoglobin, body weight, and height were 12.2 g/dL, 21.6 Kg, and 114.8 cm, respectively; while in those with Pb levels &lt;5 μg/dL it was 12.5 g/dL, 29 Kg and 126.55 cm, respectively (p&lt;0.05). Conclusion: Nutritional status, anemia, and eating habits did not differ according to BLL; however, lower median hemoglobin, weight, and height were found in children with elevated lead levels. Children with subnormal nutritional status and children with anemia presented a shorter time to reach elevated blood lead levels.