Higher Risk Of Anemia Research Articles

Nursing strategies to minimize blood loss associated with phlebotomy.

Blood loss associated with phlebotomy is significant in critically ill adults. Iatrogenic anemia may result and impose unnecessary stress on the cardiovascular and respiratory systems and may require allogeneic blood transfusions. Many strategies exist under nursing's direct control to decrease blood loss associated with phlebotomy. In the past, nursing effectively implemented many of these strategies in patients at high risk of anemia, such as pediatric, neonatal, transplant, or chronic renal failure patients, as well as patients who are Jehovah's Witnesses. Implementation of these strategies are needed for all critically ill patients because allogeneic blood transfusions carry infectious risk and because complications and chronic critical illness cannot be predicted reliably. Incorporation of these strategies into daily practice as well as the development of blood conservation programs represent imminent challenges for nursing.

A study of anemia and life activity in the elderly

One hundred senior citizens aged 80 years and over in homes for the aged were evaluated for the incidence of anemia (hemoglobin under 11.0 g/dl), Hb concentration, serum iron, and total iron binding capacity (TIBC). The subjects were classified into different groups according to age distribution (80-84, 85-89, over 90), as well as sex and life activity levels. In the 80-84 year age group, the Hb concentration was 0.5 g/dl higher than that in the other age groups. The Hb values of the male subjects were 1 g/dl higher than the corresponding values for female subjects. Subjects classified as bedridden had Hb values 1.2 g/dl lower than those in the groups that had higher activity levels (p < 0.001). The incidence of anemia was independent of sex and age differences; however, differences in activity levels were significant (p < 0.001). There are 53 patients with some diseases, urinary tract infections, bed sores (over 3 cm diameter), chronic bronchitis, progressive cancers and chronic rheumatoid arthritis, which may be origins of anemia. Seventy six percent of bedridden patients have one or two of the above diseases and 30% of non-bedridden patients have these diseases. The difference was statistically significant (p < 0.001). In the bedridden group, the differences of the mean Hb levels and the rates of anemia in patients with and without disease were not statistically significant (p > 0.1 in both factors). These facts indicate that the bedridden elderly have a high risk of anemia which is independent of some infectious and malignant diseases.

Epidemiology of Aplastic Anemia in France: A Case-Control Study. I. Medical History and Medication Use

AbstractAplastic anemia (AA) is a rare, severe disease of mainly unknown origin. Numerous case history reports have incriminated drugs in the etiology of this disease. Because those reports were questionable, a case-control study was conducted in France between 1985 and 1988. Cases selected from the national register were eligible for inclusion when at least two blood lineages were depressed (hemoglobin < or = 10 g/100 mL and reticulocytes < or = 50 x 10(9)/L, granulocytes < or = 1.5 x 10(9)/L, platelets < or = 100 x 10(9)/L) and when the bone marrow biopsy was compatible with the disease. Using a standardized questionnaire, trained investigators interviewed one AA patient and two groups of controls (two hospitalized patients and one neighbor of the AA patient) matched for age, sex, and interviewer. One hundred forty- seven AA patients, 287 hospitalized controls, and 108 neighbors were interviewed. The occurrence of AA was analyzed by matched design with relation to medical history and drug use during the last 5 years, and specifically during the last year. Three times as many AA patients reported having suffered from clinical hepatitis during the last 6 months than either type of control. Similarly, a higher proportion of AA patients reported a history of chronic immune disorder, mainly rheumatoid arthritis (odds ratio of 6.8), and a previous use of gold salts and D-penicillamine in the 5 previous years (odds ratio of 4.9 for each drug). An excess of colchicine and allo/thiopurinol intake in the 5 previous years was observed among the AA patients (odds ratio equal to 4.1 and 3.6, respectively). These results for gold salts, D- penicillamine, and colchicine were confirmed when looking for drug use within the last year. A moderate risk was associated with acetaminophen or salicylate intake during the 5 previous years or during the last year (odds ratio between 1.8 and 2.0). The frequent use of salicylates within the last year was associated with a high risk of AA (odds ratio of 5.0). A high risk was also associated with indolic derivative intake but only when comparing AA patients to neighbor controls. No association could be evidenced with diclofenac intake, whatever the control group. Differences observed with recently published studies suggest that targeted studies on each category of drugs according to the treated pathologies should be initiated.