Lower Hb Research Articles

Sex differences in inflammatory parameters after shoulder arthroplasty and blood loss.

In many diseases, sex differences in diagnostics and therapy play role that is increasingly becoming recognized as important. C-reactive protein (CRP) and white blood cell (WBC) levels are determined as inflammatory markers to detect inflammation and even infection after total shoulder arthroplasty (TSA). The general course of white blood cell, CRP, and hemoglobin (Hb) levels after TSA is well known, but there is insufficient evidence of a possible association with sex. Therefore, we aimed to investigate whether there is an influence of sex on CRP, WBCs, and Hb after TSA in the first 10 days after surgery in a complication-free course in male and female patients and to re-evaluate the specific postoperative CRP, WBC, and Hb course with their maximums (minimum for Hb) and further course until the end of the inpatient period. We retrospectively studied patients treated with TSA, reverse shoulder arthroplasty (RSA), and prosthesis replacement between 2015 and 2021. Patients with active inflammation, rheumatoid arthritis, secondary osteoarthritis, active cancer, and documented postoperative complications were not included. CRP, WBC, and Hb levels before shoulder arthroplasty (SA) and up to 10 days after SA were recorded and analyzed for sex differences. Data from a total of 316 patients (209 women and 107 men) were finally analyzed. There were no sex differences in the CRP and WBC values, but women had significantly lower preoperative Hb values, postoperative Hb values, and minimum Hb values. There were no significant differences in Hb, CRP, or WBC levels in the prosthesis exchange group. The progression of CRP and WBC levels showed no sex-specific significant differences after TSA within the first 7 postoperative days. The study confirmed a decreased Hb value for women at all stages of SA. Blood loss was significantly higher for RSA than for TSA for both men and women.

Association of regular plasmapheresis donation with serum protein and electrolyte levels: a multicentre cross-sectional study in China

BackgroundChina’s plasmapheresis donation policy differs from that of Western countries. The association between regular plasmapheresis donation and donor health in China is still unknown.ObjectivesTo investigate the association of regular plasmapheresis...

Androgen Deficiency, Associations and Survival of Men With Stage 4 and 5 Chronic Kidney Disease: A Cohort Study.

Anaemia is a key cause of morbidity in chronic kidney disease (CKD). Androgen deficiency (AD) in males can contribute to anaemia of all causes, including in CKD. We sought to examine the prevalence of AD in men with CKD, the extent to which it contributed to anaemia and whether it was independently associated with long-term survival. This cross-sectional observational study was conducted among males aged 18 years and over with CKD stages 4 and 5. The study analysed morning blood samples with regard to their full blood count, urea and electrolytes, albumin, lipids, testosterone (T) and sex hormone binding globulin, with calculation of free testosterone by mass action equation. Mortality data were obtained 15 years later for survival analysis. Among 322 patients with a mean age of 63 years, the overall prevalence of AD was 68.9%. There was a statistically significant negative correlation between erythropoiesis stimulating agent (ESA) dose and testosterone concentrations (Pearson correlation -0.193, p = 0.05). There was a positive correlation between haemoglobin (Hb) and free testosterone level among patients not on ESA therapy (Pearson correlation 0.331, p < 0.001). Kaplan-Meier plots showed p < 0.001 on log-rank analysis, indicating that AD was significantly associated with worse survival. However, in Cox regression analysis, free testosterone was not associated with survival (95% CI for free testosterone 0.997-1.000). AD is highly prevalent among this population, and increases further with older age and more severe CKD warranting haemodialysis. Association of lower Hb and higher ESA dose with lower T concentration might be causative, which has important pharmaco-economic as well as clinical implications. Lower survival in men with low T, more likely reflects overall poor health rather than causation. A properly constituted randomised controlled study evaluating the effect of native T replacement is warranted in men with CKD and AD.

Diffuse reflectance spectroscopy and RGB-imaging: a comparative study of non-invasive haemoglobin assessment

Non-invasive assessment of haemoglobin (Hb) level in blood is a hot spot in the point-of-care biomedical diagnostics. Several optical methods are suggested as a solution, some of them being approved for clinical use. Still, there is no consensus on the accuracy of optical techniques, the quality of Hb assessment on different tissue sites, and on the ability of combined use of several optical techniques to improve the quality of Hb level prediction. In this work we examined the capabilities of two optical techniques—diffuse reflectance spectroscopy and RGB-imaging of the skin and fingernails areas—in detecting low blood Hb level. The test sample consisted of 240 adult volunteers with 70 volunteers exhibiting Hb level lower than 120 g/L. We show that using simple descriptors of the diffuse reflectance spectrum of the forearm skin and fingernails is applicable for predicting low blood Hb concentration (ROC-AUC = 0.84 ± 0.08), while RGB-imaging shows similar performance when applied to the fingernail areas (ROC-AUC = 0.83 ± 0.07), which can be considered perspective for clinical use and screening properties. We also report that while the joint use of predictions from two optical methods slightly improves the accuracy of non-invasive Hb level assessment (ROC-AUC = 0.86 ± 0.07), the effect is not as high as one might expect from combining predictions of truly independent modalities, indicating the limit of the accuracy one can expect with multimodal optical approach. We review this case and propose possible solutions towards more sensitive non-invasive optical determination of hemoglobin.

A-052 Clinical usefulness of ADAMS A1c HA-8190V automatic switching mode for the HbA1c measurement in Hb variants

Abstract Background High-performance liquid chromatography (HPLC) is widely used as a HbA1c routine assay. However, quantification of glycated hemoglobin (HbA1c) is a challenge in patients with hemoglobin (Hb) variants. In this study, we evaluated the clinical utility and analytical performance of new developed ARKRAY ADMAS HA-8190V assay using autoswitch mode, that automatically switches between variant and fast mode depending on patient Hb characteristics, in patients with Hb variant suspected in Korea. Methods The measuring time for HbA1c assay was compared between the HA-8180V fast mode (existing model) and the autoswitch mode of HA-8190V (new model) in 60 normal Hb samples. And the HbA1c measured values was compared bewteen the HA-8180V fast mode and the HA-8190V autoswitch mode in 30 low Hb samples. In addition, flag detection for the abnormal Hb and measured values for 21 Hb variant samples were analyzed using the HA-8180V fast mode and the HA-8190V autoswitch mode. Results It took 50.8 minutes and 39.1 minute to measure 60 normal Hb samples by HA-8180V fast mode and HA-8190V autoswitching mode, respectively. The values could not be measured at the HA-8180V fast mode for 7 of 30 low Hb samples, whereas all samples could be measured at HA-8190V autoswitching mode. For 21 Hb variant samples, HA-8180V fast mode showed abnormal flag detections for only 14 samples, but HA-8190V autoswitch mode reported abnormal variant flags for 20 samples. In the result accuracy evaluation (% difference) based on capillary electrophoresis HbA1c assay (Sebia, Lisses, France) in the 21 Hb variant samples, the % difference of HA-8190 V autoswitch mode was 3.9%, which was superior to HA-8180V fast mode of -11.65%. Conclusions Autoswitch mode of The HA-8190V (automatically switch between variant and fast mode based on patient Hb characteristics) showed more accurate flag detection and HbA1c measurements in patients with Hb variants, along with shorter test time and manual reduction.

Prognostic Role of Hemoglobin Combined With Geriatric Nutritional Risk Index in Patients With Vater Ampulla Carcinoma Undergoing Pancreaticoduodenectomy.

The purpose of this investigation was to assess the prognostic importance of the combination of preoperative hemoglobin (Hb) levels and Geriatric Nutritional Risk Index (GNRI) in forecasting postoperative survival outcomes for patients undergoing pancreaticoduodenectomy (PD) due to Vater ampulla carcinoma (VPC). The GNRI nutritional screening was conducted for all patients, and patient outcomes, including overall survival (OS), were subsequently monitored. An H- GNRI scoring system was established using the optimal critical values of 125.5 g/L for Hb and 91.72 for GNRI, as determined by X-tile software. According to the H-GNRI score, the patients were categorized into three groups, namely low H-GNRI group (H-GNRI score = 0, n = 47) with Hb < 125.5 g/L and GNRI < 91.72; medium H-GNRI group (H-GNRI score = 1, n = 77) with Hb < 125.5 g/L and GNRI ≥ 91.72, or Hb ≥ 125.5 g/L and GNR < 91.72; and high H-GNRI group (H-GNRI score = 2, n = 51) with Hb ≥ 125.5 g/L and GNRI ≥ 91.72. The Kaplan-Meier analysis and log-rank tests were employed to evaluate the OS rate and compare survival disparities among various groups. Additionally, both univariate and multivariate analyses were conducted utilizing the Cox regression model, with p < 0.05 considered statistically significant. Finally, to evaluate the predictive effectiveness of Hb, GNRI, and H-GNRI, a receiver operating characteristic (ROC) curve was constructed to compare the area under curve (AUC) values. The OS rate was higher in patients with high Hb levels (≥ 125.5 g/L) compared to those with low Hb levels (< 125.5 g/L). Likewise, patients in the high GNRI group (≥ 91.72) exhibited significantly superior OS compared to those in the low GNRI group (< 91.72). Compared with both the medium and low H-GNRI groups, the high H-GNRI group demonstrated a notably higher OS rate. The T stage (HR = 2.523, 95% CI: 1.694-3.757, p < 0.001), N stage (HR = 2.018, 95% CI: 1.255-3.246, p = 0.004), and the H-GNRI score (H-GNRI score of 2 used as the baseline; H-GNRI score of 0: HR = 2.569, 95% CI: 1.499-4.402, p < 0.001; H-GNRI score of 1: HR = 1.835, 95% CI: 1.118-3.014, p = 0.016), after adjusting for gender, were determined to be independent significant predictors affecting the OS of patients with VPC. The AUC of H-GNRI was 0.677, exceeding that of Hb levels (0.631) and GNRI (0.615). The combination of preoperative Hb levels and GNRI demonstrates superior predictive efficacy for VPC patients undergoing PD, compared with either Hb levels or GNRI score alone. Therefore, the H-GNRI score can be utilized to promptly identify high-risk patients, establish comprehensive nutritional pre-rehabilitation plans through interdisciplinary collaboration, and inform decisions regarding additional adjunctive therapies.

A study to assess the occurrence of anaemia and beta-thalassemia in the tribal population residing in the Yadadri-Bhuvanagiri district of Telangana state

ABSTRACT Background: This study aimed to estimate the prevalence of anaemia and haemoglobinopathies, particularly beta-thalassemia in the tribal population of the Yadadri-Bhuvanagiri district of Telangana. Methods: The sample consisted of a tribal population (Banjara) that visited voluntary blood camps set up in tribal settlements, local schools, and the Gram-panchayat office, in collaboration with local healthcare workers. Haemoglobin measurements (Anaemia) and Mentzer index of whole blood (EDTA) samples were used as diagnostic screening tools for categorising the population at risk of beta-thalassemia. HPLC was used as a confirmatory test. Results: The study included a total of n = 479 (68% females and 32% males) voluntary adult participants of Banjara. Based on the haemoglobin levels, 105 females (32%) were found to be anaemic as compared to 24 males (15.5%). Among the female population, a small percentage of individuals had severe anaemia (1.9%), while most had mild (80%) or moderate anaemia (18%); on the other hand, males primarily had moderate anaemia. Out of the total screened population, 6.7% (5.2% with low Hb levels (anaemic), 3.3% by MI) were found to be thalassemia based on anaemia and Mentzer index as a screening tool. Conclusion: The prevalence of beta-thalassemia was found 6.7% in the Banjara population.

Single vs. Double-Unit Transfusion In Patients With Hematological Disorders Undergoing Chemotherapy Or Stem Cell Transplantation: A Systematic Review And Meta-Analysis

There is no consensus to support the single unit-transfusion policy (1-RBC) over the double-unit transfusion policy (2-RBC) in patients with hematological disorders undergoing chemotherapy or stem cell transplantation. We searched PubMed, Embase, and Cochrane Library. Risk ratios (RR) and mean differences (MD) were pooled. Statistical analysis was performed using Review Manager and R software. Heterogeneity was assessed using I2 statistics. Hemoglobin (Hb) levels at discharge (MD -0.41 g/dL; 95% CI -0.53, -0.29 g/dL; p<0.01) and total RBC units used per admission (MD -0.82 units; 95% CI -1.60, -0.05 units; p=0.04) were significantly lower in patients who received 1-RBC, while length of hospital stay (MD 0.05 days; 95% CI -0.29, 0.39 days; p=0.89), severe bleeding (RR 1.52; 95% CI 0.85, 2.71; p=0.16) and mortality (RR 0.89; 95% CI 0.52, 1.53; p=0.69) showed no significant difference between groups. In patients with hematological disorders undergoing chemotherapy or stem cell transplantation, 1-RBC is associated with lower Hb levels at discharge and a reduction in the total number of RBC units used per admission, with no significant difference in terms of length of hospital stay, severe bleeding risk, transfusion-related adverse events and mortality.

Septic paravertebral abscess and inferior vena cava thrombosis complicated by uro-sepsis: Case report

Paravertebral abscess is an uncommon and potentially dangerous illness characterized by the buildup of pus in the anatomical area surrounding the spinal column. A 65-year-old female, who has diabetes and high blood pressure, came in with intense discomfort in her lower back that spreads to her lower limbs, making it difficult for her to move. She also has a high fever, excessive sweating, and has lost a large amount of weight. The blood tests indicate the following abnormalities: low Hb level of 9.6 g/dl, low MCV of 70 fl, elevated total white blood cell count of 15.8 × 109/L, elevated neutrophil count of 12.4 × 109/L, normal lymphocyte count of 2.8 × 109/L, high platelet count of 485 × 109/L, and elevated ESR of 110 mm/hr. The level of phosphatase was raised to 247 U/L, which is beyond the usual range of 40-150 U/L. The blood film reveals the presence of hypochromic microcytic red blood cells, which are indicative of iron deficiency anemia. There is also evidence of neutrophil leukocytosis in the white blood cells, with no immature cells observed. Additionally, an increase in platelets is observed in the film. The D-dimer level is 2009 ng/ml, which is within the normal range of less than 500 ng/ml. The CRP level is 48 gm/l, which is above the usual range of less than 6 gm/l. The bone marrow testing yielded normal results. The blood culture indicated the presence of Streptococcus epidermidis growth. Radiological tests revealed that a CE-MRI of the dorsal and lumbar spine indicated the presence of a para-aortic abscess together with septic thrombosis of the inferior vena cava. Paravertebral abscess is a critical emergent condition required a necessary therapy protocols to stabilize the patient status. The timing of intervention is crucial in cases of paravertebral abscess, as the existence of a mass can led to spinal cord compression.

Nutritional Status and Growth Outcomes in Pediatric Idiopathic Growth Hormone Deficiency: A Retrospective Study in Turkey

Objective: Growth and development in children are significantly influenced by nutritional status. Nutritional deficiencies such as low hemoglobin (Hb), ferritin, vitamin B12, and vitamin D have been linked to impaired growth. This study aims to evaluate the impact of these nutritional markers on growth outcomes in children with idiopathic growth hormone deficiency (IGHD) undergoing recombinant growth hormone therapy (rhGH). Material and Methods: A cross-sectional, retrospective study was conducted on 100 children with IGHD, aged under 16, diagnosed between 2000 and 2023. Data were collected from medical records, including height, body mass index (BMI), pubertal status, bone age, and nutritional markers [Hb, ferritin, vitamin B12, 25-hydroxy-vitamin D3 (25(OH)D3]. Growth parameters were assessed at the start and end of the first year of rhGH treatment. Results: The cohort had a median age of 11.3 years; 30% were female, and 50% were prepubertal. The median height standard deviation score (SDS) was -2.8, and median BMI SDS was -0.7. Prevalence of nutritional deficiencies included 23% with low Hb, 31% with low ferritin, 44% with low 25(OH)D3, and 15% with low vitamin B12. Despite these deficiencies, no significant differences were observed in height SDS or growth velocity when grouped by nutritional markers or supplementation status. Growth velocity showed a significant positive correlation with Hb levels and mid-parental height (MPH). Conclusion: Nutritional deficiencies were common among IGHD patients; there was no significant difference in terms of growth-related metrics in the first year of the rhGH therapy in comparisons between the groups with and without common nutritional deficiencies. This finding underscores the resilience of growth in the presence of these deficiencies. In contrast, growth velocity correlated positively with Hb levels and MPH, suggesting that these factors may play a significant role in influencing growth. Further research with larger samples and extended follow-up is needed to explore the long-term impact of nutritional supplementation on growth in IGHD.

Prediction the Occurrence of Thalassemia With Hematological Phenotype by Diagnosis of Abnormal HbA1c.

The current investigation aims to analyze the occurrence of thalassemia in patients who participated in hemoglobin A1c (HbA1c) testing in clinical laboratory showing high hemoglobin F (HbF) level (≥ 1.5%) or abnormal Hb peak and predict the main influence factors by using different statistical models. The current investigation is a single-center retrospective cohort study. HbA1c concentration was detected by using TOSOH HLC-723G8 glycated hemoglobin analyzer. SNaPshot SNP (Single Nucleotide Polymorphism) typing and AccuCopy technology were employed to detect mutations in thalassemia-related pathogenic genes. A total of 126 patients endured high HbF levels or abnormal Hb peak during HbA1c detection, and 66.7% of subjects (n = 84) showed thalassemia mutations. Three heterozygosity mutations, including c.52A>T (p.K18*), c.-78A>G, and c.126_129delCTTT(p.F42Lfs*19) present in HBB gene, were also identified. --SEA/αα mutation demonstrated the youngest ages (p < 0.001). 17 M (p < 0.001) and 41/42 M (p < 0.01) mutations with β-thalassemia showed higher HbF levels compared with patients without thalassemia mutations. Except for -α3.7, mutations in thalassemia showed lower levels of mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) compared with patients without thalassemia mutations. Patients with thalassemia mutations showed younger age (p < 0.001), lower Hb (p < 0.001), MCV and MCH levels (p < 0.001), higher red blood cell (RBC)count (p < 0.001), and platelet distribution width (PDW) level (p = 0.007) than patients without thalassemia mutations. Three statistical models indicate MCV is the most valuable independent factor for predicting thalassemia and ROC (receiver operating characteristic) curves analysis of AUC (Area Under the Curve) of 0.855 (95% CI [0.787-0.923], p < 0.001) with MCV. High HbF level (≥ 1.5%) or abnormal Hb peak present in HbA1c testing indicated high incident rate of thalassemia. MCV is the most valuable independent predicting factor for subjects having thalassemia.

Whole Blood Donor Iron Management Across Europe: Experiences and Challenges in Four Blood Establishments

Whole blood donors lose iron while donating and frequent blood donation is therefore known to induce a risk of iron deficiency and/or anemia. In this review we present, compare and discuss the pros and cons of 4 distinctive donor iron management strategies in England, Finland, the Netherlands, and Denmark. Donor iron management policies in the countries concerned are described for the year 2021, and data on donor and donation numbers, low hemoglobin (Hb) deferral rates and Hb levels are presented. In England Hb levels were only measured in donors failing a copper sulphate test, while in the other 3 countries Hb is measured at every donation. In Finland, donors considered at risk of iron deficiency receive iron supplements, while in the Netherlands, ferritin-guided donation intervals without iron supplementation are in place. In Denmark, iron supplementation is provided to donors with low ferritin levels. Low-Hb deferral rates and average Hb levels are quite similar across the included countries, with the exception of higher deferral rates in England. To conclude, despite significant diversity in donor iron management approaches, low Hb deferral rates and average Hb levels are similar among the included countries except for England, where higher deferral rates were observed that are likely attributed to the absence of iron supplementation or ferritin-guided deferral. Achieving an optimal, more tailored iron management strategy requires further research and a nuanced understanding of both donor demographics and physiological responses to optimize the effectiveness and safety of blood donation practices.

Impact of preoperative inflammatory and nutritional markers on the prognosis of patients with peritoneal metastasis of colorectal cancer.

Identifying patients with peritoneal metastasis (PMs) of colorectal cancer (CRC) who will benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is crucial before surgery. Inflammatory and nutritional indicators play essential roles in cancer development and metastasis. To investigate the association of preoperative inflammatory and nutritional markers with prognosis in patients with CRC-PM. We included 133 patients diagnosed with CRC-PM between July 2012 and July 2018. Patients' demographics, overall survival (OS), and preoperative inflammatory and nutritional markers were evaluated. The Kaplan-Meier method and log-rank test were used to estimate differences. Of the 133 patients, 94 (70.6%) had normal hemoglobin (Hb) and 54 (40.6%) had a high neutrophil-to-lymphocyte ratio (NLR). The median OS (mOS) was significantly lower for patients with high NLR (7.9 months) than for those with low NLR (25.4 months; P = 0.002). Similarly, patients with normal Hb had a longer mOS (18.5 months) than those with low Hb (6.3 months; P < 0.001). Multivariate analysis identified age, carbohydrate antigen 199 levels, NLR, Hb, and peritoneal cancer index as independent predictors of OS. Based on these findings, a nomogram was constructed, which demonstrated a good capacity for prediction, with a C-index of 0.715 (95% confidence interval: 0.684-0.740). Furthermore, the 1- and 2-year survival calibration plots showed good agreement between predicted and actual OS rates. The areas under the curve for the 1- and 2-year survival predictions of the nomogram were 0.6238 and 0.6234, respectively. High NLR and low Hb were identified as independent predictive risk factors for poor prognosis in patients with CRC-PM. The established nomogram demonstrated high accuracy in predicting OS for patients with CRC-PM, indicating its potential as a valuable prognostic tool for this patient population.

Investigation of Hepatozoon Canis Related Alterations in the Haemato Biochemical Profile of Dogs

Aims: Hepatozoonosis, caused by a protozoan parasite Hepatozoon canis, is important for canine health due to its ability to cause chronic, debilitating disease, and the challenges it presents in terms of diagnosis and management. The present study was conducted to see the effect of H. canis infection on various haematological and biochemical parameters as compared to the normal healthy dogs in order to understand the disease pattern and suspecting the disease. Study Design: The clinically affected dogs that come to the veterinary hospital with symptoms of hepatozoonosis were included in the study. Haematological and biochemical parameters of dogs found positive for hepatozoonosis were analysed. The values of these parameters were subsequently compared to healthy animals in order to identify any significant difference caused by H. canis. Place and Duration of Study: The studied was conducted at Department of Veterinary Medicine, DUVASU Mathura, India. Total 212 blood samples were collected from the dogs that were brought for the treatment in between February 2023 to March 2024. Methodology: Total 212 dogs were included in the present study out of this 46 dogs were found positive with H. canis using PCR based molecular test. These positive animals were subjected to study the changes in biochemical parameters like blood urea nitrogen, creatinine, alkaline phosphatase, alanine transaminase, aspartate amino transferase, total leucocyte count, total erythrocyte count, haemoglobin, haematocrit, erythrocyte indices (MCV, MCH, MCHC), differential leucocyte count, platelet count and platelet indices (MPV, PDW) using autoanalyzer. Student's t-test in Graphpad Prism was used to compare these values to healthy animals. Results: The study confirms that Hepatozoonosis leads to significant haematological and biochemical changes in dogs. Infected dogs have lower Hb, TEC, and PCV than healthy animals, indicating anaemia. Thrombocytopenia and leukocytosis were also observed in the infected animals. Non-significant differences in MCV, MCH, and MCHC indicate normocytic, normochromic anaemia. Anisocytosis and non-regenerative anaemia is indicated by significant RDW-CV increases with decrease in MCV values. Increased liver-specific enzymes like ALT, AST, and ALP and kidney-related enzymes like BUN and CRT suggest hepatic and renal involvement in disease pathophysiology. Conclusion: In hepatozoonosis, haemato- biochemical parameters like non-regenerative anaemia. anisocytosis, thrombocytopenia, leukocytosis, low serum protein concentration and increased ALT, AST, ALP and BUN values may be used as non-specific biomarkers. The results can be used in making clinical decisions and monitoring therapeutic responses in cases of hepatozoonosis.

Analysis of the Haematological Phenotype and Molecular Characteristics of Rare Abnormal Haemoglobin.

Haemoglobinopathy refers to a group of common monogenic inherited conditions associated with variations in the haemoglobin molecule; however, there is relatively limited reporting on abnormal haemoglobinopathy in the Chinese population, especially rare abnormal haemoglobin (Hb). The aim of this study was to explore the clinical characteristics of haemoglobinopathy to supplement data for the epidemiological investigation of Hb variants in Guangdong province of China. Peripheral blood was collected from five patients (including a family) for Complete blood count, Hb electrophoresis, High-performance liquid chromatography analysis and degenerative globin body testing. Hb variants were further analysed by PCR and DNA sequencing. The research subjects were diagnosed with different types of abnormal Hb. The blood routine of the Hb Fukuyama (HBB:c.232C>T) diagnosed individual showed microcytic hypochromic anaemia, with a lower Hb level (64 g/L), mean corpuscular volume (MCV) of 71.5 fL and mean corpuscular haemoglobin (MCH) of 21.5 pg. Individuals diagnosed with Hb Port Phillip (HBA2:c.275T>C) exhibit a MCH level that is slightly below average, at 26.4 pg. The Hb Saint Etienne (HBB:c.279C>G) diagnosed individual showed macrocytic hypochromic anaemia, and the proband had a low Hb level (116 g/L), MCV of 102.2 fL and MCH of 29.4 pg. We confirmed the presence of Hb Fukuyama (HBB:c.232C>T) in China for the first time. Three rare patients with the Hb Saint Etienne (HBB:c.279C>G) phenotype and one patient with Hb Port Phillip (HBA2:c.275T>C) phenotype were included. Our research enriches the gene mutation map of haemoglobinopathy in Guangdong province and improves the detection system of haemoglobinopathy for population prevention and eugenics.

Predictive factors of facial nerve function after medium/large vestibular schwannoma surgery: relationships between time of surgery, dimensions and size of resection

BackgroundVestibular schwannomas (VS) are slowly growing tumor, deriving from the vestibular component of cranial nerve VIII. Primary treatment modalities include microsurgery, radiosurgery, a combination of microsurgery and radiosurgery, and conservative treatment. The management of VS is a matter of debate, particularly in case of small tumors (less than 2 cm in diameter size).MethodsWe performed an institutional retrospective review of a consecutive series of 28 surgically treated patients suffering from VS, operated in our institution. Patients were assigned on the ground of the preoperative imaging in two groups: tumors with major diameter of extra-meatal portion measuring ≥ 3 cm (Group I, 16 patients) and tumors with major diameter < to 3 cm (Group II, 12 patients).ResultsThe total amount of 18/28 patients were females; the average age was 60.1 years. The average duration of the preoperative symptoms was 25.2 months, while the average interval between the diagnosis and surgical treatment was 8.68 months. The average preoperative volume was, respectively, for Group I and II tumors of 14.35 cm3 and 3.73 cm3. Age was associated to the duration of the preoperative symptoms (r = − 364; p = 0.044), with the probability to develop a complication (p = 0.031) and preoperative low HB score (r = − 324; p = 0.040). The presence of hypoacusis as preoperative symptom was strongly associated to a lesser postoperative maximum diameter and smaller residual disease (p = 0.014). Group I had a significantly longer hospitalization period in respect to Group II (p = 0.001) that impacted negatively to postoperative performance status (r = 0.368, p = 0.042).ConclusionsWe confirmed the strong association between age and size of the lesion and the clinical results, where larger lesions in older patients are more prone to complications than smaller in young patients. We found that the patients presenting hypoacusis at onset were associate to lesser preoperative FN impairment outlining a possible differential involvement of the CN related to the internal meatus. We also introduce the strong association of Koos grade with postoperative performance status, hospitalization and facial nerve functionality.

Correlation Mineral Water Consumption and Hemoglobin Levels in Adolescent Girls

Anemia is a global health issue that affects people of all ages, particularly adolescent girls. Adolescent girls require nutritional intake, both from food and water. According to the balanced nutrition guidelines, people (particularly adolescents and adults) require 2000 liters (or eight glasses) of water daily. Most adolescent girls barely consider their water consumption. A lack of water in the body affects the balance of minerals (salt and sugar), disrupting regular metabolic processes such as hemoglobin (Hb) level regulation. This study investigates the correlation between adolescent girls' water consumption and hemoglobin levels. This quantitative study uses a cross-sectional design to collect variable data at a certain time. The study used blood with anti-coagulants EDTA from 30 adolescent girls from Universitas Muhammadiyah Semarang. The primary data for this study are water consumption and hemoglobin levels. Results of the research show that adolescent girls' water consumption was adequate (66.7%) and low (33.3%). The average Hb level among adolescent girls was 12.4 g/dL. Adequate water consumption resulted in 3 respondents with low Hb levels and 7 with normal Hb levels. In contrast, low water consumption resulted in 2 respondents with low Hb levels and 18 with normal Hb levels. The Rank-Spearman correlation test showed sig 0.177 (p&gt;0.05). The study concluded that there was no correlation between adolescent girl water consumption and hemoglobin levels. Food fluid intake can compensate for a lack of water consumption.

Clinical characteristics, laboratory features and genetic profile of hemoglobin E (HBB:c.79 G > A)/β (nucleotide -28 A > G) (HBB:c.-78 A > G) -thalassemia subjects identified from community- and hospital-recruited cohorts

Despite several existing laboratory-based studies of hemoglobin (Hb) E (HBB:c.79 G > A)/ β (nucleotide (NT) -28 A > G) (HBB:c.-78 A > G) -thalassemia, no reports have ever provided clinical severity information as well as dependency of blood transfusion. Previously, a comparative study of community- and hospital-recruited Hb E/β-thalassemia subjects was conducted in the lower northern Thailand between June 2020 and December 2021. A mobile medical team visited each community hospital on-site, collecting clinical severity parameters, and conducting Hb and DNA analyses. The control included Hb E/β-thalassemia patients undergoing transfusions. Subgroup study of adult Hb E/β (NT -28 A > G) -thalassemia subjects was subsequently conducted. Additional pediatric individuals were recruited from prenatal diagnosis databases. Twenty adult and nine pediatric subjects were enrolled; all were classified as having mild disease severity. Twenty-two individuals (75.9 %) were asymptomatic. Six adults (20.7 %) required blood transfusion. The mean Hb level of subjects without transfusion (23 [79.3 %]) was 10.77 ± 1.10 g/dL. Hb analysis revealed a distinct EFA pattern with low Hb F fraction. The positive impact of genetic modifiers could not be statistically demonstrated except rs7482144-XmnI. These findings could provide essential information for parents carrying fetuses with Hb E/β (NT -28 A > G) -thalassemia.

Assessing the Burden of Anemia in Non-Communicable Diseases at a Tertiary Care Center: A Cross-Sectional Study

Background: Anemia is a prevalent global health issue, significantly affecting patients with non-communicable diseases (NCDs) like Type 2 Diabetes Mellitus (Type 2 DM), Hypertension (HTN), and Coronary Artery Disease (CAD). This study assessed the burden of anemia in patients with Type 2 DM, HTN, and CAD, and to identify its prevalence, types, and association with these chronic diseases. Methods: A cross-sectional study was carried out, involving 250 patients diagnosed with Type 2 DM, HTN, and CAD. Patients were categorized as anemic based on WHO criteria: males with Hb &lt; 13 gm% and females with Hb &lt; 12 gm%. Data were collected through a structured questionnaire. Laboratory investigations included Hb, serum creatinine, MCV, MCHC, and reticulocyte count. Statistical analysis was accomplished using chi-square tests and logistic regression to examine associations between anemia and NCDs. Results: Anemia was prevalent in 80% of the study population, with normocytic anemia being the most common type (45%). Significant correlations were found between anemia and Type 2 DM (p=0.036), HTN (p=0.032), and CAD (p=0.013). Anemic patients had significantly lower Hb levels and MCHC, and higher serum creatinine and reticulocyte counts compared to non-anemic patients. Conclusion: The study highlights a high prevalence of anemia among patients with NCDs, indicating a critical need for routine screening and integrated management of anemia in this population. Addressing anemia could improve clinical outcomes and enhance the quality of life for individuals with chronic diseases. Recommendations: Healthcare providers should implement regular anemia screening for patients with NCDs and adopt integrated care approaches that address both chronic diseases and anemia. Further research is needed to explore the underlying mechanisms linking anemia and NCDs and to develop targeted interventions. Keywords: Anemia, Non-Communicable Diseases, Type 2 Diabetes Mellitus, Hypertension, Coronary Artery Disease..

Lipoprotein(a) and its impact on cardiovascular disease - the Polish perspective: design and first results of the Zabrze-Lipoprotein(a) Registry.

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Increased Lp(a) concentration > 30 mg/dl (75 nmol/l) and especially >50 mg/dl (125 nmol/l) may cause faster atherosclerosis, being an important and underdiagnosed residual cardiovascular risk factor. Thus, there is a need to characterize further the clinical phenotypes in patients at risk for ASCVD with high Lp(a) levels now and during follow-up, while also looking for the possible impact of geographical differences. The Zabrze Lipoprotein(a) Registry (Zabrze-Lip(a)R) was founded on the basis of data from 2,001 consecutive patients with very high cardiovascular risk treated in a tertiary hospital. The registry patients will be followed for at least 5 years with the possibility of extending this period as an open label study. All-cause and cause-specific mortality, hospitalizations, and cardiovascular events, such as myocardial infarction (MI) and stroke, will be assessed. The mean age of patients was 66.4 years (females 37.1%). The median Lp(a) concentration in the entire population was 6.6 mg/dl (16.5 nmol/l) (mean: 14.3 ±19.4 mg/dl). 540 (27%) patients had elevated Lp(a) levels above 30 mg/dl (75 nmol/l); they were significantly older (68.8 vs. 66.3 years; p = 0.04), had significantly lower hemoglobin and hematocrit, and higher platelet count and levels of NT-proBNP and C-reactive protein. The prevalence of elevated Lp(a) > 30 mg/dl (75 nmol/l) concentrations was very high in patients with a chronic coronary syndrome (CCS) (52.2% (282/540) vs. 41.5% (607/1461); p < 0.001), in patients undergoing PCI during hospitalization (23.9 vs. 19%; p = 0.01), and in patients with previous MI (20.6% vs. 14.9%; p = 0.0022). In the multivariable analysis, the independent predictors of elevated Lp(a) > 30 mg/dl (75 nmol/l) were only lower Hb values (OR = 0.925; 95% CI: 0.874-0.978; p = 0.006) and higher platelet count (1.002; 95%CI: 1.000-1.003; p < 0.02). In Poland, the largest representative of Central and Eastern European countries, 27% of patients at very high cardiovascular risk with established ASCVD experience additional risk related to an elevated Lp(a) level, with every second patient having CCS. Interestingly, only two factors were significantly related to elevated Lp(a) levels: lower Hb values and higher platelet count. However, the clinical relevance of these results needs confirmation.