Serum Concentrations Of Hemoglobin Research Articles

Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study

IntroductionPregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized “weight loss surgery” multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS.MethodsMulticenter observational cohort study including 119 pregnant women at 41.0 (18.5–70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users.ResultsDuring pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users.ConclusionLow maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population.Graphical

Trends in nutritional status and factors affecting prognostic nutritional index in ovarian cancer patients during chemotherapy: a prospective longitudinal study based on generalized estimating equations

PurposeNumerous studies have investigated the relationships between nutritional status and the prognosis of ovarian cancer (OC). However, the majority of these studies have focused on pre-chemotherapy malnutrition, with limited attention given to dynamic changes in nutritional status during chemotherapy and the associated risk factors affecting the prognostic nutritional index (PNI) in OC women. This study aims to explore the variation trend in the nutritional status of OC women over time during chemotherapy and assess its predictive factors.MethodsA prospective longitudinal study was conducted from January 2021 to August 2023. Body mass index (BMI), PNI, Nutritional Risk Screening (NRS) 2002, serum albumin, and prealbumin measurements were utilized to assess the nutritional status of OC women. Data were collected through face-to-face interviews before initial chemotherapy (T0) and during the first (T1), third (T2), and fifth (T3) cycles of chemotherapy. Generalized Estimating Equations (GEE) were employed for the analysis of potential predictive factors.ResultsA total of 525 OC women undergoing chemotherapy completed the study. Significantly varied levels of BMI, PNI, and serum concentrations of hemoglobin, albumin, prealbumin, potassium, sodium, magnesium, and calcium were observed in these patients (p < 0.05). The prevalence of nutritional risk decreased over time during chemotherapy (p < 0.05). Nutritional parameters, including BMI, PNI, and the serum concentrations of albumin and prealbumin, exhibited an upward trend in nutritional status throughout the chemotherapy cycles (p < 0.05). Multivariate analysis indicated that higher levels of BMI, serum albumin, prealbumin, absolute lymphocyte count, and hemoglobin ≥ 110 g/L at admission were associated with elevated PNI after chemotherapy (β = 0.077, p = 0.028; β = 0.315, p < 0.001; β = 0.009, p < 0.001; β = 1.359, p < 0.001; β = − 0.637, p = 0.005).ConclusionPatients consistently demonstrated improvements in nutritional risk and status from the initiation to the completion of chemotherapy cycles. Nutritional monitoring of OC women, particularly those exhibiting abnormalities at the commencement of chemotherapy, is crucial. Targeted nutritional support programs should be developed to enhance the prognosis of OC women.

Evaluation of the safety and immune stimulatory effects of multi-strain Lab Mix product on laboratory animals

Background & aimsProbiotics are alive and beneficial bacteria used as food complements with sufficient amounts to improve and balance the intestinal flora in the human gastrointestinal tract and inhibit harmful microorganisms. In this study, we conducted experiments to evaluate he safety and the effect of one of our probiotics on selected biochemical parameters in animal models. MethodsLabMix is a probiotic product containing three bacterial strains, including Lactobacillus acidophilus LA 304.17, Lactobacillus casei LC 304.08, and Bifidobacterium bifidum BF 304.98, with a density of 9 × 109 CFU/g and being mixed with suitable excipients. In this study, we conducted experiments to evaluate LabMix's acute ttoxicity in mice as well as subchronic toxicity in rats. ResultsThe LD50 dose in mice of this product could not be determined since no death or disorder was recorded. In rats receiving LabMix with doses of 2.52 × 109 CFU/kg and 12.6 × 109 CFU/kg continuously for 28 days, this product caused no significant changes in the amount of red and white blood cells and platelets. Similarly, no significant changes were recorded in serum concentrations of hemoglobin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, protein, cholesterol, bilirubin, and creatinine. Besides, LabMix products also did not cause any changes in the histology of the liver, kidney, and spleen in rats. Moreover, LabMix was well tolerated without affecting the normal growth and feeding of rats. Furthermore, LabMix also decreased serum cytokines and increased serum and gut mucosal IgA antibodies. ConclusionsLabMix product is possibly considered safe for human., and this sproduct reduced the release of pro-inflammatory cytokines (IL-6 and TNF-α), but increased IgA levels. However, it is necessary to further evaluate the product's effectiveness in the preclinical phase as well as in further phases before mass production and commercialization.

#2674 ASSOCIATION BETWEEN SARCOPENIA, BODY COMPOSITION AND FRAILTY IN PERITONEAL DIALYSIS PATIENTS: A MULTI-CENTRIC STUDY

Abstract Background and Aims Patients with chronic kidney disease (CKD) have an increased risk of mortality due to many causes. One of them is sarcopenia, a progressive skeletal muscle disorder that increases adverse outcomes such as fractures, falls, and physical disability, and has been considered an independent risk factor for mortality. Sarcopenia could be defined as a muscle failure in which muscle strength is the most solid measure of muscle function and a better predictor of adverse events rather than muscle mass. Grip strength is considered a reliable surrogate for measures of arm and leg strength. The aim of this study was to evaluate the prevalence of probable sarcopenia in peritoneal dialysis (PD) patients and its association with body composition and several clinical variables. Method This retrospective multi-centric descriptive study was conducted at the Hospital de Santa Cruz (Lisboa) and Hospital Universitario de Badajoz (Badajoz). We performed a single evaluation of 62 patients on peritoneal dialysis from at least 3 months, aged &amp;gt;18 years in whom we measured muscle strength by handgrip strength using a dynamometer. We divided patients into two groups, using cut-off points to consider probable sarcopenia for men and women less than 27 kg and 16 kg, respectively. Patients with acute infection, amputated limbs, and implantable cardiac devices were excluded. The following data were analyzed: age, anthropometric variables, gender, duration, modality of PD, presence of hypertension, diabetes, and cardiovascular disease, obtained from electronic medical records. We also analyze data from body composition using a bioelectrical impedance device (overhydration, extracellular intracellular water ratio (E/I), lean and fat tissue index and phase angle), PD parameters (weekly urea Kt/v, nGFR, D/P Cr, nPCR, residual urine output) and measured serum concentrations of hemoglobin, PCR, NT-ProBNP, PTH, Ca-125, calcium, and phosphorus. We assessed patients for the Clinical Fragility Scale (CFS) and measured performance in activities of daily living using the Barthel Scale. Results Records of 62 patients, 61% male, mean age 57 ± 22 years, and body mass index 27.5 ± 5.1 kg/m2 were reviewed, with 15 (18.8%) classified as probable sarcopenic. Old age (p = 0.005), high CFS score (p = 0.005), E/I ratio (p &amp;lt; 0,001), and low values of lean tissue index (p &amp;lt; 0.031), mean phase angle (p &amp;lt; 0.001) and residual urine output (p &amp;lt; 0,018) were correlated with the presence of probable sarcopenia. In the multivariable analysis, age (HR 1.135; CI 95% 1.015 - 1.269), CFS score (HR 2.637; CI 1,008 - 6,900), and urine output (HR 0,996; CI 95% 0.993 - 0.999) were also related to probable sarcopenia. There was no association between the presence of anemia, cardiovascular disease, type of peritoneal transport, and clearance of small solutes. Conclusion This study reported a low prevalence of probable sarcopenia in PD patients. We corroborate the association between age and frailty in the sarcopenic group. The percentage of extracellular water, muscle mass, and phase angle measured by bioimpedance could be useful variables to identify sarcopenic or at-risk patients. In multivariate analysis, age, higher CFS score, and urine output have been associated with sarcopenia. Preservation of residual renal function seems to be associated with less sarcopenia, which reinforces the importance of preserving residual renal function in PD patients. It's also important to identify sarcopenic or at-risk patients in order to promote early detection and treatment.

Nutritional Deficiencies 3 Years After Sleeve Gastrectomy Can Be Limited by a Specialized Multivitamin Supplement

PurposeLifelong daily multivitamin supplementation is highly recommended after sleeve gastrectomy (SG). Based on previous research, a specialized multivitamin supplement (MVS) for SG patients was developed and optimized (WLS Optimum 1.0 and 2.0). This study presents its mid-term effectives and compares micronutrient status of SG patients using this specialized MVS to users of standard MVS (sMVS) and non-users of multivitamin supplementation during the first three years post-surgery.Materials and MethodsOf the 226 participants that were included at baseline, yearly follow-up blood tests were completed by 193 participants (85%) at 12 months, 176 participants (78%) at 24 months, and 140 participants (62%) at 36 months of follow-up. At each time point, participants were divided into four groups: (1) Optimum 1.0, (2) Optimum 2.0, (3) sMVS, and (4) non-users. Serum concentrations (linear mixed-effects models) and the prevalence of micronutrient deficiencies (chi-square tests) during follow-up were compared between the groups.ResultsUsers of specialized MVS (Optimum 1.0 and 2.0) had higher serum concentrations of hemoglobin, folic acid, and vitamin D compared to sMVS users and non-users during follow-up. Serum concentrations of vitamin B12 and (corrected) calcium were also higher in specialized MVS users than in non-users. Overall, fewer deficiencies for folic acid and vitamin D were observed in the Optimum groups.ConclusionAlthough the perfect multivitamin supplement for all SG patients does not exist, WLS Optimum was more effective in sustaining normal serum concentrations than standard, over-the-counter supplementation. Non-users of MVS presented with most micronutrient deficiencies and will evidently develop poor nutritional status on the longer term.Graphical abstract

Long-Term In-Center Nocturnal Hemodialysis Improves Renal Anemia and Malnutrition and Life Quality of Older Patients with Chronic Renal Failure.

BackgroundOlder patients with chronic renal failure (CRF) which currently is referred to as end-stage renal disease (ESRD) are associated with higher mortality. In-center nocturnal dialysis (INHD) is a new blood purification model, which is characterized by longer sessions and nighttime administration. However, no data for the efficacy of INHD in older patients with ESRD are available. This study is to analyze the effect of INHD in the treatment of older patients with ESRD.MethodsA retrospective, observational study was conducted in a university teaching hospital. Seventy-two patients with ESRD receiving INHD were enrolled. They were divided into the older ESRD patients (age ≥60) group (n = 22) and the non-older ESRD patients (age <60) group (n = 50). The causes of older ESRD patients and non-older ESRD patients receiving INHD were analyzed. Differences of laboratory test indicators of older patients with ESRD before INHD and after INHD were compared. Quality of life for older ESRD patients receiving INHD was assessed by using the Kidney Disease Quality of Life-36 Instrument (KDQOL-36).ResultsSerum concentration of hemoglobin and serum concentration of albumin of older patients with ESRD increased significantly after INHD (p < 0.05). There were similar results in the non-older cohort (p ≤ 0.05). Scores of five KDQOL-36 subscales increased significantly after INHD (p ≤ 0.001) indicated that the quality of life for old patients with ESRD was significantly improved after INHD.ConclusionINHD is an effective blood purification therapy that can improve the condition of renal anemia, and it may provide a potential positive impact in the malnutrition of older and non-older patients with ESRD. INHD can improve the quality of life of older patients with ESRD. The results will provide a basis for formulating new policies of blood purification therapy for older patients.

POS-710 CHARACTERISTICS OF PERITONEAL DIALYSIS PATIENTS IN dr. ZAINOEL ABIDIN HOSPITAL BANDA ACEH

Background: Chronic kidney disease (CKD) in Indonesia is increasing. Indonesian Renal Registry (IRR) shows the number of CKD patients undergoing Peritoneal Dialysis (PD) in Indonesia increased (2,105 patients in 2018).1 Peritoneal dialysis (PD) is a well-established modality of renal replacement therapy. The PD is a relatively simple technique that can be done alone at home, can also reduce transportation costs to dialysis centers, and is very suitable for patients with hemodynamic problems or with certain conditions.2,3. Aims : to find out the characteristics of patients undergoing PD in dr. Zainoel abidin hospital, Banda aceh, Indonesia. Research methods: This is a cross-sectional study conducted in dr. Zainoel Abidin hospital, Banda Aceh Indonesia, from January-August 2021. We included all adults’ patients who had undergoing PD for at least three month. Serum concentrations of hemoglobin, levels of 25-hydroxyvitamin D , calcium, phosphate, parathyroid hormone, potassium, sodium, magnesium, albumin, lipid profile, uric acid, ferritin, and blood glucose were measured at the same time as Echocardiography examination. Univariate analysis were performed to analyze data. Results: A total of fourty four patients underwent PD were recruited. Average age of was (43.11±13.74) years old consisting of 18 women (40.90%) and 26 men (59.09%) with an average length of PD undergoing 22.50(4-156) months. The mean BMI ( Body Mass Index) of the patients was (24.98±4.8) Diabetic patients was 15.80% and all patients had comorbid hypertension. From the laboratory examination, it was found that the average level of hemoglobin (9.03±1.95) g/dl, calcium (7.85±1.13) mg/dl, phosphate (1.80±0.53) mg/dl, 25-hydroxyvitaminD (14.89±5.60) ng/ml, intact parathyroid hormone (743.35±592.83) pg/dl, potassium (3.48±11.03) mg/dl, sodium (141.61±5.04) mg/dl, magnesium (1.97±0.36) mg/dl, albumin (3.28±0.57) mg/dl, ferritin (774.60±896.06) mcg/l, triglycerides (129.72±60.38) mg/dl ,LDL (low-density lipoprotein) (136,52±46.10), HDL (high-density lipoprotein) (44.70±12.73), total Cholesterol (191.29±49.66) uric acid (6.60±1.24) mg/dl , blood sugar level (109.02±32.58) mg/dl. Echocardiography examination show thay LVH (Left ventricular Hypertrophy) was 81.8% and diastolic dysfunction was 65.9%. Conclusion

Serum Osteoprotegerin Is an Independent Marker of Metabolic Complications in Non-DialysisDependent Chronic Kidney Disease Patients.

Background: Osteoprotegerin (OPG) belongs to the tumour necrosis factor superfamily and is known to accelerate endothelial dysfunction and vascular calcification. OPG concentrations are elevated in patients with chronic kidney disease. The aim of this study was to investigate the association between OPG levels and frequent complications of chronic kidney disease (CKD) such as anaemia, protein energy wasting (PEW), inflammation, overhydration, hyperglycaemia and hypertension. Methods: One hundred non-dialysis-dependent men with CKD stage 3–5 were included in the study. Bioimpedance spectroscopy (BIS) was used to measure overhydration, fat amount and lean body mass. We also measured the serum concentrations of haemoglobin, albumin, total cholesterol, C-reactive protein (CRP), fibrinogen and glycated haemoglobin (HgbA1c), as well as blood pressure. Results: We observed a significant, positive correlation between OPG and age, serum creatinine, CRP, fibrinogen, HgbA1c concentrations, systolic blood pressure and overhydration. Negative correlations were observed between OPG and glomerular filtration rate (eGFR), serum albumin concentrations and serum haemoglobin level. Logistic regression models revealed that OPG is an independent marker of metabolic complications such as anaemia, PEW, inflammation and poor renal prognosis (including overhydration, uncontrolled diabetes and hypertension) in the studied population. Conclusion: Our results suggest that OPG can be an independent marker of PEW, inflammation and vascular metabolic disturbances in patients with chronic kidney disease.

Značaj određivanja koncentracije uromodulina u serumu bolesnika sa dijabetes melitusom tip 2

Introduction: In the kidney, cells in the thick ascending limb of the loop of the Henle synthesized uromodulin (UMOD). This study aims to present the evaluation of the uromodulin serum concentration in diabetes mellitus type 2 (T2DM) patients in the early detection of kidney damage. Materials and methods: The study included 50 T2DM patients mean age of 60.75 ± 11.23 years estimated glomerular filtration rate (eGFR) 114.38 ± 22.12 ml/min and a control group of 20 healthy persons. We measured serum concentration of haemoglobin, urea, creatinine, uromodulin (ELISA method), and cystatin C (nephelometry). We determined formulas: Cockcroft-Gault# (combination Cockcroft-Gault for patients with BMI &lt; 30 kg/m2 and Cockcroft-GaultLBW for patients with BMI ≥ 30 kg/m2), CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation), and simple Cystatin C. Results: T2DM patients had lower hemoglobin serum concentration as well as eGFR calculated by formulas: Cockcroft-Gault# and CKD-EPI. T2DM patients had significantly higher BMI and cystatin C compared to control group. T2DM patients had significantly lower serum uromodulin concentration (136.51 ± 84.34 vs 220.50 ± 92.39 ng/ml) than in controls. Significant positive correlation between uromodulin and Cockcroft-Gault# (r = 0.432, p = 0.000), CKD-EPI (r = 0.439; p = 0.000) formulas as well as simple cystatin C (r = 0.250, p = 0.02), but negative correlation with age (r = -0.476, p = 0.000), BMI (r = -0.313, p = 0.002) and cystatin C serum concentration (r = -0.293, p = 0.015) were found. Conclusion: The role of serum uromodulin concentration is not still fortified. The results of this study showed that reduced uromodulin serum concentration indicated early kidney damage in T2DM patients.

Markers of Environmental Enteric Dysfunction Are Associated with Poor Growth and Iron Status in Rural Ugandan Infants

ABSTRACTBackgroundEnvironmental enteric dysfunction (EED), characterized by altered intestinal permeability/inflammation, microbial translocation, and systemic inflammation (SI), may be a significant contributor to micronutrient deficiencies and poor growth in infants from low-resource settings.ObjectiveWe examined associations among EED, SI, growth, and iron status at 6 mo of age.MethodsWe performed a cross-sectional analysis of 6-mo-old infants (n = 548) enrolled in a Ugandan birth-cohort study (NCT04233944). EED was assessed via serum concentrations of anti-flagellin and anti- LPS immunoglobulins (Igs); SI was assessed via serum concentrations of ɑ1-acid glycoprotein (AGP) and C-reactive protein (CRP); iron status was assessed via serum concentrations of hemoglobin (Hb), soluble transferrin receptor (sTfR), and ferritin. Associations were assessed using adjusted linear regression analysis.ResultsAt 6 mo, ∼35% of infants were stunted [length-for-age z score (LAZ) < −2] and ∼53% were anemic [hemoglobin (Hb) <11.0 g/dL]. Nearly half (∼46%) had elevated AGP (>1 g/L) and ∼30% had elevated CRP (>5 mg/L). EED and SI biomarkers were significantly correlated (r = 0.142–0.193, P < 0.001 for all). In adjusted linear regression models, which included adjustments for SI, higher anti-flagellin IgA, anti-LPS IgA, and anti-LPS IgG concentrations were each significantly associated with lower LAZ [β (95% CI): −0.21 (−0.41, 0.00), −0.23 (−0.44, −0.03), and −0.33 (−0.58, −0.09)]. Furthermore, higher anti-flagellin IgA, anti-flagellin IgG, and anti-LPS IgA concentrations were significantly associated with lower Hb [β (95% CI): −0.24 (−0.45, −0.02), −0.58 (−1.13, 0.00), and −0.26 (−0.51, 0.00)] and higher anti-flagellin IgG and anti-LPS IgG concentrations were significantly associated with higher sTfR [β (95% CI): 2.31 (0.34, 4.28) and 3.13 (0.75, 5.51)].ConclusionsEED is associated with both low LAZ and iron status in 6-mo-old infants. Further research on the mechanisms by which EED affects growth and micronutrient status is warranted.

Molecular Aspects and Treatment of Iron Deficiency in the Elderly.

Iron deficiency (ID) is the most frequent nutritional deficiency in the whole population worldwide, and the second most common cause of anemia in the elderly. The prevalence of anemia is expecting to rise shortly, because of an ageing population. Even though WHO criteria define anemia as a hemoglobin serum concentration <12 g/dL in women and <13 g/dL in men, several authors propose different and specific cut-off values for the elderly. Anemia in aged subjects impacts health and quality of life, and it is associated with several negative outcomes, such as longer time of hospitalization and a higher risk of disability. Furthermore, it is an independent risk factor of increased morbidity and mortality. Even though iron deficiency anemia is a common disorder in older adults, it should be not considered as a normal ageing consequence, but a sign of underlying dysfunction. Relating to the molecular mechanism in Iron Deficiency Anemia (IDA), hepcidin has a key role in iron homeostasis. It downregulates the iron exporter ferroportin, inhibiting both iron absorption and release. IDA is frequently dependent on blood loss, especially caused by gastrointestinal lesions. Thus, a diagnostic algorithm for IDA should include invasive investigation such as endoscopic procedures. The treatment choice is influenced by the severity of anemia, underlying conditions, comorbidities, and the clinical state of the patient. Correction of anemia and iron supplementation should be associated with the treatment of the causal disease.

Chronic abnormal uterine bleedings and quality of women’s life. How to significantly improve the result?

Purpose of the study: to determine the effect of iron and vitamin D subsidies on the quality of women’s life who receive pathogenetic therapy for abnormal uterine bleedings (AUB) caused by adenomyosis and/or endometrial polyps.Materials and methods. 114 patients with chronic AUB were randomized into two groups. The main group consist of 58 women, including 46 women with chronic AUB and adenomyosis (AUB-A), 12 women with adenomyosis and endometrial polyps (AUB-A,P). Women with AUB-A were prescribed 2 mg dienogest daily for the treatment of adenomyosis, similarly to patients with AUB-A,P after hysteroresection. All women in the main group also took a vitamin complex (iron, folate, iodine, vitamin D3, docosahexaenoic acid). The control group included 56 patients (43 women with AUB-A, 13 women with AUB-A,P) who were prescribed etiopathogenetic treatment (dienogest 2 mg per day and/or hysteroresection for endometrial polyps) without a vitamin complex subsidy. Quality of life was assessed using the SF-36 questionnaire. All patients received serum concentrations of hemoglobin, ferritin and 25(OH)D before and 3 months after treatment.Results. Iron-free dienogest therapy led to an increase serum hemoglobin levels after 3 months (p = 0.001). After three months vitamin complex Pregna-5 added there were significantly increased of hemoglobin levels, ferritin and 25(OH)D. This is accompanied by an improvement in the overall indicator of physical (r = 0.421, p &lt;0.05) and psychological health (r = 0.385, p &lt;0.05) on the SF-36 scale. An increase in serum ferritin greatly improves the psychological (r = 0.660, p &lt;0.05) and physical components of women’s health (r = 0.522, p &lt;0.05). Optimization of serum vitamin D levels improves physical health (r = 0.494, p &lt;0.05). Conclusions. It is necessary to combine etiopathogenetic therapy with additional sources of vitamin D and iron for successful therapy of AUB and restoration of deficient conditions. This is significantly improves the quality of life.

Conservation of both hematocrit and liver regeneration in hepatectomies: a vascular occlusion approach in rats.

ABSTRACT Background: Hepatectomies promote considerable amount of blood loss and the need to administrate blood products, which are directly linked to higher morbimortality rates. The blood-conserving hepatectomy (BCH) is a modification of the selective vascular occlusion technique. It could be a surgical maneuver in order to avoid or to reduce the blood products utilization in the perioperative period. Aim: To evaluate in rats the BCH effects on the hematocrit (HT) variation, hemoglobin serum concentration (HB), and on liver regeneration. Methods: Twelve Wistar rats were divided into two groups: control (n=6) and intervention (n=6). The ones in the control group had their livers partially removed according to the Higgins and Anderson technique, while the rats in the treatment group were submitted to BCH technique. HT and HB levels were measured at day D0, D1 and D7. The rate between the liver and rat weights was calculated in D0 and D7. Liver regeneration was quantitatively and qualitatively evaluated. Results: The HT and HB levels were lower in the control group as of D1 onwards, reaching an 18% gap at D7 (p=0.01 and p=0.008, respectively); BCH resulted in the preservation of HT and HB levels to the intervention group rats. BCH did not alter liver regeneration in rats. Conclusion: The BCH led to beneficial effects over the postoperative HT and serum HB levels with no setbacks to liver regeneration. These data are the necessary proof of evidence for translational research into the surgical practice. : A) Unresected liver; B) liver appearance after the partial hepatectomy (1=vena cava; 2=portal vein; 3=hepatic vein; 4=biliary drainage; 5=hepatic artery)

Phenolic Compounds in Honey and Their Associated Health Benefits: A Review.

Honey is a natural substance appreciated for its therapeutic abilities since ancient times. Its content in flavonoids and phenolic acids plays a key role on human health, thanks to the high antioxidant and anti-inflammatory properties that they exert. Honey possesses antimicrobial capacity and anticancer activity against different types of tumors, acting on different molecular pathways that are involved on cellular proliferation. In addition, an antidiabetic activity has also been highlighted, with the reduction of glucose, fructosamine, and glycosylated hemoglobin serum concentration. Honey exerts also a protective effect in the cardiovascular system, where it mainly prevents the oxidation of low-density lipoproteins, in the nervous system, in the respiratory system against asthma and bacterial infections, and in the gastrointestinal system. A beneficial effect of honey can also be demonstrated in athletes. The purpose of this review is to summarize and update the current information regarding the role of honey in health and diseases.

Correlation between Expression of CD200 and Regulatory T Cells in Multiple Myeloma and Its Significance in Prognostic Stratification

To study the correlation between expression of CD200 and regulatory T cells (Tregs) in multiple myeloma(MM) patients and to explore its significance in prognostic stratification. CD200 and other immunophenotypes, including CD38, CD138, CD56, CD19, CD20, CD117, cytoplasm light chain Kappa and Lambda in bone marrow samples, and Tregs in peripheral blood were detected by flow cytometry from 78 newly diagnosed MM patients. Serum concentrations of hemoglobin(Hb), β2 microglobulin (β2-MG) and lactate dehydrogenase (LDH) were detected, respectively. The new risk stratification of patients was carried out according to international stage system (ISS) and cytogenetic characteristics. The correlation between expression of CD200 and Tregs in MM patients was analyzed and their differences in prognosis were compared. The positive rate of CD200 expression was 71.79% in 78 patients (56/78). The expression of CD200 in sex and age of patients was no significant different. The expression of CD117 in CD200+ group was significantly higher than that of in CD200- group (P=0.032). There was no significant difference in the expression of CD20, CD56 and CD19 between 2 groups. The level of Hb in CD200+ group was significantly lower than that in CD200- group (P=0.035). The level of β2-MG in CD200+ group was significantly higher than that in CD200- group (P=0.013). There was no significant difference in the level of LDH between 2 groups. In CD200+ group, 17 patients were in stageⅠ, accounting for 58.62% (17/29), 30 patients were in stageⅡ, accounting for 75% (30/40), 9 patients were in stage Ⅲ, accounting for 100% (9/9). With the increase of CD200 expression intensity, the risk of prognostic stratification went up (P=0). The brighter CD200 expressed, the worse the prognosis was. The percentage of Trges in CD200+ group was significantly higher than that of in CD200- group (P=0.043). The content of Tregs was positively correlated with the expression of CD200 (r=0.743, P=0.044). Overall survival in CD200- group was significantly higher than that in CD200+ group (P=0.036). Progression-free survival in CD200- group was a bit higher than that of in CD200+ group, but it wasn't statistically significant. The expression of CD200 positively correlates with the percentage of Tregs in MM patients. It is an important factor of poor prognosis and a reliable indicator for the evaluation by clinical efficacy in MM patients.

The Content of Reticulocyte Hemoglobin and Serum Concentration of the Soluble Transferrin Receptor for Diagnostics of Anemia in Chronically Hemodialyzed Patients.

Chronic renal disease constitutes a serious worldwide clinical problem. An important issue arising early during the treatment of renal failure is anemia. Patients in the end-stage of renal disease chronically treated with hemodialysis frequently suffer from anemia with iron deficiency. The aim of the study was to evaluate the usefulness of determining the reticulocyte hemoglobin content and serum concentration of soluble transferrin receptor in the detection of anemia caused by iron deficiency in comparison with the classic markers of iron circulation in serum in chronic dialysis patients with ESRD. 66 sets of hematologic results and iron turnover rates were analyzed, sampled from hemodialyzed patients (test group), as well as 34 sets of the same results taken from healthy people (control group). Statistically significant variables were found and a stepwise backward discriminant analysis was performed for them. The results showed that dialyzed patients have a significantly lower serum concentration of hemoglobin, CHr, HCT, TSAT, Fe and TIBC and significantly higher serum concentration of sTfR, ferritin and C-reactive protein compared to the control group. Based on the results of discriminant analysis, we proposed a scheme for assessing the risk of anemia. The concentrations of hemoglobin, soluble transferrin receptor, iron in the serum and C-reactive protein turned out to be the most useful for diagnostic purposes. Moreover, the concentration of soluble transferrin receptor confirmed its high diagnostic value in the detection of iron deficiency-based anemia in patients undergoing dialysis for chronic renal failure at the end-stage compared to conventional iron turnover ratios in the serum.

Impact of BMI on Cardiovascular Events, Renal Function, and Coronary Artery Calcification

Background/Aims: High BMI increases the risk of cardiovascular events (CVEs) in the general population. Conflicting results have been reported on the role of BMI on CVEs and on decline of renal function in patients with chronic kidney disease not on dialysis (CKD). This study evaluates the impact of BMI on CVEs, dialysis initiation, and coronary artery calcification (CAC) in CKD patients. Methods: CKD patients were divided in normal-BMI and high-BMI patients. CVEs, initiation of dialysis, and extent and progression of CAC were assessed. Univariate and multivariable analysis were performed (adjustment variables: age, diabetes, hypertension, gender, CKD stage, serum concentration of hemoglobin, parathyroid hormone, calcium, phosphorus, albumin, C-reactive protein, LDL-cholesterol, total calcium score, 24-hour proteinuria). Patients were followed to the first event (CVE, dialysis) or for 2 years. Results: 471 patients were evaluated. A CVE occurred in 13.5 and 21.3% (p < 0.05) of normal-BMI and high-BMI patients, respectively. High BMI did not increase the risk for CVEs in univariate (HR: 1.86; 95% CI: 0.97-3.54; p = 0.06) or multivariable analysis (HR: 1.36; 95% CI: 0.57-3.14; p = 0.50). High BMI did not increase the risk for initiation of dialysis in univariate (HR: 0.96; 95% CI: 0.58-1.60; p = 0.9) or multivariable analysis (HR: 1.77; 95% CI: 0.82-3.81; p = 0.14). Adding the interaction term (between BMI and glomerular filtration rate) to other variables, the risk of dialysis initiation significantly increased (HR: 3.06; 95% CI: 1.31-7.18; p = 0.01) in high-BMI patients. High BMI was not a predictor of CAC extent or progression. Conclusions: High BMI was not a predictor of CVEs. High BMI increased the risk for dialysis initiation, but high BMI was not associated to CAC extent and progression. The presence of confounders may underestimate the impact of high BMI on dialysis initiation.

ANEMIA PADA IBU USIA 17-35 TAHUN DI DAERAH ‘REPLETE’ ENDEMIK DEFISIENSI IODIUM

ANEMIA OF CHILD BEARING AGE MOTHERS 17-35 YEARS OF AGE IN ENDEMIC IODINE ‘REPLETE’ AREA Iron Deficiency Anemia (IDA) as well as Iodine Deficiency Disorder (IDD) both have adverse effects on cognitive and neuropsychomotor, and adverse pregnant outcomes. Both iron and iodine have role on nuero development. Iron interact with iodine through the activity of thyroid peroxidase (TPO), an iron-dependent enzyme. IDA in iodine replete area (IRA) have not been reported. Assesments IDA (Hb), free thyroxine (fT4), Thyrotropin hormone (TSH) of reproductive mothers 17-35 years of age were conducted in IRA and non-endemic deficiency iodine area (NEDIA). Casual iodine urin concentration (UIC) of school age children was also assesed to confirm iodine endemicity of study area. Analysis of risk for anemia according to iodine status and correlation hemoglobin and thyrotropin were performed. The study area was confirmed to be non endemic iodine deficiency (UIC criteria). Median EIU were 242 (24-880) µg/L in IRA and 211 (44-387) µg/L in NEDIA respectively. Proportion of EIU less than 100 µg/L in IRA were 5.0 % and in NEDIA 1.2 %. Proporsion of EIU greater than 300 µg/L were 29.6 dan 24.7 persen respectively. The results indicated that study areas were no longer endemic iodine deficiency and the people where they live consumed iodine tend to excess. These situation may effect on thyroid function as indicated by suppressed TSH and fT4 in normal range. Those two thyroid function parameters significantly different in the IRA and NEDIA. The everages serum concentration of TSH in the study area were 1,96(1,56-2,36) in IRA compared to 1,38 (1,09-1,67) mUI/L in NEDIA(p=0,23); while fT4 were 1,29 (1,14-1,44) and 0,98 (0,90-1,05) µg/dL respectively. Hemoglobin serum concentration of mothers in those two area was not signicantly different; 12,45 (12,19-12,71) in IRA compared to 12,21 (11,96-12,46) mg/dL di NEDIA. Iron deficiency anemia was found 23,3 % in IRA and 35,7 % in NEDIA; however mothers in IRA have risk for anemia as big as mothers in NEDIA OR: 0,54(0,24-1,24). Analysis correlation (Spearman’s) between TSH and Hb provided coefisient correlation Rho as much as 0.072 indicated very weak correlation between the two parameters. There were no difference in proportion of hypothyroidism in the two study areas (OR: 0,68 (0,207-2,25). Although the proportion of iron deficiensi anemia (IDA) in IRA much less than the proportion in NEDIA; there were no relationship between IDA and Iodine deficiency. Absorption of Fe in IRA may be more efficient than did in NEDIA. More studies are needed to confirm this finding. Keywords : IDA, TSH, fT4, Hb, EIU, NEDIA, IRA

Placental abruption with certified fetomaternal hemorrhage after traffic injury

We report a case of patients with placental abruption which certified fetomaternal hemorrhage (FMH) after traffic injury. A 21-year-old multipara was admitted to private clinic after traffic accident on 29th week gestation. Cardiotocogram (CTG) showed sinusoidal-like pattern with tachycardia and she was transferred to our hospital. Her injury was also not severe, but due to abnormal CTG suggesting massive FMH, immediate cesarean section was performed. The infant was saved with the umbilical cord artery blood pH=7.243, and a maternal good postoperative course was observed. FMH was proved by maternal serum concentrations of hemoglobin F and alpha fetoprotein. Language: en

The impact of electronic education on metabolic control indicators in patients with diabetes who need insulin: a randomised clinical control trial

To determine the impact of electronic education on metabolic control indicators in patients with diabetes who were insulin dependent. Education can play an important role in controlling diabetes. Electronic (web-based, telehealth) education may be an efficient way to improve the patients' ability to control this disease. Randomised clinical control study. The participants in this clinical study were 48 insulin-dependent patients referred to diabetes centres in Shiraz, Iran. Serum concentrations of haemoglobin A(1C) , fasting blood sugar, triglycerides and high-density and low-density lipoprotein cholesterol were measured. Then the participants were divided randomly into control and experimental groups (n = 24). Participants in the experimental group received a specially designed electronic education programme for twelve weeks. The main components of the programme were a consultation service, quick answers to patients' questions, contact with the healthcare team and educational materials. At the end of the intervention period, all serum values were measured again in both groups. The data were compared using spss v 13·5 software. Serum concentrations of haemoglobin A(1C) (p < 0·001) and low-density lipoprotein cholesterol (p < 0·002) were significantly lower in the intervention group. The electronic education programme was useful in lowering two metabolic indicators of diabetes. Electronic education can be associated with increased health and patient satisfaction, and can eliminate the need to train personnel.