Serum Hemoglobin Concentration Research Articles

Source and level of dietary iron influence semen quality by affecting inflammation, oxidative stress and iron utilization levels in boars

BackgroundBoars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia, which suggested that the current level and form of iron supplementation in boar diets may be inappropriate. Therefore, 56 healthy Topeka E line boars aged 15–21 months were randomly divided into 5 groups: basal diet supplemented with 96 mg/kg ferrous sulfate (FeSO4) and 54 mg/kg glycine chelated iron (Gly-Fe, control); 80 mg/kg or 115 mg/kg Gly-Fe; 80 mg/kg or 115 mg/kg methionine hydroxyl analogue chelated iron (MHA-Fe, from Calimet-Fe) for 16 weeks. The effects of dietary iron supplementation with different sources and levels on semen quality in boars were investigated.Results1) Serum Fe and hemoglobin concentrations were not affected by reduced dietary iron levels in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups compared with the control group (P > 0.05). 2) Serum interleukin-6 (IL-6) and sperm malondialdehyde (MDA) levels in the 80 mg/kg or 115 mg/kg MHA-Fe groups were lower than those in the control group (P < 0.05), and higher serum superoxide dismutase levels and lower MDA levels in the 115 mg/kg MHA-Fe group (P < 0.05). 3) Boars in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups had lower serum hepcidin (P < 0.01), ferritin (P < 0.05), and transferrin receptor (P < 0.01) concentrations, and boars in the 115 mg/kg MHA-Fe group had higher seminal plasma Fe concentrations compared with the control group. 4) Boars in the 80 mg/kg and 115 mg/kg MHA-Fe groups had lower abnormal sperm rate and in situ oscillating sperm ratio compared to the control group at weeks 12 and/or 16 of the trial. However, the effect of Gly-Fe on improving semen quality in boars was not evident. 5) Serum IL-6 level was positively correlated with hepcidin concentration (P < 0.05), which in turn was significantly positively correlated with abnormal sperm rate (P < 0.05). Furthermore, significant correlations were also found between indicators of iron status and oxidative stress and semen quality parameters.ConclusionsDietary supplementation with 80 mg/kg or 115 mg/kg MHA-Fe did not induce iron deficiency, but rather reduced serum inflammatory levels and hepcidin concentration, alleviated oxidative stress, increased body iron utilization, and improved semen quality in adult boars.

#2742 Artificial intelligence accurately approximates MGPE dose response relationship in a North American Dialysis Population

Abstract Background and Aims The Anemia Control Model (ACM) is a certified medical device aimed at optimizing the management of CKD-related anemia among patients on dialysis. ACM is based on an artificial neural network (ANN) trained on over 900’000 patients treated in the European Nephrocare Network. Over the years, ACM has offered physicians hundreds of thousands of erythropoietin stimulating agent (ESA) and intravenous iron dosing suggestions and ensured high hemoglobin target achievement rate while minimizing drug use. However, evidence concerning its validity in non-European samples is still limited. Apollo Dial DB is the largest, fully anonymized, collaborative, international database of dialysis patients. The database includes detailed clinical information of more than 500,000 patients over millions of patient-months of observation with an extensive representation over geographies as well as ethnic groups. Given its detailed medical information and size, the database may offer unprecedented opportunities to develop and test equitable and fair decision support systems based on artificial intelligence. In this study we sought to re-train and validate and assess the accuracy of the ACM in an ethnically diverse sample of North American dialysis patients in Apollo Dial DB. Method We constructed the cohort for training and validation of this new ACM version by including a random sample of patients treated in the North American Fresenius Medical Care Dialysis Network. The sample accounted for 20% of the entire North American Section of the Apollo Dial DB dataset. Each patient history has been segmented in a collection of patient-months, which was the unit of analysis. The initial cohort was split in 3 datasets for training (70%), validation (20%) and test (10%). The input variables included laboratory test results, body weight, treatment data, age, sex, and previous ESA and iron prescription. The outcome of interest was the variation in serum hemoglobin concentration over 1 month of follow up. We compared the accuracy of the original ACM based on ANN (baseline model) with a newly trained algorithm based on high-performance light GBM. Results We included 44,220 patients followed by 2,277,276 patient-months overall. The mean age=60.9 ± 13.4, 59.2% were male, 56.4% were Caucasians, 32.2% African American, 3.2% Asians and 8.2% were others. At baseline, mean Hb= 10.9 ± 1.2. The original EMEA version of the Anemia Control Model (ACM) was still accurate in North American patients (mean absolute error, MAE = 0.65 g/dL). The fine-tuned light GBM model achieved a 16% reduction in error rate (MAE = 0.55 g/dL; Fig. 1). No difference in MAE was observed across sex and ethnic groups. Conclusion This study demonstrates the excellent predictive performance of the original ANN-based ACM in the North American dialysis population. Fine tuning by re-training ACM on the dataset further improved the accuracy of the model with substantial equivalence in performance across different demographics, thus ensuring algorithmic fairness. ACM is a promising tool for anemia management in ethnically diverse dialysis population and different healthcare settings.

Association of ambient air pollution with hemoglobin levels and anemia in the general population of Korean adults

BackgroundEmerging evidence has suggested significant associations between ambient air pollution and changes in hemoglobin levels or anemia in specific vulnerable groups, but few studies have assessed this relationship in the general population. This study aimed to evaluate the association between long-term exposure to air pollution and hemoglobin concentrations or anemia in general adults in South Korea.MethodsA total of 69,830 Korean adults from a large-scale nationwide survey were selected for our final analysis. Air pollutants included particulate matter with an aerodynamic diameter less than or equal to 10 micrometers (PM10), particulate matter with an aerodynamic diameter less than or equal to 2.5 micrometers, nitrogen dioxide, sulfur dioxide (SO2), and carbon monoxide (CO). We measured the serum hemoglobin concentration to assess anemia for each participant.ResultsIn the fully adjusted model, exposure levels to PM10, SO2, and CO for one and two years were significantly associated with decreased hemoglobin concentrations (all p < 0.05), with effects ranging from 0.15 to 0.62% per increase in interquartile range (IQR) for each air pollutant. We also showed a significant association of annual exposure to PM10 with anemia (p = 0.0426); the odds ratio (OR) [95% confidence interval (CI)] for anemia per each increase in IQR in PM10 was estimated to be 1.039 (1.001–1.079). This association was also found in the 2-year duration of exposure (OR = 1.046; 95% CI = 1.009–1.083; adjusted Model 2). In addition, CO exposure during two years was closely related to anemia (OR = 1.046; 95% CI = 1.004–1.091; adjusted Model 2).ConclusionsThis study provides the first evidence that long-term exposure to air pollution, especially PM10, is significantly associated with reduced hemoglobin levels and anemia in the general adult population.

The Effect of Albumin Administration in Critically Ill Patients: A Retrospective Single-Center Analysis.

The aim of this study was to analyze the development of albumin administration in patients admitted to the adult ICU. In addition, we assessed the impact of albumin administration on serum hemoglobin concentration. We conducted a retrospective single-center study including all patients who were admitted to the ICU from January 2013 to December 2021 and stayed at least 24 hours. The study was conducted in an academic hospital (University Hospital Basel, Switzerland). A total of 20,927 admissions were included, of which 3748 received albumin at least once during their ICU stay. To analyze volume expansion, 2006 admissions met the inclusion criteria, namely at least two hemoglobin measurements within 12 hours, one albumin delivery, and experienced no bleeding, dialysis, or transfusions during this period. None. We examined the hemoglobin levels before and after albumin administration and compared them with a matched control group to assess the amount and duration of volume expansion. From 2013 to 2021 the proportion of critically ill patients treated with albumin rose from 5.0% to 32.5%. An overproportioned increase in albumin use could be seen in surgical patients (4.7-47.2%) and in those receiving RBC transfusion (13.7-72.6%). In those patients receiving albumin, a significant drop in hemoglobin of around 5 g/L on average could be observed following treatment with albumin. Hemodilution was observable for at least 12 hours after albumin administration and may have caused a decrease in hemoglobin concentration of greater than 8 g/L when isooncotic albumin solution (5%, 25 g in 500 mL) was administered. This makes albumin, especially in its isooncotic form, an ideal colloid to achieve long-lasting volume expansion. However, RBC transfusions may increase under albumin therapy, as transfusion thresholds may be undershot after albumin administration.

Application of joint modeling on the determinants of TB Status and CD4 cell count among antiretroviral therapy attendants in Gondar teaching referral hospital, Gonder, Ethiopia.

East African regions were highly affected by tuberculosis and the human immunodeficiency virus. The main objective was to identifying the associated factors with tuberculosis and CD4 cell count of patients in Gonder teaching referral hospital, Gonder, Ethiopia. A retrospective cohort study was conducted on AIDS patients from 1st January 2018 - to 30th January 2020. This study used joint mixed model, and individual profile plot to identify factors and the changeability inside and between patients respectively. The mean with a standard deviation of weight and a serum hemoglobin concentration of patients were 55.48 (10.21) kilograms and 18.25 (33.028) grams per decilitre respectively.This study shows an opportunistic infection, weight, and serum hemoglobin concentration were significantly associated with the log CD4 cell count and tuberculosis status of patients. The patient who has other diseases is 5.04 more likely to be co-infected with HIV and TB diseases. And also, the estimated odds of being co-infected in both diseases were increased by 1.14 and 1.05 times when a unit change in weight and hemoglobin respectively. Moreover, the estimated odd of patients who have no other related disease were 51.13% less likely to be co-infected with both diseases.

Association between nutritional status and biochemical markers among hematopoietic stem cell transplant candidates: a cross-sectional study

AimCandidates of Hematopoietic Stem Cell Transplantation (HSCT) may be at nutritional risk due to decreased oral intake, high nutritional requirements and nutrient malabsorption. The aim of this study was to evaluate the association between nutritional status and blood biomarkers in candidates of HSCT.MethodsA total of 278 patients aged 18–65 years old were recruited and their baseline demographic and clinical characteristics were recorded. All subjects underwent nutritional status analysis using Nutritional Risk Screening (NRS-2002). Blood biomarkers including C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), hemoglobin, albumin and total protein as well as CRP-albumin ratio (CAR) and Body Mass Index (BMI) were measured and compared between two groups based on Nutritional Risk Screening (NRS-2002) within 24 h of admission in Bone Marrow Transplant ward.ResultsThe results showed that undernourished patients (NRS ≥ 3) had significantly higher inflammatory markers including ESR, CRP and CAR as well as lower BMI and serum albumin and hemoglobin concentrations (P < 0.05); however, no significant association was observed in terms of total protein even after adjusting for confounders (P > 0.05).ConclusionsThis study revealed that BMI combined with biochemical markers are the appropriate parameters for assessment of nutritional status in HSCT candidates. Furthermore, the nutritional status was verified to be significantly associated with systematic inflammation.

An Analytical Cross-Sectional Study of Malnutrition in Hemodialysis Patients in Gorgan, Iran, 2020

Background: Malnutrition is relatively common in hemodialysis (HD) patients, which increases the risk of mortality. Seven Point Subjective Global Assessment (7-point SGA) tool is recommended to evaluate and monitor malnutrition in HD patients. The aim of this study was to investigate malnutrition using 7-point SGA in HD patients referred to dialysis centers in Gorgan city (north-eastern of Iran) in 2020. Methods: The nutritional status of 133 HD patients referred to Gorgan city dialysis center in 2020 were assessed using the 7-point SGA tool. Weight, percentage of fat, and muscle mass were measured by Omron BF511. Height was measured using the SECA portable stadiometer. Serum hemoglobin levels were recorded based on the latest recorded routine tests during the last month. A demographic information questionnaire was completed for all individuals. Medications and supplements taken by patients as well as visits by a nutrition consultant and adherence to a special diet were investigated by reviewing the medical file and asking the patient. Results: Out of 133 patients, 43.61% had no malnutrition and 56.39% had moderate malnutrition. The nutrition status was not different regarding gender and education level, but was different regarding household size (P=0.032). Patients with moderate malnutrition were older and had less weight and body mass index (BMI), but there was no statistically significant difference between height, dialysis time span, body fat and muscle mass percentage, and serum hemoglobin concentration. Conclusion: This study showed a considerable rate of malnutrition in HD patients, which should be regarded by clinicians and health policymakers.

The Longitudinal Mean Arterial Pressure among congestive heart failure patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

BACKGROUND Congestive heart failure could be defined as a condition where there is a performance or structural impairment of the heart. So this study was targeted on the determinants of the longitudinal mean arterial pressure among heart failure patients treated from January 2016 to December 2019 at Felege Hiwot Referral Hospital in Bahir Dar, Ethiopia. METHODS Hospital-based retrospective data were assembled from the medical chart of 218 randomly selected congestive heart failure patients. The linear mixed effects model corresponding to unstructured_ _covariance structure was employed to spot out the determinants of mean arterial pressure among in patients with congestive heart failure. RESULTS Individual profile plot of mean arterial pressure showed the existence of variability among and between those patients. Moreover, the mean profile plot demonstrated a linearly increasing pattern over the follow-up times. The random intercept and slope model corresponding to unstructured covariance structure was the best fit (AIC: 6001.9(χ^2=80.83), P &lt; 0.0001) as compared to the remaining models. The estimates for age, left ventricle ejection fraction, serum sodium concentration, visit times, serum hemoglobin concentration, residence(rural) and New York Heart Association Classes I, II, and III were given as 0.3758(P-value: &lt;0.0001), 0.2933(P-value: &lt;0.0001), 0.1941(P-value: &lt;0.0001), 0.4471(P-value: 0.0059), 0.5501(P-value: 0.0053), -9.9858(P-value: &lt;0.0001), 18.8943(P-value: 0.0001), 10.8833(P-value: &lt;0.0001) and 2.7318(P-value: 0.0001) respectively, and they are statistically associated with the longitudinal mean arterial pressure of congestive heart failure patients. CONCLUSION The linear mixed effects model corresponding to unstructured covariance structure provides an information on the existence of within and between subjects variations and correlations in addition to identifying the significant factors associated with the longitudinal mean arterial pressure of congestive heart failure patients. So, an application of standard models may ignore such a variation among successive measurements. Thus mixed effects model is recommended for such longitudinal data.

Less major bleeding and higher hemoglobin after left atrial appendage closure in high-risk patients: Data from a long-term, longitudinal, two-center observational study.

Left atrial appendage closure (LAAC) is a mechanical alternative for stroke prevention in patients at risk who cannot tolerate oral anticoagulation (OAC). Our hypothesis was that the reduction of anticoagulation following LAAC results in a decrease of bleeding events and a rise in serum hemoglobin in a high-risk collective of patients with atrial fibrillation (AF). Bleeding events, use of erythrocyte concentrates, anticoagulation, embolic events, and serum hemoglobin levels before and following LAAC were compared over more than 4 years. Seventy-five patients (CHA₂DS₂-VASc score 4.4 ± 1.7, HAS-BLED score 4.6 ± 1.1) were analyzed. Before LAAC (observation period 1.8 ± 1.8 years), 67 patients experienced 1.8 ± 1.4 bleeding events (0.9 ± 1.3 major) per year resulting in 0.7 ± 1.3 transfusions per year. After LAAC (2.6 ± 2.0 years), 26 patients (p < .0001 vs. before) had 0.6 ± 2.1 bleeding events (p < .0001), 0.2 ± 0.6 major bleedings (p < .0001) and received 0.6 ± 1.9 transfusions per year (p = .671). Fourteen patients had stroke before and 3 after LAAC (p = .008). Serum hemoglobin increased from initially 9.9 ± 3.0to 11.9 ± 2.3 g/dL until the end of follow-up (p = .0005). Adverse embolic events did not differ before and after LAAC in our collective. In this clinical relevant cohort of AF patients with high risk for stroke and intolerance to OAC, we show that LAAC was able to reduce the rate of stroke and bleeding events, which translated into a rising serum hemoglobin concentration.

Analysis of the clinical features and risk factors of kidney injury in patients with chronic heart failure-a retrospective cohort study.

Heart failure (HF) often leads to kidney injury and increased morbidity and mortality. Factors contributing to kidney injury in HF patients had not been elucidated completely. This study sought to comprehensively evaluate the risk factors and clinical features of kidney injury in patients with chronic heart failure (CHF) and to provide more evidence for the management of these patients. Adult patients with CHF admitted to Beijing Anzhen Hospital, Capital Medical University from January 2022 to May 2022 were included in this study. The primary endpoints were the independent risk factors for the development of kidney injury. A multivariate logistic regression model was used for the exploration of the risk factors. A total of 193 patients were included in this study, of whom 86 (44.5%) developed kidney injury. The independent risk factors for kidney injury in patients with CHF included sex (male) [odds ratio (OR): 4.30, 95% confidence interval (CI): 1.72-10.7, P=0.001], hypertension (OR: 3.68, 95% CI: 1.64-8.29, P=0.001), and stroke (OR: 3.82, 95% CI: 1.25-11.6, P=0.01). Kidney injury was significantly positively correlated with age (OR: 1.03, 95% CI: 1.008-1.06, P=0.01) and potassium (OR: 3.70, 95% CI: 1.58-8.67, P=0.002), and significantly negatively correlated with angiotensin receptor blocker (ARB) application (OR: 0.26, 95% CI: 0.11-0.61, P=0.001), serum albumin concentration (OR: 0.88, 95% CI: 0.81-0.96, P=0.005), hemoglobin concentration (OR: 0.97, 95% CI: 0.95-0.99, P=0.006), and left ventricular ejection fraction (LVEF; OR: 0.95, 95% CI: 0.92-0.98, P=0.01). Kidney injury occurred in more than half of the patients with CHF during hospitalization. The independent risk factors for kidney injury in the CHF patients included sex (male), hypertension, and stroke. Kidney injury was positively correlated with age and serum potassium, and negatively correlated with serum albumin, hemoglobin concentration, LVEF, and ARB application.

Anterior inferior cerebellar artery occlusion accompanied by hemorheology-documented increased blood viscosity: a case report.

Anterior inferior cerebellar artery (AICA) occlusion is a subtype of posterior circulation stroke. Confirmation of its angiomorphology and etiology is challenging because of the complex mechanisms underlying small-artery thrombogenesis. In addition to conventional factors, physicians frequently overlook hemorheological changes. In this case report, we describe right AICA occlusion in a 50-year-old man. He presented with an unsteady walk, tinnitus, dizziness, and left-sided peripheral facial palsy observed over 36 hours, accompanied by increased blood viscosity on hemorheological evaluation. Magnetic resonance imaging revealed acute infarction in the left cerebellar hemisphere and middle cerebellar peduncles. Magnetic resonance angiography (MRA) and computed tomographic angiography (CTA) failed to detect AICA occlusion, which was later confirmed using digital subtraction angiography. Repeat routine blood examinations showed elevated erythrocyte and leukocyte counts and serum hemoglobin concentrations that persisted over many days. Hemorheological evaluation revealed increased whole blood viscosity at a low shear rate. AICA occlusion should thus be diagnosed based on its initial characteristic manifestations; notably, MRA and CTA may fail to detect arterial occlusion. The importance of hemorheological change as a factor of stroke is frequently neglected. We therefore report this case hoping to emphasize its relevance, especially in small-artery occlusion.

Serum Ferritin as an Indicator of Neonatal Anaemia

Introduction: Haemoglobin levels are usually used to diagnose neonatal anaemia. By the time haemoglobin levels drop, body iron is depleted. Serum ferritin is the standard measure for assessment of iron levels in neonates and detects iron deficiency earlier than haemoglobin levels.&#x0D; Aims: To determine the prevalence of low haemoglobin and ferritin levels amongst term and preterm newborn babies. To determine the value of serum ferritin in the diagnosis of low iron stores amongst term and preterm newborns.&#x0D; Methodology: This was a cross sectional descriptive study carried out at the Neonatal Intensive Care Unit of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria between June and December 2014. The study included 140 newborns of all birth weights delivered at the UNTH. These were categorized into preterm (gestational age &lt;37 completed weeks) and term (gestational age ≥37 completed weeks. Babies with C-reactive protein levels &gt; 10mg/dl, who were intra-uterine growth restricted, and whose mothers had conditions associated with low iron stores were excluded from the study. Anthropometric measurements were done for all subjects. Haemoglobin estimation and ferritin assay were carried out and the prevalence of neonatal anaemia was determined using each of these.&#x0D; Results: The range of haemoglobin concentration in the study population was 12.22g/gl – 22.80g/dl. The mean serum haemoglobin concentrations were 15.69mg/dl ± 1.58 and 16.45 ± 1.92 in the preterm and term babies respectively (t = 2.557, P = .0116). The prevalence of low haemoglobin concentrations amongst both preterm and term babies was zero= .024). The range of serum ferritin level in the study population was 20.6µg/l - 296µg/l. The mean serum ferritin levels were 63.13µg/l ± 23.93 and 133.67µg/l ± 50.14 in the preterm and term babies respectively (t = 10.623, P &lt; .001). The prevalence of low serum ferritin in the study population was 22.14%, but was higher in preterm than term babies 35.7% vs 8.6%: (OR – 5.926, 95% C.I OR = 2.248 – 15.619)(P&lt;.001).&#x0D; Conclusion: Serum ferritin assay is more useful than haemoglobin as an indicator of anaemia during the neonatal period.

The comparison of effects of iron supplementation since pre-pregnant and during pregnant period on reducing iron deficiency anemia in pregnant women with mild anemia in Bali

Introduction: Iron deficiency anemia (IDA) is still a problem of pregnant women's health related to its high prevalence and its negative effects on health. Prevention efforts have been carried out through administration of oral iron tablets to women during their pregnancy; however, the expected results have not been satisfied yet. This failure is probably due to the assumption that, especially in developing countries, the iron store in pre-pregnant women is very low or may be empty, so that iron supplementation during pregnancy is not enough to prevent IDA. The aim of study is to know the difference of effect of iron supplementation in treated and control groups in terms of hemoglobin concentration, serum ferritin level and prevalence of IDA. Method: A quasi-experimental study was conducted on 99 non-pregnant new couple women. Iron tablets were administered to the treated group from the beginning of pre-pregnant period, continuing until the first 3 months of pregnancy, while in the control group iron tablets were only given during the first 3 months of pregnancy. IDA was measured by serum ferritin and hemoglobin concentration using WHO’s criteria, the benefit of iron tablet was measured by BCR technique. Result: The administration of an oral iron tablet from the prepregnant period (treated group) could decrease prevalence of IDA higher than the administration of oral iron tablet during pregnancy only (control group) (0% vs 38.46%, p&lt;0.05). A significant difference was also observed on mean serum ferritin concentration at the end of observation (the third month of pregnancy) 33.45±14.12 µg/dL in the treated group, and 19.65±8.99 µg/dL in the control group. This difference was statistically significant (p&lt;0.05). Meanwhile, the hemoglobin concentration was 12.25±1.20 g/dL in the treated group and 10.91±0.67 g/dL in the control group. This difference was also statistically significant (p&lt;0.05). Benefit analysis showed that administration of an oral iron tablet starting from pre-pregnancy is more advantageous (BCR &gt;1) compared to oral administration of iron tablet during the pregnancy period only. There were no significant differences in side effects and compliance of the patient to consume iron pills in both treated and control groups. Conclusion: The administration of oral iron tablets (iron supplementation) to pregnant women starting from pre-pregnant period results in a better effect compared to oral iron supplementation during pregnancy only. This program is feasible to be implemented in a community setting because its compliance is good.

Effect of tranexamic acid and total knee arthroplasty on perioperative coagulation indices and blo od loss in patients with knee osteoarthritis

Purpose: To study the effect of the combination of tranexamic acid and total knee arthroplasty (TKA) on perioperative coagulation indices and blood loss in patients with knee osteoarthritis (KOA). Methods: A total of 78 KOA patients who received TKA in Second Affiliated Hospital of Qiqihar Medical College from July 2020 to July 2022 were recruited and randomized to study and control groups in a ratio of 1:1 (n = 39). Patients in control group received 0.9 % sodium chloride, while those in study group were treated with 0.9 % sodium chloride plus tranexamic acid after TKA. Parameters evaluated include intraoperative bleeding, drainage volume, occult blood loss, and total blood loss. Results: The two groups of patients had similar intraoperative blood loss (p &gt; 0.05). Tranexamic acid significantly reduced postoperative drainage volume, occult blood loss, and total blood loss in TKA patients (p &lt; 0.05). Before and after treatment, no intergroup differences were seen in prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer (D-D) levels (p &gt; 0.05). The D-D levels of all patients showed a significant increase after TKA (p &lt; 0.05). Patients with tranexamic acid exhibited significantly higher serum hemoglobin (Hb) concentrations and lower serum white blood cell count (WBC) than those without tranexamic acid during TKA (p &lt; 0.05). Conclusion: Tranexamic acid plus TKA effectively reduces the intraoperative blood loss of KOA patients, restores knee function, improves serological condition, and lowers the incidence of postoperative complications and transfusion risk. Multicenter large-scale trials are, however, required prior to application in clinical practice.

Maternal factors associated with iron deficiency without anaemia in early pregnancy: ECLIPSES study

Several population-specific genetic, sociodemographic, and maternal lifestyle factors are related to iron status in early pregnancy, and their identification would allow preventive actions to be taken. The study aimed to identify maternal factors associated with iron deficiency (ID) in early pregnancy in non-anaemic pregnant women from a European Mediterranean country. Cross-sectional study using the initial population of the ECLIPSES study performed in non-anaemic pregnant women before gestational week 12. Serum ferritin (SF) and haemoglobin concentrations were measured to evaluate iron status, and ID was defined as SF < 15 µg/L. Several sociodemographic and lifestyle data were recorded and used as covariates in the multivariate-adjusted regression models. Out of the 791 participants, 13.9% had ID in early pregnancy. Underweight (OR 3.70, 95%CI 1.22, 15.53) and parity (1 child: OR 2.03, 95%CI 1.06, 3.88; ≥ 2 children: OR 6.96, 95%CI 3.09, 15.69) increased the odds of ID, while a high intake of total meat (≥ 108.57 g/day: OR 0.37, 95%CI 0.15, 0.87), red/processed meat (≥ 74.29 g/day: OR 0.70, 95%CI 0.35, 0.98), protein (≥ 65.05 g/day: OR 0.85, 95%CI 0.30, 0.99), and dietary iron (≥ 8.58 mg/day: OR 0.58, 95%CI 0.35, 0.94) protected against it. Smoking was also associated with a reduction in ID odds (OR 0.34, 95%CI 0.12, 0.99). Baseline BMI, parity, smoking, and diet are associated with ID in early pregnancy in non-anaemic women. Pregnancy planning policies should focus on women at higher risk of ID, such as those who are underweight, multiparous, or following vegetarian diets. This clinical trial was registered at www.clinicaltrialsregister.eu as EudraCT number 2012–005,480-28 and at www.clinicaltrials.gov with identification number NCT03196882.

Abstract TP117: Temporal Serum Iron And Hemoglobin Changes In Patients From The High Dose Deferoxamine In Intracerebral Hemorrhage Trial

Introduction: Following intracerebral hemorrhage (ICH), elevated cerebral tissue iron concentrations are seen. It is unclear how peripheral serum iron concentrations change over time and how they relate to anemia after ICH. Given the known impacts of iron concentrations and anemia on clinical outcomes, we explored serum iron biomarker and hemoglobin concentration changes after acute ICH. Methods: A post hoc analysis of patients with available serial (baseline and 5 day) serum biomarker data from the multicenter, High Dose Deferoxamine in Intracerebral Hemorrhage (HI-DEF) trial was performed. Changes of serum hemoglobin, iron, transferrin, and ferritin were assessed using repeated measure ANOVA analyses. Deferoxamine treatment and poor 90 day modified Rankin Scale 4-6 were separately assessed as between subject factors for these laboratory changes. Results: Of 42 ICH patients analyzed, the mean age was 64, 62% were male, median ICH volume was 15.7mL (IQR 5.7-37.5), and baseline anemia was seen in 19%. We identified significant decrements of hemoglobin (mean difference -1.4 g/dL; 95%CI: -1.9 to -0.9; p&lt;0.0001), iron (mean difference -16.9 ug/dL; 95%CI: -29.7 to -4.1; p=0.01), transferrin (mean difference -43.9 ng/mL; 95%CI: -56.6 to -31.3; p&lt;0.0001), and conversely, significant ferritin elevations (mean difference 104.5 ug/L; 95%CI: 52.5-156.6; p&lt;0.0001) at 5 days. Anemia was identified in 43% of patients at 5 days. Deferoxamine did not have a significant impact on these repeated measures. Patients with poor long-term outcomes had greater decrements in hemoglobin compared to those with good outcomes (mean difference: -1.5 g/dL; 95%CI: -2.6 to -0.3; p=0.01). Conclusions: Serum iron and hemoglobin concentrations decrease significantly over time following ICH. Patients with worse long term ICH outcomes had greater hemoglobin decrements during their hospitalization. The aggregate iron biomarker and hemoglobin concentration changes suggest anemia development may be due to anemia of inflammation. Further work is required to address the pathophysiologic difference between systemic and central iron homeostasis mechanisms following ICH and the impacts that ICH has on inflammation, systemic iron homeostasis, anemia, and clinical outcomes.

Association of the changes in hepatic enzymes, bilirubin, and plasma proteins with beta-thalassemia in iron over loaded-patients

Changes in liver enzymes and bilirubin in patients with thalassemia depend on genetic changes and the association of other genetic determinants. Iron overload is associated with increased morbidity in both transfusion-dependent and non-transfusion-dependent thalassemia patients. The main objective was to evaluate hepatic enzymes, bilirubin and plasma proteins in βTM patients and also to study the correlations of these parameters with serum hemoglobin and ferritin concentrations in βTM patients. To achieve this goal, the study was directed on two groups, the first is case group includes 39 patients with βTM and the second control group includes 34 subject. Serum ALT, AST, total bilirubin, albumin and total protein concentrations were measured by UV-Vis Spectrophotometer, while the concentration of serum ferritin was measured by ELISA Kit. Our results showed that there are highly significant differences between beta thalassemia major and ferritin at mean (2942.71) , furthermore there are highly significant differences between beta thalassemia major and liver enzymes at (71.98) for AST , (69.42) for ALT, (6.98) for Total protein, (3.92) for Albumin and (2.32) for Total bilirubin. In addition our findings showed there are Correlations between serum ferritin concentrations and liver function testes in βTM patients, where there are highly significant differences between beta thalassemia major and Alanine transaminase at mean (r = 0.44), while the Correlation between serum hemoglobin concentration and liver function testes showed highly significant differences between beta thalassemia major and aspartate aminotransferase at mean (r = 0.52). The study concluded that the increase in serum liver enzymes (ALT, AST) and total bilirubin concentrations in patients with βTM are indicator to liver dysfunction that is correlated to iron overload.

Assessment of iron status and iron deficiency anemia in patients with celiac, a single center experience.

This study aimed to assess the status of iron stores and the frequency of iron deficiency anemia in Celiac disease (CD) patients referred to the Golestan Research Center of Gastroenterology and Hepatology, Gorgan, Iran. Studies have shown that nutritional deficiencies affect 20-38% of patients with CD due to malabsorption and as a result of a gluten-free diet. In this study, 59 out of 100 CD patients were assessed. The presence and severity of anemia were determined using the concentration of serum hemoglobin according to WHO criteria. The status of body iron stores was also assessed based on serum ferritin levels. Mean and SD of age, duration of disease, serum hemoglobin, ferritin, TIBC, and serum iron were 39.9±11.9 years, 69.8±45.4 months, 12.6±1.99 g/dl, 54.3±55.3 mg/dL, 365.9±49.1 μg/dL, and 84.1±37.1 μg/dL, respectively. 68.42% had no anemia, 19.3% had mild anemia, 8.77% had moderate anemia, and 3.51% had severe anemia. 25.42% of patients had depleted iron stores, 71.19% had normal iron stores, and 3.39% were exposed to iron overload. There was a statistically significant correlation between serum hemoglobin and the duration of disease diagnosis (P=0.037, r=0.302). In this study, 31.58% of CD patients on a gluten-free diet had some degree of anemia. In addition, 25.42% of patients had depleted iron stores. These results suggest that CD patients should be evaluated for iron status, even with a gluten-free diet.

Assessment Of serum ferritin level, hemoglobin concentration and red blood cell indices in apparently healthy Sudanese blood donors attending central blood bank Gezira State –Sudan (2020)

Objectives: To correlate the serum Ferritin level, hemoglobin concentration and red blood cell indices among blood donors. Material and Methods: This is prospective, cross-sectional analytical study. Conducted in Wad-Madani central blood bank, Gezira state from July to December 2020. Venous blood samples were taken from 140 donors. The blood samples were investigated for various haematological parameters on a fully automated haematology analyzer (Sysmex xp-300). Serum Ferritin was estimated using chemical analyzer (A15). Results: The mean value of serum Ferritin was found to be (141.46 ±97.85). The study showed normal serum Ferritin level in 122 (87%) of blood donors and low serum Ferritin in 6 of male blood donors (4.3%). 12 of blood donors showed serum Ferritin level above the normal range (8.6%). Conclusion: The study concluded that regular blood donation had less effect on serum ferritin level.

Assessment Of serum ferritin level, hemoglobin concentration and red blood cell indices in apparently healthy Sudanese blood donors attending central blood bank Gezira State –Sudan (2020)

Assessment Of serum ferritin level, hemoglobin concentration and red blood cell indices in apparently healthy Sudanese blood donors attending central blood bank Gezira State –Sudan (2020)