Hb Values Research Articles

Analysis of JAK2V617F Tyrosine Kinase Mutation in Blood Donors with Erythrocytosis - A Pilot Study in a Tertiary Care Teaching Hospital of South India.

PurposeTransfusion services and blood centers provide immediate medical evaluation to blood donors by physical examination and hemoglobin (Hb) screening. Screening for Hb value before every blood donation is mainly aimed to rule out anemia. However, it is not uncommon to defer the donors for high Hb value which can be due to primary or secondary polycythemia. This study aimed to analyze the frequency of JAK2V617F mutation among blood donors with a high Hb of >18 g/dl.Patients and MethodsA prospective study was conducted over a period of 18 months involving blood donors with a persistently high Hb value of >18 g/dl. Complete blood count (CBC), JAK2V617F gene mutation and Serum Erythropoietin (EPO) levels in study donors were analyzed. Descriptive statistical analysis was performed using SPSS, version 24 (IBM, USA).ResultsOf 13,798 screened donors, 48 donors (0.34%) had persistent erythrocytosis with a high Hb value of >18 g/dl. Their age ranged between 20–50 years with a mean of 31.2 ± 6.66. The CBC parameters including red blood cell (RBC) count, Hb%, hematocrit (Hct), white blood cell (WBC) count and the platelet count ranged from 4.35–8.43 million/µL (6.2 ± 0.6), 18.6–24.4 g/dl (19 ± 0.94), 51.9–83.3% (58 ± 5.02), 3.99–10.8 × 103/µL (7.8 ± 1.5), and 120–450 × 103/µL (227 ± 57.2), respectively. Estimated mean EPO value was 8.29 mIU/± 0.04. JAK2V617F mutation was detected in 2 donors (4.1%).ConclusionThe prevalence of persistent erythrocytosis among blood donors was 0.34% and among them, two donors (4.1%) harbored the JAK2V617F mutation. Thus, blood centers play an important role in the primary screening of donors with high hemoglobin leading to early detection and management of polycythemia vera (PV).

Kalça kırığı cerrahisi geçiren yaşlı hastalarda uzun dönem antitrombotik tedavilerin perioperatif morbidite ve mortalite üzerine etkisi

ABSTRACT
 Objective: Ischemic complications or massive bleeding are important perioperative complications in elderly patients using antithrombotic drugs. The need for blood product replacement, transfusion-related complications, prolonged stay in hospital and intensive care unit, and high mortality in the perioperative period can be seen. The aim of this study was to investigate the effects of long-term different antithrombotic therapies on morbidity and mortality in elderly patients undergoing surgery for hip fracture.
 Materials and Methods: This retrospective cohort study included patients aged 65 years and older who underwent surgery for hip fracture between 2015 and 2018. Patients with no antithrombotic treatment (Group NonAT), warfarin (Group Warfarin), novel oral anticoagulants (Group NOACs), or dual antiplatelet therapy (Group DAPT) were compared in terms of major bleeding, deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) complications, length of hospital stay (LOS), ICU admission, and 30-day mortality.
 Results: The study included 668 patients; demographic data in Group NonAT (n=442), Group Warfarin (n=59), Group NOACs (n=30) and Group DAPT(n=137) were similar. Major bleeding and red blood cell transfusion did not differ statistically between all groups. (p>0.05) The preoperative and postoperative Hb values of the patients were not statistically different between the groups (p>0.05). Mortality, only there was statistically significantly higher in the dual antiplatelet group than the non user group. (p0.05) However survival was statistically significant different (p

Preoperative hemoglobin and BMI are correlated with increased risk of conversion for minimally invasive gynecological oncology surgeries (564)

Preoperative hemoglobin and BMI are correlated with increased risk of conversion for minimally invasive gynecological oncology surgeries (564)

Clinical comparison of three-dimensional exoscope vs. operative microscope in transforaminal lumbar interbody fusion: A retrospective case-control study.

Here, we sought to determine the safety and feasibility of three-dimensional exoscope (3D EX). We compared data on surgery, complications, postoperative drainage, hematology, and clinical outcomes in the group that underwent transforaminal lumbar interbody fusion (TLIF) using an operative microscope (OM) relative to those treated using 3D EX. We retrospectively reviewed records on 74 patients who underwent one- or two-level TLIF from August 2019 to October 2020. Repeated measures analysis of variance was used to compare pre- and post-operative visual analogue scale (VAS) scores and oswestry disability index (ODI). We used analysis of covariance to compare pre- and post-operative erythrocyte count (RBC), hemoglobin (Hb), and hematocrit (Hct). Independent sample t-tests was used to compare postoperative drainage volume, total blood loss (TBL), visible blood loss (VBL) and hidden blood loss (HBL). There were no significant differences in VAS and ODI scores between the two groups at all time points (all p > 0.05). RBC and HBL did not differ significantly between the two groups (all p > 0.05). There were significant differences in postoperative drainage volume,TBL, Hb, and Hct values when using 3D EX relative to OM in two-level TLIF (all p < 0.05), but not for one-level TLIF (all p > 0.05). The two groups differed significantly with regards to VBL when used for one- or two-level TLIF (all p < 0.05). Our data show that 3D EX is a suitable alternative to OM in TLIF. Relative to OM, 3D EX has important strengths in reducing perioperative bleeding in two-level TLIF.

Evaluation of Anemia Frequency and Types in Patients with Subclinical and Clinical Hypothyroidism in the Endemic Goiter Region

ABSTRACT&#x0D; Objective: Hypothyroidism is a disease that occurs as a result of thyroid hormone deficiency or rarely, due to ineffectiveness at the tissue level. While the prevalence of clinical hypothyroidism is reported to be 2-5% worldwide, of subclinical hypothyroidism it is 4-8.5%, with the prevalence of subclinical hypothyroidism in women over 60 years of age being 14-20%. Hypothyroidism affects many organs and systems in the body, one of which is the hematopoietic system. Thyroid hormone deficiency plays a role in the development of microcytic, normocytic and macrocytic anemia. The frequency of anemia in patients with hypothyroidism varies between 20-60%. In this study, our aim was to determine the regional prevalence of subclinical and clinical hypothyroidism in adult patients in our region and to evaluate the frequency and types of anemia in patients with hypothyroidism.&#x0D; &#x0D; Method and Material: This study was prospectively conducted between 01.12.2012 and 01.05.2013 at the outpatient clinic of Recep Tayyip Erdogan University Faculty of Medicine Endocrinology. Included in the study were 96 patients who had subclinical hypothyroidism, 30 patients who had clinical hypothyroidism, and 100 healthy controls. Normal fT4 and fT3, high TSH values were used for the diagnosis of subclinical hypothyroidism, and low fT4 and/or fT3, high TSH values were used for the diagnosis of clinical hypothyroidism. The diagnosis of anemia was based on subclinical hypothyroidism, clinical hypothyroidism, and control group Hb value

Effects of DL and L-Methionine on Growth Rate, Feather Growth, and Hematological Parameters of Tetra-SL Layers from 1-28 Days of Age.

Simple SummaryMethionine is the first limiting amino acid and plays an important role in the growth and health status of chicks. Animal health status was easily detected by examining the hematological parameters. This study aimed to investigate the influence of methionine sources (L-methionine and DL-Methionine) at different supplementation levels (10% deficit, 100% and 10% surplus of the recommended) on growth performance and health status of chicks. The results of the feeding trial found no differences in the chicks’ growth performance and feather growth on neither methionine sources nor methionine levels. However, most of the hematology parameters were affected by the methionine sources and/or methionine levels, as well as their interaction being significant in some cases. Therefore, this trial showed that varying methionine by ±10% of the requirements does not adversely affect growth performance and feather growth.The study was carried out to determine whether sources or levels of methionine (Met) affect the health status of Tetra-SL (TSL) chicks by examining growth performance, feather growth, and hematological parameters. A total of ninety-six (96) day-old (44.2 ± 0.18 g lw) TSL chicks were randomly allotted to six treatment groups (three levels for each DL and L-Met source) with four replicates of four chicks each. Chicks were fed ad libitum diets supplemented with 90, 100, and 110% of methionine requirements for four weeks after hatch. The parameters examined are bodyweight (BW), average daily gain (ADG), feather length (FL), and hematological parameters, including: red blood cell (RBC) count, hemoglobin (Hb) concentration in the blood, hematocrit (Ht; %), number of white blood cells (WBC), platelet count, mean corpuscular volume of red blood cells (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), lymphocyte (LYM), mid-range (MID), and granulocyte (GRAN). There was no significant effect of Met sources and levels on BW, ADG, and FL of TSL chicks for the first four weeks of rearing. The RBC, Hb, Ht, WBC, LYM, MID, and GRAN values of TSL chicks were statistically influenced by dietary Met sources and Met levels (p < 0.05). Among the treatment groups, the number of white blood cells (WBC) on 90% DL–Met was the lowest. WBC, RBC, Hb, and Ht were higher from chicks that received 100% DL-Met than all other levels, regardless of the Met sources. The MCV, MCH, and MCHC values were not affected by either Met source or levels or their interactions. Met source and level interactively affected the Ht, WBC, LYM %, and GRAN values of TSL chicks (p < 0.05). The platelet number was affected by Met source only (p < 0.05) with chicks receiving L-Met source having more than twofold higher platelet values than DL-Met source. In conclusion, varying Met levels by ±10% of the requirement does not adversely affect the growth performance, feather growth, and hematological parameters of TSL chicks reared for up to four weeks of age. DL-Met increased the body weight and improved the white blood cells, red blood cells, and hematocrit at 28 days after hatch. DL-Met showed similar biological efficacy as L-Met for body weight and feather growth but not for the hematological parameters.

Impact of hemoglobin levels at admission on outcomes among elderly patients with acute coronary syndrome treated with low-dose Prasugrel or clopidogrel: A sub-study of the ELDERLY ACS 2 trial

Hemoglobin (Hb) levels have emerged as a useful tool for risk stratification and the prediction of outcome after myocardial infarction. We aimed at evaluating the prognostic impact of this parameter among patients in advanced age, where the larger prevalence of anemia and the higher rate of comorbidities could directly impact on the cardiovascular risk. MethodsAll the patients in the ELDERLY-2 trial, were included in this analysis and stratified according to the values of hemoglobin at admission. The primary endpoint of this study was cardiovascular mortality within one year. The secondary endpoints were all-cause mortality, MI, Bleeding Academic Research Consortium (BARC) type 2–3 or 5 bleeding, any stroke, re-hospitalization for cardiovascular event or stent thrombosis (probable or definite) within 12 months after index admission. ResultsWe included in our analysis 1364 patients, divided in quartiles of Hb values (<12.2; 12.2–13.39; 13.44–14.49; ≥ 4.5 g/dl). At a mean follow- up of 330.4 ± 99.9 days cardiovascular mortality was increased in patients with lower Hb (HR[95%CI] = 0.76 [0.59–0.97], p = 0.03). Results were no more significant after correction for baseline differences (adjusted HR[95%CI] = 1.22 [0.41–3.6], p = 0.16). Similar results were observed for overall mortality. At subgroup analysis, (according to Hb median values) a significant interaction was observed only with the type of antiplatelet therapy, but not with major high-risk subsets of patients. ConclusionsAmong elderly patients with acute coronary syndrome managed invasively, lower hemoglobin at admission is associated with higher cardiovascular and all-cause mortality and major ischemic events, mainly explained by the higher risk profile.

Chronic anemia: The effects on the connectivity of white matter.

Chronic anemia is commonly observed in patients with hemoglobinopathies, mainly represented by disorders of altered hemoglobin (Hb) structure (sickle cell disease, SCD) and impaired Hb synthesis (e.g. thalassemia syndromes, non-SCD anemia). Both hemoglobinopathies have been associated with white matter (WM) alterations. Novel structural MRI research in our laboratory demonstrated that WM volume was diffusely lower in deep, watershed areas proportional to anemia severity. Furthermore, diffusion tensor imaging analysis has provided evidence that WM microstructure is disrupted proportionally to Hb level and oxygen saturation. SCD patients have been widely studied and demonstrate lower fractional anisotropy (FA) in the corticospinal tract and cerebellum across the internal capsule and corpus callosum. In the present study, we compared 19 SCD and 15 non-SCD anemia patients with a wide range of Hb values allowing the characterization of the effects of chronic anemia in isolation of sickle Hb. We performed a tensor analysis to quantify FA changes in WM connectivity in chronic anemic patients. We calculated the volumetric mean of FA along the pathway of tracks connecting two regions of interest defined by BrainSuite's BCI-DNI atlas. In general, we found lower FA values in anemic patients; indicating the loss of coherence in the main diffusion direction that potentially indicates WM injury. We saw a positive correlation between FA and hemoglobin in these same regions, suggesting that decreased WM microstructural integrity FA is highly driven by chronic hypoxia. The only connection that did not follow this pattern was the connectivity within the left middle-inferior temporal gyrus. Interestingly, more reductions in FA were observed in non-SCD patients (mainly along with intrahemispheric WM bundles and watershed areas) than the SCD patients (mainly interhemispheric).

Assessing impact of an interdisciplinary erythropoiesis‐stimulating agent dosing protocol at an outpatient community hospital hemodialysis unit

AbstractBackgroundIn adult patients with end‐stage kidney disease (ESKD), the Kidney Disease Improving Global Outcomes (KDIGO) guideline for anemia management suggests initiation of erythropoiesis‐stimulating agents (ESA) when hemoglobin (Hb) concentration is between 9 and 10 g/dL to avoid Hb below 9 g/dL and not to exceed Hb of 11.5 g/dL. Pharmacist‐led protocol for ESA dosing was implemented at an outpatient hemodialysis unit to provide standardized dosing of ESA therapy and to attain target Hb.ObjectiveThe objective of this study was to determine the impact of a pharmacist‐directed protocol on anemia management.MethodsThe study was a single‐center, retrospective cohort comparing the 6‐month outcomes between the protocol and randomly selected historic control groups. The primary endpoint was the percentage of time in therapeutic range (TTR) of Hb range: 9.5 to 10.9 g/dL. Secondary objectives were Hb concentrations, iron indices, number of red blood cell transfusions, hospital admissions due to cardiovascular events, use of alteplase for hemodialysis catheter thrombosis, and ESA and intravenous iron dosing.ResultsOne hundred and twenty‐nine adult patients with ESKD were included with 61 patients assigned to the intervention group and 68 patients in the control group. Primary endpoint of TTR within target Hb 9.5 to 10.9 g/dL was similar between the protocol and control groups (30.7% vs 29.3%, P = .177). Median weekly doses of ESA were significantly lower in the protocol group (10 064 units vs 15 227 units, P = .035).ConclusionThis study suggests that the protocol‐driven treatment was as effective as the control with respect to TTR for target Hb values, while leading to a significant reduction in ESA doses and drug‐associated costs.

Association between Anemia and New-Onset Atrial Fibrillation in Critically Ill Patients in the Intensive Care Unit: A Retrospective Cohort Analysis.

New-onset atrial fibrillation (NOAF) is one of the leading causes of morbidity and mortality, especially in older patients in the intensive care unit (ICU). Although many comorbidities are associated with NOAF, the effect of anemia on the onset of atrial fibrillation is still unknown. This study aimed to test the hypothesis that anemia is associated with an increased risk of developing NOAF in critically ill patients in intensive care. We performed a retrospective analysis of critically ill patients who underwent routine hemoglobin and electrocardiography monitoring in the ICU. Receiver operating characteristics analysis determined the hemoglobin (Hb) value that triggered NOAF formation. Bivariate correlation was used to determine the relationship between anemia and NOAF. The incidence of NOAF was 9.9% in the total population, and 12.8% in the patient group with anemia. Analysis of 1931 patients revealed a negative association between anemia and the development of NOAF in the ICU. The stimulatory Hb cut-off value for the formation of NOAF was determined as 9.64 g/dL. Anemia is associated with the development of NOAF in critically ill patients in intensive care.

Red blood cell transfusion and hemoglobin level on neurological outcome in the first 24 hours of traumatic brain injury

ObjectivesTarget hemoglobin (Hb) level is not clearly determined in patients followed up in the intensive care unit (ICU) for traumatic brain injury (TBI). This study aims to investigate the impact of red blood cell (RBC) transfusion and Hb level on the neurological outcome in the first 24 h in patients with TBI. MethodsIn this retrospective study, we reviewed the 2-year organizational database. We evaluated data from patients who underwent RBC transfusion and whose Hb values were 7–9 g/dL and >9 g/dL in the first 24 h. We considered that a Glasgow Outcome Score (GOS) of 1–3 at the time of discharge from the ICU was a poor neurological outcome (PO) and that a GOS > 3 was a good neurological outcome (GO). ResultsA total of 147 patients were included in the study 28.6% of whom were discharged from the intensive care unit with PO. The Hb (g/dL) values of PO patients in the first 24 h were lower compared to those of GO patients (median [interquartile range]; 9.2 [2.5] vs 11 [3.4], p < 0.01). RBC transfusion of PO patients in the first 24 h was also less compared to that of GO patients (median [interquartile range]; 15 [35.7] vs. 19 [18.1], p = 0.038). In logistic regression analyses, neither RBC transfusion (OR [95%CI]; 0.786 (0.108–5.740), p = 0.81) nor Hb level (OR [95% CI]; 0.50 (0.057–4.362), p = 0.53) was an independent risk factor for PO. ConclusionIn patients followed up in the ICU due to TBI, RBC transfusion and Hb values in the first 24 h are not associated with PO at the time of discharge from the ICU.

Reserves of resource saving in the manufacture of brake drums of cargo vehicles

The object of research: cast iron grade DSTU EN 1561 (EN-GJL-200), used for the manufacture of brake drums for KrAZ trucks.&#x0D; Investigated problem: obtaining the effect of resource saving by minimizing the consumption of alloying elements, while maintaining a given level of mechanical properties of cast iron.&#x0D; The main scientific results: experimental and theoretical confirmation of the possibility of reducing the content of Cr introduced into the alloy to increase its strength, as part of the Cr:Ni alloying complex, was obtained. It is shown that a decrease in the Cr content from the upper range (0.34–0.48) % to the lower one (0.21–0.33) % does not affect the ultimate strength of cast iron (σb). The obtained values of σb for both ranges are statistically equal: σb =234MPa, Sσb =16.22 MPa for the upper range of Cr content and σb=240MPa, Sσb=19.86 MPa for the lower range of Cr content, where Sσb is the standard deviation of the tensile strength value. It is established that the hardness (HB) is also unchanged: the obtained values of HB for both ranges are statistically equal: HB213, SHB=9.1 for the upper range of Cr content and HB212, SHB=12 for the lower range of Cr content, where SNB is the standard deviation of hardness. At the same time, it has been statistically proven that the Cr:Ni ratio can be shifted towards lower Cr values – from Cr:Ni=2.2:1 in the existing technology to Cr:Ni=1.76:1 in the ones proposed in this study.&#x0D; The area of practical use of the results of the study: the results obtained can be used in machine-building enterprises specializing in the manufacture of hull cast iron parts with a foundry cycle. The adaptation of the proposed results to the actual conditions of the foundry production of implementing organizations will be minimal if they comply with the following criteria: cast iron grade, predominant or minimum casting wall thickness, temperature regime of melting and out-of-furnace treatment, ferroalloys and modifiers used.&#x0D; Innovative technological product: iron smelting technology for commercial vehicle brake drum castings that reduces production costs while maintaining a given level of mechanical properties&#x0D; The scope of the technological innovative product: technological regimes for producing cast iron for the production of cast brake drums for trucks.

Perioperative Management of Tonsillectomy in Pediatrics with Tetralogy of Fallot

Introduction. Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that includes ventricular septal defect, aortic overriding, infundibular stenosis, and Right Ventricle Hypertrophy (RVH). Perioperative management includes preoperative management, intraoperative anesthesia, and post-operative and potential problem management.&#x0D; Case presentation. We report a -8-year-old-girl with congenital heart disease TOF planned for tonsillectomy and adenoidectomy. The patient weighs 18 kilograms, has a blood pressure of 96/55 mmHg, pulse rate of 104 times per minute, respiratory rate 24 times per minute, and oxygen saturation of 74-79% supine position with room air. We find ejection systolic murmur at SIC 4/6 left parasternal and clubbing fingers-on physical examination. Laboratory preoperation shown Hb value 22.9; Hct : 70; AL : 11.2; AT : 281; AE : 8.58. We pre-medicate with ondansetron, dexamethasone, and sedation in the transit room with ketamine and midazolam. Induction by fentanyl and rocuronium to facilitate endotracheal intubation. Postoperatively, the patient was transferred to the PICU with an ET in a tube. She is monitored for a post-operative complications such as active bleeding to hyper cyanotic and performed extubation less than 24 hours after surgery.&#x0D; Conclusion. Anesthetic goals in this patient are to maintain or slightly increase the Systemic Vascular Resistance, minimize Pulmonary Vascular Resistance dan provide mild cardiac depression.

Level Fatigue of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background: The hemodialysis process is beneficial for chronic kidney disease patients in maintaining their lives. This routine and the continuous process will cause complications in the body. Fatigue is the main complaint of patients undergoing long-term hemodialysis. Fatigue conditions in patients with chronic kidney disease appear to be caused by physiological and psychological factors. The fatigue condition in the client will affect the patient's daily activity level. Methods: This research is a descriptive study with a cross-sectional study design. The sample in this study was 78 patients undergoing hemodialysis who were taken using the purposive sampling technique—assessment of Fatigue using the PSF (Piper Fatigue Scale) questionnaire. Data analysis in this study used descriptive analysis to determine the variables' distribution, frequency, and percentage. Results: From the research results, some respondents do not work by 92.3%. Several reasons cause them not to work again since chronic kidney disease. One of the reasons is that they feel tired quickly, so their activity is limited, and some patients feel that they are limiting their activities because they have an av shunt attached. Based on the results of the study that most of the respondents had undergone the HD process for 2-4 years (78.8%). The highest Hb values were in the range of 9-10gr/dl (88.4%). Conclusion: Fatigue of patients undergoing hemodialysis increases. it is hoped that respondents can know and increase their level of self-efficacy after being vaccinated against covid-19

Prevalence of Anemia, Iron Deficiency, Iron Deficiency Anemia and Diagnostic Performance of Hematologic and Biochemical Markers of Sideropenia in 1- to 5-Year-Old Children in Thrace Greece.

Background and ObjectiveIron deficiency (ID) is a major public health problem with high prevalence in early childhood. We assessed the prevalence of anemia, ID, and iron deficiency anemia (IDA) in healthy children of Thrace, Greece, its correlation with several factors, and evaluated the diagnostic performance of hematologic and biochemical markers of sideropenia.Patients and MethodsFor 202 healthy children 1–5 years old, a questionnaire was filled out describing their nutritional habits during infancy and early childhood. Venous hemograms along with serum ferritin, TIBC, %TS, and CRP were obtained from all studied children. In a subset of 156 children, the concentration of sTfR was also determined.ResultsChildren with ID and IDA had significantly lower beef consumption than children without sideropenia (p=0.044). Using the WHO cutoff values of Hb <11g/dl and ferritin <12μg/l, the prevalence of anemia, ID, and IDA was 9.41%, 6.44%, and 3.47%, respectively. If Hb <12g/dl and ferritin<18μg/l were used as cutoffs, the prevalence of anemia, ID, and IDA was 26.73%, 16.33%, and 5.94%, respectively. ROC analysis revealed that at ferritin <12μg/l, the AUC of sTfR alone (0.827) was substantially better than that of TIBC (0.691), while at serum ferritin cutoff of 18μg/l, the AUC of TIBC (0.770) was better than that of sTfR (0.716).ConclusionsThe prevalence of ID and IDA in children 1–5 years old in Thrace is like in other developed countries. The chosen cutoff of serum ferritin affects the evaluation of the diagnostic significance of the different sideropenia markers.

Assessing the efficacy of parenteral iron therapy in treating pregnancy anemia of mild to moderate severity

Background: Anemia is a clinical condition characterized by the decreased number of red blood cells or their capacity to carry oxygen needed for physiological functions. Hemoglobin (Hb) value less than 2 standard deviations, less than the median value for healthy subjects matched for pregnancy status, smoking, altitude, gender, and age. Anemia is commonly seen in pregnancy where intravenous iron has proven to be highly effective as a treatment even in cases where oral iron seems ineffective. Aim: The present study was conducted to assess the efficacy of parenteral iron therapy in treating pregnancy anemia of mild to moderate severity. Materials and methods: The present study included 120 pregnant females having confirmed diagnoses of iron deficiency anemia. All the included subjects were given 100mg Mebendazole in a dose twice daily as an anti-helminthic therapy for 3 days duration. Also, during the therapy, folic acid was given to all the subjects. Stool examination for cyst and ova, urine culture, microscopy, and routine urine examination, Renal function test (RFT) was done for all the subjects. Results: The results of the present study showed that significant changes were seen in various hematologic parameters from baseline to follow-up.

Assessing the efficacy of parenteral iron therapy in treating pregnancy anemia of mild to moderate severity

Background: Anemia is a clinical condition characterized by the decreased number of red blood cells or their capacity to carry oxygen needed for physiological functions. Hemoglobin (Hb) value less than 2 standard deviations, less than the median value for healthy subjects matched for pregnancy status, smoking, altitude, gender, and age. Anemia is commonly seen in pregnancy where intravenous iron has proven to be highly effective as a treatment even in cases where oral iron seems ineffective. Aim: The present study was conducted to assess the efficacy of parenteral iron therapy in treating pregnancy anemia of mild to moderate severity. Materials and methods: The present study included 120 pregnant females having confirmed diagnoses of iron deficiency anemia. All the included subjects were given 100mg Mebendazole in a dose twice daily as an anti-helminthic therapy for 3 days duration. Also, during the therapy, folic acid was given to all the subjects. Stool examination for cyst and ova, urine culture, microscopy, and routine urine examination, Renal function test (RFT) was done for all the subjects. Results: The results of the present study showed that significant changes were seen in various hematologic parameters from baseline to follow-up.

Prevalence and outcome of anemia among children hospitalized for pneumonia and their risk of mortality in a developing country

Data are limited on the prevalence and outcome of anemia and its risk on mortality among children under five years of age hospitalized for pneumonia/severe pneumonia. Thus, we conducted a secondary analysis of data extracted from Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh to address the evidence gap. Among 3468 children fulfilling the study criteria,1712 (49.4%) had anemia. If children aged ≤ 1.0, > 1.0 to 2.0, > 2.0 to < 6.0, and ≥ 6.0 to 59 months had blood hemoglobin (Hb) value of ≤ 10.7 g/dL, ≤ 9.4 g/dL, ≤ 9.5 g/dL, and ≤ 11 g/dl respectively; we considered them anemic. The trend of prevalence of anemia was found to be inversely related to increasing age (Chi-square for linear trend analysis was done to understand the relation of anemia with increasing age, which was = 6.96; p = 0.008). During hospitalization anemic children more often developed respiratory failure (7.2% vs. 4.4%, p < 0.001) and fatal outcome (7.1.0% vs. 4.2%, p < 0.001) than the children who did not have anemia. After adjusting for potential confounders, such as female sex, lack of immunization, abnormal mental status, severe acute malnutrition, dehydration, hypoxemia, severe sepsis, and bacteremia using multivariable logistic regression analysis, anemia was found to be independently associated with fatal outcome (OR = 1.88, 95% CI 1.23–2.89, p = 0.004). Thus, future interventional studies on the early management of anemia may be warranted to understand whether the intervention reduces the morbidity and deaths in such children.

P1747: A REAL-WORLD ANALYSIS OF HEALTHCARE RESOURCE UTILIZATION AMONG PATIENTS WITH PAROXYSMAL NOCTURNAL HEMOGLOBINURIA WHO RECEIVED TREATMENT WITH RAVULIZUMAB

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and potentially life-threatening disease involving complement-mediated hemolysis and thrombosis. C5 inhibition (C5i) therapy for PNH with ravulizumab (RAV) has led to hemoglobin (Hb) stabilization (avoiding a ≥2 g/dL decrease in Hb levels from baseline) and some decreases in transfusion dependence. However, international guidance recommends assessing PNH treatment response with Hb normalization (e.g., Hb levels ≥12 g/dL; Debureaux et al., Bone Marrow Transplant. 2021 Oct;56(10):2600-2602), and evidence showing Hb normalization with RAV is scarce. Anemia-related complications, including transfusions, contribute significantly to PNH-associated costs of care, thus highlighting the need to understand Hb level changes and healthcare resource utilization (HCRU) in patients with PNH. Aims: To evaluate Hb level changes in patients with PNH and corresponding HCRU after 6 months of RAV treatment. Methods: Data were extracted from patients with PNH aged ≥12 years between 2010-2021 from the TriNetX Dataworks USA Network, a federated electronic medical record (EMR) data network of >68 million de-identified patients. Patients were required to have a PNH diagnosis based on the International Classification of Diseases 9th or 10th Revision code, a medical visit recorded ≥6 months before index/first RAV treatment, and no record of myasthenia gravis, atypical hemolytic uremic syndrome, or neuromyelitis optica spectrum disorder. RAV-treated patients were analyzed as a whole and stratified by C5i treatment history (C5i naïve or prior C5i/eculizumab). Patients were categorized by Hb levels using changes in Hb levels from baseline (within 365 days pre-index) to the final Hb value recorded between 91-180 days post-index. Patients were excluded if they were missing baseline Hb levels, Hb values at 91-180 days or received a transfusion between 0-180 days post-index. HCRU values were evaluated through 180 days post-index for inpatient visits (total number of events post-index) and length of stay ([LOS] total days in the inpatient setting post-index, calculated among all patients regardless of hospitalization history). Results: Data from 36 RAV-treated patients were extracted from the EMR network (Table). Before starting RAV treatment, 24 (66.7%) patients were naïve to C5i, and 12 (33.3%) patients had prior C5i treatment. Following 6 months of RAV, many patients displayed decreased or no change in Hb levels (77.8%, n=28). Patients with decreased or no change in Hb levels after 6 months of RAV experienced more inpatient visits (mean visits [SD]: 1.3 [2.0]) compared to patients with increased Hb levels (mean visits [SD]: 0.9 [1.5]). RAV-treated patients with decreased or no change in Hb levels also demonstrated a longer mean LOS (mean days [SD]: 2.2 [6.7]) compared to patients with increased Hb levels (mean days [SD]: 0.2 [0.4]). Findings were similar among all three analysis groups (All RAV; RAV, C5i naïve; RAV, prior C5i), but slightly more C5i naïve patients with decreased or no change in Hb levels following RAV treatment (79.2%, n=19) had higher HCRU values for inpatient visits and LOS (Table). Image:Summary/Conclusion: The majority of RAV-treated patients did not display Hb improvement after 6 months of treatment, and patients lacking Hb improvement also demonstrated increased HCRU. This suggests improvements in Hb may be an important driver of morbidity and costs among patients with PNH. These findings also highlight the utility of improved Hb levels as a metric for assessing the PNH treatment response.

Anemia is associated with increased risk of non-vertebral osteoporotic fractures in elderly men: the MrOS Sweden cohort

SummaryThis study includes 1005 men from the Gothenburg part of the Osteoporotic Fracture in Men Study (MrOS). Included are 66 men with anemia (hemoglobin < 130 g/L). The follow-up time was up to 16 years, and the main results are that anemia is associated with all fractures and non-vertebral osteoporotic fractures.IntroductionAnemia and osteoporotic fractures are conditions that are associated with increased morbidity and mortality. Clinical studies have suggested that anemia can be used as a predictor of future osteoporotic fractures.MethodMen from the Osteoporotic Fractures in Men Study (MrOS) Sweden, Gothenburg, with available hemoglobin (Hb) values (n = 1005, median age 75.3 years (SD 3.2)), were included in the current analyses. Of these, 66 suffered from anemia, defined as Hb < 130 g/L. Median follow-up time for fracture was 10.1 years and the longest follow-up time was 16.1 years.ResultsMen with anemia had, at baseline, experienced more falls and had a higher prevalence of diabetes, cancer, prostate cancer, hypertension, and stroke. Anemia was not statistically significantly associated with bone mineral density (BMD). Men with anemia had higher serum levels of fibroblast growth factor 23 (iFGF23) (p < 0.001) and phosphate (p = 0.001) and lower serum levels of testosterone (p < 0.001) and estradiol (p < 0.001). Moreover, men with anemia had an increased risk of any fracture (hazard ratio (HR) 1.97, 95% CI 1.28–3.02) and non-vertebral osteoporotic fracture (HR 2.15, 95% CI 1.18–3.93), after adjustment for age and total hip BMD, in 10 years. The risk for any fracture was increased in 10 and 16 years independently of falls, comorbidities, inflammation, and sex hormones. The age-adjusted risk of hip fracture was increased in men with anemia (HR 2.32, 95% CI 1.06–5.12), in 10 years, although this was no longer statistically significant after further adjustment for total hip BMD.ConclusionsAnemia is associated with an increased risk for any fracture and non-vertebral osteoporotic fracture in elderly men with a long follow-up time. The cause is probably multifactorial and our results support that anemia can be used as a predictor for future fracture.