BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopa...BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women,and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%.However,few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites.MEDLINE(via PubMed)searches combined medical subject headings(MeSH)terms and the keywords“gastrointestinal bleeding”with“iron-deficiency anemia”and“diagnosis”or“treatment”or“management”or“prognosis”or“prevalence”or“safety”or“iron”or“transfusion”or“quality of life”,or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding;retrieved studies were published in English between January 2003 and April 2019.Worldwide professional association websites were searched for clinical practice guidelines.Reference lists from guidelines were reviewed to identify additional relevant articles.The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.RESULTS From 494 Literature citations found during the initial literature search,17 original articles,one meta-analysis,and 13 clinical practice guidelines were analyzed.Based on the published evidence and clinical experience,the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding:(1)Evaluation of hemoglobin and iron status;(2)Laboratory testing;(3)Target treatment population identification;(4)Indications for erythrocyte transfusion;(5)Treatment targets for erythrocyte transfusion;(6)Indications for intravenous iron;(7)Dosages;(8)Monitoring;(9)Indications for intravenous ferric carboxymaltose treatment;and(10)Treatment targets and monitoring of patients.The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding,which should be implemented during the hospital stay and follow-up visits after patient discharge.CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding,which ultimately may improve health outcomes in these patients.展开更多
Objective Castleman disease, also known as giant lymph node hyperplasia, involves lesions in the lymph nodes usually located in the chest_ENREF_1, particularly in the mediastinum. Meanwhile, sinus bradycardia is a sin...Objective Castleman disease, also known as giant lymph node hyperplasia, involves lesions in the lymph nodes usually located in the chest_ENREF_1, particularly in the mediastinum. Meanwhile, sinus bradycardia is a sinus rhythm slower than 60 beats per min, and it can occur in both healthy and sick individuals. However, the comorbidity of these two disorders has not been previously reported. In this paper, we report a case of a 46-year-old woman who presented with persistent sinus bradycardia and irondeficiency anemia. Diagnostic work-up revealed hepatosplenomegaly and a giant mass near the splenic hilum. The mass was removed surgically; after which, the patient's bradycardia resolved immediately, while her anemia was corrected after subsequent chemotherapy. Pathological examination revealed lymph nodes with benign lesions, and the patient was diagnosed with hyaline-vascular variant of Castleman disease. This is the first documented case of sinus bradycardia associated with Castleman disease. In this paper, we describe the case characteristics, discuss the possible pathogenesis, and consider the appropriate treatment of symptomatic sinus bradycardia accompanying Castleman disease.展开更多
Risk factors for iron deficiency anemia among the adult population of the Quetta valley have been investigated. Anemic adult patients, both males and females, who were admitted in the Sandeman Provincial Hospital, Que...Risk factors for iron deficiency anemia among the adult population of the Quetta valley have been investigated. Anemic adult patients, both males and females, who were admitted in the Sandeman Provincial Hospital, Quetta, were invited to participate in this study. After detailed history and examination, preliminary blood tests including full blood counts, platelets count, retics count, absolute blood values and blood film examination were done. A clinical diagnosis was made based upon the findings of history, examination and blood tests. In patients suspected to have iron deficiency anemia, serum iron studies (i.e. serum iron, Total iron binding capacity (TIBC) and serum ferritin) were done to confirm the diagnosis. Among the selected anemic patients, 60% were iron deficiency anemic, while 40% were non-iron deficiency anemic. Iron deficiency anemia was more common among females than males, as 70% patients were female and 30% were male. The risk factors were found to be pregnancy (40%), nutritional inadequacy (17%), menorrhagia (9%), hemorrhoids (9%), hook worms (8%), hematuria (2%) and blood loss due to various gastro-intestinal pathologies (15%).展开更多
Purpose: Due to the high prevalence of iron deficiency anemia in women undergoing gynecological surgeries and its association with worse postoperative results, it is necessary to identify and treat anemia preoperative...Purpose: Due to the high prevalence of iron deficiency anemia in women undergoing gynecological surgeries and its association with worse postoperative results, it is necessary to identify and treat anemia preoperatively. However, although anemia and iron deficiency are significant global health problems, there are still disparities in the recognition and implementation of “Patient Blood Management” (PBM) as a comprehensive approach to mitigating the risks associated with these diseases. The purpose of the study is to review best practices for the treatment of anemia based on the Enhanced Recovery After Surgery (ERAS) protocol and PBM recommendations. Methods: This study reviewed the literature on preoperative iron deficiency anemia in patients undergoing gynecological surgery. We identified references through searches in PubMed using relevant search terms. Results: Among the various strategies used in PBM, perhaps the most important is the early detection and management of anemia. In gynecological surgery, there are several approaches to reducing perioperative blood loss, highlighting the use of gonadotropin-releasing hormone (GnRH) agonists (aGnRh) and antifibrinolytics. Oral and intravenous iron supplementation can be performed in addition to blood transfusion to treat anemia. Conclusion: Addressing preoperative and postoperative anemia through systematic correction, following the guidelines of the ERAS protocol and PBM guidelines, is essential to improving perioperative outcomes in women undergoing gynecological surgery.展开更多
The conditions of poverty and violence in Colombia have increased the displacement of people of African descent. The research group concerned with the health of these communities has performed research to find the ass...The conditions of poverty and violence in Colombia have increased the displacement of people of African descent. The research group concerned with the health of these communities has performed research to find the association of alterations in the hemoglobin molecule with the presence of iron deficiency anemia. This research was performed with the support of the epidemiological public health laboratory. The objective of the study is the association of sickle cell disease and sickle cell trait, and the presence of hemoglobin C and its trait, with iron deficiency anemia in Afro-Colombians between 18 and 50 years of age, by investigation of hemograms, peripheral blood study, serum ferritin, soluble receptor for transferrin （sTfR） and index of sTfR, and hemoglobin electrophoresis. This research is a descriptive, quantitative, transverse, structured, non-experimental and correlational study, with a total of 56 samples （10 men, 46 women）. The results showed that ferritin in men had normal values, compared to 32% （15/46） of women who had low levels of ferritin. Men＇s sTfR levels were normal, while in women 2% （1/46） had iron deficiency in stage I, 41% （19/46） iron deficiency in stage If, and 9% （4/46） possibly without anemia iron deficiency. In hemoglobin electrophoresis, 84% （46/56） of the population presents hemoglobin A, 4% （2/56） increased hemoglobin A2 and fetal hemoglobin related to a possible thalassemia trait, 11% （6/56） had hemoglobin AS related to sickle cell trait, and 2% （1/56） show hemoglobin AC, related to hemoglobin AC trait. This project supports investigative and social projects, and also contributes to the improvement of the quality of life and dissemination of good health practices in these communities.展开更多
Background:In patients with autoimmune hemolytic anemia(AIHA),the risk of relapse is high owing to persistent autoreactive B-cell activity.Multirefractory AIHA is a more advanced stage of disease that is defined by a ...Background:In patients with autoimmune hemolytic anemia(AIHA),the risk of relapse is high owing to persistent autoreactive B-cell activity.Multirefractory AIHA is a more advanced stage of disease that is defined by a lack of response to at least three lines of therapy.CD19-directed chimeric antigen receptor(CAR)T-cell therapy results in profound B-cell depletion and may be a useful approach to achieving drug-free remission in multirefractory AIHA.展开更多
Iron deficiency chlorosis of Lilium davidii var. unicolor is often the case in practice in alkaline soils of northwest region of China. It is difficult to control iron chlorosis because of high cost and short effectiv...Iron deficiency chlorosis of Lilium davidii var. unicolor is often the case in practice in alkaline soils of northwest region of China. It is difficult to control iron chlorosis because of high cost and short effective work time of conventional iron fertilizers. In this study, a 2-year field experiment was conducted to evaluate the effects of two slow-release fertilizers on the suppression of iron deficiency chlorosis, soil chemical properties, and the yield and quality of L. davidii var. unicolor. Results show that both coated slow-release iron fertilizers and embedded slow-release iron fertilizer effectively controlled iron-deficiency chlorosis. The application of slow-release iron fertilizers significantly increased plant height and chlorophyll content of L. davidii var. unicolor at different growth stages. Furthermore, coated iron fertilizer application significantly increased starch, protein, soluble sugar and vitamin C content of L. davidii var. unicolor, and it also significantly improved total amino acid content, with increases in essential amino acids(Trp, Leu, Lys, Phe, Val, and Thr contents) and in nonessential amino acids(Asp, Glu, Cit, Ihs, Acc, Ala, Pro, and Cys contents). It was concluded that application of coated slow-release iron fertilizer could be a promising option for suppression of iron deficiency chlorosis and deserves further study.展开更多
Background: Sickle cell anemia(SCA), a genetic hemoglobin disorder, suggests essential inner ear compromise and poor auditory processing. In humans, auditory processing differs physiologically between males and female...Background: Sickle cell anemia(SCA), a genetic hemoglobin disorder, suggests essential inner ear compromise and poor auditory processing. In humans, auditory processing differs physiologically between males and females, possibly true for SCA due to gender-specific disease pathophysiological changes. Objective: To investigate gender differences in psychoacoustical abilities, and speech perception in noise in SCA individuals and further compare with normal healthy(NH) population. Methods: 80 SCA and 80 NH normal-hearing participants aged 15-40 years were included and further grouped based on gender. Auditory discrimination for frequency, intensity, and duration at 500Hz and 4000Hz;temporal processing(Gap detection threshold & Modulation Detection Threshold) and Speech Perception In Noise(SPIN) at 0d BSNR tests were evaluated and compared between males and females of SCA and NH population. Results: SCA performed poorer compared to NH for all experimental measures. In the NH population, males performed poorer than females in psychoacoustical measures whereas within the SCA population, the reverse was true. Female participants performed better in the SPIN test in both populations. Conclusions: The adverse impact of SCA on the auditory system due to circulatory changes might cause poorer performance in SCA. Poorer performance by Female SCA is possibly due to the contrary impact of lower Hb level overlying Sickle disease.Estrogen levels and gender preference in auditory processing might lead to better performance by females within the NH population. SPIN performance depends on different attentional demands and sensorimotor processing strategies in noise beyond psychoacoustical processing may lead to better female performance in both populations.展开更多
Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(...Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(Tregs)frequencies and increased effector cytotoxic cells.Tregs are reduced in aAA and increase in number after successful immunosuppressive therapies.Methods In this retrospective study,we investigated the frequency of circulating Tregs by multiparametric flow cytometry immunophenotyping in non-severe aAA patients before and after immunosuppressive therapy.The samples were stained with the following antibodies:ECD anti-CD3,PE or PC5 anti-CD4,FITC anti-CD8,and PE anti-CD25,and Tregs were identified by first gating on linear parameters for lymphocyte identification and then for CD3 expression.In CD3+CD4+cells,Tregs were further identified on the basis of CD25 and FOXP3 expression.Results Although the number of Tregs tended to increase after immunosuppressive treatments,their circulating frequency remained lower than that of healthy subjects,regardless of their responsiveness to therapies.Moreover,the relative frequency combined with absolute Treg counts might be more informative in the differential diagnosis of bone marrow failure syndromes.Conclusions The persistent decrease in circulating Tregs could be the result of immunosuppressive agents that could preferentially expand other T-cell subsets.At the same time,an imbalance in immunotolerance might persist,which is also favored by chronic antigen stimulation.展开更多
Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classifi cation (microcytic, ma...Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classifi cation (microcytic, macrocytic and normocytic) and pathogenic classi-fication (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other comple-mentary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time.展开更多
Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity.Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute varicea...Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity.Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas:Whether anemia is a disease complication or a part of the disease spectrum?Should iron,folic acid,and vitamin B complex supplementation and nutritional advice,suffice in those who can perform tasks of daily living but have persistently low hemoglobin.How does one investigate and manage anemia due to multifactorial etiologies in the same patient:Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia?To add to the clinician’s woes the prevalence of anemia increases with increasing disease severity.We thus aim to critically analyze the various pathophysiological mechanisms complicating anemia in a patient with cirrhosis with an emphasis on the diagnostic flowchart in such patients and proposed management protocols thereafter.展开更多
Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from...Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from the perspective of intestinal bacteria.Methods:A total of 24 C57BL/6 J male mice were randomly and evenly divided into control,model and moxibustion groups.The myelosuppression-induced AA model was established by cyclophosphamide(CTX)and cyclosporine(Cs)intraperitoneal injection.Mice in the moxibustion group were intervened in mild moxibustion at unilateral“Zusanli(ST36)”acupoint for 15 min per day,and the sides were switched the next day.The intervention of mild moxibustion lasted 60 days consecutively.The red blood cell(RBC),white blood cell(WBC),platelet(PLT)counts and haemoglobin(Hb)concentration levels of mice in each group were detected by peripheral blood cells count staining,and the BM hematopoietic cells and hematopoietic structures were observed by BM smear Wright-Giemsa staining and HE staining.16SrDNA sequencing was used to analyze the gut bacterial species abundance and diversity in mice from each group.Results:After all the intervention,compared to the control group,the model group had lower levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05)and fewer hematopoietic cells and hematopoietic structures;compared to the model group,moxibustion group had higher levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05),and more BM hematopoietic cells and hematopoietic structures.Gut flora showed that moxibustion increased the species richness and diversity of intestinal bacteria in mice;compared with the control group,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the model group was higher(P<0.05);whereas,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the moxibustion group was lower(P<0.05)when compared with the model group.In addition,Faecalibaculum was significantly correlated with RBC,WBC,PLT count and Hb concentration(P<0.05).Conclusion:Moxibustion can improved BM histology,restored hematopoietic cells function,and increased peripheral blood cells count and Hb concentration in AA mice.The mechanism may be related to the fact that moxibustion regulates the abundance of specific intestinal bacteria to maintain the stability of the flora structure.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs)are caused by mutations in the KIT and platelet derived growth factor receptor alpha genes in approximately 90%of cases.A minority of wild-type GISTs are associated wit...BACKGROUND Gastrointestinal stromal tumors(GISTs)are caused by mutations in the KIT and platelet derived growth factor receptor alpha genes in approximately 90%of cases.A minority of wild-type GISTs are associated with neurofibromatosis type 1(NF1),an autosomal dominant genetic disease resulting from pathogenic mutations in the NF1 gene,which encodes the neurofibromin protein.NF1 patients often exhibit multi-system involvement,with café-au-lait macules and neurofibromas being characteristic symptoms.GISTs are a rare complication of NF1,with the tumors most frequently occurring in the small intestine(90%of cases),while occurrences in the stomach are rare.CASE SUMMARY A 51-year-old woman presented to the emergency department with complaints of dizziness,fatigue,chest tightness,and dark stools.Initial examination revealed a red blood cell count of 1.99×1012/L and a hemoglobin level of 43 g/L.She underwent blood transfusions and fluid replacement to stabilize her condition.Further investigations identified typical café-au-lait macules on her trunk,limbs,and face,along with neurofibromas.Endoscopy showed coffee-colored fluid in the gastric cavity,a large submucosal elevation with an exudative covering,and ulcer formation on the gastric fundus.Exploratory laparoscopy confirmed the tumor’s origin in the gastric fundus,and resection of the giant GIST was performed.Pathological analysis revealed a necrotic GIST measuring 18 cm×14 cm,classified as high-risk,with approximately 5 mitotic figures per 10 high-power fields and no tumor at the margins.Immunohistochemistry results were CD117(+),delay of germination 1(+),CD34(+),and succinate dehydrogenase complex iron sulfur subunit B intact expression.Genetic testing using next-generation sequencing confirmed an NF1 gene mutation.The patient underwent successful tumor resection and was discharged home with postoperative regorafenib therapy.A follow-up at one year showed no recurrence.CONCLUSION Given the diversity of clinical symptoms associated with NF1 and the complexity of NF1-related GISTs,surgical resection with complete tumor removal remains the preferred treatment option.However,the absence of a standardized treatment protocol for adjuvant therapy presents numerous challenges for clinicians.展开更多
Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This ...Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.展开更多
Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Dia...Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains u...BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains unclear.AIM To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.METHODS A systematic search was conducted across PubMed,Embase,and Web of Science databases to identify studies that reported the co-occurrence of anemia and DFUs in diabetic patients.The primary outcome was an association between anemia and DFU risk,expressed as odds ratios(ORs).Secondary outcomes included the risk of DFU per 1-g/dL decrease in hemoglobin and the difference in hemoglobin le-vels between patients with and without DFU.Statistical analyses were performed using random-effects models to account for heterogeneity.RESULTS Sixteen studies involving 170,949 diabetic patients were included in the analysis.The results indicated a significant association between anemia and an increased risk of DFUs(eight studies,n=166173,OR:2.72,95%CI:1.73–4.25,P<0.001;I2=93%).Subgroup analyses sup-ported consistent findings across various patient characteristics,analytic models,and study quality scores(P for subgroup differences,all>0.05).Additionally,each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs(four studies,n=2543,OR:1.65,95%CI:1.21–2.27,P=0.002;I2=68%).Furthermore,diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs(nine studies,n=3986,mean difference:-2.13 g/dL,95%CI:-2.58 to-1.68,P<0.001;I2=90%).CONCLUSION Anemia can be associated with an increased risk of DFUs in diabetic patients.Monitoring and managing anemia in diabetic population may help mitigate the risk of DFUs,emphasizing the need for early interventions.Further research is required to investigate the underlying mechanisms and potential therapeutic strategies.展开更多
Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based ...Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.展开更多
Iron deficiency anemia(IDA)is a nutritional deficiency disease with a high incidence rate worldwide.Bioactive peptides are safe and effective,have multiple functions and can serve as potential candidates for alleviati...Iron deficiency anemia(IDA)is a nutritional deficiency disease with a high incidence rate worldwide.Bioactive peptides are safe and effective,have multiple functions and can serve as potential candidates for alleviating IDA.In this study,the anti-anemia effects of tuna dark muscle peptides were explored in a dietinduced IDA mouse model.The results showed that tuna dark muscle peptides alleviated the IDA phenotype,oxidative stress and iron metabolism.In addition,tuna dark muscle peptides reversed gut microbiota dysbiosis in IDA mice.Furthermore,the transplanted fecal microbiota from tuna dark muscle peptide-treated mice also alleviated IDA symptoms and regulated iron metabolism and the gut microbiota,indicating that the antianemic effects were at least partially mediated by the gut microbiota.Thus,we identified a new and safe prebiotic material to alleviate IDA and provided ideas for the development of peptides.At the same time,these data also provided a theoretical basis for fecal microbiota transplantation to alleviate IDA.展开更多
BACKGROUND Anemia is a prevalent and challenging complication in patients with hematologic and solid malignancies,which stems from the direct effects of malignancy,treatment-induced toxicities,and systemic inflammatio...BACKGROUND Anemia is a prevalent and challenging complication in patients with hematologic and solid malignancies,which stems from the direct effects of malignancy,treatment-induced toxicities,and systemic inflammation.It affects patients’survival,functional status,and quality of life profoundly.Recent literature has highlighted the emerging role of the gut microbiome in the pathogenesis of cancer-associated anemia.The gut microbiota,through its intricate interplay with iron metabolism,inflammatory pathways,and immune modulation,may either exacerbate or ameliorate anemia depending on its composition,and functional integrity.Dysbiosis,characterized by disruption in the gut microbial ecosystem,is very common in cancer patients.This microbial imbalance is implicated in anemia causation through diminished iron absorption,persistent low-grade inflammation,and suppression of erythropoiesis.AIM To consolidate current evidence regarding the interplay between gut microbiome and anemia in the setting of malignancies.It aims to provide a detailed exploration of the mechanistic links between dysbiosis and anemia,identifies unique challenges associated with various cancer types,and evaluates the efficacy of microbiome-focused therapies.Through this integrative approach,the review seeks to establish a foundation for innovative clinical strategies aimed at mitigating anemia and improving patient outcomes in oncology.METHODS A literature search was performed using multiple databases,including Google Scholar,PubMed,Scopus,and Web of Science,using a combination of keywords and Boolean operators to refine results.Keywords included“cancerassociated anemia”,“gut microbiome”,“intestinal microbiota”,“iron metabolism”,“gut dysbiosis”,“short-chain fatty acids”,“hematopoiesis”,“probiotics”,“prebiotics”,and“fecal microbiota transplantation”.Articles published in English between 2000 and December 2024 were included,with a focus on contemporary and relevant findings.RESULTS Therapeutic strategies aimed at restoration of gut microbial homeostasis,such as probiotics,prebiotics,dietary interventions,and fecal microbiota transplantation(FMT),can inhibit anemia-causing pathways by enhancing microbial diversity,suppressing detrimental flora,reducing systemic inflammation and optimizing nutrient absorption.CONCLUSION Gut dysbiosis causes anemia and impairs response to chemotherapy in cancer patients.Microbiome-centered interventions,such as probiotics,prebiotics,dietary modifications,and FMT,have shown efficacy in restoring microbial balance,reducing inflammation,and enhancing nutrient bioavailability.Emerging approaches,including engineered probiotics and bacteriophage therapies,are promising precision-based,customizable solutions for various microbiome compositions and imbalances.Future research should focus on integrating microbiometargeted strategies with established anemia therapies.展开更多
Anemia is still prevalent among low and middle-income countries,posing serious family and social burdens.However,scarce studies provided evidence for real-world exposure to polycyclic aromatic hydrocarbons(PAHs)and an...Anemia is still prevalent among low and middle-income countries,posing serious family and social burdens.However,scarce studies provided evidence for real-world exposure to polycyclic aromatic hydrocarbons(PAHs)and anemia among pregnant women,as well as involved biological mechanisms.So,we conducted this study including 1717 late pregnant women fromZunyi Birth Cohort and collected urine samples for PAHs metabolites detection.Logistic regression and restricted cubic spline regression were used to examine exposuredisease risks and dose-response relationships.We conducted Bayesian kernel machine regression,weighted quantile sum regression,and quantile g-computation regression to fit the joint impacts of multiple PAHs in the real-world scenario on hypocalcemia and anemia.Results showed single exposure to 2-OHNap,2-OHFlu,9-OHFlu,1-OHPhe,2-OHPhe,3-OHPhe,and 1-OHPyr(all P-trend<0.05)increased the risks of hypocalcemia and anemia.Moreover,PAHs mixture was significantly related to higher risks of hypocalcemia and anemia,with 3-OHPhe and 1-OHPyr identified as their major drivers,respectively.Importantly,hypocalcemia served as a significant biological mechanism responsible for PAHs and anemia.Our findings suggest that individual and joint exposure to PAHs during late pregnancy elevate the anemia risk,and calcium supplementation might be a low-cost intervention target for reducing the PAHs-related impairment on anemia for pregnant women.展开更多
基金Supported by OM Pharma(Amadora,Portugal)for payment for medical writing support.
文摘BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women,and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%.However,few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites.MEDLINE(via PubMed)searches combined medical subject headings(MeSH)terms and the keywords“gastrointestinal bleeding”with“iron-deficiency anemia”and“diagnosis”or“treatment”or“management”or“prognosis”or“prevalence”or“safety”or“iron”or“transfusion”or“quality of life”,or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding;retrieved studies were published in English between January 2003 and April 2019.Worldwide professional association websites were searched for clinical practice guidelines.Reference lists from guidelines were reviewed to identify additional relevant articles.The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.RESULTS From 494 Literature citations found during the initial literature search,17 original articles,one meta-analysis,and 13 clinical practice guidelines were analyzed.Based on the published evidence and clinical experience,the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding:(1)Evaluation of hemoglobin and iron status;(2)Laboratory testing;(3)Target treatment population identification;(4)Indications for erythrocyte transfusion;(5)Treatment targets for erythrocyte transfusion;(6)Indications for intravenous iron;(7)Dosages;(8)Monitoring;(9)Indications for intravenous ferric carboxymaltose treatment;and(10)Treatment targets and monitoring of patients.The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding,which should be implemented during the hospital stay and follow-up visits after patient discharge.CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding,which ultimately may improve health outcomes in these patients.
文摘Objective Castleman disease, also known as giant lymph node hyperplasia, involves lesions in the lymph nodes usually located in the chest_ENREF_1, particularly in the mediastinum. Meanwhile, sinus bradycardia is a sinus rhythm slower than 60 beats per min, and it can occur in both healthy and sick individuals. However, the comorbidity of these two disorders has not been previously reported. In this paper, we report a case of a 46-year-old woman who presented with persistent sinus bradycardia and irondeficiency anemia. Diagnostic work-up revealed hepatosplenomegaly and a giant mass near the splenic hilum. The mass was removed surgically; after which, the patient's bradycardia resolved immediately, while her anemia was corrected after subsequent chemotherapy. Pathological examination revealed lymph nodes with benign lesions, and the patient was diagnosed with hyaline-vascular variant of Castleman disease. This is the first documented case of sinus bradycardia associated with Castleman disease. In this paper, we describe the case characteristics, discuss the possible pathogenesis, and consider the appropriate treatment of symptomatic sinus bradycardia accompanying Castleman disease.
文摘Risk factors for iron deficiency anemia among the adult population of the Quetta valley have been investigated. Anemic adult patients, both males and females, who were admitted in the Sandeman Provincial Hospital, Quetta, were invited to participate in this study. After detailed history and examination, preliminary blood tests including full blood counts, platelets count, retics count, absolute blood values and blood film examination were done. A clinical diagnosis was made based upon the findings of history, examination and blood tests. In patients suspected to have iron deficiency anemia, serum iron studies (i.e. serum iron, Total iron binding capacity (TIBC) and serum ferritin) were done to confirm the diagnosis. Among the selected anemic patients, 60% were iron deficiency anemic, while 40% were non-iron deficiency anemic. Iron deficiency anemia was more common among females than males, as 70% patients were female and 30% were male. The risk factors were found to be pregnancy (40%), nutritional inadequacy (17%), menorrhagia (9%), hemorrhoids (9%), hook worms (8%), hematuria (2%) and blood loss due to various gastro-intestinal pathologies (15%).
文摘Purpose: Due to the high prevalence of iron deficiency anemia in women undergoing gynecological surgeries and its association with worse postoperative results, it is necessary to identify and treat anemia preoperatively. However, although anemia and iron deficiency are significant global health problems, there are still disparities in the recognition and implementation of “Patient Blood Management” (PBM) as a comprehensive approach to mitigating the risks associated with these diseases. The purpose of the study is to review best practices for the treatment of anemia based on the Enhanced Recovery After Surgery (ERAS) protocol and PBM recommendations. Methods: This study reviewed the literature on preoperative iron deficiency anemia in patients undergoing gynecological surgery. We identified references through searches in PubMed using relevant search terms. Results: Among the various strategies used in PBM, perhaps the most important is the early detection and management of anemia. In gynecological surgery, there are several approaches to reducing perioperative blood loss, highlighting the use of gonadotropin-releasing hormone (GnRH) agonists (aGnRh) and antifibrinolytics. Oral and intravenous iron supplementation can be performed in addition to blood transfusion to treat anemia. Conclusion: Addressing preoperative and postoperative anemia through systematic correction, following the guidelines of the ERAS protocol and PBM guidelines, is essential to improving perioperative outcomes in women undergoing gynecological surgery.
文摘The conditions of poverty and violence in Colombia have increased the displacement of people of African descent. The research group concerned with the health of these communities has performed research to find the association of alterations in the hemoglobin molecule with the presence of iron deficiency anemia. This research was performed with the support of the epidemiological public health laboratory. The objective of the study is the association of sickle cell disease and sickle cell trait, and the presence of hemoglobin C and its trait, with iron deficiency anemia in Afro-Colombians between 18 and 50 years of age, by investigation of hemograms, peripheral blood study, serum ferritin, soluble receptor for transferrin （sTfR） and index of sTfR, and hemoglobin electrophoresis. This research is a descriptive, quantitative, transverse, structured, non-experimental and correlational study, with a total of 56 samples （10 men, 46 women）. The results showed that ferritin in men had normal values, compared to 32% （15/46） of women who had low levels of ferritin. Men＇s sTfR levels were normal, while in women 2% （1/46） had iron deficiency in stage I, 41% （19/46） iron deficiency in stage If, and 9% （4/46） possibly without anemia iron deficiency. In hemoglobin electrophoresis, 84% （46/56） of the population presents hemoglobin A, 4% （2/56） increased hemoglobin A2 and fetal hemoglobin related to a possible thalassemia trait, 11% （6/56） had hemoglobin AS related to sickle cell trait, and 2% （1/56） show hemoglobin AC, related to hemoglobin AC trait. This project supports investigative and social projects, and also contributes to the improvement of the quality of life and dissemination of good health practices in these communities.
文摘Background:In patients with autoimmune hemolytic anemia(AIHA),the risk of relapse is high owing to persistent autoreactive B-cell activity.Multirefractory AIHA is a more advanced stage of disease that is defined by a lack of response to at least three lines of therapy.CD19-directed chimeric antigen receptor(CAR)T-cell therapy results in profound B-cell depletion and may be a useful approach to achieving drug-free remission in multirefractory AIHA.
基金supported by China's National Natural Science Foundation (No. 41501043)by the "West Light" project of the Chinese Academy of Sciencesby the project of 60th Chinese postdoctorate science fund (No. 2016M602904)
文摘Iron deficiency chlorosis of Lilium davidii var. unicolor is often the case in practice in alkaline soils of northwest region of China. It is difficult to control iron chlorosis because of high cost and short effective work time of conventional iron fertilizers. In this study, a 2-year field experiment was conducted to evaluate the effects of two slow-release fertilizers on the suppression of iron deficiency chlorosis, soil chemical properties, and the yield and quality of L. davidii var. unicolor. Results show that both coated slow-release iron fertilizers and embedded slow-release iron fertilizer effectively controlled iron-deficiency chlorosis. The application of slow-release iron fertilizers significantly increased plant height and chlorophyll content of L. davidii var. unicolor at different growth stages. Furthermore, coated iron fertilizer application significantly increased starch, protein, soluble sugar and vitamin C content of L. davidii var. unicolor, and it also significantly improved total amino acid content, with increases in essential amino acids(Trp, Leu, Lys, Phe, Val, and Thr contents) and in nonessential amino acids(Asp, Glu, Cit, Ihs, Acc, Ala, Pro, and Cys contents). It was concluded that application of coated slow-release iron fertilizer could be a promising option for suppression of iron deficiency chlorosis and deserves further study.
文摘Background: Sickle cell anemia(SCA), a genetic hemoglobin disorder, suggests essential inner ear compromise and poor auditory processing. In humans, auditory processing differs physiologically between males and females, possibly true for SCA due to gender-specific disease pathophysiological changes. Objective: To investigate gender differences in psychoacoustical abilities, and speech perception in noise in SCA individuals and further compare with normal healthy(NH) population. Methods: 80 SCA and 80 NH normal-hearing participants aged 15-40 years were included and further grouped based on gender. Auditory discrimination for frequency, intensity, and duration at 500Hz and 4000Hz;temporal processing(Gap detection threshold & Modulation Detection Threshold) and Speech Perception In Noise(SPIN) at 0d BSNR tests were evaluated and compared between males and females of SCA and NH population. Results: SCA performed poorer compared to NH for all experimental measures. In the NH population, males performed poorer than females in psychoacoustical measures whereas within the SCA population, the reverse was true. Female participants performed better in the SPIN test in both populations. Conclusions: The adverse impact of SCA on the auditory system due to circulatory changes might cause poorer performance in SCA. Poorer performance by Female SCA is possibly due to the contrary impact of lower Hb level overlying Sickle disease.Estrogen levels and gender preference in auditory processing might lead to better performance by females within the NH population. SPIN performance depends on different attentional demands and sensorimotor processing strategies in noise beyond psychoacoustical processing may lead to better female performance in both populations.
文摘Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(Tregs)frequencies and increased effector cytotoxic cells.Tregs are reduced in aAA and increase in number after successful immunosuppressive therapies.Methods In this retrospective study,we investigated the frequency of circulating Tregs by multiparametric flow cytometry immunophenotyping in non-severe aAA patients before and after immunosuppressive therapy.The samples were stained with the following antibodies:ECD anti-CD3,PE or PC5 anti-CD4,FITC anti-CD8,and PE anti-CD25,and Tregs were identified by first gating on linear parameters for lymphocyte identification and then for CD3 expression.In CD3+CD4+cells,Tregs were further identified on the basis of CD25 and FOXP3 expression.Results Although the number of Tregs tended to increase after immunosuppressive treatments,their circulating frequency remained lower than that of healthy subjects,regardless of their responsiveness to therapies.Moreover,the relative frequency combined with absolute Treg counts might be more informative in the differential diagnosis of bone marrow failure syndromes.Conclusions The persistent decrease in circulating Tregs could be the result of immunosuppressive agents that could preferentially expand other T-cell subsets.At the same time,an imbalance in immunotolerance might persist,which is also favored by chronic antigen stimulation.
文摘Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classifi cation (microcytic, macrocytic and normocytic) and pathogenic classi-fication (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other comple-mentary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time.
文摘Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity.Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas:Whether anemia is a disease complication or a part of the disease spectrum?Should iron,folic acid,and vitamin B complex supplementation and nutritional advice,suffice in those who can perform tasks of daily living but have persistently low hemoglobin.How does one investigate and manage anemia due to multifactorial etiologies in the same patient:Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia?To add to the clinician’s woes the prevalence of anemia increases with increasing disease severity.We thus aim to critically analyze the various pathophysiological mechanisms complicating anemia in a patient with cirrhosis with an emphasis on the diagnostic flowchart in such patients and proposed management protocols thereafter.
基金Supported by the State Administration of Traditional Chinese Medicine high-level key disciplines construction project:zyyzdxk-2023068Three-year Action Plan for Shanghai TCM Development and Inheritance Program:ZY(2021-2023)-0302。
文摘Objective:To observe the effects of moxibustion on the hematopoietic function in mice with aplastic anemia(AA)induced by bone marrow(BM)suppression,and to investigate the intervention effects of moxibustion on AA from the perspective of intestinal bacteria.Methods:A total of 24 C57BL/6 J male mice were randomly and evenly divided into control,model and moxibustion groups.The myelosuppression-induced AA model was established by cyclophosphamide(CTX)and cyclosporine(Cs)intraperitoneal injection.Mice in the moxibustion group were intervened in mild moxibustion at unilateral“Zusanli(ST36)”acupoint for 15 min per day,and the sides were switched the next day.The intervention of mild moxibustion lasted 60 days consecutively.The red blood cell(RBC),white blood cell(WBC),platelet(PLT)counts and haemoglobin(Hb)concentration levels of mice in each group were detected by peripheral blood cells count staining,and the BM hematopoietic cells and hematopoietic structures were observed by BM smear Wright-Giemsa staining and HE staining.16SrDNA sequencing was used to analyze the gut bacterial species abundance and diversity in mice from each group.Results:After all the intervention,compared to the control group,the model group had lower levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05)and fewer hematopoietic cells and hematopoietic structures;compared to the model group,moxibustion group had higher levels of RBC,WBC,PLT counts and Hb concentration in peripheral blood(P<0.05),and more BM hematopoietic cells and hematopoietic structures.Gut flora showed that moxibustion increased the species richness and diversity of intestinal bacteria in mice;compared with the control group,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the model group was higher(P<0.05);whereas,the relative abundance of Faecalibaculum and Anaeroplasmataceae in the moxibustion group was lower(P<0.05)when compared with the model group.In addition,Faecalibaculum was significantly correlated with RBC,WBC,PLT count and Hb concentration(P<0.05).Conclusion:Moxibustion can improved BM histology,restored hematopoietic cells function,and increased peripheral blood cells count and Hb concentration in AA mice.The mechanism may be related to the fact that moxibustion regulates the abundance of specific intestinal bacteria to maintain the stability of the flora structure.
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)are caused by mutations in the KIT and platelet derived growth factor receptor alpha genes in approximately 90%of cases.A minority of wild-type GISTs are associated with neurofibromatosis type 1(NF1),an autosomal dominant genetic disease resulting from pathogenic mutations in the NF1 gene,which encodes the neurofibromin protein.NF1 patients often exhibit multi-system involvement,with café-au-lait macules and neurofibromas being characteristic symptoms.GISTs are a rare complication of NF1,with the tumors most frequently occurring in the small intestine(90%of cases),while occurrences in the stomach are rare.CASE SUMMARY A 51-year-old woman presented to the emergency department with complaints of dizziness,fatigue,chest tightness,and dark stools.Initial examination revealed a red blood cell count of 1.99×1012/L and a hemoglobin level of 43 g/L.She underwent blood transfusions and fluid replacement to stabilize her condition.Further investigations identified typical café-au-lait macules on her trunk,limbs,and face,along with neurofibromas.Endoscopy showed coffee-colored fluid in the gastric cavity,a large submucosal elevation with an exudative covering,and ulcer formation on the gastric fundus.Exploratory laparoscopy confirmed the tumor’s origin in the gastric fundus,and resection of the giant GIST was performed.Pathological analysis revealed a necrotic GIST measuring 18 cm×14 cm,classified as high-risk,with approximately 5 mitotic figures per 10 high-power fields and no tumor at the margins.Immunohistochemistry results were CD117(+),delay of germination 1(+),CD34(+),and succinate dehydrogenase complex iron sulfur subunit B intact expression.Genetic testing using next-generation sequencing confirmed an NF1 gene mutation.The patient underwent successful tumor resection and was discharged home with postoperative regorafenib therapy.A follow-up at one year showed no recurrence.CONCLUSION Given the diversity of clinical symptoms associated with NF1 and the complexity of NF1-related GISTs,surgical resection with complete tumor removal remains the preferred treatment option.However,the absence of a standardized treatment protocol for adjuvant therapy presents numerous challenges for clinicians.
基金supported by Muhammadiyah Research Grant (RisetMu) Batch Ⅵ (No. 1687.186/PD/I.3/D/2022)
文摘Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.
文摘Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by
基金Supported by General Program of Hainan Natural Science Foundation,No.824MS143.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains unclear.AIM To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.METHODS A systematic search was conducted across PubMed,Embase,and Web of Science databases to identify studies that reported the co-occurrence of anemia and DFUs in diabetic patients.The primary outcome was an association between anemia and DFU risk,expressed as odds ratios(ORs).Secondary outcomes included the risk of DFU per 1-g/dL decrease in hemoglobin and the difference in hemoglobin le-vels between patients with and without DFU.Statistical analyses were performed using random-effects models to account for heterogeneity.RESULTS Sixteen studies involving 170,949 diabetic patients were included in the analysis.The results indicated a significant association between anemia and an increased risk of DFUs(eight studies,n=166173,OR:2.72,95%CI:1.73–4.25,P<0.001;I2=93%).Subgroup analyses sup-ported consistent findings across various patient characteristics,analytic models,and study quality scores(P for subgroup differences,all>0.05).Additionally,each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs(four studies,n=2543,OR:1.65,95%CI:1.21–2.27,P=0.002;I2=68%).Furthermore,diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs(nine studies,n=3986,mean difference:-2.13 g/dL,95%CI:-2.58 to-1.68,P<0.001;I2=90%).CONCLUSION Anemia can be associated with an increased risk of DFUs in diabetic patients.Monitoring and managing anemia in diabetic population may help mitigate the risk of DFUs,emphasizing the need for early interventions.Further research is required to investigate the underlying mechanisms and potential therapeutic strategies.
文摘Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.
基金sponsored by the Natural Science Foundation of Zhejiang Province(LQ22D060002 and LTGC23C190001)Fund of State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products(ZS20190105)+1 种基金General Project of Zhejiang Provincial Department of Education(Y202146257)K.C.Wong Magna Fund of Ningbo University。
文摘Iron deficiency anemia(IDA)is a nutritional deficiency disease with a high incidence rate worldwide.Bioactive peptides are safe and effective,have multiple functions and can serve as potential candidates for alleviating IDA.In this study,the anti-anemia effects of tuna dark muscle peptides were explored in a dietinduced IDA mouse model.The results showed that tuna dark muscle peptides alleviated the IDA phenotype,oxidative stress and iron metabolism.In addition,tuna dark muscle peptides reversed gut microbiota dysbiosis in IDA mice.Furthermore,the transplanted fecal microbiota from tuna dark muscle peptide-treated mice also alleviated IDA symptoms and regulated iron metabolism and the gut microbiota,indicating that the antianemic effects were at least partially mediated by the gut microbiota.Thus,we identified a new and safe prebiotic material to alleviate IDA and provided ideas for the development of peptides.At the same time,these data also provided a theoretical basis for fecal microbiota transplantation to alleviate IDA.
文摘BACKGROUND Anemia is a prevalent and challenging complication in patients with hematologic and solid malignancies,which stems from the direct effects of malignancy,treatment-induced toxicities,and systemic inflammation.It affects patients’survival,functional status,and quality of life profoundly.Recent literature has highlighted the emerging role of the gut microbiome in the pathogenesis of cancer-associated anemia.The gut microbiota,through its intricate interplay with iron metabolism,inflammatory pathways,and immune modulation,may either exacerbate or ameliorate anemia depending on its composition,and functional integrity.Dysbiosis,characterized by disruption in the gut microbial ecosystem,is very common in cancer patients.This microbial imbalance is implicated in anemia causation through diminished iron absorption,persistent low-grade inflammation,and suppression of erythropoiesis.AIM To consolidate current evidence regarding the interplay between gut microbiome and anemia in the setting of malignancies.It aims to provide a detailed exploration of the mechanistic links between dysbiosis and anemia,identifies unique challenges associated with various cancer types,and evaluates the efficacy of microbiome-focused therapies.Through this integrative approach,the review seeks to establish a foundation for innovative clinical strategies aimed at mitigating anemia and improving patient outcomes in oncology.METHODS A literature search was performed using multiple databases,including Google Scholar,PubMed,Scopus,and Web of Science,using a combination of keywords and Boolean operators to refine results.Keywords included“cancerassociated anemia”,“gut microbiome”,“intestinal microbiota”,“iron metabolism”,“gut dysbiosis”,“short-chain fatty acids”,“hematopoiesis”,“probiotics”,“prebiotics”,and“fecal microbiota transplantation”.Articles published in English between 2000 and December 2024 were included,with a focus on contemporary and relevant findings.RESULTS Therapeutic strategies aimed at restoration of gut microbial homeostasis,such as probiotics,prebiotics,dietary interventions,and fecal microbiota transplantation(FMT),can inhibit anemia-causing pathways by enhancing microbial diversity,suppressing detrimental flora,reducing systemic inflammation and optimizing nutrient absorption.CONCLUSION Gut dysbiosis causes anemia and impairs response to chemotherapy in cancer patients.Microbiome-centered interventions,such as probiotics,prebiotics,dietary modifications,and FMT,have shown efficacy in restoring microbial balance,reducing inflammation,and enhancing nutrient bioavailability.Emerging approaches,including engineered probiotics and bacteriophage therapies,are promising precision-based,customizable solutions for various microbiome compositions and imbalances.Future research should focus on integrating microbiometargeted strategies with established anemia therapies.
基金supported by the Science&Technology Program of Guizhou Province(Nos.QKHPTRC-GCC[2022]039-1,QKHPTRC-CXTD[2022]014,and QKHHBZ[2020]3002)the Scientific Research Programof Guizhou Provincial Department of Education(No.QJJ[2023]019).
文摘Anemia is still prevalent among low and middle-income countries,posing serious family and social burdens.However,scarce studies provided evidence for real-world exposure to polycyclic aromatic hydrocarbons(PAHs)and anemia among pregnant women,as well as involved biological mechanisms.So,we conducted this study including 1717 late pregnant women fromZunyi Birth Cohort and collected urine samples for PAHs metabolites detection.Logistic regression and restricted cubic spline regression were used to examine exposuredisease risks and dose-response relationships.We conducted Bayesian kernel machine regression,weighted quantile sum regression,and quantile g-computation regression to fit the joint impacts of multiple PAHs in the real-world scenario on hypocalcemia and anemia.Results showed single exposure to 2-OHNap,2-OHFlu,9-OHFlu,1-OHPhe,2-OHPhe,3-OHPhe,and 1-OHPyr(all P-trend<0.05)increased the risks of hypocalcemia and anemia.Moreover,PAHs mixture was significantly related to higher risks of hypocalcemia and anemia,with 3-OHPhe and 1-OHPyr identified as their major drivers,respectively.Importantly,hypocalcemia served as a significant biological mechanism responsible for PAHs and anemia.Our findings suggest that individual and joint exposure to PAHs during late pregnancy elevate the anemia risk,and calcium supplementation might be a low-cost intervention target for reducing the PAHs-related impairment on anemia for pregnant women.
