Current Issue : January - March Volume : 2013 Issue Number : 1 Articles : 6 Articles
Heart failure is a very common disease, with severe morbidity and mortality, and a frequent reason of hospitalization. Anemia and\r\na concurrent renal impairment are two major risk factors contributing to the severity of the outcome and consist of the cardio renal\r\nanemia syndrome. Anemia in heart failure is complex and multifactorial. Hemodilution, absolute or functional iron deficiency,\r\nactivation of the inflammatory cascade, and impaired erythropoietin production and activity are some pathophysiological\r\nmechanisms involved in anemia of the heart failure. Furthermore other concomitant causes of anemia, such as myelodysplastic\r\nsyndrome and chemotherapy, may worsen the outcome. Based on the pathophysiology of cardiac anemia, there are several\r\ntherapeutic options that may improve hemoglobin levels, tissues� oxygenation, and probably the outcome. These include\r\nadministration of iron, erythropoiesis-stimulating agents, and blood transfusions but still the evidence provided for their use\r\nremains limited....
Intravenous iron therapy is a useful treatment for the rapid correction of iron deficiency anaemia and can be used to avoid or reduce\r\nthe requirement for allogeneic blood transfusion. Several intravenous iron preparations are available commercially which differ\r\nin cost, mode of administration and side effect profile. There are few data directly comparing the efficacy of these preparations.\r\nIn this retrospective single-centre study, we present the results from two hundred and eight patients treated using three different\r\niron preparations (iron dextran, iron sucrose and ferric carboxymaltose) and compare the effect on haemoglobin levels and other\r\nmeasures of iron deficiency six weeks after treatment. Within the limitations of our study design, we show a statistically and\r\nclinically significant difference in efficacy between these preparations....
Introduction. Anemia is a frequent problem in hospitalized geriatric patients, and the anemia of chronic disease (ACD) and iron\r\ndeficiency anemia (IDA) are the 2 most prevalent causes. The aim of the study was to assess the possible role of serum hepcidin in\r\nthe differential diagnosis between ACD and IDA. Methods. We investigated serum hepcidin, iron status, anemia, and C-reactive\r\nprotein in 39 consecutive geriatric patients with ACD and IDA. Serum hepcidin levels were determined using a commercial ELISA\r\nkit (DRG Instruments,Marburg, Germany).We also measured hepcidin in 26 healthy controls. Results. The serum hepcidin levels\r\nwere not significantly higher in the 28 patients with ACDas compared to the 11 patients with IDA. Conclusions. The serum hepcidin\r\nlevels measured using the commercial ELISA kit (DRG) do not appear to increase in older patients with ACD. It should be noted\r\nthat an assay-specific problem could explain our results....
Red blood cells (RBCs) from cord blood contain fetal hemoglobin that is predominant in newborns and, therefore, may be more\r\nappropriate for neonatal transfusions than currently transfused adult RBCs. Post-collection, cord blood can be stored at room\r\ntemperature for several days before it is processed for stem cells isolation, with little known about how these conditions affect\r\ncurrently discarded RBCs. The present study examined the effect of the duration cord blood spent at room temperature and other\r\ncord blood characteristics on cord RBC quality. RBCs were tested immediately after their isolation from cord blood using a broad\r\npanel of quality assays. No significant decrease in cord RBC quality was observed during the first 65 hours of storage at room\r\ntemperature. The ratio of cord blood to anticoagulant was associated with RBC quality and needs to be optimized in future. This\r\nknowledge will assist in future development of cord RBC transfusion product....
The change in hematocrit (?Hct) following packed red blood cell (pRBCs) transfusion is a clinically relevant measurement of\r\ntransfusion efficacy that is influenced by post-transfusion hemolysis. Sexual dimorphism has been observed in critical illness\r\nand may be related to gender-specific differences in immune response. We investigated the relationship between both donor and\r\nrecipient gender and ?Hct in an analysis of all pRBCs transfusions in our surgical intensive care unit (2006ââ?¬â??2009). The relationship\r\nbetween both donor and recipient gender and ?Hct (% points) was assessed using both univariate and multivariable analysis. A\r\ntotal of 575 units of pRBCs were given to 342 patients; 289 (49.9%) donors were male. By univariate analysis, ?Hct was significantly\r\ngreater for female as compared to male recipients (3.81% versus 2.82%, resp., P < 0.01). No association was observed between\r\ndonor gender and ?Hct, which was 3.02% following receipt of female blood versus 3.23% following receipt of male blood (P =\r\n0.21). By multivariable analysis, recipient gender remained associated significantly with ?Hct (P < 0.01). In conclusion, recipient\r\ngender is independently associated with ?Hct following pRBCs transfusion. This association does not appear related to either\r\ndemographic or anthropomorphic factors, raising the possibility of gender-related differences in recipient immune response to\r\ntransfusion....
Pursuit of pharmaceutical purity of the blood in the bag has led to a shrinking donor base and a significantly more expensive\r\nproduct. Decisions regarding new infectious marker testing and donor deferrals have typically been made emphasizing decreasing\r\none specific risk without considering the effect the intervention will have on the overall safety and availability of blood transfusion.\r\nRegulations have been formulated by governmental agencies with limited input from the medical community. The decision making\r\nprocess has lacked risk benefit analyses and has not had the robustness associated with spirited discussions. Policies made in this\r\nmanner may result in certain risks being decreased but can also have adverse unintended consequences. Being guided by the ethical\r\nprinciples of nonmaleficence, beneficence, autonomy, and justice, we need to evaluate our actions in the context of overall blood\r\nsafety rather than narrowly focusing on any one area....
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