Evaluation of a portable hemoglobin photometer in pregnant women in a high altitude area: a pilot study

Background  

Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women. This study examined the agreement between a portable hemoglobin photometer and a laboratory analyzer in determining hemoglobin level in pregnant women.     

Development of a nail color scale as a noninvasive tool for predicting hemoglobin in humans

Aim  

To develop a semi-quantitative nail color scale for the prediction of hemoglobin concentration in humans.     

Assessing the effect of darbepoetin alfa on patient-reported fatigue in chemotherapy-induced anemia in four randomized, placebo-controlled clinical trials

Purpose  

This analysis examined the effects of darbepoetin alfa on hemoglobin and fatigue outcomes in patients with cancer using latent growth curve modeling (LGM).     

Hemoglobin levels and anemia evaluation during pregnancy in the highlands of Tibet: a hospital-based study

Background  

Anemia is regarded as a major risk factor for unfavorable pregnancy outcomes, but there have been no previous studies describing the pattern of hemoglobin concentration during pregnancy in Tibet and the relationship between altitude and Hb concentration in the pregnant women living in Tibet still has not been clearly established. The main objectives of this study were to study the hemoglobin levels and prevalence of anemia among pregnant women living in the highlands of Tibet and to evaluate potential associations of hemoglobin and anemia with women's characteristics.     

Association between effort–reward imbalance and glycosylated hemoglobin (HbA1c) among Chinese workers: results from SHISO study

Objective  

The studies focusing on effort–reward imbalance and diabetes mellitus (DM)/glycosylated hemoglobin (HbA1c) are rare. We sought to examine the association between job tress evaluated by effort–reward imbalance (ERI) model and HbA1c in a Chinese population.     

2,4,6-Trinitrotoluene (TNT) air concentrations,hemoglobin changes,and anemia cases in respirator protected TNT munitions demilitarization workers

Purpose  

2,4,6-Trinitrotoluene (TNT) is an explosive used in munitions production that is known to cause both aplastic and hemolytic anemia in exposed workers. Anemia in a TNT worker is considered a sentinel health event (occupational) (SHE(O)) in the United States (US). Deaths have been reported secondary to aplastic anemia. Studies have shown that TNT systemic absorption is significant by both the respiratory and dermal routes. No studies encountered looked at hemoglobin change or anemia cases in respiratory protected workers. It is hypothesized that respiratory protection is insufficient to protect TNT workers from the risk of anemia development and hemoglobin concentration drop.     

Serum heavy metals and hemoglobin related compounds in Saudi Arabia firefighters

Background  

Firefighters are frequently exposed to significant concentrations of hazardous materials including heavy metals, aldehydes, hydrogen chloride, dichlorofluoromethane and some particulates. Many of these materials have been implicated in the triggering of several diseases. The aim of the present study is to investigate the effect of fire smoke exposure on serum heavy metals and possible affection on iron functions compounds (total iron binding capacity, transferrin saturation percent, ferritin, unsaturated iron-binding capacity blood hemoglobin and carboxyhemoglobin,).     

Exposure from the Chernobyl accident had adverse effects on erythrocytes,leukocytes, and,platelets in children in the Narodichesky region,Ukraine: A 6-year follow-up study

Background  

After the Chernobyl nuclear accident on April 26, 1986, all children in the contaminated territory of the Narodichesky region, Zhitomir Oblast, Ukraine, were obliged to participate in a yearly medical examination. We present the results from these examinations for the years 1993 to 1998. Since the hematopoietic system is an important target, we investigated the association between residential soil density of ¹³⁷Caesium (¹³⁷Cs) and hemoglobin concentration, and erythrocyte, platelet, and leukocyte counts in 1,251 children, using 4,989 repeated measurements taken from 1993 to 1998.     

An investigation of the population impact of variation in HbA<Subscript>1c</Subscript>levels in older people in England and Wales: From a population based multi-centre longitudinal study

Background  

Diabetes is common in the older population and is increasing. Glycated hemoglobin (HbA_1c) is an indicator of average blood glucose concentration over the past three months. The HbA_1c test is currently one of clinical methods used to check diabetes control. Recent studies have suggested diabetes is a risk factor for dementia, cognitive dysfunction and physical disability. In addition, there have reported the relationship between HbA_1c and mortality on all cause, cardiovascular disease and cognitive function, but few studies have investigated the relationship concentrating on the older population.     

Transepithelial heme-iron transport: effect of heme oxygenase overexpression

Background  

Heme iron is found in the diet mainly in the form of hemoglobin and myoglobin. It is known that heme iron (heme-Fe) and inorganic iron are absorbed differently. Intracellularly, heme oxygenase-1 (HO1) participates in the cleavage of the heme ring producing biliverdin, CO and ferrous iron. Iron released from heme becomes part of labile iron pool, and it can be stored in ferritin or released through the basolateral membrane. The mechanism by which heme-Fe is metabolized within cells is not completely understood.     

The association of hemoglobin concentration with disability and decreased mobility among older Brazilians

Objective

To examine the association between hemoglobin concentration and disability and mobility difficulty among older adults living in São Paulo, Brazil.

Design

Cross-sectional study.

Setting

Population-based study conducted in São Paulo, Brazil.

Participants

Adults age 60 and over (n=1,256) from the third data collection wave of the SABE Study (Health, Well-being, and Aging) conducted in 2010.

Measurements

Two outcome measures were included in the analyses: 1) a difficulty to perform at least one of the instrumental activities of daily living (IADL) and 2) mobility difficulty, which was assessed using the Short Physical Performance Battery (SPPB). Logistic regression models assessed the association between hemoglobin and each of the outcome measures. All analyses were adjusted for sociodemographic and health characteristics.

Results

The prevalence of IADL disability was 26.8% and 10.7% of participants had mobility difficulty. The mean hemoglobin concentration was significantly lower in older adults who already presented disability (13.7g/dL versus 14.4g/dL among independent elderly) or decreased mobility (13.4g/dL versus 14.3g/dL among elderly with preserved mobility). Higher values of hemoglobin concentration were associated with lower the risk of IADL disability (OR=0.88; p=0.04) and mobility difficulty (OR=0.81; p=0.02). Hemoglobin concentrations showed a dose-response effect in the probability of each outcome.

Conclusions

Lower hemoglobin concentration was associated with a higher probability of IADL disability and mobility difficulty, showing a clear dose-response effect.     

Association of hemoglobin concentration with handgrip strength in relation to hepatocyte growth factor levels among elderly Japanese men aged 60–69 years: a cross-sectional study

Background

Hemoglobin concentration reportedly is positively associated with muscle strength, for example, handgrip strength. However, hemoglobin cannot repair muscle directly, but is beneficial only in a supportive role. Since hepatocyte growth factor (HGF) regulates muscle satellite cell production and differentiation, which is stimulated by organ injury, the supportive effect of hemoglobin should thus be stronger for participants with high HGF than for those with low HGF. However, the association between hemoglobin concentration and handgrip strength in relation to HGF levels remains unknown.

Methods

We conducted a cross-sectional study of 255 Japanese elderly men aged 60–69 years who participated in annual health check-ups in 2014–2015. The study population was categorized on the basis of a median value of HGF of 300.6 pg/mL.

Results

Among present study population, 128 participants showed low HGF. For participants with low HGF, hemoglobin concentration showed no significant association with handgrip strength (standardized parameter estimate (β)?=?0.03, p?=?0.767), but for those with high HGF, hemoglobin concentration was significantly positively associated with handgrip strength (β?=?0.23, p?=?0.014).

Conclusions

A significant positive association between hemoglobin level and handgrip strength was established for elderly Japanese men aged 60–69 years with high HGF but not for participants with low HGF. Our finding indicates that HGF levels could determine the relationship of hemoglobin concentration with handgrip strength in elderly Japanese men aged 60–69 years. This result can be expected to serve as an effective tool for the clarification of the roles played by HGF and hemoglobin concentration in maintenance of muscle strength.

     

Malnutrition and laboratory markers in geriatric patients. A comparison of neurologic-psychiatric,internal and trauma surgical diseases

Objectives

There is minimal information on malnutrition in neurologic-psychiatric patients compared to internal and trauma-surgical patients. The aim of the present study was to explore if there is a correlation of these different disease groups with the nutritional assessment and biochemical markers.

Design

Cross - sectional study.

Setting and Participants

The study was done in a department of geriatric medicine with subspecialisation in neurologic diseases and stroke unit. 338 patients (m / f = 136 / 202, mean age 81.4 ± 7.3 years) were evaluated.

Measurements

The nutritional status was evaluated by using the short form of the Mini Nutritional Assessment (MNA-SF) and seven biochemical markers (hemoglobin, iron, ferritin, vitamin B 12, folic acid, albumin and cholinesterase) were measured.

Results

There were 74 (22%) patients with MNA ≤ 7 points (malnutrition), 148 (44%) patients with an MNA 8 - 11 points (risk of malnutrition) and 116 (34%) patients with an MNA ≥ 12 points (good nutritional status). The mean MNA score of the three major disease groups trauma-surgery, internal medicine and neurology-psychiatry was 9.1 ± 3.2 vs. 9.9 ± 3.1 vs. 10.0 ± 2.8 (p=0.236). There were significant differences of laboratory markers between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in trauma-surgical and internal patients than in neurological-psychiatric patients (albumin: 21.4%, 15.7%, 5.3%; p=0.001; cholinesterase 16.7%, 16.9%, 6.3%; p=0.007; hemoglobin 78.6%, 61.4%, 50.0%; p=0.002).

Conclusions

Following Mini Nutritional Assessment, the additional measurement of albumin, cholinesterase and hemoglobin allowed a more precise grading of malnutrition. There were significant differences between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in multimorbid trauma-surgical and internal patients than in neurologic-psychiatric patients.

     

Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia

Background:

Iron deficiency anemia (IDA) is the most common medical problem in pregnancy. Parenteral iron is a useful treatment, although iron dextran use decreased due to anaphylaxis. Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran.

Objective:

The aim of this study was to compare the efficacy and tolerance of intravenous iron sucrose (IVIS) therapy with oral iron (OI) therapy in pregnant women with IDA and to study the factors influencing treatment.

Materials and Methods:

This prospective, randomized clinical trial included pregnant women between 14 and 36 weeks with established IDA who were treated with IVIS or OI (ferrous fumarate). All patients were monitored for laboratory response and adverse effects. Independent sample-t test, Chi square test and ANOVA were used for statistical analysis. P < 0.05 was considered significant.

Results:

Although hemoglobin increased in both the groups, increase in the reticulocyte count and percentage increase in hemoglobin was significantly higher in the IVIS group than in the OI group (23.62% vs. 14.11%). Serum ferritin was significantly higher in the IVIS group than in the OI group (P = 0.000). The IVIS group had no major side-effects. Compliance was good with OI, although 23% had gastrointestinal side-effects. Patient weight, gestation at diagnosis, initial hemoglobin and ferritin levels did not influence the response to treatment.

Conclusion:

IVIS is safe and effective in the treatment of IDA during pregnancy. Iron stores increased better with IVIS compared with OI.     

Hemoglobin, lead exposure, and intelligence quotient: effect modification by the DRD2 Taq IA polymorphism

Background

Anemia and lead exposure remain significant public health issues in many parts of the world, often occurring together. Animal studies suggest that the dopamine D2 receptor (DRD2) mediates the effects of both lead and iron on cognition and behavior.

Objective

We tested the hypothesis that the DRD2 Taq IA polymorphism modifies the effects of lead and hemoglobin on intelligence quotient (IQ) among children.

Methods

Blood lead and hemoglobin were assessed in 717 children 3–7 years of age attending 12 schools in Chennai, India. IQ was determined using the Binet-Kamat scales of intelligence. Genotyping for the DRD2 polymorphism was carried out using a MassARRAY iPLEX platform. Stratified analyses and interaction models, using generalized estimating equations (GEEs), were used to explore interactions between lead and hemoglobin, and DRD2 Taq IA categories [homozygous variant (A1) vs. presence of wild-type allele (A2)].

Results

After we controlled for potential confounders, a one-unit increase in log blood lead was associated with a decrease of 9 IQ points [95% confidence interval (CI), −18.08 to −0.16] in the homozygous-variant children (n = 73) compared with a decrease of 4 IQ points (95% CI, −7.21 to −0.69) among those with the wild-type allele (n = 644). Higher hemoglobin levels were associated with higher IQ in the children who carried the wild-type allele DRD2, but in children homozygous for the variant allele, an increase of 1 g/dL hemoglobin was associated with a decrease in 1.82 points of IQ (95% CI, −5.28 to 1.64; interaction term p-value = 0.02).

Conclusion

The results of this study suggest that the DRD2 Taq IA polymorphism disrupts the protective effect of hemoglobin on cognition and may increase the susceptibility to the deficits in IQ due to lead exposure.     

How do clinical and psychological variables relate to quality of life in end-stage renal disease? Validating a proximal–distal model

Purpose

The aims of this study were to: (1) validate the proximal–distal (PD) model in predialysis and early dialysis and (2) examine the role of hemoglobin on quality of life (QoL) in these patient groups.

Methods

Cross-sectional observational studies of 475 participants recruited from four major university teaching hospitals were conducted. The multi-sample structural equation modeling with latent composite techniques was employed to test the PD model. Seven factors were measured, including QoL, positive affect, depression, physical functioning, kidney disease symptoms, comorbidity and hemoglobin.

Results

The results showed that both the equality-constrained and equality-unconstrained PD models were supported by fit statistics. The chi square difference test of the two models was non-significant, indicating that the PD model was consistent across groups. The alternative models were rejected by fit statistics, suggesting that hemoglobin does not impact on psychological states but QoL.

Conclusions

This study validates the PD model across the end-stage renal disease (ESRD) patient groups and shows a hierarchical causal relationship between clinical factors, physical functioning, psychological states and QoL, with hemoglobin as an exception. This model provides an empirical framework for integrating and studying a range of clinical factors and health outcomes in ESRD.     

Dépistage néonatal ciblé de la drépanocytose : limites du test de falciformation (test d’Emmel) dans le bilan prénatal en zone ouest africaine

Background

Newborn screening for sickle cell anemia is necessary in Africa where the disease is more frequent. Hemoglobin electrophoresis is used for screening, but is limited by a high cost and difficult access. Sickling test (Emmel test), which is more affordable and technically more accessible, is often requested for prenatal assessment of pregnant women in West African areas to reserve screening for newborns from mothers in whom the positive sickling test attests the presence of hemoglobin S. This study aims to evaluate the number of undetected sickle cell anemia newborns by a screening policy targeting only newborns from mothers in whom a sickling test would have been positive.

Usefulness of Simplified Nutritional Appetite Questionnaire (SNAQ) in Appetite Assessment in Elder Patients with Liver Cirrhosis

Background

Appetite has received little attention in health care and researches in liver cirrhosis. The Simplified Nutritional Appetite Questionnaire (SNAQ), a self-assessment nutritional screening tool, could be used to screen the risk of malnutrition and weight loss. Our objective was to assess the usefulness of SNAQ in appetite assessment in patients with liver cirrhosis.

Methods

Seventy patients were enrolled. Appetite assessment was applied in the enrolled patients by completing SNAQ. Weight, hemoglobin, albumin, pro-albumin and Child-Pugh class were evaluated and recorded. The correlation between SNAQ score and these indexes was also evaluated. The most discriminating SNAQ value was calculated, which separated the participant at risk of weight loss.

Results

In participants with SNAQ < 14, the BMI, hemoglobin, albumin and pro-albumin were significantly less than those in participants with SNAQ ≥ 14. The correlation between SNAQ and these indexes were also observed (hemoglobin: r = 0.334, p = 0.005; albumin: r = 0.384, p = 0.001; pro-albumin: r = 0.342, p = 0.004; BMI: r = 0.550, p = 0.000). The SNAQ scores reduced along with the increase of Child-Pugh class. An SNAQ score under 11.5 was the best clinical indicator of elder people at risk of weight loss.

Conclusions

SNAQ can be used to evaluate the appetite loss and predicting the weight loss in patients with liver cirrhosis. The SNAQ tool also can be used by clinicians and nurses to identify patients with a poor appetite who are at risk of weight loss.

     

Sun-dried cowpeas and amaranth leaves recipe improves β-carotene and retinol levels in serum and hemoglobin concentration among preschool children

Purpose

Vitamin A deficiency (VAD) and anemia are major challenges among children and expecting and lactating mothers in developing countries. Intervention with locally available dark green leafy vegetables (DGLV) is more sustainable to eradicate VAD, being cost-effective and readily adaptable to local communities. DGLV contain high levels of iron and β-carotene (BC) and therefore useful in fighting VAD and anemia. Since DGLVs are season-dependent sun-drying enables their availability during low seasons. However, their contribution to the bioavailability of BC and the improvement of hemoglobin are not well understood. The study therefore investigated the effect of consuming cooked recipe consisting of sun-dried amaranth and cowpea leaves on the levels of BC, retinol, and hemoglobin in preschool children from Machakos District, a semiarid region in Kenya.

Methods

Vegetables were purchased from local vegetable market, with some sun-dried in an open shade. Levels of BC and retinol in serum and BC in fresh and processed vegetables were determined by a HPLC method and hemoglobin using a portable Hemocue Analyzer.

Results

All-trans-BC levels in uncooked fresh cowpea and amaranth leaves were 806.0 μg/g and 599.0 μg/g dry matter, respectively, while the dehydration and cooking processes retained the β-carotene levels at over 60 %. Consumption of the dehydrated vegetables significantly improved both serum BC and retinol levels (p < 0.05), while the baseline hemoglobin levels improved by 4.6 %.

Conclusion

The study has shown that intervention with locally available sun-dried vegetables improves the bioavailability of BC, retinol, and hemoglobin levels among preschool children.