Hookworm Anemia: Iron Metabolism and Erythrokinetics

Iron metabolism, balance of red cell production and destruction and ironabsorption from hemoglobin were determined in 11 patients with heavy hookworm infection and severe anemia.

The plasma iron, total iron binding capacity, bone marrow hemosiderinand plasma Fe⁵⁹ clearance are in agreement with the idea that the anemia associated with hookworm infection is of the iron deficiency type.

The rate of red cell production measured by the E/M ratio, absolute reticulocyte count and plasma iron turnover showed an increase to about twicenormal, while the rate of destruction estimated by the T erythrocytesurvival showed a destruction about 5 times normal. This unbalance betweenproduction and destruction could explain the severity of the anemia.

The increase of fecal urobilinogen output to twice normal was interpretedas due to the metabolism of the hemoglobin lost into the intestine rather than toan increase of hemolysis.

The estimation of fecal blood loss in the patients whose red cells weretagged with Cr⁵¹ and Fe⁵⁹, showed that the radioactivity counted with Fe⁵⁹was only about 63 per cent of the radioactivity counted with Cr⁵¹. This difference was interpreted as due to iron absorption from the hemoglobin lostinto the intestine.

The mean daily fecal excretion of iron reaches 4.7 mg. Since the ironmetabolism in these patients is in equilibrium, we have concluded that theiron loss is replaced by the iron from food; this is in addition to the 3 mg.hemoglobin iron which is reabsorbed from the blood lost into the gut.

Submitted on January 9, 1961 Accepted on April 2, 1961     

Magnetic resonance assessment of the pulmonary arterial trunk anatomy, flow, pulsatility and distensibility

We used magnetic resonance imaging with cine velocity mappingto study the anatomy of pulmonary bifurcation and to measurevolume blood flow, pulsatility of flow and arterial wall distensibilityin the central pulmonary arteries of nine healthy volunteers.Multislice, multiplane spin echo images were acquired to displaypulmonary bifurcation anatomy. Diameters of the main pulmonaryartery (MPA) in systole were 2.56 ± 0.35 cm and in diastole2.20 ± 0.33 cm. Those of the right pulmonary artery (RPA)were 1.57 ± 0.29 cm and 1.39 ± 0.23 respectively,and of the left pulmonary artery (LPA) 1.79 ± 0.26 cmand 1.55 ± 0.10 cm respectively. A gradient echo sequencewith phase shift velocity mapping was then used to measure flowin MPA, RPA and LPA 2 cm on either side of the pulmonary bifurcation.Time averaged flow, calculated from mean velocity and the cross-sectionalarea of the vessels was 4.99 ± 1.10 l . min^–1 inMPA, 2.23 ± 0.58 l . min^–1 in RPA and 2.31 ±0.63 l. min^–1 in LPA. The pulsatility index of flow derivedfrom peak forward flow, peak backward flow and time averagedflow were as follows: MPA 4 4 ± 0.8, RPA 5.1 ±0.6 and LPA 4.6 ± 1.5. Distensibility, calculated fromthe change in cross-sectional area between diastole and systoleand expressed as percentage were as follows: MPA 25.6 ±10.7, RPA 21.4 ± 10.7 and LPA 24.5 ± 7.8. MRI with velocity mapping accurately characterized anatomy,flow, distensibility and pulsatility of the central pulmonaryarteries.     

Lung cancer in a health area of Spain: incidence,characteristics and survival

GARCÍA PRIM J.M., GONZÁLEZ BARCALA F.J., PAZ ESQUEJE J., POSE REINO A., FONDEVILA LÓPEZ A. & VALDÉS CUADRADO L. (2010) European Journal of Cancer Care 19 , 227–233
Lung cancer in a health area of Spain: incidence, characteristics and survival To examine the incidence, characteristics, therapeutic approach and survival of diagnosed lung cancer (LC) in the Santiago de Compostela Health Area. A retrospective study was carried out on LC for a period of 3 years. Of the 481 cases collected, 92.7% were male. The median age was 66.93 years. The crude incidence for men and women was 80.71 and 5.84 per 100 000 inhabitants respectively. Among the non‐small cell lung cancers (NSCLC), 68.1% were diagnosed in stage IIIB or IV. The cancer had already spread in 62.2% of the small cell lung cancer (SCLC). Chemotherapy was used in 51.6% of patients. The survival probability from the first to the fifth year was 47.7%, 24.3%, 12.9%, 10% and 8.9% respectively. The median survival at 5 years was 12.12 months for NSCLC, rising to 29.8 months in stage I, and 8.85 months in SCLC. In our Health Area LC occurs more often in men, in whom the prevalence of smoking is very high. The most common histology type was squamous cell carcinoma. In the majority of cases, the diagnosis is made in the advanced stages, which accounts for the low percentage of surgical treatments and the short survival.     

Testicular Function after Herniotomy Herniotomy and Fertility

One hundred thirty one men who underwent inguinal herniotomy were included in this study, of these, 19 (14.4%) were found to have changes in their testicular size on the side of the operation. Of the 19 men 9 had been operated on for right inguinal hernia, 6 for left inguinal hernia and 4 for bilateral inguinal hernia. All the men were infertile with decreased sperm quality (as measured by concentration, motility, degree of motility and morphology). Most of the men with damaged testes showed elevated serum FSH and decreased serum testosterone. 112 men who had undergone herniotomy were found to have normal sized testicles. They were referred to this institute because of infertility and their semen quality and blood hormones (FSH, LH and testosterone) were evaluated for comparison with the group of the men possessing damaged testicles.