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Anemia phlebotomy

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https://www.readbyqxmd.com/read/29765443/management-of-cardiac-hemochromatosis
#1
Wilbert S Aronow
Iron-overload syndromes may be hereditary or acquired. Patients may be asymptomatic early in the disease. Once heart failure develops, there is rapid deterioration. Cardiac hemochromatosis is characterized by a dilated cardiomyopathy with dilated ventricles, reduced ejection fraction, and reduced fractional shortening. Deposition of iron may occur in the entire cardiac conduction system, especially the atrioventricular node. Cardiac hemochromatosis should be considered in any patient with unexplained heart failure...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29743399/-successful-treatment-of-x-linked-sideroblastic-anemia-with-alas2-r452h-mutation-using-vitamin-b-6
#2
Toru Kawakami, Hideyuki Nakazawa, Fumihiro Kawakami, Shuji Matsuzawa, Yuriko Sudo, Hitoshi Sakai, Sayaka Nishina, Noriko Senoo, Yasushi Senoo, Michiharu Komatsu, Takeji Umemura, Tomomi Yamaguchi, Tomoki Kosho, Tohru Fujiwara, Hideo Harigae, Fumihiro Ishida
A 45-year-old man presented with fatigue and pain in the finger joints. Despite having a history of suspected sideroblastic anemia since the age of 18 years, he had not been followed up for years. Upon presentation, laboratory data revealed microcytic anemia and elevated serum ferritin levels. In addition, ringed sideroblasts were increased in the bone marrow. A liver biopsy revealed hemochromatosis and cirrhosis. Furthermore, genetic analysis revealed that he harbored the ALAS2 R452H mutation, leading to the diagnosis of X-linked sideroblastic anemia (XLSA)...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29543671/iron-overload-cardiomyopathy-from-diagnosis-to-management
#3
Carles Díez-López, Josep Comín-Colet, José González-Costello
PURPOSE OF REVIEW: Iron overload cardiomyopathy (IOC) is an important predictor of prognosis in a significant number of patients with hereditary hemochromatosis and hematologic diseases. Its prevalence is increasing because of improved treatment strategies, which significantly improve life expectancy. We will review diagnosis, treatment, and recent findings in the field. RECENT FINDINGS: The development of preclinical translational disease models during the last years have helped our understanding of specific disease pathophysiological pathways that might eventually change the outcomes of these patients...
March 14, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29461167/incidence-of-hospital-acquired-anemia-in-hospitalized-dogs-and-cats
#4
Jennie L Hiratzka, Louis G Licari, Lisa K Peters
OBJECTIVE To determine the incidence of hospital-acquired anemia among dogs and cats hospitalized at a private emergency and referral center and identify possible risk factors. DESIGN Prospective, observational study. ANIMALS 56 patients (46 dogs and 10 cats). PROCEDURES Patients admitted from August 2014 through March 2015 and hospitalized for ≥ 48 hours were eligible for inclusion. Hospital-acquired anemia was defined as a PCV within reference limits on admission with development of anemia during hospitalization...
March 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29302655/iron-reduction-response-and-demographic-differences-between-diabetics-and-non-diabetics-with-cardiovascular-disease-entered-into-a-controlled-clinical-trial
#5
Leo R Zacharski, Galina Shamayeva, Bruce K Chow
Iron-catalyzed oxygen-free radical-induced oxidative stress mediates the pathogenesis of diabetes and cardiovascular disease (CVD). Diabetics (n = 473) and non-diabetics (n = 804) with CVD entered into a randomized trial of iron (ferritin) reduction by calibrated phlebotomy (, Identifier NCT00032357) had comparable iron measures at entry but diabetics had a greater burden of CVD and comorbidities, lower hemoglobin and hematocrit levels, and higher glucose levels than non-diabetics. Entry iron measures were lower in diabetics on hypoglycemic therapy compared to previously untreated diabetics...
February 21, 2018: Metallomics: Integrated Biometal Science
https://www.readbyqxmd.com/read/29167083/the-effect-of-diagnostic-blood-loss-on-anemia-and-transfusion-among-postoperative-patients-with-congenital-heart-disease-in-a-pediatric-intensive-care-unit
#6
Dan Zhou, Yu-Lan Luo, Shu-Hua Luo, Mei Feng, Meng-Lin Tang
PURPOSE: To evaluate whether diagnostic blood loss can lead to anemia and consequent blood transfusion among postoperative patients with congenital heart disease (CHD) in the pediatric intensive care unit (PICU). DESIGN AND METHODS: This prospective observational study was conducted in a university-affiliated tertiary hospital between January and August 2016. CHD patients aged <12years, undergoing cardiac surgery, with a PICU stay >48h were included (n=205)...
January 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29101207/ferroportin-disease-pathogenesis-diagnosis-and-treatment
#7
REVIEW
Antonello Pietrangelo
Ferroportin Disease (FD) is an autosomal dominant hereditary iron loading disorder associated with heterozygote mutations of the ferroportin-1 ( FPN ) gene. It represents one of the commonest causes of genetic hyperferritinemia, regardless of ethnicity. FPN1 transfers iron from the intestine, macrophages and placenta into the bloodstream. In FD, loss-of-function mutations of FPN1 limit but do not impair iron export in enterocytes, but they do severely affect iron transfer in macrophages. This leads to progressive and preferential iron trapping in tissue macrophages, reduced iron release to serum transferrin (i...
December 2017: Haematologica
https://www.readbyqxmd.com/read/29049500/evidence-based-guidelines-to-eliminate-repetitive-laboratory-testing
#8
REVIEW
Kevin P Eaton, Kathryn Levy, Christine Soong, Amit K Pahwa, Christopher Petrilli, Justin B Ziemba, Hyung J Cho, Rodrigo Alban, Jaime F Blanck, Andrew S Parsons
Routine daily laboratory testing of hospitalized patients reflects a wasteful clinical practice that threatens the value of health care. Choosing Wisely initiatives from numerous professional societies have identified repetitive laboratory testing in the face of clinical stability as low value care. Although laboratory expenditure often represents less than 5% of most hospital budgets, the impact is far-reaching given that laboratory tests influence nearly 60% to 70% of all medical decisions. Excessive phlebotomy can lead to hospital-acquired anemia, increased costs, and unnecessary downstream testing and procedures...
December 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28804090/repeated-phlebotomies-decrease-body-iron-storage-in-adult-dogs
#9
Seishiro Chikazawa, Fumio Hoshi, Kazutaka Kanai
The aim of the present study was to determine changes in body iron storage in adult dogs following phlebotomy. We performed repeated phlebotomies by removing 1% body weight (approximately 10% of the total blood volume) weekly for a total of 12 times using adult beagle dogs without an iron-restricted diet. After treatment, stored iron was decreased, as demonstrated by gradual reductions in serum ferritin levels and hepatic iron contents. Anemia and abnormalities in blood chemistry analysis were not observed; therefore, this method was considered safe and useful for control of stored iron levels in adult dogs...
October 7, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28701427/controlling-phlebotomy-volume-diminishes-picu-transfusion-implementation-processes-and-impact
#10
Katherine Steffen, Allan Doctor, Julie Hoerr, Jeff Gill, Chris Markham, Sarah M Brown, Daniel Cohen, Rose Hansen, Emily Kryzer, Jessica Richards, Sara Small, Stacey Valentine, Jennifer L York, Enola K Proctor, Philip C Spinella
BACKGROUND AND OBJECTIVES: Phlebotomy excess contributes to anemia in PICU patients and increases the likelihood of red blood cell transfusion, which is associated with risk of adverse outcomes. Excessive phlebotomy reduction (EPR) strategies may reduce the need for transfusion, but have not been evaluated in a PICU population. We hypothesized that EPR strategies, facilitated by implementation science methods, would decrease excess blood drawn and reduce transfusion frequency. METHODS: Quantitative and qualitative methods were used...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28666715/-the-role-of-erythroferrone-in-iron-metabolism-from-experimental-results-to-pathogenesis
#11
N Vallet
In case of erythropoiesis, body iron needs to increase to enable the production of new red blood cells. In the 1950s, the observation of an increased digestive iron absorption in the case of phlebotomies had led to propose the existence of an "erythroid factor", which regulate the availability of iron for erythropoiesis in this situation. The factor regulating iron stores has been identified in 2000 to be hepcidin. Recently, in 2014, a new factor was discovered, which regulates iron metabolism, independently of iron stores and responds to the increased requirements for iron after stimulation of erythropoiesis by erythropoietin...
March 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28494509/estimates-of-total-body-iron-indicate-19-mg-and-38-mg-oral-iron-are-equivalent-for-the-mitigation-of-iron-deficiency-in-individuals-experiencing-repeated-phlebotomy
#12
Walter Bialkowski, Joseph E Kiss, David J Wright, Ritchard Cable, Rebecca Birch, Pam D'Andrea, Barbara J Bryant, Bryan R Spencer, Alan E Mast
Iron deficiency anemia is a common clinical condition often treated with tablets containing 65 mg of elemental iron. Such doses can elicit gastrointestinal side effects lowering patient compliance. Oral iron supplements also increase hepcidin production causing decreased fractional absorption of subsequent doses. Frequent blood donors often become iron deficient. Therefore, they were enrolled in a two-year study involving continued blood donations and randomization to receive no pill, placebo, 19, or 38 mg ferrous gluconate for 60 days...
September 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28452910/brief-report-safety-of-frequent-blood-sampling-in-research-participants-in-an-acute-hiv-infection-cohort-in-thailand
#13
Carlo Sacdalan, Trevor Crowell, Donn Colby, Eugène Kroon, Phillip Chan, Suteeraporn Pinyakorn, Nitiya Chomchey, Peeriya Prueksakaew, Suwanna Puttamaswin, Michelle Chintanaphol, Theresa Cheng, Nittaya Phanuphak, Jintanat Ananworanich
INTRODUCTION: Anemia is a potential adverse effect of phlebotomy during participation in research. Clinical studies of acute HIV infection (AHI) require frequent phlebotomy to maximize scientific yield, but this participant population may also be at increased risk for anemia and other adverse events. OBJECTIVE: The objective of this study was to describe baseline and longitudinal hemoglobin changes among participants with AHI. METHODS: Participants with AHI (n = 202) were enrolled in a prospective cohort study in Thailand...
September 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28399115/neonatal-mouse-hippocampus-phlebotomy-induced-anemia-diminishes-and-treatment-with-erythropoietin-partially-rescues-mammalian-target-of-rapamycin-signaling
#14
Diana J Wallin, Tara G Zamora, Michelle Alexander, Kathleen M Ennis, Phu V Tran, Michael K Georgieff
BackgroundPhlebotomy-induced anemia (PIA) is common in premature infants and affects neurodevelopment. PIA alters hippocampal metabolism in neonatal mice through tissue hypoxia and iron deficiency. The mammalian target of rapamycin (mTOR) pathway senses the status of critical metabolites (e.g., oxygen, iron), thereby regulating hippocampal growth and function. We determined the effect of PIA and recombinant human erythropoietin (rHuEpo) treatment on mTOR signaling and expression of genes related to mTOR pathway functions...
September 2017: Pediatric Research
https://www.readbyqxmd.com/read/28362411/continuous-manual-exchange-transfusion-for-patients-with-sickle-cell-disease-an-efficient-method-to-avoid-iron-overload
#15
Bérengère Koehl, Florence Missud, Laurent Holvoet, Ghislaine Ithier, Oliver Sakalian-Black, Zinedine Haouari, Emmanuelle Lesprit, André Baruchel, Malika Benkerrou
Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients...
March 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#16
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27789107/successful-treatment-of-iron-overload-cardiomyopathy-in-hereditary-hemochromatosis-with-deferoxamine-and-deferiprone
#17
Lydie Tauchenová, Barbora Křížová, Miloš Kubánek, Soňa Fraňková, Vojtěch Melenovský, Jaroslav Tintěra, Dana Kautznerová, Jana Malušková, Milan Jirsa, Josef Kautzner
There is scarce evidence regarding the use of iron chelators in patients with hereditary hemochromatosis who are intolerant of phlebotomy or erythrocytapheresis. A 52-year-old man with genetically confirmed HFE hemochromatosis presented with liver disease and heart failure with severe left ventricular systolic dysfunction. Because of anemia after initial treatment, we added intravenous deferoxamine followed by oral deferiprone to less frequent erythrocytapheresis, which normalized systolic function within 1 year...
December 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27538924/safe-reduction-of-blood-volume-in-the-blood-gas-laboratory
#18
Phillip R Jensen, Boaz A Markewitz
BACKGROUND: Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes...
November 2016: Laboratory Medicine
https://www.readbyqxmd.com/read/27473810/bloodless-medicine-current-strategies-and-emerging-treatment-paradigms
#19
REVIEW
Linda M S Resar, Elizabeth C Wick, Talal Nael Almasri, Elizabeth A Dackiw, Paul M Ness, Steven M Frank
BACKGROUND: Advances in our understanding of the risks associated with allogeneic blood transfusions (ABTs) and the growing number of patients who wish to avoid ABTs have led to the emergence of new treatment paradigms for "bloodless" medicine and surgery. STUDY DESIGN AND METHODS: Here, we review prior studies and summarize current strategies for bloodless care used at our institution. We advocate three basic principles: 1) diagnosing and aggressively treating anemia, 2) minimizing blood loss from laboratory testing and invasive procedures, and 3) identifying and managing bleeding diatheses...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27271482/efficacy-and-safety-of-erythrocytapheresis-and-low-dose-erythropoietin-for-treatment-of-hemochromatosis
#20
Dorothea Brückl, Sundrela Kamhieh-Milz, Julian Kamhieh-Milz, Abdulgabar Salama
BACKGROUND: The aim of this study was to determine retrospectively the efficacy of combined therapy using erythropoietin (EPO) and erythrocytapheresis (EA) in patients with hereditary hemochromatosis (HH) who did not tolerate phlebotomy. PATIENTS AND METHODS: Twenty patients (age range, 43-74 years) with genetically confirmed HH had received low-dose EPO (4,000 IU) in accordance to the patient's hemoglobin levels between each EA session. Laboratory parameters including hemoglobin, ferritin, transferrin, and iron were measured at regular intervals...
June 2017: Journal of Clinical Apheresis
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