Anemia-related subjective symptoms in the general adult population in Japan / Journal of Rural Medicine

Objectives: Approximately 17% of Japanese women have hemoglobin concentrations less than 12 g/dL. Therefore, anemia prevention and early intervention are crucial public health issues in Japan. This study aimed to identify the symptoms and characteristics of anemic individuals in the general adult population by comparing survey responses of individuals with anemia and without anemia visiting blood donation centers.Materials and Methods: This cross-sectional study used self-administered questionnaires. Individuals who visited two Japanese Red Cross Society blood donation centers in Fukushima Prefecture, Japan were included. Hemoglobin levels were measured at blood donation, and the levels of 13 g/dL for men and 12 g/dL for women were defined as anemia.Results: Of the 857 individuals analyzed, 530 were men and 327 were women, of whom 19 (3.6%) and 12 (3.7%) had low hemoglobin levels, respectively. Logistic regression analysis was performed in men, and the results showed that “lightheadedness” (odds ratio [OR]=8.4) and “depressive symptoms” (OR=3.6) were significantly associated with hemoglobin levels. None of the evaluated items were significantly associated with hemoglobin levels in women.Conclusion: Among healthy Japanese men, those who exhibit lightheadedness and depressive symptoms have an increased risk of anemia. Lightheadedness and depressive symptoms may be indicative of undiagnosed anemia in men, which necessitates greater clinical attention.

Efectividad del mousse de sangrecita y nivel de hemoglobina en los niños de 3 años en las instituciones educativas iniciales, Ica-Perú / Effectiveness of sangrecita mousse little blood and hemoglobin level in children from 3 years of age in the initial educational institutions Ica-Peru

El estudio tuvo como Objetivo: Evaluar la efectividad del mousse de sangrecita en los niveles de hemoglobina en los niños de dos instituciones Educativas iniciales. Materiales y métodos: Estudio Experimental con diseño cuasi experimental de corte longitudinal, la población de estudio estuvo conformada por 80 niños los cuales todos participaron (consentimiento de los padres), 52 niños fueron de la IEI de Ica y 28 de la IEI de Comatrana, para la muestra se realizó un muestreo no probabilístico mediante el descarte de anemia utilizando el analizador de hemoglobina (hemoQ), microcubetas, lancetas y demás implementos, de ellos 9 niños tuvieron una hemoglobina <=11gr/dl quienes ingresaron al programa de mousse de sangrecita. Se elaboró una ficha de control. Resultados: Después de 7 semanas de consumir el mousse de sangrecita los 9 niños que ingresaron al programa de las dos IEI, se evidencio un incremento en sus niveles de hemoglobina superior al primer control. Conclusiones: El consumo de mousse de sangrecita es efectiva en el tratamiento de la anemia en niños de la IEI incrementando el nivel de hemoglobina. (AU)

The Objective of the study was to evaluate the effectiveness of blood mousse on hemoglobin levels in children from two initial educational institutions. Materials and Methods: Study experimental Quasi-experimental desing of longitudinal cut, the study population was made up of 80 children who all participated (parental consent), 52 children were from the IEI of Ica and 28 from the IEI of Comatrana, for the sample a non-probability sampling was carried out by discarding anemia using the hemoglobin analyzer (hemoQ), microcuvettes, lancets andother implements, of them 9 children had a hemoglobin < = 11gr / dl who would enter the blood mousse program. A control sheet was drawn up. Results: After 7 weeks of consuming the blood mousse of the 9 children who entered the program of the two IEI, there was evidence of an increase in their hemoglobin levels higher than the first control. Conclusions: The consumption of blood mousse is effective in the treatment of anemia in children with IEI by increasing the level of hemoglobin. (AU)

The effectiveness of theory-based intervention to improve haemoglobin levels among women with anaemia in pregnancy

@#health problem throughout the world. The effects of theexisting intervention in ensuring compliance to thesubscribed regimen and the impact of nutrition education inenhancing dietary modification during pregnancy inMalaysia have been minimal. This study aims to develop,implement and evaluate the effects of the Health BeliefModel educational intervention on haemoglobin level amonganaemic pregnant women.Methods: This is a quasi-experimental research with pre-post test design with control group involving 81 participantsper group from two health clinics in Sepang. The primaryoutcome was a change in the haemoglobin levels followingeducational intervention. Secondary outcomes includeknowledge on anaemia, Health Belief Model (HBM)constructs, dietary iron intake and compliance towards ironsupplementation. The intervention group received a HBM-based education intervention programme. Results: The response rate in the intervention and controlgroup were 83.9% and 82.7% respectively. Generalisedestimating equations analysis showed that the interventionwas effective in improving the mean haemoglobin level(β=0.75, 95%CI=0.52, 0.99, p<0.001), the knowledge score(β=1.42, 95%CI=0.36, 2.49, p=0.009), perceived severityscore (β=2.2, 95%CI= 1.02, 3.39, p<0.001) and increasedproportion of high compliance level (AOR=4.59, 95%CI=1.58,13.35, p=0.005).Conclusion: HBM-based health education programme hasproven to be effective in improving the haemoglobin levels,knowledge scores, perceived severity scores andcompliance level of participants. The study resultsemphasized on the effectiveness of such an approach,therefore it is recommended that future educationalinterventions which aim at increasing preventive healthybehaviours in pregnant women may benefit from theapplication of this model in primary health care settings.

Hemoglobin Level and Karyotype Status are Independent Prognostic Parameters for Acute Myeloid Leukemia: Pilot Study of 244 Patients

Purpose: Acute myeloid leukemia (AML) is a heterogeneous disease with genetic profiling being the primary prognostic factor. The objective of this study was to examine if routinely acquired parameters may be used to improve the prognosis of AML prognosis. Methods: Karyotyping was performed using bone marrow-derived mononuclear cells of 244 de novo diagnosed AML patients and age, sex, total leukocyte count (TLC), platelet count and hemoglobin (Hb) levels at initial presentation were recorded. The patients were given standard treatment and overall survival (OS) for 1 year and 5 years were recorded. Results: As expected, patients with aberrant karyotype status had poor overall survival. Aneuploidy was strongly associated with poor patient survival; while patients presented with hyperploidy had significantly lower OS at both 1 year and 5 years of time points; hypoploidy was correlated only with poor 1 year OS. Interestingly, 146 patients with Hb levels ≤ 8 g/dl had significantly lower 1 year and 5 years OS compared to 95 patients with Hb levels ≥ 8 g/dl. Combining karyotype status or Hb levels with other parameters did not improve patient prognosis. Conclusion: In summary, our results show that in addition to karyotype status, Hb level is an independent prognostic marker that should also be considered for early identification of patients that may benefit from alternative therapies.

Association of Hemoglobin Levels and Cognitive Function in Alzheimer's Disease and Mild Cognitive Impairment / 정신신체의학

OBJECTIVES: Anemia is a common problem in the management of elderly patients. Recent studies reported that anemia was associated with cognitive impairment and Alzheimer's disease. This study was aimed to analyze the differences of hemoglobin levels in Korean patients with Alzheimer's disease(AD) dementia, mild cognitive impairment(MCI), and healthy controls. Furthermore, the study also examined if any association between hemoglobin levels and cognitive functions existed. METHODS: A total of 116 Korean elderly adults were participated in this study(mean age 74.67 years ; 60.3% female). The Korean version of the Mini-Mental State Examination(MMSE-K), Clinical Dementia Rating(CDR) and Global Deterioration Scale(GDS) were applied to all subjects. Hematological and related blood chemistry values were investigated. RESULTS: We found that patients with AD dementia had significantly lower hemoglobin and hematocrit levels than MCI subjects and healthy control group. The hemoglobin levels showed a positive correlation with MMSE-K and negative correlation with CDR, GDS. CONCLUSIONS: Among Korean elderly, low hemoglobin level is associated with a cognitive impairment. This study indicates that AD is associated with anemia, and low hemoglobin levels may contribute to potentially useful clinical markers of AD. The risk factor for dementia needs to be confirmed by prospective longitudinal studies in a larger group of patients.

Efecto del clampeo demorado del cordón umbilical en la ferritina sérica a los seis meses de vida. Estudio clínico controlado aleatorizado / The effect ofearly and delayed umbilical cord clamping onferritin levels in term infants at six months oflife. A randomized, controlled trial

Introducción. El clampeo demorado del cordón umbilical aumentaría el depósito de hierro en lactantes. Para comprobar esta hipótesis medimos la ferritina sérica a los seis meses de vida en niños nacidos a término, participantes en un estudio controlado aleatorizado que evaluó el efecto del tiempo de clampeo del cordón en el hematócrito venoso y la evolución neonatal. Métodos. De 276 neonatos incluidos en el estudio original, 255 (92,4%) fueron seguidos seis meses, 86 tuvieron clampeo temprano, 83 al minuto y 83 al tercer minuto. La variable principal de resultado fue la concentración de ferritina sérica a los seis meses. Resultados. Las características de los grupos de madres y niños fueron similares. La ferritina fue significativamente más alta en los niños con clampeo al tercer minuto (33,2 μg/L) que en los de clampeo temprano (20,9 μg/L) (diferencia de medias geométrica: 1,6; IC 95%: 1,2-2,1). No hubo diferencia significativa entre clampeo al minuto (25,5 μg/L) y clampeo temprano. Tampoco hubo diferencia en los valores medios de hemoglobina, entre los grupos temprano [10,6 g/dl (DE 1,11)], al minuto [10,8 g/dl (DE 0,86)] y tres minutos [10,7 g/dl (DE 0,97)], respectivamente. La prevalencia de anemia ferropénica fue tres veces mayor en niños con clampeo temprano (7%) en comparación con los del tercer minuto (2,4%) (diferencias no significativas; RR: 0,30; IC 95%: 0,10-1,60). Conclusión. En niños nacidos a término, el clampeo del cordón umbilical a los tres minutos del nacimiento aumentó significativamente las concentraciones de ferritina a los seis meses de edad. No hubo diferencias significativas en los niveles de hemoglobina.

Background. Delayed umbilical cord clamping could increase iron stores and prevent iron deficieney in infants. To test this hypothesis we measured serum ferritin and hemoglobin levels at six months of age in term infants who had participated in a randomized controlled trial, assessing the effect of cord clamping timing on neonatal hematocrit values and clinical outcome. Main outcome measure. Serum ferritin level at six months of age. Methods. Out of the 276 mothers and their infants that participated in the initial study, 255 (92.4%) were followed up to six months and included in this study. Of these, 86 had their cords clamped within the first 15 seconds (early clamping), 83 at one minute, and 83 at three minutes. The pediatricians in charge of the evaluations during the follow-up period and personnel in charge of the biochemical tests were blinded to the assignment group. In all but 3 infants the ferritin levels and hemoglobin levels were measured at six months of age. Results. Mothers and infants in the three groups had similar baseline characteristics. Serum ferritin levels were significantly higher in the infants of the three minutes group than in the infants of the early group: 33.2 μg/L vs. 20.9 ug/L(geometric mean ratio: 1.6;95%CI: 1.2 to 2.11) but no difference was observed in one minute group (25.5 μg/L) vs. early group. There were no significant differences inmeanhemoglobin values, 10.6 g/dl (SD 1,1); 10.8 g/dl (SD 0.9) and 10.7 g/dl (SD 1.0) between groups early, one minute, and three minutes, respectively. Although there were no significant differences between groups, the prevalence of iron deficiency anemia (hemoglobin < 10.5 g/dl and ferritin < 9 μg/L) was 3 times more frequent in early clampling group (7.2%) than in three minutes group (2.4%) (RR: 0.30; IC 95%: 0.10-1.60). Conclusions. Delayed umbilical cord clamping at three minutes significantly increases serum ferritin levels in infants at 6 months of age. No significant differences were found between groups in mean hemoglobin levels.

Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados / Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

Es frecuente observar el desarrollo de anemia durante la internación, especialmente en pacientes graves. Esto se ha relacionado a extracciones de laboratorio. Pocos estudios evaluaron su prevalencia y factores asociados en pacientes internados en sala general. El objetivo fue determinar la prevalencia, características y factores clínicos asociados a anemia intrahospitalaria y descenso de hemoglobina en pacientes internados. Se efectuó un estudio transversal, prospectivo, descriptivo. Se analizaron 192 internaciones consecutivas en sala general. Se determinó aquellas que presentaron un descenso del valor de hemoglobina = 2 g/dl y se analizaron factores de riesgo asociados. Presentaron anemia 139 pacientes (72.4%), 89 (46.4%) al ingreso y 50 (26%) durante la internación. Se presentaron 47 casos de descenso de hemoglobina = 2 g/dl (24.47%), en los que se observaron los valores más bajos de hematocrito y hemoglobina al alta (p = 0.01), hidratación parenteral con mayor volumen (p = 0.01) y estadías hospitalarias más prolongadas (p = 0.0001). En el análisis univariado las variables leucocitosis = 11 000mm³ (OR; IC95%: 2.02; 1.03-4; p = 0.01), días de internación = 7 (OR; IC95%: 3.39; 1.62-7.09; p = 0.0006), hidratación parenteral = 1500 ml/día (OR; IC95%: 2.47; 1.06-6.4; p = 0.01), vía central (OR; IC95%: 10.29; 1.75-108.07, p = 0.003) y anemia intrahospitalaria (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004) fueron estadísticamente significativos como factores de riesgo para descenso de hemoglobina = 2 g/dl. En el análisis multivariado las variables leucocitosis = 11 000 mm³ (OR; IC95%:2.45; 1.14-5.27; p = 0.02); días de internación = 7 (OR; IC95%: 5.15; 2.19-12.07; p = 0.0002); hidratación parenteral = 1500 ml/día (OR; IC95%: 2.95; 1.13-7.72; p = 0.02) y vía central (OR; IC95%:8.82; 1.37-56.82; p = 0.02) fueron factores predictivos independientes de descenso de hemoglobina = 2 g/dl. La anemia intrahospitalaria tuvo una elevada prevalencia. La estadía hospitalaria prolongada, la presencia de leucocitosis, la hidratación parenteral y colocación de acceso venoso central fueron factores predictivos de descenso de hemoglobina = 2 g/dl.

It is common to observe the development of anemia in hospitalized patients, especially in critical cases. Few studies have evaluated its prevalence and associated factors in patients in the general ward. The purpose of this study is to determine the prevalence, characteristics and associated clinical factors of hospital-acquired anemia and the drop of hemoglobin concentration in hospitalized patients. This is a cross-sectional, prospective and descriptive study. A total of 192 consecutive in-patients in the general ward were studied. Associated risk factors to the drop in hemoglobin by = 2g/dl were analyzed; 139 patients (72.4%) presented anemia; 89 of them (46.4%) had it at admission and 50 (26%) developed hospital-acquired anemia, 47 out of 192 showed a drop in hemoglobin = 2 g/dl(24.48%). They also presented lower values of hematocrite and hemoglobin at discharge (p = 0.01), parenteral hydration at a higher volume (p = 0.01), and lengthier hospitalizations (p = 0.0001). In the univariate analysis, the following variables were statistically significant risk factors: leukocytosis = 11 000 mm³ (OR; IC95%: 2,02; 1.03-4; p = 0.01), hospitalization days = 7 (OR; IC95%:3.39; 1.62-7.09; p = 0.0006), parenteral hydration = 1500 ml/day (OR; IC95%: 2.47; 1.06-6.4; p = 0.01), central venous access (OR; IC95%:10.29; 1.75-108.07; p = 0.003) and hospital-acquired anemia (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004). In the multivariate analysis, the following variables were independent predictive factors of the hemoglobin decrease = 2 g/dl: leukocytosis = 11 000 mm³ (OR; IC95%: 2.45; 1.14-5,27; p = 0.02), hospitalization days = 7 (OR; IC95%:5.15; 2.19-12.07; p = 0.0002), parenteral hydration = 1500 ml/day (OR; IC95%: 2.95; 1.13-7.72; p = 0.02), central venous access (OR; IC95%:8.82; 1.37-56.82; p = 0.02). Hospital-acquired anemia has a high prevalence. Lengthier stays, presence of leukocytosis, parenteral hydration and central venous access placement are predictive factors of the drop in hemoglobin = 2 g/dl.