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1.
Rev. colomb. cir ; 40(1): 99-110, Enero 8, 2025. tab, fig
Article in Spanish | LILACS | ID: biblio-1587070

ABSTRACT

Introducción. La fuga anastomótica es una complicación que en las últimas tres décadas ha mantenido sus tasas de incidencia entre 1 % y 19 % y ha alcanzado una mortalidad que varía entre 6 % y 22 %. Tiene una alta morbilidad, siendo responsable del 56 % de los estomas definitivos en pacientes sometidos a cirugía colorrectal. El objetivo de este estudio fue identificar los factores asociados con un mayor riesgo de incidencia de fuga anastomótica, para lograr impactar en la morbilidad y mortalidad de los pacientes llevados a cirugía colorrectal. Métodos. Estudio de casos y controles multicéntrico enfocado en los factores de riesgo preoperatorios e intraoperatorios asociados con la fuga anastomótica después de la resección de colon. Resultados. Se incluyeron 480 pacientes llevados a cirugía colorrectal entre enero de 2014 y diciembre de 2019. Se estimó que existe mayor riesgo de presentar dehiscencia de anastomosis con nivel de hemoglobina menor de 9 g/dl (p=0,001; OR=3,2; IC95%: 1,64-6,25), clasificación ASA > 3 (p=0,001; OR=9,96; IC95%: 4,75-20,9), duración prolongada de la cirugía (p=0,005) y necesidad de transfusión intraoperatoria (p=0,001; OR=4,57; IC95%: 2,32-9,01). El reforzamiento de la anastomosis se relacionó a un menor número de fugas anastomóticas (p=0,001; OR=0,14; IC95%: 0,04-0,46). Conclusión. La anemia y la transfusión de glóbulos rojos se relacionaron con un aumento de fuga anastomótica. Por otro lado, el refuerzo de la anastomosis se presenta como una medida potencialmente beneficiosa para mitigar la incidencia de esta complicación. La identificación precisa de estos factores de riesgo ofrece la oportunidad de transformar la fuga anastomótica en una complicación prevenible.


Introduction. Anastomotic leak is a complication that in the last three decades has maintained its incidence rates between 1% and 19% and has reached a mortality rate that varies between 6% and 22%. It has a high morbidity rate, being responsible for 56% of definitive stomas in patients undergoing colorectal surgery. The objective of this study was to identify factors associated with a higher risk of anastomotic leak incidence, in order to impact the morbidity and mortality of patients undergoing colorectal surgery. Methods. Multicentric case-control study focused on preoperative and intraoperative risk factors associated with anastomotic leak after colon resection. Results. 480 patients who underwent colorectal surgery between January 2014 and December 2019 were included. It was estimated that there is a higher risk of anastomotic dehiscence with hemoglobin levels <9 mg/dl (p=0.001; OR=3.2; 95% CI: 1.64-6.25), ASA classification >3 (p=0.001; OR=9.96; 95% CI: 4.75-20.9), prolonged surgery duration (p=0.005), and the need for intraoperative transfusion (p=0.001; OR=4.57; 95% CI: 2.32-9.01). Anastomosis reinforcement was related to fewer anastomotic leaks (p=0.001; OR=0.14; 95% CI: 0.04-0.46). Conclusion. Anemia and red blood cell transfusion were associated with an increased anastomotic leak. On the other hand, anastomosis reinforcement is presented as a potentially beneficial measure to mitigate the incidence of this complication. Accurate identification of these risk factors offers the opportunity to transform anastomotic leak into a preventable complication.


Subject(s)
Humans , Colorectal Surgery , Anastomotic Leak , Colorectal Neoplasms , Risk Factors , Surgical Stapling , Anemia
2.
Rev. Fed. Centroam. Obstet. Ginecol. ; 28(3): 81-84, 20 de diciembre de 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1584761

ABSTRACT

INTRODUCCIÓN: El embarazo en la adolescencia es un problema de salud pública. América latina es la región con mayor fecundidad adolescente en el mundo después de áfrica subsahariana. En panamá alrededor del 15 al 20% de embarazos ocurre en adolescentes a pesar de las estrategias, de ahí el interés en realizar este estudio el cual tuvo como objetivo conocer los factores de riesgo y las complicaciones asociadas al embarazo en adolescentes de 10 a 19 años que completaron su embarazo en el hospital dr. Luis "chicho" fábrega entre enero y diciembre 2022. MATERIALES Y MÉTODOS: Se realizó un estudio descriptivo, transversal donde se revisaron los expedientes de dichas pacientes. Para el cálculo de la muestra, la tabulación y análisis de la información se utilizó el programa EPI INFO 7. RESULTADOS: Se pudo conocer que de 3353 partos atendidos un 16% fueron en adolescentes, se describen determinantes como lugar de residencia en comarcas (35.7%), inicio de vida sexual entre 10 y 13 años (12.1%), multiparidad (17%), vía de terminación del parto vaginal (62.1%) y cesárea (37.9%), pérdida de bienestar fetal (36.5%). Las complicaciones más frecuentes fueron desgarro del canal del parto (17.4%), anemia (16.1%) y ruptura prematura de membranas (15,6%). CONCLUSIONES: Estos resultados respaldan la necesidad de mejorar las estrategias para prevenir los factores de riesgo modificables y prevenir el embarazo adolescente y sus complicaciones. (provisto por Infomedic International)


INTRODUCTION: Teen pregnancy is a public health problem. Latin America is the region with the highest adolescent fertility in the world after Sub-Saharan Africa. In Panama about 15 to 20% of pregnancies occur in adolescents despite strategies, hence the interest in conducting this study which aimed to know the risk factors and complications associated with pregnancy in adolescents aged 10 to 19 years who completed their pregnancy at the Hospital Dr. Luis "Chicho" Fábrega between January and December 2022. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted where the records of said patients were reviewed. The Epi Info 7 program was used to calculate the sample, tabulate and analyze the information. RESULTS: It was possible to know that out of 3353 deliveries attended 16% were adolescents. Determinants were described as place of residence in Comarcas (35.7%), start of sexual life between 10 and 13 years (12.1%), multiparity (17%), vaginal (62.1%) and cesarean (37.9%), loss of fetal well-being (36.5%). The most frequent complications were birth canal tear (17.4%), anemia (16.1%) and premature rupture of membranes (15.6%). CONCLUSIONS: These results support the need to improve strategies to prevent modifiable risk factors and prevent adolescent pregnancy and its complications. (provided by Infomedic International)

3.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1569588

ABSTRACT

está disponible en el texto completo


Introduction: Anemia is a highly prevalent disorder. Preoperative anemia is associated with higher mortality, more complications, longer hospital stays, and higher healthcare costs. Red blood cell transfusion (RBC) does not improve these outcomes. The World Health Organization recommends implementing Patient Blood Management (PBM) programmes, as they can improve these clinical outcomes, reduce unnecessary RBC transfusions, and save costs. Despite compelling evidence, the implementation of these measures has yet to be effectively achieved. The objective of this study is to conduct a situational analysis to raise awareness about this issue and encourage the implementation of these measures. Methodology: An observational, longitudinal, retrospective cohort study was conducted at a single center. All patients undergoing elective surgery from 01/01/2022 to 01/04/2022 at the Hospital de Clínicas were included. Exclusion criteria: absence of a complete blood count in the three months prior to surgery and refusal to participate in the study. Results: A total of 329 surgeries were analyzed. 52 out of 100 procedures were performed on patients with anemia. A statistically significant association was found between preoperative anemia and receiving RBC transfusion during hospitalization. OR 11.746 (4.518 - 30.540). Anemia and RBC transfusions significantly prolonged hospital stay. Length of hospitalization based on patient condition: No anemia: 10.1 ± 1.1 days, with anemia: 27.2 ± 2.3 days. Value of p < 0.001. Non-transfused: 14.5 ± 1.3 days, transfused: 41.8 ± 4.4 days. Value of p < 0.001. Only 49 (28.6%) of the 171 patients with anemia had iron metabolism assessed before surgery. Among the 140 patients with Hb < 12 g/dL undergoing surgeries with non-insignificant bleeding, only 4 received specific treatment to optimize Hb. A total of 185 units of red blood cells (RBC) were administered during hospitalization. 49 to unstable patients (intraoperative or acute hemorrhage) and 136 to stable patients. From the analysis of the latter group, 42.5% of the patients received 3 or more RBC units. The average pre-transfusion hemoglobin was 7.0 ± 0.1. A statistically significant association was found between receiving RBC units and dying during hospitalization. OR 17.182 (3.360 - 87.872). Conclusiones: A situational analysis was conducted, revealing a high prevalence of preoperative anemia, scarce study and treatment of anemia before surgeries, and an excessive amount of blood transfusions received by some patients. This work establishes the need to implement Patient Blood Management programs to reduce the prevalence of preoperative anemia and improve our transfusion practices. It also sets a comparative framework to evaluate the progress of these measures and indicates possible indicators to assess the benefits of their implementation.


Introdução : A anemia é um distúrbio altamente prevalente. A anemia pré-operatória está associada a maior mortalidade, mais complicações, tempo prolongado de internação e maiores custos de saúde. A transfusão de glóbulos vermelhos (TGV) não melhora esses resultados. A Organização Mundial da Saúde recomenda a implementação de medidas de Gerenciamento de Sangue do Paciente (GSP), pois permitem melhorar esses resultados clínicos, reduzir TGV desnecessárias e economizar custos. Apesar da evidência contundente, a implementação dessas medidas ainda está aquém de ser efetivada. O objetivo deste trabalho é realizar uma análise da situação para conscientizar sobre o problema e incentivar a implementação dessas medidas. Metodologia: Foi realizado um estudo observacional, longitudinal, retrospectivo de coorte histórica, unicêntrico. Foram incluídos todos os pacientes submetidos a cirurgias de coordenação de 01/01/2022 a 01/04/2022 no Hospital de Clínicas. Critérios de exclusão: ausência de hemograma nos três meses anteriores à cirurgia e recusa em participar do estudo. Resultados: Foram analisadas um total de 329 cirurgias. 52 a cada 100 procedimentos foram realizados em pacientes com anemia. Foi encontrada uma associação estatisticamente significativa entre a anemia pré-operatória e a recepção de TGR durante a internação. OR 11,746 (4,518 - 30,540). A anemia e as TGR prolongaram significativamente a internação hospitalar. Dias de internação em função da condição do paciente: Sem anemia: 10,1 ± 1,1 dias, com anemia: 27,2 ± 2,3 dias. Valor p < 0,001. Não transfundidos: 14,5 ± 1,3 dias, transfundidos: 41,8 ± 4,4 dias. Valor p < 0,001. Apenas 49 (28,6%) dos 171 pacientes com anemia tinham metabolismo do ferro antes da cirurgia. Dos 140 pacientes com Hb < 12 mg/dL submetidos a cirurgias com sangramento não insignificante, 4 receberam tratamento específico para otimizar a Hb. Foram administradas um total de 185 unidades de glóbulos vermelhos (UGV) durante a internação. 49 em pacientes instáveis (intraoperatório ou hemorragia aguda) e 136 em pacientes estáveis. Da análise desses últimos, 42,5% dos pacientes receberam 3 ou mais UGV. A hemoglobina pré-transfusional média foi de 7,0 ± 0,1. Foi encontrada uma associação estatisticamente significativa entre receber UGV e falecer durante a internação. OR 17,182 (3,360 - 87,872). Conclusões: Foi realizado uma análise da situação na qual foi observada uma elevada prevalência de anemia pré-operatória, um estudo e tratamento escasso da anemia antes das cirurgias e uma quantidade excessiva de UGV recebidas por alguns pacientes. Este trabalho estabelece a necessidade de implementar programas de Gerenciamento de Sangue do Paciente para reduzir a prevalência de anemia pré-operatória e melhorar nossas práticas transfusionais. Além disso, estabelece um quadro comparativo para avaliar o progresso dessas medidas e aponta possíveis indicadores para avaliar os benefícios de sua implementação.

4.
Rev. Enferm. UERJ (Online) ; 32: e79186, jan. -dez. 2024.
Article in English, Spanish, Portuguese | LILACS-Express | LILACS | ID: biblio-1556452

ABSTRACT

Objetivo: identificar o local e os cuidados diretos recebidos por pessoas com úlceras da perna por doença falciforme nos serviços de atenção à saúde. Método: estudo transversal, realizado em 11 centros, no período de agosto de 2019 a abril de 2020. Fizeram parte do estudo 72 pessoas com úlcera da perna ativa. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultado: apresentavam anemia falciforme 91,7% dos participantes, com mediana de três anos de existência da úlcera; 77,8% eram redicivantes; 40,3% compravam os insumos; 66,7% trocavam o próprio curativo no domicílio; 52,8% realizavam uma ou mais trocas diárias; 45,8% dos tratamentos foram prescritos pelo médico; 37,5% eram pomada (colagenase ou antibiótico); 89% não utilizavam compressão para o manejo do edema. Conclusão: a maioria dos participantes não estava inserida na Rede de Atenção à Saúde para o tratamento da úlcera, e não recebia assistência sistematizada e nem insumos apropriados.


Objective: to identify the location and direct care received by people with leg ulcers due to sickle cell disease in health care services. Method: a cross-sectional study carried out in 11 centers from August 2019 to April 2020. The study included 72 people with active leg ulcers. The study was approved by the Research Ethics Committee. Results: a total of 91.7% of the participants had sickle cell anemia, with a median of three years of ulcer existence; 77.8% were recurrent; 40.3% bought the supplies; 66.7% changed their own dressings at home; 52.8% did one or more changes a day; 45.8% of the treatments were prescribed by physician; 37.5% were ointments (collagenase or antibiotics); and 89% did not use compression to manage edema. Conclusion: most of the participants were not included in the Health Care Network for ulcer treatment and did not receive systematized care or appropriate supplies.


Objetivo: identificar el lugar y los cuidados directos recibidos por personas con úlceras de pierna por enfermedad falciforme en los servicios de atención a la salud. Método: estudio transversal, realizado en 11 centros, en el período de agosto de 2019 a abril de 2020. Participaron 72 personas con úlcera de pierna activa. El estudio fue aprobado por el Comité de Ética en Investigación. Resultado: presentaban anemia falciforme 91,7% de los participantes, con una mediana de tres años de existencia de la úlcera; 77,8% eran recidivantes; 40,3% compraban los insumos; 66,7% cambiaban su propio vendaje en el domicilio; 52,8% realizaban uno o más cambios diarios; 45,8% de los tratamientos fueron prescritos por el médico; 37,5% eran pomada (colagenasa o antibiótico); y 89% no utilizaban compresión para el manejo del edema. Conclusión: la mayoría de los participantes no estaba integrada en la Red de Atención a la Salud para el tratamiento de la úlcera, y no recibía asistencia sistematizada ni insumos apropiados.

5.
Rev. med. Risaralda ; 30(1): 21-28, jul.-dic. 2024. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1576516

ABSTRACT

Resumen Introducción: la organización mundial de la salud estima que 2000 millones de personas padecen anemia, mientras que la pre-diabetes y la diabetes afectan aproximadamente a 352 y 460 millones de personas, respectivamente. La anemia es una complicación frecuente en la diabetes mellitus (DM). Objetivo: evaluar la asociación y probabilidad de alteraciones de la hemoglobina en pre-diabéticos y diabéticos. Metodología: estudio descriptivo, retorspectivo y transversal, la población fue de 1103 pacientes (211 prediabéticos, 223 diabéticos y 669 normoglucémicos), la muestra fue el total de la población que cumplió con los criterios de inclusión y exclusión: adultos normoglucémicos y pre-diabéticos sin presencia de enfermedad aguda o crónica al momento del examen. La asociación entre variables se realizó por medio de la prueba de chi-cuadrado y la probabilidad fue determinada por la prueba de Odds Ratio. Resultados: las mujeres pre-diabéticas tuvieron una probabilidad 1.72 mayor de anemia que mujeres no diabéticas. Los hombres pre-diabéticos tuvieron una probabilidad 2.80 veces mayor de anemia que los no diabéticos. Las mujeres diabéticas tuvieron una probabilidad 2,37 más alta de tener anemia, mientras que los hombres diabéticos tuvieron una probabilidad 4,41 veces más alta que lo hombres no diabéticos de padecer anemia. Conclusiones: pacientes pre-diabéticos tienen mayor probabilidad de anemia que en no diabéticos. Es posible que la hiperglucemia persistente en pre-diabéticos se asocie a cambios en la concentración de esta hemoproteína años antes del desarrollo de diabetes por mecanismos similares, pero de forma incipiente.


Abstract Introduction: The World Health Organization estimates that 2 billion people suffer from anemia, while pre-diabetes and diabetes affect approximately 352 and 460 million people, respectively. Anemia is a frequent complication in diabetes mellitus. Objective: To evaluate the association and probability of hemoglobin alterations in pre-diabetics and diabetics. Methodology: Descriptive, retrospective and cross-sectional study, the population was 1103 patients (211 prediabetics, 223 diabetics and 669 normoglycemics), the sample was the total population that met the inclusion and exclusion criteria: normoglycemic and prediabetic adults without presence of acute or chronic disease at the time of examination. The association between variables was performed using the chi-square test and the probability was determined by the Odds Ratio test. Results: Pre-diabetic women had a 1.72 higher probability of anemia than non-diabetic women. Pre-diabetic men were 2.80 times more likely to have anemia than non-diabetics. Diabetic women were 2.37 times more likely to have anemia, while diabetic men were 4.41 times more likely than non-diabetic men to have anemia. Conclusions: Pre-diabetic patients are more likely to have anemia than non-diabetics. It is possible that persistent hyperglycemia in pre-diabetics is associated with changes in the concentration of this hemoprotein years before the development of diabetes by similar mechanisms, but in an incipient manner.

6.
Article | IMSEAR | ID: sea-240435

ABSTRACT

Background: The most prevalent nutritional disorder during pregnancy is iron-deficiency anemia (IDA). Management of anemia can be done by either oral, parenteral, or blood transfusion, depending on the severity. Oral iron (OI) replacements can be taken as they are safe, effective, and lower cost. However, one disadvantage is poor tolerability, as they cause gastrointestinal complications. Iron sucrose complex is a relatively new drug used intravenously (IV) for the correction of IDA. Aims and Objectives: This research compared the safety and effectiveness of OI versus iron sucrose in the treatment of IDA during pregnancy. Materials and Methods: A prospective observational study was performed involving 60 patients who attended the antenatal clinic from June 2019 to November 2019 at Bidar Institute of Medical Science between 24 and 36 weeks of gestation and hemoglobin levels between 7 and 10 g/dL. In the IV group, 200 mg of iron sucrose was administered in 100 mL of 0.9% normal saline over 15–20 min on alternate days. In the oral group, 200 mg of ferrous ascorbate per day for 4 weeks was prescribed. All patients were monitored for laboratory responses and adverse effects. An unpaired “t” test was used for statistical analysis. P < 0.05 was considered significance. Results: There was an increase in hemoglobin in both groups, but there was a significant increase in hemoglobin in the IV group. The other laboratory parameters also showed a significant increase in the IV group than in the oral group. The IV group had no major side effects. Conclusion: The IV iron sucrose formulation was more effective than the oral formulation for anemia correction in pregnancy.

7.
Hematología (B. Aires) ; 28(2): 6-10, oct. 2024. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1582379

ABSTRACT

Resumen Las anemias sideroblásticas (AS) son un grupo heterogéneo de patologías raras en las que se ve afectada la biosíntesis del hemo y la utilización del hierro durante la síntesis de la hemoglobina. Se caracterizan por la presencia en médula ósea de precursores eritroides con depósitos patológicos de hierro en las mitocondrias. Pueden ser congénitas o adquiridas. La forma hereditaria más común es la ligada al cromosoma X (ASLX), debido a variantes genéticas en el gen ALAS2 que codifica para la primera enzima en la biosíntesis del hemo, la delta aminolevulinato sintetasa 2 (ALAS2). Afecta predominantemente a varones hemicigotas, que se presentan con anemia microcítica hipocrómica. En algunos pacientes es efectivo el tratamiento con fosfato de piridoxal. Presentamos tres casos relacionados de ASLX por alteración del gen ALAS2.


Abstract Sideroblastic anemias (SAs) are a heterogeneous group of rare pathologies in which heme biosynthesis and iron utilization during hemoglobin synthesis is affected. They are characterized by the presence in the bone marrow of erythroid precursors with pathological iron deposits in the mitochondria. They can be congenital or acquired. The most common hereditary form is X-linked (XLSA), caused by genetic variants in the ALAS2 gene, which encodes for the first enzyme in heme biosynthesis, the delta-aminolevulinic acid synthetase 2 (ALAS2). It predominantly affects hemizygous males, who present with microcytic hypochromic anemia. In some patients, treatment with pyridoxal phosphate is effective. We present three related cases of XLSA due to alteration in the ALAS2 gene.

8.
Hematología (B. Aires) ; 28(2): 71-76, oct. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1582387

ABSTRACT

Resumen La vitamina B12 es un cofactor que forma parte de la síntesis de ADN, formación de glóbulos rojos y determinante de funciones neurológicas. Su deficiencia genera manifestaciones variadas. La seudomicroangiopatía trombótica se caracteriza por anemia hemolítica microangiopática y trombocitopenia asociada a eritrocitos dismórficos secundario a deficiencia severa de vitamina B12. Con una incidencia aproximada de 2.5%. A menudo es confundida con púrpura trombocitopénica trombótica y tratada como tal. La reposición con cianocobalamina produce mejoría inmediata de los síntomas, sin la necesidad de otros tratamientos. Describimos tres casos de pacientes hospitalizados en un hospital general en la ciudad de Panamá, República de Panamá. Dos varones y una mujer sin antecedentes patológicos que debutan con síndrome anémico, datos de anemia hemolítica microangiopática y deficiencia severa de vitamina B12. Con mejoría clínica posterior a la reposición con cianocobalamina.


Abstract Vitamin B12 is a cofactor involved in DNA synthesis, red blood cell production and essential for neurologic functions. Its deficiency can lead to varied manifestations. Thrombotic pseudomicroangiopathy is characterized by microangiopathic hemolytic anemia and thrombocytopenia associated with dysmorphic red blood cells secondary to severe vitamin B12 deficiency, with an approximate incidence of 2.5%. It is often confused with thrombotic thrombocytopenic purpura and treated as such. Replacement with cyanocobalamin leads to immediate improvement of symptoms without the need of other treatments. We describe three cases of patients hospitalized in a general hospital in Panama City, Republic of Panama. Two males and one female with no pathological history presenting with anemic syndrome, microangiopathic hemolytic anemia and severe vitamin B12 deficiency. Clinical improvement was observed following parenteral cyanocobalamin replacement.

9.
Arch. latinoam. nutr ; Arch. latinoam. nutr;74(3): 206-221, oct. 2024. ilus, tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1585448

ABSTRACT

Introducción: La anemia es una enfermedad de prevalencia mundial caracterizada por ineficacia de los eritrocitos para distribuir oxígeno, cuya principal etiología es ferropénica. Existen métodos mundialmente conocidos para combatirla; sin embargo, Latinoamérica dispone de escasa evidencia sobre el impacto de estas en la reducción de prevalencia de anemia. Objetivo: El presente estudio revisó las intervenciones del sector salud y multisectoriales para la reducción de anemia en niños de 6 meses a 5 años en Latinoamérica. Materiales y métodos: Se realizó una revisión exhaustiva de la literatura con las palabras clave: child, anemia, Latin America, prevention and control en las bases de datos de Embase, Pubmed, La Biblioteca Virtual en Salud (BVS) y Google Scholar, los artículos fueron filtrados en 4 etapas (identificación, selección, elegibilidad e inclusión) individualmente por los autores quedando 9 ensayos clínicos aleatorizados elegibles. Resultados: De los ensayos se encontraron intervenciones como micronutrientes en polvo (MNP), suplemento alimenticio Nutrisano, bebida láctea Nutrisano, jarabes, ollas de hierro y galletas fortificadas con plantas. Se halló que los MNP, jarabes y galletas con caupí reducen la anemia significativamente; sin embargo, por factores como adherencia y eficiencia los MNP y las galletas son las más recomendadas. El uso de la bebida láctea Nutrisano + MNP y el uso de ollas de hierro no redujeron la anemia significativamente. Conclusiones: En Latinoamérica se recomiendan los MNP según Neufeld para reducir la anemia, y las galletas fortificadas con caupí según Landim para incrementar la hemoglobina(AU)


Introduction: Anemia is a worldwide prevalence disease characterized by inefficiency of erythrocytes to distribute oxygen, whose main etiology is iron deficiency. There are worldwide known methods to combat it; however, Latin America has little evidence on the impact of these methods in reducing the prevalence of anemia. Objective: The present study reviewed health sector and multisectoral interventions for the reduction of anemia in children aged 6 months to 5 years in Latin America. Materials and methods: An exhaustive review of the literature was carried out with the keywords: child, anemia, Latin America, prevention and control in the Embase, Pubmed, La Biblioteca Virtual en Salud (BVS) and Google scholar databases, the articles were filtered in 4 stages (identification, selection, eligibility and inclusion) individually by the authors, leaving 9 eligible randomized clinical trials. Results: From the trials, interventions such as micronutrient powder (MNP), Nutrisano food supplement, Nutrisano milk drink, syrups, iron pots and plant-fortified cookies were found. MNP, syrups and cookies with cowpea were found to reduce anemia significantly; however, for factors such as adherence and efficiency MNP and cookies are the most recommended. The use of Nutrisano milk drink + MNP and the use of iron pots did not significantly reduce anemia. Conclusions: In Latin America, MNP according to Neufeld are recommended to reduce anemia, and cookies fortified with cowpea according to Landim to increase hemoglobin(AU)


Subject(s)
Humans , Infant , Child, Preschool , Food, Fortified , Minors , Anemia , Micronutrients , Dietary Supplements
10.
Article | IMSEAR | ID: sea-235033

ABSTRACT

Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by clotting in small blood vessels (thromboses), resulting in a low platelet count. In its full- blown form, the disease consists the pentad of microangiopathic hemolytic anemia, thrombocytopenic purpura, neurologic abnormalities, fever and kidney disease

11.
Article | IMSEAR | ID: sea-242117

ABSTRACT

Background: Intrauterine growth restriction (IUGR) is a common disorder in which the birth weight is less than 10th percentile. This ongoing challenging fetal adverse condition leads to postnatal morbidities and fetal mortality. Methods: Forty postnatal women with newborns weighing less than the 10th percentile for gestational age (GA) were recruited as cases in this case-control research, and forty postnatal women whose neonatal weight was within the GA were recruited as controls. A thorough history of medical, obstetric, and maternal Sociodemographic factors was recorded and compared. Results: Most mothers (46.3%) were 21-30 with a mean±SD of 24.83±4.09 years. Most of them (78.8%) belonged to the lower middle class; there was significantly poor weight gain during pregnancy among cases (80%) as compared to among controls (60%). Anemia, hypertensive disorders of pregnancy, previous history of abortion, or IUGR were significantly associated with fetal growth retardation (p<0.05). Conclusion: Low socioeconomic level, low gestational weight gain, anemia, hypertensive disorders of pregnancy, and previous history of abortion are potent risk factors for IUGR. Therefore, proper screening of these risk factors is essential to improve neonatal health.

12.
Rev. colomb. gastroenterol ; 39(3): 310-317, July-Sept. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1583560

ABSTRACT

Abstract Hookworm infections can lead to iron deficiency anemia, and in rare cases, severe life-threatening anemia. This case presents a 38-year-old male patient who consulted due to melena, asthenia, adynamia, dizziness, blurred vision, precordial pain, and shortness of breath with minimal exertion. The evaluation indicated that the patient had severe iron deficiency anemia with hemodynamic instability, but upper digestive endoscopy and colonoscopy were normal. Capsule endoscopy revealed multiple hookworms in the jejunum, which were the cause of the chronic intestinal bleeding. The patient was treated with albendazole for five days and received a repeat dose at 21 days. This case highlights that hookworms should be considered in the differential diagnosis for patients with obscure digestive bleeding from rural areas.


Resumen Las infecciones por uncinarias pueden producir anemia por deficiencia de hierro y en raras ocasiones producen anemia grave que amenaza la vida. Se presenta el caso de un paciente masculino de 38 años que consultó por presentar deposiciones melénicas, astenia, adinamia, vértigo, visión borrosa, dolor precordial y disnea de pequeños esfuerzos. En la evaluación se consideró que el paciente presentaba anemia grave por deficiencia de hierro con inestabilidad hemodinámica; la endoscopia de vías digestivas altas y la colonoscopia fueron normales. La cápsula endoscópica reveló múltiples uncinarias en el yeyuno que fueron la causa del sangrado intestinal crónico. El paciente fue tratado con albendazol por 5 días, y repitió una dosis a los 21 días. El presente caso evidencia que las uncinarias deben ser consideradas en el diagnóstico diferencial de pacientes con hemorragia digestiva oscura procedentes de zonas rurales.

13.
Arq. ciências saúde UNIPAR ; 28(2): 215-229, 20240000.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1578578

ABSTRACT

Objetivo: Analisar a taxa de óbitos por anemias nos últimos cinco anos (2018 a 2022) no Brasil. Método: Trata-se de um estudo quantitativo do tipo descritivo com dados secundários do DATASUS realizado entre os meses de janeiro a fevereiro de 2024. Os dados foram extraídos por dois pesquisadores, de forma independentes, utilizando a mesma estratégia de busca no próprio site do Ministério da Saúde, buscando amenizar os potenciais riscos de perda de dados. Em seguida, foram apesentados em tabelas e gráficos. Resultados: Os resultados revelaram tendências de aumento nas taxas de mortalidade por anemias ao longo dos anos, com variações regionais notáveis. A região Sudeste destacou-se com o maior número de óbitos, especialmente em São Paulo. A análise demográfica indicou maior incidência em idosos, disparidades significativas por cor/raça, com brancos e pardos liderando em número de óbitos, e uma prevalência mais alta entre mulheres. Anemias falciformes foram as mais prevalentes, seguidas por anemias por deficiência de ferro. Conclusão: O estudo contribuiu para a compreensão da epidemiologia das anemias no Brasil, ressaltando a necessidade de estratégias específicas para cada região. A pesquisa destaca a importância da vigilância epidemiológica, redução de disparidades socioeconômicas e acesso equitativo à saúde.


Objective: To analyze the rate of deaths from anemia in the last five years (2018 to 2022) in Brazil. Method: This is a quantitative descriptive study using secondary data from DATASUS, carried out between January and February 2024. The data was extracted by two researchers, independently, using the same search strategy on the Ministry of Health's own website, seeking to mitigate the potential risks of data loss. They were then presented in tables and graphs. Results: The results revealed increasing trends in mortality rates due to anemia over the years, with notable regional variations. The Southeast region stood out with the highest number of deaths, especially in São Paulo. Demographic analysis indicated a higher incidence in the elderly, significant disparities by color/race, with whites and browns leading in number of deaths, and a higher prevalence among women. Sickle cell anemia was the most prevalent, followed by iron deficiency anemia. Conclusion: The study contributed to understanding the epidemiology of anemia in Brazil, highlighting the need for specific strategies for each region. The research highlights the importance of epidemiological surveillance, reducing socioeconomic disparities and equitable access to health.


Objetivo: Analizar la tasa de muertes por anemia en los últimos cinco años (2018 a 2022) en Brasil. Método: Se trata de un estudio cuantitativo descriptivo con datos secundarios de DATASUS, realizado entre enero y febrero de 2024. Los datos fueron extraídos de forma independiente por dos investigadores utilizando la misma estrategia de búsqueda en el propio sitio web del Ministerio de Salud, con el fin de minimizar el riesgo potencial de pérdida de datos. Posteriormente se presentaron en tablas y gráficos. Resultados: Los resultados revelaron tendencias crecientes en las tasas de mortalidad por anemia a lo largo de los años, con notables variaciones regionales. La región Sudeste se destacó con el mayor número de muertes, especialmente en São Paulo. El análisis demográfico indicó una mayor incidencia en los ancianos, disparidades significativas por color/raza, con los blancos y pardos a la cabeza en número de muertes, y una mayor prevalencia entre las mujeres. Las anemias falciformes fueron las más prevalentes, seguidas de las anemias ferropénicas. Conclusión: El estudio contribuyó a la comprensión de la epidemiología de las anemias en Brasil, destacando la necesidad de estrategias específicas para cada región. La investigación destaca la importancia de la vigilancia epidemiológica, la reducción de las disparidades socioeconómicas y el acceso equitativo a la salud.

14.
Respirar (Ciudad Autón. B. Aires) ; 16(3): 255-261, Septiembre 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1570577

ABSTRACT

Introducción: La anemia es frecuentemente subdiagnosticada dada su vaga sintomatología. Estudios con evaluación subjetiva-visual por expertos describen signos tomográficos sugerentes de anemia, tales como el septo denso. Proponemos que lectores con entrenamiento básico realicen mediciones objetivas de alto poder estadístico para la detección de anemia. Material y Métodos: Se cruzaron datos de tomografía computarizada (TC) de tórax no contrastada (2021) con medición de hemoglobina plasmática (Hb) realizada 24 horas antes o después del estudio tomográfico. Dos estudiantes de Medicina, previamente entrenados, realizaron mediciones de Unidades Hounsfield (UH) en el septo interventri-cular (SIV) y cavidades ventriculares derecho (VD) e izquierdo (VI). Las relaciones SIV/VI y SIV/VD se correlacionaron con los valores de Hb. Se analizó la variabilidad interob-servador y se determinó el punto de corte óptimo para detectar anemia. Resultados: En una muestra de 112 casos, hubo alta concordancia interobservador con r de 0,85 (VD), 0,67 (SIV) y 0,87 (VI). La relación SIV/VI obtuvo el mayor AUC con 0,86 (IC 95%: 0,72 a 0,91), con una sensibilidad de 80% y especificidad de 88% utilizando un punto de corte de 1,15. Conclusiones: La razón SIV/VI con punto de corte de 1,15 es un parámetro confiable para detectar anemia mediante TC de tórax no contrastada, en observadores con entrenamiento básico.


Introduction: Anemia is frequently underdiagnosed given its vague symptomatology. Studies with subjective-visual evaluation by experts describe tomographic signs suggestive of anemia, such as a dense septum. This study aims to evaluate if readers with basic training can perform high statistical value measurements for anemia detection. Material and Methods: Data of non-contrast thoracic computed tomography (CT) (2021) with a measurement of plasma hemoglobin (Hb) performed 24 hours before or after the CT were identified. Two previously trained medical students performed measurements of Hounsfield Units (HU) on the interventricular septum (IVS) and right (RV) and left (LV) ventricular cavities. The SIV/VI and SIV/VD ratios were correlated with Hb values. Interobserver variability was analyzed and the optimal cut-off point to detect anemia was determined. Results: In a sample of 112 cases, there was a high interobserver correlation with r of 0.85 (VD), 0.67 (SIV), and 0.87 (VI). SIV/VI ratio obtained the highest AUC with 0.86 (95% CI: 0.72 to 0.91), with a sensitivity of 80% and specificity of 88% using a cut-off point of 1.15. Conclusions: The SIV/VI ratio with a cut-off point of 1.15 is a reliable parameter to detect anemia using non-contrast chest CT in observers with basic training.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Tomography , Anemia/diagnostic imaging , Students, Medical , Thorax/diagnostic imaging , Hemoglobins , Chile , Ventricular Septum/diagnostic imaging , Heart Ventricles
15.
Article | IMSEAR | ID: sea-234184

ABSTRACT

Hypokalemic paralysis is a rare neuromuscular disorder characterized by painless muscle weakness resulting from low potassium levels, most commonly presenting during adolescence. In this case report, we detail the presentation and management of an 80-year-old female who experienced sudden onset bilateral limb weakness. Initial clinical assessment revealed the absence of reflexes and hypotonia in all four limbs without any gastrointestinal or neurological symptoms. Comprehensive diagnostic evaluation identified severe iron deficiency anemia and an unusual history of clay ingestion due to pica as the underlying causes of her hypokalemic paralysis. Treatment included intravenous and oral potassium supplementation, as well as packed cell volume transfusions, leading to a significant improvement in her symptoms and normalization of her potassium levels. This case highlights the need to consider atypical etiologies, such as pica-induced clay ingestion, in the differential diagnosis of hypokalemic paralysis, particularly in elderly patients with nutritional deficiencies. Early recognition and appropriate management are critical for favourable outcomes.

16.
Article | IMSEAR | ID: sea-234158

ABSTRACT

Background: Blood transfusion holds utmost importance in comprehensive obstetric care and Gynaecology. The present study has been done to evaluate the indications of blood transfusion in the Obstetrics and Gynaecology Department. Methods: The retrospective observational study was conducted between April 2023 to April 2024 in Department of Obstetrics and Gynaecology, Government Medical College, Saharanpur. Results: A total of 257 units of Blood was transfused between April 2023 to April 2024 in Obstetrics and Gynaecology Department. 60.6% transfusion were in age group 21-30 years. 48.26% transfusion were in hemoglobin 7-9 gm/dl. Most common blood group transfused was B positive 40.79% and 85.2% transfusion were packed red blood cell, 84.07% had single unit blood transfusion, 57.25% had transfusion for anemia in pregnancy, 36.84% transfusion were for abnormal uterine bleeding. Conclusions: Prevalence of anemia in reproductive age group is an important reason for blood transfusion in obstetrics and gynaecology. Hence emphasis should be to treat anemia through drugs to reduce unnecessary transfusion especially single unit transfusion.

17.
Article | IMSEAR | ID: sea-232822

ABSTRACT

Background: Low birth weight is a substantial global health issue with significant consequences to the newborn, family and society. It affects nearly 25 million births worldwide.Methods: This was a prospective study. Total 100 patients included in this study. This study conducted for 6 months. at tertiary health care center.Results: Maternal variables like anemia, hypertension, lack of proper antenatal care and lower socioeconomic status significantly influenced low birth weight in newborns. Clinical intervention such as iron supplementation and proper maternal nutrition, timely management of hypertensive disorders of pregnancy and creating public awareness regarding the importance of antenatal care have shown to impact neonatal outcomes positively.Conclusions: Low birth weight is one of the leading causes of perinatal morbidity and mortality and hence it should be managed in a tertiary health care center with trained obstetricians and with facility of neonatal intensive care unit (NICU).

18.
Article | IMSEAR | ID: sea-232800

ABSTRACT

Background: Anemia during pregnancy, often attributed to iron deficiency, poses substantial risks to both maternal and fetal health. This retrospective study aims to evaluate the safety and efficacy of intravenous ferric carboxymaltose (FCM) in managing anemia among pregnant women.Methods: The study encompasses women who received FCM treatment for anemia during pregnancy between October 2023 and March 2024 at SSG hospital, Vadodara. Key outcomes evaluated include maternal safety and pregnancy outcomes. Prospective observational study; Treatment effectiveness was assessed by repeat hemoglobin (Hb) measurements and patient report of well-being in the postpartum period. Safety was assessed by analysis of adverse drug reactions and fetal heart rate monitoring during the infusion.Results: A total of 50 patients were included. The intravenous administration of FCM notably raised hemoglobin levels in all pregnant female participants compared to initial levels. Monitoring of fetal heart rate showed no adverse effects attributable to the medication. No severe side effects were observed.Conclusions: This prospective observational study suggests that FCM represents a safe and effective therapeutic option for managing anemia during pregnancy. Despite study limitations, the findings underscore the potential of FCM in addressing this prevalent concern, advocating for its consideration in clinical practice.

19.
Article | IMSEAR | ID: sea-240229

ABSTRACT

Background: Diabetes mellitus is a rapidly increasing global health concern, having a substantial impact on morbidity and mortality. Glycated hemoglobin (HbA1c) is the primary measure of diabetes control, reflecting glycemic levels over the past 3 months. However, hemoglobin (Hb) abnormalities, such as those seen in iron deficiency anemia (IDA), can theoretically affect HbA1c levels. IDA, affecting over 30% of the global population, results from inadequate iron intake, hemorrhage, or poor iron absorption, leading to reduced Hb production. This study aims to evaluate the impact of IDA on HbA1c levels in non-diabetic patients, providing insights into accurate HbA1c interpretation in anemic patients. Aims and Objectives: The study aimed to determine the impact of IDA on HbA1c levels in non-diabetic individuals. Materials and Methods: This cross-sectional study was conducted over 6 months at Trichy SRM Medical College Hospital and Research Center. There were a total of 100 IDA patients and 100 age- and sex-matched healthy controls. Hb levels below 10 g/dL with a microcytic image suggestive of iron deficiency, postprandial blood sugar (PPBS) levels below 140 mg/dL following an oral glucose tolerance test (OGTT), and fasting blood sugar (FBS) levels below 100 mg/dL were the inclusion criteria. Exclusion criteria included Hb levels above 10 g/dL, altered FBS or PPBS values post-OGTT, diagnosed Type 2 diabetes mellitus, individuals younger than 18 years, and those with conditions such as hemoglobinopathies, hemolytic anemia, hypothyroidism, pregnancy, or abnormal renal function tests. Ethical approval and informed consent were obtained. Data collection included demographics, medical history, and laboratory investigations. Statistical analysis was performed using SPSS version 26, with t-tests, mean, and standard deviation (SD) for association analysis, and Chi-square tests for sex comparisons. Correlations were assessed through t-test. The significance level was kept at 0.05. Results: The study confirmed that both groups met the inclusion criteria for non- diabetic status. The control group exhibited normal Hb levels, whereas the study group had Hb levels indicative of IDA. General and systemic examination findings were normal in both groups. Significant differences were observed across all measured parameters, with Hb levels, serum ferritin, mean corpuscular volume, mean corpuscular Hb, mean corpuscular Hb concentration, and red cell distribution width significantly lower in the study group. HbA1c levels were significantly elevated in the study group compared to the control group (5.87 ± 1.25 vs. 4.97 ± 1.59, P < 0.001),supporting the hypothesis that IDA is associated with elevated HbA1c levels in non-diabetic patients. Conclusion: The study’s findings align with previous research indicating that IDA leads to elevated HbA1c levels. The prolonged erythrocyte survival and altered Hb glycation processes in IDA are likely contributors to this elevation. These results emphasize the need to consider anemia status when interpreting HbA1c valuesto avoid misdiagnosis and inappropriate management of diabetes. Clinicians should ensure comprehensive evaluations, including iron status assessments when encountering unexpectedly high HbA1c levels in non-diabetic individuals.

20.
Article | IMSEAR | ID: sea-240225

ABSTRACT

Background: Blood donation is an essential and most important part of the health care system across the world. It becomes necessary to know the root cause of individuals who are willing to donate the blood but deferred on some grounds. Aim and Objectives: The aim of this study is analysis of such deferrals so as to promote voluntary blood donation practice in our health-care system. The objectives of this study are to promote voluntary blood donation, provide safe blood and blood components/products to the recipients, ensure the safety and well-being of blood donors and make strategies to retain already motivated but deferred donors. Materials and Methods: A prospective observational study was done during the period January 2021–December 2021 at blood center of S.B.K.S. MI & RC, Dhiraj Hospital, Vadodara. All individuals willing for whole blood donation were subjected to detailed history taking and general physical examination and were either accepted or denied for blood donation using the standard blood donor guidelines. Pre-donation deferred individuals and their data were then thoroughly analyzed. Results: A total of 2168 individuals reported at blood center for whole blood donation out of which 311 donors (14.34%) were deferred. Of all deferred donors, male-to-female ratio of deferral found out to be 4.02:1. Two hundred and forty-nine deferrals (80.06%) were males while 62 deferrals (19.94%) were females. Two hundred and seventy-two deferrals (12.54%) were deferred temporarily while 39 deferrals (1.79%) were permanent. Youngest deferred donor was aged 18 years while the eldest was 59 years. Low hemoglobin cases were 134 making it 43.09% of all reasons of deferring a pre-donation whole blood donor. Conclusion: Low hemoglobin (<12.5 gm%) was the leading cause of deferrals accounting for 43.09%. The majority of the deferrals were temporary where the cause can be treated or eliminated. Such donors need to be remotivated and bring them back to the donor pool so that maximum blood donation which indeed is a life- saving measure can be promoted. Furthermore, the analysis done by doing such study can help to promote the blood donation on a large scale and not only saving many lives but also create awareness among the society.

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