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1.
Arch. pediatr. Urug ; 92(2): e210, dic. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278303

ABSTRACT

Antecedentes: la nutrición durante el embarazo impacta en la salud del recién nacido, con efectos a nivel epigenético determinando consecuencias neurológicas a largo plazo. Las necesidades de hierro durante el embarazo se estiman en 27 mg/día. El hierro hemo que se absorbe mejor se encuentra en la carne. La determinación de ferritina en sangre de cordón umbilical permite evaluar los depósitos de hierro alcanzados durante la etapa fetal. Sus niveles se asociaron con efectos a largo plazo sobre el desarrollo infantil. Objetivos: el objetivo de este estudio de carácter exploratorio es determinar la relación entre el consumo de carnes rojas durante el tercer trimestre de gestación y el nivel de ferritina en el cordón umbilical. Métodos: se realizó un estudio observacional descriptivo con datos recolectados prospectivamente durante un año en el Departamento de Neonatología del Centro Hospitalario Pereira Rossell (CHPR) en Montevideo, Uruguay. Un total de 188 pacientes cumplieron los criterios de inclusión. Se extrajo sangre del cordón umbilical después de un pinzamiento estricto del cordón pasado un minuto de vida. La ferritina se midió utilizando el método de quimioinmunofluorescencia. Se aplicó una encuesta nutricional materna (cualitativo-cuantitativa) que midió la frecuencia de consumo de alimentos con fuente de hierro y las cantidades aproximadas consumidas durante el último trimestre del embarazo. Esta encuesta se centró en el consumo materno de carne vacuna como principal fuente de hierro hemínico en Uruguay. Se analizó la relación entre estas variables. Resultados: el déficit latente de hierro (ferritina en el cordón umbilical <100 ng/ml) se asoció con un menor consumo de carne vacuna durante el embarazo. Valor p de Fisher: 0,0133, OR: 3,71, IC del 95% (1,25-11,05). Conclusiones: este estudio considera adecuada la evidencia que relaciona que los niveles bajos de consumo total de hierro y de carne vacuna durante el tercer trimestre de gestación determinarán un mayor riesgo de déficit latente de hierro y de ferritina medido en el cordón umbilical. Los niveles descendidos de ferritina en cordón umbilical se asocian con un mayor riesgo de efectos adversos a largo plazo sobre la mielinización y el desarrollo neurocognitivo.


Background: nutrition during pregnancy impacts the foetus and the newborn health, it has consequences at the epigenetic level and determines long-term neurological consequences. Iron requirements during pregnancy are estimated at 27 mg/day. Iron is blood absorption from is most efficient from beef. Umbilical cord blood ferritin levels can be used to assess iron deposits reached during the foetal stage. Ferritin levels are linked to the child's long-term development. Objective: this exploratory study's objective is to determine the relationship between beef consumption during the first quarter of pregnancy and ferritin levels in the umbilical cord. Methods: we carried out a descriptive, observational study with prospectively collected data for one-year at the Neonatology Department of the Pereira Rossell Hospital Center (CHPR) in Montevideo, Uruguay. A total of 188 patients met the inclusion criteria. We extracted umbilical cord blood after a strict cord clamping after one minute of life. Ferritin was measured using the chemoimmunofluorescence method. We carried out a maternal nutritional survey using a qualitative-quantitative method and measured the frequency and approximate quantity of iron source food consumption during the last quarter of pregnancy. This survey was focused on maternal beef consumption as the major heme iron source in Uruguay. We analyzed the relationship between these variables. Results: latent iron deficiency (ferritin in the umbilical cord <100 ng / ml) was associated with lower beef consumption during pregnancy. Fisher p-value: 0.0133, OR: 3.71, 95% CI (1.25 - 11.05). Conclusions: this study agrees with the evidence that shows that low levels of total iron and beef consumption during pregnancy determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.


Contexto: a nutrição durante a gravidez tem impacto sobre a saúde do recém-nascido, com efeitos no nível epigenético, determinando consequências neurológicas a longo prazo. As necessidades de ferro durante a gravidez são estimadas em 27 mg / dia. O ferro heme de melhor absorção e aquele encontrado na carne vacuna. A determinação da ferritina no sangue do cordão umbilical permite avaliar os depósitos de ferro atingidos na fase fetal. Seus níveis foram associados a efeitos de longo prazo no desenvolvimento das crianças. Objetivos: o objetivo deste estudo exploratório é determinar a relação entre o consumo de carne vermelha durante o terceiro trimestre de gestação e o nível de ferritina no cordão umbilical. Métodos: foi realizado um estudo observacional descritivo com dados coletados prospectivamente durante um ano no Departamento de Neonatologia do Centro Hospitalar Pereira Rossell (CHPR) em Montevidéu, Uruguai. Um total de 188 pacientes cumpriram os critérios de inclusão. O sangue do cordão umbilical foi coletado após clampeamento estrito do cordão após um minuto de vida da criança. A ferritina foi medida pelo método de quimioimunofluorescência. Aplicamos um inquérito nutricional materno (qualitativo-quantitativo) que mediu a frequência de consumo de alimentos com fonte de ferro e as quantidades aproximadas consumidas durante o último trimestre da gravidez. Esta pesquisa enfocou o consumo materno de carne bovina como principal fonte de ferro heme no Uruguai. A relação entre essas variáveis foi analisada. Resultados: a deficiência latente de ferro (ferritina no cordão umbilical <100 mg / ml) foi associada ao menor consumo de carne bovina durante a gestação. Valor de p de Fisher: 0,0133, OR: 3,71, IC 95% (1,25-11,05). Conclusões: este estudo concorda com as evidências que relacionam que os baixos níveis de ferro total e consumo de carne bovina durante o terceiro trimestre de gestação determinam um maior risco de déficit de ferro latente e ferritina mensurado no cordão umbilical. A redução dos níveis de ferritina no cordão umbilical está associada a um risco aumentado de efeitos adversos de longo prazo na mielinização e no desenvolvimento neurocognitivo.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Hemoglobins/analysis , Parenteral Nutrition , Ferritins/blood , Fetal Blood , Red Meat , Pregnancy Trimester, Third , Uruguay , Iron Deficiency/complications , Child Development/physiology , Epidemiology, Descriptive
2.
Article in English | WPRIM | ID: wpr-887738

ABSTRACT

Objective@#This study aims to assess the dose-response relationship between serum ferritin (SF) and metabolic syndrome (MetS) in the two sexes.@*Methods@#We searched for articles on PubMed, the Cochrane Library, EMBASE, and the Web of Science databases that were published from 1950 to 2020. The summary odds ratio ( @*Results@#This study included 14 studies and 74,710 samples. The results of the classical meta-analysis showed that SF was positively associated with MetS ( @*Conclusions@#Our study shows that SF is significantly and positively associated with MetS, and the risk in the male population is higher than that in the female population. This finding also supports the recommendation of using SF as an early warning marker of MetS.


Subject(s)
Biomarkers/blood , Female , Ferritins/blood , Humans , Male , Metabolic Syndrome/epidemiology , Risk Factors , Sex Characteristics
3.
Arch. argent. pediatr ; 118(6): 411-417, dic 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1146074

ABSTRACT

Introducción. La anemia por deficiencia de hierro en hemodiálisis es frecuente. Para su detección se utiliza la ferritina sérica y la saturación de transferrina (ST). El equivalente de hemoglobina reticulocitaria (RET-He) es un análisis que no se modifica en estados inflamatorios y refleja directamente el hierro disponible en médula ósea.Objetivo. Explorar la capacidad diagnóstica de deficiencia absoluta de hierro del RET-He y evaluar su correlación con marcadores tradicionales de ferropenia.Población y métodos. Estudio retrospectivo que comparó RET-He con ferritina y ST en niños en hemodiálisis atendidos en el Hospital Garrahan entre julio de 2016 y julio de 2019. Resultados. En 164 observaciones realizadas en 40 niños, se encontró correlación positiva débil entre hemoglobina y RET-He (r 0,35, p < 0,001), positiva significativa entre ST y RET-He (r 0,52, p < 0,001), negativa baja entre hemoglobina y ferritina (r -0,19, p 0,02) y ausencia de correlación entre hemoglobina y ST (r 0,05, p 0,5). El 50 % presentaba anemia; la ferropénica fue por marcadores tradicionales en el 13 % y por RET-He en el 44 %. El RET-He mostró sensibilidad del 90,9 % (IC 95: 57,1-99,5 %), especificidad del 74,5 % (IC 95: 66,7-81 %), valor predictivo negativo del 99,1 % (IC 95: 94,5-99,9 %) y positivo del 20,4 % (IC 95: 10,7-34,7 %) para detectar anemia ferropénica con valor de corte de 29 picogramos.Conclusiones. Pese a su capacidad limitada, el RET-He como biomarcador de deficiencia de hierro aumenta la detección de anemia ferropénica en niños en hemodiálisis


Introduction. Iron-deficiency anemia is common in hemodialysis patients. Serum ferritin and transferrin saturation (TS) are used for its detection. The reticulocyte hemoglobin equivalent (RET-He) is a marker that is not altered by inflammatory conditions and directly reflects iron availability in the bone marrow.Objective. To explore the diagnostic capability of RET-He to detect absolute iron deficiency and assess its correlation with traditional markers of iron deficiency.Population and methods. Retrospective study comparing RET-He with ferritin and TS in children on hemodialysis seen at Hospital Garrahan between July 2016 and July 2019.Results. In 164 observations carried out in 40 children, a weak positive correlation was found between hemoglobin and RET-He (r = 0.35, p < 0.001), a significant positive correlation between TS and RET-He (r = 0.52, p < 0.001), a low negative correlation between hemoglobin and ferritin (r = -0.19, p = 0.02), and a lack of correlation between hemoglobin and TS (r = 0.05, p = 0.5). Anemia was observed in 50 %; iron-deficiency anemia was detected by traditional markers in 13 % and by RET-He in 44 %. RET-He showed a sensitivity of 90.9 % (95 % CI: 57.1-99.5 %), a specificity of 74.5 % (95 % CI: 66.7-81 %), a negative predictive value of 99.1 % (95 % CI: 94.5-99.9 %), and a positive predictive value of 20.4 % (95 % CI: 10.7-34.7 %) to detect iron-deficiency anemia with a cut-off value of 29 pg.Conclusions. Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Iron Deficiency , Renal Dialysis , Anemia, Iron-Deficiency/diagnosis , Reticulocytes/chemistry , Hemoglobins/analysis , Retrospective Studies , Ferritins/blood
4.
Rev. Assoc. Med. Bras. (1992) ; 66(2): 227-231, Feb. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136169

ABSTRACT

SUMMARY BACKGROUND An association between increased serum ferritin levels and acute myocardial infarction (AMI) remains controversial. The purpose of this meta-analysis is to confirm the association between increased serum ferritin levels and AMI. METHODS We searched PubMed and China National Knowledge Infrastructure (CNKI) for relevant articles that assessed the association between serum ferritin and acute myocardial infarction using terms that included serum ferritin and acute myocardial infarction up to February 13, 2019. RESULTS A total of 11 studies were identified for analysis. All pooled analysis was based on a random-effects models. The variance was exhibited using a forest plot, and the heterogeneity among studies was examined using the I2 index, the publication bias was evaluated using a funnel plot. The pooled standard mean difference of ferritin levels between AMI and controls was 0.78 (95%CI,0.68-0.88). CONCLUSION The results of this meta-analysis demonstrate that serum ferritin in acute myocardial infarction patients is higher than that of healthy controls.


RESUMO ANTECEDENTES a correlação entre o aumento do nível de proteínas de ferro no soro e o infarto agudo do miocárdio (AMI) continua controversa. O objetivo desta análise é confirmar a relação entre o aumento dos níveis de proteínas de ferro no soro y o AMI. METODOLOGIA busca de artigos sobre Pubmed e a infraestrutura nacional de conhecimentos da China (cnki) para avaliar a relação entre a proteína de ferro no soro e o infarto agudo do miocárdio, incluída a proteína de ferro no soro e o infarto agudo de miocárdio, até 13 de fevereiro de 2019. RESULTADO foram identificados 11 estudos para sua analise e todas as análises resumidas tiveram base em modelos de efeitos aleatórios. Foram utilizados mapas florestais para mostrar as margens, foi utilizado o índice 12 para examinar a heterogeneidade dos estudos e foram utilizados mapas de funil para avaliar os desvios publicados.A diferença entre a norma de fusão dos níveis de proteína de ferro do Grupo ami e o Grupo de controle é de 0,78 (intervalo de confiança de 95% 0,68-0,88). CONCLUSÃO nos resultados das análises da meta indicam que os pacientes com infarto agudo do miocárdio têm proteínas de ferro superiores às do Grupo de controle de saúde.


Subject(s)
Humans , Ferritins/blood , Myocardial Infarction/blood , Risk Factors , Risk Assessment , Myocardial Infarction/etiology
5.
Rev. Col. Bras. Cir ; 47: e20202404, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1136612

ABSTRACT

RESUMO Objetivos: Comparar a evolução do perfil nutricional de pacientes submetidos ao bypass gástrico em Y de Roux (BGYR) e ao Sleeve, em hospitais dos setores público e privado da Saúde de Pernambuco. Método: O estudo incluiu pacientes submetidos à cirurgia bariátrica nos setores público e privado de saúde de Pernambuco no período de 2008 a 2016. Foram avaliados dados antropométricos e bioquímicos (Hemoglobina, Vitamina B12, Ferro e Ferritina) no período pré-operatório e com 3, 6 e 12 meses de pós-operatório. Resultados: Não foram registradas diferenças significativas entre os pacientes internados nos dois setores da Saúde no tocante às variáveis: níveis hemoglobina, anemia por deficiência de ferro e vitamina B12 em nenhuma das avaliações e conforme o tipo de cirurgia. Entre os pacientes submetidos ao BGYR, os níveis de ferro sérico foram significativamente menores nos pacientes do setor privado da Saúde apenas na primeira avaliação. Baixos níveis de ferritina sérica foram observados na segunda avaliação, sendo os pacientes do setor privado os que apresentaram menores valores. O sucesso cirúrgico foi significativamente maior no grupo que realizou o BGYR na rede privada. Conclusões: Com um seguimento de 12 meses pós-cirurgia bariátrica, não foi observada diferença estatisticamente significante no que diz respeito às deficiências de micronutrientes entre pacientes usuários dos setores público e privado de Saúde.


ABSTRACT Purpose: To compare the nutritional status follow up of patients who underwent Roux-en-Y gastric bypass (BGYR) and Sleeve gastrectomy (SG) in hospitals of the private and public health systems, in Pernambuco. Methods: This study included patients who underwent bariatric surgery in the public and private health systems, in Pernambuco, from 2008 to 2016. Anthropometric and biochemical (hemoglobin, B12, iron and ferritin) data were evaluated in the preoperative period and at 3, 6 and 12 months after the operation. Results: There were no significant difference between patients seen at the two health systems regarding the levels of hemoglobin, iron, anemia and vitamin B12. Patients who underwent the RYGB, presented with iron deficiency which was significantly lower for those in the private system, but only at the 3 month evaluation. Low levels of ferritin were observed at the 6 month evaluation, and patients in the private health system presented with the highest ferritin deficiency. The rate of surgical success was significantly higher in those patients undergoing the RYGB at the private system. Conclusions: After a 12-month bariatric surgery follow-up, there was no statistically significant difference regarding micronutrient deficiency between patients followed up at the private and public health systems.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Obesity, Morbid/surgery , Nutritional Status , Bariatric Surgery/methods , Vitamin B 12/blood , Obesity, Morbid/blood , Hemoglobins/analysis , Retrospective Studies , Follow-Up Studies , Public Sector , Private Sector , Ferritins/blood , Middle Aged
6.
J. bras. nefrol ; 41(3): 384-392, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040258

ABSTRACT

Abstract Introduction: Chronic kidney disease (CKD) has a high prevalence and is a worldwide public health problem. Reuse of dialyzers is a cost reduction strategy used in many countries. There is controversy over its effects on clinical parameters and microbiological safety. Methods: In this clinical crossover study, 10 patients performed consecutive hemodialysis (HD) sessions divided in two phases: "single use" sessions (N = 10 HD sessions) followed by "dialyzer reuse" sessions (N = 30 HD sessions). Clinical, laboratory, and microbiological parameters were collected in the following time points: "single use", 1st, 6th, and 12th sessions with reuse of dialyzers, including bacterial cultures, endotoxins quantification in serum and dialyzer blood chamber, and detection of hemoglobin and protein residues in dialyzers. Results: Mean age of the sample was 37 ± 16 years, 6 (60%) were men, and 5 (50%) were white. CKD and HD vintage were 169 ± 108 and 47 (23-111) months, respectively. Serum C-reactive protein (CRP) [4.9 (2.1) mg/mL], ferritin (454 ± 223 ng/mL), and endotoxin levels [0.76 (0.61-0.91) EU/mL] were high at baseline. Comparison of pre- and post-HD variations of serum levels of CRP and endotoxins in the "single use" versus "reuse" phases did not result in differences (p = 0.8 and 0.4, respectively). Samples of liquid in the dialyzer inner chamber were negative for the growth of bacteria or endotoxins. There was no significant clinical manifestation within and between the phases. Conclusion: Dialyzers reuse was safe from a clinical, microbiological, and inflammatory point of view. The dialyzer performance remained adequate until the 12th reuse.


Resumo Introdução: A doença renal crônica (DRC) é um problema de saúde pública mundial de alta prevalência. O reúso de dialisadores é uma estratégia de redução de custos empregada em muitos países. Seus efeitos sobre parâmetros clínicos e de segurança microbiológica são alvo de controvérsia. Métodos: No presente estudo clínico cruzado, 10 pacientes realizaram sessões consecutivas de hemodiálise (HD) divididas em duas fases: a primeira com sessões de "uso único" (N = 10 sessões de HD) e a segunda com sessões com "reúso de dialisadores" (N = 30 sessões de HD). Parâmetros clínicos, laboratoriais e microbiológicos foram registrados nos seguintes momentos: "uso único", 1a, 6a e 12a sessões com reúso de dialisadores, incluindo culturas bacterianas, quantificação de endotoxinas no soro e na câmara interna do dialisador e detecção de hemoglobina e resíduos de proteína nos dialisadores. Resultados: A idade média da amostra foi de 37 ± 16 anos seis (60%) eram homens e cinco (50%) eram brancos. Os tempos com DRC e em HD foram de 169 ± 108 e 47 (23-111) meses, respectivamente. Os níveis séricos de proteína C-reativa (PCR) [4,9 (2,1) mg/mL], ferritina (454 ± 223 ng/mL) e endotoxinas [0,76 (0,61-0,91) UE/mL] estavam elevados no início do estudo. A diferença dos níveis séricos de PCR e endotoxinas pré e pós-HD nas fases de "uso único" e "reúso" não foi significativa (p = 0,8 e 0,4, respectivamente). As amostras de líquido retiradas da câmara interna do dialisador foram negativas para crescimento de bactérias e endotoxinas. Não houve registro de manifestações clínicas significativas nas fases do estudo. Conclusão: O reúso de dialisadores foi seguro dos pontos de vista clínico, microbiológico e inflamatório. O desempenho do dialisador permaneceu adequado até o 12º reuso.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Renal Dialysis/instrumentation , Equipment Reuse , Kidneys, Artificial/adverse effects , Kidneys, Artificial/microbiology , C-Reactive Protein/analysis , Pilot Projects , Follow-Up Studies , Cross-Over Studies , Endotoxins/blood , Renal Insufficiency, Chronic/therapy , Ferritins/blood , Inflammation/blood
7.
Arq. gastroenterol ; 56(1): 28-33, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001327

ABSTRACT

ABSTRACT BACKGROUND: Insulin resistance, especially that induced by obesity, plays a central role in the development of non-alcoholic fatty liver disease. Although the evaluation of overweight patients is important, the nutritional assessment tools used in clinical practice have limitations. Neck circumference (NC), from this, becomes a viable and low-cost alternative, which seems to be related to the accumulation of fat in the hepatic tissue. OBJECTIVE: To evaluate the association between NC and metabolic alterations in patients with non- alcoholic fatty liver disease. METHODS: A cross-sectional study performed in 82 patients, of whom 76 underwent liver biopsy. We performed weight, height, abdominal circumference and NC measures. Values of NC ≥42 cm and ≥36 cm were considered as altered for men and women, respectively. Laboratory tests and liver biopsy result were collected in the participants' charts. We evaluated fasting blood glucose levels, insulin, glycosylated hemoglobin, triglycerides, total cholesterol, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), ferritin, alkaline phosphatase, gamma glutamyltransferase, albumin, total bilirubin, direct bilirubin, glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase and the HOMA-IR index. RESULTS: We evaluated eighty-two patients. Patients with altered NC had increased body mass index (P=0.043), abdominal circumference (P=0.007), insulin (P=0.003) and HOMA-IR (P=0.029) when compared to those with adequate NC. NC was significantly correlated with reduced levels of high-density cholesterol (HDL-C) in men (r= -042, P<0.05), increased insulin levels in men and female (rs=0.47; P<0.05 and rs=0.51; P<0.01, respectively), as well as higher HOMA-IR index both males (rs=0.49; P<0.01) and female (rs=0.30; P<0.05). There was no significant association between NC and liver outcomes (r=0.145; P=0.36). CONCLUSION: NC is associated with the HOMA-IR index in patients with non-alcoholic fatty liver disease. NC can be used in the screening of insulin resistance in these patients, considering that insulin resistance plays a key role in the progression of the disease.


RESUMO CONTEXTO: A resistência à insulina, em especial a induzida pela obesidade, desempenha papel central no desenvolvimento da doença hepática gordurosa não alcoólica (DHGNA). Embora seja importante a avaliação de pacientes com excesso de peso, as ferramentas de avaliação nutricional utilizadas na prática clínica apresentam limitações. A circunferência do pescoço, a partir disso, torna-se uma alternativa viável e de baixo custo, a qual parece estar relacionada ao acúmulo de gordura no tecido hepático. OBJETIVO: Avaliar a associação entre a circunferência do pescoço (CP) e as alterações metabólicas em pacientes com DHGNA. MÉTODOS: Estudo transversal realizado em 82 pacientes, dos quais 76 foram submetidos à biópsia hepática. Foram realizadas as medidas de peso, altura, circunferência abdominal e CP. Valores de CP ≥42 cm e ≥36 cm foram considerados alterados para homens e mulheres, respectivamente. Os exames laboratoriais e o resultado da biópsia hepática foram coletados dos prontuários dos participantes. Foram avaliados os níveis glicêmicos em jejum, insulina, hemoglobina glicosilada, triglicerídeos, colesterol total, lipoproteína de alta densidade (HDL-C), lipoproteína de baixa densidade (LDL-C), ferritina, fosfatase alcalina, gama glutamiltransferase, albumina, bilirrubina total, bilirrubina direta, transaminase glutâmico-oxalacética, transaminase glutâmico-pirúvica e o índice HOMA-IR. RESULTADOS: Foram avaliados 82 pacientes. Os pacientes com CP alterada apresentaram aumento do índice de massa corporal (P=0,043), circunferência abdominal (P=0,007), insulina (P=0,003) e HOMA-IR (P=0,029) quando comparados àqueles com CP adequada. A CP foi significativamente correlacionada com níveis reduzidos de colesterol de alta densidade (HDL-C) em homens (r= -042, P<0,05), aumento dos níveis de insulina em homens e mulheres (rs=0,47, P<0,05 e rs = 0,51; P<0,01, respectivamente), bem como maior índice HOMA-IR, tanto do sexo masculino (rs=0,49; P<0,01) quanto do feminino (rs=0,30; P<0,05). Não houve associação significativa entre CP e os desfechos hepáticos (r=0,145, P=0,36). CONCLUSÃO: A CP está associada com o índice HOMA-IR em pacientes com DHGNA. A CP pode ser utilizada no rastreamento da resistência à insulina nesses pacientes, considerando que a resistência à insulina desempenha um papel fundamental na progressão da doença.


Subject(s)
Humans , Male , Female , Adult , Insulin Resistance/physiology , Non-alcoholic Fatty Liver Disease/metabolism , Neck/anatomy & histology , Biopsy , Blood Glucose/analysis , Body Mass Index , Sex Factors , Cross-Sectional Studies , Waist Circumference , Ferritins/blood , Non-alcoholic Fatty Liver Disease/physiopathology , Homeostasis/physiology , Insulin/blood , Cholesterol, HDL/blood , Liver/pathology , Middle Aged
8.
Arq. gastroenterol ; 56(1): 10-14, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001326

ABSTRACT

ABSTRACT BACKGROUND: The bacterium Helicobacter pylori is strongly associated with the development of gastric adenocarcinoma. Currently, the prevalence in developed countries is 40%, but this value increases considerably in developing countries, which can reach rates bigger than 90%. OBJECTIVE: The objective of this study was to determine the mean and annual prevalence of Helicobacter pylori infection in patients from Itajaí during the period from July 1992 to April 2016, as well as the gender and age groups most affected. METHODS: After consent of the clinical director of the Gastroclinica Itajaí and confidentiality commitment about the research, the database of the Endoscopy Service of the clinic was evaluated. All the patients who underwent their first upper digestive endoscopy with urease test and/or histological analysis were included. The data were submitted to statistical analysis of prevalence by gender, age group and years of study, with subsequent correction through the confidence interval. RESULTS: The mean prevalence of Helicobacter pylori infection thru all years of study was 50.07%. With the calculation of the annual prevalences, it was evident the gradual reduction of infection in the population of Itajaí, that was 81.3% in 1992, declining to 33% in the year of 2016. When classifying the prevalence of infection by gender, it was higher in males (53.59%), and gender distribution by age group showed no statistically significant difference among genders between the ages of 40 and 80 years. In relation to the age group, the highest prevalence was in the group between 40 and 49 years. CONCLUSION: Although this study is retrospective and based on endoscopic database analysis, without access to clinical data of patients such as prior use of proton pump inhibitor and antibiotics to endoscopy, its results are important because they may reflect the current panorama of Helicobacter pylori infection in the city under study, where it has been presenting a gradual reduction of prevalence over the years, with current rates similar to that of developed countries (33%). Future studies are needed to confirm our data.


RESUMO CONTEXTO: A bactéria Helicobacter pylori associa-se fortemente ao desenvolvimento do adenocarcinoma gástrico. Atualmente, a prevalência em países desenvolvidos é de 40%, porém esse valor cresce consideravelmente em países em desenvolvimento, que chegam a alcançar taxas de até 90%. OBJETIVO: O objetivo desta pesquisa foi determinar a prevalência média e anual da infecção por Helicobacter pylori nos pacientes de Itajaí durante o período de julho de 1992 a abril de 2016, assim como o sexo e as faixas etárias mais acometidas. MÉTODOS: Após consentimento do diretor técnico da Gastroclínica Itajaí e comprometimento de sigilo em relação à pesquisa, foi avaliada a base de dados do Serviço de Endoscopia da clínica. Foram selecionados todos os pacientes que realizaram pela primeira vez o exame de endoscopia digestiva alta com teste da urease e/ou análise histológica. Os dados obtidos foram submetidos à análise estatística de prevalência por sexo, faixa etária e anos do estudo, com posterior correção dos dados através do intervalo de confiança. RESULTADOS: A prevalência média da infecção por Helicobacter pylori em todos os anos de estudo foi de 50,07%. Com o cálculo das prevalências anuais, ficou evidente a redução gradual da infecção na população de Itajaí, que era de 81,3% em 1992, passando a 33% no ano de 2016. Ao classificar a prevalência da infecção por gênero, foi maior no sexo masculino (53,59%) e a distribuição dos gêneros por faixa etária não mostrou diferença estatisticamente significativa entre os sexos entre as idades de 40 a 80 anos. Em relação à faixa etária, a maior prevalência foi no grupo entre 40 e 49 anos. CONCLUSÃO: Embora este estudo seja retrospectivo e baseado em análise de banco de dados de endoscopias digestivas, sem acesso a dados clínicos de pacientes como uso prévio de nibidor de bomba de próton e antibióticos à endoscopia, seus resultados são importantes, pois podem refletir o panorama atual da infecção por Helicobacter pylori no município em estudo, que vem apresentando uma redução gradual da prevalência ao longo dos anos, com taxas atuais semelhantes às dos países desenvolvidos (33%). Estudos futuros são necessários para confirmar nossos dados.


Subject(s)
Humans , Male , Female , Adult , Insulin Resistance/physiology , Non-alcoholic Fatty Liver Disease/metabolism , Neck/anatomy & histology , Biopsy , Blood Glucose/analysis , Body Mass Index , Sex Factors , Cross-Sectional Studies , Waist Circumference , Ferritins/blood , Non-alcoholic Fatty Liver Disease/physiopathology , Homeostasis/physiology , Insulin/blood , Cholesterol, HDL/blood , Liver/pathology , Middle Aged
9.
Article in English | AIM, AIM | ID: biblio-1263506

ABSTRACT

Objective: Iron deficiency may play a role in the pathophysiology of attention deficit hyperactivity disorder (ADHD) by causing dopamine dysfunction, but there is conflicting evidence in the literature regarding this relationship. This study investigates the possible correlation between iron deficiency and ADHD in children and adolescents attending a South African child and adolescent psychiatry outpatient service.Method: In this retrospective study, we gathered data from 245 outpatient children and adolescents who had their serum ferritin and/or iron levels tested between February 2011 and January 2016. Relevant statistical methods were used to test for correlations between ADHD and various demographic and clinical factors, including iron deficiency.Results: Out of 245 patients, 88 (35.9%) had iron deficiency, 156 (63.7%) had ADHD and 55 (22.4%) had both iron deficiency and ADHD. Variables found to be significantly correlated with ADHD included gender, age, and methylphenidate treatment, but there was no significant correlation between ADHD and iron deficiency.Conclusions: Our study emphasizes the great complexity involved in understanding ADHD. Comparisons between mentally-ill paediatric patients and matched healthy controls from the same communities are required to further explore the possible association between iron deficiency and ADHD


Subject(s)
Adolescent , Anemia, Iron-Deficiency , Attention Deficit Disorder with Hyperactivity/blood , Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/physiopathology , Child , Ferritins/blood , South Africa
10.
Rev. chil. endocrinol. diabetes ; 11(4): 161-170, dic. 2018. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-968669

ABSTRACT

Type 2 Diabetes Mellitus (DM2) is considered a chronic inflammatory and systemic disease of low degree of intensity that promotes other pathologies such as cardiovascular disease, cancer and cognitive impairment. The relationship between inflammatory markers and insulin resistance in obese patients is known. Low-grade inflammation is an independent predictor of chronic diseases and mortality from all causes. Ferritin may be increased in DM2, but it is not clear if its cause is hyperglycemia or chronic inflammation. Objective: To evaluate the impact of a twenty-week program of exercise and diet on the markers of inflammation, metabolic control and the value of ferritin in a sample of obese patients with DM2, assisted in our National Health System. Materials and Methods: Open, controlled and randomized clinical trial in primary care patients. Of 161 patients with DM2 evaluated 35 fulfilled the inclusion criteria. They were divided into two homogeneous groups (control and intervention). Blood was taken from both groups to measure Ferritin along with other inflammatory and metabolic markers, before and after the exercise and diet program. These variables and the changes in serum Ferritin were analyzed. Results: At the beginning of the study Ferritin was elevated in 72.2% and 52.9% of the control and intervention group respectively. In the end, there was a significant difference between the groups, with benefit of the intervention group in the decrease of Interleukin-6, glycosylated hemoglobin, waist and body mass index. There was a non-significant decrease in C-reactive protein and Ferritin. This last one was not related to the other variables. The control group showed no significant decrease of any variable Conclusions: To apply a program of controlled exercise and diet, in the usual treatment of patients with DM2, improves inflammation and glucose homeostasis, discernible by the decrease in inflammatory parameters and by the improvement in the glycemic control. Serum ferritin was not useful to predict the metabolic control of these patients and assess the response to treatment.


Introducción: La diabetes mellitus 2 (DM2) es considerada una enfermedad inflamatoria crónica y sistémica de bajo grado de intensidad que promueve otras patologías. Es conocida la relación entre |inflamación e insulino resistencia en pacientes obesos, siendo un predictor independiente de morbimortalidad por todas las causas. Ferritina puede estar aumentada en la DM2, no es claro si su causa es la hiperglucemia o la inflamación crónica. Objetivo: Evaluar el impacto de un programa de veinte semanas de ejercicio y dieta sobre los marcadores de inflamación, control metabólico y el valor de ferritina en una muestra de pacientes con DM2 obesos. Materiales y Métodos: Ensayo clínico abierto, controlado y randomizado en pacientes del nivel primario de atención. Se evaluaron 35 pacientes con DM2 que se dividieron en dos grupos homogéneos (control e intervención). Se extrajo sangre para medir Ferritina, marcadores inflamatorios y metabólicos, antes y luego del programa de ejercicio y dieta. Analizamos los cambios de esas variables. Resultados: Ferritina estaba elevada en el 72.2% y 52.9% del grupo control e intervención respectivamente. Al final hubo una diferencia significativa entre los grupos, con beneficio del grupo intervención en el descenso de Interleucina-6, hemoglobina glicosilada, cintura e índice de masa corporal. Hubo un descenso no significativo de Ferritina y Proteína C reactiva. Ferritina no presentó relación con las demás variables. En el grupo control no hubo descenso significativo de ninguna variable. Conclusiones: Aplicar un programa de ejercicio controlado y dieta, en el tratamiento de pacientes con DM2, mejora la inflamación y la homeostasis de la glucosa, discernible por el descenso de parámetros inflamatorios y por la mejora en el control glucémico. Ferritina sérica no fue útil para predecir el control metabólico y valorar la respuesta al tratamiento.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Exercise/physiology , Diabetes Mellitus/therapy , Ferritins/blood , C-Reactive Protein , Biomarkers , Diabetes Mellitus, Type 2/blood , Diet , Inflammation , Obesity
11.
Arch. argent. pediatr ; 116(6): 736-743, dic. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-973688

ABSTRACT

Introducción.La vitamina D afecta la eritropoyesis.Objetivo: evaluar, en niños de 6 meses a 5 años, la asociación entre concentraciones de 25-hidroxi vitamina D (25-OHD) en la madre/niño, ferropenia y anemia ferropénica (AF). Población y métodos. Se incluyeron los niños que asistieron a la consulta entre septiembre de 2014 y enero de 2016. Se excluyeron aquellos con infección aguda/crónica, desnutrición, enfermedades crónicas y prematuros. Se realizó hemograma, hierro sérico, capacidad fijación del hierro, ferritina y 25-OHD. Se investigó suplemento con hierro y vitamina D durante lactancia y embarazo.Resultados. Se incluyeron 117 niños: 67 tenían ferropenia/AF [Grupo 1, edad (años): 2,05 ± 1,24 (0,5-5)] y 50 niños sanos [Grupo 2, edad (años): 1,87 ± 1,12 (0,58-5)]. Más niños y madres tuvieron deficiencia de vitamina D en Grupo 1 que en Grupo 2 (niños, 49,3 % vs 20 %, p = 0,002, y madres: 94 % vs 64 %; p= < 0,001, respectivamente). Hubo correlación positiva entre la hemoglobina en niños y la 25-OHD en madres/niños. Factores independientes de riesgo de AF fueron más tiempo de lactancia (OR: 0,35; IC 95 % [0,155-0,789]; p = 0,011), más breve suplementación con hierro durante la lactancia (OR: 1,69; IC 95 % [1,148-2,508]; p = 0,008) y embarazo (OR: 1,39; IC 95 % [1,070-1,820]; p = 0,014) y concentraciones < 25-OHD en madres (OR: 1,16; IC del 95 % [1,034-1,292]; p = 0,011). Conclusiones. La deficiencia de vitamina D en madres/niños está asociada con ferropenia/AFen los niños.


Introduction. Vitamin D (VitD) affects the erythropoiesis. The aim of this study was to evaluate the association between maternal/child 25-OH VitD (25-OHD) levels and iron deficiency (ID) and anemia (IDA) in children aged 6 months-5 years. Population and methods. Between September 2014 and January 2016 children who were admitted to outpatient clinic were included to study. We excluded the children with acute or chronic infection, malnutrition, chronic disease and preterm birth history. Complete blood count, serum iron, total iron binding capacity, ferritin, 25-OHD levels were examined from children and their mothers. Iron and VitD supplementation during infancy and pregnancy and breastfeeding history were questioned.Results. The study included totally 117 children. There were 67 children with ID/IDA [Group 1, mean age (years):2.05±1.24 (0.5-5)] and 50 normal children [Group 2, mean age (years): 1.87±1.12 (0.58-5)]. There were more VitD deficient children and mothers in Group 1 than in Group 2 (respectively, children 49.3 % vs. 20 % p=0.002; mothers 94 % vs.64 %, p=<0.001). There was a positive correlation between hemoglobin levels of children and maternal/child 25-OHD. The independent risk factors for IDA in children were longer exclusively breastfeeding time (odds ratio [OR], 0.35; 95 % confidence interval [CI], 0.155-0.789; p=0.011), shorter duration of regular iron supplementation during infancy and pregnancy (infancy: OR,1.69; 95 % CI 1.148-2.508; p=0.008. pregnancy: OR,1.39; 95 % CI,1.070-1.820; p=0.014) and lower maternal 25-OHD level (OR,1.16; 95 % CI,1.034-1.292; p=0.011). Conclusions. Maternal/child VitD deficiency is associated with ID/IDA in children aged 6 months-5 years.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Vitamin D/blood , Vitamin D Deficiency/complications , Anemia, Iron-Deficiency/epidemiology , Iron/deficiency , Time Factors , Vitamin D/administration & dosage , Vitamin D Deficiency/epidemiology , Breast Feeding/statistics & numerical data , Hemoglobins/analysis , Pregnancy , Risk Factors , Dietary Supplements , Ferritins/blood , Iron/blood
12.
Arq. bras. cardiol ; 111(2): 144-150, Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-950213

ABSTRACT

Abstract Background: Iron metabolism disorders have been associated with an increased risk of cardiovascular events. However, the prognostic impact on patients (pts) with acute coronary syndrome (ACS) has yet to be clarified. Objective: To determine the prognostic value of serum iron and ferritin levels in pts with ACS in the short and long-term. Methods: Consecutive pts admitted to a coronary care unit with a diagnosis of ACS, for a period of 2 years, were evaluated. The population was divided into tertiles of serum iron and ferritin distribution. The primary adverse events were the occurrence of in-hospital death or heart failure (HF) and death or HF at 1 year of follow-up. Results: We studied 280 pts (73% males; mean age 68 ± 13 years). The mean levels of serum iron and ferritin were 59 ± 34 mcg/dL and 205 ± 185 ng/mL, respectively. Patients included in the 1st tertile of serum iron (≤ 40 mcg/dL) had a higher rate of adverse events, in-hospital and after 1 year. Lower and higher levels of ferritin (1st and 3rd tertiles, ≤ 110; >219 ng/ml, respectively) were associated with a higher incidence of HF during hospitalization and death at 1 year. A ferritin value >316 ng /mL was an independent risk factor for death at 1 year (adjusted OR: 14; 95%CI: 2.6 to 75.9). Conclusion: In this population, iron metabolism alterations were associated with a higher rate of adverse events and higher ferritin levels constituted an independent mortality predictor in the long-term.


Resumo Fundamento: Alterações do metabolismo do ferro têm sido associadas a um aumento do risco de eventos cardiovasculares. No entanto, o impacto prognóstico em doentes (dts) com síndrome coronária aguda (SCA) encontra-se ainda pouco esclarecido. Objetivo: Determinar o valor prognóstico a curto e longo prazo dos níveis séricos do ferro e ferritina em dts com SCA. Métodos: Foram avaliados doentes consecutivos admitidos numa Unidade Coronária com o diagnóstico de SCA no período de 2 anos. A população foi agrupada segundo os tercis de distribuição de ferro e ferritina. Os eventos adversos primários foram a ocorrência de morte intrahospitalar e a 1 ano, bem como, insuficiência cardíaca (IC) intrahospitalar e a 1 ano de follow-up. Resultados: Estudaram-se 280 dts (73% sexo masculino; idade média de 68 ± 13 anos). O nível médio de ferro sérico e de ferritina foi 59 ± 34 mcg/dl e 205 ± 185 ng/ml, respetivamente. Os doentes incluídos no 1º tercil (≤ 40 mcg/dl) de ferro sérico apresentaram maior percentagem de eventos adversos intrahospitalares e a 1 ano. Níveis mais baixos e mais elevados de ferritina (1º e 3º tercil, respetivamente, ≤ 110; > 219 ng/ml) estiveram associados a uma maior ocorrência de IC em internamento e de morte a 1 ano. Um valor de ferritina > 316 ng/mL constituiu fator de risco independente de morte a 1 ano (OR ajustado 14 IC 95% 2,6-75,9). Conclusão: Nesta população alterações do metabolismo do ferro estiveram associadas a uma maior ocorrência de eventos adversos e níveis elevados de ferritina constituíram preditor independente de mortalidade a longo prazo.


Subject(s)
Humans , Male , Female , Aged , Acute Coronary Syndrome/blood , Ferritins/blood , Iron/blood , Prognosis , Time Factors , Biomarkers/blood , Acute Coronary Syndrome/mortality
13.
PJMR-Pakistan Journal of Medical Research. 2018; 57 (1): 40-44
in English | IMEMR | ID: emr-192414

ABSTRACT

Background: Anaemia is commonly found in developing countries associated with nutritional deficiencies and multiple pregnancies. Iron Deficiency Anaemia in pregnancy is a risk for preterm delivery, low birth weight babies and adverse effects on infant development. The current study investigated frequency of iron deficiency anemia and beta thalassaemia trait during antenatal check up among pregnant women visiting a tertiary care hospital in Islamabad


Objectives: To investigate iron deficiency anemia and beta thalassaemia trait among pregnant females visiting a tertiary care hospital in Islamabad


Study design, settings and duration: The retrospective comparative study was done to investigate iron deficiency anemia among pregnant females visiting a tertiary care hospital in Islamabad from May 2006 to April 2009


Subjects and Methods: The study was conducted at National Institute of Health [Department of Hematology] for Complete Blood Count and differential counts using Automated Hematology Analyzer [Sysmex KX-21]. Serum Ferritin levels were measured by Electro-chemiluminescence technique using Elcys Ferritin Kit [Roche, Germany]


Results: Among 359 subjects, 237 [66%] had iron deficiency anemia. The mean age was 27.32 +/- 4.9 years [range 18-50 years], 18 [5%] had beta thalassaemia trait and 104 [29%] had non-beta thalassaemia Trait. Forteen cases had concomitant iron deficiency anemia and beta thalassemia trait. The findings of this study indicate a relatively higher burden of iron deficiency anemia as compared to beta thalassemia trait


Conclusion: Anemia is a neglected problem which needs priority. Routine iron supplementation should be given to women of child bearing age during pregnancy and post partum. Obstetricians have an important role to aware the women of reproductive age about the iron content in a balanced diet and motivation for iron supplements


Subject(s)
Humans , Female , Adult , Middle Aged , beta-Thalassemia , Pregnancy , Ferritins/blood , Blood Cell Count , Retrospective Studies
14.
Medicina (B.Aires) ; 77(6): 458-464, dic. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-894521

ABSTRACT

El consumo excesivo de hierro (Fe) en portadores de mutaciones en el gen HFE puede resultar en sobrecarga. Para evaluar el riesgo de sobrecarga de Fe fueron investigados 166 varones adultos donantes de sangre de la ciudad de Buenos Aires. Se estimó la ingesta diaria de Fe (IFe), de Fe hemínico y de Fe proveniente de harinas enriquecidas con SO4Fe. Se determinó ferritina sérica y porcentaje de saturación de transferrina (criterio de sobrecarga de Fe: ferritina sérica > 300 ng/ml y saturación de transferrina ≥ 50%). Las mutaciones C282Y, H63D y S65C fueron investigadas en sangre mediante PCR-RFLP. Todos los participantes cubrieron ampliamente el requerimiento estimado promedio de Fe (6 mg Fe/día) y 3.0% superó el máximo tolerable (45 mg Fe/día). El Fe hemínico correspondió al 9.4% de la IFe y el de harinas enriquecidas al 47.7%. Se observó una asociación entre el aumento de IFe y el de ferritina sérica (p = 0.0472), y el 2.3% de los donantes presentaron ferritina sérica > 300 ng/ml y saturación de transferrina ≥ 50%. El 29.3% de los donantes eran portadores de los genotipos H63D, S65C o C282Y, asociados a hemocromatosis hereditaria, y tenían valores de saturación de transferrina significativamente mayores a los de los donantes wild type (p = 0.0167). Si bien la incidencia clínica de hemocromatosis hereditaria fue baja en el grupo estudiado (1.2%), el consumo excesivo de Fe plantea un riesgo potencial para la salud de individuos que ignoran sus antecedentes familiares de sobrecarga de Fe.


Excess iron (Fe) intake in subjects carrying certain mutations in the HFE gene may result in Fe overload. To estimate risk of Fe overload, 166 male blood donors (19-65 years) from Buenos Aires city were investigated. Daily Fe intake (FeI), hem Fe intake, and Fe intake from SO4Fe enriched flours were estimated (SARA Computer Program and Food Composition Table, USDA). Serum ferritin and transferrin saturation were determined; criteria for Fe overload was serum ferritin > 300 ng/ml and transferrin saturation ≥ 50%. HFE genotypes C282Y, H63D and S65C were analyzed by PCR-RFLP in blood samples. No participant presented FeI lower than the estimated average requirement (6 mg Fe/day) and 3.0% was over the upper level (45 mg Fe/day). Hem Fe and Fe from flour enrichment were 9.4% and 47.7% of daily Fe intake, respectively. A significant association was observed between the increase in serum ferritin (ng/ml) and the increase in FeI (p = 0.0472); 2.3% of the donors presented serum ferritin > 300 ng/ml and transferrin saturation ≥ 50%. Genotypes associated with hereditary hemochromatosis (H63D, S65C and C282Y) were found in 29.3% of the donors. The percentage of transferrin saturation was higher in subjects carrying mutation than in wild type subjects (p = 0.0167). Although penetrance of hereditary hemochromatosis in the studied group was only 1.2%, an excessive Fe intake could enhance adverse effects in individuals unaware of any family history of Fe overload.


Subject(s)
Humans , Male , Adult , Blood Donors/statistics & numerical data , Iron, Dietary/administration & dosage , Ferritins/blood , Hemochromatosis Protein/genetics , Hemochromatosis/genetics , Hemochromatosis/chemically induced , Polymorphism, Restriction Fragment Length , Transferrin/analysis , Genotype , Iron/blood , Mutation
15.
J. pediatr. (Rio J.) ; 93(5): 482-489, Sept.-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-894050

ABSTRACT

Abstract Objective: To analyze the seasonality of blood parameters related to iron homeostasis, inflammation, and allergy in two riverine populations from the Brazilian Amazon. Methods: This was a cross-sectional study of 120 children and adolescents of school age, living in riverine communities of Porto Velho, Rondonia, Brazil, describing the hematocrit, hemoglobin, ferritin, serum iron, total white blood cell count, lymphocytes, eosinophils, C-reactive protein, and immunoglobulin E levels in the dry and rainy seasons. The chi-squared test and the prevalence ratio were used for the comparison of proportions and mean analysis using paired Student's t-test. Results: Hemoglobin (13.3 g/dL) and hematocrit (40.9%) showed higher average values in the dry season. Anemia prevalence was approximately 4% and 12% in the dry and rainy seasons, respectively. Serum iron was lower in the dry season, with a mean of 68.7 mcg/dL. The prevalence of iron deficiency was 25.8% in the dry season and 9.2% in the rainy season. Serum ferritin did not show abnormal values in both seasons; however, the mean values were higher in the dry season (48.5 ng/mL). The parameters of eosinophils, lymphocytes, global leukocyte count, C-reactive protein and immunoglobulin E showed no seasonal differences. C-reactive protein and immunoglobulin E showed abnormal values in approximately 7% and 60% of the examinations, respectively. Conclusion: Hematological parameters of the red cell series and blood iron homeostasis had seasonal variation, which coincided with the dry season in the region, in which an increase in atmospheric pollutants derived from fires is observed.


Resumo Objetivo: Analisar a sazonalidade climática de parâmetros sanguíneos relacionados à homeostase do ferro, inflamação e alergia em duas populações ribeirinhas da Amazônia brasileira. Método: Fez-se um estudo transversal em 120 crianças e adolescentes em idade escolar, residentes em comunidades ribeirinhas de Porto Velho, Rondônia. Foram analisados hematócrito, hemoglobina, ferritina, ferro sérico, leucometria global, linfócitos, eosinófilos, proteína C-reativa e imunoglobulina E nas estações seca e chuvosa. Usaram-se o teste do qui-quadrado e a razão de prevalência para a comparação das proporções, além do teste t de Student pareado para a análise de médias. Resultados: Hemoglobina (13,3 g/dL) e hematócrito (40,9%) apresentaram maiores valores médios no período de seca. A prevalência de anemia foi de 4% e 12% na seca e na chuva, respectivamente. O ferro sérico foi menor no período de seca com média de 68,7 mcg/dL. A prevalência de deficiência de ferro foi em média 25,8% na seca e 9,2% na chuva. A concentração sérica de ferritina não apresentou valores alterados em ambos os períodos, no entanto os valores médios apresentaram-se mais elevados na seca (48,5 ng/mL). Os parâmetros dos eosinófilos, linfócitos, leucometria global, proteína C-reativa e imunoglobulina E não apresentaram diferenças sazonais. A proteína C-reativa e a imunoglobulina E apresentaram valores alterados em 7% e 60% dos exames feitos, respectivamente. Conclusão: Os parâmetros hematológicos da série vermelha e a homeostasia ferro sanguíneo apresentaram variação sazonal, que coincide com o período de seca na região, no qual se observa aumento dos poluentes atmosféricos derivados das queimadas.


Subject(s)
Humans , Male , Female , Child , Adolescent , Seasons , Blood Cell Count , C-Reactive Protein/analysis , Hemoglobins/analysis , Immunoglobulin E/blood , Ferritins/blood , Hematocrit , Reference Values , Weather , Brazil , Cross-Sectional Studies , Iron/blood
16.
Braspen J ; 32(3): 231-234, jul-set. 2017.
Article in Portuguese | LILACS | ID: biblio-906151

ABSTRACT

Introdução: No pós-operatório de pacientes submetidos à cirurgia bariátrica, o comportamento do ferro e ferritina séricos são pouco estudados. O objetivo deste estudo foi avaliar a evolução dos níveis séricos destas variáveis no pós-operatório de pacientes submetidos à cirurgia bariátrica. Método: Estudo retrospectivo incluindo pacientes submetidos à cirurgia bariátrica no período de janeiro de 2011 a dezembro de 2013. Foram excluídos pacientes menores de 18 anos, não submetidos à técnica do by-pass gástrico de Fobi-Capella (em Y-de-Roux) e que não possuíam exame laboratorial no acompanhamento ambulatorial. As variáveis registradas foram sexo, idade, data da cirurgia, hemoglobina, ferro e ferritina. Foram comparados resultados com três, seis e 12 meses de pós-operatório. Utilizou-se o teste T pareado para comparação das dosagens laboratoriais ao longo do tempo. O nível de significância adotado foi de 5% (p<0,05). Resultados: Foram analisados dados relativos a 862 pacientes (573 mulheres; 66,5%) com idade mediana de 36 (18-69) anos. Não houve diferença significante ao longo do tempo estudado em relação à hemoglobina (média (DP)=13,1±1,3 g/dl no 3º mês; 13,1±1,5 g/dl no 6º mês; e 13,0±2,0 g/dl no 12º mês; p>0.05). A dosagem de ferro sérico aumentou progressivamente do 3º para o 12º mês de pósoperatório (3º mês: 82,21±26,61 mcg/dl; 6º mês: 91,42±41,00 mcg/dl e 12º mês: 99,79±38,94 mcg/dl; p<0,001). Contrariamente, houve queda da ferritina sérica ao longo do período estudado (3º mês: 234,43±242,86 ng/ml; 6º mês: 208,46±246,64 ng/ml e 12º mês: 155,21±163,08 ng/ ml;p<0.01). Conclusão: Ferro e ferritina séricos têm variações opostas no pós-operatório tardio de cirurgia bariátrica. Entretanto, essas alterações em paciente recebendo atenção nutricional não foram suficientes para determinar anemia no seguimento de até 1 ano de pós-operatório.(AU)


Introduction: The seric changes of iron and ferritin in patients submitted to bariatric procedure are seldom reported. The aim of this study was to evaluate the evolution of the levels of iron and ferritin during the late postoperative course of patients undergoing bariatric surgery. Method: Retrospective study including patients submitted to bariatric procedure from January 2011 to December 2013 with three months of follow-up. Age less of 18 years-old, procedure other than Fobi-Capella gastric by-pass (Roux-en-Y), previous hematological disorders, and lack of postoperative laboratorial exams were items of exclusion criteria. The following variables were collected: sex, age, date of the surgical procedure, hemoglobin, seric iron and ferritin. The data were collected at 3rd; 6th; and 12th postoperative month. Paired T test were used to compare the evolution of the dosages. A 5% level of significance (p<0.05) was established. Results: We analyzed the data of 862 patients ((573 females; 66.5%) with a median age of 36 (18-69) years-old. There was no difference on the hemoglobin levels along the three-time points (mean (SD)=13.1±1.3 g/dl at 3rd month; 13.1±1.5 g/dl at 6th month; and 13.0±2.0 g/dl at 12th month; p>0.05). The seric iron significantly increased from 3rd to 12th postoperative month (3rd month: 82.21±26.61 mcg/dl; 6th month: 91.42±41.00 mcg/dl and 12th month: 99,79±38,94 mcg/dl; p<0,001). Conversely, there was a fall of the seric ferritin along the study (3rd month: 234.43±242.86 ng/ml; 6th month: 208.46±246.64 ng/ml and 12th month: 155.21±163.08 ng/ml; p<0.01). Conclusion: Serum iron and ferritin have opposite variation during late postoperative of bariatric surgery. However, these alterations in patients receiving nutritional attention were not sufficient to promote anemia in the follow-up of at least one year postoperatively.(AU)


Subject(s)
Humans , Postoperative Care/nursing , Bariatric Surgery , Ferritins/blood , Anemia/blood , Iron/blood , Retrospective Studies
17.
Rev. Bras. Saúde Mater. Infant. (Online) ; 17(3): 511-518, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-1013043

ABSTRACT

Abstract Objectives: to evaluate the neuropsychomotor development and the genomic stability associated to folate and blood iron levels in preschool children. Methods: a cross-sectional study in which evaluated the biochemical exams (complete hemogram, serum ferritin, iron and folate), neuropsychomotor development (Denver II Test) and genotoxicity (micronuclei cytome in buccal mucosa cells) of 55 children aging 36-59 months old. Student´s T test, Kruskal-Wallis and Pearson's or Spearman's correlation tests were applied with a significance level of p<0.05 for data analysis. Results: the prevalence of anemia was 1.8%. The Denver II test classified 32.7% of the children as normal and 67.3% were suspected of having a delay. The children suspected of having a delay presented a slight reduction on hemoglobin and hematocrit (p=0.05 and p=0.14), intermediate reduction on iron and folate (p=0.29 and p=0.23) and a notable reduction on ferritin (p=0.03). Folate and iron were significantly associated to the frequency of cells with DNA damages (p<0.05). The frequency of binucleated cells was positively associated to the Red Cell Distribution Width (RDW) (r=0.56; p=0.02) in children without a delay and negatively with folate (r=-0.334; p=0.047) in children with a delay. Conclusions: this study showed a low prevalence of anemia, but a high rate of children suspected of having a neuropsychomotor, possibly associated to low ferritin levels. Additionally, iron and folate were associated to DNA damage which may have contributed to the psychomotor development delay.


Resumo Objetivos: avaliar o desenvolvimento neuropsicomotor e a estabilidade genômica associados ao folato e ferro sanguíneos em pré-escolares. Métodos: estudo transversal, no qual avaliou-se exames bioquímicos (hemograma completo, ferritina sérica, ferro e folato), desenvolvimento neuropsicomotor (Teste Denver II) e genotoxicidade (citoma de micronúcleos em células bucais esfoliadas) de 55 crianças com 36-59 meses de idade. Para a análise dos dados, empregou-se os testes T de Student, Kruskal-Wallis e correlação de Pearson ou Spearman, com nível de significância de p<0,05. Resultados: a prevalência de anemia foi de 1,8%. Pelo teste de Denver II foram classificadas 32,7% das crianças como normais e 67,3% como suspeita de atraso. As crianças com suspeita de atraso apresentaram pequena redução no hematócrito e hemoglobina (p=0,05 e p=0,14), redução intermediária de ferro e folato (p=0,29 e p=0,23) e redução marcante de ferritina (p=0,03). Ferro e folato associaram-se significativamente com a frequência de células com lesões no DNA (p<0,05). A frequência de células binucleadas associou-se positivamente com Red Cell Distribution Width (RDW) (r=0,56; p=0,02), nas crianças sem atraso e negativamente com folato (r=-0,33; p=0,05), nas crianças com atraso. Conclusões: este estudo mostrou baixa prevalência de anemia, mas elevada taxa de crianças com suspeita de atraso neuropsicomotor, possivelmente associada com baixos níveis de ferritina. Ademais, observou-se associação entre ferro e folato com dano no DNA, o que pode ter contribuído para o atraso neuropsicomotor.


Subject(s)
Child, Preschool , Psychomotor Performance , Child, Preschool , Ferritins/blood , Neurodevelopmental Disorders/blood , Iron/blood , Statistics, Nonparametric , Genomics , Erythrocyte Indices , Hematocrit , Anemia , Mutagenicity Tests
18.
J. pediatr. (Rio J.) ; 93(3): 301-307, May.-June 2017. tab
Article in English | LILACS | ID: biblio-841354

ABSTRACT

Abstract Objective: The aim of this study was to verify the association of echocardiogram, ferritin, C-reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis. Methods: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients aged between 28 days and 18 years. Inclusion criteria were diagnosis of sepsis, need for mechanical ventilation for more than 48 h, and vasoactive drugs. Serum levels of C-reactive protein, ferritin, and leukocyte count were collected on the first day (D0), 24 h (D1), and 72 h (D3) after recruitment. Patients underwent transthoracic echocardiography to determine the ejection fraction of the left ventricle on D1 and D3. The outcomes measured were length of hospital stay and in the pediatric intensive care unit, mechanical ventilation duration, free hours of VM, duration of use of inotropic agents, maximum inotropic score, and mortality. Results: Twenty patients completed the study. Patients with elevated ferritin levels on D0 had also fewer ventilator-free hours (p = 0.046) and higher maximum inotropic score (p = 0.009). Patients with cardiac dysfunction by echocardiogram on D1 had longer hospital stay (p = 0.047), pediatric intensive care unit stay (p = 0.020), duration of mechanical ventilation (p = 0.011), maximum inotropic score (p = 0.001), and fewer ventilator-free hours (p = 0.020). Conclusion: Cardiac dysfunction by echocardiography and serum ferritin value was significantly associated with unfavorable outcomes in pediatric patients with sepsis.


Resumo Objetivo: Verificar a associação do ecocardiograma, da ferritina, da proteína C reativa (PCR) e da contagem de leucócitos com desfechos desfavoráveis na sepse pediátrica. Métodos: Estudo de coorte prospectivo, de março a dezembro de 2014, com pacientes críticos pediátricos entre 28 dias e 18 anos. Critérios de inclusão foram diagnóstico de sepse, necessidade de ventilação mecânica (VM) por mais de 48 horas e uso de drogas vasoativas. Avaliaram‐se os níveis séricos PCR, ferritina, contagem de leucócitos, no recrutamento (D0), 24 horas (D1) e 72 horas (D3) após o recrutamento. No D1 e no D3 todos os pacientes foram submetidos a ecocardiograma transtorácico para determinação da Fração de Ejeção (FE) do ventrículo esquerdo. Os desfechos avaliados foram tempo de internação hospitalar e na Unidade de Terapia Intensiva Pediátrica (UTIP); duração da VM; horas livres de VM; duração do uso de inotrópicos; escore de inotrópicos máximo e mortalidade. Resultados: Vinte pacientes completaram o estudo. Ferritina elevada no D0 associou‐se com menor tempo livre de ventilação (p = 0,046) e maior escore de inotrópicos máximo (p = 0,009). A disfunção cardíaca pelo ecocardiograma no D1 relacionou‐se com maior tempo de internação hospitalar (p = 0,047), de UTIP (p = 0,020), VM total (p = 0,011), escore de inotrópicos máximo (p = 0,001) e menor tempo livre de VM (p = 0,020). Conclusão: A disfunção cardíaca pelo ecocardiograma e o valor de ferritina sérica associaram‐se significativamente com desfechos desfavoráveis nos pacientes pediátricos com sepse.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , C-Reactive Protein/analysis , Echocardiography, Doppler , Sepsis/diagnosis , Ferritins/metabolism , Ferritins/blood , Heart/physiopathology , Echocardiography , Biomarkers/blood , Intensive Care Units, Pediatric , Prospective Studies , Sepsis/complications , Sepsis/physiopathology , Sepsis/blood , Length of Stay , Leukocyte Count
19.
Rev. Assoc. Med. Bras. (1992) ; 63(3): 284-289, Mar. 2017. tab
Article in English | LILACS | ID: biblio-956432

ABSTRACT

Summary Objective: In liver diseases, hyperferritinemia (HYF) is related to injured cells in acquired and genetic conditions with or without iron overload. It is frequent in patients with nonalcoholic fatty liver disease (NAFLD), in which it is necessary to define the mean of HYF to establish the better approach for them. The present study evaluated the significance of elevated ferritin in patients with NAFLD and steatohepatitis (NASH). Method: The review was performed using search instruments of indexed scientific material, including MEDLINE (by PubMed), Web of Science, IBECS and LILACS, to identify articles published in Portuguese, English and Spanish, from 2005 to May, 2016. Studies eligible included place and year of publication, diagnose criteria to NAFLD, specifications of serum ferritin measurements and/or liver histopathologic study. Exclusion criteria included studies with patients with alcohol consumption ≥ 20 g/day and other liver diseases. Results: A total of 11 from 30 articles were selected. It included 3,564 patients and they were cross-sectional, retrospective, case series and case-control. The result's analyses showed in 10 of these studies a relationship between ferritin elevated serum levels and NAFLD/NASH with and without fibrosis and insulin resistance. Conclusion: Hyperferritinemia in patients with NAFLD/NASH is associated more frequently with hepatocellular injury than hemochromatosis. These data suggest the relevance to evaluate carefully HYF in patients with NAFLD/NASH to establish appropriate clinical approach.


Resumo Objetivo: A hiperferritinemia (HPF) está associada à agressão hepatocelular nas doenças do fígado e à sobrecarga de ferro, em doenças genéticas e adquiridas. A HPF é frequente em pacientes com doença hepática gordurosa não alcoólica (DHGNA) e é necessário definir seu significado para estabelecer as melhores condutas para esses indivíduos. Esta revisão avaliou o significado da HPF em portadores de DHGNA e esteato-hepatite não alcoólica (EHNA). Método: A busca de artigos foi realizada através do PubMed (Medline), Web of Science e Lilacs, e foram selecionados aqueles publicados em português, inglês e espanhol de 2005 a maio de 2016. Os artigos foram elegíveis quando informavam data e local da publicação, critérios diagnósticos para DHGNA, especificações das dosagens de ferritina sérica e/ou estudo histopatológico. Foram excluídos os artigos cujos pacientes relataram ingestão alcoólica ≥ 20 g/dia ou eram portadores de outras doenças do fígado. Resultados: Foram selecionados 11 de 30 artigos, totalizando 3.564 pacientes. Os artigos eram de corte transversal, retrospectivos, série de casos e caso-controles. Em dez artigos, observou-se correlação entre alteração de ferritina e DHGNA/EHNA com e sem fibrose hepática e resistência à insulina. Conclusão: Hiperferritinemia em pacientes com DHGNA/EHNA se associa com maior frequência à agressão hepatocelular do que com sobrecarga de ferro hepático. Os resultados da revisão sugerem a necessidade de um maior cuidado na interpretação da elevação da ferritina sérica em pacientes com DHGNA/EHNA para o estabelecimento de condutas clínicas apropriadas.


Subject(s)
Humans , Iron Overload/etiology , Iron Overload/blood , Ferritins/blood , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/blood , Risk Factors , Iron Overload/pathology , Non-alcoholic Fatty Liver Disease/pathology , Iron/blood
20.
Rev. bras. ginecol. obstet ; 39(3): 94-101, Mar. 2017. tab
Article in English | LILACS | ID: biblio-843927

ABSTRACT

Abstract Introduction Anemia is a very frequent event among pregnant women. There are evidences of differences in the incidence of dental caries between pregnant and nonpregnant women, but the relationship between salivary iron (Fe) and serummarkers of anemia and caries development has not been investigated. Objective To evaluate the correlation between salivary (Fe) and serum iron (Fe, ferritin and hemoglobin) parameters in pregnant women with the development of dental caries. Methods A prospective cohort was conducted with 59 women. The outcome of interest was represented by new dental caries lesions during pregnancy, using the Nyvad criteria. Pregnant women were evaluated at three clinical times: up to the 16th week of gestational age (GA) (T1), in the last trimester of pregnancy (T2), and postpartum (T3), at the Mother and Child Unit ofUniversityHospital of the Universidade Federal doMaranhão.A stimulated saliva sample was collected for biochemical analysis of salivary Fe, and a blood sample was collected early in the morning. The correlation between salivary and serum Fe was evaluated through the Pearson correlation test. Analysis of variance (ANOVA) and Kruskal-Wallis were used to compare the means of anemia parameters at different times. The Student's t and Mann-Whitney tests were used to compare the anemia parameters between the groups of pregnant women (with and without new caries lesions). Results SerumFe concentrationswere higher in the first trimester of pregnancy and lower after delivery (p = 0.036). It was also observed that the ferritin concentrations were higher in the first trimester and lower at the end of gestation (p = 0.011). Therewas no association between the expositions of salivary iron and anemia, and the development of dental caries. There was a positive correlation between serum Fe in T1 and salivary Fe in T2 (p < 0.05). Conclusion The serummarkers of anemiaweremore prevalent in the last trimester of pregnancy.


Resumo Introdução A anemia é um evento muito frequente entre mulhres grávidas. Existem evidências de diferenças na incidência de cárie dentária entre mulheres grávidas e não grávidas,mas a relação entre o íon ferro (Fe) salivar, osmarcadores séricos de anemia e o desenvolvimento de cárie não foi investigada. Objetivo Avaliar a correlação entre os parâmetros salivares (Fe) e séricos (Fe, ferritina e hemoglobina) em gestantes e o desenvolvimento de cárie dentária. Métodos Uma coorte prospectiva foi conduzida com 59 mulheres. O desfecho de interesse foi representado por novas lesões de cárie durante a gravidez, medido pelo critério Nyvad. Mulheres grávidas foram avaliadas em três tempos clínicos: até a 16ª semana de idade gestacional (IG) (T1), no último trimestre de gravidez (T2), e no puerpério (T3), na Unidade Materno-infantil do Hospital Universitário da Universidade Federal do Maranhão. A amostra de saliva estimulada foi coletada para análise bioquímica de Fe salivar, e a amostra de sangue foi coletada no início da manhã. A correlação entre o Fe salivar e o Fe sérico foi avaliada através do teste de correlação de Pearson. Os testes ANOVA e Kruskal-Wallis foram utilizados para comparar parâmetros de anemia em diferentes momentos. Os testes t de Student e Mann-Whitney foram utilizados para comparar os parâmetros da anemia entre os grupos de gestantes (come sem lesões de cárie). Resultados As concentrações séricas de Fe foram maiores no primeiro trimestre de gestação e menores após o parto (p = 0,036). Observou-se também que as concentrações de ferritina forammaiores no primeiro trimestre emenores no final da gestação (p = 0,011). Não houve associação entre as exposições e o desenvolvimento de cárie dentária. Houve correlação positiva entre o Fe sérico em T1 e o Fe salivar em T2 (p < 0,05). Conclusão Os marcadores séricos de anemia foram mais prevalentes no último trimestre de gestação.


Subject(s)
Humans , Female , Pregnancy , Anemia/blood , Dental Caries/blood , Ferritins/blood , Hemoglobins/analysis , Iron/analysis , Saliva/chemistry , Biomarkers/blood , Dental Caries/epidemiology , Iron/blood , Prospective Studies , Risk Factors , Self Report
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