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Chinese Journal of Hematology ; (12): 408-412, 2023.
Article in Chinese | WPRIM | ID: wpr-984637


Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

Male , Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Anemia, Iron-Deficiency/epidemiology , Sucrose/therapeutic use , Ferric Compounds/therapeutic use , Retrospective Studies , Iron/therapeutic use , Hemoglobins/therapeutic use
Journal of Experimental Hematology ; (6): 1831-1837, 2023.
Article in Chinese | WPRIM | ID: wpr-1010046


OBJECTIVE@#To observe the variability of hemoglobin (HB) level in patients with renal anemia, and to analyze its relationship with effect of repeated blood transfusion therapeutic in patients.@*METHODS@#A retrospective cohort study and propensity score matching method were used, 60 patients with renal anemia who had effective treatment with repeated blood transfusion in Changzhou No.2 People's Hospital from May 2018 to May 2021 were retrospectively analyzed and set as the effective group; 153 patients with renal anemia who had ineffective treatment with repeated blood transfusion in the hospital in the same period were collected and set as the ineffective group, the propensity score matching method was used, the patients who were effective and ineffective in repeated blood transfusion were matched 1∶1 for analysis; the medical records and laboratory indexes of the two groups were checked; the Hb level of patients within 6 months (1/month) were recorded, the residual standard deviation (Res-SD) of Hb of patients was calculated according to the Hb level and evaluated the variability of Hb level; the relationship between HB variability level and therapeutic effect of repeated blood transfusion in patients with renal anemia was analyzed.@*RESULTS@#After propensity score matching, there was no statistical significant difference between the two groups in terms of baseline data such as age, sex, dialysis age and BMI (P>0.05). The levels of serum albumin and transferrin of patients in the ineffective group were significantly lower than those of patients in the effective group (P<0.05); at 1 and 2 months of the observation period, there was no statistical significant difference in Hb levels of patients in both groups (P>0.05); the Hb level of patients in the ineffective group was significantly lower than that of patients in the effective group at 3, 5 and 6 months, and significantly higher than that of patients in the effective group at 4 months (P<0.05); the Res-SD of male patients and female patients in the ineffective group were respectively significantly higher than that of male patients and female patients in the effective group (P<0.05). Logistic regression analysis results showed that high variability of Hb level (Res-SD) was a risk factor for the ineffective treatment of repeated blood transfusion in patients with renal anemia (OR>1, P<0.05); the decision curve results showed that, when the high-risk threshold was 0.0-1.0, Res-SD predicted the net benefit rates of male and female patients with renal anemia were greater than 0, which was clinically significant, the smaller the high-risk threshold in the above range, the greater the net benefit rate.@*CONCLUSION@#The therapeutic effect of repeated blood transfusion in patients with renal anemia may be related to the variability of Hb level.

Humans , Male , Female , Retrospective Studies , Hemoglobins/therapeutic use , Anemia/therapy , Chronic Disease , Blood Transfusion , Kidney Diseases
Journal of Experimental Hematology ; (6): 481-486, 2022.
Article in Chinese | WPRIM | ID: wpr-928740


OBJECTIVE@#To investigate the prognostic value of hemopoietic scoring system composed of hemoglobin (HB), platelet count (PLT) and mean corpuscular volume (MCV) in MM patients and its correlation with curative effect.@*METHODS@#The clinical data of 172 newly diagnosed MM patients treated by bortezomib as the first-line regimen in our hospital from May 2014 to December 2019 were collected, three variables (HB≤100 g/L, PLT≤150×109/L, MCV≥96 fl) were introduced, each variable was distributed 1 score, the patients were divided into four groups (0, 1, 2 and 3 points in group 1, 2, 3 and 4, respectively), and the clinical characteristics and prognosis of the patients in the four groups were analyzed. The initial efficacy evaluation after 3-4 courses of treatment was carried out, and the curative effect of the patients in the different hematopoiesis score groups were compared.@*RESULTS@#The median OS time of the patients in group 1, 2, 3 and 4 was 27.0, 22.5, 20.7 and 18.1 months, while the median PFS time were 23.0, 19.0, 18.0 and 14.0 months, respectively. The OS and PFS of the patients in low score group were significantly better than those in high score group (P=0.045, P=0.048). There was no significant difference in the curative effect of the patients treated by bortezomib after 3-4 courses (P>0.05).@*CONCLUSION@#Hematopoiesis score can preliminarily predict the overall survival of newly diagnosed MM patients, but there is no significant difference between different scoring groups in the initial curative effect.

Humans , Bortezomib/therapeutic use , Erythrocyte Indices , Hemoglobins/therapeutic use , Multiple Myeloma/diagnosis , Prognosis , Retrospective Studies
São Paulo; s.n; s.n; set. 2015. 96 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-834105


A transfusão de sangue é uma intervenção terapêutica capaz de salvar muitas vidas. Entretanto, transfusões também apresentam uma alta gama de possíveis eventos adversos, questões logísticas, econômicas e sociais. Dentre as principais preocupações terapêuticas estão a incompatibilidade (principalmente do sistema ABO), a transmissão de microrganismos patogênicos, os distúrbios imunomodulatórios, as reações hemolíticas, o aumento estatístico do risco de morte proporcional ao volume de sangue infundido, dentre outros. Diversas alternativas às transfusões sanguíneas são propostas na literatura científica, dentre elas o desenvolvimento de transportadores de oxigênio que utilizam a hemoglobina, comumente intitulados substitutos sanguíneos. Neste âmbito, o presente estudo teve como objetivo o desenvolvimento de uma rota de síntese e a síntese de partículas de gelatina contendo hemoglobina polimerizada. Para tanto, realizou-se a síntese do polietileno glicol bis-[succinimidil succinato], extraiu-se e polimerizou-se com glutaraldeído ou polietileno glicol bis-[succinimidil succinato] hemoglobina de sangue bovino e, partículas de gelatina coriácea ou óssea contendo hemoglobina polimerizada foram sintetizadas e caracterizadas. A síntese do polietileno glicol bis-[succinimidil succinato] (SSPEG) foi caracterizada por espectroscopia RAMAN, análise diferencial de calorimetria (DSC) e os resultados obtidos indicaram o sucesso das reações. O produto da reação de polimerização da hemoglobina e albumina com o SSPEG foi verificado por SDS-PAGE e os resultados obtidos indicaram a formação com sucesso de polímeros de alta massa molecular. As partículas contendo hemoglobina polimerizada geradas com gelatina coriácea apresentaram diâmetro hidrodinâmico de 1370 nm, dispersividade de 0,029 e potencial zeta de -36,1 mV. As partículas contendo hemoglobina polimerizada geradas com gelatina óssea apresentaram diâmetro hidrodinâmico de 438 nm, dispersividade de 0,563 e potencial zeta de -24,5 mV. Os resultados obtidos sugerem a aplicabilidade da gelatina coriácea para a produção de partículas contendo hemoglobina polimerizada com possível aplicação como transportador de oxigênio

Blood transfusion is a therapeutic intervention that can save many lives. However, transfusion is also related to several possible adverse therapeutic events and logistic, economic and social concerns. Among the major therapeutic concerns are incompatibility (mainly of the ABO group system), pathogenic microorganisms' transmission, immunomodulatory disturbances, hemolytic reactions, death risk increase that is proportional to the infused volume, among others. Several alternatives to blood transfusion are proposed in the scientific literature. Among them is the development of hemoglobin based oxygen carriers, commonly entitle blood substitutes. To this extent, the present work aimed to develop a synthetic route and to synthesize gelatin particles containing polymerized hemoglobin. To this purpose PEG bis(succinimidyl succinate) was synthesized, bovine hemoglobin was extracted and polymerized with glutaraldehyde or PEG and polyhemoglobin contained particles of gelatin from leather or bones were synthesized and characterized. PEG bis(succinimidyl succinate) synthesis was characterized by RAMAN spectroscopy and by differential scanning calorimetry (DSC) and the obtained results indicated the successful synthesis. The reaction product of the polymerization of hemoglobin or albumin with PEG was verified by SDS-PAGE and the results indicated the successful formation of high molecular mass polymers. The particles generated with leather gelatin and polyhemoglobin had a hydrodynamic diameter of 1370 nm, dispersity of 0.029 and zeta potential of -36.1 mV. Particles generated with bone gelatin and polyhemoglobin had hydrodynamic diameter of 438 nm, dispersity of 0.563 and zeta potential of -24.5 mV. The obtained results suggest the applicability of leather gelatin for the production of polyhemoglobin containing particles aiming to the development of a hemoglobin based oxygen carrier

Blood Transfusion , Hemoglobins/therapeutic use , Therapeutic Uses , Polyethylene Glycols/pharmacology , Artificial Organs , Biotechnology/standards , Gelatin/pharmacology
Int. braz. j. urol ; 41(4): 690-696, July-Aug. 2015. tab, graf
Article in English | LILACS | ID: lil-763057


ABSTRACTPurpose:To evaluate the clinical value of computed tomography angiography (CTA) in reducing the risk of hemorrhage associated with mini-percutaneous nephrolithotomy (PCNL).Materials and Methods:A total of 158 patients with renal or ureter stones who had undergone mini-percutaneous nephrolithotomy were retrospectively enrolled into this study from May of 2011 to April of 2014. Group 1 (65 patients) underwent computed tomography angiography, and Group 2 (93 patients) underwent non-contrast CT. The clinical characteristics of the patients and hemorrhagic complications were recorded. The hematologic complications (transfusion rate, and preoperative and postoperative hemoglobin values) were assessed.Results:There were no statistically significant differences in age, body mass index(BMI), stone diameter, operative time, stone-free rate, and hospital stay between the 2 groups. In group 2, 1 patient (1.1%) developed a renal arteriovenous fistula and was treated with embolus therapy. In addition, Group 2 showed significantly drop in hemoglobin (3.6 g/dL vs. 2.4 g/dL, respectively; P <0.001) and more transfusions (9.7% vs. 1.5%, respectively; P <0.05) compared with Group 1.Conclusion:The study showed that patients who underwent computed tomography angiography prior to percutaneous nephrolithotomy had lower drop of hemoglobin and needed less transfusions. These findings may suggest that the use of computed tomography angiography may reduce the risk of bleeding during percutaneous nephrolithotomy.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Hemorrhage/etiology , Hemorrhage/therapy , Kidney/blood supply , Nephrostomy, Percutaneous/adverse effects , Tomography, Emission-Computed , Angiography/methods , Blood Transfusion/statistics & numerical data , Contrast Media , Hemoglobins/analysis , Hemoglobins/therapeutic use , Kidney Calculi/therapy , Operative Time , Postoperative Hemorrhage , Retrospective Studies , Risk Factors
São Paulo med. j ; 127(2): 97-100, May 2009.
Article in English | LILACS | ID: lil-518409


Fluid resuscitation is intended to eliminate microcirculatory disorders and restore adequate tissue oxygenation. The safety limits for a restrictive transfusion policy are given by patients' individual tolerance of acute normovolemic anemia. Artificial oxygen carriers based on perfluorocarbon or hemoglobin are attractive alternatives to allogenic red blood cells. There are many risks involved in allogenic blood transfusions and they include transmission of infections, delayed postoperative wound healing, transfusion reactions, immunomodulation and cancer recurrence. Regardless of whether artificial oxygen carriers are available for routine clinical use, further studies are needed in order to show the safety and efficacy of these substances for clinical practice.

Os fluidos de ressuscitação são utilizados para abolir os distúrbios microcirculatórios e restaurar a adequada oxigenação tissular. Os limites de segurança na prática da transfusão restrita são dados pela tolerância individual do paciente na anemia normovolêmica aguda. Os transportadores artificiais de oxigênio baseados no perfluorocarbono e na hemoglobina são opções atrativas para a transfusão alogênica de células vermelhas. Os riscos da transfusão sanguínea alogênica são muitos e incluem a transmissão de infecções, retardo na cicatrização pós-operatória, reações transfusionais, imunomodulação e risco de recorrência do câncer. Independentemente de os carreadores artificiais de oxigênio estarem disponíveis para o uso clínico rotineiro, mais estudos são necessários para mostrar a segurança e a eficácia dessas substâncias na prática clínica.

Humans , Blood Substitutes/therapeutic use , Blood Transfusion/methods , Fluorocarbons/therapeutic use , Hemoglobins/therapeutic use , Oxygen/metabolism , Hemodilution
Rev. argent. anestesiol ; 62(4): 261-283, jul.-ago. 2004. tab, graf
Article in Spanish | LILACS | ID: lil-411707


La mayoría de las transfusiones de sangre se efectúan durante una operación, por lo cual todo lo relacionado con el manejo de ella es relevante para el anestesiólogo. Esto adquiere importancia especialmente durante la anestesia y la cirugía, cuando ocurre una alteración de la fisiología normal del paciente; en estas situaciones pueden estar ausentes (en especial durante anestesia general), o al menos ser difíciles de interpretar, los síntomas y signos de una inadecuada provisión de oxígeno a los tejidos. En este trabajo presentamos las alternativas con que se enfrenta el anestesiólogo frente al paciente sangrante, y las condiciones o los criterios para la utilización de la sangre o sus sustitutos -sobre todo la posibilidad de utilizar soluciones libres de hematíes (hemoglobina libre del estroma de los glóbulos rojos). Además nos referimos a las soluciones fluoradas como transportadores de oxígeno, sustitutas de la hemoglobina. Analizamos también los problemas secundarios a la transfusión masiva y sus complicaciones más frecuentes.

Humans , Anemia/complications , Surgical Procedures, Operative , Surgical Procedures, Operative/adverse effects , Blood Transfusion/adverse effects , Blood Transfusion/methods , Blood Transfusion/standards , Blood Component Transfusion/methods , Erythropoietin , Fluorocarbons/therapeutic use , Hemodilution , Hemoglobins/therapeutic use , Oxygen Transfer , Oxyhemoglobins , Blood Substitutes/administration & dosage , Blood Substitutes/therapeutic use
Rev. chil. nutr ; 27(3): 340-4, dic. 2000. tab, graf
Article in Spanish | LILACS | ID: lil-284971


En Chile la prevalencia de anemia por deficiencia de hierro de preescolares, escolares, adolescentes, hombres adultos y mujeres en edad fértil es baja. Sólo los lactantes y las embarazadas presentan una prevalencia significativa de anemia. Es altamente probable que la fortificación de la harina de trigo con hierro han influido en el mejoramiento del estado de nutrición de hierro de aquellos grupos etáreos de la población chilena que consume pan. La fortificación de la leche con hierro y ácido ascórbico es una efectiva estrategia para la prevención de la deficiencia de hierro en el lactante. Desde fines de 1998 el Programa Nacional de Alimentación Complementaria (PNAC) está entregando a los lactantes y embarazadas una leche completa en polvo fortificada con 10 mg de Fe, 5 mg de Zn, 0,5 mg de Cu y 70 mg de ácido ascórbico por 100 g de polvo. El objetivo de este programa es reducir la prevalencia de anemia en el lactante de un 27 - 30 por ciento a menos de un 5 por ciento

Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Food, Fortified/analysis , Iron, Dietary/administration & dosage , Anemia, Iron-Deficiency/epidemiology , Anemia, Iron-Deficiency/prevention & control , Hemoglobins/therapeutic use
Arch. Hosp. Vargas ; 41(1/2): 43-7, ene.-jun. 1999. graf
Article in Spanish | LILACS | ID: lil-259251


Serendipidad (Serendipity), palabra inventada por Horace Walpole, escritor inglés del siglo XVIII y relación con los "tres príncipes del Serendip" (antiguo nombre del Ceilán). En medicina expresa un descubrimiento logrado por accidente o casualidad. Sería la acción de descubrir algo mientras se busca otra cosa. Esta situación se produjo en relación al descubrimiento de la utilidad clínica de la determinación de hemoglobina glicosilada (HbG) por Rabhar en 1968; cuando investigando hemoglobinopatías anormales en poblaciones de Irán, encontró dos pacientes diabéticos con niveles elevados de HbG "serendipity". El hallazgo fue confirmado posteriormente al estudiar otros 47 casos. El presente es un trabajo descriptivo; en el que reportamos el hallazgo casual de diversas hemoglobinopatías en 437 pacientes diabéticos en quienes se estudiaba la calidad del control metabólico a través de la determinación del HbG, por el método de electroforesis de proteínas en agar gel a pH 6,1. De 437 pacientes, 13 de ellos (3 por ciento) presentaron hemoglobinopatías de diferentes tipos. Conformado este grupo por 8 pacientes (61 por ciento) del sexo femenino y 5 pacientes (39 por ciento) del sexo masculino, con un promedio de edad de 42.3 años y un valor promedio de HbG de 15 por ciento, 10 pacientes (77 por ciento) presentaron rasgo falciforme (HbSA), 1 paciente (7,7 por ciento) anemia falciforme (HbSS) y 2 pacientes (15,3 por ciento), rasgo talasémico (HbAA)

Humans , Male , Female , Adolescent , Adult , Diabetes Mellitus/pathology , Diabetes Mellitus/prevention & control , Diabetes Mellitus/therapy , Hemoglobinopathies/prevention & control , Hemoglobinopathies/therapy , Hemoglobins/administration & dosage , Hemoglobins/therapeutic use