Anemia in COPD patients and its relation to serum levels of erythropoietin

Although chronic obstructive pulmonary disease [COPD] is traditionally associated with polycythemia, its systemic inflammatory components can interfere with erythropoietin and result in anemia of chronic disease. We assessed the frequency of anemia and its relation to serum erythropoietin [EPO] levels and severity of the disease in a group of COPD patients. Eighty patients with the mean age of 66.48 +/- 11.55 years and mean forced expiratory volume in first second [FEV1] of 45.14 +/- 16.88% predicted were enrolled in this study. Severity of the disease was defined according to the global initiative for chronic obstructive lung disease [GOLD] guidelines. Hemoglobin and erythropoietin levels were assessed in all patients. Anemia of chronic disease was present in 13 of 80 patients [16%]. The mean serum levels of EPO were 59 +/- 203 [SD] micro/l and 70.3 +/- 255 [SD] micro/l in anemic and nonanemic COPD patients, respectively. There was no significant difference between the two groups [p=0.13]. A significant correlation was seen between hemoglobin and serum EPO in all COPD and nonanemic patients [r = - 0.86, p < 0.001 and r = - 0.28, p = 0.02]. No significant correlation was seen between hemoglobin and serum erythropoietin levels in the anemic group [r = 0.07, p = 0.82]. This study showed that anemia occurred relatively frequently in COPD patients. In addition to erythropoietin resistance, other factors are probably involved in the pathogenesis of anemia in these patients

[Incidence of hearing abnormality in neonate hospitalized in neonate intensive care unit]

Risk factors including asphyxia, meningitis, form of delivery, etc may cause hearing loss in neonates results in speech and language deprivation, emotional and educational problems. The aim of this study was to determine the prevalence of hearing loss and its relationship with risk factors among neonates hospitalized in neonate intensive care unit [NICU]. It was a cross-sectional study on 234 NICU hospitalized neonates in Ghaem and Imam-Reza hospitals of Mashhad. Epidemiologic and pathologic information were obtained. Otoacoustic emissions were done in all of neonates. Patients referred to the second otoacoustic emissions [OAEs] and patients failed in the second test controlled by auditory brainstem response [ABR]. Hearing abnormality was found in 11 neonates [4.7%] including 2 girls and 9 boys. [1 neonate with mild, 2 with mild to moderate, 2 with moderate to severe, 1 with sever to profound hearing loss and 4 with auditory neuropathy]. Hearing abnormality has a significant greater incidence in group with apgar 5, so, a comprehensive hearing screening program must be applied for early identification and intervention