ABSTRACT
Hemolysis is a clinical entity, which can be severe. It is commonly of multifactorial etiology. The activity of a specialist in transfusion medicine consists in treating the patient with transfusion support in case of severe anemia. If the etiology is partly alloimmune this therapeutic strategy is more arduous. Immunohematological work-up must be very rigorous to ensure transfusion management with utmost safety. However, without the precise knowledge of both the clinical condition and the treatment (current and past) of the patient, such management is impossible.
Subject(s)
Anemia , Transfusion Reaction , Blood Transfusion , Hemolysis , HumansABSTRACT
Iron deficiency is generally investigated when faced with anemia, or with symptoms that could be related to iron deficiency without anemia. This simple disorder is easy to treat, provided that the diagnosis is correct. Several biological tests are available, but their interpretation is oftentimes problematic. Pre-analytical factors can interfere with measurements, normal values can change depending on suppliers, and, above all, results from different markers can be contradictory in some clinical situations. The aim of this article is to evaluate how the evolution of scientific knowledge and clinical trials can contribute to a better understanding and greater reliability in the diagnosis of iron deficiency.
Subject(s)
Anemia, Iron-Deficiency/diagnosis , Ferritins/blood , Iron/blood , Trace Elements/blood , Transferrins/blood , Alleles , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/genetics , Anti-Bacterial Agents/blood , Antimicrobial Cationic Peptides/blood , Biomarkers/blood , Clinical Trials as Topic , Diagnosis, Differential , Erythrocyte Count , Erythrocyte Indices , Hematocrit , Hemoglobins/metabolism , Hepcidins , Humans , Mutation , Platelet Count , Polymorphism, Single Nucleotide , Predictive Value of Tests , Randomized Controlled Trials as Topic , Receptors, Transferrin/blood , Receptors, Transferrin/genetics , Sensitivity and SpecificityABSTRACT
Should we treat iron deficiency without anemia? The simple fact that the question can be formulated already leads to controversies. During the past years, the development of a new formulation of intravenous iron has helped fuel the controversy. What is the situation in 2012? This article gives a practical point of view on the actual situation and provides indications on the use of new intravenous medications.
Subject(s)
Drug Design , Iron Compounds/therapeutic use , Iron Deficiencies , Anemia, Iron-Deficiency/drug therapy , Humans , Infusions, Intravenous , Iron/administration & dosage , Iron Compounds/administration & dosageABSTRACT
In 546 officials the arterial blood pressure was measured twice at the beginning and at the end of a working day, filling also an inquiry form. As hypertension systolic BP over 160 mm Hg (21.3 kPa) or more, and diastolic BP 96 mm Hg (12.7 kPa) or more were accepted. In 90 subjects (16.5%) above normal pressure values were found. Hypertension had been diagnosed previously in 50 subjects in this group (55.5%) but only 13 of them (26%) were treated systematically. Excessive stress of work was complained of by 62.6% of the subjects. Increased blood pressure was found significantly more frequently in the group perceiving excessive stress of work (19.9%) as compared to those not experiencing this stress (10.8%, p less than 0.1). In the group in managerial posts these proportions were 24.8% and 14.4% respectively (p less than 0.1). Blood pressure rise to abnormal levels during the working day occurred also significantly more frequently in the group experiencing it this was noted only in 1.6% of cases (p less than 0.5). The knowledge of own hypertension was very low in this group. These results indicate the necessity of increasing prophylactic measures in the form of greater frequency of control measurements of the blood pressure, better health education, and limitation of stress situations in working environment.
