Alarmingly high prevalence of obesity in haemophilia in the state of Mississippi.

The state of Mississippi has consistently been ranked as the state with most number of obese people in the United States with prevalence rates of >30%. Our aims in this study were to estimate the prevalence of overweight and obesity in children and adults diagnosed with haemophilia in Mississippi, and to assess whether race/ethnicity and the severity of haemophilia are important risk factors. A retrospective chart review was performed for all haemophilic patients seen at the Mississippi Hemophilia Treatment Center. Patients were classified into two major age groups: age 2-19.9 years and > or =20 years. Body mass index (BMI) was calculated from the height and weight in kg m(-2) from the last clinic visit. Out of a total of 132 haemophilic patients, 61% were white and 37% were African American. Overall, 51% of the haemophilic patients were either obese or overweight. The prevalence of obesity in the adult (> or =20 years old) haemophilic patients was 36% and an additional 32% were overweight. A significantly greater proportion of patients >20 years old were overweight or obese as compared with the patients in the 2-19.9 year age range (P < 0.002). However, race/ethnicity and severity of haemophilia were not significant risk factors for overweight and obesity. There is a very high prevalence of obesity in the Mississippi haemophilic population, especially in adults. Particular attention at clinic visits should be paid to the BMI in order to identify patients that are overweight or obese to allow for early and appropriate intervention.

Specificity of hematopoietic stem cell homing.

Homing of hematopoietic stem cells (HSC) may be defined as the cells' ability to seek marrow stroma selectively, to interact with it and subsequently to lodge within it to initiate hematopoiesis. This complex process is no doubt mediated through multiple recognition/adhesion events. Homing may proceed through one of several alternative mechanisms, however, such as through physical trapping of stem cells by marrow ultrastructural elements or through the providing of a selective survival and/or proliferative advantage by marrow. A third alternative that provides for the central element of stem cell homing--its high degree of specificity--is through the action of a specific homing protein in HSC. There are data to support this latter mechanism of stem cell homing as the correct one, and the nature of this protein may be similar to that of the lymphocyte homing receptors that are lectin-like molecules. Lectin-carbohydrate interactions are known to provide enormous specificity to cell recognition processes and to participate in cellular targeting. Leukemic cells have recently been demonstrated to home to marrow stroma and proliferate in the same way as normal stem cells. Thus, identification of proteins or other adhesion molecules that participate in normal and malignant cell homing could lead to more specific recruitment regimens for tumour-free collections.

Clinical characteristics of children with hereditary hemolytic anemias and aplastic crisis: a 7-year review.

We reviewed the clinical courses of children < or = 16 years of age with hereditary hemolytic anemias who were admitted to the University of Mississippi Medical Center for aplastic crisis. Constitutional signs, gastrointestinal complaints, and headache were the most frequent findings. Statistically significant decreases in hemoglobin levels, hematocrit, and reticulocyte counts, but not total white blood cell or platelet counts, were found on admission when compared to other times of determination. For 27 of 49 patients, IgM antibody determinations to human parvovirus (B19) were available, and 15 (56%) had positive values. We conclude that erythroid (but not other) blood cell lines are helpful in establishing a clinical diagnosis, and that both acute and convalescent titers are necessary to assess the immune response to the infection. Physicians should continue to search for agents other than B19 parvovirus in patients in whom B19 antibodies cannot be found.