Glutathionyl hemoglobin is elevated in iron deficiency anemia.

There are few good biomarkers of iron deficiency anemia (IDA). Since IDA patients have evidence for increased oxidative stress, we used mass spectrometry (MS) [i.e. matrix-assisted laser desorption/ionization (MALDI) and electrospray ionization] to identify novel biomarkers. Using MALDI-MS, the following oxidative modifications of hemoglobin with the following mass-to-charge ratios were identified: 1,087.5 (α32-40), 1,545.7 (α17-31), 1,290.0 (ß31-40) and 2,076.1 (ß41-59). On electrospray ionization MS, the IDA patients had significantly elevated glutathionyl hemoglobin (GSHb) compared with the controls (16.9 ± 9.6 vs. 7.7 ± 3.7%; p = 0.002). GSHb levels correlated inversely with serum ferritin (Spearman rho -0.485; p = 0.003) and positively with serum transferrin receptor (0.460; p = 0.002). GSHb also demonstrated inverse correlations with hemoglobin (-0.512; p = 0.001), mean cell volume (-0.419; p = 0.026), serum iron (-0.446; p = 0.008) and transferrin saturation (-0.460; p = 0.008). For the first time, we show that GSHb is elevated in patients with IDA and has potential as a biomarker of this form of anemia.

Substance abuse during pregnancy: effect on pregnancy outcomes.

OBJECTIVE: To determine the contribution of drug use to maternal and perinatal complications, controlling for social confounders. STUDY DESIGN: This is a retrospective cohort study of 247 drug-using women and 741 controls over a 4-year period from 1997 to 2000. Cases were identified from the drug dependency register. Three controls for each woman with substance abuse were selected from the delivery suite records, with calliper matching by year of delivery (any control patient who delivered within 6 months before or after the date of delivery of a drug-using woman was considered as a potential match) and district of residence (post code). The primary outcomes of interest were preterm birth, abruption, pre-eclampsia, intrauterine growth restriction and low birth weight. RESULTS: There were statistically significantly more preterm births amongst drug-using women (relative risk (RR) 2.5, 95% confidence interval (CI) 1.6-3.8), with preterm births complicating 25% of births amongst drug users. The incidence of low birth weight was 30.8% amongst drug-using women compared to 8% in control women (RR 3.6, CI 2.4-5.4), and the incidence of growth restriction was 25%, significantly higher than the control group (RR 3.82, CI 2.4-6.1). The risk of abruption was also higher (RR 2.74, CI 1.1-7.0). Of note is the extremely low incidence of pre-eclampsia among drug users, even after controlling for the confounder effects of parity and smoking. CONCLUSIONS: Despite multidisciplinary co-ordinated antenatal care, women with substance abuse during pregnancy are at significant risk of adverse obstetric and perinatal outcome, controlling for social confounders. A limitation of the study is that the sample size was not large enough to clearly assess individual drugs. This is the first study to highlight low incidence of pre-eclampsia among drug users over and above the effect of smoking. Further research is needed to elucidate the underlying biological reason for the lack of pre-eclampsia in women with substance abuse during pregnancy.

Qualidade microbiológica do leite refrigerado nas fazendas / Microbiological quality of refrigerated milk on farms

Avaliaram-se a qualidade microbiológica do leite obtido mecanicamente e refrigerado durante 48 horas, em 24 rebanhos, e a associação entre a contaminação microbiana e os procedimentos de higienização dos equipamentos de ordenha e armazenamento do leite. Os procedimentos de higiene foram avaliados in loco com auxilio de questionários. Foram realizadas a contagem padrão em placas, a contagem de coliformes totais e a pesquisa de Staphylococcus aureus e Streptococcus agalactiae. No leite de 14 rebanhos, foram pesquisadas Salmonella spp. e Listeria monocytogenes. As médias geométricas da contagem padrão foram <1,0×10(6) UFC/ml em 20 rebanhos, e <7,5×10(5) UFC/ml em 19. Onze rebanhos apresentaram contagem média de <1,0×10(5) UFC/ml. Contagens médias de coliformes >10³ UFC/ml foram verificadas em sete rebanhos. S. aureus e S. agalactiae foram isolados em 22 e 12 dos 24 rebanhos, respectivamente, e não foram encontradas Salmonella spp. e L. monocytogenes. O uso de detergentes alcalino e ácido, mais o de sanitizante foi associado (P<0,05) à contagem padrão <1,0×10(5), e o emprego de apenas um ou de nenhum produto foi associado a contagens >5×10(5) UFC/ml.

The effect of bulk tank and milking machine cleaning procedures (determined from a questionnaire) on bacterial contamination of 48-hour refrigerated milk was examined in 24 herds. Milk samples were analyzed for standard plate count (SPC) and for total coliform, Staphylococcus aureus and Streptococcus agalactiae contamination. Milk samples from 14 herds were cultured for Salmonella and Listeria monocytogenes. Geometrical means of SPC were <1.0×10(6) UFC/ml in 20 herds, <7.5×10(5) UFC/ml in 19 herds and <1.0×10(5) UFC/ml in 11 herds. Geometrical means >10³ UFC/ml of total coliforms were observed in seven herds. S. aureus and S. agalactiae were found in 22 and 12 herds, respectively. Salmonella and L. monocytogenes were not found in any of the samples. The use of alkaline and acid detergents plus sanitizing was associated (P<0.05) with SPC <1.0×10(5), and the use of either alkoline or acid detergent or sanitizing or no chemical product was associated with SPC >5.0×10(5) UFC/ml.

Artroplastia total do quadril em espondilite anquilosante. / Total arthroplasty of the hip in ankylosing spondylitis

Os autores apresentam revisao de 19 quadris acometidos por espondilite anquilosante tratados pela artroplastia total. Os resultados mostraram que o procedimento cirurgico produz alivio da dor no quadril e mesmo na columa em presenca de coxofemoral anquilosado, melhora da marcha e funcao e uma restauracao ampla e permanente da mobilidade