Diagnosis, treatment, and work impact of iron deficiency anemia in a Portuguese urban community.

INTRODUCTION: Little is known about iron deficiency anemia (IDA)'s treatment in Portugal. We aim to estimate the proportion of anemia, IDA, and iron deficiency without anemia; characterize the diagnostic procedures and prescription patterns; assess anemia's impact over work absenteeism, in a Local Health Unit. MATERIAL AND METHODS: Cross-sectional study that evaluated complete blood counts, iron-containing prescriptions, comorbidities, economic failure, and disability certificates issued in 2015 at the Local Health Unit. RESULTS: We evaluated 62,794 complete blood count. The proportion of anemia was 16.5%, higher in patients with economic failure, pregnant women, and patients with congestive heart failure. Of the patients with anemia 87.8% had not serum iron and/or ferritin dosing, and of those with serum iron/ferritin levels tested 50.6% had IDA. IDA was higher in pregnant women, women aged ≥15 years and in patients with congestive heart failure. Approximately 56.2% of patients with IDA did not receive iron-containing medication, and in 38% of the cases the prescribed dose was subtherapeutic. Of the total iron prescriptions 44.1% were association therapies. Anemia accounted for 5.2% of the disability certificates issued in 2015 (1749 workdays lost). DISCUSSION: Most patients with anemia are not being adequately evaluated and a major proportion does not undergo treatment or has subtherapeutic doses of iron. These results may explain the anemia's impact on work capacity. CONCLUSION: This is one of the largest studies on anemia in Portugal. An effort to adapt to the established recommendations is urged, to minimize the consequences of this disease.

Under what conditions would people be willing to make a living organ donation?

The aim was to examine the factors involved in people's willingness to make a living organ donation. A convenience sample of 200 people in southern France rated willingness to be a living donor in 48 scenarios consisting of all combinations of five factors: recipient's identity (close family member and city resident); donor's surgical risk (little and some); donor's possible long-term health consequences (none, some lessening over time, and durable); transplant success ("generally durably successful" and "durably successful one time out of two"); and likelihood of other donors (subject is one of the rare compatible donors or one among others). Cluster analyses showed the existence of three distinct organ donation philosophies. For the largest cluster (49% of participants), willingness to donate was very high to a family member, but low to a city resident. For the second cluster (37%), willingness was high to family, but also moderately high to a city resident. For the third cluster (14%), willingness was always low. Thus, most participants judged themselves ready to make a living organ donation to a family member and many even to a stranger.