Daisy Asiimwe, Isaac Bangi, Jospeh Esanyu, Daniel Ojok, Benedict Okot, Clinton Olong, Robert Wagubi, Godfrey Kisembo, Fred Sempijja, Enoch Muwanguzi, Benson Okongo
Purpose: To determine the prevalence of anemia and its association with Helicobacter pylori infection among adult dyspeptic patients.
Patients and methods: A cross-sectional study was conducted among 283 dyspeptic patients at Kiryandongo General Hospital, in Uganda. A structured questionnaire was administered to capture demographic and clinical characteristics of study participants. Four milliliters of blood were then collected into an EDTA vacutainer for Complete Blood Count (CBC) and analyzed using HUMA COUNT 30TS, and peripheral blood smears were made and stained using Giemsa stain. Anemia was defined as hemoglobin levels <12g/dl in females and <13g/dl in men according to the World Health Organization (WHO). Helicobacter pylori (H. pylori) stool antigen test was performed using Whole power H. pylori Ag rapid test device, and saline stool preparation was examined for intestinal parasites. Chi-squared test and Logistic regression were performed to determine association, and a p-value of ≤0.05 was considered statistically significant.
Results: The overall prevalence of Helicobacter pylori infection was 42.4% (120/283). The prevalence of anemia among H. pylori-infected patients was 25.8% (31/120) and 15.3% (25/163) among H. pylori-negative counterparts. H. pylori infection was significantly associated with anemia (p-value 0.042), age (p-value 0.02, 0.009), water sources (p-value 0.0049,) and intestinal parasitic infestation (p-value 0.02), respectively.
Conclusion: This study has shown that the prevalence of H. pylori infection and anemia is high among dyspeptic patients at Kiryandongo General Hospital. H. pylori infection was found associated with anemia, age, water sources, and intestinal parasitic infestation. Routine screening of anemia in H. pylori-infected individuals and further studies to explore the relationship between anemia and H. pylori disease is highly recommended.
{"title":"Association Between <i>Helicobacter pylori</i> Infection and Anemia Among Adult Dyspeptic Patients Attending Kiryandongo General Hospital, Uganda.","authors":"Daisy Asiimwe, Isaac Bangi, Jospeh Esanyu, Daniel Ojok, Benedict Okot, Clinton Olong, Robert Wagubi, Godfrey Kisembo, Fred Sempijja, Enoch Muwanguzi, Benson Okongo","doi":"10.2147/JBM.S392146","DOIUrl":"https://doi.org/10.2147/JBM.S392146","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the prevalence of anemia and its association with <i>Helicobacter pylori</i> infection among adult dyspeptic patients.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted among 283 dyspeptic patients at Kiryandongo General Hospital, in Uganda. A structured questionnaire was administered to capture demographic and clinical characteristics of study participants. Four milliliters of blood were then collected into an EDTA vacutainer for Complete Blood Count (CBC) and analyzed using HUMA COUNT 30<sup>TS</sup>, and peripheral blood smears were made and stained using Giemsa stain. Anemia was defined as hemoglobin levels <12g/dl in females and <13g/dl in men according to the World Health Organization (WHO). <i>Helicobacter pylori (H. pylori)</i> stool antigen test was performed using Whole power <i>H. pylori</i> Ag rapid test device, and saline stool preparation was examined for intestinal parasites. Chi-squared test and Logistic regression were performed to determine association, and a p-value of ≤0.05 was considered statistically significant.</p><p><strong>Results: </strong>The overall prevalence of <i>Helicobacter pylori</i> infection was 42.4% (120/283). The prevalence of anemia among <i>H. pylori</i>-infected patients was 25.8% (31/120) and 15.3% (25/163) among <i>H. pylori</i>-negative counterparts. <i>H. pylori</i> infection was significantly associated with anemia (p-value 0.042), age (p-value 0.02, 0.009), water sources (p-value 0.0049,) and intestinal parasitic infestation (p-value 0.02), respectively.</p><p><strong>Conclusion: </strong>This study has shown that the prevalence of <i>H. pylori</i> infection and anemia is high among dyspeptic patients at Kiryandongo General Hospital. <i>H. pylori</i> infection was found associated with anemia, age, water sources, and intestinal parasitic infestation. Routine screening of anemia in <i>H. pylori</i>-infected individuals and further studies to explore the relationship between anemia and <i>H. pylori</i> disease is highly recommended.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/c8/jbm-14-57.PMC9883989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathrine M Neuman Johnsen, Karin Magnussen, Christian Erstad, Sadaf Nabi Bhatti, Lise Sofie H Nissen-Meyer
Purpose: In Norway, blood donors using antihypertensive medication were deferred until 2015. Following revision of the national directive, these donors could be allowed, providing stable dose for at least 3 months, adequate blood pressure control and no adverse effects caused by the therapy. The new practice was evaluated by a quality study where the major aim was to establish whether donations from blood donors on antihypertensive medication pose a risk to the donor. The risk was assessed by counting the number and categorizing the adverse events related to blood donation. In addition, the quantitative effect of including these donors was calculated.
Subjects and methods: In this retrospective quality study, blood donors on antihypertensive therapy were recruited from four different blood centers to fill out a questionnaire. A total of 265 donors answered questions regarding their health status, type of medication used, and adverse events connected to blood donation both before and after starting the therapy.
Results: No severe adverse events were observed in donors on antihypertensive medications. The amount of mild adverse events, as exhibited by only 7 persons (0.46%) in this donor population, was the same as for donors without hypertensive treatment.
Conclusion: Blood donation from persons on antihypertensive therapy poses no extra risk of severe adverse events, given the use of screening criteria to identify and bleed only low-risk donors.
{"title":"Safe Blood Donation from Donors Using Antihypertensive Medication. A Multi-Center Retrospective Quality Study from South-East Norway.","authors":"Kathrine M Neuman Johnsen, Karin Magnussen, Christian Erstad, Sadaf Nabi Bhatti, Lise Sofie H Nissen-Meyer","doi":"10.2147/JBM.S390609","DOIUrl":"https://doi.org/10.2147/JBM.S390609","url":null,"abstract":"<p><strong>Purpose: </strong>In Norway, blood donors using antihypertensive medication were deferred until 2015. Following revision of the national directive, these donors could be allowed, providing stable dose for at least 3 months, adequate blood pressure control and no adverse effects caused by the therapy. The new practice was evaluated by a quality study where the major aim was to establish whether donations from blood donors on antihypertensive medication pose a risk to the donor. The risk was assessed by counting the number and categorizing the adverse events related to blood donation. In addition, the quantitative effect of including these donors was calculated.</p><p><strong>Subjects and methods: </strong>In this retrospective quality study, blood donors on antihypertensive therapy were recruited from four different blood centers to fill out a questionnaire. A total of 265 donors answered questions regarding their health status, type of medication used, and adverse events connected to blood donation both before and after starting the therapy.</p><p><strong>Results: </strong>No severe adverse events were observed in donors on antihypertensive medications. The amount of mild adverse events, as exhibited by only 7 persons (0.46%) in this donor population, was the same as for donors without hypertensive treatment.</p><p><strong>Conclusion: </strong>Blood donation from persons on antihypertensive therapy poses no extra risk of severe adverse events, given the use of screening criteria to identify and bleed only low-risk donors.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/74/jbm-14-337.PMC10164375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9498262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gili Kenet, Thomas Moulton, Brian M Wicklund, Sanjay P Ahuja, Miguel Escobar, Johnny Mahlangu
Introduction: Previous clinical trials established the efficacy and safety of sucrose-formulated recombinant factor (F) VIII (rFVIII-FS/Kogenate FS®/Helixate FS®) and octocog alfa (BAY 81-8973/Kovaltry®; LEOPOLD trials).
Aim: To report the results of a post hoc subgroup analysis assessing efficacy and safety outcomes in patients with hemophilia A who were receiving rFVIII-FS prior to enrolling into the LEOPOLD I Part B and LEOPOLD Kids Part A clinical trials and switching to octocog alfa.
Methods: LEOPOLD I Part B (NCT01029340) and LEOPOLD Kids Part A (NCT01311648) were octocog alfa Phase 3, multinational, open-label studies in patients with severe hemophilia A aged 12-65 years and ≤12 years, respectively. Annualized bleeding rate (ABR) was the efficacy endpoint for both studies. Safety endpoints included adverse events (AEs) and development of FVIII inhibitors.
Results: Of the 113 patients in both LEOPOLD trials, 40 (35.4%) patients received rFVIII-FS prophylaxis pre-study and had data available for pre-study total ABR. In LEOPOLD I Part B (n = 22, 35.5%), median (Q1; Q3) total ABR decreased from 2.5 (0.0; 9.0) pre-study to 1.0 (0.0; 6.8), and from 1.0 (0.0; 6.0) pre-study to 0.0 (0.0; 6.02) in LEOPOLD Kids Part A (n = 18, 35.3%). Octocog alfa was well tolerated, and no patients had drug-related serious AEs or inhibitors.
Conclusion: Treatment with octocog alfa prophylaxis appeared to have a favorable risk-benefit profile compared with rFVIII-FS and thus could be an effective and improved alternative strategy for individualized treatment for children, adolescent and adult patients with severe hemophilia A currently on rFVIII-FS treatment.
先前的临床试验证实了蔗糖配方重组因子(F) VIII (rFVIII-FS/Kogenate FS®/Helixate FS®)和octocog alfa (BAY 81-8973/Kovaltry®;利奥波德试验)。目的:报告一项事后亚组分析的结果,评估在参加LEOPOLD I部分B和LEOPOLD儿童部分a临床试验之前接受rFVIII-FS的a型血友病患者的疗效和安全性结果。方法:LEOPOLD I Part B (NCT01029340)和LEOPOLD Kids Part A (NCT01311648)分别是在12-65岁和≤12岁的严重血友病A患者中进行的10 - cog α 3期跨国开放标签研究。两项研究的疗效终点均为年化出血率(ABR)。安全性终点包括不良事件(ae)和FVIII抑制剂的发展。结果:在两项LEOPOLD试验的113例患者中,40例(35.4%)患者接受了rFVIII-FS预防预研究,并有预研究总ABR数据。在LEOPOLD I Part B中(n = 22, 35.5%),中位数(Q1;Q3)总ABR从2.5 (0.0;9.0)预学习到1.0 (0.0;6.8),从1.0 (0.0;6.0)预学习至0.0 (0.0;LEOPOLD儿童A组(n = 18, 35.3%) 6.02)。Octocog alfa耐受性良好,没有患者出现与药物相关的严重ae或抑制剂。结论:与rFVIII-FS相比,occog α - fa预防治疗似乎具有更有利的风险-收益特征,因此对于目前接受rFVIII-FS治疗的儿童、青少年和成人严重血友病a患者来说,可能是一种有效和改进的个性化治疗策略。
{"title":"Switching from Sucrose-Formulated rFVIII to Octocog Alfa (BAY 81-8973) Prophylaxis Improves Bleed Outcomes in the LEOPOLD Clinical Trials.","authors":"Gili Kenet, Thomas Moulton, Brian M Wicklund, Sanjay P Ahuja, Miguel Escobar, Johnny Mahlangu","doi":"10.2147/JBM.S405624","DOIUrl":"https://doi.org/10.2147/JBM.S405624","url":null,"abstract":"<p><strong>Introduction: </strong>Previous clinical trials established the efficacy and safety of sucrose-formulated recombinant factor (F) VIII (rFVIII-FS/Kogenate FS®/Helixate FS®) and octocog alfa (BAY 81-8973/Kovaltry®; LEOPOLD trials).</p><p><strong>Aim: </strong>To report the results of a post hoc subgroup analysis assessing efficacy and safety outcomes in patients with hemophilia A who were receiving rFVIII-FS prior to enrolling into the LEOPOLD I Part B and LEOPOLD Kids Part A clinical trials and switching to octocog alfa.</p><p><strong>Methods: </strong>LEOPOLD I Part B (NCT01029340) and LEOPOLD Kids Part A (NCT01311648) were octocog alfa Phase 3, multinational, open-label studies in patients with severe hemophilia A aged 12-65 years and ≤12 years, respectively. Annualized bleeding rate (ABR) was the efficacy endpoint for both studies. Safety endpoints included adverse events (AEs) and development of FVIII inhibitors.</p><p><strong>Results: </strong>Of the 113 patients in both LEOPOLD trials, 40 (35.4%) patients received rFVIII-FS prophylaxis pre-study and had data available for pre-study total ABR. In LEOPOLD I Part B (n = 22, 35.5%), median (Q1; Q3) total ABR decreased from 2.5 (0.0; 9.0) pre-study to 1.0 (0.0; 6.8), and from 1.0 (0.0; 6.0) pre-study to 0.0 (0.0; 6.02) in LEOPOLD Kids Part A (n = 18, 35.3%). Octocog alfa was well tolerated, and no patients had drug-related serious AEs or inhibitors.</p><p><strong>Conclusion: </strong>Treatment with octocog alfa prophylaxis appeared to have a favorable risk-benefit profile compared with rFVIII-FS and thus could be an effective and improved alternative strategy for individualized treatment for children, adolescent and adult patients with severe hemophilia A currently on rFVIII-FS treatment.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/16/jbm-14-379.PMC10257928.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 48-year-old patient with stable residual schizophrenia experienced a syndromic psychosis relapse following an episode of severe combined immunohemolytic and pure red cell aplastic anemia, with a hemoglobin level of 4.7 g/dl. The anemia was attributed to her anti-HIV medication zidovudine. Her HIV infection had been well-controlled; no other organic precipitant of the psychosis was found. Following transfusion of 2 units of leukocyte-poor packed red cells, schizophrenia symptoms promptly recovered to her baseline. This was maintained at 3- and 6-month follow-ups without any need for antipsychotic dose adjustment. Following zidovudine discontinuation and a short course of oral prednisolone, her anemia gradually recovered.
{"title":"\"Severe Anemia: A Case Report of an Uncommon Precipitant of Schizophrenia Relapse\".","authors":"Krittisak Anuroj, Siwat Chongbanyatcharoen, Romteera Chiencharoenthanakij","doi":"10.2147/JBM.S407722","DOIUrl":"https://doi.org/10.2147/JBM.S407722","url":null,"abstract":"<p><p>A 48-year-old patient with stable residual schizophrenia experienced a syndromic psychosis relapse following an episode of severe combined immunohemolytic and pure red cell aplastic anemia, with a hemoglobin level of 4.7 g/dl. The anemia was attributed to her anti-HIV medication zidovudine. Her HIV infection had been well-controlled; no other organic precipitant of the psychosis was found. Following transfusion of 2 units of leukocyte-poor packed red cells, schizophrenia symptoms promptly recovered to her baseline. This was maintained at 3- and 6-month follow-ups without any need for antipsychotic dose adjustment. Following zidovudine discontinuation and a short course of oral prednisolone, her anemia gradually recovered.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/02/jbm-14-329.PMC10132291.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luis Miguel Osorio-Toro, Jhon Herney Quintana-Ospina, Luis Álvaro Melo-Burbano, Paola Andrea Ruiz-Jiménez, Jorge Enrique Daza-Arana, Giovanna Patricia Rivas-Tafurt, Jorge Hernán Izquierdo-Loaiza
Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.
{"title":"Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus-a Rare Association: Case Report.","authors":"Luis Miguel Osorio-Toro, Jhon Herney Quintana-Ospina, Luis Álvaro Melo-Burbano, Paola Andrea Ruiz-Jiménez, Jorge Enrique Daza-Arana, Giovanna Patricia Rivas-Tafurt, Jorge Hernán Izquierdo-Loaiza","doi":"10.2147/JBM.S420937","DOIUrl":"https://doi.org/10.2147/JBM.S420937","url":null,"abstract":"<p><p>Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/7d/jbm-14-507.PMC10488652.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hematological abnormalities are a common complication of malaria infection. However, there is a paucity of evidence regarding it among malaria-infected adult patients in association with the ABO blood group in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the hematological abnormalities among malaria-infected adult patients in association with ABO blood groups at Jinella Health Center, Harar, Eastern Ethiopia.
Methods: An institutional-based cross-sectional study was conducted from July 10, 2022, to January 10, 2023. Four milliliters of venous blood were collected from each study participant. Drops of blood were used for blood film preparation. ABO blood group was determined by agglutination test using monoclonal anti-sera (Agape Diagnostics Ltd., India). A complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of <0.05.
Results: The study revealed that 47.2% (95% CI: 41.0 53.6) of the participants were anemic. Being female (AOR = 3.18, 95% CI = 1.67, 6.04), having the A blood group (AOR = 2.75, CI = 1.20, 6.31), and being infected with P. falciparum (AOR = 2.64, CI = 1.26, 5.53) were all significantly associated with malaria anemia. The overall prevalence of thrombocytopenia was also 67.7% (95% CI: 61.7-73.4%). It was significantly associated with P. falciparum infection (AOR = 8.03, CI = 3.53, 18.25) and high parasitemia levels (AOR = 4.40, CI = 1.57, 12.32).
Conclusion: Patients with malaria who belonged to the "A" blood group in the study area had anemia as a serious health problem. Hence, frequently checking for anemia in patients with malaria who have blood group "A" can help with early detection and better management of anemia.
背景:血液学异常是疟疾感染的常见并发症。然而,在埃塞俄比亚,特别是在哈拉里地区,缺乏与ABO血型有关的疟疾感染成年患者的证据。因此,本研究旨在评估埃塞俄比亚东部哈拉尔Jinella卫生中心疟疾感染成人患者的血液学异常与ABO血型的关系。方法:于2022年7月10日至2023年1月10日进行基于机构的横断面研究。从每个研究参与者身上采集了4毫升静脉血。滴血用于血膜制备。采用单克隆抗血清凝集试验测定ABO血型(Agape Diagnostics Ltd, India)。使用DxH 800 (Beckman Coulter, Inc, Miami, FL)血液学分析仪进行全血细胞计数。数据采用SPSS 26进行分析。拟合了双变量和多变量logistic回归模型。显著性水平以结果的p值宣布:研究显示47.2% (95% CI: 41.0 53.6)的参与者贫血。女性(AOR = 3.18, 95% CI = 1.67, 6.04)、A型血(AOR = 2.75, CI = 1.20, 6.31)、感染恶性疟原虫(AOR = 2.64, CI = 1.26, 5.53)与疟疾贫血有显著相关性。血小板减少症的总体患病率也为67.7% (95% CI: 61.7-73.4%)。与恶性疟原虫感染(AOR = 8.03, CI = 3.53, 18.25)和高寄生虫血症(AOR = 4.40, CI = 1.57, 12.32)显著相关。结论:研究区A血型疟疾患者存在贫血严重的健康问题。因此,经常检查A型血疟疾患者的贫血情况有助于早期发现和更好地管理贫血。
{"title":"Hematological Abnormalities Among Malaria Infected Adult Patients in Association with ABO Blood Groups at Jinella Health Center, Harar, Eastern Ethiopia.","authors":"Haftu Asmerom, Kabtamu Gemechu, Beza Sileshi, Mesay Arkew","doi":"10.2147/JBM.S419815","DOIUrl":"https://doi.org/10.2147/JBM.S419815","url":null,"abstract":"<p><strong>Background: </strong>Hematological abnormalities are a common complication of malaria infection. However, there is a paucity of evidence regarding it among malaria-infected adult patients in association with the ABO blood group in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the hematological abnormalities among malaria-infected adult patients in association with ABO blood groups at Jinella Health Center, Harar, Eastern Ethiopia.</p><p><strong>Methods: </strong>An institutional-based cross-sectional study was conducted from July 10, 2022, to January 10, 2023. Four milliliters of venous blood were collected from each study participant. Drops of blood were used for blood film preparation. ABO blood group was determined by agglutination test using monoclonal anti-sera (Agape Diagnostics Ltd., India). A complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were analyzed using SPSS version 26. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of <0.05.</p><p><strong>Results: </strong>The study revealed that 47.2% (95% CI: 41.0 53.6) of the participants were anemic. Being female (AOR = 3.18, 95% CI = 1.67, 6.04), having the A blood group (AOR = 2.75, CI = 1.20, 6.31), and being infected with <i>P. falciparum</i> (AOR = 2.64, CI = 1.26, 5.53) were all significantly associated with malaria anemia. The overall prevalence of thrombocytopenia was also 67.7% (95% CI: 61.7-73.4%). It was significantly associated with <i>P. falciparum</i> infection (AOR = 8.03, CI = 3.53, 18.25) and high parasitemia levels (AOR = 4.40, CI = 1.57, 12.32).</p><p><strong>Conclusion: </strong>Patients with malaria who belonged to the \"A\" blood group in the study area had anemia as a serious health problem. Hence, frequently checking for anemia in patients with malaria who have blood group \"A\" can help with early detection and better management of anemia.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/13/jbm-14-463.PMC10457518.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Both primary (e.g. common variable immune deficiency, CVID) and secondary immune deficiency as well as multiple myeloma (MM) require medical intervention and treatment delay can exacerbate morbidity. This study investigated the potential importance of low levels of calculated globulin to detect immune deficiency and MM associated with immunoparesis (light chain, non-secretory MM).
Methods: One hundred and thirty-nine patient serum samples from community physicians and outpatient clinics for liver function tests with low calculated globulin (<16 g/L, RR 18-37 g/L) levels were screened for immunoglobulins and protein electrophoresis. Further, 110 patients with globulin levels ≤16 g/L with screening for immunoglobulin levels and protein electrophoresis, requested through routine clinical care, were included in the analysis.
Results: Approximately 47% of patients in this cohort had secondary antibody deficiency as a result of hematological malignancy. Secondary iatrogenic (immunosuppressants, antiepileptic drugs) immune deficiency was detected in 20% of patients and a significant percentage of the patients were found by reflex testing at globulin levels <16 g/L. During the study period the screening detected new light chain and non-secretory MM in 2.2% of patients. Three patients with CVID and six patients with light chain myeloma were previously detected by screening, consequently alerting clinicians and reducing delay in treatment. A further 23% with several co-morbid conditions showed unexpected hypogammaglobulinemia; in this category, the study identified a subgroup that required further investigation.
Conclusion: Investigation of low globulin levels detects patients with primary and secondary immune deficiency and MM. Optimizing treatment for decreased immunoglobulins in patients with other clinical co-morbidities may require increased clinician awareness and watchful clinical and laboratory assessment.
{"title":"A Single Center Study Investigating Clinical Outcomes of Testing for Multiple Myeloma and Immune Deficiency at Low Globulin Levels.","authors":"Indra Ramasamy","doi":"10.2147/JBM.S409234","DOIUrl":"https://doi.org/10.2147/JBM.S409234","url":null,"abstract":"<p><strong>Background: </strong>Both primary (e.g. common variable immune deficiency, CVID) and secondary immune deficiency as well as multiple myeloma (MM) require medical intervention and treatment delay can exacerbate morbidity. This study investigated the potential importance of low levels of calculated globulin to detect immune deficiency and MM associated with immunoparesis (light chain, non-secretory MM).</p><p><strong>Methods: </strong>One hundred and thirty-nine patient serum samples from community physicians and outpatient clinics for liver function tests with low calculated globulin (<16 g/L, RR 18-37 g/L) levels were screened for immunoglobulins and protein electrophoresis. Further, 110 patients with globulin levels ≤16 g/L with screening for immunoglobulin levels and protein electrophoresis, requested through routine clinical care, were included in the analysis.</p><p><strong>Results: </strong>Approximately 47% of patients in this cohort had secondary antibody deficiency as a result of hematological malignancy. Secondary iatrogenic (immunosuppressants, antiepileptic drugs) immune deficiency was detected in 20% of patients and a significant percentage of the patients were found by reflex testing at globulin levels <16 g/L. During the study period the screening detected new light chain and non-secretory MM in 2.2% of patients. Three patients with CVID and six patients with light chain myeloma were previously detected by screening, consequently alerting clinicians and reducing delay in treatment. A further 23% with several co-morbid conditions showed unexpected hypogammaglobulinemia; in this category, the study identified a subgroup that required further investigation.</p><p><strong>Conclusion: </strong>Investigation of low globulin levels detects patients with primary and secondary immune deficiency and MM. Optimizing treatment for decreased immunoglobulins in patients with other clinical co-morbidities may require increased clinician awareness and watchful clinical and laboratory assessment.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/79/jbm-14-345.PMC10239245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Anticoagulants are the cornerstone therapy for thromboembolism prevention and treatment. Warfarin is the frequently prescribed drug and remains the oral anticoagulant of choice in low- and middle-income countries, including Ethiopia. It is a narrow therapeutic index drug that needs high-quality anticoagulation monitoring with frequent international normalization ratio (INR) testing.
Objective: The study aimed to assess anticoagulation management with warfarin among adult outpatients at two selected private cardiac centers in Addis Ababa, Ethiopia.
Methods: A hospital-based retrospective study design that enrolled 374 patients receiving warfarin was employed at two private cardiac centres in Addis Ababa, Ethiopia. The time in the therapeutic range (TTR) was calculated using the Rosendaal method. The data were analyzed using Statistical Package for Social Science version 25.
Results: The mean age of the patients was 57 years, and 218 (58.3%) participants were females. Out of 3384 INR tests, 1562 (46.5%) were within the therapeutic range and the mean percentage of TTR was 47.24%. Only 25.67% of the patients spent their TTR ≥ 65%. The present study revealed that dose adjustments were required 1764 times. In non-therapeutic INR values of 1764 that required warfarin dose adjustment, 59.7% of the doses were adjusted. About 262 (70.1%) of co-prescribed medications had interaction with warfarin. Sixty-four patients (17.11%) experienced bleeding events.
Conclusion: Anticoagulation management with warfarin was suboptimal in private cardiac Addis Ababa, Ethiopia, private cardiac centers. Warfarin adjustment practice for nontherapeutic INR values was not minimal, and many patients encountered bleeding during their course of therapy.
抗凝剂是预防和治疗血栓栓塞的基础疗法。华法林是常用的处方药,在包括埃塞俄比亚在内的中低收入国家,华法林仍然是首选的口服抗凝剂。它是一种狭窄的治疗指标药物,需要高质量的抗凝监测和频繁的国际正常化比(INR)检测。目的:该研究旨在评估华法林在埃塞俄比亚亚的斯亚贝巴两家选定的私人心脏中心的成人门诊患者中的抗凝管理。方法:一项基于医院的回顾性研究设计,在埃塞俄比亚亚的斯亚贝巴的两家私人心脏中心招募了374名接受华法林治疗的患者。采用Rosendaal法计算治疗范围时间(TTR)。使用Statistical Package for Social Science version 25对数据进行分析。结果:患者平均年龄57岁,女性218例(58.3%)。在3384例INR试验中,1562例(46.5%)在治疗范围内,TTR的平均百分比为47.24%。只有25.67%的患者的TTR≥65%。目前的研究表明,剂量调整需要1764次。在需要调整华法林剂量的1764的非治疗性INR值中,调整了59.7%的剂量。共处方药物中约有262种(70.1%)与华法林相互作用。64例(17.11%)出现出血事件。结论:在埃塞俄比亚亚的斯亚贝巴的私人心脏中心,华法林抗凝治疗效果不理想。华法林对非治疗性INR值的调整并不少,许多患者在治疗过程中出现出血。
{"title":"Anticoagulation Management in Patients Receiving Warfarin at Private Cardiac Centers in Addis Ababa, Ethiopia.","authors":"Roza Getachew, Tamrat Assefa Tadesse, Bekele Alemayehu Shashu, Amsalu Degu, Getachew Alemkere","doi":"10.2147/JBM.S397189","DOIUrl":"https://doi.org/10.2147/JBM.S397189","url":null,"abstract":"<p><strong>Introduction: </strong>Anticoagulants are the cornerstone therapy for thromboembolism prevention and treatment. Warfarin is the frequently prescribed drug and remains the oral anticoagulant of choice in low- and middle-income countries, including Ethiopia. It is a narrow therapeutic index drug that needs high-quality anticoagulation monitoring with frequent international normalization ratio (INR) testing.</p><p><strong>Objective: </strong>The study aimed to assess anticoagulation management with warfarin among adult outpatients at two selected private cardiac centers in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A hospital-based retrospective study design that enrolled 374 patients receiving warfarin was employed at two private cardiac centres in Addis Ababa, Ethiopia. The time in the therapeutic range (TTR) was calculated using the Rosendaal method. The data were analyzed using Statistical Package for Social Science version 25.</p><p><strong>Results: </strong>The mean age of the patients was 57 years, and 218 (58.3%) participants were females. Out of 3384 INR tests, 1562 (46.5%) were within the therapeutic range and the mean percentage of TTR was 47.24%. Only 25.67% of the patients spent their TTR ≥ 65%. The present study revealed that dose adjustments were required 1764 times. In non-therapeutic INR values of 1764 that required warfarin dose adjustment, 59.7% of the doses were adjusted. About 262 (70.1%) of co-prescribed medications had interaction with warfarin. Sixty-four patients (17.11%) experienced bleeding events.</p><p><strong>Conclusion: </strong>Anticoagulation management with warfarin was suboptimal in private cardiac Addis Ababa, Ethiopia, private cardiac centers. Warfarin adjustment practice for nontherapeutic INR values was not minimal, and many patients encountered bleeding during their course of therapy.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/01/jbm-14-107.PMC9926997.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10742790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-29eCollection Date: 2022-01-01DOI: 10.2147/JBM.S385737
Yona Mbalibulha, Bernard Natukunda, Andrew Livex Okwi, Joan N Kalyango, Kajja Isaac, Sam Ononge
Introduction Maternal red cell alloimmunization to Rh antigen in pregnant women occurs when the immune system is sensitized by foreign red blood cell surface antigens, in this case fetal red blood cells, inducing an immune response. Various antigens of blood group systems may cause alloimmunization, especially the Rh, Kel, Fy, JK, and MNS systems. This study aimed to determine alloimmunization to the different frequencies of Rh antigen among pregnant women in South Western Uganda. Methods A total of 1369 pregnant women consented and were recruited into a cross-sectional study during their regular antenatal visits during the period August 2020 to July 2021. Samples (4 mL) of anticoagulated and coagulated blood were obtained, and Rh blood grouping including Rh antigen and the indirect antiglobulin test (IAT) was carried out using the agglutination technology of the LISS ID-Card technique in the Ortho Biovue ID-Micro Typing System. Results Out of 1369 participants recruited to the study, 78 (5.7%) were D−, 1291 were D+, and 134 (9.8%) had alloantibodies. Among those with alloantibodies, 115 (85.8%) were D+ and 19 (14.2%) D−. The percentage alloimmunization according to the Rh antigens was highest in e (9.72%), c (2.48%), C (2.34%) and E (0.94%) antigens. With the ABO system, alloimmunization was highest in blood group B (10.7%), followed by A (10.6%), O (9.2%) and then AB (7.1%). Alloimmunization was more prevalent in D− (24%) than in D+ participants (8.9%). Rhesus antigen e was the most prevalent antigen (99.8%), followed by c. The alloimmunization rate of 9.8% among these participants is high, and appears in both D+ and D− women. The other Rhesus antigens are seen to cause alloimmunization, with antigen e causing the highest prevalence. In conclusion, there is a need to identify antibodies and study the outcome for clinical significance, especially in D+ women, to facilitate proper pregnancy management.
{"title":"Alloimmunization to Rh Antigen (D, C, E, C, E) Among Pregnant Women Attending Antenatal Care in South Western Uganda.","authors":"Yona Mbalibulha, Bernard Natukunda, Andrew Livex Okwi, Joan N Kalyango, Kajja Isaac, Sam Ononge","doi":"10.2147/JBM.S385737","DOIUrl":"https://doi.org/10.2147/JBM.S385737","url":null,"abstract":"Introduction Maternal red cell alloimmunization to Rh antigen in pregnant women occurs when the immune system is sensitized by foreign red blood cell surface antigens, in this case fetal red blood cells, inducing an immune response. Various antigens of blood group systems may cause alloimmunization, especially the Rh, Kel, Fy, JK, and MNS systems. This study aimed to determine alloimmunization to the different frequencies of Rh antigen among pregnant women in South Western Uganda. Methods A total of 1369 pregnant women consented and were recruited into a cross-sectional study during their regular antenatal visits during the period August 2020 to July 2021. Samples (4 mL) of anticoagulated and coagulated blood were obtained, and Rh blood grouping including Rh antigen and the indirect antiglobulin test (IAT) was carried out using the agglutination technology of the LISS ID-Card technique in the Ortho Biovue ID-Micro Typing System. Results Out of 1369 participants recruited to the study, 78 (5.7%) were D−, 1291 were D+, and 134 (9.8%) had alloantibodies. Among those with alloantibodies, 115 (85.8%) were D+ and 19 (14.2%) D−. The percentage alloimmunization according to the Rh antigens was highest in e (9.72%), c (2.48%), C (2.34%) and E (0.94%) antigens. With the ABO system, alloimmunization was highest in blood group B (10.7%), followed by A (10.6%), O (9.2%) and then AB (7.1%). Alloimmunization was more prevalent in D− (24%) than in D+ participants (8.9%). Rhesus antigen e was the most prevalent antigen (99.8%), followed by c. The alloimmunization rate of 9.8% among these participants is high, and appears in both D+ and D− women. The other Rhesus antigens are seen to cause alloimmunization, with antigen e causing the highest prevalence. In conclusion, there is a need to identify antibodies and study the outcome for clinical significance, especially in D+ women, to facilitate proper pregnancy management.","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/64/jbm-13-747.PMC9719281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35347579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-29eCollection Date: 2022-01-01DOI: 10.2147/JBM.S362222
Christina M Barriteau, Sherif M Badawy
Sickle cell disease (SCD) is one of the most common inherited blood disorders. Deoxygenated hemoglobin S (HbS) polymerizes and causes anemia and various end organ effects. Voxelotor acts by increasing HbS oxygen affinity, decreasing anemia and hemolysis. Voxelotor is approved for use in individuals with SCD age 4 years and older. Phase 3 trials demonstrated an increase in hemoglobin levels and a decrease in markers of hemolysis; however, data or benefits related to clinical and quality of life outcomes are relatively limited and varied across different studies. This review summarizes the published clinical trials and research studies focused on the use of voxelotor in SCD to provide an evidence-based practical guide for hematology providers on its utilization in clinical settings, including physicians and independent licensed practitioners.
{"title":"Practical Guidance for the Use of Voxelotor in the Management of Sickle Cell Disease.","authors":"Christina M Barriteau, Sherif M Badawy","doi":"10.2147/JBM.S362222","DOIUrl":"10.2147/JBM.S362222","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is one of the most common inherited blood disorders. Deoxygenated hemoglobin S (HbS) polymerizes and causes anemia and various end organ effects. Voxelotor acts by increasing HbS oxygen affinity, decreasing anemia and hemolysis. Voxelotor is approved for use in individuals with SCD age 4 years and older. Phase 3 trials demonstrated an increase in hemoglobin levels and a decrease in markers of hemolysis; however, data or benefits related to clinical and quality of life outcomes are relatively limited and varied across different studies. This review summarizes the published clinical trials and research studies focused on the use of voxelotor in SCD to provide an evidence-based practical guide for hematology providers on its utilization in clinical settings, including physicians and independent licensed practitioners.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/b6/jbm-13-739.PMC9719266.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35347578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}