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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a search for a new way to recognize the patients who are at higher risk of unexpected hospitalizations, the characteristics of patients with diabetes mellitus were examined after their last office visit prior to hospitalization. Six characteristics contributed significantly in distinguishing 256 patients who were subsequently hospitalized from 512 patients who were not. The six characteristics included the following: frequent emergency room visits, low serum albumin level, cardiomegaly, anemia, hypotension, and hyperglycemia. The sensitivity of prediction was 43.2%, specificity was 77.4%, and the relative risk by odds ratio was 2.60:1. The intensity of care, as estimated by the level of the provider, and the intended intensity of care, as measured by the scheduled return-visit interval, were not clinically consistent with the magnitude of risk. The characteristics of patients at higher risk of unexpected hospitalizations were identified and provide a direction for increased intensity of ambulatory care.
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PMID:Unexpected hospital admissions among patients with diabetes mellitus. 621 92

The major limitation for continuous administration of natural retinoids for chemoprevention of cancer is their high toxicity; however, synthetic retinamides have the desirable quality of reduced toxicity while retaining most of the biological activity. We have presently evaluated the comparative toxicity of all-trans- and 13-cis-isomers of N-ethyl retinamide (ER), N-2-hydroxyethyl retinamide (HER), and N-4-hydroxyphenyl retinamide (HPR) in mice and rats after po and ip administration. The computed LD90, DL50, and LD10 values for combined sexes of mice following 21 daily doses of the above retinoids were determined. Identical doses of the same retinoid by ip administration produced more toxicity and deaths than by the po route. The 13-cis-isomers exhibited comparatively less toxicity than the corresponding all-trans-isomer. Based on the lethality data, all-trans-retinoic acid was most toxic followed by all-trans-HER greater than all-trans-HPR greater than all-trans-ER. Changes in clinical chemistry and hematological parameters associated with administration of the retinamides include a dose-dependent peripheral anemia evidenced by erythrocytopenia and decreased hemoglobin concentration and packed cell volume. Retinoid treatment also caused increased plasma alkaline phosphatase activity and decreased serum albumin levels. Histopathological changes associated with retinoid administration primarily included liver lesions as characterized by degeneration and enlargement of hepatocytes. The present studies indicate that synthetic retinoids are less toxic than the natural ones.
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PMID:Subacute toxicity of all-trans- and 13-cis-isomers of N-ethyl retinamide, N-2-hydroxyethyl retinamide, and N-4-hydroxyphenyl retinamide. 622 23

Suppression of antibody production by splenic lymphocytes from rats immunized with sheep red blood cells (SRBC) after incubation with plasma from rats infected with Trypanosoma brucei rhodesiense was confirmed. Suppressive activity became evident in plasma after the sixth day of infection and was manifested by reduction in the number of hemolytic Jerne plaques produced by the treated cells. The activity was temporally associated with increased amounts of soluble immune complex (SIC) reduced titers of lytic complement, elevated titers of immunoconglutinin (IK) and anemia. Treatment of suppressive plasma with hemolysin sensitized SRBC alexinated with horse complement to reduce IK did not reduce suppressive activity, and the activity appeared to have been enhanced when the plasma was heated to inactivate the remaining complement (C'). When fresh rat C' was added to the treated cells, the suppression was largely, though not completely, reversed. Treatment of spleen cells with SIC prepared in vitro from bovine serum albumin (BSA) and rabbit antiBSA also suppressed the plaque forming capacity of the cells. Complexes of BSA-antiBSA-C' and complexes of BSA-antiBSA-C'-IK were equally suppressive. Again, addition of fresh C' to cells treated with these complexes largely, though not completely, reversed the suppressive effect on the cells. From the results it is suggested that immunosuppression associated with experimental T. b. rhodesiense infection may be in part a suppression of the capacity of induced lymphocytes to produce antibody. It is possible that the suppression was mediated by SIC present in the plasma of the infected rats and this effect was probably enhanced by reduced levels of complement in the suppressive plasma.
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PMID:Complement reversal of immunosuppression induced with plasma of rats infected with Trypanosoma brucei rhodesiense. 639 93

Aluminum ion is bound to at least one of the two specific iron binding sites of serum transferrin and also to serum albumin, as shown by in vivo competition studies with 67-Ga, gel filtration chromatography and ultraviolet difference spectroscopy. Binding of aluminum to transferrin requires CO2 and therefore involves a specific iron site. Samples of commercial transferrin contained large amounts of aluminum. Aluminum may cause anemia by entering pathways of iron distribution and metabolism.
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PMID:Plasma aluminum is bound to transferrin. 641 Jan 38

Lipoxygenase activity with linoleic acid as substrate and the immunologically detectable amount of lipoxygenase protein were estimated in the course of in vitro maturation of rabbit reticulocytes withdrawn at the sixth day of an experimental bleeding anaemia. With unseparated cell mixture there was a significant increase in the lipoxygenase activity of 67 +/- 15% after a maturation period of 4 h followed by a decrease up to the initial level. The maturational changes were more pronounced when the fraction of youngest reticulocytes after buoyant density separation in a serum albumin gradient was used, whereas the cells of medium density failed to show the intermittent increase. The lipoxygenase activity was largely paralleled by the amount of lipoxygenase protein. The increase of lipoxygenase was prevented by either anaerobiosis or addition of oligomycin. The protein synthesis was greatly decreased after 4 h of incubation. The decline of the amount of lipoxygenase between 4 and 24 h incubation is probably largely caused by proteolysis. The results support former interpretations as to the synthesis and biological dynamics of lipoxygenase in reticulocytes.
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PMID:In vitro maturation of rabbit reticulocytes. III. Response of lipoxygenase. 642 28

A mutant strain, Nagase analbuminemia rats (NAR), was established from Sprague-Dawley rats. Hematological evaluations were made on NAR of 4 to 52 weeks of age. NAR had an abnormally low number of red blood cells (RBC), a low hematocrit, a reduced hemoglobin concentration and an increased number of reticulocytes. Their plasma electrolyte level was normal. Osmotic fragility of RBC was slightly increased in the rats. Thus NAR shows a slight anemia. The in vitro experiments on RBC were performed. The incubation of blood showed a hemolytic tendency and elevated potassium efflux in the blood of NAR. In addition, an increased efflux of potassium was found in the RBC of NAR, when the RBC was washed with phosphate buffered saline and then was incubated with the saline containing CaCl2. This potassium efflux was prevented in the presence of rat albumin. These findings suggest that the deficiency of serum albumin may increase the permeability of potassium in erythrocyte membrane in NAR.
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PMID:Anemia and potassium permeability of red blood cells in analbuminemic rats. 654 21

6 patients with end-stage renal disease, hypertension and anemia were studied to determine the effect of endurance exercise training on their blood pressure. Initial exercise capacities were low (VO2 max = 18 +/- 2 ml/kg/min); however, their capacities increased (17 +/- 9%, p less than 0.05) after 14 +/- 5 months of training. This was associated with reductions in the antihypertensive medications in the 5 patients initially requiring them, and decreases in both predialysis systolic and diastolic blood pressures. There were significant increases in hemoglobin concentrations (7.3 +/- 0.4 to 9.8 +/- 0.9 g%) and hematocrit levels (23 +/- 2 to 30 +/- 3%) during training with no changes in body weights, interdialysis weight gains or serum albumin concentrations. 6 nonexercising dialysis patients had no changes in these same variables over the same period of time. These results suggest that endurance exercise training will reduce blood pressure and improve anemia in some hemodialysis patients.
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PMID:Exercise training improves hypertension in hemodialysis patients. 661 71

Nutritional surveys were conducted on all 115 patients of a Medicare-approved nursing home. The techniques of nutritional assessment used included anthropometric measurements (weight/height, triceps skinfold, arm-muscle and arm circumference), biochemical and hematologic tests (serum albumin, serum transferrin, total lymphocyte count, hemoglobin, and hematocrit), and an intradermal skin test for cell mediated immunity. The prevalence of protein-calorie malnutrition (PCM) of moderate to severe degree was very high by currently used standards (weight/height, 43%; triceps skinfold, 37%; arm-muscle circumference, 85%; serum albumin, 32%; serum transferrin, 38%; and total lymphocyte counts, 22%). Anemia was found in 52% of the men and 14% of the women by normal adult standards; in addition, 19% of the patients had negative cell-mediated immunity (CMI) tests. The mortality rate during the 6 months after surveying was 13% for the immunocompetent (CMI-positive) patients and 48% for the anergic (CMI-negative). These findings confirm that PCM is prevalent in 85% of nursing home patients according to currently accepted nutritional assessment standards. In this nursing home population, 485 had marasmus, 35% had marasmus-kwashiorkor mixed syndrome, and 2% had kwashiorkor. Perhaps new standards need to be derived for such specific age groups as the elderly.
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PMID:Nutritional status of nursing home patients. 677 18

140 adult hospitalized Thai patients were assessed for their nutritional status. The prevalence of protein-calorie malnutrition in these patients based on various parameters was as follows: 73.2% according to weight-height, 80.0% accroding to triceps skinfold thickness, 60.7% according to upper arm muscle circumference, 50.4% according to hair root morphology and 66.2% according to serum albumin level. These data reflected the disproportionate loss of the patients' body tissues. Severity of protein-calorie malnutrition was also detected by physical signs. Anemia and vitamin deficiencies were present in some of the patients. This study signifies that intensive nutritional management should be done to combat hospital malnutrition.
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PMID:Assessment of nutritional status in adult hospitalized patients. 677 17

Protein calorie malnutrition is being recognized with greater frequency in the hospitalized patient. This report describes the clinical presentation and response to nutritional therapy in nine elderly malnourished patients ranging from 73 to 95 years. Clinical features of malnutrition include weight loss, confusion, hypoalbuminemia (mean 2.8 gm/dl), a low total iron binding capacity (TIBC) (mean 192 micrograms/dl), anergy, lymphocytopenia (mean 1 X 10(3) cells/microliter) and an anemia (mean 9.0 gm/dl). Our subjects were followed for 42 days. In two, hyperalimentation was achieved by voluntary food intake and polymeric dietary supplements. In seven, feeding for 21 days via nasogastric tube was required. After three weeks, weight gain, decreased confusion, improved appetite and mobility, and significant increases in serum albumin and TIBC were seen. At that time, no subject was anergic and lymphocyte counts increased significantly. Increase in the serum iron and percent saturation was noted, and by day 42, a significant elevation in the hemoglobin occurred. As a measure of stem cell function, the committed granulocyte/macrophage progenitor cell (CFU-C) was quantitated in four subjects prior to and following 21 days of nutritional support. A marked increase in CFU-C number from a mean of 0.1 X 10(7) cells/kg to a normal value of 0.85 X 10(7) cells/kg was seen. Thus in addition to correcting the nutritional deficit, hyperalimentation returned immune and hematopoietic abnormalities to near normal levels. While improvement could reflect recovery from an associated disease, it is just as likely that correction of malnutrition, a well-recognized cause of these immunologic and hematopoietic abnormalities, accounted for the response. These observations emphasize the importance of recognizing malnutrition in the elderly and highlight the need for a careful nutritional assessment prior to ascribing hematologic and immunologic abnormalities to the aging process.
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PMID:The correctability of the nutritional, immune, and hematopoietic manifestations of protein calorie malnutrition in the elderly. 682 Oct 77


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