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

528 pregnancies of primiparous girls 13-17 years old who gave birth during 1988-90 at the obstetrical ward of the city of Pleven, Bulgaria, were evaluated. The pregnancy outcome and neonatal results were compared with those of 100 controls. These 528 births amounted to 5.48% of a total of 9635 births at the clinic. These girls were of low socioeconomic status, 14.2% were illiterate or had low educational attainment, and 56.42% were of Gypsy origin, without skills, and from rural areas. Only 32.89% of the Bulgarian girls had an official marriage license. Anemia was found in 13.64%, kidney infection (without symptoms of bacteriuria, pyelonephritis) in 6.44%, preeclampsia in 2.46%, and eclampsia in 0.76%. The most frequent occurrence was premature rupture of the membrane (9.85%). Term deliveries numbered 433 and preterm deliveries 95. There was a statistically significant difference between the two groups with respect to term and preterm deliveries (p 0.01). Dystocia amounted to 2.8% and instrumental delivery to 1.70% among these adolescent girls. The rate of premature delivery reached 17.99%, and cesarean section was performed in 5.44%. There was a significant difference between the two groups with respect to vaginal delivery (p 0.01) and cesarean section (p 0.01). 44% of 16-year old girls underwent cesarean section; and there was a significant difference in the rate of cesarean section between 14-year-old and 17-year-old girls (p 0.05) as well as between 16-year-old and 17-year-old girls (p 0.01). 71.95% of newborns had a birth weight of less than 3000 g. There was also a significant difference between the groups with regard to term and prematurely born neonates (p or = 0.01). Intrauterine growth retardation reached 2.46% because of the inadequate uterine size of girls 13-14 years old, insufficient weight gain during pregnancy (under 9 kg), and complications (preeclampsia and eclampsia). The rate of stillbirths was 7.63%, attributed to prematurity and malformation of the fetus. Maternal mortality reached 1.89% owing to pregnancy complications (eclampsia) among 17-year old girls because of low socioeconomic status and complete lack of prenatal care.
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PMID:[Pregnancy and labor in young girls]. 779 32

680 Peptostreptococcus sp. (Ps) were recovered from 598 (34%) of 1,750 specimens obtained from 554 patients. They included 103 Ps asaccharolyticus, 74 Ps magnus, 56 Ps prevotii, 51 Ps micros, 46 Ps anaerobius, 11 Ps morbilorum, and 10 Ps saccharolyticus. Most infections were polymicrobial (in 553 instances or 92%) but in 45 (8%), Ps were recovered in pure culture. Most Ps were isolated from abscesses (237), ears (104), peritoneal fluid (95), lung infections (66), bone (30) and sinuses (24). Predisposing conditions were present in 224 (40%) children. These were previous surgery (54), immunodeficiency (43), malignancy (35), trauma (34), diabetes (23), prematurity (22), steroid therapy (19), foreign body (10) and sickle-cell anemia (7). The organisms most commonly isolated with Ps were Bacteroides sp. (276, including 190 B. fragilis group), Prevotella sp. (159), Fusobacterium sp. (122), Escherichia coli (114), and Staphylococcus aureus (97). Antimicrobial therapy was administered to all but 14 patients. Surgical drainage or correction of pathology was performed in 307 (56%) patients. 10 patients (2%) died of their infection. These data illustrate the importance of Ps and suggests their enhancing potentials in infection in children.
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PMID:Peptostreptococcal infection in children. 785 47

The prevelance of IDA in industrialized countries has declined in recent decades, but there has been little change in the worldwide prevalence. IDA is currently estimated to affect more than 500 million people. Recent studies have indicated that anemia per se, the most common manifestation of iron deficiency, is less important from a public health standpoint than liabilities associated with tissue iron deficiency. The most important of the latter are an impairment in psychomotor development and cognitive function in infants and preschoolers, a deficit in work performance in adults, and an increase in the frequency of low birth weight, prematurity, and perinatal mortality in pregnancy. There have been several recent advances in combatting nutritional iron deficiency. One of the major problems has been in distinguishing iron deficiency from other causes of anemia seen epidemiologically such as malaria, HIV infection, chronic inflammation, hemoglobinopathies, and protein energy malnutrition. When combined with serum ferritin and hemoglobin determinations, the serum transferrin receptor assay is a valuable addition in epidemiologic surveys because it provides a quantitative measure of functional iron deficiency and it distinguishes true IDA from the anemia of chronic disease. The most difficult challenge is to develop effective methods of supplying iron to large segments of a population. Supplementation with iron tablets is suitable for only brief periods of need such as during pregnancy. The poor compliance with existing supplementation programs is believed to be due mainly to the gastrointestinal side effects of oral iron which can be eliminated by the use of a gastric delivery system. The most effective long-term strategy is to increase the intake of bioavailable iron in the diet. The customary approach has been to fortify a food staple such as wheat, rice, sugar, or salt, and thereby increase the iron intake of the entire population. However, because of concerns about the risk of cancer and heart disease in individuals with high iron stores, there is an increasing reluctance to supply iron to individuals who do not require it. A more effective strategy is to fortify food vehicles that are targeted to segments of the population at greatest risk of iron deficiency such as infants and school children. Because of the strong inhibitory properties of diets in regions of the world where iron deficiency is most prevalent, the use of NaFeEDTA has important advantages for food fortification.
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PMID:Iron deficiency: the global perspective. 788 26

One hundred eighty-four premature infants, < 1800 g at birth and < 36 wk gestation, were entered into a study investigating the role of additional folate and vitamin B-12 supplementation of the anemia of prematurity. All patients initially received vitamin E and iron in accordance with accepted standards. Patients were randomly assigned to four groups to receive orally 0.1 mg folate/d for 4 mo, 100 micrograms vitamin B-12 intramuscularly monthly for 4 mo, both supplements, or neither. All other activities including parenteral nutrition were carried out according to established practices, irrespective of study group. By 10-12 wk, infants treated with vitamin B-12 alone or combined with folate had higher hemoglobin values than the untreated (P < 0.0005) or solely folate-treated (P < 0.01) groups. These findings held true irrespective of wide variations in treatment and feeding practices. The only uncontrolled hematologic nutritional factor, selenium, showed a similar pattern of decline for 10-12 wk in all study patients, whether or not they received additional vitamin supplements.
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PMID:Premature infants require additional folate and vitamin B-12 to reduce the severity of the anemia of prematurity. 798 36

Sixteen infants with the anemia of prematurity were randomly assigned to treatment with packed erythrocyte transfusions, recombinant erythropoietin alone, or epo plus recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF). During the treatment period, blood reticulocyte concentrations remained unchanged in those randomly assigned to receive transfusions, but increased significantly in those who received erythropoietin, either alone or in combination with GM-CSF. The magnitude of increase in hematocrit was not greater in those who received erythropoietin plus GM-CSF than in those who received erythropoietin alone. Blood neutrophil concentrations fell in all four infants who received erythropoietin alone, but increased in all who received erythropoietin plus GM-CSF.
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PMID:Pilot study comparing recombinant erythropoietin alone with erythropoietin plus recombinant granulocyte-macrophage colony-stimulating factor for treatment of the anemia of prematurity. 801 92

In a prospective study, a population of 528 pregnant primiparas aged 13-17 years were surveyed who gave birth at the obstetrical clinic of the Medical University of Pleven, Bulgaria, during the period of 1988-90. The data were compared to data of a sample of 100 pregnant primiparas aged 20-24 years and the data of the literature. The rate of abortion among these adolescents was 2.4% compared to 1.78%, 7.44%, and 9.37%, respectively, reported from authors in Spain (1980), Tunisia (1991), and the US (1983). These 528 births to adolescents accounted for 5.48% of a total of 9635 births. This percentage exceeded the rate of 1.2% among 112 women reported by a French researcher (1984). Pregnant girls under 15 years of age face more medical complications. In this sample there were 72 (13.64%) cases of anemia, 52 (9.85%) cases of premature rupture of the amniotic sac, 13 (2.46%) cases of preeclampsia (3-18% reported in the literature), and 4 (0.76%) cases of eclampsia. In most cases delivery occurred spontaneously, and it lasted 8 hours and 35 minutes in the adolescents compared to 10 hours and 37 minutes in the controls. Among the girls under age 15, often analgesics, tranquilizers, and anesthesia had to be used because of the instrumental extraction of the fetus. The high rate of cesarean section (5.11%) indicated pelvic-fetal disproportion, which was even higher (15%) as reported by other researchers. The rate of vaginal instrumental delivery amounted to 6.72%. Fetal retardation occurred in 1.32% vs. 9.33% reported in Tunisia and 6.69% in France. The adoption rate made up a 8.29% vs. 20.11% reported in Tunisia and 18.20% reported in France. 56.82% of these girls were of Gypsy origin; 51.70% were single or cohabiting with the father of the child; 14.20% were illiterate. The rate of stillbirths amounted to 0.76% (4 children) vs. 11.11% (Tunisia) and 3.25% (France). However, prematurity reached 17.99% in the adolescent groups compared to 4.7% in the controls (p 0.05).
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PMID:[The general circumstances of the problem of adolescent pregnancy and labor]. 803 6

We determined the effects of anemia of prematurity on myocardial, metabolic, and erythropoietic functions. Twelve anemic (hemoglobin range, 65 to 78 gm/L) infants without symptoms (gestational age, (mean +/- SD) 28 +/- 2 weeks; birth weight, 1178 +/- 326 gm) were studied at a postconceptional age of 35 +/- 1.6 weeks. All measurements were done before and 36 to 48 hours after a transfusion of packed erythrocytes. Cardiac output, heart rate, and myocardial function were assessed. Oxygen consumption, carbon dioxide production, resting energy expenditure, arterial oxygen pressure for 50% hemoglobin saturation, and the concentrations of erythropoietin and 2,3-diphosphoglycerate were also determined. After transfusion, increased hemoglobin level (75 +/- 4 to 150 +/- 16 gm/L) and decreased oxyhemoglobin affinity (20.8 +/- 1.7 to 23.6 +/- 2.1 gm/L; p < 0.05) caused a decrease in plasma erythropoietin concentration (from 21.1 +/- 6.2 to 5.8 +/- 1.5 mU/ml; p < 0.01). There was a decrease in heart rate (from 155 +/- 10 beats/min to 146 +/- 7 beats/min) and cardiac output (from 281 +/- 73 ml/kg per minute to 199 +/- 62 ml/kg per minute; p < 0.05). Myocardial function indexes, weight gain, and metabolic demands were normal before and after transfusion. These results suggest that oxygenation is adequately maintained in symptom-free infants with anemia of prematurity.
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PMID:Myocardial, erythropoietic, and metabolic adaptations to anemia of prematurity. 804 Jul 78

Between July 3rd 1990 and January 4th 1993, directed blood transfusion was authorized in neonatology in France. In 1991 and 1992, anemia of prematurity was treated at Lenval hospital by directed blood transfusion. 60 preterm infants with non immune mediated anemia received 85 transfusions, 24.7% of them being provided from parental blood. 26.7% of these 60 infants were transfused only with familial blood. Although authors and parents found these preliminary results very encouraging, directed blood transfusion has been forbidden in France since January 4th 1993. It is believed that such a transfusion does not solve many problems (ie: methodological, material, moral, ethical), and the risk of transmitted infections diseases seems not to be decreased. Therefore traditional transfusion using anonymous donors is recommended.
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PMID:[Blood donation intended for the transfusion of anemic premature infants]. 805 40

Erythropoietin (EPO) is a glycoprotein produced primarily by the kidney in response to tissue hypoxia, and is the principal factor regulating red blood cell production. It stimulates erythroid precursors in the bone marrow to proliferate and mature into morphologically identifiable red blood cells. This hormone acts by binding to specific high-affinity receptor on erythroid precursors. Failure to produce adequate quantities of EPO leads to severe anemia, a situation most often encountered in patients with end stage renal disease. With the application of recombinant DNA technology, the gene for this hormone has been molecularly cloned, sequenced and expressed in a biologically active form in mammalian cells. The recombinant EPO has been demonstrated to correct anemia in patients with severe end stage renal disease and alleviate their transfusion requirements. It has also been studied for anemia associated with HIV infection/zidovudine therapy, in cancer, rheumatoid arthritis, and prematurity. In addition it has been studied as a facilitator of autologous blood predeposit in patients scheduled for elective surgery and as a perisurgical adjuvant to hasten hematologic recovery and possibly avoid the need for homologous transfusion after elective surgery. When administered with the current guidelines EPO appears to be safe drug with favorable risk/benefit ratio.
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PMID:[Clinical applications of erythropoietin]. 806 96

In the human fetus, liver macrophages appear to be the primary source of erythropoietin (Epo). Epo production shifts from the liver to peritubular cells in the kidney sometime during the 3rd trimester. Some preterm infants experience a hyporegenerative anemia that appears to be caused by inadequate Epo production. It is not clear whether this anemia is due to deficient Epo production by liver macrophages or renal peritubular cells. To assess this situation, we measured Epo mRNA and protein in macrophages obtained from cord blood of preterm and term infants and from peripheral blood of adults. Macrophages from preterm infants generated Epo mRNA and protein as effectively as those from term infants and adults. It appears that the anemia of prematurity is not due to defective Epo production by macrophages.
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PMID:Erythropoietin production by macrophages from preterm infants: implications regarding the cause of the anemia of prematurity. 816 50


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