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

The repletion of iron stores after treatment was studied in 38 patients with uncomplicated iron-deficiency anaemia. The serum ferritin concentration rose significantly when oral treatment was continued for two months after the attainment of a normal haemoglobin concentration. Patients treated with a total-dose infusion of iron dextran had thehighest final serum levels, which were significantly greater than in patients given Ferro-Gradumet. Oral ferrous sulphate was almost as effective as parenteral iron in producing iron stores.
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PMID:Accumulation of storage iron in patients treated for iron-deficiency anaemia. 113 48

Sixty hospitalised patients receiving treatment for tuberculosis, diabetes or chronic bronchitis and who had iron-deficiency anaemia (Hb levels less than 12.5g./100 ml.) were entered in a between-patient comparative study of a new, fast-release iron capsule ('Eryfer') and a standard slow-release iron tablet ('Ferro-Gradumet'). Patients were allocated to either drug at random and recived either 2 capsules (100 mg. elemental iron) or 1 tablet (105 mg. elemental iron) daily for 30 days. Haemoglobin levels and packed cell volume were measured before and at the end of the trial period. The results, analysed in 57 patients (28 on 'Eryfer' and 29 on the slow-release iron) indicate that treatment with 'Eryfer' produced a significantly more predictable response in haemoglobin regeneration, the response being dependent on the initial haemoglobin level. Both treatments, however, produced a highly significant increase in haemoglobin levels in the patients (mean increas: 'Eryfer' 1.09 g. and slow-release iron 0.76 g.). No side-effects were recorded with either treatment.
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PMID:A comparative trial of a new, fast-release iron capsule ("Eryfer") and a slow-release tablet ('Ferro-Gradumet') in iron-deficiency anaemia. 114 82

Iron deficiency occurs when the body's iron stores are exhausted. The source of blood loss leading to iron deficiency must be identified in all cases. Anemia of chronic disease generally results from an infectious, inflammatory, or malignant process. However, in some reported cases, no such process could be identified. Differentiating iron deficiency anemia from anemia of chronic disease may be difficult because of similarities in presentation. Physicians need to be aware of special clinical considerations when these two types of anemia coexist. Ferrous sulfate therapy is the ideal form of iron replacement.
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PMID:Iron deficiency and anemia of chronic disease. Clues to differentiating these conditions. 152 10

We conducted a Phase I-II trial of recombinant human erythropoietin-beta (rhEPO) in patients with myelodysplastic syndrome (MDS). Patients with anemia and pathologically confirmed MDS were eligible for the study. Treatment consisted of rhEPO by subcutaneous injection thrice weekly for 6 weeks at one of three dose levels (100 U/kg (three patients), 200 U/kg (three patients) and 400 U/kg (14 patients)). Ferrous sulfate (325 mg po tid) was also administered if the transferrin saturation was below 30% (two patients). Patients were monitored with weekly CBC, white cell differential, and reticulocyte counts. Bone marrow examinations were performed at the conclusion of the treatment period and after a 2 week washout period. Patients who responded to therapy were continued on rhEPO at the same dose for 6 additional months. Response criteria included: 50% reduction in transfusion requirements compared with the 6 week pre-study period; doubling of reticulocyte count that was maintained on two determinations at least 1 week apart; or an increase in hemoglobin by at least 1.2 gm/dl without transfusions. Pre-treatment factors potentially predictive of response were analyzed by univariate analysis and in a multivariate fashion by classification and regression trees. Seven of the twenty patients sustained an untransfused rise in serum hemoglobin > or = 1.2 gm/dl. Four of the sixteen patients (including three of seven patients experiencing a rise in serum hemoglobin) who were transfusion-dependent prior to the study achieved a reduction or elimination of their transfusion requirements. Five of thirteen patients who received rhEPO during the extension phase had a continued response. A low baseline erythropoietin level (< 50 mU/ml) was the best predictor of hemoglobin response when controlling for other variables. rhEPO has a role in the treatment of certain patients with MDS, particularly in those whose endogenous serum erythropoietin levels are not markedly elevated.
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PMID:Therapy with recombinant human erythropoietin in patients with myelodysplastic syndromes. 793 35

Iron deficiency affects more than one billion people worldwide, although it is most common among young children and women of childbearing age. Poor iron status has severe nutritional and health consequences. The authors describe the longitudinal effect of iron-fortified drinking water given to a group of Brazilian preschool children as a way of combatting iron deficiency and anemia. The statuses of 31 preschool children attending a day-care institution for low socioeconomic families in Ribeirao Preto were followed from November 1990 to October 1991. Iron sulfate was added daily to subjects' drinking water container. Measurements of hemoglobin and serum ferritin levels in the children were taken before the addition and four and eight months later to evaluate iron status. Mean hemoglobin values increased from 10.6 to 13.7 g/dL and serum ferritin from 13.7 to 25.6 ug/L with no problems reported related to the salt addition or to the children drinking the iron-enriched water. The number of iron-deficient children decreased drastically after they began drinking the iron-enriched water. It may therefore be concluded that iron-enriched drinking water is a practical alternative to supply iron to children attending a day-care institution.
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PMID:Drinking water as an iron carrier to control anemia in preschool children in a day-care center. 800 2

Iron fortification has been used for decades in a number of industrialized countries to combat iron deficiency and seems to have played a significant role in reducing its prevalence, especially in infants and women. The overall strategy has been one in which staples such as wheat, flour, have been fortified with iron. While the effects appear to have been positive, there are still problems not yet completely resolved. In this context, the selection of the fortificant always represents a compromise between a choice of chemically reactive compounds of high bioavailability, such as ferrous sulfate, and inert compounds, which are poorly absorbed. Ferrous sulfate is very effective when added during the preparation of bread and bakery products and infant formulas, but cannot be used in stores flour because of organoleptic problems and inert compounds, such as elemental iron powders, have to be used. The search, therefore, continues for compounds of high bioavailability which do not cause organoleptic changes in the vehicles to which they are added. Problems associated with effective iron fortification programmes are compounded in a number of developing countries by a variety of factors. Most potential vehicles are not centrally processed, inhibitory ligands in staple cereal diets depress the absorption of both intrinsic and fortification iron, anemia is often of multifactorial in etiology, financial resources are scanty and governmental support sometimes lacking. Despite such difficulties there are encouraging signs of progress in a number of countries, using a variety of fortificants and vehicles. In the present review particular attention is paid to the potential role of NaFeEDTA as a fortificant in developing countries. It is much less affected by the inhibitors of iron absorption present in diets of low bioavailability, it can be added to a number of vehicles without causing organoleptic problems and its efficacy has been underlined in three intervention studies.
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PMID:Iron fortification with special reference to the role of iron EDTA. 1097 33

Deficiencies in small quantities of micronutrients, especially iodine and iron, severely affect more than a third of the world's population, resulting in serious public health consequences, especially for women and young children. Salt is an ideal carrier of micronutrients. The double fortification of salt with both iodine and iron is an attractive approach to the reduction of both anemia and iodine-deficiency disorders. Because iodine is unstable under the storage conditions found during the manufacturing, distribution, and sale of salt in most developing countries, the effects of packaging materials and environmental conditions on the stability of salt double-fortified with iron and iodine were investigated. Salt was double-fortified with potassium iodide or potassium iodate and with ferrous sulfate or ferrous fumarate. The effects of stabilizers on the stability of iodine and iron were followed by storing the salt under three conditions that represent the extremes of normal distribution and sale for salt in developing countries: room temperature (25 degrees C) with 50%-70% relative humidity, 40 degrees C with 60% relative humidity, and 40 degrees C with 100% relative humidity. The effects of stabilizers, such as sodium hexametaphosphate (SHMP), calcium carbonate, calcium silicate, and dextrose were investigated. None of the combinations of iron and iodine compounds was stable at elevated temperatures. Essentially all of the iodine was lost over a period of six months. SHMP effectively slowed down the iodine loss, whereas magnesium chloride, a typical hygroscopic impurity, greatly accelerated this process. Calcium carbonate did not have a sparing effect on iodine, despite contrary indications in the literature. Ferrous sulfate-fortified salts generally turned yellow and developed an unpleasant rusty flavor. Salt fortified with ferrous fumarate and potassium, iodide was reasonably stable and maintained its organoleptic properties, making it more likely to be acceptable to consumers. We confirmed that application of the iodine compounds as solutions resulted in a more even distribution of the iodine throughout the sample. The effect of the packaging materials was overshadowed by the other variables. None of the packaging materials was clearly better than any other. This may have been due to the fact that the polymer bags were not heat sealed, and thus some moisture penetration was possible. The results indicate that with careful control of processing, packaging, and storage conditions, a double-fortified salt could be stabilized for the six-month period required for distribution and consumption. Unfortunately, the processing and storage required are difficult to attain under typical conditions in developing countries.
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PMID:Iodine stability in salt double-fortified with iron and iodine. 1209 70

After 1 y of distributing a milk-based fortified weaning food provided by the Mexican social program PROGRESA, positive effects on physical growth, prevalence of anemia, and several vitamin deficiencies were observed. There was no effect on iron status, which we hypothesized was related to the poor bioavailability of the reduced iron used as a fortificant in PROGRESA. The objective of this study was to compare the iron bioavailability from different iron sources added as fortificants to the weaning food. Children (n = 54) aged 2-4 y were randomly assigned to receive 44 g of the weaning food fortified with ferrous sulfate, ferrous fumarate, or reduced iron + Na(2)EDTA. Iron absorption was measured using an established double-tracer isotopic methodology. Iron absorption from ferrous sulfate (7.9 +/- 9.8%) was greater than from either ferrous fumarate (2.43 +/- 2.3%) or reduced iron + Na(2)EDTA (1.4 +/- 1.3%) (P < 0.01). The absorption of log-(58)Fe sulfate given with the iron source correlated with serum ferritin (s-ferritin) concentration (n = 13, r = 0.63, P = 0.01) and log-(57)Fe absorption (reference dose) (n = 14, r = -0.52, P = 0.02). Absorption from ferrous fumarate and reduced iron + Na2EDTA did not correlate with s-ferritin or absorption of (57)Fe. The recommended daily portion of the fortified complementary food provides an average of 0.256, 0.096, 0.046 mmol (1.44, 0.54, and 0.26 mg) of absorbed iron, if fortified with sulfate, fumarate and reduced iron + Na(2)EDTA, respectively. Ferrous sulfate was more bioavailable than either ferrous fumarate or reduced iron + Na(2)EDTA when added to the milk-based fortified food and more readily met the average daily iron requirements for children 2-3 y of age.
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PMID:Ferrous sulfate is more bioavailable among preschoolers than other forms of iron in a milk-based weaning food distributed by PROGRESA, a national program in Mexico. 1562 34

In the majority of cases, microcytosis is the result of impaired hemoglobin synthesis. Disorders of iron metabolism and protoporphyrin and heme synthesis, as well as impaired globin synthesis, lead to defective hemoglobin production and to the generation of microcytosis and microcytic anemia. Iron deficiency anemie, anemia of chronic diseases, thalassemias, congenital sideroblastic anemias and homozygous HbE disease are the main representatives of microcytosis and microcytic anemias. Serum iron, total iron binding capacity, transferrin saturation, serum ferritin, serum transferrin receptor, transferrin receptor-ferritin index, and zinc-protoporhyrin concentration in erythrocytes are tests used for assessment of iron deficiency. The convention laboratory test for diagnosing iron deficiency is the measurement of serum ferritin. The most precise method for evaluating body iron stores is the examination for iron on aspirated bone marrow or marrow biopsy. Increased content of Hb A2 over 3.5% is diagnostic for beta-thalassemia. Presence of ringed sideroblasts is characteristic of sideroblastic anemias. Hemoglobin electrophoresis is required for the diagnosis of hemoglobinopathy E. The optimal therapeutic regimen in iron deficiency anemia used in this country is to administer 100 mg of elemental iron twice daily separately from meals. Ferrous sulphate (Ferronat Retard tbl. or Sorbifer Dulures tbl.) which are slow-releasing iron formulations are preferred because of their low cost, high bioavailability and low side-effects. Parenteral iron therapy is justified only in patients who cannot absorb iron, who have blood losses that exceed the maximal absorptive capacity of their intestinal tract or who are totally intolerant of oral iron. However, parenteral iron therapy may be associated with serious and even fatal side-effects.
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PMID:[Microcytic and hypochromic anemias]. 1563 79

The aim of this study was to determine the iron status of infants who consumed porridge cooked in water with added ferrous sulphate. A total of 234 infants, aged 6-12 months, were recruited from 36 nurseries in the Democratic Peoples Republic of Korea (DPRK North Korea) and randomly divided into iron (Fe) and placebo groups. At baseline, almost half the children had Hb<110 g/L and no significant differences between the two groups were found with regard to hemoglobin concentration and anemia prevalence. The Fe group received rice porridge fortified with 10 mg of iron (as ferrous sulfate) per day, added to the water in which the rice was cooked and the placebo group non-fortified cereal for 6 months. After which, the hemoglobin (Hb), serum ferritin (SF) and packed cell volume (PCV) were measured and it was found that the proportion of children with anemia (Hb<110 g/L) was lower (24.3% v 48.1% p<0.01), the Hb levels (117.6 g/L v 109.8 g/L p<0.001) and serum ferritin were higher (40.7 v 26.8 mcg/L p<0.001); and iron deficiency anemia (Hb<110 g/L, SF<12 mcg/L) was lower in the Fe group (3% v 22% p<0.001) when compared to the placebo group. Ferrous sulphate, added to the water in which rice was cooked, lowered the prevalence of iron deficiency anemia of infants in the DPRK with no adverse reactions. This simple fortification would be suitable as a nationwide program in the DPRK and other countries with large infant nurseries.
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PMID:Effect of iron fortification of nursery complementary food on iron status of infants in the DPRKorea. 1858 46


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