scholarly journals Assessing the Frequency, Investigation, and Management of Post-operative Anaemia in Hip Fracture Patients

2021 ◽  
Author(s):  
David Livingstone McCormack ◽  
Orla Costigan ◽  
Emily McGarry ◽  
Shane O’Hanlon ◽  
Conor Hurson
Keyword(s):  
Hip Fracture ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
University Hospital ◽  
Major Surgery ◽  
Deficiency Anaemia ◽  
Retrospective Audit ◽  
B12 Deficiency

Abstract BackgroundPost-operative anaemia affects up to 90% of patients undergoing major surgery [1]. Post-operative anaemia can contribute to slower rehabilitation, increased morbidity, and increased mortality [2]. AimsWe aimed to examine the frequency, investigation, and management of anaemia in patients admitted to St. Vincent’s University Hospital (SVUH) with a hip fracture.MethodsA retrospective audit, examining all patients who were admitted to SVUH with a hip fracture between the 1st of April and the 30th of June 2020, was performed. ResultsA total of 58 patients were included. Upon admission, 29.3% (n = 17) of patients were anaemic. Post-operatively, 91.4% of patients (n = 53) were anaemic. 43.1% (n = 25) of patients had iron studies, ferritin, folate and B12 levels measured. Iron deficiency anaemia was detected in 22.4% (n = 13) of patients, folate deficiency was detected in 10.3% (n = 6), and no patients were found to have vitamin B12 deficiency. Of the patients with iron deficiency anaemia, 15.4% (n = 2) were given IV iron infusions and 7.7% (n = 1) received a prescription for oral iron. Of the 6 patients with folate deficiency, 33.3% (n = 2) received a prescription for folic acid. Red cell transfusions were given to 13.8% (n = 8) of patients. Upon discharge, 89.7% (n = 52) of patients remained anaemic. ConclusionsAnaemia is an under-investigated and under-treated complication of hip fractures.

scholarly journals ETIOLOGICAL PROFILE OF 50 CASES 0F ANAEMIA IN CKD

2020 ◽  
pp. 1-2
Author(s):  
Yalavarthi Hema Choudary ◽  
E. Karthik ◽  
Ch. Sudhakar
Keyword(s):  
Chronic Disease ◽  
Kidney Disease ◽  
Iron Deficiency ◽  
Clinical Examination ◽  
Iron Deficiency Anaemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anaemia ◽  
Anaemia Of Chronic Disease ◽  
B12 Deficiency ◽  
Erythropoietin Deficiency

Background and objectives: Anaemia is a common and significant complication of chronic kidney disease (CKD). When present it may cause symptoms such as fatigue and shortness of breath. It is associated with reduced quality of life and increased cardiovascular disease, hospitalizations, cognitive impairment and mortality. As kidney disease progresses, anaemia increases in prevalence affecting nearly all patients with stage V CKD. In patients with CKD, anaemia is defined as the situation in which the concentration of haemoglobin (Hb) in the blood is below 2 times the SD of the mean Hb of the general population. As the pathogenesis of anaemia in CKD is mutlifactorial, this study is intended to know various etiological factors responsible for anaemia in CKD patients. Methods: 50 patients who met with inclusion criteria and exclusion criteria are subjected to detail clinical examination and investigations. Depending upon data obtained, results are evaluated and the percentage of various types of anaemia in CKD was calculated. Results: At the end of study, anaemia of chronic disease (60%) constitutes the commonest cause of anaemia in CKD, followed by iron deficiency anaemia (30%) and megaloblastic anaemia (10%) due to vitamin B12 deficiency. Conclusion: Among 50 cases of anaemia in CKD, anaemia of chronic disease due to erythropoietin deficiency was the most common cause followed by iron deficiency anaemia. Usually clinical examination and routine simple investigations will clinch the diagnosis in most of the cases.

Audit of the prevalence and investigation of iron deficiency anaemia in patients with heart failure in hospital practice

2019 ◽  
Vol 96 (1134) ◽  
pp. 206-211
Author(s):  
Steny Simon ◽  
Adam Ioannou ◽  
Stuart Deoraj ◽  
Sofia Metaxa ◽  
Amit K J Mandal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Healthcare Professionals ◽  
Deficiency Anaemia ◽  
Heart Failure Patients ◽  
Qualitative Survey ◽  
Retrospective Audit ◽  
Iron Deficient ◽  
Iron Replacement

Purpose of the studyIron deficiency anaemia (IDA) is associated with increased morbidity and mortality in heart failure patients. The aim of our audit was to evaluate the current practice in diagnosis and assessment of IDA in patients admitted with heart failure.Study designWe conducted a retrospective audit of patients admitted to our hospital between January 2017 and June 2017 with a diagnosis of heart failure, and obtained data regarding each patient’s demographics and anaemic status. We also conducted a qualitative survey to assess healthcare professionals’ ability to diagnose IDA, and their knowledge of iron replacement in heart failure patients.ResultsOur audit identified 218 heart failure patients, nearly two-thirds (n=138, 63.3%) of which were anaemic. Of the 138 anaemic patients, only 40 had a full haematinic screen compared with 98 who had incomplete investigations (29% vs 71%, p=0.007). Iron studies were the most commonly performed haematinic investigation (n=87, 63%), and over half of these patients were iron deficient (n=49, 56.3%). Only 12 (24.5%) iron deficient patients were prescribed oral iron therapy, while 37 (75.5%) were left without iron replacement (X2=12.8, p=0.0003). Our survey demonstrated a lack of awareness among healthcare professionals with only 19.7% of participants being able to correctly define anaemia and 9.1% being aware of guidelines regarding treatment of IDA.ConclusionMany patients admitted to hospital with heart failure also have a concomitant diagnosis of anaemia. The aetiology of the underlying anaemia is often poorly investigated, and where IDA is identified it is poorly treated.

scholarly journals The effects of nutrients on mood

1999 ◽  
Vol 2 (3a) ◽  
pp. 403-409 ◽  
Author(s):  
David Benton ◽  
Rachael T Donohoe
Keyword(s):  
Iron Deficiency ◽  
Elderly Patients ◽  
Iron Deficiency Anaemia ◽  
Psychological Symptoms ◽  
Folate Deficiency ◽  
Double Blind ◽  
Deficiency Anaemia ◽  
Laboratory Conditions ◽  
The Brain ◽  
Do So

AbstractA recent major theory was that a meal high in carbohydrate increased the rate that tryptophan enters the brain, leading to an increase in the level of the neurotransmitter serotonin that modulates mood. Although such a mechanism may be important under laboratory conditions it is unlikely to be of significance following the eating of any typical meal. As little as 2–4% of the calories of a meal as protein will prevent an increased availability of tryptophan. Arguably the food with the greatest impact on mood is chocolate. Those who crave chocolate tend to do so when they feel emotionally low. There have been a series of suggestions that chocolate's mood elevating properties reflect ‘drug-like’ constituents including anandamines, caffeine, phenylethylamine and magnesium. However, the levels of these substances are so low as to preclude such influences. As all palatable foods stimulate endorphin release in the brain this is the most likely mechanism to account for the elevation of mood. A deficiency of many vitamins is associated with psychological symptoms. In some elderly patients folate deficiency is associated with depression. In four double-blind studies an improvement in thiamine status was associated with improved mood. Iron deficiency anaemia is common, particularly in women, and is associated with apathy, depression and rapid fatigue when exercising.

Does Cell Size Matter?: Utilizing Mean Cell Volume in Hospitalized Patients As a Screen to Determine Common Causes of Anemia Including Iron Deficiency Anemia, Vitamin B12 and Folate Deficiency

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2338-2338 ◽  
Author(s):  
Manika Gupta ◽  
Kathleen Copley ◽  
Michael Keeney ◽  
Ian Chin-Yee
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cell Volume ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Deficiency Anemia ◽  
Mean Cell Volume ◽  
Common Causes ◽  
B12 Deficiency

Abstract Background: The approach to anemia is traditionally based on the Mean Cell Volume. Based on this approach anemia is subdivided into microcytic, normocytic and macrocytic causes. This approach may not accurately discern common causes of anemia in hospitalized patients. Previous studies suggest the MCV may not be a sensitive measurement to differentiate iron deficiency anemia (IDA) and megaloblastic anemia due to vitamin B12 or folate deficiency. Methods: In a retrospective, single-centre study at London Health Sciences Center, all adult patients (age 18 years or older) with confirmed IDA, vitamin B12 and folate deficiency and their associated MCV and RDW values at LHSC over a one year period were reviewed. IDA was defined as hemoglobin less than 115 g/l and ferritin less than 30 (M) and 10 (F). Vitamin B12 deficiency was defined as a value of less than 145. Results: 1119 patients were identified with confirmed IDA, B12 or Folate deficiency. 894 patients had IDA of which 564 patients had low MCV (sensitivity 63.1%) and 797 patients had low MCV or high RDW (sensitivity 89.1%). Of the 96 patients with vitamin B12 deficiency anemia, 12 patients had high MCV (sensitivity 12.5%) and 70 patients had high MCV or high RDW (72.9%). Only one of 2244 patients who had RBC folate measured had an actual folate deficiency. Conclusion: Our results confirm that a normal MCV does not exclude IDA or vitamin B12 deficiency. Clinicians need to be aware of the low sensitivity of the MCV as a screen. The sensitivity of MCV for IDA or vitamin B12 deficiency is improved with indices such as RDW. Folate deficiency is rare in North America and should not be routinely ordered for assessment of nutritional anemia. Disclosures No relevant conflicts of interest to declare.

Impaired Response to Iron Dextran Infusion Due to Latent Vitamin B12 Deficiency without Achlorhydria

1968 ◽  
Vol 13 (1) ◽  
pp. 24-26
Author(s):  
J. J. Boyd ◽  
John Bonnar ◽  
R. W. Payne
Keyword(s):  
Hydrochloric Acid ◽  
Iron Deficiency Anaemia ◽  
Vitamin B12 Deficiency ◽  
Severe Anaemia ◽  
Free Hydrochloric Acid ◽  
Vitamin B ◽  
Iron Dextran ◽  
Deficiency Anaemia ◽  
Haematological Response ◽  
B12 Deficiency

A case of severe iron-deficiency anaemia as a result of intractable menorrhagia is described. Following treatment with an iron dextran infusion, an impaired haematological response occurred; this was shown to be the result of vitamin B12 deficiency despite the presence of abundant free hydrochloric acid in the gastric juice. The severe anaemia (3.5 g. %) was corrected within 5 weeks by one iron dextran infusion and vitamin B12 therapy prior to hysterectomy.

scholarly journals Trace Element Status (Iron, Zinc, Copper, Chromium, Cobalt, and Nickel) in Iron-Deficiency Anaemia of Children under 3 Years

Anemia ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Georgieva Angelova ◽  
Tsvetelina Valentinova Petkova-Marinova ◽  
Maksym Vladimirovich Pogorielov ◽  
Andrii Nikolaevich Loboda ◽  
Vania Nedkova Nedkova-Kolarova ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Trace Element ◽  
Reference Values ◽  
Iron Deficiency Anaemia ◽  
University Hospital ◽  
Serum Concentrations ◽  
Deficiency Anaemia ◽  
Trace Element Status ◽  
Copper Chromium ◽  
Cobalt And Nickel

Aim. To determine trace element status and aetiologic factors for development of trace elements deficiencies in children with iron-deficiency anaemia (IDA) aged 0 to 3 years.Contingent and Methods. 30 patients of the University Hospital, Pleven, Bulgaria—I group; 48 patients of the Sumy Regional Child’s Clinical Hospital, Sumy, Ukraine—II group; 25 healthy controls were investigated. Serum concentrations of iron, zinc, copper, chromium, cobalt, and nickel were determined spectrophotometrically and by atomic absorption spectrophotometry.Results. Because the obtained serum levels of zinc, copper, and chromium were near the lower reference limits, I group was divided into IA and IB. In IA group, serum concentrations were lower than the reference values for 47%, 57%, and 73% of patients, respectively. In IB group, these were within the reference values. In II group, results for zinc, cobalt, and nickel were significantly lower (P<0.05), and results for copper were significantly higher in comparison to controls.Conclusion. Low serum concentrations of zinc, copper, cobalt, and nickel were mainly due to inadequate dietary intake, malabsorption, and micronutrient interactions in both studied groups. Increased serum copper in II group was probably due to metabolic changes resulting from adaptations in IDA. Data can be used for developing a diagnostic algorithm for IDA.

Apparent Folate Deficiency in Iron-Deficiency Anaemia

1971 ◽  
Vol 20 (2) ◽  
pp. 165-176 ◽  
Author(s):  
P. D. Roberts ◽  
D. J. B. StJohn ◽  
R. Sinha ◽  
J. S. Stewart ◽  
I. M. Baird ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Folate Deficiency ◽  
Deficiency Anaemia
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