scholarly journals Prevalence and Causes of Anemia in Hospitalized Patients: Impact on Diseases Outcome

2020 ◽  
Vol 9 (4) ◽  
pp. 950 ◽  
Author(s):  
Maria Luigia Randi ◽  
Irene Bertozzi ◽  
Claudia Santarossa ◽  
Elisabetta Cosi ◽  
Fabrizio Lucente ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Inflammatory Diseases ◽  
Specific Treatment ◽  
Hospitalized Patients ◽  
Medical Attention ◽  
Loss Of Function ◽  
Discharge Letter ◽  
A Minor

Anemia is extremely common in hospitalized patients who are old and often with multiple diseases. We evaluated 435 consecutive patients admitted in the internal medicine department of a hub hospital and 191 (43.9%) of them were anemic. Demographic, historic and clinical data, laboratory tests, duration of hospitalization, re-admission at 30 days and death were recorded. Patients were stratified by age (<65, 65–80, >80 years), anemia severity, and etiology of anemia. The causes of anemia were: iron deficiency in 28 patients, vitamin B12 and folic acid deficiencies in 6, chronic inflammatory diseases in 80, chronic kidney disease in 15, and multifactorial in 62. The severity of the clinical picture at admission was significantly worse (p < 0.001), length of hospitalization was longer (p < 0.001) and inversely correlated to the Hb concentration, re-admissions and deaths were more frequent (p 0.017) in anemic compared to non-anemic patients. A specific treatment for anemia was used in 99 patients (36.6%) (transfusions, erythropoietin, iron, vitamin B12 and/or folic acid). Anemia (and/or its treatment) was red in the discharge letter only 54 patients. Even if anemia is common, in internal medicine departments scarce attention is paid to it, as it is generally considered a “minor” problem, particularly in older patients often affected by multiple pathologies. Our data indicate the need of renewed medical attention to anemia, as it may positively affect the outcome of several concurrent medical conditions and the multidimensional loss of function in older hospitalized patients.

scholarly journals Nitazoxanide against COVID-19 in three explorative scenarios

2020 ◽  
Vol 14 (09) ◽  
pp. 982-986
Author(s):  
José Meneses Calderón ◽  
Ma. del Rocío Figueroa Flores ◽  
Leopoldo Paniagua Coria ◽  
Jesús Carlos Briones Garduño ◽  
Jazmín Meneses Figueroa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Positive Outcome ◽  
Hospitalized Patients ◽  
Ambulatory Setting ◽  
Medical Attention ◽  
Clinical Settings ◽  
Medicine Service ◽  
Ambulatory Patients

Introduction: Nitazoxanide has shown efficacy in vitro against coronavirus infections (MERS, SARS, SARS-CoV-2). The aim of this report is to describe the results of treating COVID-19 positive patients with nitazoxanide in three clinical settings: pregnancy/puerperium, hospitalized patients in an Internal Medicine Service and in an ambulatory setting. Methodology: This was a prospective follow-up and report of COVID-19 cases in three different situations, pregnant women, hospitalized patients receiving medical attention in an Internal Medicine Service and ambulatory patients residing in Toluca City, and Mexico City. Results: The experience with a first group of 20 women, pregnant (17) or in immediate puerperium (3) was successful in 18 cases with two unfortunate deaths. The five cases treated in an Internal Medicine service showed a positive outcome with two patients weaned from mechanical ventilation. Of the remaining 16 patients treated in an ambulatory setting, all got cured. Nitazoxanide seems to be useful against SARS-CoV-2, not only in an early intervention but also in critical condition as well as in pregnancy without undesired effects for the babies. As an adjunctive therapy budesonide was used that seems to contribute to the clinical improvement. Conclusions: Nitazoxanide could be useful against COVID-19 as a safe and available regimen to be tested in a massive way immediately.

scholarly journals The CONFINE (Comorbidities and Outcome iN patients with chronic heart Failure: a study in INternal mEdicine units) study: a new epidemiologic observational study on heart failure in the internal medicine departments in Italy

2013 ◽  
pp. 57-64
Author(s):  
P. Biagi
Keyword(s):  
Internal Medicine ◽  
Heart Failure ◽  
Observational Study ◽  
Inflammatory Diseases ◽  
Correct Diagnosis ◽  
Cognitive Disorders ◽  
Epidemiological Data ◽  
Chronic Kidney Failure ◽  
Chronic Obstructive ◽  
Quality Life

BACKGROUND The burden of heart failure (HF) is enormous and its prevalence increases sharply with age. It has been estimated that heart failure affects up to 3% of the general population and 10% of the elderly. It contributes to hospital admission for most of them, mainly elder adults (admitted in internal medicine units) with more than one comorbidity, cognitive disorders, impairment and so on. Despite the increasing prevalence of heart failure, its exact incidence and prevalence remain largely unknown and probably underestimated due to a lack of accurate epidemiological data and difficulties associated with comorbidities and correct diagnosis: over 40% of recurrent hospitalization causes, either cardiac or extracardiac, cannot be determined due to the lack of data. AIM OF THE STUDY The objective of this study estimated the prevalence and the primary care burden associated with comorbidities in internal medicine units. METHOD The design: a longitudinal multicentric observational study using spot analysis three data sheets were filled in during the hospital stay according to three crucial moments: enrolment (“the index day”), admission and discharge. Will be analyzed the following primary outcomes: total and cardiovascular mortality, intensive unit care admission, recurrent cardiovascular disorders, length of stay, hospital readmission, changes in activities of daily living, need for care. Second outcomes: clinical, therapeutic, instrumental and laboratory changes during the admission process. Deep analysis of the following comorbidities will be also taken into account: acute and chronic kidney failure, anaemia, chronic obstructive pulmonary disease, muscle loss, nutritional status, cirrhosis of the liver, neoplasms, blood cell disorders, chronic inflammatory diseases. Further evalutation items: cognitive impairment, self-sufficiency and perception of quality life.

Serum levels of folic acid, vitamin B12, and iron in anemia of pregnancy

1966 ◽  
Vol 96 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Fred Benjamin ◽  
Frank A. Bassen ◽  
Leo M. Meyer
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Serum Levels

scholarly journals A family harboring an MLKL loss of function variant implicates impaired necroptosis in diabetes

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Joanne M. Hildebrand ◽  
Bernice Lo ◽  
Sara Tomei ◽  
Valentina Mattei ◽  
Samuel N. Young ◽  
...  
Keyword(s):  
Potential Role ◽  
Autosomal Dominant ◽  
Inflammatory Diseases ◽  
Diabetic Patients ◽  
Incomplete Penetrance ◽  
Loss Of Function ◽  
Healthy Sibling ◽  
Dominant Disease ◽  
Terminal Effector

AbstractMaturity-onset diabetes of the young, MODY, is an autosomal dominant disease with incomplete penetrance. In a family with multiple generations of diabetes and several early onset diabetic siblings, we found the previously reported P33T PDX1 damaging mutation. Interestingly, this substitution was also present in a healthy sibling. In contrast, a second very rare heterozygous damaging mutation in the necroptosis terminal effector, MLKL, was found exclusively in the diabetic family members. Aberrant cell death by necroptosis is a cause of inflammatory diseases and has been widely implicated in human pathologies, but has not yet been attributed functions in diabetes. Here, we report that the MLKL substitution observed in diabetic patients, G316D, results in diminished phosphorylation by its upstream activator, the RIPK3 kinase, and no capacity to reconstitute necroptosis in two distinct MLKL−/− human cell lines. This MLKL mutation may act as a modifier to the P33T PDX1 mutation, and points to a potential role of impairment of necroptosis in diabetes. Our findings highlight the importance of family studies in unraveling MODY’s incomplete penetrance, and provide further support for the involvement of dysregulated necroptosis in human disease.

scholarly journals IL-6 Is Not Absolutely Essential for the Development of a TH17 Immune Response after an Aerosol Infection with Mycobacterium tuberculosis H37rv

Cells ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 9
Author(s):  
Kristina Ritter ◽  
Jan Christian Sodenkamp ◽  
Alexandra Hölscher ◽  
Jochen Behrends ◽  
Christoph Hölscher
Keyword(s):  
Immune Response ◽  
Inflammatory Diseases ◽  
Mycobacterial Infection ◽  
Minor Effect ◽  
Mycobacterium Tuberculosis H37rv ◽  
Th 17 ◽  
Anti Inflammatory ◽  
A Minor ◽  
Aerosol Infection ◽  
Deficient Mice

Anti-inflammatory treatment of chronic inflammatory diseases often increases susceptibility to infectious diseases such as tuberculosis (TB). Since numerous chronic inflammatory and autoimmune diseases are mediated by interleukin (IL)-6-induced T helper (TH) 17 cells, a TH17-directed anti-inflammatory therapy may be preferable to an IL-12-dependent TH1 inhibition in order to avoid reactivation of latent infections. To assess, however, the risk of inhibition of IL-6-dependent TH17-mediated inflammation, we examined the TH17 immune response and the course of experimental TB in IL-6- and T-cell-specific gp130-deficient mice. Our study revealed that the absence of IL-6 or gp130 on T cells has only a minor effect on the development of antigen-specific TH1 and TH17 cells. Importantly, these gene-deficient mice were as capable as wild type mice to control mycobacterial infection. Together, in contrast to its key function for TH17 development in other inflammatory diseases, IL-6 plays an inferior role for the generation of TH17 immune responses during experimental TB.

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