Ferritin and transferrin saturation cannot be used to diagnose iron-deficiency anemia in critically ill patients

Abstract Introduction: Iron-deficiency anaemia (IDA) is the most common anaemia globally. The frequency of IDA among critically ill patients is not known. The aim of our study was to analyse performance of standard iron metabolism parameters in diagnosis of IDA in the critically ill. Material and methods: We performed a retrospective analysis of consecutive anaemic patients admitted to the intensive care unit. Based on various cut-off values for ferritin and/or transferrin saturation (TfS), we determined the incidence of IDA. Results: The population consisted of 27 (53%) men and 24 (47%) women. The median haemoglobin concentration was well 96 [interquartile range (IQR 87–109)] g/L. The studied population had markedly increased concentration of C-reactive protein [119 (IQR 44–196) mg/L], ferritin [686 (385–1114) µg/L], whereas iron concentration and TfS were below reference value. Depending on cut-off value chosen, IDA could be diagnosed in between 7.8 (ferritin < 100 µg/L +TfS < 20%) and 56.9 % (TfS < 20%) of patients. Conclusions: Ferritin and transferrin saturation cannot be used for precise diagnosis of IDA caused by absolute or functional iron deficiency in the critically ill

Anemia adquirida em hospital

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizA anemia adquirida em hospital (AAH) é uma consequência derivada da hospitalização que persiste ainda nos dias de hoje. Nos doentes com maior número de comorbilidades, não anémicos à admissão hospitalar, os níveis de hemoglobina podem diminuir devido a intervenções médicas e/ou terapêuticas abaixo do limite de diagnóstico de anemia. O risco de aquisição de anemia durante a hospitalização é tanto maior quanto mais prolongado for o período de internamento e depende da concentração de hemoglobina na admissão e do número de comorbidades. É fundamental perceber a etiologia da AAH, que é multifatorial, a fim de identificar os doentes de risco e implementar medidas que previnam a anemia nosocomial e transfusões sanguíneas nos doentes mais suscetíveis.Hospital-acquired anaemia (HAA) is a consequence of hospitalization that persists to this day. In patients with a greater number of comorbidities, who are not anaemic on admission to the hospital, haemoglobin levels may decrease due to medical and/or therapeutic interventions below the diagnostic threshold for anaemia. The risk of acquiring anaemia during hospitalization is greater the longer the hospital stay and depends on the haemoglobin concentration on admission and the number of comorbidities. It is essential to understand the aetiology of AAH, which is multifactorial, to identify patients at risk and implement measures to prevent nosocomial anaemia and blood transfusions in the most susceptible patients

Brain Injury

The present two volume book "Brain Injury" is distinctive in its presentation and includes a wealth of updated information on many aspects in the field of brain injury. The Book is devoted to the pathogenesis of brain injury, concepts in cerebral blood flow and metabolism, investigative approaches and monitoring of brain injured, different protective mechanisms and recovery and management approach to these individuals, functional and endocrine aspects of brain injuries, approaches to rehabilitation of brain injured and preventive aspects of traumatic brain injuries. The collective contribution from experts in brain injury research area would be successfully conveyed to the readers and readers will find this book to be a valuable guide to further develop their understanding about brain injury

Cardiac Arrhythmias

This book is useful for physicians taking care of patients with cardiac arrhythmias and includes six chapters written by experts in their field. Chapter 1 discusses basic mechanisms of cardiac arrhythmias. Chapter 2 discusses the chronobiological aspects of the impact of apnoic episodes on ventricular arrhythmias. Chapter 3 discusses navigation, detection, and tracking during cardiac ablation interventions. Chapter 4 discusses epidemiology and pathophysiology of ventricular arrhythmias in several noncardiac diseases, methods used to assess arrhythmia risk, and their association with long-term outcomes. Chapter 5 discusses the treatment of ventricular arrhythmias including indications for implantation of an AICD for primary and for secondary prevention in patients with and without congestive heart failure. Chapter 6 discusses surgical management of atrial fibrillation

The Mystery of Yawning in Physiology and Disease

Yawning is a stereotyped phylogenetically ancient phenomenon that occurs in almost all vertebrates. As an emotional behavior and an expressive movement, yawning has many consequences; nevertheless, it has so far been poorly addressed in medical research and practice. Bringing together the latest research from many fields, this volume integrates current insights within embryology, ethology, neurophysiology, psychology, fMRI and pathology. The phylogenetic and ontogenetic aspects of yawning offer an interesting perspective on human development, and its occurrence in neurological diseases - an area explored by only a few investigators - may provide useful clinical information. This book will make valuable and fascinating reading to neurologists, sleep specialists, psychologists, ethologists and pharmacologists, as well as to anybody interested in uncovering the mystery of yawning

Epidemiology Insights

This book represents an overview on the diverse threads of epidemiological research, brings together the expertise and enthusiasm of an international panel of leading researchers to provide a state-of-the art overview of the field. Topics include the epidemiology of dermatomycoses and Candida spp. infections, the epidemiology molecular of methicillin-resistant Staphylococcus aureus (MRSA) isolated from humans and animals, the epidemiology of varied manifestations neuro-psychiatric, virology and epidemiology, epidemiology of wildlife tuberculosis, epidemiologic approaches to the study of microbial quality of milk and milk products, Cox proportional hazards model, epidemiology of lymphoid malignancy, epidemiology of primary immunodeficiency diseases and genetic epidemiology family-based. Written by experts from around the globe, this book is reading for clinicians, researchers and students, who intend to address these issues