Use of alternative methods in the treatment of anemia in pregnant women – prospective observational study

Objectives: Anemia in pregnant women is a common condition, diagnosed when the concentration of hemoglobin falls below 11 g/dL. Taking into consideration the accounts of nephrologists about good results of treatment of secondary anemia using erythropoietin in patients with renal failure, we tried to use EPO to cure anemia in pregnant women.  The aim of the study was to evaluate the results of EPO treatment on pregnant women diagnosed with iron deficiency anemia, as well as possible side effects.  Material and methods: The study consisted of 25 patients: Group I — treated with iron supplement administered parenterally — Ferrum Lek every two days intramuscularly.  Group II — treated with recombinant human erythropoietin — 1000 j intravenously every three days, with oral iron sup- plements.  Results: After a week of treatment the positive response was higher in the second group (92.3% in II, vs 33.3% in I, p < 0.005). The average increase of hemoglobin and RBC was significantly higher in II group.  An increase in hemoglobin did not correlate with the age of women (r = 0.07) or with the duration of pregnancy (r = 0.08). However, a negative correlation was found between basic hemoglobin level and its increase after treatment (r = 0.602).  Conclusions: EPO administered with the oral dose of iron in pregnant women with anemia caused by iron deficiency shows higher effectiveness than the use of iron preparations parenterally.  The usage of EPO during pregnancy is not related to any dangerous side effects for the mother or fetus.

Prevalence of atrial fibrillation in Polish population >=65 old. Report of cross-sectional NOMED-AF study

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia, characterized by an increased risk of thromboembolic complications that can be markedly reduced with anticoagulation. There is a paucity of studies assessing the total prevalence of AF in national populations.AimsTo assess the nationwide prevalence of AF in a population of adults ≥65 old and to determine the impact of duration of electrocardiogram (ECG) monitoring on the number of newly detected AF episodes.MethodsThe NOMED-AF study (ClinicalTrials.gov; NCT: 0324347) was a cross-sectional study performed on a nationally representative random sample of 3014 Polish citizens 65 years or older. Final estimates were adjusted to the national population. All participants underwent up to 30 days of continuous ECG monitoring. Total AF prevalence was diagnosed based on the patient's medical records or the presence of AF in ECG monitoring.ResultsThe prevalence of AF in the Polish population ≥65 years was estimated as 19.2% (95% confidence interval [CI], 17.9%-20.6%). This included 4.1% (95% CI, 3.5%-4.8%) newly diagnosed cases and 15.1% (95% CI, 13.9%-16.3%) previously diagnosed cases and consisted of 10.8% (95% CI, 9.8%-11.9%) paroxysmal AF and 8.4% (95% CI, 7.5%-9.4%) persistent/permanent AF. The incidence of all paroxysmal AF events as a function of ECG monitoring duration increased from 1.9% (95% CI, 1.4%-2.6%) at 24 hours to 6.2% (95% CI, 5.3%-7.2%) at 4 weeks.ConclusionsThe prevalence of AF in elderly adults is higher than estimated based on medical records only. Four weeks of monitoring compared to 24-hour ECG Holter allow detection of 7-fold more cases of previously undiagnosed paroxysmal AF