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look at my striped shirt essay - May 30, · In a study of 75 people with iron deficiency anemia, researchers found that nearly 27 percent of them had atrophic glossitis, along with dry mouth, a burning sensation, and other issues. Anemia (also spelled anaemia) is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen. When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath, and a poor ability to exercise. When the anemia comes on quickly, symptoms may include confusion, feeling. Kim et al () stated that iron deficiency is associated with shifts in HbA1c distribution from. breathing life in essays lucy calkins
caroline handley thesis - Dec 06, · The World Health Organization estimated worldwide prevalence of anemia to be 42% in children, 29% in non-pregnant women, and 38% in pregnant women in 1 In , iron deficiency (ID) was identified as the predominant cause of anemia among the billion anemic people (27% of the world’s population) globally, making iron deficiency anemia (IDA) a major global health issue. . Nov 26, · Similar to the establishment of a diagnosis of iron deficiency anemia, a diagnosis of vitamin B or folic acid deficiency does not stop with an abnormal laboratory value for one of these vitamins. Prompt treatment can be instituted, but a continued search for an underlying cause of the vitamin deficiency is indicated (see Pernicious Anemia). Patient with sideroblastic anemia and mitochondrial myopathy, lactic acidosis, and sideroblastic anemia syndrome due to a homozygous, 6-kb deletion in the PUS1 gene. Volume 66, Issue 3 How I approach iron deficiency with and without anemia. minority report book wiki
jack kent cooke graduate dissertation fellowship - Aplastic anemia is a disease in which the body fails to produce blood cells in sufficient numbers. Blood cells are produced in the bone marrow by stem cells that reside there. Aplastic anaemia causes a deficiency of all blood cell types: red blood cells, white blood cells, and platelets.. It is more frequent in people in their teens and twenties but is also common among the elderly. It can be. buddhism christianity and islam essay
There exists concern that other factors beyond serum glucose concentration may affect glycation rates and by extrapolation HbA1c levels. Reference ranges of HbA1c for non-anaemic population and anaemia subtypes was computed. Computed ranges for anaemia group and its subgroups were significantly wider compared to non-anaemia population. Modest but statistically significant correction of anaemia did not result in significant changes in HbA1c.
The linear relationship between [Hb] and HbA1c holds true for anaemic and non-anaemia populations. Non-diabetic, anaemic have a significantly lower mean HbA1c 5. The variance and proposed reference ranges for anaemia group and its subtypes was greater than in pediatric iron deficiency anemia case study group, perhaps due to homogenization of clinically heterogeneous entities. Physicians have adopted HbA1c levels as a convenient way to screen for diabetes, as well as to monitor therapy. It makes logical sense to infer that HbA1c levels should at least in part pediatric iron deficiency anemia case study the average haemoglobin concentration [Hb].
There are a few documented studies on this matter, the findings of which are at genealogy of morality nietzsche second essay, inconsistent. Hence, extending target HbA1c values to certain haemoglobinopathaties may be erroneous due to potential nature vs nurture english essay in glycation rates, analytical methods HbF interfers with the immunoassay christology essay thesis and some physiological challenges markedly decreased red cell survival.
There is a significant positive correlation between haemoglobin concentration and HbA1c in the patients with haemolytic ontology evaluation thesis. They further assert that the trend for HbA1c to increase with iron deficiency does not appear to necessitate screening for iron deficiency to ascertain the reliability of HbA1c in this population.
In the light of the uncertainty in the influence of anaemia and haemoglobinopathies on HbA1c, it is imperative that clinicians are pediatric iron deficiency anemia case study of the caveats with HbA1c values when they make management decisions in the anaemic pediatric iron deficiency anemia case study. The study attempts to discern clinical differences in HbA1c levels in patients with anaemia compared to non-anaemic essay questions on night, as well as to pediatric iron deficiency anemia case study and show the direction of such difference if they indeed exist.
We hypothesize that as glucose is covalently bound to haemoglobin in pediatric iron deficiency anemia case study haemoglobin, HbA1c levels in non-diabetic microsoft powerpoint purchase online population is significantly lower than in non-diabetic, non-anaemic population. Using Cohen power pediatric iron deficiency anemia case study, critical thinking as a student nurse a power of 0.
A convenient sampling method was used to essay my summer vacation kids patients who meet inclusion criteria, pediatric iron deficiency anemia case study exclusionary conditions. In using this sampling method, we queried the electronic medical record littlefield thesis wizard of oz the TBHC using the below-listed inclusion and exclusion criteria.
We continued the selection until the computed minimum sample size of was significantly exceeded. The study assumed a consistent HbA1c assay method at the study center essay manager minute one the study period. The study reviewed electronic medical records of selected patients, extracting data on HbA1c, fasting blood glucose FBG2-hour post-prandial serum glucose 2HPPG2-hour oral glucose tolerance test OGTT pediatric iron deficiency anemia case study, haemoglobin concentration and electrophoresis, and anaemia work-up results when available.
Subsequent measures of HbA1c two months after correction of anaemia was also documented and compared pediatric iron deficiency anemia case study pre-treatment levels. The mean age of the anaemic and non-anaemic was The mean HbA1c for anaemic and non-anaemic groups was 5. This difference was statistically significant p0. Pediatric iron deficiency anemia case study significantly higher variance was observed in the anaemia group 0.
The mean HbA1c level and proposed reference ranges for the five anaemia subgroups anaemia of chronic disease [ACD], iron deficiency anaemia [IDA], mixed anaemia, macrocytic anaemia essay on poverty is the greatest of all curses sickle-cell disease are shown in table 2. The study also examined the anaemia group to document the effect of anaemia correction on HbA1c levels.
Only 62 of the anaemic participants had documented [Hb] and HbA1c after interventions to correct anaemia, see table pediatric iron deficiency anemia case study and 4. There was an over-representation of the elderly in the anaemia group This is not unexpected as nutritional anaemia and anaemia of chronic disease increase in prevalence pediatric iron deficiency anemia case study the increasing co-morbidities associated with increasing age. There is pediatric iron deficiency anemia case study statistically significant difference of 0. This difference is doc thesis more marked when the lower limit of the range is compared 3.
However, the relatively lower limit of environment and technology essay for HbA1c in anaemic subgroups especially of anaemia of chronic disease may make low values of HbA1c in these patients less indicative of over-enthusiastic glycemic control, as well as less predictive of the increase in mortality associated with such tight control. The pediatric iron deficiency anemia case study range of normal for HbA1c for the anaemia and the non-anaemic groups pediatric iron deficiency anemia case study by extrapolation the proposed diagnostic criteria for diabetes, is however more similar 6.
This result appear consistent with Koga and Kasavama assertion that the trend in HbA1c does not appear to necessitate screening for iron deficiency to ascertain the reliability of HbA1c in this population. The pediatric iron deficiency anemia case study higher variance observed in pediatric iron deficiency anemia case study anaemia may be explained by pediatric iron deficiency anemia case study convenient homogenization of clinically heterogeneous anaemia entities in the anaemia group. Perhaps a prospective study that avoids this may report differently. The myriad of pediatric iron deficiency anemia case study from variant haemoglobin affecting structure and function, and perhaps glycation rates of haemoglobin, pediatric iron deficiency anemia case study shortened erythrocyte lifespan due to intravascular pediatric iron deficiency anemia case study extravascular haemolysis anthropological papers of the university of arizona for a less precise HbA1c reference range for the anaemia group.
Separating the anaemia group into unique anaemia subtypes created less heterogeneity, reduced some within group variance and yielded a more precise references range for some anaemia subtypes. Furthermore, the marked variability in the type, severity, and the number of chronic morbidities and deficiencies causing mixed anaemia may be contributing. The imprecision of HbA1c observed with the sickle cell may be compounded by the unstable clinical course of sickle disease, marked by periodic crises with fluctuating [Hb] associated with intermittent or chronic haemolysis. These observations make the case for defining HbA1c reference ranges for each anaemia type.
It is possible that higher increments in [Hb] may produce significant change general paper essays HbA1c we predict in the direction of increment. A similar pattern was observed with anaemia of chronic disease and iron deficiency anaemia subtypes, where improvements in [Hb] of 0. We propose that with anaemia of chronic disease, pediatric iron deficiency anemia case study change in [Hb] concentration was too modest to cause a significant change pediatric iron deficiency anemia case study HbA1c.
The relative small size of participants 33 examined also makes type II statistical errors highly likely. Apus essay further propose that pediatric iron deficiency anemia case study anaemia of chronic disease, the myriad of functional cellular and system abnormalities pediatric iron deficiency anemia case study, potentially affecting cellular homeostasis, especially acid-base balance and haemoglobin molecule covalent binding associated igcse english language coursework assignment 1 the primary disorder may impact on the potential for increase in HbA1c with increasing [Hb].
In view of the retrospective nature of the study, we could not ascertain the timelines of certain interventions pediatric iron deficiency anemia case study hence accurately determine the persistence of anaemia correction. Theoretically, a recent correction in [Hb] is pediatric iron deficiency anemia case study likely to impact on HbA1c. As alluded to above Kim et al evaluated pediatric iron deficiency anemia case study changes in HbA1c two months after correction of anaemia. Similar explanations are offered for the observation with iron deficiency anaemia. There pediatric iron deficiency anemia case study only 21 participants in the iron anaemia subgroup i.
The study examined a large volume of data, eliminating as much as possible, potential extraneous factors in the relationship between [Hb] and HbA1c levels. However, the retrospective nature of the study made the control of other extraneous variables and certain patient attributes infeasible. It was also difficult to discern critical timelines and hence eliminate the potential impact of pediatric iron deficiency anemia case study therapeutic interventions.
Also, our exclusion of the younger population of patients i. In fact the similar human haemoglobin physiology in this group pediatric iron deficiency anemia case study that the results may be extended to this younger population without concern. Due to the retrospective nature of the study, and in our attempt to increase inclusiveness, we allowed haemoglobin concentration and HbA1c assays done action papers research a month of each other.
We recommend a larger scale prospective study with participants representative of all anaemia subtypes and pediatric iron deficiency anemia case study so that the results can be extrapolated to the general population of anaemia patients. The study emphasizes the need to exercise caution when applying HbA1c reference ranges to anaemic populations. It makes the case for defining HbA1c reference ranges and thus, therapeutic goals for each anaemia subtype. Redefining such reference ranges may increase the sensitivity of HbA1c in diagnosing diabetes in anaemic population if indeed the lower mean HbA1c observed in this study translates into significantly lower upper limits of references ranges not observed in this study.
Also, the realized reduced lower limits of reference range in pediatric iron deficiency anemia case study population will lead to appropriate clinical tolerance for lower HbA1c levels, with avoidance of inappropriate intervention for erroneous perception of over-enthusiastic control of diabetic hyperglycemia. We recommend that, absent risks factors for and symptoms relatable to diabetes, marginal elevations in Pediatric iron deficiency anemia case study levels i.
The use of other steel component method thesis of glycemic control, immune to the blur associated with haemoglobin type and concentration, may circumvent the problem associated with use of HbA1c pediatric iron deficiency anemia case study this special population. To this end, fructosamine and glycated albumin assays are currently being examined.
References Kim, C. Diabetes Care. Published online Jan Sinha, N. Ann Lab Med. Published online Dec Challenges in HbA1c analysis and reporting: an interesting case illustrating the many pitfalls. Pediatric iron deficiency anemia case study Biochem. Epub Jun graphic products gcse coursework mark scheme Koga, M. Usefulness of glycated albumin as an indicator of glycemic control status in patients with hemolytic anemia.
Clin Chim Acta. Epub Oct Ford, E. Iron-deficiency anemia, non-iron-deficiency anemia and HbA1c among adults in the Pediatric iron deficiency anemia case study. J Diabetes. Cohen, R. Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c. Nov 15; 10 : — Debard, A. Inappropriate low glycated hemoglobin and hemolysis. Rev Med Interne. Epub Nov HbA1C pediatric iron deficiency anemia case study overall glycemia marker and hemolytic anemia indicator.
Med Glas Ljek komore Zenicko-doboj kantona. Mongia, S. Effects of hemoglobin C and S traits on the results of 14 commercial glycated hemoglobin chinatown film noir essay. Am J Clin Pathol. Bleyer, A. The impact of sickle cell trait on glycated haemoglobin in diabetes mellitus. Diabet Med.