Substitution of hemoglobin levels in pregnant women with iron supplement: A prospective randomized clinical study

Introduction: Iron deficiency anemia (IDA) is the most common form of anemia. Women who are pregnant or lactating and young children are the most affected. Iron protein acetyl aspartilate is a ferroprotein complex that is more efficient versus iron protein succinylate in relatively short periods of time, for example 30 days. Objective: The aim of this clinical study was to investigate the efficacy of acetyl aspartate iron protein supplement in the treatment of anemia in pregnant women after the first trimester. This is the first real-time clinical study testing the usage of an iron protein supplement in a specific population, as there are not sufficient data for such studies in the literature. Study Design: 28 pregnant women with hemoglobin 18, gestational week > 12, Hb < 10.5 g/dL, Ht < 32%. Exclusion criteria included: age <18, pregnancy < 12 weeks, many pregnancies, history: allergy to iron preparations, ulcer, cirrhosis, hemodialysis, hemochromatosis, aplastic anemia, chronic disease anemia, pancreatitis, renal disease. Results: Treatment with acetyl aspartylated iron lead to higher levels of hemoglobin after four weeks of treatment. Following successive measurements of hemoglobin levels in the 28 women of the study group, Hb levels increased from an initial mean Hb value of 10.04 gr/dL to 10.69 gr/dL. In the control group of 35 pregnant women, an increase in the mean hemoglobin from Hb was observed from 9.99 gr/dL to 10.46 gr/dL. The difference was statistically significant with p < 0.0001. Conclusions: The use of acetyl aspartate iron protein is a very promising option, as there has been an increase in hemoglobin levels to 0.5 gr/dL

Substitution of hemoglobin levels in pregnant women with iron supplement: A prospective randomized clinical study

Introduction: Iron deficiency anemia (IDA) is the most common form of anemia. Women who are pregnant or lactating and young children are the most affected. Iron protein acetyl aspartilate is a ferroprotein complex that is more efficient versus iron protein succinylate in relatively short periods of time, for example 30 days. Objective: The aim of this clinical study was to investigate the efficacy of acetyl aspartate iron protein supplement in the treatment of anemia in pregnant women after the first trimester. This is the first real-time clinical study testing the usage of an iron protein supplement in a specific population, as there are not sufficient data for such studies in the literature. Study Design: 28 pregnant women with hemoglobin &amp;lt; 10.5 gr/dL and after completing the 12th week of pregnancy, initiated acetyl aspartate protein iron at a daily dose yielding 80g of elemental iron in two uptakes. Similarly, 35 women were studied who received different iron supplements at the same daily dose. After 30 days, hemoglobin values were measured. Inclusion criteria included: age &amp;gt; 18, gestational week &amp;gt; 12, Hb &amp;lt; 10.5 g/dL, Ht &amp;lt; 32%. Exclusion criteria included: age &amp;lt;18, pregnancy &amp;lt; 12 weeks, many pregnancies, history: allergy to iron preparations, ulcer, cirrhosis, hemodialysis, hemochromatosis, aplastic anemia, chronic disease anemia, pancreatitis, renal disease. Results: Treatment with acetyl aspartylated iron lead to higher levels of hemoglobin after four weeks of treatment. Following successive measurements of hemoglobin levels in the 28 women of the study group, Hb levels increased from an initial mean Hb value of 10.04 gr/dL to 10.69 gr/dL. In the control group of 35 pregnant women, an increase in the mean hemoglobin from Hb was observed from 9.99 gr/dL to 10.46 gr/dL. The difference was statistically significant with p &amp;lt; 0.0001. Conclusions: The use of acetyl aspartate iron protein is a very promising option, as there has been an increase in hemoglobin levels to 0.5 gr/dL. ©2020 Daniilidis et al

Retrospective study on prevalence, specificity, sex, and age distribution of alloimmunization in two general hospitals in athens [Atina’da iki hastanede alloimmünizasyonun sıklığı, özgüllüğü, cinsiyet ve yaş dağılımı üzerine geriye dönük çalışma]

Objective: Blood transfusion is a common lifesaving treatment but it is often complicated with alloimmunization. Previously studies in Greece have concentrated on alloimmunization in multiply transfused thalassemic patients or antenatal women. However, the relative frequency of red blood cell (RBC) alloantibodies in the general patient population has not been studied so far. The aim of the present retrospective study was to estimate the prevalence and specificity of RBC alloantibodies in a large cohort of patients in two general hospitals and their association with age, sex, and the patients’ clinic of hospitalization. Materials and Methods: Data from 2012 to 2016 from the “Sismanogleio” and “Thriasio” general hospitals in Athens, Greece, were studied retrospectively. Statistical analysis was performed with SAS for Windows 9.4. Results: Six hundred twenty-six patients (626/53800, 1.16%) were alloimmunized for one or more alloantibodies. The mean age was 67.99±17.56 years. Most antibodies were found in women [62.66% (438/699) in women vs. 37.34% (261/699) in men (p=0.0007)], while the vast majority of antibodies (66.81%) were found in patients aged 61-90. The most frequent antibody was anti-Kell (26.61%), followed by anti-E (16.02%), anti-D (15.02%), anti-Jka (5.87%), and anti-M (5.72%). Anti-C (81.48%, n=27) and anti-Cw (54.17%, n=24) tended to be found more often in patients with multiple antibodies. Most alloimmunized cases were found in general surgery (42.65%) and internal medicine departments (38.66%). Conclusion: According to our results, the alloimmunization data in a general patient population in Greece were consistent with the majority of studies in the international literature. Whether a strategy at national level needs to be directed towards extending matching for the whole population or towards applying sensitive and compulsory indirect antiglobulin tests before any transfusions in order to efficiently prevent alloimmunization remains an issue of debate. Alloimmunization, Prevalence, Red blood cells, Alloantibodies, Specificity, Age distribution, Sex distribution, Blood transfusion çögiAÖ © 2020 by Turkish Society of Hematology Turkish Journal of Hematology

Emerging patterns of resistance in a cohort of Greek patients with recurrent UTIs: a pilot study

Bacterial urogenital infections caused by multi-drug resistant organisms (MDROs), are increasingly becoming a severe public health issue. The purpose of the present study was to examine the epidemiology of recurrent UTIs along with antimicrobial resistance patterns in a cohort of patients followed as outpatients at an Infectious Disease clinic of a tertiary care center in Greece. One hundred, sequential patients suffering from recurrent UTIs and coming for clinical evaluation, follow-up and treatment were examined; microbiological urine culture results were analyzed. Patients were separated into Group A: patients with ≥3 urogenital infections during the last study year, and Group B: patients with ≤2 urogenital infections. Furthermore, antimicrobial resistance patterns and presence of MDROs in relation to the number of urogenital infections during a three years period was evaluated. Group A had a mean of 4.3 ± 1.7 urogenital infections during the last year of the study, while patients in Group B 1.9 ± 0.3 infections over a three years period. An age cut-off of 30 years was critical for higher UTI rates. Escherichia Coli was the predominant isolated pathogen in 96.2% of the patients. Patients with diabetes mellitus had a 3 fold-higher risk for ≥3 UTIs. Resistance to colistin and imipenem was associated with a history of more than 2 episodes of UTIs but observed in a small number of patients with comorbidities. In this pilot study MDRO detection in patients suffering from recurrent UTIs emphasizes the need for continuous epidemiological surveillance in order to improve our understanding of the evolution of resistance in a common community infection as well as to implement successful prevention strategies. © 2019, © 2019 Edizioni Scientifi che per l&apos;Informazione su Farmaci e Terapia

JAK2V617F positive polycythemia vera with paroxysmal nocturnal hemoglobinuria and visceral thromboses: a case report and review of the literature

Background: Polycythemia vera (PV) is characterized by red cell mass expansion in the peripheral blood and can be complicated with thrombosis, bleeding, evolution to acute myeloid leukemia (AML) or a fibrotic phase. Paroxysmal nocturnal hemoglobinuria (PNH) in an acquired clonal haematopoietic stem cell disorder associated with chronic intravascular hemolysis, venous thrombosis, defective hematopoiesis, frequent episodes of infection and, rarely, leukemic transformation. Herein, we report an interesting case of a patient with coexistence of PNH clones and a JAK2V617F positive PV, with unusual thromboses without hemolysis. Case presentation: A 51-year-old woman presented with increased levels of hematocrit, multiple liver, spleen, and left kidney infarctions and ascites; further investigation revealed a JAK2V617F-positive polycythemia vera and the presence of a significant PNH population (more than 90% CD55– CD59– cells among both granulocytes and red blood cells). Interestingly, the patient has experienced severe thrombotic events without any signs or symptoms of hemolysis. Conclusions: This case raises questions over uncharted aspects of the PNH etiopathogenesis and its potential association with myeloproliferative neoplasms (MPN) and highlights the difficulty of diagnosing and managing patients with more than one potentially thrombophilic conditions, especially with established and severe thromboses. © 2021, The Author(s)

A Unique Case of Primary Extranodal Marginal Zone Lymphoma of the Anal Canal

Marginal zone lymphomas represent approximately 10-12% of all B-cell lymphomas. Extranodal marginal zone lymphomas (EMZL) or mucosa-associated lymphoid tissue (MALT) lymphomas are the most common subtype. Almost half of all MALT lymphomas arise in the gastrointestinal (GI) tract and, while the stomach is the most common site of GI involvement, the small and large intestines can also be involved. Rare cases of MALT lymphoma involving the rectum have been reported; however, to our knowledge, involvement of the anal canal has never been reported in the literature. Here, we describe a unique case of MALT lymphoma of the anal canal. Infectious agents have been implicated in the pathogenesis of MALT lymphomas, possibly through persistent antigenic stimulation of the area; however, in our case no such infection was documented. © 2019 S. Karger AG, Basel. All rights reserved

Detection of CALR mutations using high resolution melting curve analysis (HRMA); application on a large cohort of Greek ET and MF patients

Background and Objectives: Somatic mutations in the calreticulin gene (CALR) are detected in approximately 70% of patients with essential thrombocythemia (ET) and primary or secondary myelofibrosis (MF), lacking the JAK2 and MPL mutations. To determine the prevalence of CALR frameshift mutations in a population of MPN patients of Greek origin, we developed a rapid low-budget PCR-based assay and screened samples from 5 tertiary Haematology units. This is a first of its kind report of the Greek patient population that also disclosed novel CALR mutants. Methods: MPN patient samples were collected from different clinical units and screened for JAK2 and MPL mutations after informed consent was obtained. Negative samples were analyzed for the presence of CALR mutations. To this end, we developed a modified post Real Time PCR High-Resolution Melting Curve analysis (HRM-A) protocol. Samples were subsequently confirmed by Sanger sequencing. Results: Using this protocol we screened 173 MPN, JAK2 and MPL mutation negative, patients of Greek origin, of whom 117 (67.63%) displayed a CALR exon nine mutation. More specifically, mutations were detected in 90 out of 130 (69.23%) essential thrombocythaemia cases (ET), in 18 out of 33 (54.55%) primary myelofibrosis patients (pMF) and in 9 out of 10 (90%) cases of myelofibrosis secondary to ET (post-ET sMF). False positive results were not detected. The limit of detection (LoD) of our protocol was 2%. Furthermore, our study revealed six rare novel mutations which are to be added in the COSMIC database. Conclusions: Overall, our method could rapidly and cost-effectively detect the mutation status in a representative cohort of Greek patients; the mutation make-up in our group was not different from what has been published for other national groups. © Universita Cattolica del Sacro Cuore. All rights reserved

Genital tract infection and associated factors affect the reproductive outcome in fertile females and females undergoing in vitro fertilization

Assisted reproductive techniques including in vitro fertilization (IVF) are being used increasingly worldwide and screening for genital tract infections (GTIs) is recommended prior to treatment as their presence may affect the success rate of IVF. The current study aimed to assess the possible associations between GTI-associated factors and reproductive outcome in a group of reproductive age fertile females and infertile females receiving IVF. A total of 111 infertile women enrolled in an IVF programme (Group A) and 104 fertile women (mothers of at least one child; Group B) underwent microbiological screening of vaginal and cervical samples. All samples were cultured using different protocols for aerobic pathogens, bacterial vaginosis (BV), Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis and human papilloma virus (HPV). Although each group were comparable in age, more infertile women were &gt;30 years (P=0.0064), had a higher education level (P=0.0001) and were smokers (P=0.007). Only BV (P=0.0013) was more prevalent in Group A. Of the 111 infertile females who were scheduled for IVF, 32 females had a successful pregnancy (Group C) and 79 females exhibited IVF failure (Group D). Tubal factor (P=0.012), estradiol-2 (E2) levels &lt;2,500 pg/ml (P=0.0009) and Mycoplasma infection (P=0.003) were identified to be the strongest predictors of IVF failure. The current study determined certain GTI-associated factors that may contribute to infertility in Greek females of reproductive age as well as other risk factors associated with failure in patients undergoing IVF. Further studies are required to confirm this conclusion. © 2019, Spandidos Publications. All rights reserved

Health risk behaviors among high school and university adolescent students

Tobacco, alcohol and drug abuse constitute a public health concern. Data regarding health risk behaviors among Greek youth are scarce. The aim of the present study was to investigate health risk behaviors of a large adolescent sample (730 adolescents, 294 males and 436 females), residing in different areas of Greece, trace perceived side effects and associate the findings with the adopted lifestyle. High school students and University newcomers, aged 14-21 years (17.8±4.5 years), selfreported health risk behaviors via an anonymous, closed-type, validated questionnaire. Simultaneous adoption of unhealthy habits, such as smoking and drug abuse, were not independent (χ2 =38.668, P=0.01). Age was the most significant factor in the adoption of unhealthy behaviors; smoking (χ2 =27.220, P=0.01), misuse of cannabis and recreational drugs (χ2 =9.874, P=0.05) and combining alcohol and smoking with entertainment (χ2 =8.708, P=0.05; χ2 =317.309, P=0.05, respectively) were adopted more by the elder (18-20 years) than the younger (15-18 years) teenagers. Males were more prone to abuse of cannabis (χ2 =8.844, P=0.01), whereas females combined drinking and smoking with loud music during entertainment (χ2 =6.618, P=0.05). The majority (64%) reported driving after drinking alcohol and intense entertainment, especially in urban areas. Almost half of smokers (53.1%) and drug users (46.3%) first encountered smoking or drugs from friends. Educational institutions and entertainment venues were the main places of initiation of smoking (26%) or drug use (35.2%), respectively. Adolescents from touristic regions were more prone to smoking (33.9%, P=0.01) and drug abuse (53.7%, P=0.01). The lower the frequency of exercise, the higher the consumption of psychoactive substances (P=0.022). Youth engaging in unhealthy habits were also willing to use prohibited doping substances (56%, P=0.043). Health problems were the main reason to consider changing habits (72%). In conclusion, health risk behaviors were multifactorial and tended to cluster. Thus, preventive youth strategies should target negative peer influences, especially during late adolescence. © 2018, Spandidos Publications. All rights reserved