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At least 19 recordsLinked to original sources
PubMed2005

Association of hemoglobin levels, acute hemoglobin decrease, age, and co-morbidities with rehabilitation outcomes after total knee replacement.

OBJECTIVE: A study was undertaken to assess the association of preoperative and postoperative hemoglobin levels with rehabilitation outcomes, age, and selected co-morbidities DESIGN: Charts of 49 patients admitted to rehabilitation after total knee arthroplasty due to degenerative joint disease were reviewed. Outcome measures included rehabilitation admission and discharge motor FIMtrade mark scores, motor FIM gain, and rehabilitation length of stay. RESULTS: Patients with higher preoperative hemoglobin levels had higher rehabilitation admission motor FIM scores (r=0.38, P<0.01) and lower motor FIM gains (r=-0.45, P<0.001). Patients who had higher hemoglobin levels at rehabilitation admission had higher admission motor FIM scores and shorter length of stay. Patients with diabetes had lower preoperative hemoglobin levels. Patients with hypertension had longer length of stay. Older patients had lower admission and discharge motor FIM scores and longer length of stay. CONCLUSIONS: Patients admitted to rehabilitation after total knee replacement have the potential to improve motor function, regardless of their preoperative and rehabilitation admission hemoglobin levels and the decrease in hemoglobin levels. However, those admitted to rehabilitation with lower hemoglobin levels, those with lower admission motor FIM scores, those who are older, and those who have hypertension may expect longer hospital stays to reach their functional goals.

Age Factors↗
PubMed2006

Analysis of free hemoglobin level and hemoglobin peptides from human puerperal uterine secretions.

OBJECTIVE: Hemocidins are a novel class of antibacterial peptides generated proteolytically from hemoglobin. These peptides play a particularly important role in maintaining vaginal homeostasis during menstrual bleeding. To investigate the hemoglobin fragmentation process during the last stages of pregnancy, we examined uterine secretion (lochia) samples from a group of 22 healthy women who underwent cesarean delivery at term. METHODS: Patients were divided into three groups: (1) the elective cesarean deliveries without symptoms of spontaneous labor, (2) the nonelective cesarean deliveries with spontaneous beginning of labor, and (3) the nonelective cesarean deliveries during advanced labor. The samples were subjected to chromatographic estimation of free hemoglobin and peptides. In three representative patients the identification of all lochial peptides was performed. RESULTS: All samples contained a significant amount of free hemoglobin and its level increased with labor progression. The presence of peptide fractions was also detected in most lochia samples. They were confirmed to be human hemoglobin fragments, almost identical to the recently described bactericidal hemocidins from menstrual discharge. The level of peptides also increased during labor. The subgroup with advanced labor demonstrated the highest amount of hemocidins. CONCLUSIONS: The presented results prove that proteolysis of free hemoglobin in the female upper reproductive tract begins together with the clinical symptoms of normal labor. We speculate that cesarean delivery affects molecular mechanisms involved in antibacterial hemocidins generation and, in effect, might be responsible for the increased risk of gynecologic infections in cesarean deliveries.

Anti-Bacterial Agents↗
PubMed1990

Relation of pregnancy serum ferritin levels to hemoglobin levels throughout pregnancy.

Thirty women were studied for the impact of pregnancy iron status on hemoglobin (Hb) and serum ferritin (Ft) during the course of pregnancy. Blood samples were taken 4 weeks before their last menstrual period, at 8, 12, 16, 20, 24, 28, 32 and 36 weeks of pregnancy, during labor and 1 month after delivery. Two groups were formed based on prepregnancy Ft concentration: with high Ft (Ft greater than or equal to 20 micrograms/l) and with low Ft (Ft less than 20 micrograms/l). In women with high Ft, Hb decreased significantly during the first weeks of pregnancy while Ft increased, followed by a gradual fall as pregnancy progressed. In women with low Ft, Hb increased during the first weeks of pregnancy while Ft remained practically unchanged but very close to 0 microgram/l throughout pregnancy. Our findings suggest that besides the hemodilution characteristic of pregnancy, iron deficiency does develop during this period. The fall in Ft in well-nourished women during the first 30 weeks of pregnancy suggests an increased utilization of iron stores, while for those with already low levels of prepregnancy serum Ft, iron stores are not available for this physiological response. Therefore, iron supplementation should be given to women with reduced iron stores before they start a pregnancy so as to insure sufficient iron deposits to cope with the increased iron requirements during this period.

Adolescent↗
PubMed1985

The microchromatographic measurement of fetal hemoglobin levels in hemoglobin C-associated conditions.

We report the microchromatographic estimation of fetal hemoglobin (Hb F) in 3 conditions associated with hemoglobin C: hemoglobin C-hereditary persistence of fetal hemoglobin (Hb C-HPFH), homozygous hemoglobin C disease, and hemoglobin SC disease. In the case of Hb C-HPFH (Case 1) the Hb F level by alkali denaturation was 32.5% while the Hb F level by microchromatography was 35.3%. In both cases of homozygous Hb C disease and Hb SC disease the Hb F level by alkali denaturation was less than 1% and the microchromatographic Hb F level was 0.7%. We conclude that microchromatographic methods for determination of Hb F levels can be employed in the Hb C-HPFH, homozygous Hb C, and Hb SC conditions. To our knowledge, the microchromatographic determination of Hb F levels has not been applied previously to the Hb C-HPFH condition or Hb C disease.

Adolescent↗
PubMed1996

A clinical approach for the diagnosis of diabetes mellitus: an analysis using glycosylated hemoglobin levels. Meta-analysis Research Group on the Diagnosis of Diabetes Using Glycated Hemoglobin Levels.

OBJECTIVE: To determine whether a glycosylated hemoglobin level can be used in place of an oral glucose tolerance test (OGTT) to diagnose diabetes. DATA SOURCES/STUDY SELECTION: An augmented MEDLINE search was performed to identify all reports from 1966 through June 1994 in which glycosylated hemoglobin levels were measured concurrently with performance of OGTTs in the same study. The corresponding authors were contacted and asked to provide individual data for all subjects tested. A total of 31 investigators representing 34 possible studies responded, and 18 were able to provide us with the data requested. Overall fasting plasma glucose concentrations, 2-hour postdextrose glucose concentrations, and glycosylated hemoglobin levels were available from 11 276 individuals. DATA EXTRACTION: To define normal glucose tolerance, impaired glucose tolerance (IGT), and diabetes, modified World Health Organization criteria were used. DATA SYNTHESIS: An analysis of the methods used for measurement of glycosylated hemoglobin levels revealed that the HbA1c assay showed the least variance in normal subjects. Therefore, only data from the 8984 subjects who had HbA1c levels measured were used. When we used the mean HbA1c level plus 4 SDs as a cutpoint, the sensitivity was 36% and specificity was 100% compared with the results of the OGTT. Because of the lack of agreement between OGTT results and HbA1c levels, models were created to analyze the distribution of HbA1c levels in each study. Using these models, we identified 3 subpopulations. The third subpopulation was likely to represent subjects with diabetes. When we applied an HbA1c level of 7.0% as a cutpoint, the sensitivity was 99.6% for the third subpopulation. When this cutpoint was reapplied to the OGTT results, of those subjects with an HbA1c level of at least 7.0%, 89% had diabetes, 7% had IGT, and 4% were normal. CONCLUSIONS: Although the OGTT is the "gold standard" for diagnosing diabetes, it is known to be poorly reproducible and is often not performed. Not only is use of an HbA1c level to diagnose diabetes more convenient, but therapeutic decisions are based on this value, regardless of the findings on the OGTT. An HbA1c level of 7.0% or higher often requires pharmacological intervention and is most often associated with the diagnosis of diabetes by World Health Organization standards. An HbA1c level below 7.0% would generally be treated with diet and exercise, regardless of the diagnosis of IGT or diabetes by OGTT. Thus, measurement of HbA1c levels may represent a reasonable approach to identifying treatment-requiring diabetes.

Diabetes Mellitus↗
PubMed1990

Elective surgery without transfusion: influence of preoperative hemoglobin level and blood loss on mortality.

To clarify the widespread practice of preoperative transfusion to attain a 10 g/dL level of hemoglobin, the relationship between preoperative hemoglobin level, operative blood loss, and mortality was studied by analyzing the results of 113 operations in 107 consecutive Jehovah's Witness patients who underwent major elective surgery. Ninety-three patients had preoperative hemoglobin values greater than 10 g/dL; 20 had preoperative hemoglobin levels between 6 to 10 g/dL. Mortality for preoperative hemoglobin levels greater than 10 g/dL was 3 of 93 (3.2%); for preoperative hemoglobin levels between 6 to 10 g/dL, mortality was 1 of 20 (5%). Mortality was significantly increased with an estimated blood loss of greater than 500 mL, regardless of the preoperative hemoglobin level (p less than 0.025). More importantly, there was no mortality if estimated blood loss was less than 500 mL, regardless of the preoperative hemoglobin level. From these data, we conclude that: (1) Mortality in elective surgery appears to depend more on estimated blood loss than on preoperative hemoglobin levels; and (2) Elective surgery can be done safely in patients with a preoperative hemoglobin level as low as 6 g/dL if estimated blood loss is kept below 500 mL.

Adolescent↗
PubMed1995

Immunoglobulin levels in populations with low hemoglobin levels: study of five tribes of central India.

Average hemoglobin levels for 424 individuals belonging to 5 tribes of central India vary between 10.64 g/dl and 11.30 g/dl among males and between 9.62 g/dl and 9.97 g/dl among females. These ranges indicate the poor state of health and nutrition in these tribes. Three immunoglobulin levels (IgG, IgA, and IgM) measured in a subset of the 424 individuals reveal that immunoglobulin and hemoglobin levels are inversely related to some extent. Levels of all three classes of immunoglobulins were found to be significantly correlated. This suggests that humoral immunity is not impaired even under acute nutritional stress.

Adolescent↗
PubMedDate not supplied

Attaining target hemoglobin levels in patients new to dialysis: individualizing therapy based on initial hemoglobin levels.

Incident patients on dialysis typically have Hgb levels that are well below the target range of 11 to 12 g/dL as recommended by the NKF-K/DOQI (NKF 2001). Despite a nationwide emphasis on anemia as a quality indicator, low Hgb levels often persist for months after dialysis is initiated. This report provides an overview of an innovative, evidence-based approach to treating anemia that can help shorten the time required to achieve target Hgb levels in patients new to dialysis.

Anemia↗
PubMedDate not supplied

[Factors participating in the variability of glycosylated hemoglobin levels].

Glycated hemoglobin values are a good indicator of metabolic control of the diabetic patients; however the levels can be influenced by analytic, clinic and biological variability. In the first, it is important to know that the variation coefficient between-laboratory should be < 3-4%; the second, depends on the metabolic control of the patients, while the third is determined by internal and external factors. Family studies had shown that genetic factors are involved in the biological variability of glycated hemoglobin. In order to have a correct interpretation of the glycated hemoglobin levels, it is important to know the causes of variability.

Diabetes Mellitus↗
PubMed1993

Relationship of hemoglobin level and duration of hospitalization after total hip arthroplasty: implications for the transfusion target.

We analyzed the relationship of hemoglobin level and duration of hospitalization of patients who underwent primary cemented total hip arthroplasty for degenerative joint disease at our institution. Retrospectively, we reviewed the medical records of 332 patients treated during a 16-month period (May 6, 1989, to Aug. 20, 1990). The following variables were analyzed: number of postoperative days to dismissal from the hospital, level of hemoglobin preoperatively and at dismissal, decrease in hemoglobin level from preoperatively to time of dismissal, patient age, surgeon, and blood products transfused. No correlation was found between level of hemoglobin at dismissal, preoperative hemoglobin level, or decrease in hemoglobin concentration from preoperatively to time of dismissal and number of days to dismissal from the hospital. Advanced age was associated with a longer hospital stay. A slight but statistically significant difference was noted in duration of hospitalization among patients operated on by different surgeons. Patients who received both autologous and homologous blood required more transfusion (3.8 units) and had a longer hospital stay (10.7 days) than did patients who received autologous blood only (2.4 units and 9.5 days) or homologous blood only (2.6 units and 10.2 days). We conclude that variation in hemoglobin levels among patients in our study was unrelated to duration of hospitalization. This finding suggests that transfusion of autologous or homologous blood to achieve a higher hemoglobin level (higher transfusion target) solely for shortening hospital stay is unwarranted.

Age Factors↗
PubMed2003

Is pretreatment hemoglobin level a predictor of complete response to salvage chemotherapy for recurrent platinum-pretreated ovarian carcinoma?

PURPOSE OF INVESTIGATION: The aim of this retrospective study was to correlate some patient characteristics at relapse, including also baseline hemoglobin levels, with complete response rate and survival following second-line chemotherapy for recurrent platinum-pretreated ovarian carcinoma. METHODS: The investigation was conducted on 63 patients who received salvage chemotherapy with different agents for clinically detectable recurrent ovarian carcinoma following initial surgery and first-line platinum-based chemotherapy. Some patient characteristics at relapse (patient age, serum CA 125 level, baseline hemoglobin level, number of recurrence sites, ascites, platinum-free interval, and treatment-free interval) were related to complete response rate to salvage chemotherapy and survival after recurrence. Median baseline hemoglobin level was 11.6 g/dl (range, 7.5-15.0 g/dl). RESULTS: Second-line chemotherapy obtained a complete response in 17 (27.0%) patients and a partial response in 11 (17.5%), whereas stable disease and progressive disease were detected in 19 (30.1%) and 16 (25.4%) patients, respectively. By univariate analysis, complete response rate was related to baseline hemoglobin level (p = 0.0019), platinum-free interval (p = 0.0012) and treatment-free interval (p = 0.0048). Multiple logistic regression showed that platinum-free interval (p = 0.0107) and baseline hemoglobin level (0.0312) were independent predictors of complete response. Patients with baseline hemoglobin levels >11.6 g/dl had a 5.338 higher chance of obtaining a complete response when compared to those with lower hemoglobin values. The platinum-free interval was the only independent prognostic variable for survival after recurrence (p = 0.0141), whereas baseline hemoglobin level was not related to survival at univariate nor at multivariate analysis. CONCLUSIONS: Baseline hemoglobin level is an independent predictor of complete response to salvage chemotherapy in patients with recurrent platinum-pretreated ovarian carcinoma. Attention must be paid to anemia correction in these patients, with the aim of improving both the chance of response to salvage treatment and the quality of life.

Adult↗
PubMed1985

Relationships of Schistosoma hematobium, hookworm and malarial infections and metrifonate treatment to hemoglobin level in Kenyan school children.

Relationships between hemoglobin level and S. hematobium, hookworm, and malarial infection before and six months after metrifonate treatment were studied in Kenyan primary school children in an area where anemia, S. hematobium and hookworm are common (prevalences 61%, 46%, and 95%, respectively) and malaria is holoendemic. The mean hemoglobin level in children from one school, both with and without S. hematobium infection (n = 250), was significantly lower in children with higher S. hematobium egg counts, heavier hookworm infections, positive Plasmodium slides, and larger spleens. All children with light-moderate S. hematobium infection (1-500 eggs/10 ml adj) in four schools were examined (Exam 1), allocated at random to either placebo (MIP, n = 198) or metrifonate treatment (MIT, n = 202) groups, treated, and examined again six months later (Exam 2). Hemoglobin levels rose significantly in both groups between exams, but the rise in the MIT group was 30% higher than in the MIP group (1.3 vs. 1.0 g/dl, P less than 0.014). The increase in hemoglobin level in the MIT group was significantly and positively correlated with decreases between exams in S. hematobium and hookworm egg counts and with higher malarial parasite counts at Exam 1 (Pearson r's 0.21, 0.20, 0.20, respectively, P less than 0.01). A stepwise multiple regression equation using hemoglobin rise between exams as the dependent variable showed that decreases in S. hematobium and hookworm egg counts were equally important determinants of hemoglobin rise and that malarial parasite count was almost as important as the changes in intensities of the helminth infections. These results show that treatment for S. hematobium with metrifonate can increase hemoglobin levels in children in an area where S. hematobium and anemia are common. They also emphasize the importance of measuring multiple parasitic infections and using multivariate statistical techniques such as multiple regression analysis in order to define the relationships between parasitic infections and morbidity.

Adolescent↗
PubMed1988

Major congenital anomalies in infants and glycosylated hemoglobin levels in insulin-requiring diabetic mothers.

Glycosylated hemoglobin levels were obtained in 133 diabetic pregnancies. Nongestational diabetic mothers delivered of infants with major congenital anomalies had significantly higher glycosylated hemoglobin levels than the remaining nongestational diabetic mothers (P less than .001). The higher a mother's glycosylated hemoglobin level, the higher her risk of having a severely affected infant was. The positive predictive value for a nongestational diabetic mother having an infant with severe congenital anomalies was 26% if the glycosylated hemoglobin level was greater than or equal to 11%, 40% if the level was greater than or equal to 12%, and 56% if the level greater than or equal to 13%. However, high glycosylated hemoglobin levels in insulin-requiring gestational diabetic mothers were not predictive of major congenital anomalies.

Congenital Abnormalities↗
PubMed1990

The effect of cigarette smoking on hemoglobin levels and anemia screening.

The relationships among cigarette smoking, hemoglobin concentration, and carboxyhemoglobin concentration were examined using data from the Second National Health and Nutrition Examination Survey. Among women, smokers had a mean (+/- SE) hemoglobin level of 137 +/- 0.4 g/L, significantly higher than the mean hemoglobin level of 133 +/- 0.5 g/L for never-smokers. Among men, the mean hemoglobin levels for smokers and never-smokers were 156 +/- 0.4 and 152 +/- 0.5 g/L, respectively. No significant difference in mean hemoglobin was noted between ex-smokers and never-smokers. Mean hemoglobin levels and carboxyhemoglobin levels increased progressively with the number of cigarettes consumed per day. Cigarette smoking seems to cause a generalized upward shift of the hemoglobin distribution curve, which reduces the utility of hemoglobin level to detect anemia. Among women of comparable socioeconomic status, the prevalence of anemia was 4.8% +/- 0.6% among smokers, compared with 8.5% +/- 1.2% among never-smokers. This study suggests that minimum hemoglobin cutoff values should be adjusted for smokers to compensate for the masking effect of smoking on the detection of anemia.

Adolescent↗
PubMed2000

Effect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy.

BACKGROUND: Hemoglobin levels below 10 g/dL lead to left ventricular (LV) hypertrophy, LV dilation, a lower quality of life, higher cardiac morbidity, and a higher mortality rate in end-stage renal disease. The benefits and risks of normalizing hemoglobin levels in hemodialysis patients without symptomatic cardiac disease are unknown. METHODS: One hundred forty-six hemodialysis patients with either concentric LV hypertrophy or LV dilation were randomly assigned to receive doses of epoetin alpha designed to achieve hemoglobin levels of 10 or 13.5 g/dL. The study duration was 48 weeks. The primary outcomes were the change in LV mass index in those with concentric LV hypertrophy and the change in cavity volume index in those with LV dilation. RESULTS: In patients with concentric LV hypertrophy, the changes in LV mass index were similar in the normal and low target hemoglobin groups. The changes in cavity volume index were similar in both targets in the LV dilation group. Treatment-received analysis of the concentric LV hypertrophy group showed no correlation between the change in mass index and a correlation between the change in LV volume index and mean hemoglobin level achieved (8 mL/m2 per 1 g/dL hemoglobin decrement, P = 0.009). Mean hemoglobin levels and the changes in LV mass and cavity volume index were not correlated in patients with LV dilation. Normalization of hemoglobin led to improvements in fatigue (P = 0.009), depression (P = 0.02), and relationships (P = 0.004). CONCLUSIONS: Normalization of hemoglobin does not lead to regression of established concentric LV hypertrophy or LV dilation. It may, however, prevent the development of LV dilation, and it leads to improved quality of life.

Adult↗
PubMed1995

Higher levels of interleukin-6 in cystic fluids from patients with malignant versus benign ovarian tumors correlate with decreased hemoglobin levels and increased platelet counts.

BACKGROUND: Recently, high pretreatment platelet counts and low pretreatment hemoglobin levels were found to be negative prognostic factors in patients with ovarian cancer. Interleukin-6 (IL-6) is a multifunctional cytokine with a diversity of functions leading to the induction of C-reactive protein (CRP), increased platelet counts, and low hemoglobin levels. Different epithelial ovarian cancer cell lines are found to produce varying amounts of IL-6. In this study, a possible relationship between IL-6 levels in cystic fluids of benign and malignant ovarian tumors and pretreatment serum CRP, platelet counts, and hemoglobin levels was evaluated. METHODS: A bioassay and enzyme-linked immunosorbent assay (ELISA) were performed to determine the IL-6 levels in cystic fluids and serum from 42 patients with benign and malignant ovarian tumors. RESULTS: The median IL-6 level was higher in cystic fluids of malignant tumors (n = 21) when compared with cystic fluids of benign tumors (n = 21) (P < 0.01 for bioassay and ELISA). Serum IL-6 levels in patients with malignant tumors were not significantly higher compared with IL-6 levels in patients with benign tumors, whereas CRP levels were higher in patients with malignant tumors (P < 0.01). Cystic fluid IL-6 levels were related to serum CRP levels (r = 0.60, P < 0.01 [bioassay]; r = 0.41, P < 0.01 [ELISA]), and were related inversely to hemoglobin levels (r = -0.57, P < 0.01 [bioassay]; r = 0.54, P < 0.01 [ELISA]). CONCLUSIONS: IL-6 levels are higher in cystic fluids of malignant ovarian tumors compared with benign tumors. The relationship of cystic fluid IL-6 levels with CRP, platelet counts, and hemoglobin levels suggests a possible causative role of tumor-derived IL-6 in the appearance of general side effects of ovarian cancer, which recently have been recognized as prognostic factors.

Adenocarcinoma↗
PubMed2007

Is it necessary to consider obesity when constructing norms for hemoglobin or when screening for anemia using hemoglobin levels?

OBJECTIVE: To assess the relationship of total adiposity and abdominal adiposity on hemoglobin levels in Saudi nonpregnant women. METHODS: We carried out this cross-sectional study during winter of 2002 (from January to March) in and around Abha city, Kingdom of Saudi Arabia. Included in the study were 530 non-pregnant women between the age of 18-65 years. Body weight was measured using an Avery Beam weighing scale, while height was measured using a stadiometer and waist circumference using a fiberglass. Hemoglobin levels were estimated using cyanmethemoglobin method. Total obesity was defined as body mass index (BMI) >or=30 and abdominal obesity as WC >88 cm. RESULTS: The mean and median hemoglobin levels were significantly higher in abdominally obese women compared with totally obese (p<0.04 versus <0.02) and non obese ones (p<0.04 versus <0.03). No significant differences in the mean and median hemoglobin levels were observed when abdominally obese women were compared with both abdominally and totally obese ones (p<0.7 for both). The mean and the median hemoglobin levels were virtually identical in non-obese and totally obese women. Statistical analysis showed that the mean hemoglobin level was positively and significantly associated with WC (p<0.005) and negatively and insignificantly associated with BMI (p<0.8). CONCLUSION: In view of the positive and significant association between abdominal obesity and the mean hemoglobin level in this population, abdominal obesity should be considered when constructing norms for hemoglobin or when screening for anemia using hemoglobin levels.

Adolescent↗