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2013年9月26日星期四

Severe Anemia Linked to Higher Death Risk After Heart Surgery: MedlinePlus

Severe Anemia Linked to Higher Death Risk After Heart Surgery: MedlinePlus


 







Severe Anemia Linked to Higher Death Risk After Heart Surgery


Condition should be treated before elective procedures if possible, researcher says


By Robert Preidt

Thursday, October 4, 2012



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THURSDAY, Oct. 4 (HealthDay News) — Anemia is a risk factor for complications and death following heart surgery, and elective heart surgeries should be delayed to treat moderate to severe anemia, a new study suggests.
In the study, Italian researchers compared the outcomes of 401 adult heart surgery patients with severe anemia and 401 heart surgery patients without severe anemia. The patients with severe anemia were nearly twice as likely to die and had a greater risk of stroke, prolonged mechanical ventilation and longer stays in the intensive care unit following surgery.
Similar results were found in patients with moderate anemia, according to the study in the October issue of The Annals of Thoracic Surgery.
“Unlike other recognized risk factors for cardiac surgery patients, such as advanced age and poor kidney function, anemia can be corrected with iron supplementation and medications that stimulate red blood cell production,” lead author Dr. Marco Ranucci said in a news release from the Society of Thoracic Surgeons. “Unfortunately, to correct anemia we need two to three weeks before the operation, which may be too long for many patients to wait.”
In people with anemia, the blood does not carry sufficient oxygen to the rest of the body. Blood loss, iron-poor diet or insufficient iron absorption from food all can lead to iron-deficiency anemia. Older adults are at risk for this common, easily treated anemia, the researchers noted.
Under current risk models, anemia is not considered a risk factor for survival following heart surgery, according to the release.
“Until it can be clearly demonstrated that correcting anemia improves outcomes, I think that working to correct and preserve the natural hemoglobin in a patient’s blood prior to surgery is a viable and safe option,” Ranucci said.
The study presents a convincing case for adding severe anemia to current models used to calculate the risks faced by heart surgery patients, Jeremiah Brown, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine in Hanover, N.H., wrote in an accompanying journal commentary.
While the study found an association between severe anemia and post-heart surgery death risk, it did not prove a cause-and-effect relationship.



SOURCE: Society of Thoracic Surgeons, news release, Oct. 1, 2012


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2013年9月13日星期五

Household Molds Linked to Childhood Asthma - NIH Research Matters - National Institutes of Health (NIH)

Household Molds Linked to Childhood Asthma – NIH Research Matters – National Institutes of Health (NIH)


August 20, 2012

Household Molds Linked to Childhood Asthma


Three specific species of mold were more common in the homes of babies who later developed asthma. The finding highlights the importance of preventing water damage and mold growth in households with infants.



Scanning electron micrograph of Penicillium mold producing spores.

Penicillium variabile, one of the mold species most associated with asthma. Image by David Gregory and Debbie Marshall, Wellcome Images. All rights reserved by Wellcome Images.


More than 6 million children in the U.S. have asthma. Genes are known to play a role, and so does the home environment. Childhood asthma has been linked to indoor mold growing in a child’s home as a result of moisture problems such as water leaks. The connection between mold and asthma, however, is complicated and not fully understood. Asthma is often associated with allergies, and molds spread by releasing tiny spores into the air, which can cause allergic reactions.
A team led by Dr. Tiina Reponen of the University of Cincinnati has been investigating the relationship between mold and childhood asthma. Between 2001 and 2003, they collected dust samples from 289 homes with infants who were an average of 8 months old. At age 7, the kids had allergy skin tests and tests for asthma. The study was funded by NIH’s National Institute of Environmental Health Sciences (NIEHS), the U.S. Department of Housing and Urban Development and U.S. Environmental Protection Agency (EPA).
The researchers analyzed the original samples of house dust for concentrations of 36 different species of mold. The molds are on the Environmental Relative Moldiness Index, or ERMI, which was developed by the EPA to measure how moldy a house is.
In the August 2012 edition of the Journal of Allergy and Clinical Immunology, the team reported that 69 of the children (24%) had developed asthma. The ERMI score of a baby’s home predicted whether the child would have asthma at age 7. ERMI values range from about -10 to 20. For a 10-point increase in ERMI, a child’s risk of asthma increased 80%. Three particular species of mold were most associated with asthma: Aspergillus ochraceus, Aspergillus unguis and Penicillium variabile.
The home inspection team also looked and smelled for evidence of mold. Sometimes even homes with no sign of mold were found to have high ERMI values and result in the development of asthma. Other studies have shown that many homes with high ERMI values have undetected mold problems and that remediating those homes improves children’s asthma.
The association between the trio of molds and asthma doesn’t prove that the molds cause asthma on their own. But it does provide strong evidence that indoor mold can contribute to asthma development. “This stresses the urgent need for remediating water damage in homes, particularly in lower income, urban communities where this is a common issue,” Reponen says.
—by Helen Fields


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Reference: J. Allergy Clin. Immunology. 2012 July 10; Epub ahead of print. PMID: 22789397.