- Serum Iron Levels and Copper-to-Zinc Ratio in Sickle Cell Disease. [Journal Article]
- MMedicina (Kaunas) 2019 May 21; 55(5)
- CONCLUSIONS: Elevated copper-to-zinc ratio may be a biomarker of sickle cell oxidative stress and associated complications. The ratio may also be informative for the management of sickle cell oxidative burden. The significantly lower levels of zinc in the SCD patients may warrant zinc supplementation.
- Comparative study of alloimmunization against red cell antigens in sickle cell disease & thalassaemia major patients on regular red cell transfusion. [Journal Article]
- IJIndian J Med Res 2019; 149(1):34-40
- CONCLUSIONS: : About 11 per cent of the transfused sickle cells patients developed alloantibodies. The antibody specificity was restricted to Rh, Kell and Duffy blood group systems. Extended antigen matching involving Rh, Kell and Duffy antigens may prevent alloantibody in such patients.
- Health-related quality of life of adolescents with sickle cell disease in sub-Saharan Africa: a cross-sectional study. [Journal Article]
- BHBMC Hematol 2019; 19:9
- CONCLUSIONS: This study highlighted that pain was negatively associated with both physical and psychosocial functioning; whereas getting Pneumococcal vaccine was positively associated with both physical and psychosocial functioning as reported by children and caretakers.
- Hemoglobin level and macular thinning in sickle cell disease. [Journal Article]
- COClin Ophthalmol 2019; 13:627-632
- CONCLUSIONS: Macular thinning observed on SD-OCT in SCD patients with SS genotype may be related to the level of anemia in this population.
- Hydroxyurea Initiation Among Children With Sickle Cell Anemia. [Journal Article]
- CPedClin Pediatr (Phila) 2019 May 21; :9922819850476
- This study assesses characteristics of children with sickle cell anemia associated with hydroxyurea initiation. Medicaid administrative claims from 6 states (2005-2012) were used to identify children…
This study assesses characteristics of children with sickle cell anemia associated with hydroxyurea initiation. Medicaid administrative claims from 6 states (2005-2012) were used to identify children with sickle cell anemia enrolled in Medicaid for ≥2 years. Hydroxyurea use was defined as >30 days' supply of filled prescriptions. Children were classified as initiators (no use in year 1; use in year 2) or nonusers (no use in either year). Logistic regression was used to estimate associations between initiation, health care encounters, and demographics. A total of 4435 children were enrolled for 2 years during the study period; 885 (20.0%) initiators and 3080 (69.4%) nonusers. Children had an annual mean of 2.0 sickle cell disease-related inpatient admissions (SD = 2.2), 8.2 sickle cell disease-related outpatient visits (SD = 7.2), and 3.6 emergency department visits (SD = 3.5). The odds of initiating hydroxyurea increased with increasing health care utilization, age, and calendar year (all P values <.05).
- Achievable Benchmarks of Care for Pediatric Readmissions. [Journal Article]
- JHJ Hosp Med 2019 May 12; 14:E1-E7
- CONCLUSIONS: ABCs based on hospital type may serve as a better metric to explain case-mix variation among different hospital types in pediatric inpatient care. The mean rates and ABCs for SCD and mental health disorders were much higher and with more outlier hospitals, which indicate high-value targets for quality improvement.
- Controlling for confounding via propensity score methods can result in biased estimation of the conditional AUC: A simulation study. [Journal Article]
- PSPharm Stat 2019 May 20
- In the medical literature, there has been an increased interest in evaluating association between exposure and outcomes using nonrandomized observational studies. However, because assignments to expo…
In the medical literature, there has been an increased interest in evaluating association between exposure and outcomes using nonrandomized observational studies. However, because assignments to exposure are not random in observational studies, comparisons of outcomes between exposed and nonexposed subjects must account for the effect of confounders. Propensity score methods have been widely used to control for confounding, when estimating exposure effect. Previous studies have shown that conditioning on the propensity score results in biased estimation of conditional odds ratio and hazard ratio. However, research is lacking on the performance of propensity score methods for covariate adjustment when estimating the area under the ROC curve (AUC). In this paper, AUC is proposed as measure of effect when outcomes are continuous. The AUC is interpreted as the probability that a randomly selected nonexposed subject has a better response than a randomly selected exposed subject. A series of simulations has been conducted to examine the performance of propensity score methods when association between exposure and outcomes is quantified by AUC; this includes determining the optimal choice of variables for the propensity score models. Additionally, the propensity score approach is compared with that of the conventional regression approach to adjust for covariates with the AUC. The choice of the best estimator depends on bias, relative bias, and root mean squared error. Finally, an example looking at the relationship of depression/anxiety and pain intensity in people with sickle cell disease is used to illustrate the estimation of the adjusted AUC using the proposed approaches.
- Role of iron metabolism in heart failure: From iron deficiency to iron overload. [Journal Article]
- BBBiochim Biophys Acta Mol Basis Dis 2019 Jul 01; 1865(7):1925-1937
- Iron metabolism is a balancing act, and biological systems have evolved exquisite regulatory mechanisms to maintain iron homeostasis. Iron metabolism disorders are widespread health problems on a glo…
Iron metabolism is a balancing act, and biological systems have evolved exquisite regulatory mechanisms to maintain iron homeostasis. Iron metabolism disorders are widespread health problems on a global scale and range from iron deficiency to iron-overload. Both types of iron disorders are linked to heart failure. Iron play a fundamental role in mitochondrial function and various enzyme functions and iron deficiency has a particular negative impact on mitochondria function. Given the high-energy demand of the heart, iron deficiency has a particularly negative impact on heart function and exacerbates heart failure. Iron-overload can result from excessive gut absorption of iron or frequent use of blood transfusions and is typically seen in patients with congenital anemias, sickle cell anemia and beta-thalassemia major, or in patients with primary hemochromatosis. This review provides an overview of normal iron metabolism, mechanisms underlying development of iron disorders in relation to heart failure, including iron-overload cardiomyopathy, and clinical perspective on the treatment options for iron metabolism disorders.
- Decreased Bleeding Incidence with Direct Oral Anticoagulants Compared to Vitamin K Antagonist and Low-Molecular-Weight Heparin in Patients with Sickle Cell Disease and Venous Thromboembolism. [Journal Article]
- AHActa Haematol 2019 May 20; :1-6
- CONCLUSIONS: There was no difference between VTE recurrence and choice of anticoagulation in SCD patients with VTE. Bleeding events were lower for DOACs compared to VKA or LMWH.
New Search Next
- Chronic pain in adults with sickle cell disease is associated with alterations in functional connectivity of the brain. [Journal Article]
- PlosPLoS One 2019; 14(5):e0216994
- Chronic pain affects 50% of adults with sickle cell disease (SCD). Although central sensitization is thought to contribute to the pathogenesis of this chronic pain, no studies have examined differenc…
Chronic pain affects 50% of adults with sickle cell disease (SCD). Although central sensitization is thought to contribute to the pathogenesis of this chronic pain, no studies have examined differences in functional connectivity of the brain between patients with SCD with and without chronic pain. We performed an observational cohort study using resting-state functional MRI (rsfMRI) of the brain on adults with SCD with and without chronic pain. We tested the hypothesis that, compared to those without chronic pain, those with chronic pain would have differences in functional connectivity between the periaqueductal grey (PAG) and other regions of the brain. Twenty-two adults with SCD, 15 with chronic pain and 7 without chronic pain, as well as 10 African-American controls, underwent rsfMRI of the brain. When SCD patients with chronic pain were compared to those without chronic pain, significant differences in connectivity were noted between the PAG and 9 regions of the brain, including several in the default mode network, a network involved in introspection that has been implicated in other chronic pain syndromes. Changes in functional connectivity between patients with SCD with and without chronic pain suggest a mechanism for chronic pain that involves neuro-plastic changes to the brain.