Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.
Cho, Ju Rae;Kim, Soon Ki;Park, Sang Kyu;Hah, Jeong Ok
Clinical and Experimental Pediatrics
/
v.45
no.3
/
pp.362-369
/
2002
Background : Anemia is still the most common nutrient deficiency worldwide, especially in adolescence because of an insufficient supply of iron, an increased iron requirement due to accelerated physical growth and blood loss due to menstruation in girls. This study was designed to assess the anemia and serum iron status of middle school girls. Methods : Hematologic examinations, physical examinations and questionnaires were performed for middle school girls in 1990, 1997, 1999 and 2000. Anemia was defined as a serum hemoglobin level of less than 11.5 g/dL. Iron deficiency was defined as a serum ferritin level of less than 10 ng/mL. Iron deficiency anemia was defined as anemia plus one of the following; MCV less than 78 fL, Ferritin level less than 10 ng/mL or Transferrin saturation rate less than 10%. Results : There was no significant difference in mean Hb between urban and rural areas and decreases in mean Hb as with age. The prevalence of anemia decreased by year; 13.5% in 1990, 6.9 % in 1997, 6.0% in 1999, and 5.7% in 2000. It was high in high school girls(10.1% in 1997 and 12.6% in 2000). The prevalence of iron deficiency decreased by year; 36.1% in 1990, 13.9% in 1997, 13.3% in 1999, and 23.2% in 2000. It was 21.3% in 1997 high school girls and 37.8% in 2000. The prevalence of iron deficiency anemia(IDA) decreased by year; 10.0% in 1990, 4.6% in 1997, 8.3% in 1999, and 6.1% in 2000. It was 11.6% in 1997 high school girls and 18.6% in 2000. Conclusion : Although the prevalence of iron deficiency decreased during this period, the prevalence of anemia in the elder adolescence girls was high. Two things are recommended; first, it is necessary to screen for anemia in middle school girls and high risk groups, second, it is important to evaluate the knowledge of nutrition and to enforce effective nutritional education, leading to subjects receiving adequate nutrition.
This study was carried out to evaluate the iron nutrition status of 212 middle school students(106 males and 106 females) residing in Seoul(13-14 years old ) using eating patterns and a measurement of anthropometrical determination and hematological indices. Fasting blood samples were taken from all subjects, serum iron (SI) and total iron binding capacity(TIBC) concentrations were measured, and transferrin saturation(TS) levels were calculated. Iron and other nutrient intakes were estimated by a semi-quantitative frequency questionnaire. The level of TS(%) which was calculated with TIBC and SI in females(20.4$\mu\textrm{g}$/dl) was significantly lower(p<0.050 than that of males (27.4$\mu\textrm{g}$/㎗). The prevalence of iron deficiency was found to be 36.7% when defined by TS(%) (<05%). Mean daily intake of total iron in the study subjects was 14mg and heme iron intake was 5.4mg(38.1%) . There was a significant negative correlation between the level of SI and the income level and a positive correlation with the level of TIBC and the income level. TIBC had a positive correlation with the anthropometric variables(Ht, Wt, BMI, RI and PIBW). SI and TS had a negative correlation with body fat percentage. There was a positive correlation between energy intake and TIBC only among females. The logistic regression analysis revealed that income level, body fat percentage , weight and energy intake were major determinants of low SI levels. Among the determinants of abnormal TIBC levels were weight , height, income level and energy intake. Finally , among those of low TS% were iron and energy intake and income level. These observations suggest that physical status, body fat percentage energy and iron intakes and income level are risk factors for iron-deficiency anemia among the middle school students in Seoul.
Purpose: Recently, the favorable merits of breast feeding have received widespread attention and the number of breast feeding children is increasing. We investigated the weaning practices between breast feeding infants and non-breast feeding infants with respect to iron deficiency anemia (IDA). Methods: Between March 2006 and January 2009, we surveyed 70 parents, the children of whom had been medically diagnosed with IDA, and 140 parents, the children of whom did not have IDA, about how they feed their children and how much they know about the weaning process. The infants and children were 6∼36 months of age and attended the Inha University hospital. Results: IDA patients started weaning later than non-IDA patients. Also, breast feeding in IDA patients was more frequent than in non-IDA patients (82% vs. 30%). The breast feeding group began weaning at approximately 6.4 months of age, which was statistically meaningfully compared to non-breast feeding infants. There were no differences in knowledge between the two groups of parents. Conclusion: According to our research, we assume that if weaning begins at 6 months, we cannot supply sufficient iron to meet the infant's needs, which increase sharply around 6 months of age because of depletion of stored iron. Thus, infants need to initiate weaning from breast feeding at 4 months of age to furnish an ample amount of iron or take iron-containing supplements. These methods would be expected to prevent IDA in breast feeding infants.
This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fifty- three female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 $\pm$ 5.57 cm and 51.06 $\pm$ 9.42 kg respectively. The average Body Mass Index (BMI, $kg/m^2$) was 20.63 $\pm$ 3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 $\pm$ 343.47 kcal(83.01% of the Korean RDA) and the calcium intake was 634.98 $\pm$ 201.43 mg (79.37% of the Korean RDh) . The mean daily intake of iron was 14.76 : 4.36 mg (92.25% of the Korean RDh) and the heme iron intake was 6.12 $\pm$ 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 $\pm$ 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 $\pm$ 4.10%. The transferrin saturation {TS (%)} was 19.41 $\pm$ 9.21%, and the ferritin level was 26.26 $\pm$ 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/ml), 20.5% by using Hct (< 36%), 30.8% by using 75 (< 14%) , and 23.1% by using ferritin (< 12 ng/ml) The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and 75. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face'(p < 0.05) . In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p<0.01) and the ferritin concentration was negatively correlated with 'no appetite '(p < 0.05) ,'pale face (p < 0.05) . These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.
This study was designed to assess the iron nutritional status and anemia of middle school girls in Ulsan City, who were evaluated with a questionnaire, measurement of hematological indices. The average height and weight of respondents were 154.81$\pm$6.28cm and 48.51$\pm$8.80kg, respectively. Mean daily energy intake was 1815.72$\pm$328.04kcal and iron intake was 15.13$\pm$4.50mg. The average hemoglobin concentration of subjects was 11.98$\pm$0.78g/dl, and the average hematocrit level was 36.62$\pm$2.21%. Transferrin saturationTS (%) was 25.58$\pm$9.82%, and the ferritin level was 40.45$\pm$23.03ng/ml. Iron deficiency anemia among the subjects was estimated as 54.2% by using hemoglobin(<12g/이), 33.9% by hematocrit (<36%). The clinical symptoms relating anemia were measured with 4 Likert scale (1 : never, 4 : often), 'tired out easily (2.34$\pm$0.92)' was the highest, followed by 'feel dizzy always (2.26$\pm$0.85)', 'decreasing ability to concentrate (2.23$\pm$0.77)', 'get a cold easily (2.19$\pm$0.82)', 'have a headache (2.10$\pm$0.79)', 'poor memory (2.09$\pm$0.83)', 'no appetite (1.99$\pm$0.85)', As for the correlation between iron parameter and clinical symptoms related to anemia, the hematocrit rate was negatively correlated with 'get a cold easily', 'pale face', 'feeling blue', 'difficult digestion' (p<0.05). The level of iron was negatively correlated with 'tired out easily', 'get a cold easily' (p<0.05) and TS (%) were negatively correlated with 'tired out easily (p<0.05)', 'get a cold easily (p<0.01). Our study resulted that the prevalence of a iron deficiency of a middle school girl is very high, therefore the guidelines for iron supplementation and nutritional education to improve their iron status should be provided.
Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.
Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Choi, Joon Young;Kim, Sang Eun;Lee, Kyung Han;Kim, Byung-Tae
The Korean Journal of Nuclear Medicine
/
v.32
no.1
/
pp.114-119
/
1998
We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intervals. On initial scan, uplake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.
Ferritin, an iron-storage protein, is found in bacteria and some animal tissues such as liver, spleen, and bone marrow. It is more effective and causes less side reactions than the traditional ferrous sulfate, and thus has been used primarily to treat iron deficiency in pregnancy anaemia. Currently, the ferritin extracted from the bovine and equine spleens are sold as a commercial product. Its market is estimated as several hundreds of million US dollars. However, because of the recent warnings against the viral diseases of animal origins such as mad cow disease, a safer ferritin is sought after. Our research team has successfully developed a production process for recombinant human ferritin. Its expression titer from yeast is high enough to be economically viable, and its particle formation characteristics are as effective as well.
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