Haematology

Findings from a study conducted in elderly patients indicate that anaemia is associated with an increased risk of developing dementia, and that the presence of iron deficiency, the leading cause of anaemia, could contribute to risk of developing dementia in later life.

The study included older adults (50–79 years) who were free of dementia at baseline. Dementia diagnosis was determined by dementia medication use, hospital records, or a change in Modified Mini-Mental State (3MS) score of >1.5 standard deviation from the mean.

Iron deficiency is the leading cause of preoperative anaemia, a frequent condition amongst patients undergoing major orthopaedic surgery1. Preoperative anaemia is associated with increased risk of postoperative mortality and morbidity, nosocomial infection, and prolonged hospitalisation1–4. Perioperative blood loss and blunted erythropoiesis due to surgery-induced inflammation, may lead to postoperative anaemia in almost 90% of procedures5.

Clinical studies suggest that a total dose infusion (TDI) of 1 g of intravenous (IV) iron is a suitable iron replacement approach compared with multiple small-dose infusions for patients with iron deficiency1–3. In the last decade, evidence has been published demonstrating safety, efficacy and, particularly, convenience of rapid administration of 1000–1500 mg of IV iron1–4.

Expert comment: Professor Jorge Toblli

"This interesting study emphasises the concept that chronic inflammation is associated with an increase in serum hepcidin, thus contributing to poor intestinal iron absorption. The authors report that H. pylori infection upregulates serum hepcidin levels and was associated with diminished response to oral iron therapy in children with iron-deficiency anemia."

Study summary

This article highlights the importance of the relationship between serum hepcidin and iron deposition in the brain of patients with HBV-related cirrhosis. The study is based on a group of HBV-related cirrhotic patients and age- and sex-matched healthy controls.  The evaluation of brain iron content was conducted by susceptibility weighted phase imaging technique.

Preoperative iron deficiency is associated with low haemoglobin levels and a high rate of intraoperative blood transfusion, according to a new study. The authors suggest that pretransplant iron deficiency is a prognostic factor for intraoperative transfusion, which may have important implications for future transfusion practices in liver transplant recipients.

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