Hemoglobin

Background: Hemoglobin levels measured after hemodialysis, as compared to hemoglobin levels measured before hemodialysis, are suggested to be a more accurate reflection of the hemoglobin levels between hemodialysis sessions, and to be a better reference point for adjusting erythropoietin dosing.
Objectives: The aim of this study was to compare the hemoglobin levels before and after hemodialysis, to calculate the required erythropoietin doses based on these levels, and to develop a model to predict effective erythropoietin dosing.
Patients and Methods: In this cross-sectional study, the hemoglobin levels of 52 patients with end-stage renal disease were measured before and after hemodialysis. The required erythropoietin doses and the differences in cost were calculated based on the hemoglobin levels before and after hemodialysis. A model to predict the adjusted erythropoietin dosages based on post-hemodialysis hemoglobin levels was proposed.
Results: Hemoglobin levels measured after hemodialysis were significantly higher than the hemoglobin levels before hemodialysis
(11.1 1.1 vs. 11.9 1.2 g/dL, P < 0.001, 7% increase). The mean required erythropoietin dose based on post-hemodialysis
hemoglobin levels was significantly lower than the corresponding erythropoietin dose based on pre-hemodialysis hemoglobin levels
(10947 6820 vs. 12047 7542 U/week, P < 0.001, 9% decrease). The cost of erythropoietin was also significantly lower when
post-hemodialysis levels were used (15.96 9.85 vs. 17.57 11.00 dollars/patient/week, P < 0.001). This translated into 83.72 dollars/
patient/year in cost reduction. The developed model for predicting the required dosage is: Erythropoietin (U/week) = 43540.8 +
(-2734.8)Post-hemodialysis Hb* (g/dL). [(R2) = 0.221; *P < 0.001].
Conclusions: Using post-hemodialysis hemoglobin levels as a reference point for erythropoietin dosing can result in significant
dose and cost reduction, and can protect hemodialysis patients from hemoconcentration. The prediction of the erythropoietin
adjusted dosage based on post-hemodialysis Hb may also help in avoiding overdosage.

Pakistan has a high prevalence of β-thalassemia (β-thal) but lacks a screening program for its prevention. This questionnaire-based cross-sectional study was conducted in six randomly chosen non medical universities to assess the students&#39; knowledge of β-thal and premarital screening, and their attitude towards such a program. Comparison was made between the respondents&#39; attitude towards premarital screening before and after providing them some information regarding the disease. Only 54.5% (207) of 380 students had heard of β-thal, with a mean knowledge score of 13.0 ± 4.4 out of 27 questions. Most respondents were aware of the concept of premarital screening. Out of 207 students, 60.4% wanted to know if they were carriers, 69.1% wanted to know their spouse&#39;s carrier status and 59.4% wanted premarital screening to be made mandatory in Pakistan. These figures increased to 72.5, 78.3 and 67.6%, respectively after provision of written information (p values: 0.03, 0.02, and ...

The ascorbate peroxidase reactivity of hemoglobin and myoglobin has already been investigated and demonstrated in previous studies. Affinity toward urate, another natural antioxidant of plasma was analyzed, too. This study reviews the effect of two exogenous reducing agents, hydroquinone and anthracene on strong oxidant ferryl species of bovine hemoglobin. Anthracene appears to act as an inhibitor since the rate of ascorbate decay in ascorbate peroxidase catalytic cycle linearly decreases with anthracene concentration. Kinetic data suggest that inhibition can not be competitive in nature and anthracene can not act as a substrate in the peroxidase catalytic cycle of hemoglobin. Besides, it is shown here that hydroquinone efficiently protects hemoglobin from peroxide-induced free radical damage and the peroxidase activity of hemoglobin toward hydroquinone has well-measurable Michaelis-Menten parameters. The low K m , close to physiological ranges is indicative of in vivo relevance. Moreover, hydroquinone appears to be a ferric iron reductant. Therefore a multifunctional role of hydroquinone in limiting the redox toxicity of Hb and maintaining its functional oxy state is proposed here.

High doses of isolated antioxidant supplements such as vitamin C and E have demonstrated the potential to blunt cellular adaptations to training. It is, however, unknown whether intake of high doses of antioxidants from foods has similar effects. Hence, the aim of the study was to investigate whether intake of antioxidant-rich foods affects adaptations to altitude training in elite athletes. In a randomized controlled
trial, 31 national team endurance athletes (23 ± 5 years) ingested antioxidant-rich foods (n = 16) or eucaloric control foods (n = 15) daily during a 3-week altitude training camp (2320 m). Changes from baseline to post-altitude in hemoglobin mass (Hbmass; optimized CO rebreathing), maximal oxygen uptake (VO2max; n = 16) or
100 m swimming performance (n = 10), and blood parameters were compared between the groups. The antioxidant group significantly increased total intake of antioxidant-rich foods (~118%) compared to the control group during the intervention. The total study population improved VO2max by 2.5% (1.7 mL/kg/min, P = .006) and Hbmass by 4.7% (48 g, P < .001), but not 100 m swimming performance. No difference was found between the groups regarding changes in Hbmass, VO2max or swimming performance. However, hemoglobin concentration increased more in the antioxidant group (effect size = 0.7; P = .045) with a concomitantly larger decrease in plasma and blood volumes compared to control group. Changes in ferritin and erythropoietin from pre-to post-altitude did not differ between the groups. Doubling the intake of antioxidant-rich
foods was well tolerated and did not negatively influence
the adaptive response to altitude training in elite endurance athletes.