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Biomedical subjects

N Milman

Publications and source records attributed to N Milman.

211 records · Page 12Linked to original sources

Iron therapy in patients undergoing maintenance hemodialysis.

Twelve patients in maintenance hemodialysis, receiving long-term oral iron therapy, have been treated with i.v. iron dextran, in order to evaluate the effect on the Hb level. Both Hb and hematocrit were unchanged before and after the iron dextran infusion (p greater than 0.5, p greater than 0.7, respectively). Oral iron therapy is usually sufficient to maintain an adequate iron balance in dialysed patients and should be preferred to parenteral iron in view of the better utilization and absence of side-effects. The indication for parenteral iron should be limited to patients with impaired gastrointestinal iron absorption.

Administration, Oral↗

Normal iron absorption determined by means of whole body counting and red cell incorporation of 59Fe.

Gastrointestinal iron absorption has been measured in 27 apparently healthy subjects (8 males and 19 females) by means of whole body counting. Whole body retention 14 days after oral administration of 10 muCi59Fe with a carrier dose of 9.9 mg Fe2+ was used as an expression of absorption. The percentage incorporation of the orally applied 59Fe into the total erythrocyte mass within 14 days (erythrocyte incorporation) was estimated as well. Geometric mean iron absorption was 9.1 +/- 2.2 (S.D.) % in males and 8.3 +/- 2.1% in females; in the entire series it was 8.5 +/- 2.1%. The difference between males and females was not significant. Arithmetic mean red cell utilization of absorbed 59Fe was 92.9 +/- 4.0 (S.E.M.) % in the entire series. The correlation between iron absorption and erythrocyte incorporation was found to be highly significant (r=0.96, p less than 0.001).

Adult↗

Iron absorption in patients with chronic renal failure not requiring dialytic therapy.

Gastrointestinal iron absorption, by means of whole body counting, has been measured in 15 patients with chronic renal failure, not requiring dialysis. Whole body retention 14 days after oral administration of 10 muCi 59Fe together with a carrier dose of 10 mg Fe2+ was taken as expression of absorption. The percentage incorporation in the total erythrocyte mass of administered 59Fe (erythrocyte incorporation) and absorbed 59Fe (red cell utilization) was estimated as well. Iron absorption was 9.6+/-2.0 (S.D.)% (geometric mean) and erythrocyte incorporation 7.5+/-2.3 (S.D.)% (geometric mean) while red cell utilization averaged 80.3+/-4.8 (S.E.M.)% (arithmetic mean). None of these parameters were significantly different from those obtained in a normal control group (p greater than 0.5, p greater than 0.9 and p greater than 0.2, respectively). The correlation between iron absorption and erythrocyte incorporation was highly significant (r=1.00, p less than 0.001). Iron supplementation is often indicated in the investigated category of patients due to increased blood loss and insufficient iron intake and should be given orally in consideration of the normal gastrointestinal absorption.

Erythrocytes↗

No effect of the calcium antagonist, isradipine, on plasma catecholamines in irreversible chronic obstructive pulmonary disease (COPD). A randomized, double-blind, placebo-controlled study.

Calcium antagonists have been claimed to decrease the pulmonary artery pressure and increase oxygen uptake and cardiac output in patients with chronic obstructive pulmonary disease (COPD). This should tend to decrease the plasma levels of catecholamines. The purpose of the present study was to assess the effects of the vasodilating calcium antagonist, isradipine, on resting and exercise levels of catecholamines in patients with COPD. Eighteen patients with severe respiratory insufficiency (FEV1<1.01) were investigated. During maximum exercise, the baseline levels of plasma noradrenaline rose from 2.27 nmol/l (0.41-7.66: mean, range) to 3.86 nmol/l (1.3-12.2) (P = 0.0002) and plasma adrenaline rose from 0.39 nmol/l (0.07-1.02) to 0.64 nmol/l (0.07-1.77) (P = 0.0001). The patients were randomly allocated to receive either capsules of placebo or capsules of 5 mg of isradipine and were reinvestigated after 2 h and 3 months. There was no significant difference between the two groups concerning the change in plasma catecholamines, neither at rest nor at exhaustion. Furthermore, the increase in catecholamines during exercise in the two groups did not differ from each other, neither before administration of isradipine nor after. In conclusion, a vasodilating calcium antagonist did not alter the resting level or exercise induced increase in plasma catecholamines.

Adrenergic alpha-Agonists↗

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation.

The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18-30 years. Iron deficiency (S-ferritin <16 microg/l) was observed in 9.7%, of the women, iron deficiency anemia (S-ferritin < 13 microg/l and Hb < 121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14-20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0%, in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (rs= -0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r(s)= -0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.

Adolescent↗

Iron stores in male blood donors evaluated by serum ferritin.

Iron stores were evaluated by serum ferritin measurements in 1348 male blood donors. Blood donation was associated with a decrease in serum ferritin concentrations. First-time donors (n = 21) had a geometric mean serum ferritin concentration of 52 micrograms per l, and multiple-time donors (n = 1327) of 36 micrograms per l (p less than 0.01). In the donating population, 6.0 percent had serum ferritin values less than 15 micrograms per l (i.e., depleted iron stores), 33.9 percent had values from 15 to 30 micrograms per l (i.e., reduced iron stores), 52.5 percent had values from 31 to 90 micrograms per l, and 7.6 percent had values greater than 90 micrograms per l (i.e., normal iron stores). The frequency of donations per year was more predictive of decreased iron stores than the number of lifetime donations. Serum ferritin showed a moderate fall up to the fourth donation (p less than 0.001); thereafter serum ferritin levels showed only minor insignificant changes. An increase in donation frequency was accompanied by a significant decrease in serum ferritin; values less than 15 micrograms per l were found in 1.3 percent of donors bled two times per year, in 6.0 percent bled three times per year, and in 7.9 percent bled four times per year. Regular monitoring of iron stores by serum ferritin in blood donors seems justified in order to identify those with depleted iron stores who will benefit from iron supplementation.

Adolescent↗