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Appropriateness of the study of iron deficiency anemia prior to referral for small bowel evaluation at a tertiary center

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World Journal of Gastroenterology 2017年第24期23卷 4444-4453页

作者： Jaime Pereira Rodrigues Rolando Pinho Joana Silva Ana Ponte Mafalda Sousa Joao Carlos Silva Joao Carvalho department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/EspinhoRua Conceicao FernandesVila Nova de Gaia

To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODSAll consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and december 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected. Relevant clinical information regarding prior anemia workup was retrospectively collected from medical records. An appropriate pre-referral study was considered the execution of esophagogastroduodenoscopy (EGD) with Helicobacter pylori (H. pylori) investigation, colonoscopy with quality standards (recent, total and with adequate preparation) and celiac disease (CD) screening (through serologic testing and/or histopathological investigation). RESULTSA total of 77 patients (58.4% female, mean age 67.1 ± 16.7 years) were included. Most (53.2%) patients were referred from general practitioners, 41.6% from other hospital specialties and 5.2% directly from the emergency department. The mean pre-referral hemoglobin concentration was 8.8 ± 2.0 g/dL and the majority of anemias had microcytic (71.4%) and hypochromic (72.7%) characteristics. 77.9% of patients presented with an incomplete pre-referral study: EGD in 97.4%, with H. pylori investigation in 58.3%, colonoscopy with quality criteria in 63.6%, and CD screening in 24.7%. Patients with an appropriate study at the time of referral were younger (48.7 ± 17.7 vs 72.3 ± 12.3 years, P dertaken in 72.7% of patients, with a more frequent evaluation in patients with a quality colonoscopy at referral (78.6% vs 23.8%); P ded as the likely cause of IDA was small bowel angioectasia (18.2%) but additional causes were also found in the upper and lower ga

关键词： Iron deficiency anemia Colonoscopy Celiac disease Esophagogastroduodenoscopy Helicobacter pylori Small bowel

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Neonatal Nutrition and Later Outcomes of Very Low Birth Weight and Preterm Infants <32 Gestational Age at a Tertiary Care Hospital of Portugal

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Open Journal of pediatrics 2015年第3期5卷 190-198页

作者： Conceicao Costa Teresa Torres Andreia Teles departments of pediatrics—centro hospitalar vila nova de gaia/espinho Vila Nova de GaiaPortugal epartments of pediatrics Neonatology Unit—Centro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal

Premature infants, especially those born with less than 1500 g, often exhibit slow overall growth. Lack of early nutritional support is an important element. The present authors describe parenteral nutritional practices in a tertiary hospital and evaluate postnatal growth of preterm infants under 32 weeks of gestational age or with a birth weight ded on the first day. The average time was 14.7 days. The average weight gain by the 30th day was 425 g. At discharge, 37% were rd month 20% had their weight under P3, decreasing to 10% by the 12th month. Children who initiated PN in the first 24 hours of life had significantly better weight on the 30th day of their life (p th month of corrected age (p = 0.038). And they had better Body Mass Index (BMI) in the 3rd (p = 0.012) and 12th (p = 0.023) months. despite better feeding practices, there is still significant failure in post natal growth. Early introduction of PN was associated with an improved weight gain, which suggests that nutrition that included amino acids may be critical during the first 24 hours of life.

关键词： Growth Parenteral Nutrition Preterm Infant Very Low Birth Weight

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