De acordo com dado da OrganizaÃÃo Mundial de SaÃde (OMS) existem cerca de 12 milhÃes de pessoas no mundo com leishmaniose. No Brasil o agente etiolÃgico da Leishmaniose visceral (LV) à a Leishmania chagasi, e a principal forma de transmissÃo do parasita ao homem e outros hospedeiros mamÃferos à por meio da picada do mosquito fÃmea de insetos dÃpteros da famÃlia Psychodidae, cujo vetor principal à o Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva). O calazar ou leishmaniose visceral à uma doenÃa tropical que se caracteriza pela presenÃa de febre, anemia, hepatoesplenomegalia, manifestaÃÃes hemorrÃgicas, alÃm de linfoadenomegalia, perda de peso, taquicardia, tosse seca, diarrÃia, febre, pancitopenia e hipergamaglobulinemia. O envolvimento hematolÃgico à comum nos pacientes com LV, sendo a anemia a anormalidade mais freqÃente decorrente de natureza multifatorial e com prevalÃncia variÃvel conforme a populaÃÃo analisada. Consiste em avaliar o padrÃo das alteraÃÃes hematolÃgicas perifÃricas dos pacientes com Leishmaniose Visceral. As amostras de sangue foram colhidas apÃs o diagnÃstico laboratorial de pesquisa de formas amastigotas de Leishmania sp em aspirado medular nos pacientes (n=30) do Hospital SÃo Josà de DoenÃas Infecciosas, em Fortaleza, CearÃ, no perÃodo de Janeiro de 2007 a Julho de 2008 e de um grupo controle (n=30) constituÃdo de doadores de sangue do HEMOCE. As anÃlises laboratoriais foram realizadas no LaboratÃrio de AnÃlises ClÃnicas do Hospital Geral de Fortaleza e no LaboratÃrio Louis Pasteur Medicina DiagnÃstica. As contagens dos elementos sanguÃÃneos foram realizadas em contador hematolÃgico Pentra 120 ABX, seguido de avaliaÃÃo citomorfolÃgica. As dosagens bioquÃmicas foram realizadas em Analisador bioquÃmico HITACHI Modular P800 e Modulo E/RocheÂ. A comparaÃÃo entre os grupos, em relaÃÃo à mÃdia das variÃveis quantitativas foi realizada atravÃs do Teste t de Student, para os dados com hipÃtese de distribuiÃÃo normal e Mann-Whitney, no caso de nÃo normalidade dos dados. Foram considerados estatisticamente significantes valores de p < 0,05. Das anÃlises (n=30) pacientes, observou-se que 63%(19) dos pacientes sÃo do interior do Estado do Cearà e 37%(11) pacientes sÃo da capital, Fortaleza. Que 80%(24) dos pacientes sÃo do sexo masculino e 20(8%) do sexo feminino. A maioria dos pacientes, 57% apresentavam-se na faixa etÃria entre 31 a 45 anos de idade. Com relaÃÃo ao tempo da doenÃa atà a data do diagnÃstico laboratorial, 47%(14) dos pacientes jà apresentavam sinais clÃnicos da doenÃa com 30 a 90 dias. Obtivemos para o sexo masculino contagem das HemÃcias, uma mÃdia de 3,69 0,6644 (x106/mm3), Hemoglobina de 9,383Â1,3002 (g/dL), HematÃcrito de 28,6708Â4,0687(%),para o sexo feminino contagem das HemÃcias, uma mÃdia de 3,525 0,6233(x106/mm3), Hemoglobina de 8,5666Â1,6561(g/dL), HematÃcrito de 26,9666Â3,9026(%). Com relaÃÃo aos Ãndices hematimÃticros observamos para ambos os sexo, um Volume Corpuscular MÃdio(VCM) de 78,1Â7,0 (fL), Hemoglobina Corpuscular MÃdia(HCM) de 25,42Â2,51 (pg), ConcentraÃÃo de Hemoglobina Corpuscular MÃdia(CHCM) de 32 2,15 (%), DistribuiÃÃo de amplitude das hemÃcias(RDW) de 15,337Â2,435 (%), Contagem de reticulÃcitos de 20.636,63Â20.300,39 (/mm3). Das anÃlises citomorfolÃgica, Das anÃlises morfolÃgicas evidenciou-se um perfil laboratorial caracterÃstico de anemia do tipo microcÃtica e hipocrÃmica seguido de normocÃtica e normocrÃmica e em 65% das amostras observamos a presenÃa de ârouleauxâ. Para as determinaÃÃes do Ferro sÃrico obtivemos uma mÃdia de 32,53Â17,31 (Âg/dL), Transferrina de 146,83Â42,19 (mg/dL), Ferritina de 1339,47Â599,05 (ng/mL), Vitamina B12 de 573,5Â253,94 (pg/mL). Ãcido FÃlico de 10Â3,47 (ng/mL). Para as contagens dos leucÃcitos a mÃdia observada foi de 2802,33 Â2322,16 (nÂ/mm3), neutrÃfilos de 1.426,33Â1.348,88(nÂ/mm3), linfÃcitos de 982,60Â576,47x(nÂ/mm3), monÃcitos de 350,13Â283,47(nÂ/mm3), plaquetas de 120,233,33Â90.640,89 (nÂ/mm3). Para as determinaÃÃes do VHS ao diagnÃstico, os pacientes apresentaram uma mÃdia de 81,77 mm na primeira hora de observaÃÃo. As determinaÃÃes do TAP nos mostrou que ao diagnÃstico os pacientes apresentaram uma mÃdia de 67,87% de atividade de protrombina. Das anÃlises observou-se que na LV existe um comprometimento na hematopoese traduzindo no sangue perifÃrico por uma pancitopenia a favor principalmente da linhagem eritrÃide, sendo a anemia nestes pacientes de natureza provavelmente crÃnica / According to World Health Organization (WHO) data there are some 12 million people worldwide with leishmaniasis. In Brazil the etiological agent of visceral leishmaniasis (VL) is Leishmania chagasi, and is the main means of transmission from the parasite to human beings and other hosts mammals is through the biting of the female mosquito of the order diptera insects belonging to the Psychodidae family, whose main vector is the Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva). The visceral leishmaniasis or kala azar is a tropical disease that is characterized by the presence of fever, anemia, hepatosplenomegaly, hemorrhagic manifestations, and linfoadenomegaly, weight loss, tachycardia, dry cough, diarrhea, fever, pancytopenia and hypergammaglobulinemia. The hematological involvement is common in patients with VL, with anemia the most frequent abnormality due to its multifactor nature and prevalence varies depending on the population being studied. It is meant to evaluate the pattern of peripheral alterations of patients with hematological Visceral Leishmaniasis. Blood samples were collected after the diagnosis of researches seeking ways of amastigotes Leishmania sp in bone marrow aspirate in patients (n = 30), Hospital of Infectious Diseases SÃo JosÃ, in Fortaleza, in the state of CearÃ, in the period from January 2007 to July 2008 and a control group (n = 30) consists of blood donors from HEMOCE. Laboratory tests were performed at the Clinical Analysis Laboratory of the General Hospital of Fortaleza and the Louis Pasteur Medical Diagnosis Laboratory. The counting of blood elements were measured with an ABX blood Pentre 60 gauge, followed by cytomorphology assessment. The biochemical measurements were made in a HITACHI biochemical analyzer Module P800 and Roche  Modular I. The comparison between the groups, for the average of quantitative variables was performed by Student t-test, for the normal distribution and Mann â Whitney hypothesis data, in case of non-normality of the data. We have statistically considered meaningful values of 0.05. The analysis (n = 30) patients, the study showed that 63% (19) of the patients are from within the State of Cearà and 37% (11)of the patients are from the capital of the state of CearÃ, Fortaleza. That 80% (24) of patients are male and 20 (8%) were females. Most of the patients, 57% were aged between 31 to 45 years old. In what concerns the period of time of the disease until the date of laboratory diagnosis, 47% (14) of the patients already had signs of clinical disease with 30 to 90 days. We have to count the male of red blood cells, an average of 3.69  0.6644 (x106/mm3), hemoglobin of 9383  1.3002 (g/dL), Hematocrit of 28.6708  4.0687 (%) for the female count of red blood cells, an average of 3525  0.6233 (x106/mm3), hemoglobin from 8.5666  1.6561 (g/dL), Hematocrit of 26.9666  3.9026 (%) . With regard to RBC indices observed for both sex, cell volume Medium (MCV) of 78.1  7.0 (fL), mean corpuscular hemoglobin (MCH) of 25.42  2.51 (pg), mean corpuscular hemoglobin concentration (MCHC) of 32  2.15 (%), distribution of amplitude of red blood cells (RDW) of 15,337  2435 (%), reticulocyte count of 20.636.63  20.300.39 (/ mm3). Of the morphological analysis showed up a laboratory profile characteristic of the type of anemia and microcytic normocytic and hypochromic followed by normochromic and 65% of the samples found the presence of "rouleax". For the determinations of serum iron had a average of 32.53  17.31 (Âg/dL), Transferrin of 146.83  42.19 (mg/dL), Ferritin of 1.339.47  599.05 (ng /ml), Vitamin B12 from 573.5  253.94 (pg/mL), Folic Acid, 10  3.47 (ng/mL). For the average counts of leukocytes observed was 2802.33  2322.16 (nÂ/mm3), of neutrophils 1426.33  1348.88 (nÂ/mm3), lymphocytes from 982.60  576.47 (nÂ/ mm3); monocytes of 350.13  283.47 (nÂ/mm3), platelet count 120.233.33  90640.89 (n Â/mm3). For the determinations of the VHS diagnosis, the patients had an average of 81.77 mm in the first hours of observation. The determination of TAP showed us that the diagnosis of the patients showed an average of 67.87% of activity prothrombin. The analysis it was observed that there is an impairment in VL hematopoese in translating in peripheral blood by a pancytopenia mainly in favor of the erythroid lineage, and the anemia in patients with chronic nature probably

A anemia falciforme é uma hemoglobinopatia de grande heterogeneidade clínica, que vem sendo abordada como uma condição inflamatória crônica nas últimas décadas. A maioria dos pacientes com anemia falciforme faz uso da hidroxiuréia (HU), uma droga citotóxica que induz a produção de hemoglobina fetal (HbF). Apesar de amplamente utilizada, os detalhes do mecanismo de ação da HU não estão completamente estabelecidos. Este trabalho propôs-se a estudar a expressão gênica de células eritróides de pacientes com anemia falciforme diferenciadas in vitro e tratadas com HU, através da técnica de DD-PCR, bem como dar continuidade aos estudos imunogenéticos em andamento neste laboratório, através da análise de citocinas séricas pró- e anti-inflamatórias e do estudo de polimorfismos nos genes que codificam as moléculas de adesão ICAM-1 e PECAM-1, nestes pacientes. As análises de DD-PCR revelaram genes envolvidos em tradução, transcrição e outros processos, dos quais 3 foram escolhidos para discussão detalhada, com base em sua função (NACA, LXN e THRA). Os polimorfismos estudados (ICAM-1 rs5498, PECAM-1 53 G/A e PECAM-1 rs668) não apresentaram relação com o quadro clínico da doença, e as freqüências alélicas e genotípicas foram semelhantes em pacientes e controles. Os níveis das citocinas pró- e anti-inflamatórias (interleucinas 2, 4, 5 e 10, interferon-gama e TNF-alfa), investigadas através de citometria de fluxo, não foram diferentes na comparação entre controles e pacientes. / Sickle cell disease (SCD) is a hemoglobinopathy that presents extremely variable clinical manifestations. It has been approached as an inflammatory disorder within the past decades and several works have tried to determine which factors are involved in such characteristic. Most of the SCD patients are under treatment with hydroxyurea (HU), a cytotoxic drug which induces the production of fetal hemoglobin. Despite its widespread use, the mechanisms by which HU acts to improve the clinical picture of SCD patients are not fully understood. The present study aimed to investigate the gene expression of erythroid cells from SCD patients differentiated in vitro and cultivated with HU, as well as to continue the ongoing immunogenetic studies on SCD patients in our lab, by analyzing plasma cytokines and investigating polymorphisms on the adhesion molecules iICAM-1 and PECAM-1 n a group of SCD patients. Our DD-PCR analysis revealed several genes involved in transcription and translation, among other processes, and we chose 3 of those genes to discuss in more detail (NACA, LXN and THRA). The polymorphisms studied here (ICAM-1 rs5498, PECAM-1 53 G/A and PECAM-1 rs668) were not correlated with the clinical aspects of SCD, and the genotypic and allelic frequencies were similar among patients and controls. The levels of pro- and anti-inflammatory cytokines (interleukins 2, 4, 5 and 10, interferon-gamma and TNF-alpha) were similar in patients and controls.

BACKGROUND: Bariatric surgery is effective for weight loss, but is associated with deficiencies of several micronutrients. Among these, deficiencies in iron and vitamin B12 have been well-described in the literature. While it is known that blood levels of several micronutrients differ between racial groups, it is currently unknown whether the impact of bariatric surgery on micronutrient levels is also race-specific. We addressed this question in reference to vitamin B12 and iron because of the known racial differences in these micronutrients and their impact on red blood cell indices. The aim of our study was to determine whether there are differences in levels of ferritin and vitamin B12, as well as in hemoglobin (HGB) and hematocrit (HCT) levels, between African-Americans (AA), Hispanic-Americans (HA), and Caucasian-Americans (CA) after Roux-en-Y gastric bypass (RYGB) surgery. METHODS: A retrospective medical record review of 1,046 (201 AA, 106 HA, and 344 CA), who underwent bariatric surgery at Boston Medical Center (BMC) between 2004 and 2015 was conducted. Analysis of variance and linear mixed modeling was used to compare adjusted mean changes in biomarkers of anemia, vitamin B12, and ferritin between racial groups before RYGB and up to a period of 4+ years after the surgery. RESULTS: There were significant decreases in all racial/ethnic groups in mean HCT and HGB within the first year following surgery. Mean HCT from baseline to time point 1 (6months-1 year post-operatively) decreased by 3.3% for AA’s (p<0.001), 3.2% for HA’s (p<0.001), and 5% (p<0.001) for CA’s. Mean HCT and mean HGB for the entire sample decreased from baseline to the end of the observation period by 4.4% and 1.45 g/L, respectively. AA's had lower levels of HCT and HGB throughout the observation period compared to HA's and CA's in both the unadjusted and adjusted models. CA's had the highest levels of these blood markers. Decreases in ferritin were also significant, with a decrease from baseline to the end of the observation period of 27.8 μg/L for AA's (p=0.004), a decrease of 49.6 μg/L for HA's (p<0.001), and 54.5 μg/L (p<0.001) for CA's. In comparison with HA's and AA's, CA's had a higher ferritin level at baseline (p=0.715 and p=0.028, respectively). However, when adjusted for age, sex, and initial BMI, CA's had lower ferritin levels throughout much of the observation period compared to HA's and AA's. After an initial increase at 6 months- 1 year post-operatively (time point 1), mean B12 levels remained fairly stable throughout the observation period with levels only slightly declining for AA’s and HA’s over the observation period. Levels remained higher than baseline for all racial/ethnic groups with mean B12 levels at the end increasing by 144.6 ng/L for AA’s (p<0.001), 70.4 ng/L for HA’s (p=0.186), and 182.2 ng/L for CA’s (p<0.001). Though CA’s saw the greatest increase in mean B12 levels from baseline, AA’s had the highest mean B12 levels over the entire observation period, with significantly different levels compared to HA’s and CA’s at time points 1 (p=0.003 and p=0.028, respectively) and 3 (p=0.050 and p=0.042, respectively). Additionally, when other factors significantly affecting mean HCT, HGB, ferritin, and B12 were analyzed and adjusted for in the mixed model, AA’s continued to have the lowest HCT and HGB levels throughout much of the observation period, with CA's having the highest mean levels. For mean B12, even after adjusting for pre-BMI and sex, levels remained highest in AA’s compared to HA’ and CA’s. CONCLUSIONS: Our data demonstrate that ferritin levels, as well as red blood cell indices, decrease after RYGB and blood markers of anemia occur despite supplementation and post-operative follow-up care. We also show that ethnic minorities exhibit more exaggerated decreases in HCT and HGB, suggesting greater risk of anemia after RYGB in these groups. Thus, it is critical to consider race/ethnicity when providing treatment for patients undergoing gastric bypass surgery. However, future prospective studies are needed to further the preliminary results of this study.

Thesis (Ph.D.)--University of Delaware, 2006. / Principal faculty advisor: John K. Rosenberger, Dept. of Animal and Food Sciences. Includes bibliographical references.

Aproximadamente la tercera parte de la población mundial (2 billones de personas) cursa con algún grado de anemia, el 35% de las mujeres en edad reproductiva, el 51% en gestantes. A nivel nacional 28% de las gestantes presento algún grado de anemia; 25,1% presenta anemia leve; 2,6% anemia moderada y 0,2% anemia grave. La anemia afecta no sólo a la gestante, sino también al producto. El 95 % de los casos de anemia se debe a una depleción de hierro. El estudio tiene como objetivo determinar la prevalencia de anemia moderada y severa en las gestantes y su repercusión materna perinatal. Es un estudio descriptivo, retrospectivo y transversal. Se presentó 160 gestantes con anemia moderada y 15 con anemia severa, con relación porcentual de 6,3%, y 0,6% con respecto a las gestantes registradas en el SIP (sistema informático perinatal). Se encontró que la Hemorragia post parto, Infección de Herida Quirúrgica, Pre-eclampsia, Amenaza de aborto y Aborto, Bajo peso del Recién Nacido, Prematuridad, y Mortalidad perinatal es más frecuente en la anemia severa.

Este estudio se realizó entre el período comprendido entre Febrero a Junio del 2002. Se estudiaron 50 pacientes, (9 mujeres y 41 varones), que representaron el 18 % y 82 % respectivamente hospitalizados en los servicios de medicina del Hospital Nacional Dos de Mayo, con Diagnósticos de Tuberculosis y Anemia con, Hemoglobina menor de 14 gr/dl para varones y menor de 13gr/dl en mujeres y en acianos varones menor de 13 gr/dl, mujeres menor de 12 gr/dl, con el propósito de tipificar y evaluar el grado de severidad de las anemias. Los estudios realizados de medula ósea fueron: 44 % de los pacientes con Anemia por Enfermedad crónica, y en el 56 % de los pacientes fueron Anemias carenciales. Del 56 % de los pacientes con Anemias carenciales el 22 % fueron ferropenicas puras , 22 % Megaloblásticas puras y un 12 % carencial mixtas. El grado de Anemia que se presentó con más frecuencia en los pacientes con Tuberculosis fueron; Las Anemias Moderadas y severas con un 44% y 42 % respectivamente, las anemias leves representaron el 14 % . Los pacientes con BK 1+ fueron un 40 %, pacientes con BK 2+ 34 % , y pacientes con BK 3+ fue de 18 % , y un 8 % de los pacientes presentaron diagnóstico de TBC extrapulmonar. / This study was carried out among the understood periods of February from 2002 to June of 2002, 50 patients they were studied, (9 women and 41 males) that represented 18% and 82% respectively hospitalized in the services of medicine of the National “ Dos de Mayo” Hospital, with Diagnostic of Tuberculosis and Anemia with, Hemoglobin smaller than 14 g/dl for males and smaller than 13 g/dl in women and in male cornflowers smaller than 13 g/dl, women smaller than 12 g/dl, with the classify purpose and to evaluate the grade of severity of anemia. The studies carried out of bone marrow were: 44% of the patients with was Anemia for chronic disease, and 56% lacking Anemia. Of 56% that correspond to the lacking Anemia 22% they are iron-deficiency anemia, 22% Megaloblastic and 12% was mixed. The grade of Anemia that you presents with more frequency in the patients with Tuberculosis was; The Moderate and severe Anemia with 44% and 42% respectively, the light anemia represented 14%. The patients with BK 1 + they were 38%, patient with BK 2 + 36%, and patient with BK 3 + 18%, and 8 % of the patients presented extrapulmonary loction diagnostic of TBC.

Se determinó el estado nutricional y la prevalencia de Anemia en 151 niños procedentes del Asentamiento Humano Monterrey I del Distrito de Ate – Vitarte, cuyas edades están entre 1 año 1 mes y 15 años, durante los meses de mayo y junio del año 2006. La anemia se evaluó a través de la hemoglobina, empleando la técnica de cianometahemoglobina, del hematocrito utilizando el método micrométrico y a través del recuento de glóbulos rojos, mediante el método de Gower. El estado nutricional se determinó por antropometría, a través del uso de sus indicadores: peso para la edad (P/E), peso para la talla (P/T) y talla para la edad (T/E). Del total de niños investigados el 49,2% corresponden al sexo masculino y el 50,8% al sexo femenino. Los resultados obtenidos fueron comparados con los patrones de Referencia del Centro Nacional de Estadística Sanitaria de los Estados Unidos de América y aprobados por la Organización Mundial de la Salud. Para la determinación de anemia se empleó los puntos de corte dados por la Organización Mundial de la Salud. La prevalencia total de anemia fue de 18,03%, encontrándose mayor porcentaje de anemia en mujeres (22.6%) que entre los varones (13,3%). Los resultados demuestran que el 25,8 % de la población presenta desnutrición crónica moderada y el 6,6 % desnutrición crónica grave, lo que nos indica un déficit en la talla con respecto a su edad, el 1,3 % presenta desnutrición aguda moderada y no se encontraron casos de desnutrición aguda grave y el 1,3 % presenta desnutrición global. De los 151 niños que presentaron desnutrición (35 %), entre el 22,0 (disminución de hemoglobina) y 23,0 % (disminución de hematocrito) presentaron un cuadro de anemia. / The nutritional state and the prevalence of anaemia in 151 children from Monterrey I, a slum located in the district of Ate-Vitarte (Lima), which ages were between one year one month and fifteen years, through a research between May and June in 2006, were determined. Anaemia was evaluated through the haemoglobin, which was evaluated using the cyanmet-haemoglobin technique, through the hematocrit using the micrometric method and through the red corpuscules count, using the Gower method. In order to determine the nutritional state, the anthropometric method was used, through the use of its indicators: weight for age (W/A), weight for height (W/H) and height for age (H/A), and. From the total of the researched children, 49.2% belongs to male sex and 50.8% to female sex. The obtained results were compared with the reference patterns of the National Center for Health Statistics (NCHS) of the United States of America. For the anaemia determination, the cut points of the World Health Organization were used. The total prevalence of anaemia was 18.03%, so the percentage of anaemia in women (22.6%) was greater than in men (13.3%). The results demonstrated that 25.8 % of the population presents moderate chronic undernourishment and 6.6 %, grave chronic undernourishment, which indicates a deficit in height respect to their age, 1.3% presents moderate acute undernourishment and grave acute undernourishment cases, were not found, and 1.3 % presents global undernourishment. From the 51 children that presented undernourishment (35.0 %), between 22.0 (haemoglobin decrease) and 23.0 % (haematocrit decrease) presented anaemia.

La anemia, enfermedad ocasionada por la ingesta inadecuada de hierro. Según la OPS más del 40% de todos los casos presentan en Asía y África. La prevalencia en menores de 5 años es de 50-60% en los países en desarrollo. Más frecuente en R. N. de bajo peso y menores de 2 años. Según el ENDES (2,005) pese a la reducción, de 49.6% a 46.2% en menores de 5 años la prevalencia se mantiene alta, frecuente en niños de la Sierra 54.9% y Selva 51.3%.

INTRODUCCIÓN.- La alteración del perfil hematínico que conlleva a anemia como evento final, es una alteración prevalente en la población anciana sin existir justificación fisiológica que la condicione; siendo producida por una serie de elementos como: comorbilidades, limitaciones nutricionales, sociales, económicas, polifarmacia. Sería importante tener una aproximación clínico-laboratorial del perfil hematínico y valoración geriátrica de la población anciana; para conocer cuales son sus alteraciones y describir los posibles elementos a los que estarían asociados en este importante grupo poblacional. MATERIALES Y METODOS.- Se realizo valoración geriátrica integral y se tomaron muestras de laboratorio para cuantificar perfil hematínico en la población del servicio de Geriatría del HNGAI Lima – Perú. RESULTADOS.- Se evaluaron 102 pacientes 52 mujeres y 50 varones, 49% provenientes de la unidad geriátrica aguda, con una media de 79,5 años. Se encontró Hemoglobina menor de 12 g/dl (anemia) en 42 pacientes (41,11%) siendo 22 (21,57%) microcítica y 8 (7,8%) macrocítica. Se encontró ferropenia en 8 (8%) y disminución de ácido fólico en 10 (9,8%). Hubo 6 de 32 pacientes con disminución de Vitamina B12. Se encontró 38 (37.2%) pacientes independientes y 64 (63,8%) con algún grado de dependencia. Con algún grado de deterioro cognitivo 76 (74,5%) con comorbilidades importantes eran 46,42% con dificultad social moderada 68 (66%). Se encontró anemia en la población con mayor comorbilidad, menor apoyo social y menor condición económica. CONCLUSIONES: La población atendida en el servicio de Geriatría del HNGAI tiene mayor alteración del perfil hematínico, mayor cantidad de pacientes anémicos; comparado con otros grupos poblaciones y comparado con poblaciones ancianas de otro países, siendo en nuestra población relevantes la disminución de ácido fólico, déficit de Vitamina B12, la comorbilidad y limitaciones socioeconómicas. La anemia está asociada a mayor limitación funcional. La intervención de anemia en el anciano debe ser integral.

Thesis--University of Chicago, 1909. / Reprinted from the Botanical gazette, v. 49. Includes bibliographical references (p. 179-180).