vitamin-b-12 and Hemorrhage

Micronutrient deficiencies are relatively common, in particular iron and cobalamin deficiency, and may potentially lead to life-threatening clinical consequences when not promptly recognized and treated, especially in elderly patients. The stomach plays an important role in the homeostasis of some important hematopoietic micronutrients like iron and cobalamin, and probably in others equally important such as ascorbic acid, calcium, and magnesium. A key role is played by the corpus oxyntic mucosa composed of parietal cells whose main function is gastric acid secretion and intrinsic factor production. Gastric acid secretion is necessary for the digestion and absorption of cobalamin and the absorption of iron, calcium, and probably magnesium, and is also essential for the absorption, secretion, and activation of ascorbic acid. Several pathological conditions such as

Topics: Achlorhydria; Animals; Biomarkers; Bone Density; Calcium; Deficiency Diseases; Digestive System Surgical Procedures; Disease Management; Disease Susceptibility; Dysbiosis; Gastric Acid; Gastric Mucosa; Hemorrhage; Humans; Micronutrients; Stomach Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Anemia; Bone Marrow; Erythrocytes; Erythropoiesis; Erythropoietin; Ferritins; Folic Acid; Hemoglobins; Hemorrhage; Hemostasis; Humans; Hypersplenism; Iron; Kidney Failure, Chronic; Kidney Transplantation; Renal Dialysis; Uremia; Vitamin B 12

Acute promyelocytic leukemia (APL) is characterized by proliferation of morphologically abnormal promyelocytes and a severe bleeding diathesis. The abnormal promyelocyte is characterized by abundant, large granules, many of which are spindle-shaped. Electron microscopic appearance of the granules closely resembles that of Auer rods. The granules appear to possess tissue thromboplastin activity by both immunologic and clotting assays. Coagulation studies in APL are generally consistent with disseminated intravascular coagulation. Prolongation of the prothrombin time and elevation of fibrinogen degradation products are the tests that are most commonly abnormal. Although occasional reports indicate a favorable response of the coagulopathy to drugs that inhibit fibrinolysis, the use of prophylactic heparin appears to be the treatment of choice. The response rate of APL to chemotherapy regimens that contain an anthracycline is comparable to that of acute myelogenous leukemia. The recent description of the 15;17 chromosomal translocation which may be pathognomonic for APL is only the second example of a chromosomal marker of human neoplasia. Marked elevation of serum vitamin B12 and B12 binding proteins appears to be another characteristic feature of APL. An in vitro cell line of APL cells has been demonstrated to have the capacity to differentiate to functional polymorphonuclear leukocytes, but the cause for the maturation arrest is unknown.

Topics: Blood Coagulation Disorders; Bone Marrow; Cell Line; Chromosome Banding; Daunorubicin; Fibrinogen; Fibrinolysis; Hemorrhage; Heparin; Humans; Leukemia, Myeloid, Acute; Prognosis; Prothrombin Time; Thromboembolism; Vitamin B 12

Topics: Anemia; Anemia, Hemolytic; Blood Circulation; Bone Marrow; Catalase; Erythrocytes; Ferritins; Hemoglobins; Hemolysis; Hemorrhage; Humans; Iron; Metals; Mononuclear Phagocyte System; Neoplasm Metastasis; Neoplasms; Polysaccharides, Bacterial; Regional Blood Flow; Vitamin B 12

Topics: Aneurysm; Angiography; Diabetic Retinopathy; Diathermy; Diet; Exudates and Transudates; Fluorescence; Hemorrhage; Humans; Hypophysectomy; Insulin; Light Coagulation; Retinal Vessels; Retinitis; Testosterone; Trypsin; Vitamin B 12; Vitreous Body

The aim of this retrospective cohort study was to identify early risk factors of mortality and develop a mortality risk stratification instrument for severely anaemic Jehovah's Witness patients. It has been shown that Jehovah's Witness patients with the Auckland Anaemia Mortality Risk Score (Auckland AMRS) of 0 to 3 had 4% mortality, Auckland AMRS 4 to 5 32%, Auckland AMRS 6 to 7 50% and Auckland AMRS 8 and above 83%. It is concluded that the Auckland AMRS predicts mortality of severely anaemic Jehovah's Witness patients.

Topics: Adolescent; Adult; Aged; Anemia; Cardiovascular Diseases; Erythropoietin; Factor VIIa; Female; Filgrastim; Folic Acid; Granulocyte Colony-Stimulating Factor; Hemorrhage; Hospital Mortality; Hospitals, Public; Humans; Infections; Iron; Jehovah's Witnesses; Kidney Failure, Chronic; Male; Middle Aged; New Zealand; Plasma; Postoperative Complications; Recombinant Proteins; Retrospective Studies; Risk Assessment; Risk Factors; Vitamin B 12; Young Adult

Folate metabolism has been implicated in stroke. However, the possibility of a role for folate and vitamin B12, independent of their effects on homocysteine status, remains to be explored. The aim of this prospective, nested case-referent study was to relate plasma and dietary intake levels of folate and vitamin B12 to risk of stroke, taking into consideration plasma homocysteine concentrations and methylenetetrahydrofolate reductase polymorphisms.. Subjects were 334 ischemic and 62 hemorrhagic stroke cases and matched double referents from the population-based Northern Sweden Health and Disease Cohort.. Plasma folate was statistically significantly associated with risk of hemorrhagic stroke in an inverse linear manner, both in univariate analysis and after adjustment for conventional risk factors including hypertension (odds ratio [OR] for highest versus lowest quartile 0.21 (95% confidence interval [CI], 0.06 to 0.71; P for trend=0.008)). Risk estimates were attenuated by inclusion of homocysteine in the model (OR, 0.34; 95% CI, 0.08 to 1.40; P for trend=0.088). A similar pattern was observed for increasing folate intake (multivariate OR, 0.07; 95% CI, 0.01 to 0.55; P for trend=0.031 without homocysteine, and OR, 0.16, 95% CI, 0.02 to 1.23; P for trend=0.118 with homocysteine in the analysis). We found little evidence of an association between plasma or dietary folate and risk of ischemic stroke. Neither plasma nor dietary vitamin B12 was associated with risk of either stroke subtype.. The results of this study suggest a protective role for folate, possibly in addition to its effects on homocysteine status, in hemorrhagic but not ischemic stroke.

Topics: Adult; Aged; Brain Ischemia; Case-Control Studies; Cohort Studies; Diet; Female; Folic Acid; Hemorrhage; Homocysteine; Humans; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Multivariate Analysis; Nutritional Status; Odds Ratio; Polymorphism, Genetic; Prospective Studies; Registries; Risk; Stroke; Sweden; Vitamin B 12

1. The effects of haemorrhage on vitamin B12 (cobalamin) homoeostasis have been studied in rats with and without prior administration of 57Co-labelled cyanocobalamin. 2. Arteriovenous differences in radioactivity and endogenous B12 were measured across the thigh extensor muscles. Radioactivity and endogenous B12 were also measured in skeletal muscle, liver and kidney. 3. Haemorrhage induced a marked rise in circulating B12 with a concomitant loss of the vitamin from skeletal muscle and liver, but in kidney there was a net gain. Restoration of the blood volume with autologous plasma did not prevent release of B12 from tissues. 4. The results suggest that vitamin B12 reserves may be seriously depleted by the wasting of skeletal muscle.

Topics: Animals; Arteries; Hemorrhage; Homeostasis; Kidney; Liver; Male; Muscles; Rats; Rats, Inbred Strains; Veins; Vitamin B 12

Thirteen patients with significant hemorrhage, severe thrombocytopenia, and megaloblastic bone marrows are described. Unusual features of this problem included its acute onset, frequent absence of the typical peripheral blood changes of megaloblastic anemia, normal serum B12 levels, and serum folates which were often not clearly abnormal. Most patients were critically ill and common clinical features included reduced dietary intake, renal failure, renal dialysis, the postoperative state, and sepsis. These clinical features, the laboratory findings, and a platelet increase in most patients after folate therapy lead to the conclusion that this problem is probably due to acute folic acid deficiency. Possible explanations for the atypical laboratory findings include the acuteness of onset, recent blood transfusion therapy, and impaired folate utilization. This problem may be relatively common. Because of its potential clinical importance, rapid onset, and attendent diagnostic difficulties, prophylactic folic acid is recommended in the clinical setting described.

Topics: Acute Disease; Anemia, Megaloblastic; Bone Marrow Examination; Folic Acid; Folic Acid Deficiency; Hemorrhage; Humans; Thrombocytopenia; Vitamin B 12

Egg production, liver lipid, and liver hemorrhagic score were not significantly altered by diets that contained inositol (at 1 or 2 g./kg. diet) and fed ad libitum, or force-fed to S.C. White Leghorn hens to produce fatty liver-hemorrhagic syndrome (FLHS). FLHS was not prevented by lecithin, iodinated casein alone or with inositol. The vitamins B12, choline and E appeared to reduce FLHS and liver lipid in the one group tested. The dose-response relationship between feed intake, liver hemorrhagic score and liver lipid content was again demonstrated.

Topics: Animal Feed; Animals; Caseins; Chickens; Choline; Eggs; Fatty Liver; Female; Hemorrhage; Inositol; Iodine; Lipids; Lipotropic Agents; Liver; Oviposition; Phosphatidylcholines; Poultry Diseases; Syndrome; Vitamin B 12; Vitamin E; Vitamins

Topics: Adolescent; Anemia, Macrocytic; Anemia, Megaloblastic; Drug Combinations; Female; Folic Acid Deficiency; Hemorrhage; Humans; Infectious Mononucleosis; Pyrimethamine; Sulfamethoxazole; Trimethoprim; Vitamin B 12

Acute promyelocytic leukaemia (A.P.L.) is a rare but important type of acute myeloid leukaemia characterized by major bleeding in association with thrombocytopenia, a specific peripheral blood and bone marrow picture, low plasma fibrinogen, and the presence in the serum of fibrin degradation products. These last abnormalities are related to the disseminated intravascular consumption of coagulation factors with secondary fibrinolysis. A.P.L. requires early recognition and urgent treatment. With optimal management up to half of the patients may achieve complete remission of two years or more. Undoubtedly patients with A.P.L. do especially well when treated in special centres and some patients with A.P.L. now die before the nature of their disease is recognized. Increased familiarity with the problem, which has been known for nearly 20 years, should yield great dividends for those few patients who have this disease.

Topics: Acid Phosphatase; Binding Sites; Bone Marrow Cells; Erythrocytes; Factor V; Factor VIII; Fibrinogen; Hematuria; Hemorrhage; Heparin; Humans; Leukemia, Myeloid; Leukocyte Count; Peroxidases; Platelet Transfusion; Prognosis; Prothrombin; Purpura; Remission, Spontaneous; Thrombocytopenia; Vitamin B 12

Topics: Acute Disease; Adolescent; Adult; Afibrinogenemia; Autopsy; Biopsy; Blood Proteins; Bone Marrow; Child; Disseminated Intravascular Coagulation; Female; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Leukopenia; Liver; Male; Middle Aged; Protein Binding; Vitamin B 12

Topics: Animals; Body Weight; Chickens; Choline; Cobalt; Diet; Fatty Liver; Female; Hemorrhage; Inositol; Lipids; Liver; Methionine; Poultry Diseases; Selenium; Syndrome; Vitamin B 12; Vitamin E

Topics: Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Anemia, Hypochromic; Anemia, Macrocytic; Antibodies; Cell Survival; Cobalt Isotopes; Diagnosis, Differential; Erythrocytes; Feces; Female; Folic Acid; Gastric Juice; Hematologic Diseases; Hemorrhage; Humans; Intrinsic Factor; Iron; Iron Isotopes; Plasma Volume; Radioimmunoassay; Radioisotope Dilution Technique; Radioisotopes; Radionuclide Imaging; Schilling Test; Spleen; Vitamin B 12; Whole-Body Counting

Topics: Anemia, Aplastic; Animal Feed; Animals; Ascorbic Acid; Blood Volume Determination; Chickens; Copper; Hemorrhage; Iron; Poultry Diseases; Quinoxalines; Vitamin B 12

Topics: Adolescent; Adult; Aged; Agranulocytosis; Anemia; Bone Marrow; Bone Marrow Cells; Cell Division; Cell Nucleus; Diploidy; DNA; Erythrocytes; Erythropoiesis; Female; Hematologic Diseases; Hemorrhage; Humans; Male; Middle Aged; Photometry; Polycythemia; Reticulocytes; Time Factors; Vitamin B 12

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Bone Marrow Diseases; Chromosome Aberrations; Chromosome Disorders; Chromosomes, Human, 1-3; Chromosomes, Human, 13-15; Chromosomes, Human, 4-5; Chronic Disease; Diagnosis, Differential; Female; Hemorrhage; Hemostasis; Hepatomegaly; Humans; Leukemia, Myeloid; Leukocytes; Male; Megakaryocytes; Middle Aged; Myeloproliferative Disorders; Polycythemia Vera; Primary Myelofibrosis; Splenomegaly; Thrombocytosis; Vitamin B 12

Topics: Blood Platelets; Blood Transfusion; Hematologic Diseases; Hemorrhage; Humans; Iatrogenic Disease; Leukemia; Lymphoma; Thalassemia; Vitamin B 12

1. An increase in apparent renal clearances is frequently observed on restoring urine flow after a period of anuria or on increasing it after oliguria. An analysis of such 'peaks' in clearance has been made in experiments on anaesthetized dogs, using two preparations of labelled vitamin B12 and urine collections of 1-2 min. [57Co]B12 was infused throughout the experiments, while [58Co]B12 was given as a single injection during periods of anuria or oliguria induced by noradrenaline infusion, haemorrhage or aortic obstruction. 2. The apparent high clearance in the first minute or two of restored or increased flow is an artifact explained by inclusion in the peak of material filtered earlier, but not excreted. By means of the integrated plasma concentration ratio of the two B12 isotopes during the period of low or absent flow, the excess B12 in the peak may be reapportioned between the period before the 58Co was injected and the period after it. 3. The findings indicate that filtration may temporarily continue during anuria, but this is concealed as a result of failure of onward flow of filtrate. In oliguria a similar concealment of filtration may result from the cessation of onward flow in some nephrons.

Topics: Animals; Anuria; Artifacts; Cobalt Radioisotopes; Dogs; Glomerular Filtration Rate; Hemorrhage; Kidney; Norepinephrine; Oliguria; Renal Artery; Sympathomimetics; Vitamin B 12

Topics: Blood Transfusion; Decontamination; Folic Acid; Gastrointestinal Diseases; Hemorrhage; Humans; Infection Control; Pyridoxine; Radiation Injuries; Radiodermatitis; Vitamin B 12; Water-Electrolyte Balance

The incidence of megaloblastic anaemia in pregnancy and the puerperium in north Staffordshire has steadily declined as a result of prophylaxis with folic acid. In the presence of advanced folic acid deficiency and with a florid megaloblastic marrow, the anaemia is usually severe, but in many patients the disease is relatively mild and the degree of anaemia is determined more by blood loss or associated iron deficiency than by the megaloblastosis. Microscopic examination of marrow films is still the most reliable method of diagnosis, although estimation of the labile serum folate has produced a 95% correlation with the marrow findings. There are three main factors which operate in the pathogenesis of megaloblastic anaemia in pregnancy and the puerperium. First, the maternal stores of folic acid are used up by the growing foetus, and this process is accelerated in multiple pregnancies, after haemorrhage, or in women with haemolytic anaemia. Secondly, an insufficient intake of folic acid, due to poor diet in pregnancy, plays a part in many cases. The third, and possibly the most important, factor is an absorption defect. Folic acid absorption is usually impaired in established cases, and this can still be demonstrated years later in a majority of patients, when they are neither pregnant nor anaemic. More than 20% of all cases also show abnormal fat absorption. An inherited defect in folic acid absorption may also explain why certain women appear to be constitutionally predisposed to megaloblastic anaemia of pregnancy and the puerperium, as shown by the abnormal blood group distribution in these patients and by the tendency of megaloblastic anaemia to recur not only in subsequent pregnancies, but, as in six of our cases, following other kinds of stress. The significance of commonly associated conditions like pre-eclampsia and infection is still incompletely understood. Although the treatment of megaloblastic anaemia is simple and effective, the main emphasis should be placed on prophylaxis by administering folic acid to all pregnant women.

Topics: Adult; Anemia, Hemolytic; Anemia, Macrocytic; Blood; Blood Group Antigens; Female; Folic Acid; Hemorrhage; Humans; Iron; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Vitamin B 12

Topics: Animal Diseases; Animals; Diet; Fishes; Hemorrhage; Liver; Mortality; Sepsis; Spleen; Virus Diseases; Vitamin B 12; Vitamin E

Topics: Anemia; Blood; Blood Cells; Blood Transfusion; Bone Marrow; Cobalt Isotopes; Feces; Hemolysis; Hemorrhage; Kidney; Kinetics; Liver; Metabolism; Phenylhydrazines; Rats; Research; Urine; Vitamin B 12

Topics: Adolescent; Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Breast Neoplasms; Bronchopneumonia; Child; Deficiency Diseases; Female; Folic Acid; Gastroenterology; Geriatrics; Hemorrhage; Humans; Liver Diseases; Liver Extracts; Multiple Myeloma; Nucleosides; Postpartum Hemorrhage; Postpartum Period; Rheumatic Fever; Sepsis; Toxicology; Virus Diseases; Vitamin B 12; Vitamin B Complex

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Blood Platelet Disorders; Drug Therapy; Epilepsy; Female; Folic Acid; Hemorrhage; Humans; Phenobarbital; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Primidone; Thrombocytopenia; Toxicology; Vitamin B 12

Topics: Anilides; Animals; Chick Embryo; Corrinoids; Hemorrhage; Rous sarcoma virus; Sarcoma, Avian; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Blood Sedimentation; Chromium Isotopes; Colitis, Ulcerative; Feces; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Iron; Iron Isotopes; Occult Blood; Radioisotopes; Radionuclide Imaging; Vitamin B 12

Topics: Cushing Syndrome; Female; Hemorrhage; Hemorrhagic Disorders; Humans; Phenacetin; Postpartum Hemorrhage; Postpartum Period; Vitamin B 12

Topics: Animals; Diet; Growth; Hemorrhage; Kidney; Liver; Rats; Vitamin B 12; Vitamins

Topics: Animals; Corrinoids; Dogs; Erythrocytes; Folic Acid; Hemorrhage; Humans; Vitamin B 12; Vitamin B Complex

Topics: Cortisone; Hemorrhage; Humans; Shock; Shock, Hemorrhagic; Vitamin B 12

Topics: Animals; Choline; Corrinoids; Hematinics; Hemorrhage; Kidney; Kidney Diseases; Rats; Vitamin B 12