1011: Umbilical Venous Catheterization Impact of Simulation Training on Trainee Confidence and Competence

Ogun, Aminat; Adeyinka, Adebayo; Pierre, Louisdon; Bailey, Keneisha; Leblanc, Patrick; Morales, Yesenia; Okonkwo, Oluchukwu; Ogun, Haroun

doi:10.1097/01.ccm.0000642980.23120.43

Cited by 8 publications

(14 citation statements)

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“…16 Ferritin is a very sensitive marker for iron deficiency anemia and the first marker to become low. 17 This relationship can be seen in our results as ferritin and iron both had a significant increase after ETI initiation. There was no significant change in transferrin, which mediates the transport of iron throughout the body.…”

Section: Discussionsupporting

confidence: 72%

Analysis of iron status after initiation of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

James,

Li,

List

et al. 2023

Pediatric Pulmonology

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BackgroundIron deficiency is highly prevalent in people with cystic fibrosis (PwCF). While elexacaftor/tezacaftor/ivacaftor (ETI) has shown remarkable improvements in respiratory symptoms in PwCF, the effect of ETI on iron status remains unknown. This study aims to identify the effect of ETI on iron status in PwCF.MethodsA single‐center retrospective cohort study of 127 adult PwCF was conducted to assess the impact of ETI on iron, ferritin, transferrin levels, and percent saturation of transferrin (PSAT). Data were collected from the electronic medical record from January 2017 to September 2022, encompassing 2 years before and after ETI initiation. The primary outcome was serum iron parameters: iron, ferritin, transferrin, and PSAT levels following ETI treatment. Secondary outcomes analyzed iron supplementation. Univariate and multivariate mixed‐effects models were used for the analysis of ETI.ResultsAfter adjusting for covariates, following ETI initiation, the mean iron level increased by 20.24 μg/dL (p < .001), ferritin levels were 31.4% (p < .001) higher, PSAT showed a 5.09 percentage point increase (p < .001), and transferrin levels increased by 2.71 mg/dL (p = .439). Patients with and without iron supplementation experienced a significant increase in iron after ETI (p < .001).ConclusionsETI is associated with a significant increase in iron, ferritin, and PSAT levels. Patients with and without iron supplementation demonstrated a significant increase in iron. This study shows the benefits of ETI on iron status in PwCF. However, further translational studies are required to understand the impact of ETI on iron absorption and metabolism in PwCF.

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Section: Discussionsupporting

confidence: 72%

Analysis of iron status after initiation of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

James,

Li,

List

et al. 2023

Pediatric Pulmonology

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“…29 This may help explain why a STC ≤ 2.3 g/L was most clearly associated with a higher all-cause mortality in patients with HFmrEF/HFpEF. Cancer is known to be associated with a fall in STC 28,30,31 possibly due to upregulation and over-expression of transferrin receptors on cancer cells, leading to internalization of transferrin/transferrin-receptor complexes. 32 The results of clinical trials for any intervention reflect the net effects of the benefits and harms that it may bring about; when benefit outweighs harm, then the trial may have a positive result.…”

Section: Discussionmentioning

confidence: 99%

Influence of serum transferrin concentration on diagnostic criteria for iron deficiency in chronic heart failure

et al. 2023

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AimsTransferrin saturation (TSAT), a marker of iron deficiency, reflects both serum concentrations of iron (SIC) and transferrin (STC). TSAT is susceptible to changes in each of these biomarkers. Little is known about determinants of STC and its influence on TSAT and mortality in patients with heart failure. Accordingly, we studied the relationship of STC to clinical characteristics, to markers of iron deficiency and inflammation and to mortality in chronic heart failure (CHF).Methods and resultsProspective cohort of patients with CHF attending a clinic serving a large local population. A total of 4422 patients were included (median age 75 (68–82) years; 40% women; 32% with left ventricular ejection fraction ≤40%). STC ≤ 2.3 g/L (lowest quartile) was associated with older age, lower SIC and haemoglobin and higher high‐sensitivity C‐reactive protein, ferritin and N‐terminal pro‐brain natriuretic peptide compared with those with STC > 2.3 g/L. In the lowest STC quartile, 624 (52%) patients had SIC ≤13 μmol/L, of whom 38% had TSAT ≥20%. For patients in the highest STC quartile, TSAT was <20% when SIC was >13 μmol/L in 185 (17%) patients. STC correlated inversely with ferritin (r = −0.52) and high‐sensitivity C‐reactive protein (r = −0.17) and directly with albumin (r = 0.29); all P < 0.001. In models adjusted for age, N‐terminal pro‐brain natriuretic peptide and haemoglobin, both higher SIC (hazard ratio 0.87 [95% CI: 0.81–0.95]) and STC (hazard ratio 0.82 [95% CI: 0.73–0.91]) were associated with lower mortality. SIC was more strongly associated with both anaemia and mortality than either STC or TSAT.ConclusionsMany patients with CHF and a low STC have low SIC even when TSAT is >20% and serum ferritin >100 μg/L; such patients have a high prevalence of anaemia and a poor prognosis and might have iron deficiency but are currently excluded from clinical trials of iron repletion.

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“…Other evidence of iron overload in the subjects of our study was the elevated expression of serotransferrin. Serotransferrin (i.e., transferrin), binds to iron with high affinity and transports iron to the liver, spleen and bone marrow 47 . Typically, its level rises with iron deficiency, and drops with iron stores 48 .…”

Section: Discussionmentioning

confidence: 99%

Longitudinal proteomics study of serum changes after allogeneic HSCT reveals potential markers of metabolic complications related to aGvHD

Wong

Kato

Rodenburg

et al. 2022

Sci Rep

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Even though hematopoietic stem cell transplantation (HSCT) allows successful treatment for many malignant and non-malignant disorders, its curative potential remains limited by severe side effects, including infections and other transplant-related complications such as graft-versus-host disease (GvHD). This study examined changes in serum proteome via high-performance two-dimensional gel electrophoresis (2-DE) during HSCT to search for diagnostic biomarkers for post-HSCT complications. Longitudinal proteomic analysis revealed proteins related to metabolic complications and hemolytic anemia. Retinol-binding protein 4 (RBP4), a reliable marker of insulin resistance, was identified, and is possibly associated with the onset mechanism of acute graft-versus-host disease (aGvHD) and/or skin GvHD. Although the cause of insulin resistance is not fully understood, it is thought to be associated with adipocytes inflammation induced by RBP4, iron overload and hemolytic anemia after HSCT, as observed in this study. The present study has demonstrated that insulin resistance and metabolic complications could be immediate complications after transplantation and are associated with aGvHD. The biomarkers revealed in this study are promising tools to be used for improving the early diagnosis of HSCT-associated complications, especially aGvHD, possibly even before clinical manifestations.

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1011: Umbilical Venous Catheterization Impact of Simulation Training on Trainee Confidence and Competence

Cited by 8 publications

References 0 publications

Analysis of iron status after initiation of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

Analysis of iron status after initiation of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis

Influence of serum transferrin concentration on diagnostic criteria for iron deficiency in chronic heart failure

Longitudinal proteomics study of serum changes after allogeneic HSCT reveals potential markers of metabolic complications related to aGvHD

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