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Teens may need iron supplements after donating blood

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Teens who donate blood are at significant risk for long-term iron deficiency, a new study warns.

The concern comes as 16- to 18-year-olds have emerged as one of the fastest-growing groups of blood donors nationwide. But this study of nearly 31,000 teens who gave blood more than once between 2016 and 2018 found that roughly one in 10 were already iron-deficient when they donated for the first time.

And a year later, one-third of the girls and about 15 percent of the boys still had low iron levels, according to the report published online June 5 in the journal Pediatrics.

“Blood loss of any kind is a common cause of iron deficiency in the U.S.,” said lead author Dr. Ralph Vassallo. And “blood donation results in the loss of iron-containing red blood cells,” he added. Vassallo is chief medical and scientific officer at Vitalant in Scottsdale, Ariz., a nonprofit that collects and distributes volunteer blood donations in 27 states.

The researchers pointed out that the teen donations occur against a backdrop of rapid growth, the start of menstruation for girls and less-healthy eating habits. All affect iron levels.

Dr. Alan Mast, chairman for blood research at the Versiti Blood Research Institute in Milwaukee, Wisc., wrote an editorial that accompanied the study findings.

Mast pointed out that menstruation contributes to iron loss among teen girls and women, but after several blood donations, males will also develop iron deficiency. Donors are not required have their iron levels tested.

The consequences of iron deficiency can be significant. The kind sometimes seen in blood donors of any age can undermine exercise performance, lead to lower infant birth weights, and trigger cravings for non-food items such as ice, clay or starch, according to Vassallo.

So U.S. blood centers recommend that all donors take low-dose (18 to 28 milligrams) iron for 60 days after donating “to quickly replace just the amount of iron lost during donation.”

Vassallo said most teen donors could safely take low-dose iron indefinitely. Most fall short of the daily recommended 11 mg for boys and 15 mg for girls. Foods that are good sources of iron include fortified cereals, some beans, lean beef and liver, spinach, tofu and potatoes.

About 79 percent of girls and 75 percent of boys in the new study were first-time blood donors, the study authors noted.

The vast majority (96 percent of girls and 74 percent of boys) gave whole blood (WB), meaning the full gamut of red cells, white cells, platelets and plasma. Such donations lead to loss of about 250 mg of iron, according to study background notes.

A smaller number made “double red blood cell” (2RBC) donations, in which only red blood cells are collected. A 2RBC donation leads to loss of 425 mg of iron.

To help iron levels replenish, donors are required to wait 56 days between WB donations and 112 days between 2RBC blood draws.

But a year after their first WB donation, up to 40 percent of girls and 20 percent of boys had iron deficiency, the investigators found. This increased to about 50 percent of girls and 30 percent of boys who were red blood cell donors.

“This underscores the need for iron replacement in young donors,” Vassallo said, noting that other research suggests that “time-limited, over-the-counter supplements” could reverse the trends.

But Mast suggested that a greater emphasis on adult donations may be a better way to go.

“Teenagers are still growing and developing neurocognitive function, which are developmental processes that require iron,” he noted. “They also tend to have poor diets that may be low in iron.” And girls are also adjusting to the start of their periods.
“Thus, teenagers have lower levels of iron stored in their body than adults, need more iron each day than adults, and are more susceptible to iron deficiency following blood donation than adults,” Mast said.

And that, he added, is why he doesn’t let his teenage daughter donate.

“Blood transfusion is a critical part of health care in the United States, and an adequate blood supply is essential,” Mast said. But, he added, parents should learn about the iron-deficiency risk their children could face — and having done so, step up and donate themselves.

“It would be wonderful if this happened more often, and we could decrease our reliance on teenagers for contributing to the blood supply,” he said.

More information
For more about blood donations and iron deficiency, visit the Stanford Blood Center.

Copyright 2020 HealthDay. All rights reserved.



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‘Green prescriptions’ could cancel mental health benefits for some

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So-called “green prescriptions” may end up being counterproductive for people with mental health conditions, researchers say.

Spending time in nature is believed to benefit mental health, so some doctors are beginning to “prescribe” outdoor time for their patients.

That led researchers to investigate whether being in nature helps actually does help people with issues such as anxiety and depression. They collected data from more than 18,000 people in 18 countries.

The takeaway: Time in nature does provide several benefits for people with mental health conditions, but only if they choose on their own to visit green spaces.

While being advised to spend time outdoors can encourage such activity, it can also undermine the potential emotional benefits, according to the authors of the study published this month in the journal Scientific Reports.

The researchers said they were surprised to find that people with depression were spending time in nature as often as folks with no mental health issues, and that people with anxiety were doing so much more often.

While in nature, those with depression and anxiety tended to feel happy and reported low anxiety. But those benefits appeared to be undermined when the visits were done at others’ urging, the investigators found.

The more external pressure people with depression and anxiety felt to visit nature, the less motivated they were to do so and the more anxious they felt.

“These findings are consistent with wider research that suggests that urban natural environments provide spaces for people to relax and recover from stress,” said study leader Michelle Tester-Jones, a postdoctoral research associate at the University of Exeter in the United Kingdom.

But the findings also show that health care practitioners and loved ones should be sensitive about recommending time in nature for people who have mental health issues.

“It could be helpful to encourage them to spend more time in places that people already enjoy visiting, so they feel comfortable and can make the most of the experience,” Tester-Jones said in a university news release.

More information

For more on the benefits of green spaces, go to the National Recreation and Park Association.

Copyright 2020 HealthDay. All rights reserved.



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Study: Nearly half of ‘essential workers’ in U.S. at risk for severe COVID-19

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Nov. 9 (UPI) — Nearly half of those classified as “essential workers” in the United States are at increased risk for severe COVID-19, according to an analysis published Monday by JAMA Internal Medicine.

This means that more than 74 million workers and those with whom they live could be at risk for serious illness, based on disease risk guidelines developed by the U.S. Centers for Disease Control and Prevention, the researchers said.

“Many parts of the country face high and rising infection rates, [and] we should not think about work exposure and health risks in isolation, given that workers and persons at increased risk often live in the same households,” study co-author Thomas M. Selden told UPI.

“Insofar as we can reduce the prevalence of COVID-19 in our communities, we can reduce the extent to which policymakers have to choose between the economy and keeping the population safe,” said Selden, an economist with the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.

Since the COVID-19 pandemic spread to the United States in March, states and cities across the country have instituted lockdown measures designed to limit the spread of the disease.

Many of these measures entailed closing schools and non-essential businesses, with only banks, grocery stores, pharmacies and other businesses deemed to provide vital services allowed to stay open.

For this study, Selden and his colleagues analyzed data on the U.S. workforce to examine how many people were in essential jobs, how often they were able to work at home, their risk for severe COVID-19 and the potential health risks for their household members.

Of the more than 157 million workers across the country, 72% are in jobs deemed essential — based on U.S. Department of Homeland Security criteria — and more than three-fourths of all essential workers are unable to work at home, Selden said.

Essential workers include those in the medical and healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics and energy, water and wastewater industries, as well as those in law enforcement and public works, the DHS criteria stipulates.

The study notes that up to 60% of these workers have underlying health issues, placing them at increased risk for severe COVID-19 if they get infected, as defined by U.S. Centers for Disease Control and Prevention guidelines.

Those with diabetes, heart disease, high blood pressure and chronic respiratory conditions like asthma are considered to be at high risk for serious illness, the CDC says.

Based on these findings, between roughly 57 million and 74 million adults working in on-site essential jobs — and their families — are at increased risk for serious illness, Selden and his colleagues estimated.

“Policymakers face important decisions about how to balance the economic benefits of keeping workers employed and the public health benefits of protecting those with increased risk of severe COVID-19,” Selden said.

“These issues arise in the context of decisions to close segments of the economy and decisions about how to distribute vaccines, which will initially be available only with limited supply, [and] become all the more difficult when the prevalence of infection rises in parts of the country,” he said.



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Study: Hydroxychloroquine no better than placebo for hospitalized COVID-19 patients

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Nov. 9 (UPI) — COVID-19 patients treated with hydroxychloroquine showed no signs of significant improvement in “clinical status” compared with those given a placebo, a study published Monday by JAMA found.

Patients given a five-day course of the drug were scored as “category six” based on the World Health Organization’s seven-category COVID Ordinal Outcomes Scale, the same as those given a placebo, the researchers said.

Also, 28 days after they started treatment, 10.4% of those treated with hydroxychloroquine died, just slightly lower than the 10.6% fatality rate in the placebo group.

“The results show that hydroxychloroquine did not help patients recover from COVID-19,” study co-author Dr. Wesley H. Self told UPI.

“In the study, patients treated with hydroxychloroquine and those treated with a placebo had nearly identical outcomes, [so] I do not foresee any role for hydroxychloroquine in acutely ill patients hospitalized with COVID-19,” said Self, an infectious disease specialist at Vanderbilt University Medical Center.

Hydroxychloroquine is an immunosuppressive and anti-parasitic drug that is used to treat malaria.

Early in the COVID-19 pandemic, it was touted by President Donald Trump and others as a potential treatment for the virus, despite the lack of any scientific data supporting its use.

Given its effectiveness helping those sickened with malaria — a mosquito-borne infection — to recover, “there was a strong rationale for why hydroxychloroquine may have been beneficial for patients with COVID-19,” according to Self.

However, in July, the U.S. Food and Drug Administration warned against the drug’s use in the treatment of those infected with the new coronavirus, due to potentially serious heart-related side effects.

For this study, Self and his colleagues treated 433 COVID-19 patients at 34 hospitals across the United States with either the drug or a placebo for a period of five days.

Patients assigned to the hydroxychloroquine group received 400 milligrams of the drug in pill form twice a day for the first two doses and then 200 mg. in pill form twice a day for the next eight doses, for a total of 10 doses over the five days.

All of the patients were then assessed based on the WHO’s COVID Ordinal Outcomes Scale, which categorizes those infected according to disease severity.

Most of the patients in both the hydroxycholorquine group and the placebo group were in “category six,” meaning they were hospitalized and receiving extracorporeal membrane oxygenation or invasive mechanical ventilation to maintain their breathing, the researchers said.

“Our results, especially when combined from other studies conducted in the United Kingdom and Brazil, are good evidence that hydroxychloroquine does not provide benefit for patients hospitalized with COVID-19,” Self said.



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