Welcome To ANEMIA ALERT!

Thank you for signing up for AnemiaAlert, the monthly e-newsletter of the National Anemia Action Council, Inc. AnemiaAlert is a timely, easy-to-read anemia source that disseminates anemia information to health care professionals, managed care directors, and organizational leaders.

Each issue contains facts from recent research that may impact your practice or organization. For more information, see www.anemia.org, the National Anemia Action Council, Inc. (NAAC) web site. Health care professionals, patients, and members of the media will find the latest in research, commentaries, and articles...all focusing on anemia.

Anemia: Fast Facts (Peer reviewed publications)

Prevalence and Impact of Anemia in Six Clinical Areas
On April 5, 2004, the American Journal of Medicine published a supplement entitled Anemia and Its Clinical Consequences in Patients with Chronic Diseases. Members of NAAC contributed to the publication that summarized systematic literature reviews on anemia in 6 clinical areas: geriatrics, oncology, human immunodeficiency (HIV) infection, inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and surgery. Published articles from peer reviewed publications in the above mentioned clinical areas were reviewed, and evaluations were made as to the prevalence and impact of anemia on clinical and functional outcomes.

The literature review identified a knowledge gap regarding anemia's impact on clinical and functional outcomes in all 6 clinical areas. Inconsistent criteria for defining anemia in published studies were a major contributing factor to this knowledge gap. The supplement details the necessity for revision of the criteria utilized for defining anemia, and the need for a paradigm shift to recognize anemia as a condition that must be properly identified and treated to improve healthcare outcomes. "Two accepted classification schemes - the WHO and the National Cancer Institute [anemia] definitions - are a starting point for developing a uniform set of definitions for anemia." NAAC is currently in the process of developing clinical guidelines for anemia management.

For summaries of each literature review, please read AnemiaWatch Spring 2004, the quarterly health professional publication of the National Anemia Action Council, Inc.

The Characteristics of Anemia in Nursing Home Residents: Study Results
Findings of a multi-institutional study were reported in the March 2004 Journal of the American Geriatrics Society. The article entitled Mechanisms of Unexplained Anemia in the Nursing Home, reported the results of a study characterizing anemia in nursing home residents.

The cause of anemia was unknown in 45% of the anemic population. Iron deficiency anemia (IDA) was found in 23% of the studied population, versus previous reports of IDA in up to 40% of nursing home residents. Anemia of chronic disease was found in 13% of patients.

The article concludes with the implication that within the elderly nursing home population EPO levelsrather than bone marrow unresponsiveness, was the likely cause of anemia.

For additional information on this prospective multi-institutional cohort study, please read AnemiaWatch Spring 2004, the quarterly health professional publication of the National Anemia Action Council, Inc.

Anemia in the Press (Non-peer reviewed publications):

Iron Deficiency
In a recent Clinical Chemistry newsletter, it was stated that iron deficiency anemia is one of the most common diseases worldwide.
(Clinical Chemistry, 2003 49: 1573-1578)

AMA recommends anemia screening be included in the adolescent athletic exam
The AMA has recommended that the adolescent athletic exam (which is given before the start of an athletic program)should include an assessment for special health problems, such as anemia. (CSA Rep.B, A-92)

Strenuous Exercise May be the Only Unmasker of Anemia
The Richmond Times-Dispatch reported (March 17, 2004) that athletes with mild anemia may have their performance affected when undertaking strenuous exercise. Such a decreased level of performance may be the only evidence of the anemia. Patients with mild or moderate anemia usually feel normal at rest. However, once strenuous exercise is undertaken, those who are anemic may experience "heart beating too fast...breathing too hard...or dizziness." Certain athletes, who experienced a subtle change of performance, including fatigue only when accompanied by exertion, were shown to have abnormally low hemoglobin levels The article also notes some athletes get evaluated for exercise-induced asthma when, in fact, they may have anemia.

Answers to Your Clinical Questions

NAAC welcomes clinical questions from health care professionals related to anemia management. Answers will be provided by physicians who are medical experts in the field of anemia. All relevant clinical questions will be posted on the Ask the Expert section of the web site if appropriate, at times via e-mail, and selected questions will be published in AnemiaWatch.
Please e-mail anemia-related clinical questions to Asktheexpert@anemia.org.

NAAC Developing Clinical Guidelines for Anemia Management

Clinical guidelines for anemia management are currently being developed and will be disseminated via peer-reviewed journals. As soon as these guidelines are available, they will be posted on www.anemia.org in the Professional Link.