Using these criteria, an algorithm was developed, in which a patient subset was identified that would benefit most from G 6 PD screening, yielding a sensitivity of This algorithm may provide a cost-effective strategy for improving care in resource-limited settings. The prevalence of G 6 PD deficiency among the sickle cell anaemia patients studied was found to be Two apparent glucosephosphate dehydrogenase variants in normal XY males: G 6 PD Alabama.
A six-year-old black boy who had transient hemolysis after a viral infection was found to have mildly decreased red cell glucosephosphate dehydrogenase G 6 PD activity 1. Two G 6 PD bands, both slightly faster than normal G 6 PD B, were seen on electrophoresis in both the propositus as well as in his maternal grandfather. This is an unexpected finding, since the G 6 PD gene is located on the long arm of the X chromosome that is subject to X-chromosome inactivation, and available evidence indicates that it is present as a single functional copy in the human genome.
The obvious possibility of duplication of the X chromosome was eliminated by cytogenetic analysis with G-banding. G 6 PD duplication is unlikely, since peripheral blood granulocytes, platelets, and lymphocytes; cultured skin and bone marrow fibroblasts; and Epstein-Barr virus-stimulated lymphocytes yielded only a single electrophoretic band with mobility identical to the slower band seen in crude red blood cell hemolysate. Study of partially purified red blood cell hemolysate G 6 PD also yielded a single band with identical mobility.
Kinetic studies of the enzyme in the propositus and in three generations of his family identified a unique, previously unpublished G 6 PD mutant that is herein designated G 6 PD Alabama. Red blood cells were separated by density gradient into a reticulocyte-enriched, an intermediate, and a dense, older portion. Two distinct enzyme bands were identified on electrophoresis of hemolysate from the reticulocyte-enriched portion, but not from the other two portions. It is postulated that two transcriptional products of the mutant G 6 PD gene exist; one with a short half-life and detectable only in young red blood cells, and another with a longer half-life present in all cells.
The existence of two distinct mutant genes in the genome or a unique post-translational form of the mutant G 6 PD detected only in reticulocytes cannot be excluded. The gene responsible for this deficiency is on the X chromosome. G 6 PD deficiency is most common in males of African heritage. Many females of African heritage are carriers Neonatal nucleated red blood cells in G 6 PD deficiency.
The objective of this study is to study the absolute number of nucleated red blood cells RBC at birth, an index of active fetal erythropoiesis, in infants with G 6 PD deficiency and in controls. We tested the hypothesis that hematocrit and hemoglobin would be lower, and absolute nucleated RBC counts higher, in the G 6 PD deficient and that these changes would be more prominent in infants exposed passively to fava bean through maternal diet.
Thirty-two term infants with G 6 PD deficiency were compared with 30 term controls. Complete blood counts with manual differential counts were obtained within 12 hours of life. Absolute nucleated RBC and corrected leukocyte counts were computed from the Coulter results and the differential count.
G 6 PD deficient patients did not differ from controls in terms of gestational age, birth weight, or Apgar scores or in any of the hematologic parameters studied, whether or not the mother reported fava beans consumption in the days prior to delivery. Although intrauterine hemolysis is possible in G 6 PD deficient fetuses exposed passively to fava beans, our study supports that such events must be very rare. L-Cysteine in vitro can restore cellular glutathione and inhibits the expression of cell adhesion molecules in G 6 PD -deficient monocytes.
L-Cysteine is a precursor of glutathione GSH , a potent physiological antioxidant.
Oxidative stress and monocyte adhesion was considered to be an initial event in the progression of vascular dysfunction and atherosclerosis. Molecular epidemiology and activity of erythrocyte G 6 PD variants in G 6 PD activity decreased significantly with age among non-deficient individuals. The range of enzyme activities was wide and overlapping among the different G 6 PD variants. G 6 PD deficiency was very high in the population. The gene frequencies were similar to previous findings. Molecular methods of typing Since G 6 PD is the only source of. NADPH in red blood cells, defense against oxidative damage strongly depends on its activity Mehta et al.
Defi- ciency of G 6 PD enzyme in Glucosephosphate dehydrogenase G 6 PD mutations and haemoglobinuria syndrome in the Vietnamese population. The G 6 PD variants within the Vietnamese Kinh contributing to the disease risk in this population, and more generally to haemoglobinuria, are currently unknown. Method Eighty-two haemoglobinuria patients and healthy controls were screened for G 6 PD deficiency using either the methylene blue reduction test, the GPDH kit or the micro-methaemoglobin reduction test.
Conclusion The primary frequency of several G 6 PD mutations, including novel mutations, in the Vietnamese Kinh population are reported and the contribution of G 6 PD mutations to the development of haemoglobinuria are investigated. Validation of the quantitative point-of-care CareStart biosensor for assessment of G 6 PD activity in venous blood. Decreased G 6 PD enzymatic activity is associated with drug-induced hemolysis and increased risk of severe neonatal hyperbilirubinemia leading to brain damage. Current G 6 PD qualitative tests are unable to diagnose G 6 PD intermediate activities which could hinder wide use of 8-aminoquinolines for Plasmodium vivax elimination.
The aim of the study was to assess the diagnostic performances of the new Carestart G 6 PD quantitative biosensor. A total of samples of venous blood with G 6 PD deficient, intermediate and normal phenotypes were collected among healthy volunteers living along the north-western Thailand-Myanmar border.
Samples were analyzed by complete blood count, by gold standard spectrophotometric assay using Trinity kits and by the latest model of Carestart G 6 PD biosensor which analyzes both G 6 PD and hemoglobin. The Carestart G 6 PD biosensor represents a significant improvement for quantitative diagnosis of G 6 PD deficiency over previous versions. Molecular study of sickle cell disease associated with alpha thalassemia and G 6 PD deficiency].
The prevalence of hemoglobinopathies and glucosephosphate dehidrogenase G 6 PD deficiency in the Catalan neonatal population is increasing due to immigration. Coinheritance of more than a single RBC genetic defect is becoming more frequent and diagnostic pitfalls are also increasing. We intended to demonstrate the need to perform an early diagnosis of sickle cell disease SCD by means of neonatal screening, to establish the prevalence of SCD associated with alpha thalassemia and G 6 PD deficiency and to identify genotypes associated with sickle cell disease and G 6 PD deficiency.
For the screening of hemoglobinopathies the high performance liquid chromatography method was used and for G 6 PD deficiency the fluorescent spot test was employed. We studied the association between betaS gene and alpha thalassaemia del In all the cases, sickle hemoglobin was confirmed by ARMS amplification refractory mutation system. Association between betaS gene and alpha thalassaemia del This study confirms the high prevalence of SCD and G 6 PD deficiency in population at risk as well as their genetic and clinical heterogeneity.
Glucose 6 phosphatase dehydrogenase G 6 PD and neurodegenerative disorders: Mapping diagnostic and therapeutic opportunities. The physiological significance of enzyme is providing reduced energy to specific cells like erythrocyte by maintaining co-enzyme nicotinamide adenine dinucleotide phosphate NADPH.
There are preponderance research findings that demonstrate the enzyme G 6 PD role in the energy balance, and it is associated with blood-related diseases and disorders, primarily the anemia resulted from G 6 PD deficiency. The X-linked genetic deficiency of G 6 PD and associated non-immune hemolytic anemia have been studied widely across the globe. Recent advancement in biology, more precisely neuroscience has revealed that G 6 PD is centrally involved in many neurological and neurodegenerative disorders.
Though G 6 PD deficiency remains a global health issue, however, a paradigm shift in research focusing the potential of the enzyme in neurological and neurodegenerative disorders will surely open a new avenue in diagnostics and enzyme therapeutics. Here, in this study, more emphasis was made on exploring the role of G 6 PD in neurological and inflammatory disorders as well as non-immune hemolytic anemia, thus providing diagnostic and therapeutic opportunities. Glucosephospate dehydrogenase G 6 PD deficient cells are sensitive to oxidative damage leading to the formation of microparticles MPs.
Therefore, we examined the concentration of MPs and changes in the antioxidant balance after an acute strenuous exercise SEx and moderate-intensity exercise MEx. It was found that SEx triggered the release of total microparticles TTMPs above baseline levels and remained significantly higher 45 minutes after the exercise in G 6 PD normal individuals. Present status of understanding on the G 6 PD deficiency and natural selection. Full Text Available G 6 PD deficiency is a common hemolytic genetic disorder, particularly in the areas endemic to malaria.
Individuals are generally asymptomatic and hemolytic anemia occurs when some anti-malarial drugs or other oxidizing chemicals are administered.
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It has been proposed that G 6 PD deficiency provides protection against malaria. A comprehensive review of the literature on the hypothesis of malarial protection and the nature of the selection is being presented. Most of the epidemiological, in vitro and in vivo studies report selection for G 6 PD deficiency. Prevalence of G 6 PD deficiency in Indian caste and tribal populations and the different variants reported has also been reviewed.
Parental discussion of G 6 PD deficiency and child health: Parents are encouraged to discuss self-care with children affected by G 6 PD deficiency; however, little is known about the extent or impact of these discussions on the physical and psychosocial health of these children. The purpose of this study was to examine the nature of parental-child discussions of G 6 PD deficiency self-care and their relationship to child health. A quantitative cross-sectional survey of Taiwanese parents of children with G 6 PD deficiency was conducted.
The extent of parental-child self-care discussions was assessed in regards to coverage of nine key topics. Parent's G 6 PD deficiency status, knowledge of haemolytic anaemia symptoms and reported G 6 PD deficiency education from providers were examined as correlates of parental discussion. Child health was assessed with the child health questionnaire-parent form Chinese version and a item haemolytic anaemia symptom list.
There are preponderance research findings that demonstrate the enzyme G 6 PD role in the energy balance, and it is associated with blood-related diseases and disorders, primarily the anemia resulted f Prevalence of glucosephosphate dehydrogenase G 6 PD deficiency among malaria patients in Upper Myanmar. Primaquine PQ has been used for radical cure of P. Recently, it is also used to reduce P. However, PQ metabolites oxidize hemoglobin and generate excessive reactive oxygen species which can trigger acute hemolytic anemia in malaria patients with inherited G 6 PD deficiency.
A total of blood samples collected from malaria patients in Myanmar were used in this study. The accuracy of the multiplex allele specific PCR was confirmed by sequencing analysis. Prevalence and distribution of G 6 PD variants in malaria patients in Myanmar were analysed. Six different types of G 6 PD allelic variants were identified in 50 7 females and 43 males malaria patients.
Results of this study suggest that more concern for proper and safe use of PQ as a radical cure of malaria in Myanmar is needed by combining G 6 PD deficiency test before PQ prescription. Establishment of a follow-up system to monitor potential PQ toxicity in malaria patients who are given PQ is also required. Point-of-care G 6 PD diagnostics for Plasmodium vivax malaria is a clinical and public health urgency. Malaria caused by Plasmodium vivax threatens over 2 billion people globally and sickens tens of millions annually. Recent clinical evidence discredits the long-held notion of this infection as intrinsically benign revealing an often threatening course associated with mortality.
Most acute attacks by this species derive from latent forms in the human liver called hypnozoites. Radical cure for P. The only hypnozoitocide available is primaquine, a drug causing life-threatening acute hemolytic anemia in patients with the inherited blood disorder glucosephosphate dehydrogenase G 6 PD deficiency. In the absence of certain knowledge regarding the G 6 PD status of patients infected by P.
Resolving this dilemma requires the availability of point-of-care G 6 PD diagnostics practical for use in the impoverished rural tropics where the vast majority of malaria patients seek care. Full Text Available Mutations in the glucosephosphate dehydrogenase G 6 PD gene result in red blood cells with increased susceptibility to oxidative damage.
Significant haemolysis can be caused by primaquine and other 8-aminoquinoline antimalarials used for the radical treatment of Plasmodium vivax malaria. The distribution and phenotypes of mutations causing G 6 PD deficiency in the male population of migrants and refugees in a malaria endemic region on the Thailand-Myanmar border were characterized.
Further studies are needed to characterise the haemolytic risk of using 8-aminoquinolines in patients with these genotypes. Neonatal Hyperbilirubinemia in infants with G 6 PD c. Full Text Available Abstract Background There is a strong correlation between glucosephosphate dehydrogenase G 6 PD deficiency and neonatal hyperbilirubinemia with a rare but potential threat of devastating acute bilirubin encephalopathy.
The present study was aimed at evaluating the time to onset of hyperbilirubinemia and the postnatal bilirubin trajectory in infants having G 6 PD c. We studied icteric male neonates who were re-admitted for phototherapy during the study period. No selection was exercised. Each infant was studied for birth weight, gestational age, age at the time of presentation, presence of cephalhematoma, sepsis and neurological signs, peak bilirubin level, age at peak bilirubin level, days of hospitalization, whether phototherapy or exchange blood transfusion was initiated, and the outcome.
During hospital stay, each baby was tested for complete blood count, reticulocyte count, ABO and Rh blood type, direct antiglobulin test and quantitative G 6 PD estimation [by kinetic determination of G6PDH]. Results G 6 PD variants c. In contrast to G 6 PD normal neonates, infants with c. Pakistan has an estimated annual burden of 1. The current situation calls for an effective malaria control and eradication programme in this country. Currently, primaquine is an attractive option for eliminating reservoirs of Plasmodium vivax hypnozoites and killing gametocytes of Plasmodium falciparum.
However, this drug causes haemolysis in individuals who are glucosephosphate G 6 PD deficient. It is important to map G 6 PD deficiency and malaria distribution in Pakistan to design an effective malaria eradication regimen. The purpose of this study was to evaluate the frequency of G 6 PD c.
Two hundred and ten archived DNA samples from males from falciparum malaria patients and from healthy individuals were utilized in this study. Healthy blood donors were selected based on stringent pre-defined criteria. Patients were confirmed for malaria parasites on microscopy and or immune chromatographic assay detecting P.
Parasitaemia was also computed. Cumulative allelic frequency for G 6 PD c. Frequency for this G 6 PD allele was 0. Large studies including females are needed to elucidate the true. Full Text Available "nGlucosephosphate dehydrogenase G 6 PD deficiency is the most important disease of the hexose monophosphate pathway. Deficiency of this enzym can lead to hemolysis of red blood cells. Our aim was to study the prevalence of G 6 PD deficiency in relation to neonatal jaundice. We studied clinically icteric neonates Laboratory investigations included determination of direct and indirect serum bilirubin concentrations, blood group typing, direct coomb's test, hemoglobin, blood smear, reticulocyte count and G 6 PD level.
We divided these neonates to 3 groups based on total serum bilirubin level TSB: In only 35 7. All of these babies were male. There was statistically significant difference of prevalence of G 6 PD deficiency between group 2 and 3 Between groups 1 vs 2 and 1 vs 3 no statistically significant difference was found.
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Early detection of this enzymopathy regardless of sex and close surveillance of the affected newborns may be important in reducing the risk of severe hyperbilirubinemia. This emphasizes the necessity of neonatal screening on cord blood samples for G 6 PD deficiency. Full Text Available Glucosephosphate dehydrogenase G 6 PD is a key regulatory enzyme that plays a crucial role in the regulation of cellular energy and redox balance.
Mutations in the gene encoding G 6 PD cause the most common enzymopathy that drives hereditary nonspherocytic hemolytic anemia. Although all Class III mutants were located in different regions of the three-dimensional structure of the enzyme and were not close to the active site, these mutants had a deleterious effect over catalytic activity and structural stability.
Severe acute haemolytic anaemia associated with severe methaemoglobinaemia in a G 6 PD -deficient man. Methaemoglobinaemia, the presence of methaemoglobin in the blood, is most commonly treated with methylene blue. However, methylene blue cannot be used in patients with glucosephosphate dehydrogenase G 6 PD deficiency as it is ineffective in such patients and it can worsen G 6 PD deficiency haemolysis. He was administered blood transfusions and intravenous ascorbic acid.
This case demonstrates the successful management of a patient with severe methaemoglobinaemia in the setting of G 6 PD deficiency haemolysis.
Emergency physicians should be aware of the possible co-occurrence of severe methaemoglobinaemia in a patient with G 6 PD deficiency haemolysis. No commercial use is permitted unless otherwise expressly granted. Methods for the field evaluation of quantitative G 6 PD diagnostics: Individuals with glucosephosphate dehydrogenase G 6 PD deficiency are at risk of severe haemolysis following the administration of 8-aminoquinoline compounds. Primaquine is the only widely available 8-aminoquinoline for the radical cure of Plasmodium vivax.
Tafenoquine is under development with the potential to simplify treatment regimens, but point-of-care PoC tests will be needed to provide quantitative measurement of G 6 PD activity prior to its administration. There is currently a lack of appropriate G 6 PD PoC tests, but a number of new tests are in development and are likely to enter the market in the coming years. As these are implemented, they will need to be validated in field studies.
This article outlines the technical details for the field evaluation of novel quantitative G 6 PD diagnostics such as sample handling, reference testing and statistical analysis. Field evaluation is based on the comparison of paired samples, including one sample tested by the new assay at point of care and one sample tested by the gold-standard reference method, UV spectrophotometry in an established laboratory.
Samples can be collected as capillary or venous blood; the existing literature suggests that potential differences in capillary or venous blood are unlikely to affect results substantially. Test results can be visually presented as scatter plot, Bland-Altman plot, and a histogram of the G 6 PD activity distribution of the study population.
Calculating the adjusted male median allows categorizing results according to G 6 PD activity to calculate standard performance indicators and to perform receiver operating characteristic ROC analysis. BAG3 elevation inhibits cell proliferation via direct interaction with G 6 PD in hepatocellular carcinomas. The current study demonstrated that BAG3 directly interacted with glucose 6 phosphate dehydrogenase G 6 PD , the rate-limiting enzyme of the pentose phosphate pathway PPP. In addition, supplement of nucleosides alone was sufficient to recover the growth defect mediated by BAG3 elevation.
Itis a risk factor for hyperbilirubinemia in neonates, which can cause serious complications such as bilirubininduced encephalopathy or kernicterus. Methods This is a cross-sectional and retrospective study; infants' data were obtained from medical records. Blood samples were collected using filter papers. We considered a result to be nonnal if it exceeded 3. Results A total neonates were screened. We found 94 neonates 5. Out of males, 59 6. We observed that prevalence of G 6 PD deficiency according to sex distribution was significantly higher in males than females 6.
Conclusions The frequencies of G 6 PD deficiency were 6. We recommend universal neonatal screening for G 6 PD deficiencies in Jakarta since our findings exceed the WHO recommendation for routine testing. A Prospective Observational Study. A prospective observational study was conducted to assess the efficacy of the current antimalarial policy. Patients with uncomplicated malaria, confirmed by microscopy, attending a health care facility in the Chittagong Hill Tracts, Bangladesh, were treated with artemether-lumefantrine days plus single dose primaquine 0.
Hb was measured on days 0, 2 and 9 in all patients and also on days 16 and 30 in patients with P. Participants were followed for 30 days.
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The study was registered with the clinical trials website NCT Median parasite clearance times were All participants were afebrile within 48 hours, two patients with P. No patient had recurrent parasitaemia within 30 days. Adjusted male median G 6 PD activity was 7. The Hb nadir occurred on day 2 prior to primaquine treatment in P. The current antimalarial policy remains effective.
The prevalence of G 6 PD deficiency was low. Main contribution to haemolysis in G 6 PD normal individuals was attributable to acute malaria rather. Kawasaki disease with G 6 PD deficiency--report of one case and literature review. Kawasaki disease KD is a systemic vasculitis primarily affecting children who are younger than 5 years. The most serious complications are coronary artery aneurysms and sequelae of vasculitis with the subsequent development of coronary artery aneurysm.
However, aspirin has been reported to have hemolytic potential in individuals with glucosephosphate dehydrogenase G 6 PD deficiency. Published by Elsevier B. Diurnal fluctuation of leukocyte G 6 PD activity. A possible explanation for the normal neutrophil bactericidal activity and the low incidence of pyogenic infections in patients with severe G 6 PD deficiency in Israel. Acute hemolytic anemia associated with red blood cell RBC glucosephosphate dehydrogenase G 6 PD deficiency is commonly encountered in the Mediterranean basin.
Nevertheless, concomitant clinical evidence of white blood cell G 6 PD deficiency is extremely rare in Israel. This study sought to assess. Reduced prevalence of Plasmodium falciparum infection and of concomitant anaemia in pregnant women with heterozygous G 6 PD deficiency. Glucosephosphate dehydrogenase G 6 PD deficiency confers protection against malaria in children, yet its role in malaria in pregnancy is unknown.
In a cross-sectional study among pregnant Ghanaian women, Plasmodium falciparum infection, anaemia and G 6 PD genotypes were assessed. Full Text Available The molecular and pedigree analyses in a Javanese Chinese family were carried oul on glucosephosphate dehydrogenase deficiencies. The disease is named favism after the Italian word for broad beans fava , which cause a classic reaction when eaten by people with G 6 PD deficiency.
The G 6 PD enzyme is particularly important in red blood cells, where it protects against damage that can be caused by Interesting case of G 6 PD deficiency anemia with severe hemolysis. Full Text Available Severe hemolysis was observed in a critically ill patient with G 6 Pd deficiency where the causative trigger could not be identified. We describe one young patient with severe hemolysis treated with two cycles of plasmapheresis which proved to be an effective tool in the treatment.
The patient presented with diffuse pain abdomen, vomiting, yellowish discoloration of sclera and skin and acute breathlessness. Subsequently patient started passing black color urine. As the patient developed severe hemolysis and the trigger agent of hemolysis was unknown, two cycles of plasmapheresis were performed with the aim to remove unknown causative agent. Consequently no trace of hemolysis was found and patient stabilized. Plasmapheresis can be used to treat G 6 PD deficient patients with severe hemolysis due to unidentified trigger agent. Glucosephosphate dehydrogenase G 6 PD deficiency is associated with development of acute hemolytic anemia AHA induced by a number of drugs.
Unless preemptive genotyping has established a positive diagnosis of G 6 PD deficiency, quantitative enzyme assay remains the mainstay of screening prior to rasburicase use. The purpose of this article is to help interpret the results of clinical G 6 PD genotype tests so that they can guide the use of rasburicase. Detailed guidelines on other aspects of the use of rasburicase, including analyses of cost-effectiveness, are beyond the scope of this document. Prevalence of G 6 PD deficiency in selected populations from two previously high malaria endemic areas of Sri Lanka.
Full Text Available GlucosePhosphate Dehydrogenase G 6 PD enzyme deficiency is known to offer protection against malaria and an increased selection of mutant genes in malaria endemic regions is expected. However, anti-malarial drugs such as primaquine can cause haemolytic anaemia in persons with G 6 PD deficiency.
We studied the extent of G 6 PD deficiency in selected persons attending Teaching Hospitals of Anuradhapura and Kurunegala, two previously high malaria endemic districts in Sri Lanka. Each assay was conducted with a set of controls and the colour development assessed visually as well as with a microplate reader at ODnm. Severe deficiency G 6 PD deficiency are warranted in these high risk areas irrespective of gender for the prevention of disease states related to this condition.
G 6 PD deficiency in Latin America: Plasmodium vivax radical cure requires the use of primaquine PQ , a drug that induces haemolysis in glucosephosphate dehydrogenase deficient G6PDd individuals, which further hampers malaria control efforts. A systematic search of the published literature was undertaken in August Bibliographies of manuscripts were also searched and additional references were identified. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available.
Full Text Available Plasmodium vivax radical cure requires the use of primaquine PQ, a drug that induces haemolysis in glucosephosphate dehydrogenase deficient G6PDd individuals, which further hampers malaria control efforts. Glucosephosphate dehydrogenase is one of the most common genetic deficiencies, which approximately million people in the world suffer from. According to authors' initial search, numerous studies have been carried out in Iran regarding molecular variants of this enzyme.
Thus, this meta-analysis presented a reliable estimation about prevalence of different types of molecular mutations of G 6 PD Enzyme in Iran. Keywords "glucose 6 phosphate dehydrogenase or G 6 PD , Mediterranean or Chatham or Cosenza and mutation, Iran or Iranian and their Persian equivalents" were searched in different databases. Moreover, reference list of the published studies were examined to increase sensitivity and to select more studies. After studying titles and abstracts of retrieved articles, excluding the repeated and unrelated ones, and evaluating quality of articles, documents were selected.
After performing systematic review, 22 papers were entered this meta-analysis and subjects were examined concerning G 6 PD molecular mutation. In this meta-analysis, prevalence of Mediterranean mutation, Chatham mutation and Cosenza mutation in Iran was estimated This meta-analysis showed that in spite of prevalence of different types of G 6 PD molecular mutations in center, north, north-west and west of Iran, the most common molecular mutations in people with G 6 PD deficiency in Iran, like other Mediterranean countries and countries around Persian Gulf, were Mediterranean mutation, Chatham mutation and Cosenza mutation.
It is also recommended that future studies may focus on races and regions which haven't been taken into consideration up to now. Glucosephosphate dehydrogenase G 6 PD deficiency is a common X-linked inherited enzymopathic disorder affecting more than million people worldwide. It has so far been linked to distinct genetic variants in the exons and exon-intron boundaries of the G 6 PD gene, giving rise to a wide range of biochemical heterogeneity and clinical manifestations.
Reports from different settings suggested the association of intronic and other mutations outside the reading frame of the G 6 PD gene with reduced enzyme activity and presenting clinical symptoms. The present study aimed to investigate any association of other variations apart of the exonic or exonic intronic boundaries in the development of G 6 PD deficiency. Sixty-seven unrelated Palestinian children admitted to the pediatric hospital with hemolytic crises due to G 6 PD deficiency were studied.
In our Palestinian cohort of 67 [59 males M and 8 females F ] G 6 PD -deficient children, previously hospitalized for acute hemolytic anemia due to favism, molecular sequencing of the G 6 PD gene revealed four cases 3M and 1F that did not have any of the variants known to cause G 6 PD deficiency, but the 3' UTR c.
Vitamin E has role in maintaining the integrity of red cell member by preventing oxidation of polyunsaturated fatty acids, thus protects cells from oxidative stress-induced lysis in G 6 PD deficiency. To observe the effects of vitamin E supplementation on these changes in order to evaluate the role of this anti-oxidant vitamin in reducing chronic haemolysis in G 6 PD deficient patients.
A total number of subjects with age ranged of 5 to 40 years of both sexes were included in the study. Among them 68 were G 6 PD enzyme deficient patients, of whom 34 were in supplemented group experimental group and 34 were in non-supplemented group control group. Age and sex matched 34 apparently healthy subjects with normal blood G 6 PD level were taken to observe the base line data healthy control and also for comparison.
All the parameters were measured on day 1 of their first visit and also were on day 60 in deficient group. Data were compared among the deficient groups, also in supplemented group just before and after supplementation. Analysis of data was done by appropriate statistical method. Single Low Dose Primaquine 0. Full Text Available Primaquine is the only drug consistently effective against mature gametocytes of Plasmodium falciparum.
The transmission blocking dose of primaquine previously recommended was 0. To reduce transmission in low transmission settings and facilitate elimination of P. Direct evidence of the safety of this low dose is lacking. The tolerability and safety of primaquine single dose 0.
G 6 PD deficiency was assessed with a phenotypic test and genotyping was performed in male subjects with deficient phenotypes and in all females. Fractional haemoglobin changes in relation to G 6 PD phenotype and genotype and primaquine round were assessed using linear mixed-effects models. No adverse events related to primaquine were reported during the trial. Mean fractional haemoglobin changes after each primaquine treatment in G 6 PD deficient subjects Full Text Available Osteonecrosis of the jaw ONJ, a rare side effect of bisphosphonate therapy, is a debilitating disorder with a poorly understood etiology.
Our goals were to analyze FAERS data to discover possible relationships between ONJ and specific conditions and drugs and then to consult the scientific literature to deduce biological explanations.
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Our methodology revealed a very strong association between gastroesophageal reflux and bisphosphonate-induced ONJ, suggesting acidosis as a key factor. Overgrowth of acidophilic species, particularly Streptococcus mutans, in the oral microbiome in the context of insufficient acid buffering due to impaired salivary glands maintains the low pH that sustains damage to the mucosa.
Glucose 6 phosphate dehydrogenase G 6 PD deficiency can explain much of the pathology. An inability to maintain vitamin C and other antioxidants in the reduced form leads to vascular oxidative damage and impaired adrenal function. Thus, pathogen-induced acidosis, hypoxia, and insufficient antioxidant defenses together induce ONJ.
G 6 PD deficiency and adrenal insufficiency are underlying factors. Impaired supply of adrenal-derived sulfated sterols such as DHEA sulfate may drive the disease process. Prevalence and molecular characterization of G 6 PD deficiency in two Plasmodium vivax endemic areas in Venezuela: Glucosephosphate dehydrogenase G 6 PD deficiency causes acute haemolytic anaemia triggered by oxidative drugs such as primaquine PQ , used for Plasmodium vivax malaria radical cure.
However, in many endemic areas of vivax malaria, patients are treated with PQ without any evaluation of their G 6 PD status. Blood samples from randomly recruited unrelated individuals were screened for G 6 PD activity by a quantitative method. Quantitative biochemical characterization revealed that overall 24 3. No other mutation was found in the analysed exons.
The G6PDd prevalence was as low as that one shown by nearby countries. This study contributes to the knowledge of the genetic background of Venezuelan population, especially of those living in malaria-endemic areas. The data suggest that 1: Seizure is a rare presentation for acute hemolysis due to G 6 PD deficiency. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucosephosphate dehydrogenase deficiency G 6 PD an. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucosephosphate dehydrogenase deficiency G 6 PD and probably secondary methemoglobinemia, following the ingestion of fava beans.
Glucosephosphate dehydrogenase G 6 PD -deficient infants: Enzyme activity and gene variants as risk factors for phototherapy in the first week of life. Glucosephosphate dehydrogenase G 6 PD deficiency is a recognised cause of severe neonatal hyperbilirubinaemia, and identifying which infants are at risk could optimise care and resources.
In this study, we determined if G 6 PD enzyme activity EA and certain gene variants were associated with neonatal hyperbilirubinaemia requiring phototherapy during the first week after birth. Newborn infants with G 6 PD deficiency and a group with normal results obtained by the fluorescent spot test were selected for analyses of G 6 PD EA and the 10 commonly encountered G 6 PD mutations in this region, relating these with whether the infants required phototherapy before discharge from the hospital in the first week.
A total of infants with mean gestation and birth weight of The mean EA level was 3. The EA had good accuracy in predicting phototherapy use, with area under the receiver-operating-characteristic curve of 0. Diagnostic performances of the fluorescent spot test for G 6 PD deficiency in newborns along the Thailand-Myanmar border: Glucosephosphate dehydrogenase G 6 PD deficiency is an inherited enzymatic disorder associated with severe neonatal hyperbilirubinemia and acute haemolysis after exposure to certain drugs or infections. The disorder can be diagnosed phenotypically with a fluorescent spot test FST , which is a simple test that requires training and basic laboratory equipment.
This study aimed to assess the diagnostic performances of the FST used on umbilical cord blood by locally-trained staff and to compare test results of the neonates at birth with the results after one month of age. The FST was performed at birth on the umbilical cord blood by locally-trained staff and quality controlled by specialised technicians at the central laboratory. The FST was repeated after one month of age.
Genotyping for common local G 6 PD mutations was carried out for all discrepant results. FST was performed on umbilical cord blood samples. Quality control and genotyping revealed 10 misdiagnoses. After quality control, The FST repeated at one month of age or later diagnosed 8 additional G 6 PD deficient infants who were phenotypically normal at birth. This study shows the short-comings of the G 6 PD FST in neonatal routine screening and highlights the importance of training and quality control.
A more conservative interpretation of the FST in male newborns could increase the diagnostic performances. Quantitative point-of-care tests might show higher sensitivity and specificity for diagnosis of G 6 PD deficiency on umbilical cord blood and should be investigated. A cohort study [version 1; referees: Full Text Available Background: The disorder can be diagnosed phenotypically with a fluorescent spot test FST, which is a simple test that requires training and basic laboratory equipment.
Rapid diagnostic test for G 6 PD deficiency in Plasmodium vivax-infected men: The aim of this study was to estimate the incremental budget impact IBI of a rapid diagnostic test to detect G6PDd in male patients infected with Plasmodium vivax in the Brazilian Amazon, as compared with the routine protocol recommended in Brazil which does not include G6PDd testing. The budget impact analysis was performed from the perspective of the Brazilian health system, in the Brazilian Amazon for the years , and The analysis used a decision model to compare two scenarios: The analysis identified negative IBIs which were progressively smaller in the 3 years evaluated.
The sensitivity analysis showed that the uncertainties associated with the analytical model did not significantly affect the results. Using G 6 PD tests to enable the safe treatment of Plasmodium vivax infections with primaquine on the Thailand-Myanmar border: Full Text Available Primaquine is the only licensed antimalarial for the radical cure of Plasmodium vivax infections. Many countries, however, do not administer primaquine due to fear of hemolysis in those with glucosephosphate dehydrogenase G 6 PD deficiency. In other settings, primaquine is given without G 6 PD testing, putting patients at risk of hemolysis.
New rapid diagnostic tests RDTs offer the opportunity to screen for G 6 PD deficiency prior to treatment with primaquine. Here we assessed the cost-effectiveness of using G 6 PD RDTs on the Thailand-Myanmar border and provide the model as an online tool for use in other settings. Decision tree models for the management of P. Screening with G 6 PD RDTs before primaquine use was compared to 1 giving chloroquine alone and 2 giving primaquine without screening. Data were taken from a recent study on the impact of primaquine on P. Compared to the use of chloroquine alone, the screening strategy had similar costs while averting 0.
Compared to primaquine administered without screening, the screening strategy provided modest cost savings while averting 0. The model results are limited by the paucity of data available in the literature for some parameter values. However, the differences in the degree of metabolic alterations among patients during an oxidative crisis have not been extensively studied.
In this study, we applied mathematical modeling to assess the metabolic changes in erythrocytes of various G 6 PD -deficient patients during hydrogen peroxide- H2O2- induced perturbation and predict the kinetic properties that elicit redox imbalance after exposure to an oxidative agent. Simulation results showed a discrepancy in the ability to restore regular metabolite levels and redox homeostasis among patients.
The former was concluded to apply to patients with severe clinical symptoms. Low max and high mG6P of G 6 PD were shown to be kinetic properties that enhance consequent redox imbalance. Primaquine PQ is the only licensed drug effective against P. Unfortunately, few epidemiological data of these disorders was in Indonesia. This study aimed to assesses the prevalence and genotyping variant of G6PDd among the people on malaria-endemic. The prevalence of malaria and anemia was Obligatory anti-malaria doses for G 6 PD deficient individuals, population screening, are needed on endemic malaria in eastern Indonesia.
Aquatic ecosystems have been negatively affected by the contamination of ground and surface waters as a result of various activities. Due to the ferrous chloride FeCl2 , which is used as the reducing agent for the organic synthesis reactions in the contamination of water column and sediment, iron salts may be very toxic for some aquatic organisms.
In order to minimize these effects, natural products such as zeolite have been widely used in recently years. At the end of the treatment period, Glucose phosphate dehydrogenase G 6 PD activity was determined in the samples taken from livers. Eighty-four patients had neither positive history of stroke or silent infarct, nor abnormal transcranial Doppler NORM group.
Biological analyses were performed on samples obtained at steady state and before the beginning of any chronic treatment. Translocations affecting human immunoglobulin heavy chain locus.
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We have analysed published data and identified eleven breakpoint cluster regions bcr related to these cancers within the IgH locus. Our findings could help devise PCR-based assays to detect cancer-related translocations, to identify the mechanisms of translocations and to help in the research of potential translocation partners of the immunoglobulin locus at different stages of B-cell differentiation.
Hemoglobinopathies are known as the most common genetic disorders in Iran. The paper aims to provide global estimates of deaths and disability adjusted life years DALYs due to hemoglobinopathies in Iran by sex and age during to and describe the challenges due to limitations of the Global Burden of Disease Study GBD Years of life lost due to disability YLDs were computed by multiplication of prevalence, the disability weight for occurrence of sequelae, and the duration of symptoms.
Prevalence was estimated through a systematic search of published and available unpublished data sources, with a Bayesian meta-regression model developed for GBD Disability weights were produced using collected data from population-based surveys. Uncertainty from all inputs was incorporated into the computations of DALYs using simulation methods.
We aim to prepare and criticize the results of GBD and provide some recommendations for reaching better conclusions about the burden of hemoglobinopathies in Iran. Between and , the overall deaths attributed to hemoglobinopathies decreased from 0. There was a reduction in deaths and DALYs rates for all ages and the rates attributed to all ages followed the same pattern in Iranian men and women.
The highest DALYs for hemoglobinopathies, thalassemia, sickle cell disorder, and glucosephosphate dehydrogenase deficiency G 6 PD -D were found in those aged less than 5 years. The collective burden of all of these hemoglobin disorder was lower in than in Although the screening programs in Iran have been very successful in reducing the number of thalassemia patients between to , in order to provide a better estimation of the.
Birth control necessary to limit family size in tribal couples with aberrant heterosis of G - 6 - PD deficiency and sickle cell disorders in India: A random genetic study of screening for hemoglobinopathies and G - 6 - PD deficiency among Dhelki Kharia tribal community in Sundargarh district of Orissa was carried out for intervention during the year A total of 81 Dhelki Kharia families were screened and six families with double heterozygosity for above genetic anomalies were encountered.
Analysis was carried out following the standard procedures after cross checking for quality control. There were on an average 3. The average number of children 3. It is very difficult to maintain the normal health of an affected child with aberrant anomalies due to exorbitant cost of treatment, frequent transfusions and huge involvement of economy. One of the implications of aberrant heterosis is its adverse affects on routine individual physiology and hard activities. It is suggested to limit the family size in carrier couples to avoid aberrant heterosis of hereditary hemolytic disorders in their offsprings.
Clinical or epidemiologic screening of single-nucleotide polymorphism markers requires large-scale multiplexed genotyping. Available genotyping tools require DNA extraction and multiplex PCR, which may limit throughput and suffer amplification bias. Subsequent enzymatic extension and ligation form target single-nucleotide polymorphism-spanning single-stranded templates, which are PCR-amplified using universal primers.
Genotyping archival blood from malaria patients taking primaquine found 10 G 6 PD -deficient variants, including 1 patient with a hemizygous Mahidol mutation who had hemolysis. Preemptive G 6 PD genotyping of dried blood spots from a malaria-endemic area identified three variants. MELPA also enabled pooled genotyping without diluting rare alleles, in which undesired common-allele background increased by sample pooling can be repressed by adding specific common allele blockers.
Thus, MELPA represents a high-throughput, cost-effective approach to targeted genotyping at the population level. Published by Elsevier Inc. Full Text Available We evaluated a battery of GlucosePhosphate Dehydrogenase diagnostic point-of-care tests PoC to assess the most suitable product in terms of performance and operational characteristics for remote areas. Results were compared to spectrophotometry Procedure , Trinity Biotech, Ireland. The adjusted male median was The analysis of venous blood samples by the CSG yielded significantly higher results than FST and CSG performed on capillary blood p Co-ordinated stage-dependent enhancement of Plasmodium falciparum antioxidant enzymes and heat shock protein expression in parasites growing in oxidatively stressed or G 6 PD -deficient red blood cells.
The latter are only considered to protect against thermal stress. Important issues are poorly explored: Those issues are interesting as several antimalarials increase the oxidative stress or block antioxidant defense in the parasitized RBC. In addition, numerous inhibitors of HSPs are currently developed for cancer therapy and might be tested as anti-malarials.
Protein expression of antioxidant enzymes was assayed by Western blotting. The pentosephosphate-pathway flux was measured in isolated parasites after Sendai-virus lysis of RBC membrane. Results In parasites growing in normal RBCs, mRNA expression of antioxidant enzymes and HSPs displayed co-ordinated stage-dependent modulation, being low at ring, highest at early trophozoite and again very low at schizont stage. Additional exogenous oxidative stress or growth in antioxidant blunted G 6 PD -deficient RBCs indicated remarkable flexibility of both systems, manifested by enhanced, co-ordinated mRNA expression of.
Co-ordinated stage-dependent enhancement of Plasmodium falciparum antioxidant enzymes and heat shock protein expression in parasites growing in oxidatively stressed or G 6 PD -deficient red blood cells. Plasmodium falciparum-parasitized red blood cells RBCs are equipped with protective antioxidant enzymes and heat shock proteins HSPs. Stage-dependent mRNA expression of ten representative P. In parasites growing in normal RBCs, mRNA expression of antioxidant enzymes and HSPs displayed co-ordinated stage-dependent modulation, being low at ring, highest at early trophozoite and again very low at schizont stage.
Additional exogenous oxidative stress or growth in antioxidant blunted G 6 PD -deficient RBCs indicated remarkable flexibility of both systems, manifested by enhanced, co-ordinated mRNA expression of antioxidant enzymes and HSPs. Fatal Chromobacterium violaceum septicaemia in northern Laos, a modified oxidase test and post-mortem forensic family G 6 PD analysis. Full Text Available Abstract Background Chromobacterium violaceum is a Gram negative facultative anaerobic bacillus, found in soil and stagnant water, that usually has a violet pigmented appearance on agar culture.
It is rarely described as a human pathogen, mostly from tropical and subtropical areas. Case presentation A 53 year-old farmer died with Chromobacterium violaceum septicemia in Laos. Allegro moderato ; Poco adagio, quasi andante ; Rondo: Two sonatas Concert etudes for horn and string orchestra. Concerto in E-flat major for horn and string orchestra. Con discrezione ; Adagio ; Allegro Michael Haydn.
Concertino in D major for horn and orchestra. Rondo in E-flat major, K. Prelude, theme and variations for horn and piano Robert Schumann. Adagio and allegro for horn and piano, op. Concerto in C minor for horn and orchestra, op. Concerto in D major for horn and orchestra, TWV Concertino in E minor for horn and orchestra, op.
Best wishes from Cecilia Bartoli []. Arthaus Musik, [] Description Video — 3 Blu-ray discs: La boutique fantasque []. Deutsche Grammophon, [] Description Music recording — 1 audio disc 1: Deutsche Grammophon, [] Description Music recording — 1 online resource 1 sound file Sound: Summary Concert piece for clarinet, basset horn and orchestra, Op. Allegro con fuoco ; 2. The Clarinotts are the ensemble of father Ernst and his sons Daniel and Andreas Ottensamer -- the Viennese 'royal family of clarinet' with Ernst and Daniel being solo clarinettists at Vienna Philharmonic and Andreas solo clarinettist at Berlin Philharmonic.
Deutsche Grammophon Gesellschaft, the mono era []. Description Music recording — 51 audio discs min. Concerto for piano and orchestra no. Mazurka in C sharp minor op. Sonata for piano and violoncello in E minor op. Variations and fugue on a theme by Johann Adam Hiller op. Fantasia in C major op. Ein deutsche requiem op. String quartet in G minor op.
Sonata for piano and violin in G major op. March in G minor op. Concerto for violin and orchestra no. Der Ring des Nibelungen selected scenes: Capriccio New Releases, [] Description Music recording — 1 online resource 1 sound file. Summary Malinconia, ninfa gentile 1: Franz Liszt und seine Zeit: Frederica von Stade live! Sony Classical, [] Description Music recording — 1 online resource 1 sound file Sound: Why do they shut me out of heaven? From Praxedis with love []. Paladino Music, [] Description Music recording — 1 online resource 1 sound file Sound: Dance of the Priestesses of Dagon 2: Dynamic, [] Description Video — 1 videodisc min.
Das grosse Abenteuer Musik. Das Geheimnis der Oper []. Meister Music, [] Description Music recording — 1 online resource 1 sound file. Summary Petite Messe solennelle. Humbly, yet with dedicated proficiency, the Finnish a cappella group Luminos has boldly taken on some of the greatest musical works of all time, resulting in enchantingly mellow music. Genuin, [] Description Music recording — 1 online resource 1 sound file Sound: Dynamic, [] Description Video — 1 videodisc 94 min.
Italian opera arias []. Summary Il ritorno d'Ulisse in patria. Summary Il barbiere de Siviglia. Vois que l'on dit sensible Dieu, quel frisson court dans mes veines!
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O rendetemia la speme Qui la voce sua soave Sony Classical, [] Description Music recording — 1 audio disc: Una voce poca fa []. Voce poco fa Rossini, Gioacchino, , composer. Francis of Assisi []. Navona, [] Description Music recording — 1 online resource 1 sound file Sound: Verlag Dohr, [] Description Music score — 1 score 66 pages: Metastasio - Pour Album nach ? Tirana alla spagnola rossinizzata nach 7a. Un rien variante nach R M63 Unknown.
Music for two guitars. Naxos Guitar Collection, [] Description Music recording — 1 online resource 1 sound file. Summary Overture to Rossini's opera La gazza ladra 7: Cantata per il battesimo del figlio del banchiere Aguado: Cantata per il battesimo del figlio del banchiere Aguado Rossini, Gioacchino, , composer. R C2 Unknown. Cantata per il battesimo del figlio del banchiere Aguado. Vocal score Rossini, Gioacchino, , composer.
Verlag Dohr, [] Description Music score — 1 vocal score 33 pages: Scherzos, piano, A minor Rossini, Gioacchino, , composer. Verlag Dohr, [] Description Music score — 1 score 14 pages: R S3 Unknown. Summary Adagio for strings, op. Summary Demetrio e Polibio. Pien di contento in seno 4: Sazia tu fossi alfine 2: Serti intrecciar le vergini 2: O sospirato lido 5: Eccomi alfine in Babilonia 5: Nel misero tuo stato 4: Chi sa dirmi se la sposa 2: Summary La donna del lago.
Tanti affetti in tal momento Otello. Salvatore Sciarrino Il barbiere di Siviglia. Berlin Classics, [] Description Music recording — 1 online resource 1 sound file. Stabat Mater ; Giovanna d'Arco []. Summary Stabat Mater Theme, violin, piano, A major Rossini, Gioacchino, , composer. Edition Dohr, [] Description Music score — 1 score 10 pages: R T3 Unknown. Trascrizioni operistiche per organo [].
Tactus, [] Description Music recording — 1 online resource 1 sound file Sound: Summary Symphonie concertante in E-flat major, W. The ultimate collection []. Summary La fille du regiment. Il viaggio a Reims []. Works for string orchestra []. Audite, [] Description Music recording — 1 online resource 1 sound file Sound: Summary Concerto grosso in D major, op. The 69th annual Midwest Clinic Mark Records, [] Description Music recording — 1 online resource 1 sound file Sound: Deborah Baker Monday 2: Description Music recording — 1 audio disc Summary La forza del destino ; Nabucco ; I vespri siciliani ; La traviata: Summary 12 ariettes italiennes sur motifs de Rossini.
Arthaus Musik, [] Description Video — 2 videodiscs min. Meister Music, [] Description Music recording — 1 online resource 1 sound file Sound: The complete Conchita Supervia. Marston, [] Description Music recording — 1 audio disc: Summary Newly located selections. Attends un peu, Carmen 4: Danza ritual del fuego 3: Summary Vol I, Album italiano. I, I gondolieri 5: I, Toast pour le nouvel an 3: VIII, Il candore in fuga 2: