0 stringlengths 12 494 | embeddings listlengths 384 384 |
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12\n-responsive\nneurologic\n\tdisorders;\tpatients\twith\tunexplained\tleukoencephalopathy\tshould\tbe\ttreated\tproactively\nbecause\teven\tlong-standing\tdeficits\tmay\tbe\treversible\t(\nGraber\tet\tal,\t2010\n).\nStage\t1:\tEarly\tnegative\tvitamin\tB\n12\n\tbalance\tbegins\twhen\tvitamin\tB\n12\n\tintake\tis\tlow... | [
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12\n\tbalance\tbegins\twhen\tvitamin\tB\n12\n\tintake\tis\tlow\tor\nabsorption\tis\tpoor,\tdepleting\tthe\tprimary\tdelivery\tprotein,\tTCII.\tA\tlow\tTCII\t(<40\tpg/mL)\tmay\nbe\tthe\tearliest\tdetectable\tsign\tof\ta\tvitamin\tB\n12\n\tdeficiency\n\t(\nNexo\tand\tHoffmann-Lucke,\n2011\n).\tThis\tis\ta\tvitamin\tB\n12... | [
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0.02883... |
Stage\t2:\tVitamin\tB\n12\n\tdepletion\tshows\ta\tlow\tB\n12\n\ton\tTCII\tand\ta\tgradual\tlowering\tof\tB\n12\n\tin\nhaptocorrin\t(holohap\t<50\tpg/mL),\tthe\tstorage\tprotein.\nStage\t3:\tDamaged\tmetabolism\tand\tvitamin\tB\n12\n–deficient\terythropoiesis\tincludes\tan\tabnormal\ndU\tsuppression,\thypersegmentation,... | [
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low\tRCF\tlevel\t(<140\tng/mL),\tand\tsubtle\tneuropsychiatric\tdamage\t(impaired\tshort-term\tand\nrecent\tmemory).\nStage\t4:\tClinical\tdamage\toccurs,\tincluding\tvitamin\tB\n12\n\tdeficiency\tanemia;\tit\tincludes\tall\npreceding\tparameters,\talong\twith\tmacroovalocytic\terythrocytes,\televated\tMCV,\televated | [
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TCII\tlevels,\tincreased\thomocysteine\tand\tmethylmalonic\tacid\tlevels,\tand\tmyelin\tdamage.\nLeukoencephalopathy\tand\tautonomic\n\tdysfunction\toccur\twith\tvery\tlow\tserum\tB\n12\n\tlevels\n(<200\tpg/mL);\tpsychiatric\tchanges,\tneuropathy,\tand\tdementia\talso\tmay\toccur\t(\nGraber\tet\tal,\n2010\n)\t(see\t\nF... | [
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0.052789... |
Graber\tet\tal,\n2010\n)\t(see\t\nFig.\t31.3\n).\nClinical\tfindings\nPernicious\tanemia\taffects\tnot\tonly\tthe\tblood\tbut\talso\tthe\tgastrointestinal\ttract\tand\tthe\tperipheral\nand\tcentral\tnervous\tsystems.\tThis\tdistinguishes\tit\tfrom\tfolate-deficiency\tanemia.\tThe\tovert\nsymptoms,\twhich\tare\n\tcaused... | [
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(especially\tnumbness\tand\ttingling\tin\tthe\thands\tand\tfeet),\tdiminution\tof\tthe\tsenses\tof\tvibration\tand\nposition,\tpoor\tmuscular\tcoordination,\tpoor\tmemory,\tand\thallucinations.\tIf\tthe\tdeficiency\tis\nprolonged,\tthe\tnervous\tsystem\tdamage\tmay\tbe\tirreversible,\teven\twith\tinitiation\tof\tvitami... | [
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0.0813... |
12\ntreatment.\nHelicobacter\tpylori\n\tcauses\tpeptic\n\tulcer\tdisease\tand\tchronic\tgastritis\t(see\t\nChapter\t26\n).\tBoth\nconditions\tare\tassociated\twith\thypochlorhydria,\treduced\tproduction\tof\tIF\tby\tepithelial\tcells\tin\tthe\nstomach,\tvitamin\tB\n12\n\tmalabsorption,\tand\tpernicious\tanemia.\tThere\... | [
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0.031... |
autoimmune\tgastritis\tand\tpernicious\tanemia.\tMore\tthan\t90%\tof\tpatients\twith\tpernicious\tanemia\nhave\tparietal\tcell\tantibodies\t(PCAs),\tand\t50%\tto\n\t70%\thave\televated\tIF\tantibodies.\tSerum\tvitamin\tB\n12\nlevels\tof\tthe\t\nH.\tpylori\n–infected\tpatients\tare\tsignificantly\tlower\tthan\tthat\tof\... | [
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0.06816... |
A\tstudy\ton\t\nH.\tpylori\n\tinfection\tand\tautoimmune\ttype\tatrophic\tgastritis\texamined\tserum\tmarkers\tfor\ngastric\tatrophy\t(pepsinogen\tI,\tpepsinogen\tI/II,\tand\tgastrin)\tand\tautoimmunity.\tPositive\tserum\nautoimmune\tmarkers\t(IF\tantibodies\tand\tPCA)\tsuggest\tthat\n\t\nH.\tpylori\n\tcontributes\tto\... | [
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0.0515... |
gastritis\tand\tpernicious\tanemia\t(\nVeijola\tet\tal,\t2010\n).\nVitamin\tB\n12\n\tdeficiency\tis\tan\timportant\tmodifiable\trisk\tfactor\tfor\tosteoporosis\tin\tmen\tand\twomen.\nAdults\twith\tlow\tvitamin\tB\n12\n\tlevels\thave\ta\tlower\taverage\tbone\tmineral\tdensity\tand\tgreater\trisk\tfor\nosteoporosis\t(\nK... | [
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0.0... |
osteoporosis\t(\nKarpouzos\tet\tal,\t2017\n).\nReduced\tvitamin\tB\n12\n\tstatus\tand\televated\thomocysteine\tconcentrations\tare\n\tcommon.\tThese\nalterations\tare\tproblematic\tamong\tvegans\t(\nElmadfa\tand\tSinger,\t2009\n).\tB\n12\n-folate-homocysteine\ninteractions\taggravate\theart\tdisease\tand\tmay\tlead\tto... | [
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0.0... |
Ganguly\tand\nAlam,\t2015\n;\t\nShahbazian\tet\tal,\t2016\n)\t(see\t\nChapters\t14\n\tand\t\n32\n).\nAssessment\nVitamin\tB\n12\n\tstores\tare\tdepleted\tafter\tseveral\tyears\twithout\tvitamin\tB\n12\n\tintake.\tA\tlow\tholo\tTCII\tvalue\n(<40\tpg/mL)\tis\ta\n\tsign\tof\tearly\tB\n12\n\tdeficiency.\nOther\tlaboratory\... | [
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0.00... |
12\n\tdeficiency\tand\tdetermining\nits\tcause\tinclude\tmeasurements\tof\tserum\tB\n12\n,\tIF\tantibody\t(IFAB),\tPCA,\tserum\thomocysteine\tand\nserum\tmethylmalonic\tacid\t(MMA)\tlevels\t(see\t\nChapter\t5\n\tand\t\nAppendix\t12\n).\tThe\tIFAB\tand\tPCA\ttests\ncan\tdetermine\twhether\tthe\tdeficiency\tis\tcaused\tb... | [
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0.06... |
Medical\tmanagement\nTreatment\tusually\tconsists\tof\tan\tintramuscular\tor\tsubcutaneous\tinjection\tof\t100\tmcg\tor\tmore\tof\nvitamin\tB\n12\n\tonce\tper\tweek.\tAfter\tan\tinitial\tresponse\tis\telicited,\tthe\tfrequency\tof\tadministration\tis\nreduced\tuntil\tremission\tcan\tbe\tmaintained\tindefinitely\twith\t... | [
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0.0206047... |
large\toral\tdoses\tof\tvitamin\tB\n12\n\t(1000\tmcg\tdaily)\tare\talso\teffective,\teven\tin\tthe\tabsence\tof\tIF,\tbecause\napproximately\t1%\tof\tvitamin\tB\n12\n\tis\tabsorbed\tby\tdiffusion.\tInitial\tdoses\tshould\tbe\tincreased\twhen\nvitamin\tB\n12\n\tdeficiency\tis\tcomplicated\tby\tdebilitating\tillness\tsuc... | [
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0.03936854377388954,
0.06358046... |
uremia,\tcoma,\tsevere\tdisorientation,\tor\tmarked\tneurologic\tdamage.\tA\tresponse\tto\ttreatment\tis\nevidenced\tby\timproved\tappetite,\talertness,\tand\tcooperation,\tfollowed\tby\timproved\thematologic\nresults,\tas\tmanifested\n\tby\tmarked\treticulocytosis\twithin\thours\tof\tan\tinjection.\nMedical\tnutrition... | [
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0.020... |
Medical\tnutrition\ttherapy\nA\thigh-protein\tdiet\t(1.5\tg/kg\tof\tbody\tweight)\tis\tdesirable\tfor\tblood\tcell\tregeneration.\tBecause\tgreen\nleafy\tvegetables\tcontain\tiron\tand\tfolate,\tthe\tdiet\tshould\tcontain\tincreased\tamounts\tof\tthese\tfoods.\nMeats\t(especially\tbeef\tand\tpork),\teggs,\tmilk,\tand\t... | [
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0.0013... |
12\n(see\t\nAppendix\t31\n).\nFor\tthose\tindividuals\tprescribed\tmetformin\tfor\ttreatment\tof\tdiabetes,\t10%\tto\t30%\thave\treduced\nvitamin\tB\n12\n\tabsorption.\tMetformin\tnegatively\taffects\tthe\tcalcium-dependent\tmembrane\tand\tthe\tB\n12\n-\nIF\tcomplex\tby\tdecreasing\tthe\tabsorbability\tby\tthe\tileal\t... | [
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0.03383... |
calcium\tmay\treverse\tthe\tvitamin\tB\n12\n\tmalabsorption.\tHowever\ta\trecent\tstudy\tfound\tthat\nsupplementation\twith\n\ta\tmultivitamin\tsupplement\twas\tprotective\tagainst\tB\n12\n\tdeficiency.\nThe\tInstitute\tof\tMedicine\trecommends\tthat\tpeople\tolder\tthan\tage\t50\tconsume\tvitamin\tB\n12\n\tin\tits | [
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0.021552... |
12\n\tin\tits\ncrystalline\tform\t(i.e.,\tin\tfortified\tcereals\tor\tsupplements)\tto\tovercome\tthe\teffects\tof\tatrophic\ngastritis.\tThe\tRDAs\tfor\tB\n12\n\tare\tsummarized\tin\tthe\tfront\tof\tthe\tbook.\tThe\tRDA\tfor\tadult\tmen\tand\nwomen\tis\t2.4\tmcg\tdaily.\nOther\tnutritional\n\tanemias\nAnemia\tof\tprot... | [
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0.003... |
Other\tnutritional\n\tanemias\nAnemia\tof\tprotein-energy\tmalnutrition\nProtein\tis\tessential\tfor\tthe\tproper\tproduction\tof\themoglobin\tand\tRBCs.\tBecause\tof\tthe\treduction\tin\ncell\tmass\tand\tthus\toxygen\trequirements\tin\tprotein-energy\tmalnutrition\t(PEM),\tfewer\tRBCs\tare | [
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0.0249... |
required\tto\toxygenate\tthe\ttissue.\tBecause\tblood\tvolume\tremains\tthe\tsame,\tthis\treduced\tnumber\tof\nRBCs\twith\ta\tlow\themoglobin\tlevel\t(hypochromic,\tnormocytic\tanemia),\n\twhich\tcan\tmimic\tan\tiron\ndeficiency\tanemia,\tis\tactually\ta\tphysiologic\t(nonharmful)\trather\tthan\tharmful\tanemia.\tIn\ta... | [
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0.021... |
the\tloss\tof\tactive\ttissue\tmass\tmay\tbe\tgreater\tthan\tthe\treduction\tin\tthe\tnumber\tof\tRBCs,\tleading\tto\npolycythemia\n\t(an\tincrease\tin\tRBCs\twhere\tthey\tmake\tup\ta\tlarger\tproportion\tof\tthe\tblood\tvolume).\nThe\tbody\tresponds\tto\tthis\tRBC\tproduction,\twhich\tis\tnot\ta\treflection\tof\tprote... | [
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0.016481... |
and\tamino\tacid\ndeficiency\tbut\tof\tan\toversupply\tof\tRBCs.\tIron\treleased\tfrom\tnormal\tRBC\tdestruction\tis\tnot\treused\tin\nRBC\tproduction\tbut\tis\tstored\tso\tthat\tiron\tstores\tare\toften\tadequate.\tIron\tdeficiency\tanemia\tcan\nreappear\twith\trehabilitation\twhen\tRBC\tmass\texpands\trapidly. | [
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0.09601718932390213,
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0.012692407704889774,
0.043... |
The\tanemia\tof\tPEM\tmay\tbe\tcomplicated\tby\tdeficiencies\tof\tiron\tand\tother\tnutrients\tand\tby\nassociated\tinfections,\tparasitic\tinfestation,\n\tand\tmalabsorption.\tA\tdiet\tlacking\tin\tprotein\tis\tusually\ndeficient\tin\tiron,\tfolic\tacid,\tand,\tless\tfrequently,\tvitamin\tB\n12\n.\tThe\tnutrition\tcou... | [
0.021146556362509727,
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0.03375912085175514,
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0.12686124444007874,
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0.05147835239768028,
0.09620349109172821,
-0.047036062926054,
-0.002790641039609909,
0.025428... |
12\n.\tThe\tnutrition\tcounselor\tplays\tan\nimportant\trole\tin\tassessing\trecent\tand\ttypical\tdietary\tintake\tof\tthese\tnutrients.\nCopper\tdeficiency\tanemia\nCopper\tand\tother\theavy\tmetals\tare\tessential\tfor\tthe\tproper\tformation\tof\themoglobin.\nCeruloplasmin\n,\ta\tcopper-containing\tprotein,\tis\n\t... | [
0.01787889376282692,
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0.02927161380648613,
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0.07871637493371964,
0.07673964649438858,
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-0.013891947455704212,
0.04629... |
required\tfor\tnormal\tmobilization\tof\tiron\tfrom\tits\nstorage\tsites\tto\tthe\tplasma.\tIn\ta\tcopper-deficient\tstate,\tiron\tcannot\tbe\treleased;\tthis\tleads\tto\tlow\nserum\tiron\tand\themoglobin\tlevels,\teven\tin\tthe\tpresence\tof\tnormal\tiron\tstores.\tOther\tconsequences\nof\tcopper\tdeficiency\tsuggest\... | [
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0.09800020605325699,
0.02765522338449955,
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0.06296246498823166,
0.07201886177062988,
-0.06931320577859879,
0.07180468738079071,
0.0... |
erythrocyte\tand\tfor\toptimal\tfunctions\tof\tthe\terythrocyte\n\tmembrane.\tThe\tamounts\tof\tcopper\tneeded\nfor\tnormal\themoglobin\tsynthesis\tare\tso\tminute\tthat\tthey\tare\tusually\tamply\tsupplied\tby\tan\tadequate\ndiet;\thowever,\tcopper\tdeficiency\tmay\toccur\tin\tinfants\twho\tare\tfed\tcow’s\tmilk\tor\t... | [
-0.00875078048557043,
-0.08093832433223724,
0.03159825876355171,
-0.03511209413409233,
-0.05501222237944603,
0.013340331614017487,
0.12710359692573547,
0.07288380712270737,
-0.01328778825700283,
0.07800505310297012,
0.08327912539243698,
-0.06113147363066673,
-0.0013244617730379105,
0.08018... |
infant\tformula.\tIt\talso\tmay\tbe\tseen\tin\tchildren\tor\tadults\twho\thave\ta\tmalabsorption\tsyndrome\tor\twho\nare\treceiving\tlong-term\ttotal\tparenteral\tnutrition\tthat\tdoes\tnot\n\tsupply\tcopper.\nSideroblastic\t(B\n6\n-responsive)\tanemia\nSideroblastic\t(pyridoxine-responsive)\tanemia\n\tis\tcharacterize... | [
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-0.05132869631052017,
0.005752519238740206,
-0.010881173424422741,
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0.05553988739848137,
0.07824432104825974,
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0.0024053126107901335,
0.013475... |
is\tcharacterized\tby\ta\tderangement\tin\tthe\tfinal\npathway\tof\theme\tsynthesis,\tleading\tto\ta\tbuildup\tof\timmature\tRBCs.\tIt\thas\tfour\tprimary\ncharacteristics:\t(1)\tmicrocytic\tand\thypochromic\tRBCs;\t(2)\thigh\tserum\tand\ttissue\tiron\tlevels\t(causing\nincreased\ttransferrin\tsaturation);\t(3)\tthe\tp... | [
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0.06416172534227371,
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0.0447496697306633,
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0.05332401767373085,
0.05053010955452919,
-0.012922171503305435,
0.025993328541517258,
0.0214176... |
defect\tin\tthe\tformation\tof\tδ-\naminolevulinic\tacid\tsynthetase,\tan\tenzyme\tinvolved\tin\theme\tsynthesis\t(pyridoxal-5-phosphate\tis\nnecessary\tin\tthis\treaction);\tand\t(4)\ta\tbuildup\tof\tiron-containing\timmature\tRBCs\t(sideroblasts,\tfor\nwhich\tthe\tanemia\tis\tnamed).\tThe\tiron\tthat\tcannot\tbe\tuse... | [
-0.046543411910533905,
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0.06625930964946747,
-0.032898660749197006,
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0.015986764803528786,
0.054098036140203476,
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0.07698279619216919,
0.08573146909475327,
-0.03814195096492767,
-0.025299279019236565,
0... |
mitochondria\tof\timmature\tRBCs.\tThese\tiron-laden\tmitochondria\tdo\tnot\tfunction\n\tnormally,\tand\tthe\ndevelopment\tand\tproduction\tof\tRBCs\tbecome\tineffective.\tThe\tsymptoms\tare\tthose\tof\tanemia\tand\niron\toverload.\tEven\tthough\tthe\tanemia\tresponds\tto\tthe\tadministration\tof\tpharmacologic\tdoses\... | [
0.012392659671604633,
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0.008858738467097282,
0.03122645802795887,
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0.015527870506048203,
0.06218170002102852,
0.04140507057309151,
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0.08423241972923279,
0.07413534075021744,
-0.014279145747423172,
0.022058498114347458,
0.0259... |
pyridoxine\tand\tthus\tis\treferred\tto\tas\tpyridoxine–responsive\tanemia,\tthe\tneurologic\tand\tcutaneous\nmanifestations\tof\tvitamin\tB\n6\n\tdeficiency\tare\tnot\tobserved.\tThis\tdistinguishes\tit\tfrom\tanemia\tcaused\nby\ta\tdietary\tvitamin\tB\n6\n\tdeficiency.\nTreatment\tconsists\tof\ta\ttherapeutic\ttrial\... | [
-0.012296073138713837,
-0.07992208749055862,
0.014555612578988075,
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0.009780882857739925,
0.08601729571819305,
0.08783411979675293,
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0.041375782340765,
0.07672090083360672,
0.01224598940461874,
0.02558591030538082,
0.0607381... |
phosphate\t(PLP\tor\tpyridoxal-5-phosphate)\twhich\tis\t30\tto\t150\ttimes\tthe\tRDA.\tIf\tthe\tanemia\tresponds\nto\tone\tor\tthe\tother,\tpyridoxine\ttherapy\tis\tcontinued\tfor\tlife.\tHowever,\tif\tthe\tanemia\tis\tonly\tpartially\ncorrected,\ta\tnormal\thematocrit\tvalue\tis\tnever\tregained.\tPatients\n\trespond\... | [
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0.05563178285956383,
0.0737186074256897,
0.04088570922613144,
0.039475586265325546,
0.0476... |
respond\tto\tthis\ttreatment\tto\tvarying\ndegrees,\tand\tsome\tmay\tonly\tachieve\tnear-normal\themoglobin\tlevels.\nAcquired\tsideroblastic\tanemias\tsuch\tas\tthose\tattributable\tto\tdrug\ttherapy\t(isoniazid,\nchloramphenicol),\tcopper\tdeficiency,\thypothermia,\tand\talcoholism\tare\tnot\tresponsive\tto\tB\n6\nad... | [
-0.003341801231727004,
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0.019515011459589005,
0.02644677273929119,
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0.0007660461124032736,
0.07908161729574203,
0.08805104345083237,
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0.023423273116350174,
0.0603310689330101,
-0.0025178019423037767,
0.024195890873670578,
0.0... |
6\nadministration.\nVitamin\tE–responsive\themolytic\tanemia\nHemolytic\tanemia\n\toccurs\twhen\tdefects\tin\tRBC\tmembranes\tlead\n\tto\toxidative\tdamage\tand\neventually\tto\tcell\tlysis.\tThis\tanemia\tis\tcaused\tby\tshortened\tsurvival\tof\tmature\tRBCs.\tVitamin\tE,\tan\nantioxidant,\tis\tinvolved\tin\tprotectin... | [
0.007096168585121632,
-0.0776437446475029,
0.007527164649218321,
0.013202479109168053,
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0.025222552940249443,
0.12244580686092377,
0.06809389591217041,
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0.019358711317181587,
0.06095002219080925,
-0.038022130727767944,
0.010778254829347134,
0.00403... |
signs\tnoted\tin\tvitamin\tE\tdeficiency\tis\tearly\themolysis\tof\tRBCs.\nNonnutritional\tanemias\nAnemia\tof\tpregnancy\nA\tphysiologic\tanemia\tis\tthe\tanemia\tof\tpregnancy,\twhich\tis\trelated\n\tto\tincreased\tblood\tvolume\tand\nusually\tresolves\twith\tthe\tend\tof\tthe\tpregnancy.\tHowever,\tdemands\tfor\tiro... | [
0.0017387978732585907,
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0.03131243214011192,
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0.03790798410773277,
0.05533621460199356,
0.03561508283019066,
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0.05051099881529808,
0.06279520690441132,
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-0.03886888548731804,
-0.029... |
are\tincreased\tso\tthat\tinadequate\tiron\tintake\tmay\talso\tplay\ta\trole\tin\twhether\tit\tdevelops\t(see\t\nChapter\n14\n\tfor\tfurther\tdiscussion).\nAnemia\tof\tchronic\tdisease\nAnemia\tof\tchronic\tdisease\toccurs\tfrom\tinflammation,\tinfection,\tautoimmune\tdisorders,\tchronic\nkidney\tand\tliver\n\tdisease\... | [
0.0217271875590086,
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0.03690002113580704,
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0.03909509629011154,
0.06501904129981995,
0.008650132454931736,
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0.09879761189222336,
0.08145011961460114,
-0.040067821741104126,
0.03618278726935387,
0.0432404... |
result\tof\tdisordered\tiron\tmetabolism.\tFerritin\tlevels\tare\tnormal\tor\tincreased,\tbut\tserum\tiron\tlevels\nand\tTIBC\tare\tlow\t(see\t\nChapter\t5\n).\tIt\tis\timportant\tthat\tthis\tform\tof\tanemia,\twhich\tis\tmild\tand\nnormocytic,\tnot\tbe\tmistaken\tfor\tiron\tdeficiency\tanemia;\tiron\tsupplements\tshou... | [
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0.006750059314072132,
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0.0553436316549778,
0.042044252157211304,
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0.07288710027933121,
0.09394408017396927,
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0.016827264800667763,
0.02... |
Standard\ttherapy\tinvolves\ttreating\n\tthe\tunderlying\tdisorder,\twhich\tusually\timproves\tor\tcorrects\tthis\nanemia\t(\nNemeth\tand\tGanz,\t2014\n).\tErythrocyte\ttransfusion\tand\terythropoiesis-stimulating\tagents\n(ESAs)\tmay\tbe\trequired\tin\trare\tbut\tsevere\tcases.\nSickle\tcell\tdisease\nPathophysiology\... | [
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0.08357871323823929,
0.07504232227802277,
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0.0584... |
Sickle\tcell\tdisease\nPathophysiology\nSickle\tcell\tdisease\t(SCD)\n\tdescribes\ta\tgroup\tof\tinherited\tblood\tdisorders\tof\tRBCs.\tIt\tis\ttypically\nassociated\twith\tAfrican\tancestry\tbut\taffects\tmillions\n\tof\tpeople\tworldwide\tincluding\tCentral\tand\nSouth\tAmerican,\tMediterranean,\tand\tSouth\tAsian\t... | [
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0.08272463083267212,
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0.05757419019937515,
0.10962164402008057,
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0.024238958954811096,
-0.0... |
Prevention\t[CDC],\t2018\n).\tThose\taffected\tinherit\ttwo\tabnormal\themoglobin\tgenes\tcalled\themoglobin\nS,\tone\tfrom\teach\tparent.\tThis\tresults\tin\timpaired\themoglobin\tsynthesis,\twhich\tproduces\tsickle-\nshaped\tRBCs\tthat\tget\tcaught\tin\tcapillaries\tand\tdo\tnot\tcarry\toxygen\twell\t(\nFig.\t31.6\n)... | [
-0.020125096663832664,
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0.005158646032214165,
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-0.05038275942206383,
0.027050668373703957,
0.11502846330404282,
0.0672731101512909,
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0.10727148503065109,
0.08901353180408478,
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0.022742757573723793,
0.039... |
Fig.\t31.6\n).\tThe\tsickle-\nshaped\tRBCs\tdie\tearlier\tthan\ttypical\tRBCs,\tusually\tin\t10\tto\t20\tdays.\tThe\tbone\tmarrow\tcannot\tmake\nnew\tcells\tfast\tenough\tto\treplace\tthem,\twhich\tcan\tresult\tin\tanemia\tand\tenlargement\tof\tthe\tspleen.\nThe\tdisease\tis\tusually\tdiagnosed\tat\tbirth\tand\taffects... | [
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0.03151630982756615,
-0.03297107294201851,
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0.0060233259573578835,
0.08147099614143372,
0.06903457641601562,
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0.06756248325109482,
0.06862886250019073,
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0.013649994507431984,
-0.0080... |
million\tAmericans\thave\tthe\tsickle\tcell\ttrait,\tcharacterized\tby\thaving\tonly\tone\tcopy\n\tof\tthe\tsickle\tcell\ngene.\t(\nCenters\tfor\tDisease\tControl\tand\tPrevention\t[CDC],\t2018\n).\nFIG.\t31.6\nA,\n\tNormal\tred\tblood\tcells\tand\t\nB,\n\tAbnormal,\tsickled\tred\tblood\tcells.\n\tSource:\t(From\tNatio... | [
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0.03461724519729614,
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0.10960127413272858,
0.004225992131978273,
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0.08292261511087418,
0.11421747505664825,
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0.06977848708629608,
-0.020... |
Source:\t(From\tNational\tInstitutes\tof\nHealth\t(NIH),\tNational\tHeart,\tLung,\tand\tBlood\tInstitute\t(NHLBI):\t\nSickle\tcell\tdisease\n\t(website).\t\t\nhttps://www.nhlbi.nih.gov/health-\ntopics/sickle-cell-disease\n,\t2018.)\nIn\taddition\tto\tanemia,\tSCD\tis\tcharacterized\tby\tepisodes\tof\tpain\tresulting\tf... | [
-0.019449889659881592,
0.01423500757664442,
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0.0690518468618393,
0.14583174884319305,
0.028485490009188652,
0.08204098045825958,
0.04571007937192917,
0.028725894168019295,
0.018692702054977417,
-0.020... |
small\tblood\tvessels\n\tby\tthe\tabnormally\tshaped\terythrocytes.\tThe\tocclusions\tfrequently\toccur\tin\tthe\nabdomen,\tcausing\tacute,\tsevere\tabdominal\tpain.\tThe\themolytic\tanemia\tand\tvasoocclusive\tdisease\ncan\tresult\tin\timpaired\tliver\tfunction,\tjaundice,\tgallstones,\tand\tdeteriorating\trenal\tfunc... | [
0.025639718398451805,
-0.03903930261731148,
0.04116763174533844,
-0.0020363247022032738,
-0.12400057166814804,
0.0015787896700203419,
0.09013839066028595,
0.07464729994535446,
-0.05531296879053116,
0.07843556255102158,
0.08489041030406952,
-0.044963397085666656,
-0.027530984953045845,
0.04... |
constant\themolysis\tof\terythrocytes\tincreases\tiron\tstores\tin\tthe\tliver;\thowever,\tiron\tdeficiency\tanemia\nand\tSCD\tcan\tcoexist.\n\tIron\toverload\tis\tless\tcommon\tand\tis\tusually\ta\tproblem\tonly\tin\tthose\twho\thave\nreceived\tmultiple\tblood\ttransfusions.\nTypically\tserum\thomocysteine\tlevels\tar... | [
0.006731677334755659,
-0.09112366288900375,
0.010723572224378586,
-0.012090102769434452,
-0.07743337750434875,
0.007255706004798412,
0.08113373070955276,
0.04563118889927864,
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0.05369243770837784,
0.10293661803007126,
-0.02944832295179367,
0.02806367166340351,
0.04518... |
vitamin\tB\n6\n.\tChildren\twith\tSCD\twere\tfound\tto\thave\tthese\tlower\tvitamin\tB\n6\n\tlevels\tdespite\tB\n6\n\tintakes\ncomparable\tto\tthose\tof\tunaffected\tchildren.\nMedical\tmanagement\nA\tnew\tset\tof\tguidelines\n\tfor\tmanaging\tSCD\trecommends\tusing\tmonthly\tblood\ttransfusions\tand\tthe\ndrug\thydrox... | [
-0.0350581593811512,
-0.05253906920552254,
0.03244528919458389,
-0.025383980944752693,
-0.046675290912389755,
0.04310851916670799,
0.05684560164809227,
0.042196124792099,
-0.05441446602344513,
0.04706409201025963,
0.09090851247310638,
0.029383674263954163,
0.05410286784172058,
0.0041473396... |
drug\thydroxyurea\t(\nYawn\tet\tal,\t2014\n).\tConsistent\tblood\ttransfusions\tstop\tthe\tbody\tfrom\tproducing\nsickle\tcells\tand\tattempts\tto\tnormalize\tRBC\tcount.\tHydroxyurea\tincreases\tthe\tproduction\tof\thealthy\nfetal\themoglobin,\treducing\thospitalizations.\tBecause\thydroxyurea\talso\tlowers\tthe\tnumb... | [
-0.008806661702692509,
-0.010367784649133682,
0.04414844512939453,
-0.0528128407895565,
-0.0603228434920311,
0.020905746147036552,
0.05105307325720787,
0.059235502034425735,
0.004672706127166748,
0.00987720862030983,
0.08776334673166275,
0.03550325334072113,
0.0734928548336029,
0.001576411... |
blood\tcells,\tpatients\tmust\tbe\tmonitored\n\tregularly\twith\tblood\ttests.\nOther\ttreatment\tfor\tSCD\tfocuses\ton\trelieving\tpain\tduring\ta\tcrisis,\tkeeping\tthe\tbody\toxygenated\n(using\toxygen\ttherapy\tif\tneeded),\tand\tpossibly\tadministering\tan\texchange\ttransfusion.\tIt\tis\nimportant\tthat\tSCD\tnot... | [
-0.0013631449546664953,
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supplements,\tbecause\tiron\tstores\tin\tthe\tpatient\twith\tSCD\tsecondary\tto\ttransfusions\tare\n\tfrequently\nexcessive.\nZinc\tcan\tincrease\tthe\toxygen\taffinity\tof\tnormal\tand\tsickle-shaped\terythrocytes.\tThus\tzinc\nsupplements\tmay\tbe\tbeneficial\tin\tmanaging\tSCD,\tespecially\tbecause\tdecreased\tplasm... | [
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common\tin\tchildren\twith\tthe\tSS\tgenotype\tSCD\tand\tis\tassociated\twith\tdecreased\tlinear\tand\tskeletal\ngrowth,\tmuscle\tmass,\tand\tsexual\tmaturation.\tZinc\tsupplementation\talso\tmay\tprevent\tthe\tdeficit\tin\ngrowth\tthat\tappears\tin\tthese\tchildren\t(\nHyacinth\tet\tal,\t2010\n)\tBecause\tzinc\tcompet... | [
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binding\tsites\ton\tproteins,\tthe\tuse\tof\thigh\tdoses\tof\tzinc\tmay\tcause\tcopper\tdeficiency,\tso\nsupplementation\twith\tat\tleast\tthe\tRDA\tof\tcopper\tis\trecommended.\nMedical\tnutrition\ttherapy\nChildren\twith\tSCD\tand\ttheir\tfamilies\tshould\treceive\tinstruction\tabout\thow\tthey\tcan\tdevelop\ta\twell... | [
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balanced\tfood\tplan\n\tproviding\tenough\tcalories\tand\tprotein\tfor\tgrowth\tand\tdevelopment.\tTheir\tdietary\nintake\tmay\tbe\tlow\tbecause\tof\tthe\tabdominal\tpain\tcharacteristic\tof\tthe\tdisease.\tThey\talso\thave\nincreased\tmetabolic\trates,\tleading\tto\ta\tneed\tfor\ta\thigher\tcaloric\tintake.\tThis\thyp... | [
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probably\tis\tdue\tto\ta\tconstant\tinflammation\tand\toxidative\tstress\t(\nHyacinth\tet\tal,\t2010\n;\t\nYawn\tet\tal,\n2014\n).\tTherefore\ttheir\tdiets\n\tmust\tbe\thigh\tenough\tin\tcalories\tto\tmeet\tthese\tneeds\tand\tmust\tprovide\nfoods\thigh\tin\tfolate\tand\tthe\ttrace\tminerals\tzinc\tand\tcopper\t(see\t\n... | [
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Appendix\t47\n\tfor\tsources\tof\tzinc).\nIn\taddition,\tthese\tchildren\tmay\tbe\tlow\tin\tvitamins\tA,\tC,\tD,\tand\tE;\tfolate;\tcalcium;\tand\tfiber.\tThe\ndiet\tshould\tbe\thigh\tin\tfolate\t(400\tto\t600\tmcg\tdaily)\tbecause\tthe\tincreased\tproduction\tof\terythrocytes\nneeded\tto\treplace\tthe\tcells\n\tbeing\... | [
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Appendix\t31\n).\nWhen\tassessing\tthe\tnutrition\tstatus\tof\tpatients\twith\tSCD,\tclinicians\tmust\tpay\tattention\tto\tthe\nquestions\trelated\tto\tthe\tuse\tof\tvitamin\tand\tmineral\tsupplements,\tthe\tconsumption\tof\talcohol\t(which\nincreases\tiron\tabsorption),\tand\tsources\tof\tprotein\t(animal\tsources\tbe... | [
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diet.\tA\tmultivitamin\n\tand\tmineral\tsupplement\tcontaining\t50%\tto\t150%\tof\tthe\tRDA\tfor\tfolate,\tzinc,\tand\ncopper\t(not\tiron)\tis\trecommended.\nDietary\tfluid\tand\tsodium\tintake\tinfluence\tthe\trisk\tfor\tvasoocclusive\tevents\tin\tSCD;\tincreasing\tfluid\nintake\tand\tlimiting\thigh-sodium\tfoods\tsho... | [
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Fowler\tet\tal,\t2010\n)\t(see\t\nChapter\t32\n).\nIntake\tof\t2\tto\t3\tquarts\tof\twater\tdaily\tis\trecommended.\tFinally,\tit\tis\timportant\tto\tremember\n\tthat\npatients\twith\tSCD\tmay\trequire\thigher\tthan\tRDA\tamounts\tof\tprotein.\nIf\tit\tis\tnecessary\tfor\tthe\tdiet\tto\tbe\tlow\tin\tabsorbable\tiron,\t... | [
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proteins.\tIron-rich\tfoods,\tsuch\tas\tliver,\tiron-fortified\tformula,\tiron-fortified\tcereals,\tand\tiron-fortified\nenergy\tbars\tand\tiron-fortified\tsport\tdrinks,\tshould\tbe\texcluded.\tSubstances\tsuch\tas\talcohol\tand\nvitamin\tC\tsupplements,\n\tboth\tof\twhich\tenhance\tiron\tabsorption,\tshould\tbe\tavoi... | [
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deficiency\tmay\tbe\tpresent\tin\tsome\tpatients\twith\tSCD;\tiron\tdeficiency\tshould\tbe\tconfirmed\tand\tthe\ndiet\tadjusted\tappropriately.\nHypochromic\tmicrocytic\ttransient\tanemia\t(sports\tanemia)\nIncreased\tRBC\tdestruction,\talong\twith\tdecreased\themoglobin,\tserum\tiron,\tand\tferritin\nconcentrations,\t... | [
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concentrations,\tmay\toccur\tat\tthe\tinitiation\tand\tearly\n\tstages\tof\ta\tvigorous\ttraining\tprogram.\t\nSports\nanemia\n\tis\tassociated\twith\ta\treduction\tin\themoglobin\tin\tthe\tearly\tstages\tof\taerobic\ttraining\tdue\tto\nhemodilution.\tThe\tadaptations\tare\tconsidered\tadvantageous\tand\tdo\tnot\timpai... | [
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(see\t\nChapter\t22\n\tfor\tfurther\tdiscussion).\nAthletes\twho\thave\themoglobin\tconcentrations\tbelow\tthose\tneeded\tfor\toptimal\toxygen\tdelivery\tmay\nbenefit\tfrom\tconsuming\n\tnutrient\tand\tiron-rich\tfoods;\tensuring\tthat\ttheir\tdiets\tcontain\tadequate\nprotein;\tand\tavoiding\ttea,\tcoffee,\tantacids,\... | [
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2\n-blockers,\tand\ttetracycline,\tall\tof\twhich\tinhibit\tiron\nabsorption.\tNo\tathlete\tshould\ttake\tiron\tsupplements\tunless\ttrue\tiron\tdeficiency\tis\tdiagnosed\tbased\non\ta\tcomplete\tblood\tcell\tcount\twith\tdifferential,\tserum\tferritin\tlevel,\tserum\tiron\tlevel,\tTIBC,\tand\npercent\tsaturation\tof | [
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percent\tsaturation\tof\n\tiron-binding\tcapacity.\tAthletes\twho\tare\tfemale,\tvegetarian,\tinvolved\tin\nendurance\tsports,\tor\tentering\ta\tgrowth\tspurt\tare\tat\trisk\tfor\tiron\tdeficiency\tanemia\tand\ttherefore\nshould\tundergo\tperiodic\tmonitoring\t(see\t\nChapter\t22\n).\nThalassemias\nThalassemias | [
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Chapter\t22\n).\nThalassemias\nThalassemias\n\t(alpha\tand\tbeta)\tare\tinherited\tanemias\tcharacterized\tby\tmicrocytic,\thypochromic,\nand\tshort-lived\tRBCs\tresulting\tfrom\tdefective\themoglobin\tsynthesis,\n\twhich\tprimarily\taffect\tpersons\nfrom\tthe\tMediterranean,\tSouthern\tAsia,\tAfrica,\tand\tthe\tMiddle... | [
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National\tHeart,\tLung,\tand\nBlood\tInstitute,\t2014\n).\tSeverity\tof\tthe\tdisorder\tranges\tfrom\tasymptomatic\tor\tmild\tanemia\tto\tmore\nsevere\tsymptoms\trequiring\troutine\tblood\ttransfusions.\tThe\tineffective\terythropoiesis\tleads\tto\tan\nincrease\tin\tplasma\tvolume,\tprogressive\tsplenomegaly,\tand\tbon... | [
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with\tthe\tresult\tof\nfacial\tdeformities,\tosteomalacia,\tand\tbone\tchanges.\tUltimately\tthere\tis\tincreased\tiron\tabsorption\nand\tprogressive\tiron\tdeposition\tin\ttissues,\tresulting\tin\toxidative\tdamage.\tThe\taccumulation\tof\tiron\ncauses\tdysfunction\tof\tthe\theart,\tliver,\tand\tendocrine\tglands.\tBe... | [
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form\trequire\ttransfusions\tto\tstay\talive,\tthey\talso\tmust\thave\tregular\tchelation\ttherapy\n\tto\tprevent\tthe\ndamaging\tbuildup\tof\tiron\tthat\tcan\toccur.\tImpaired\tgrowth\tin\tchildren\taccompanying\tthalassemia\nmajor\tcan\tbe\tpartially\tcorrected\tby\tincreasing\tcaloric\tintake.\nMedical\tnutrition\tt... | [
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Medical\tnutrition\ttherapy\nThe\tdiet\tshould\temphasize\tfoods\thigh\tin\tfolate,\tvitamins\tA\tand\tC,\tand\ttrace\tminerals,\tincluding\tzinc,\ncopper,\tand\tselenium\t(\nCunningham,\t2016\n).\tAdditionally,\tadequate\tintake\tof\tcalcium\tand\tvitamin\n\tD\tis\nneeded\tto\tsupport\tbone\thealth.\tPatients\tnot\tre... | [
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moderately\tlow-iron\tdiet\tthat\tlimits\tiron-fortified\tfoods\tand\thigh\tred\tmeat\tintakes.\tMultivitamin\tand\nmineral\tsupplements\tthat\tcontain\tamounts\tof\tiron\tand\tvitamin\tC\tabove\tthe\tRDA\tshould\tbe\talso\navoided.\tPatients\treceiving\ttransfusions\twith\tchelation\ttherapy\tdo\tnot\tneed\tto\tfollow... | [
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CLINICAL\tCASE\tSTUDY\nMarisa,\ta\t27-year-old\tHispanic\tfemale,\treports\tincreased\tsymptoms\tof\trestless\tlegs\tsyndrome,\nfatigue,\tand\theavy\tmenses\tfor\tthe\tpast\tyear.\tA\tphysical\texamination\treveals\tinflammation\tand\ntenderness\taround\ther\tknee\tand\tankle\tjoints.\nHer\ttypical\tdaily\tintake\tincl... | [
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32\nMedical\tnutrition\ttherapy\tfor\ncardiovascular\tdisease\nJanice\tL.\tRaymond,\tMS,\tRDN,\tCSG,\tSarah\tC.\tCouch,\tPhD,\tRDN\nKEY\tTERMS\n3-hydroxy-3-methylglutaryl–\tcoenzyme\tA\t(HMG-CoA)\nangina\nangiography\napolipoproteins\natherosclerotic\tcardiovascular\tdisease\t(ASCVD)\natheroma\nbile\tacid\tsequestrant\... | [
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blood\tpressure\nB-natriuretic\tpeptide\t(BNP)\ncardiac\tcachexia\ncardiac\tcatheterization\ncardiovascular\tdisease\t(CVD)\nC-reactive\tprotein\t(hs-CRP)\nCerebrovascular\tAccident\t(CVA)\nchylomicron\ncoronary\tartery\tbypass\tgraft\t(CABG)\ndiastolic\tblood\tpressure\t(DBP)\nDietary\tApproaches\tto\tStop\tHypertensi... | [
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dyslipidemia\ndyspnea\nedema\nendothelial\tcell\nessential\thypertension\nfamilial\tcombined\thyperlipidemia\t(FCHL)\nfamilial\tdysbetalipoproteinemia\nfamilial\thypercholesterolemia\n\t(FH)\nfatty\tstreak\nfoam\tcells\nheart\tfailure\t(HF)\nhigh-density\tlipoprotein\t(HDL)\nhomocysteine\nhypertension\nhypertriglycerid... | [
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-0... |
hypertriglyceridemia\nintermediate-density\tlipoprotein\t(IDL)\nischemia\nleft\tventricular\thypertrophy\t(LVH)\nlipoprotein\nlow-density\tlipoprotein\t(LDL)\nMediterranean\tdiet\t(MeD) | [
0.0017161575378850102,
-0.064524345099926,
-0.051136795431375504,
-0.012150648050010204,
-0.039959315210580826,
0.006975457537919283,
0.059829115867614746,
0.10545877367258072,
0.02318025752902031,
0.006767637096345425,
0.08249080926179886,
-0.004267878830432892,
-0.03239059075713158,
0.02... |
metabolic\tsyndrome\nmyocardial\tinfarction\t(MI)\nnitric\toxide\t(NO)\nplaque\nprehypertension\nrenin-angiotensin\n\tsystem\t(RAS)\nsecondary\thypertension\nstatins\nstroke\nsyncope\nsystolic\tblood\tpressure\t(SBP)\nthrombus\ntrans\tfatty\tacids\ntransient\tischemic\tattack\t(TIA)\ntrimethylamine-N-oxide\t(TMAO)\nver... | [
-0.05026192218065262,
-0.05106411874294281,
-0.05145522952079773,
0.040588606148958206,
-0.0333910770714283,
-0.010283654555678368,
0.008373280987143517,
0.11097747087478638,
-0.034501880407333374,
0.009603668004274368,
0.08240041136741638,
0.006472230888903141,
0.013730629347264767,
0.040... |
very-low-density\tlipoprotein\t(VLDL)\nxanthoma\nCardiovascular\tdisease\t(CVD)\n\tis\ta\tgroup\tof\tinterrelated\tdiseases\tthat\tincludes\tatherosclerosis,\nhypertension,\tischemic\theart\tdisease,\tperipheral\tvascular\tdisease,\n\tand\theart\tfailure\t(HF).\tThese\ndiseases\tare\tinterrelated\tand\toften\tcoexist.\... | [
-0.005600701551884413,
-0.06970538198947906,
0.00939723290503025,
-0.017411451786756516,
-0.061522167176008224,
-0.017377762123942375,
0.018408142030239105,
0.07402575016021729,
-0.0014878174988552928,
0.05134793370962143,
0.11473748832941055,
-0.06364800035953522,
-0.021751604974269867,
0... |
have\tone\tor\tmore\ttypes\tof\tCVD\t(\nBox\t32.1\n).\nBOX\t32.1\nTypes\tand\tIncidence\tof\tCardiovascular\tDisease\tin\tthe\tUnited\nStates\nHypertension:\t75,000,000\nCoronary\theart\tdisease:\t25,155,000\nMyocardial\tinfarction:\t790,000\nHeart\tfailure:\t6,500,000\nStroke:\t7,950,000 | [
-0.01149167213588953,
-0.01692867837846279,
-0.02665792964398861,
-0.07608035206794739,
-0.1305495649576187,
0.005057088099420071,
0.08828255534172058,
0.04626203328371048,
-0.038975249975919724,
0.019210100173950195,
0.028148788958787918,
-0.10807453095912933,
-0.003151130862534046,
0.021... |
Heart\tfailure:\t6,500,000\nStroke:\t7,950,000\nBecause\tof\tcomorbidities,\tit\tis\tnot\tpossible\tto\tadd\tthese\tnumbers\ttogether\tto\treach\ta\ttotal\t(American\nHeart\tAssociation\t[AHA],\t2010;\t\nhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408160/\n;\nhttps://www.cdc.gov/heartdisease/heart_attack.htm\n). | [
0.07182706147432327,
-0.004119385965168476,
-0.029641367495059967,
0.047778986394405365,
-0.05811949446797371,
0.018041519448161125,
-0.01587649993598461,
0.03647788614034653,
0.008848865516483784,
0.0011216663988307118,
0.044939082115888596,
0.0009519826853647828,
-0.006735955830663443,
-... |
;\nhttps://www.cdc.gov/heartdisease/heart_attack.htm\n).\nCVD\tremains\tthe\tnumber\tone\tkiller\tof\tmen\tand\twomen\tin\tthe\tUnited\tStates;\tone\tof\tevery\tthree\ndeaths\tis\tattributed\tto\tCVD.\tCVD\tis\tthe\tcause\tof\tmore\tdeaths\n\tthan\tcancer,\tchronic\tlower\trespiratory\ndiseases,\tand\taccidents\tcombin... | [
0.027519071474671364,
0.019768403843045235,
0.027574677020311356,
-0.031227048486471176,
-0.0345422625541687,
0.03175063803792,
0.02353346161544323,
-0.050484590232372284,
-0.03756067156791687,
0.06983917951583862,
0.11002965271472931,
-0.02642473205924034,
0.005533966235816479,
0.00194652... |
about\tevery\tminute\tsomeone\twill\tdie\tof\tone.\tOn\taverage,\tsomeone\tin\tthe\tUnited\tStates\tsuffers\ta\nstroke\tevery\t40\tseconds\t(\nAmerican\tHeart\tAssociation\t[AHA],\t2015\n).\tThe\tlifetime\trisk\tfor\tCVD\tin\nAmerican\tmen\tis\ttwo\tin\tthree\tand\tfor\twomen\tis\tone\tin\ttwo\t(\nAHA,\t2015\n).\tWorld... | [
-0.0006480988231487572,
-0.029199143871665,
0.05252664163708687,
-0.07293836027383804,
-0.14713001251220703,
-0.008673097938299179,
0.04565088823437691,
-0.025680331513285637,
-0.025212449952960014,
0.07044406980276108,
0.1017783060669899,
-0.02763381227850914,
0.06813891977071762,
0.02356... |
deaths\tper\tyear\tare\tattributed\tto\tCVD\t(\nYusuf\tet\tal,\t2014\n).\nAtherosclerotic\tcardiovascular\tdisease\t(ASCVD)\n\tinvolves\tthe\tnarrowing\tof\tsmall\tblood\tvessels\nthat\toxygenate\tthe\theart\tmuscle\tby\tthe\tbuild-up\tof\t\nplaque\n\t(the\tlesion\tin\tthe\tblood\tvessels).\tThe | [
0.003946826793253422,
-0.03137016296386719,
0.049271125346422195,
-0.0445978119969368,
-0.0843583345413208,
0.03459018096327782,
0.06241043657064438,
0.02214621938765049,
0.008047149516642094,
0.07883302122354507,
0.12070874869823456,
-0.05105624347925186,
0.033477816730737686,
0.010519389... |
plaque\n\t(the\tlesion\tin\tthe\tblood\tvessels).\tThe\nplaque,\tknown\tas\tatherosclerosis,\tcan\trupture,\tcausing\ta\tblood\tclot\tto\tform\tthat\tblocks\tthe\tartery\tor\ntravels\tsomewhere\telse\tin\tthe\tbody,\n\tcausing\tblockage\tat\tthat\tsite.\tThe\tresult\tcan\tbe\ta\t\nmyocardial\ninfarction\t(MI)\n,\twhich... | [
-0.04648687690496445,
0.00237495475448668,
0.08076369762420654,
-0.05102621763944626,
-0.16090720891952515,
0.015244723297655582,
0.062137093394994736,
-0.011086707934737206,
-0.003497886937111616,
0.04340435191988945,
0.06899785995483398,
-0.03565237671136856,
-0.0026047921273857355,
0.02... |
stroke\n,\nwhich\tis\talso\tknown\tas\ta\t\ncerebrovascular\taccident\t(CVA)\n.\tHeart\tdisease\tand\tstroke\tcause\tthe\nmost\tdeaths\tin\tboth\tsexes\tof\tall\tethnic\tgroups,\tincreasing\twith\tage.\tUntil\tthe\tage\tof\t65\tyears,\tblack\nmen\thave\tthe\thighest\trates\tof\tASCVD\tdeaths;\n\tthereafter,\twhite\tmen... | [
0.012880055233836174,
-0.06017148494720459,
0.04375169426202774,
-0.03477436676621437,
-0.15807074308395386,
-0.006374237593263388,
0.04055395349860191,
0.01743798889219761,
-0.03075208142399788,
0.08638306707143784,
0.0759766697883606,
-0.05416015908122063,
0.006410473491996527,
0.0097284... |
thereafter,\twhite\tmen\thave\tthe\thighest\trates.\tBlack\nwomen\thave\thigher\trates\tthan\twhite\twomen\tat\tall\tages.\tAmong\twhites\tolder\tthan\tage\t18,\t12.1%\nhave\tCVD.\tIn\tthe\tsame\tage\tgroup,\t10.2%\tof\tblacks\thave\theart\tdisease,\tand\tin\tHispanics\tthe\nincidence\tis\t8.1%.\tThe\tincidence\tin\tad... | [
0.017334051430225372,
-0.02114250883460045,
0.07748622447252274,
-0.04036647453904152,
-0.10321071743965149,
-0.02544918656349182,
0.045961711555719376,
-0.024344952777028084,
-0.01207650639116764,
0.07907930016517639,
0.09316971898078918,
-0.0725286528468132,
0.017683176323771477,
-0.0034... |
Pacific\tIslanders\tit\tis\t19.7\t%,\tand\tin\tAsians\tit\tis\t5.2%\t(\nAHA,\t2015\n).\tThis\tchapter\tdiscusses\tthe\nincidence,\tpathophysiologic\tfindings,\tprevention,\tand\ttreatment\tof\teach\tof\tthe\tCVDs.\nAtherosclerosis\tand\tcoronary\theart\tdisease\nAnatomy\tand\tphysiology\nBlood\tvessels\tare\tcomposed\t... | [
0.03279717639088631,
-0.052684128284454346,
0.0719202309846878,
0.005582474637776613,
-0.0801275447010994,
0.027885397896170616,
0.07689370214939117,
-0.020309463143348694,
0.011863978579640388,
0.07989342510700226,
0.09445996582508087,
-0.03717663139104843,
0.006511114537715912,
0.0682492... |
structure\tto\tthe\tvessels.\tThe\tmiddle\tlayer\tis\tsmooth\tmuscle\tthat\tcontracts\tand\tdilates\tto\tcontrol | [
-0.02281530573964119,
-0.0574302114546299,
0.06626531481742859,
-0.027763286605477333,
-0.11873827874660492,
0.006142899859696627,
0.08400341868400574,
0.021334799006581306,
-0.000509753474034369,
0.06088022515177727,
0.0746842697262764,
-0.061260975897312164,
-0.001108290278352797,
0.0474... |
blood\tflow\tand\n\tblood\tpressure.\tThe\tinner\tlining\tis\ta\tthin\tlayer\tof\t\nendothelial\tcells\n\t(the\nendothelium)\tthat\tin\ta\thealthy\tstate\tis\tsmooth\tand\tresponsive.\tThe\tendothelium\tfunctions\tas\ta\nprotective\tbarrier\tbetween\ttissues\tand\tcirculating\tblood.\tIt\tfacilitates\tbidirectional\tpa... | [
0.007767478469759226,
-0.07395368814468384,
0.07397590577602386,
-0.019719859585165977,
-0.1139497235417366,
0.032631728798151016,
0.06791029870510101,
0.02145194821059704,
0.008882940746843815,
0.06792686134576797,
0.0874885693192482,
-0.05340474471449852,
-0.0013690696796402335,
0.055449... |
macromolecules\tand\tblood\tgases\tto\tand\tfrom\ttissues\tand\tblood.\tEndothelial\tcells\tsense\tchanges\tin\nblood\tflow\tand\trespond\twith\tthe\n\trelease\tof\tbioactive\tsubstances\tthat\tmaintain\tvascular\thomeostasis.\nOne\tsuch\tsubstance\tis\t\nnitric\toxide\t(NO)\n.\tNO\tis\ta\tsoluble\tgas\tcontinually\tsy... | [
0.02378181181848049,
-0.09307856857776642,
0.04642701894044876,
-0.00956439133733511,
-0.05817548930644989,
0.056277479976415634,
0.11743750423192978,
0.05467210337519646,
-0.016103465110063553,
0.08096624910831451,
0.081355020403862,
-0.0353403240442276,
-0.008671030402183533,
0.074259132... |
.\tNO\tis\ta\tsoluble\tgas\tcontinually\tsynthesized\tfrom\tthe\namino\tacid\tl-arginine\tin\tendothelial\tcells.\tNO\thas\ta\twide\trange\tof\tbiologic\tproperties\tthat\tmaintain\nvascular\thomeostasis.\tIt\tappears\tto\tbe\tinvolved\tin\tprotection\tfrom\tinjurious\tsubstances\tand\tplays\ta\nkey\trole\tin\tvasodila... | [
0.03300710767507553,
-0.09644576162099838,
0.02714877761900425,
-0.03124251216650009,
-0.11942065507173538,
0.013191208243370056,
0.06377623975276947,
0.08440735191106796,
-0.011218754574656487,
0.06672272086143494,
0.08398716896772385,
-0.019612183794379234,
0.026707759127020836,
0.087020... |
key\trole\tin\tvasodilation\t(\nTousoulis\tet\tal,\t2012\n).\tDecreased\tNO\tis\ta\tfactor\tin\tthe\tendothelial\tcell\ndysfunction\tthat\tdisrupts\tvascular\tbalance\tand\tcan\tresult\tin\tvasoconstriction,\tplatelet\tactivation,\nleukocyte\tadherence,\tand\tvascular\tinflammation.\nPathophysiology | [
-0.018417248502373695,
-0.1106807067990303,
0.03831132873892784,
-0.044713642448186874,
-0.12472762167453766,
0.007371910382062197,
0.10443630069494247,
0.05277017503976822,
0.014827492646872997,
0.08493079245090485,
0.08249033987522125,
-0.006380333565175533,
-0.02060731127858162,
0.05417... |
leukocyte\tadherence,\tand\tvascular\tinflammation.\nPathophysiology\nASCVD\tinvolves\tthe\taccumulation\tof\tplaque\twithin\tthe\twalls\tof\tthe\tarteries.\tIt\tstarts\twith\tinjury\tto\nthe\tendothelial\tcells\twith\tan\tassociated\tinflammatory\tresponse\tinvolving\tphagocytes\n\tand\tmonocytes.\nOnce\tin\tthe\ttiss... | [
0.011899782344698906,
-0.08500513434410095,
0.05599311739206314,
-0.05991324782371521,
-0.12232642620801926,
0.009581291116774082,
0.08869677037000656,
0.07739520072937012,
-0.009495752863585949,
0.10339969396591187,
0.03640950098633766,
-0.03712160885334015,
0.018235711380839348,
0.084027... |
foam\tcell\n\tthat\ningests\toxidized\tcholesterol\tand\tbecomes\t\nfatty\tstreaks\n\tin\tthese\tvessels.\tIntracellular\nmicrocalcification\toccurs,\tforming\tdeposits\twithin\tthe\tvascular\tsmooth\tmuscle\tcells\tof\tthe\nsurrounding\tmuscular\tlayer\t(\nFig.\t32.1\n).\nFIG.\t32.1\nThe\tstructure\tof\tmature,\tstabl... | [
-0.02407023496925831,
-0.08542663604021072,
0.041735630482435226,
-0.034453775733709335,
-0.08488067239522934,
-0.015438980422914028,
0.09275103360414505,
0.03271973505616188,
-0.02922634780406952,
-0.0006000910652801394,
0.06434691697359085,
-0.06400704383850098,
0.04161924868822098,
0.05... |
Source:\t(From\tRudd\tJHF\tet\tal:\tImaging\tof\natherosclerosis—can\twe\tpredict\tplaque\trupture?\t\nTrends\tCardiovasc\tMed\n\t15:17,\t2005.)\nA\tprotective\tfibrin\tlayer\tor\t\natheroma\n\tforms\tbetween\tthe\tfatty\tdeposits\tand\tthe\tartery\tlining.\nAtheromas\tproduce\tenzymes\tthat\tcause\tthe\tartery\tto\ten... | [
-0.07446914911270142,
0.0059768385253846645,
0.031494252383708954,
-0.03803909942507744,
-0.0502343587577343,
0.0007181997643783689,
0.07887768000364304,
0.025415536016225815,
0.023516660556197166,
0.037125326693058014,
0.08743970841169357,
-0.019290046766400337,
0.054884158074855804,
0.01... |
narrowing\tcaused\n\tby\tthe\tplaque.\tThis\t“remodeling”\tof\tthe\tshape\tand\tsize\tof\tthe\tblood\tvessel\tmay\nresult\tin\tan\taneurysm.\tAtheromas\tcan\trupture\tor\tbreak\toff,\tforming\ta\t\nthrombus\n\t(blood\tclot),\twhere\nthey\tattract\tblood\tplatelets\tand\tactivate\tthe\tclotting\tsystem\tin\tthe\tbody.\t... | [
-0.0020503192208707333,
-0.027488764375448227,
0.06794431805610657,
-0.03970911353826523,
-0.12201565504074097,
-0.02240748144686222,
0.09238863736391068,
0.03002668358385563,
0.019770367071032524,
0.05596630275249481,
0.0790998786687851,
0.012689548544585705,
0.03778940439224243,
0.015730... |
blockage\tand\trestricted\tblood\tflow.\nOnly\thigh-risk\tor\tvulnerable\tplaque\tforms\tthrombi.\tVulnerable\tplaques\tare\tlesions\n\twith\ta\tthin\nfibrous\tcap,\tfew\tsmooth\tmuscle\tcells,\tmany\tmacrophages\t(inflammatory\tcells),\tand\ta\tlarge\tlipid\tcore\n(\nFig.\t32.2\n).\tArterial\tchanges\tbegin\tin\tinfan... | [
-0.007796574849635363,
-0.024271102622151375,
0.05101458728313446,
0.0007433979189954698,
-0.07781646400690079,
-0.0030676606111228466,
0.10070805996656418,
0.052284639328718185,
-0.020246274769306183,
0.0373825803399086,
0.06185733899474144,
-0.0043733431957662106,
0.03930729627609253,
0.... |
FIG.\t32.2\nNatural\tprogression\tof\tatherosclerosis.\n\tSource:\t(From\tHarkreader\tH:\t\nFundamentals\tof\tnursing:\tcaring\tand\nclinical\tjudgment,\n\tPhiladelphia,\t2007,\tSaunders.)\nFIG.\t32.3\nPlaque\tthat\tcan\tbe\tsurgically\tremoved\tfrom\tthe\tcoronary\tartery.\n\tSource:\t(Photographs\tcourtesy\tRonald\tD... | [
-0.006929597817361355,
-0.007501667365431786,
0.059127215296030045,
-0.03513610363006592,
-0.07498317211866379,
-0.009460938163101673,
0.0541265532374382,
0.03853364661335945,
0.010053555481135845,
0.03998418152332306,
0.13453951478004456,
-0.054393235594034195,
0.012039847671985626,
0.024... |
Source:\t(Photographs\tcourtesy\tRonald\tD.\nGregory\tand\tJohn\tRiley,\tMD.)\nThe\tclinical\toutcome\tof\timpaired\tarterial\tfunction\tarising\tfrom\tatherosclerosis\tdepends\ton\tthe\nlocation\tof\tthe\timpairment.\tIn\tthe\tcoronary\tarteries\tatherosclerosis\tcan\tcause\t\nangina\n\t(chest\tpain),\nMI,\tand\tsudde... | [
-0.04528522491455078,
0.027631767094135284,
0.06490607559680939,
-0.005642996169626713,
-0.07585872709751129,
-0.02663153037428856,
0.06704350560903549,
0.03348429128527641,
0.023228056728839874,
0.0112385805696249,
0.0630112886428833,
-0.05090203136205673,
0.049152180552482605,
0.03115905... |
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