OBJECTIVE:To evaluate, using longitudinal laboratory data, potential care gaps, and the prevalence of anemia in pregnant women residing in New Mexico, USA.METHODS:A total of 985 pregnant women aged 13-60 were included from December 1, 2018 to December 1, 2019. Parameters included frequency of CBC, iron studies, reticulocyte panel, prevalence of anemia, iron deficiency anemia (IDA), iron deficiency (ID), anemia change throughout pregnancy, and ICD-10 codes utilization.RESULTS:CBC was completed in 896/985 (91%) of the sample population in the first trimester and 528/985 (53.6%) in the third trimester. Two hundred and fifty-two (25.6%) women had anemia at any given point during pregnancy. ID was prevalent in 1.3% of women in the first trimester and 1.0% in the third, while IDA was prevalent in 0.4% in their first trimester and 5.5% in the third. Data also show an overall worsening of anemia from first to third trimester (2.8% and 40.9%, respectively, p < .0001). A positive correlation was found between mean corpuscular volume (MCV) and reticulocyte hemoglobin (RET-He) (r = .8592, 95% CI 0.7475 to 0.9237).CONCLUSION:Test utilization for anemia screening during pregnancy can be improved to guide patient management to reduce anemia rate and potential anemia-associated complications.

Background: Lice infestation is a commonly encountered disorder in emergency medicine. The louse survives from a blood meal from its host; hence, iron deficiency anemia is a theoretic possibility. A limited number of reports of severe iron deficiency anemia have appeared in the veterinary literature, but a thorough review of the medical literature did not reveal a single instance in human beings. Objective: We report a small case series of patients with heavy louse infestation and profound iron deficiency anemia. Case report: The index case along with two other cases discovered from an exhaustive search of 4 years of the institution's Emergency Department records all had heavy infestation with head and body lice. Laboratory evaluation revealed serum hemoglobin levels under 6 gm/dL, low serum ferritin levels, and microcytic red blood cell indices. All patients were admitted to the hospital, received transfusions, and had evaluation of their anemia. No patient had evidence of gastrointestinal blood loss or alternative explanation for their anemia. Conclusions: Although cause and effect cannot be established from this case series, to the best of our knowledge, this is the first published evidence of a provocative association of louse infestation and severe iron deficiency anemia in humans. (C) 2011 Elsevier Inc.

Military small arms ranges in the United States have been used for munitions training with tungsten rounds, which are comprised of powdered tungsten (W) pressed together with polymeric binders. As a result, W has been introduced into surface soils. The environmental and human health effects of W remain open questions. The US Army Corps of Engineers is responsible for environmental monitoring, site assessments, and cleanup of small arms ranges. This work requires routine measurements of tungsten in natural waters and soils. However, the existing sample preparation and analytical procedures were not specifically developed with W in mind for environmental analysis. Our work suggests modification of existing metal sample preparation and analytical procedures are necessary to accurately quantify W in environmental media. Our group has been actively conducting W measurements using inductively coupled plasma mass spectrometry (ICPMS), both with quadrupole and sector field ICPMS systems. We have used heavy rare earth elements and iridium as internal standards. For soils, the great majority of the W from small arms can be dissolved using acid leaching with HNO3–H3PO4 mixtures; more rigorous preparations with fusion or HF digestions can also be used. In ICPMS analysis, the largest challenge involves dealing with the significant carry-over and memory of W in sample introduction systems. This ultimately limits measurement capabilities, particularly at sub-µg L−1 levels. With careful attention to the sample and standards’ matrix constituents, and proper washout time, successful analysis is possible and ICPMS is clearly the preferred technique. A commercially available fluoropolymer sample introduction system exhibits significantly improved memory characteristics.