Shock Tube/Laser Absorption Measurements of the High-Temperature Spectra and Decomposition of Propyl Ethers.

This work presents measurements of temperature-dependent absorption spectra and thermal decomposition rates of propyl ethers, specifically di-n-propyl ether (DnPE) and diisopropyl ether (DiPE), which are two renewable fuel candidates. We employed a broadband rapid-tuning MIRcat-QT laser, operating in the scan/fixed-wavelength mode in combination with a shock tube. Spectral measurements were performed over the wavelength range of 8.4-11 µm (909.1-1190.5 cm-1), covering the strongest infrared absorption bands of the studied ethers, at temperatures of 559-853 K and pressure near 1 bar. These high-temperature spectra help in selecting the optimum wavelength for sensitive and selective measurements of the target ethers. Based on the criteria of high sensitivity, minimum interference, and insensitivity to temperature and pressure variations, we selected a wavelength of 1121.82 cm-1 for high-temperature diagnostics of DnPE and DiPE. Absorption cross sections at the selected wavelength of 1121.82 cm-1 were measured over 550-1500 K, and pressures ranging from 0.3-1.4 bar. This diagnostic was then applied to study the high-temperature pyrolysis of these ethers by measuring their time histories behind the reflected shock waves. Our experimentally measured overall decomposition rate coefficients for DnPE and DiPE are given as (unit of s-1) kDnPE = 1.25 × 1027 × T-3.483 × exp(-37620 K/T) and kDiPE = 5.26 × 1023 × T-2.857 × exp(-32360 K/T).

Curcumin Nanoemulsion: Unveiling Cardioprotective Effects via ACE Inhibition and Antioxidant Properties in Hypertensive Rats.

Background and Objectives: Curcumin, derived from Curcuma longa, is a well-known traditional medicinal compound recognized for its therapeutic attributes. Nevertheless, its efficacy is hampered by limited bioavailability, prompting researchers to explore the application of nanoemulsion as a potential alternative. Materials and Methods: This study delves into the antihypertensive effects of curcumin nanoemulsion (SNEC) by targeting the renin-angiotensin-aldosterone system (RAAS) and oxidative stress in deoxycorticosterone acetate (DOCA) salt-induced hypertensive rats. To gauge the cardio-protective impact of SNEC in DOCA salt-induced hypertension, molecular docking was undertaken, uncovering curcumin's high affinity and adept binding capabilities to the active site of angiotensin-converting enzyme (ACE). Additionally, the investigation employed uninephrectomized rats to assess hemodynamic parameters via an AD instrument. Serum ACE, angiotensin II, blood urea nitrogen (BUN), and creatinine levels were quantified using ELISA kits, while antioxidant parameters were evaluated through chemical assays. Result: The outcomes of the molecular docking analysis revealed robust binding of curcumin to the ACE active site. Furthermore, oral administration of SNEC significantly mitigated systolic, diastolic, and mean arterial blood pressure in contrast to the DOCA-induced hypertensive group. SNEC administration also led to a reduction in left ventricular end-diastolic pressure (LVEDP) and an elevation in the maximum rate of left ventricular pressure rise (LV (dP/dt) max). Moreover, SNEC administration distinctly lowered serum levels of ACE and angiotensin II compared to the hypertensive DOCA group. Renal markers, including serum creatinine and BUN, displayed a shift toward normalized levels with SNEC treatment. Additionally, SNEC showcased potent antioxidant characteristics by elevating reduced glutathione, catalase, and superoxide dismutase levels, while decreasing the concentration of thiobarbituric acid reactive substances. Conclusions: Collectively, these findings underscore that curcumin nanoemulsion exerts noteworthy cardio-protective effects through ACE activity inhibition and remarkable antioxidant properties.

A systematic review and meta-analysis of non-adherence to anti-diabetic medication: Evidence from low- and middle-income countries.

BACKGROUND: Non-adherence to anti-diabetic medication is an important cause of uncontrolled blood glucose that leads to complications of diabetes. However, there is a lack of evidence on the burden of and factors associated with non-adherence to anti-diabetic medication among individuals living with diabetes in low-and middle-income countries (LMICs). OBJECTIVES: This systematic literature review and meta-analytic synthesis aims to estimate non-adherence to anti-diabetic medication reported among individuals in LMICs and explores factors affecting non-adherence. METHODS: We systematically searched MEDLINE and Embase to identify studies investigating non-adherence to anti-diabetic medications published from January 2000 to May 2020. Two authors carried out study selection, screening, and data extraction independently. Cross-sectional studies that had been conducted among individuals with diabetes in LMICs were eligible for the selection process. Critical appraisal of the included studies was carried out using the Newcastle Ottawa Scale. Meta-analysis was carried out using Stata 14.2. Random effects model was used to compute the pooled proportion at a 95% confidence interval (CI). RESULTS: Forty-three studies met the inclusion criteria, of which 13 studies were used in meta-analysis. The pooled proportion of non-adherence to anti-diabetic medications using the eight-item Morisky Medication Adherence Scale (MMAS-8) was 43.4% (95% CI: 17.5-69.4; P < 0.001) and 29.1% (95% CI: 19.8-38.4; P < 0.001) when using the cut-off at 80 or 90%. The pooled proportion of non-adherence was 29.5% (95% CI: 25.5-33.5; P = .098) when using the four-item Morisky Medication Adherence Scale (MMAS-4). Using the World Health Organization (WHO) five dimensions of medication adherence framework, the factors contributing to non-adherence were varied, including disease factors, therapy-related factors, healthcare system factor, patient-centred factors, and socio-economic factors. CONCLUSIONS: Non-adherence to anti-diabetic medication remains an ongoing challenge in LMICs and several factors operating at different levels were cited as reasons. Comprehensive intervention strategies are urgently needed to address these factors in effectively tackling medication non-adherence in LMICs.

Impact on quality of life in patients with dermatophytosis.

BACKGROUND/OBJECTIVES: Dermatophytosis can have a significant effect on patient's psychosocial and economic life. Despite this, knowledge on the quality of life (QoL) in patients with dermatophytosis is limited. The objective of the present study was to assess the quality of life in patients with dermatophytosis. METHODS: This was a cross-sectional study conducted in the Department of Dermatology at a tertiary care hospital from August 2018 to December 2018. All the patients with dermatophytosis aged ≥16 years were included and evaluated for impact on quality of life. The association of Dermatology Life Quality Index (DLQI) scores with disease characteristics was assessed using t-test, ANOVA and Pearson's correlation test, as applicable. RESULTS: A total of 348 patients were analysed. The mean ± SD DLQI score in our study was 13.4 ± 7.3. Dermatophytosis was found to have a very large effect on the QoL in majority (44.8%) of our patients. DLQI questions pertaining to symptoms and feelings and daily activity had the highest impact on patients. The DLQI score was significantly affected by the number of sites involved (P < 0.001), body surface area (P < 0.001) and the severity of symptoms (P = 0.007). CONCLUSION: Dermatophytosis was found to have a significant impact on the QoL of affected patients. The DLQI score was influenced by the severity of the disease. This study also underscores the feasibility of DLQI score based QoL assessment in dermatophytosis.

Erythromelanosis follicularis faciei et colli: A clinicoepidemiologic study.

We describe 25 cases of erythromelanosis follicularis faciei et colli from India. The male:female ratio was 5.25:1 and the average age of onset was 12.3 years. The cheeks, preauricular area, and submandibular region were the sites most commonly affected. Keratosis pilaris was seen in 22 (88%) of the patients.

Ameliorative effect of berberine against gentamicin-induced nephrotoxicity in rats via attenuation of oxidative stress, inflammation, apoptosis and mitochondrial dysfunction.

BACKGROUND: Gentamicin (GM) is the commonly used antibiotics against Gram-negative infection, but the nephrotoxic potential of drug limit its clinical interest. The aim of this study was to investigate the protective effect of berberine (BER) against GM-induced nephrotoxicity and possible underlying mechanisms. MATERIAL AND METHODS: The rats were divided into various group, namely normal, GM-control, GM + BER (10, 20, and 40 mg/kg). Nephrotoxicity was induced by intraperitoneal administration of GM (120 mg/kg) for 7 consecutive days. BER (10, 20, and 40 mg/kg; p.o.) was also administered for the 7 days. Various biochemical, molecular, and histological parameters were assessed in serum and kidney. RESULTS: GM-administration significantly increased (p < 0.001) the serum creatinine and blood urea nitrogen (BUN) as well as renal malonaldehyde (MDA), nitric oxide (NO) along with Kidney Injury Molecule-1 (KIM-1), Neutrophil gelatinase-associated lipocalin (NGAL), and nuclear factor-kappa B (NF-KB) renal mRNA expressions. In addition, GM also significantly decreased (p < 0.001) the renal superoxide dismutase (SOD), reduced glutathione (GSH), B-cell lymphoma 2 (Bcl-2) mRNA expression, and mitochondrial enzymes (NADH dehydrogenase and cytochrome c oxidase) activities. Rats treated with BER (20 and 40 mg/kg; p.o.) significantly and dose-dependently (p < 0.05 and p < 0.01) restore the altered levels of antioxidant, inflammatory, apoptosis, AKI markers as well as depleted mitochondrial enzymes. Histopathological abbreviations were also ameliorated by BER administration. CONCLUSION: Berberine exerts renoprotective effects through its anti-oxidant, anti-inflammatory, and anti-apoptotic properties.[Formula: see text].

Ameliorative effect of naringin in acetaminophen-induced hepatic and renal toxicity in laboratory rats: role of FXR and KIM-1.

CONTEXT: Acetaminophen (APAP) is an analgesic and antipyretic agent commonly known agent to cause hepatic and renal toxicity at a higher dose. Naringin, a bioflavonoid possesses multiple pharmacological properties such as antioxidant, anti-inflammatory, analgesic and anti-hyperlipidemic activity. OBJECTIVE: To evaluate the effect of naringin against the APAP-induced hepatic and renal toxicity. MATERIALS AND METHODS: Male Wistar albino rats (180-220 g) were divided into various groups, and toxicity was induced by APAP (700 mg/kg, p.o., 14 days). Naringin (20, 40 and 80 mg/kg, p.o.) or Silymarin (25 mg/kg) was administered to rats 2 h before APAP oral administration. Various biochemical, molecular and histopathological parameter were accessed in hepatic and renal tissue. RESULTS: Naringin pretreatment significantly decreased (p < 0.05) serum creatinine, blood urea nitrogen, bilirubin, aspartate transaminase, alanine transaminase, lactate dehydrogenase, low-density lipoprotein, very low-density lipoprotein, cholesterol and triglycerides as compared with APAP control rats. Decreased level of serum albumin, uric acid, and high-density lipoprotein were also significantly restored (p < 0.05) by naringin pretreatment. It also significantly restores (p < 0.05) the altered level of superoxide dismutase, reduced glutathione, malondialdehyde and nitric oxide in hepatic and renal tissue. Moreover, altered mRNA expression of hepatic farnesoid X receptor and renal injury molecule-1 (KIM-1) were significantly restored (p < 0.05) by naringin treatment. Naringin treatment also reduced histological alteration induced by APAP in the liver and kidney. CONCLUSION: Naringin exerts its hepato- and nephroprotective effect via modulation of oxido-nitrosative stress, FXR and KIM-1 mRNA expression.

Naringin ameliorates sodium arsenite-induced renal and hepatic toxicity in rats: decisive role of KIM-1, Caspase-3, TGF-ß, and TNF-α.

Chronic exposure of a naturally occurring metal arsenic leads to renal and hepatic diseases. Naringin, a flavanone glycoside, possesses anti-inflammatory and anti-oxidant potential. The aim of this investigation was to evaluate the protective effect of naringin against arsenic-induced renal and hepatic toxicity in rats. Renal and hepatic toxicity was induced in rats by sodium arsenite (5 mg/kg, p.o.). Rats were treated orally with either vehicle or naringin (20, 40, and 80 mg/kg) or Coenzyme Q10 (10 mg/kg) for 28 days. Various biochemical, histological, and molecular biomarkers were assessed in kidney and liver. Treatment with naringin (40 and 80 mg/kg) significantly and dose-dependently restored (p < 0.01 and p < 0.001) altered levels of kidney (serum creatinine, urine creatinine, BUN, uric acid, and creatinine clearance) and liver function test (AST and ALT) induced by sodium arsenite. Elevated levels of oxido-nitrosative stress in renal and hepatic tissue was significantly and dose-dependently decreased (p < 0.01 and p < 0.001) by naringin (40 and 80 mg/kg) treatment. It significantly and dose-dependently down-regulated (p < 0.01 and p < 0.001) renal KIM-1, Caspase-3, TGF-ß, and TNF-α mRNA expression. Histopathological alteration induced in kidney and liver by sodium arsenite was reduced by naringin (40 and 80 mg/kg) treatment. In conclusion, naringin treatment ameliorates arsenic-induced renal and hepatic damage in rats due its antioxidant and anti-inflammatory properties via down-regulation of elevated oxido-nitrosative stress, KIM-1, Caspase-3, TGF-ß, and TNF-α levels.

Investigation of VEGF (rs 699947) polymorphism in the progression of Rheumatoid Arthritis (RA) and in-silico nanoparticle drug delivery of potential phytochemicals to cure RA.

Mutation in the VEGF gene disturbs the production of chondrocytes and angiogenesis which are essential for cartilage health. Cytokines and chemokines produced by auto-activation of B-cells degrade cartilage. Bruton's Tyrosine Kinase (BTK) plays a crucial role in the activation of these B-cells. VEGF has a central part in angiogenesis, in the recruitment of endothelial cells, and is involved in mechanisms that result in tumour formation. The objective of this research is to investigate the potential role of VEGF polymorphism in the development of Rheumatoid Arthritis (RA) and the screening of potential natural, synthetic BTK inhibitor compounds as possible in-silico chemotherapeutic agents to control auto-activation of B-cells and cartilage degrading cytokines. In this study, it had been shown that allele A frequency was significantly higher than that of allele C in RA-positive patients as compared to controls. Hence it depicts that allele A of VEGF (rs699947) can increase the risk of RA while allele C has a protective role. The phytochemicals which showed maximum binding affinity at the inhibitory site of BTK include beta boswellic acid, tanshinone, and baicalin. These phytochemicals as BTK inhibitor give insights to use them as anti-arthritic compounds by nanoparticle drug delivery mechanism.

Disseminated Cysticercosis Masquerading as Mucocutaneous Nodules.

Cysticercus cellulosae is the larval form of the pork tapeworm, Taenia solium. It can be transmitted to humans through food and water contaminated with eggs. The cysticerci formed are spread through the intestinal wall and are carried by the blood stream to muscles, brain, and subcutaneous tissues, leading to clinical manifestations. Rarely, disseminated cysticercosis is observed. We present a case of an asymptomatic disseminated cysticercosis in a 55-year-old man who presented with multiple subcutaneous nodules over the body for 1 year. A nodule was also present over the dorsum of the tongue. No systemic symptoms were associated. The diagnosis was made based on histopathology which revealed cystic lesions with larvae. Ultrasonography showed a cystic cavity with a scolex. On further investigations, involvement of the brain and thyroid gland were revealed. A high index of suspicion with appropriate investigations is required in such cases in endemic areas. Also, this raises the importance of thorough investigations, which should be performed to rule out disseminated disease even in the absence of systemic symptoms.

Theoretical investigation of hybrid nanomaterials transient flow through variable feature of Darcy-Forchheimer space with exponential heat source and slip condition.

Nanomaterials have achieved remarkable importance in cooling small electronic gadgets like akin and microchips devices. The role of nanoparticles is essential in various aspects, especially in biomedical engineering. Thus hybrid nanomaterials is introduced to strengthen the heat exchangers' performance. In view of the above practical and existing applications of nanomaterials. Our aim is to examine the consequences of Darcy-Forchheimer's radiative and Hall current flow of nanomaterials over a rotating porous disk with variable characteristics. Stretching disk accounting for the slip condition. Nanoparticles ZnO and CoF2O4 are dispersed in based fluid water. The present model is utilized for thermo-physical attributes of hybrid nanomaterials with the impact of shape factor. Transformations convert the modeled PDEs into ODEs. The obtained highly non-linear system is tackled numerically by the NDSolve technique through the software Mathematica. The outcomes of significant variables against different profiles are executed and elaborated in detail. Obtained results show that both nano and hybrid nanofluid radial velocity have reverse behavior against variable porosity and permeability parameters, whereas it decays for larger Forchheimer numbers. Further, it is worthy to point out that, hybrid nanophase has a higher impact on distinct profiles when compared with nano and common liquid phases.

Risk factors and outcomes associated with diabetes mellitus in COVID-19 patients: a meta-analytic synthesis of observational studies.

Purpose: We carried out a meta-analytic synthesis to evaluate the association between diabetes mellitus (DM) and related clinical outcomes, co-morbidities, their risk factors and resource utilization in patients with COVID-19. Methods: The MEDLINE and Web of Science databases were reviewed for identification of eligible studies. Meta-analysis was carried out using Review Manager 5.3. The random- effects model was used to compute the pooled estimates of odds ratio (OR)/mean difference and 95% confidence interval (CI). Results: A total of 14 studies including 3,644 individuals without DM and 1,428 with DM were included in the meta-analysis. Cardiovascular diseases (CVDs) [OR 2.91, 95% CI 2.34, 3.63], hypertension [OR 2.19, 95% CI 1.39, 3.46], acute kidney injury (AKI) [OR 3.59, 95% CI 1.46, 8.84], cerebrovascular disease [OR 2.09, 95% CI 1.22, 3.61], and acute respiratory distress syndrome (ARDS) [OR 3.40, 95% CI 2.09, 5.55] were significantly associated with DM in COVID-19 patients compared with non-DM patients (p < 0.05 for all instances). Mortality was significantly higher among COVID-19 patients with DM [OR 2.46, 95% CI 1.68, 3.58]. Intensive Care Unit (ICU) admission and use of mechanical ventilation were significantly associated with COVID-19 patients with DM [OR 2.79, 95% CI 1.79, 4.34], and [OR 3.33, 95% CI 2.05, 5.42], respectively. No significant difference was observed in the length of stay (LOS) and hospitalization. Conclusions: This meta-analysis shows that CVDs, hypertension, AKI, cerebrovascular disease, and ARDS are significantly higher among DM patients with COVID-19 compared with non-DM patients. Mortality, ICU admission and the use of mechanical ventilation were significantly associated with COVID-19 patients with DM. Further long-term, multinational and large sample size clinical studies are warranted to justify the current findings.

Simulation of hybridized nanofluids flowing and heat transfer enhancement via 3-D vertical heated plate using finite element technique.

The present study probed the creation of heat energy and concentrating into Newtonian liquids across vertical 3D-heated plates. The role of the Soret and Dufour theories in concentrating and energy formulas is discussed. The role of hybrid nanoparticles is introduced to illustrate particle efficiency in terms of solute and thermal energy. It is removed a viscous dissipation process and a changing magnetic field. The proposed approach is motivated by the need to maximize solute and thermal energy uses in biological and industrial domains. The constructed system of (partial differential equations) PDEs includes concentration, momentum, and thermal energy equations within various thermal characteristics. Transformations are used to formulate the system of (ordinary differential equations) ODEs for solution. To assess various features vs various variables, a Galerkin finite element approach is used. Motion into nanoscale components is shown to be smaller than motion into hybrid nanoparticles. Furthermore, fluctuations in heat energy and solute particle counts are seen in relation to changes in Soret, Eckert, magnetic, and Dufour numbers. The basic finding is that the generation of thermal energy for hybridized nanomaterials is much higher.

Investigating the Retrofitting Effect of Fiber-Reinforced Plastic and Steel Mesh Casting on Unreinforced Masonry Walls.

Unreinforced masonry (URM) is one of the most popular construction materials around the world, but vulnerable during earthquakes. Due to its brittle nature, the URM structures may lead to a possible collapse of the wall of a building during earthquake events causing casualties. In the current research, an attempt is made to enhance the seismic capacity of URM structures by proposing a new innovative composite material that can improve the shear strength and deformation capacity of the URM wall systems. The results revealed that the fiber-reinforced plastic having high tensile and shear stiffness can significantly increase in-plane as well as out-of-plane bending strength of the URM wall. It was recorded that the bending moment of the prism increased up to 549.5% by increasing the bending moment from 490 N*mm to 3183 N*mm per mm deflection of prism upon using glass fibers. Moreover, the ductility ratio amplified up to 5.73 times while the stiffness ratio increased up to 4.16 times with the aid of glass fibers. Since the material used in this research work is low cost, easily available, and no need for any skilled labor, which is economically good. Therefore, the URM walls retrofitted with fiber-reinforced plastic is an economical solution.

Solar energy optimization in solar-HVAC using Sutterby hybrid nanofluid with Smoluchowski temperature conditions: a solar thermal application.

In solar heating, ventilation, and air conditioning (HVAC), communications are designed to create new 3D mathematical models that address the flow of rotating Sutterby hybrid nanofluids exposed to slippery and expandable seats. The heat transmission investigation included effects such as copper and graphene oxide nanoparticles, as well as thermal radiative fluxing. The activation energy effect was used to investigate mass transfer with fluid concentration. The boundary constraints utilized were Maxwell speed and Smoluchowksi temperature slippage. With the utilization of fitting changes, partial differential equations (PDEs) for impetus, energy, and concentricity can be decreased to ordinary differential equations (ODEs). To address dimensionless ODEs, MATLAB's Keller box numerical technique was employed. Graphene oxide Copper/engine oil (GO-Cu/EO) is taken into consideration to address the performance analysis of the current study. Physical attributes, for example, surface drag coefficient, heat move, and mass exchange are mathematically processed and shown as tables and figures when numerous diverse factors are varied. The temperature field is enhanced by an increase in the volume fraction of copper and graphene oxide nanoparticles, while the mass fraction field is enhanced by an increase in activation energy.

Longitudinally extensive transverse myelitis and Hepatitis C-a case report and literature review.

Tractopathy lesions in the spinal cord associated with HCV infection, which normalized on MRI after antiviral treatment, are described. These specific MRI findings can be used in the diagnosis and treatment of secondary causes of transverse myelitis.

Comparison of efficacy and safety of 30% hydrogen peroxide with 50% trichloroacetic acid in seborrheic keratosis: a randomized controlled study.

BACKGROUND: Seborrheic keratosis is a benign skin tumour. None of the common therapies is satisfactory. This study compared the efficacy of 30% hydrogen peroxide versus 50% trichloroacetic acid in treatment of seborrheic keratoses. METHODS: This unblinded, comparative interventional study was conducted on 85 patients of seborrheic keratosis. Lesions were graded using physician's lesion assessment (PLA) scale (0, clear; 1, nearly clear; 2≤1 mm thick; 3≥1 mm thick). Patients were randomly assigned into two groups: A and B. Five target seborrheic keratosis lesions with PLA score of three were selected in each patient. Group A was treated with 30% hydrogen peroxide and group B with 50% trichloroacetic acid. Both groups received treatment every week up to 5 weeks or till complete resolution of lesions. Clinical photographs of all patients were taken every 2 weeks. RESULTS: Both the groups were comparable in terms of age and sex. At the end of 6 weeks, lesions were cleared completely in 41.8% of patients in group A and in 23.8% in group B. Mean PLA score decreased significantly in group A from 3 to 1.79 (40.3%) at 2 weeks and to 0.63 (79%) at 6 weeks (P<0.001). The decrease in PLA score in group B was 2.41 (19.7%) and 1.13 (62.3%) at 2, and 6 weeks respectively (P<0.001). Hydrogen peroxide produced greater clearance of seborrheic keratosis (P=0.017) than trichloroacetic acid. Also, no major adverse effects were observed in the two groups. CONCLUSIONS: Application of 30% hydrogen peroxide appears to be more efficacious as compared to trichloroacetic acid (50%) for treatment of seborrheic keratosis.

Improving the safety of intravenous iron treatments for patients with chronic kidney disease.

Introduction: Iron-deficiency anemia in chronic kidney disease (CKD) is common and has prognostic, financial, and quality of life implications. Intravenous (IV) iron is a key intervention for optimal management, however, ongoing safety concerns exist. Area covered: The potential side effects associated with IV iron use are addressed as we review the most recent studies. Hypersensitivity reactions and true anaphylaxis are indeed rare with a greater understanding of the nature of labile iron and 'Fishbane' reactions. Hypophosphatemia appears commoner with certain IV iron preparations, however its significance in CKD requires exploration. The long-standing questions regarding oxidative stress and the potential susceptibility to infections and worsening cardiovascular morbidity are discussed. Iron overload secondary to repeat IV iron infusions is plausible, however, a number of guidelines limit and strictly guide prescription. Expert opinion: The past decade has improved our understanding of IV iron administration safety in patients with CKD. Third generation IV iron compounds have minimized hypersensitivity reactions while allowing high doses to be administered safely and rapidly in non-dialysis-dependent CKD patients. However, differences in safety profiles such as hypophosphatemia require further study and therapy should be tailored to the individual. Clinicians should feel confident in using IV iron therapy.