ABSTRACT
The segetal flora of winter crops includes mostly native or archaeophyte annual species that are often strong specialists of their habitats. Threatened by the intensification of agriculture, segetal flora is particularly valuable from a perspective of biodiversity conservation and evolution. Moreover, it contributes to maintain biodiversity in agroecosystems and provides several ecosystem services. The dataset here described was set up to provide the first inventory of the segetal flora of Italian winter cereal crops and allied crop types, the latter including flax and autumn-sown legumes. It includes 24,676 georeferenced occurrence data deriving from 1,240 floristic and phytosociological relevés. The data were collected from the greater part of Italian territory, in a temporal range spanning from 1946 to 2018.
ABSTRACT
BACKGROUND: Real-life data on the use of R2 MRI for the assessment of liver iron concentration (LIC) remain limited. METHODS: We conducted a cross-sectional analysis on 363 patients (mean age 35.6 yr, 44.1% men) with hemoglobinopathies (204 ß-thalassemia major [TM], 102 ß-thalassemia intermedia [TI], and 57 sickle cell disease [SCD]) that were evaluated with R2 MRI as part of LICNET, an MRI network of 13 Italian treatment centers. RESULTS: The mean LIC was 7.8 mg/g (median: 4.0), with high LIC (>7 mg/g) noted in both transfused (TM, TI 37%; SCD 38%) and non-transfused (TI 20%) patients. Ferritin levels correlated with LIC in both transfused (TM, TI, SCD) and non-transfused (TI) patients (P < 0.001), although lower values predicted high LIC in non-transfused patients (1900 vs. 650 ng/mL in TM vs. non-transfused TI). A correlation between LIC and ALT levels was only noted in HCV-negative patients (rs = 0.316, P < 0.001). The proportion of patients with high LIC was significantly different between iron chelators used (P = 0.023), with the lowest proportion in deferasirox (30%) and highest in deferiprone (53%)-treated patients. CONCLUSIONS: High LIC values persist in subgroups of patients with hemoglobinopathy, warranting closer monitoring and management optimization, even for non-transfused patients with relatively low ferritin levels.
Subject(s)
Hemoglobinopathies/complications , Iron Overload/diagnosis , Iron Overload/etiology , Iron/metabolism , Liver/metabolism , Liver/pathology , Magnetic Resonance Imaging , Adolescent , Adult , Aged , Alanine Transaminase/blood , Biomarkers , Child , Comorbidity , Cross-Sectional Studies , Female , Ferritins/blood , Hemoglobinopathies/diagnosis , Humans , Iron Chelating Agents/therapeutic use , Iron Overload/drug therapy , Magnetic Resonance Imaging/methods , Male , Middle Aged , Young AdultABSTRACT
A 34 year-old female thalassaemia major patient regularly followed in our Thalassaemia Centre was diagnosed at 16 years of age with primary amenorrhea. The endocrine investigations were compatible with hypogonadotropic hypogonadism. Puberty was induced with oral oestrogens and progesterone, followed by transdermal hormone replacement therapy. She had initiated regular blood transfusions at 8 months of age and iron chelation therapy with desferioxamine at the age of 2 years, and in 2006 she was switched to treatment with the oral iron chelator deferasirox (DFX). In November 2009, the patient reported a temporary interruption of transdermal hormone replacement therapy during the previous July and August, and complained of the absence of menstrual flow since then. We suspected a pregnancy that was confirmed by pelvic ultrasound (presence of a fetus of 20 weeks' gestational age) and positive plasma b-hCG levels (14000 mIU/ ml). DFX was immediately discontinued and the patient was managed jointly with an obstetrician expert in haemoglobin disorders. In March 2010 she delivered via caesarean section, at 38 weeks of gestation, a male neonate with a weight of 3.300 Kg with no complications or malformations. The main messages from this patient are that: (i) the hypogonadotropic hypogonadism, secondary to iron overload, may be reversible, (ii) transdermal hormone replacement therapy and regular iron chelation therapy may have had a synergistic action on the activation of hypothalamic-pituitary-gonadal axis, (iii) the deferasirox treatment during pregnancy may be harmless for the fetus at the usually recommended therapeutic doses, (iv) periodic patient education is needed in order to fully explain the aim and the effects of sex steroid hormone replacement therapy given transdermally. The Authors discuss the current knowledge on iron chelation therapy during pregnancy.