Impact of in-hospital intravenous iron supplementation on red blood cell transfusions: experience from an Internal Medicine Unit.

BACKGROUND: Pharmacological treatment of iron deficiency anaemia can reduce red blood cell (RBC) transfusions. Intravenous iron provides a more effective and quicker correction of iron deficiency anaemia than oral iron, and third-generation high-dose intravenous iron formulations allow the complete correction of iron deficiency with just one or two drug infusions, thus facilitating iron supplementation therapy and reducing transfusion requirement. MATERIAL AND METHODS: In an observational, retrospective study we compared RBC transfusion requirement during hospitalisation and within 3 months of hospital discharge in 88 patients with iron deficiency anaemia treated with high-dose ferric carboxymaltose and in 85 patients treated with ferric gluconate while hospitalised in the Internal Medicine unit of our Institution. RESULTS: Ferric carboxymaltose reduced the number of RBC units given to each transfused patient during hospitalisation (1.81±0.84 vs 2.39±1.49, p=0.011). At hospital discharge, fewer ferric carboxymaltose patients were prescribed home therapy with iron. No differences between treatment groups were observed in the proportion of patients or the number of RBC units transfused within 3 months of discharge. At one month from discharge, however, only 2 ferric carboxymaltose patients had been transfused compared with 7 ferric gluconate patients (p=0.078). Patients transfused post-discharge were more likely to have an underlying malignancy and/or higher serum creatinine concentrations. DISCUSSION: Treatment with ferric carboxymaltose reduced the number of RBC units per transfused patient. Larger studies are required to define risk factors associated with post-discharge transfusion requirement and to establish if home therapy with iron will reduce subsequent transfusions in patients treated with ferric carboxymaltose.

Mining in the Newspapers: Local and Regional Media Representations of Mineral Exploration and Mining in Finland, Germany, and Spain.

The understanding of public debates over mineral exploration and mining largely originates from exceptional situations such as mining accidents of conflicts. Less is known about how mining is portrayed and understood under more conventional settings. What storylines dominate the local day-to-day public debate? This article presents results from a comparative case study focusing on newspaper coverage of mineral exploration and mining in three European countries representing different geological and socio-economic contexts. Newspaper articles from the Geyer-Erzgebirge region in Germany, the Andalusia region in Spain, and Northern Finland are studied. The sample looks into the period between September 2018 and February 2020 and shows that regional newspapers report about mining issues relatively intensively even in the absence of major accidents or other media events causing peaks of attention. The tone of the articles is generally neutral to positive towards mining activities, reflecting the specific local settings, historical experiences, and future expectations. Despite the different contexts of the three countries, there were considerable similarities to the topics highlighted, including common themes of mining revival, mining events and social interaction, history of mining, and damages related to mining. Past, present, and future employment opportunities related directly or indirectly to the mining sector are key storylines. Another recurrent underlying theme is the need to balance environment and safety risks and socio-economic prosperity, typically covered through ordinary disputes among the mining sector, public authorities, regional non-governmental organizations, and local initiatives.