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1.
Rev Med Liege ; 75(1): 23-28, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31920040

RESUMO

Anemia and iron deficiency are two common comorbidities in heart failure with reduced ejection fraction (HFrEF) and are associated with a poor prognosis. In contrast to iron oral supplementation, administration of intravenous ferric carboxymaltose (Injectafer®) improves quality of life, exercise capacity, and seems to reduce hospitalizations for heart failure. Unfortunately, although anaphylactic reactions are extremely rare, it is recommended to administer Injectafer® in a suitable medical environment. This limitation hinders Injectafer® administration and may cause reluctance from both physician and patient. The aim of this article is to optimize and harmonize management of iron deficiency in heart failure, by proposing a simple solution for the patient and the practitioner.


Assuntos
Anemia Ferropriva , Insuficiência Cardíaca , Ferro , Anemia Ferropriva/complicações , Anemia Ferropriva/tratamento farmacológico , Insuficiência Cardíaca/complicações , Humanos , Ferro/uso terapêutico , Qualidade de Vida , Volume Sistólico
4.
Postgrad Med ; 131(8): 612-618, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31524033

RESUMO

Objectives: The objective of this study was to assess the diagnosis and management of anemic patients in free clinics around the Tampa Bay area.Methods: In this retrospective study we extracted data including demographics, chronic diseases, and laboratory values from medical charts of uninsured patients seen in 9 free clinics from January 2016 through December 2017 in the Tampa Bay area, FL, USA. Multiple logistic regression analysis was used to assess relationships between socioeconomic variables and a documented history of anemia.Results: From two years of documented data, 6971 patients were included, of which 367 (5%) had a documented diagnosis of anemia. Most were women (315, 86%), and the median age was 41 years (6-91). Among the 367 patients with anemia,191 (52%) patients had an unspecified type of anemia, 144 (39%) were diagnosed with IDA, 16 (4%) with anemia of chronic disease, and the remaining were other uncommon causes. Only 67% (97/144) of IDA patients had documented iron replacement. Colonoscopies were documented in only 32 (9%) of all patients with anemia, and in 23 (16%) IDA patients. Several chronic diseases were statistically associated and comorbid with a diagnosis of anemia.Conclusions: Uninsured patients with IDA are prescribed iron and undergo colonoscopies at sub-optimal rates. Increasing resources, awareness, and education of providers in these settings could lead to improved treatment practices and decrease the risk of morbidity and mortality.


Assuntos
Anemia/epidemiologia , Doença Crônica/epidemiologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Provedores de Redes de Segurança/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/epidemiologia , Criança , Colonoscopia/estatística & dados numéricos , Feminino , Florida/epidemiologia , Comportamentos Relacionados com a Saúde , Disparidades nos Níveis de Saúde , Humanos , Ferro/uso terapêutico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto Jovem
5.
Int J Mol Sci ; 20(18)2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31487938

RESUMO

To evaluate the iron ion release profile of zero-valent iron (ZVI)-based nanoparticles (NPs) and their relationship with lysosomes in cancer cells, silica and mesoporous silica-coated ZVI NPs (denoted as ZVI@SiO2 and ZVI@mSiO2) were synthesized and characterized for the following study of cytotoxicity, intracellular iron ion release, and their underlying mechanisms. ZVI@mSiO2 NPs showed higher cytotoxicity than ZVI@SiO2 NPs in the OEC-M1 oral cancer cell line. In addition, internalized ZVI@mSiO2 NPs deformed into hollow and void structures within the cells after a 24-h treatment, but ZVI@SiO2 NPs remained intact after internalization. The intracellular iron ion release profile was also accordant with the structural deformation of ZVI@mSiO2 NPs. Burst iron ion release occurred in ZVI@mSiO2-treated cells within an hour with increased lysosome membrane permeability, which induced massive reactive oxygen species generation followed by necrotic and apoptotic cell death. Furthermore, inhibition of endosome-lysosome system acidification successfully compromised burst iron ion release, thereby reversing the cell fate. An in vivo test also showed a promising anticancer effect of ZVI@mSiO2 NPs without significant weight loss. In conclusion, we demonstrated the anticancer property of ZVI@mSiO2 NPs as well as the iron ion release profile in time course within cells, which is highly associated with the surface coating of ZVI NPs and lysosomal acidification.


Assuntos
Ferro/uso terapêutico , Nanopartículas Metálicas/efeitos adversos , Neoplasias Experimentais/tratamento farmacológico , Animais , Apoptose , Linhagem Celular Tumoral , Células Cultivadas , Liberação Controlada de Fármacos , Humanos , Ferro/farmacologia , Lisossomos/efeitos dos fármacos , Lisossomos/metabolismo , Masculino , Nanopartículas Metálicas/química , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Espécies Reativas de Oxigênio/metabolismo , Dióxido de Silício/química
6.
N Z Med J ; 132(1499): 72-75, 2019 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-31352477

RESUMO

Iron-induced hypophosphatemia represents an increasingly recognised complication of iron infusion. A 34-year-old woman presented for surgical management of her colorectal cancer. Post-operative blood tests revealed severe hypophosphatemia, resistant to oral phosphate supplementation and large volumes of intravenous phosphate replacement. Further questioning and biochemical investigation led to the recognition of iron-induced hypophosphatemia as a contributory cause, secondary to iron infusion administered as part of pre-operative optimisation. Early consideration, diagnosis and management of this complication has the potential to reduce fluid burden associated with intravenous phosphate supplementation and optimise post-operative care.


Assuntos
Cirurgia Colorretal , Hipofosfatemia/induzido quimicamente , Ferro/efeitos adversos , Adulto , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Calcitriol/uso terapêutico , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Feminino , Humanos , Hipofosfatemia/tratamento farmacológico , Ferro/uso terapêutico , Vitamina D/análogos & derivados , Vitamina D/uso terapêutico
7.
Blood Purif ; 48(2): 158-166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31311016

RESUMO

BACKGROUND: Transferrin saturation (TSAT) is an index that represents the iron-binding capacity of transferrin, which is the main transport protein for iron, and is widely used to evaluate iron status. OBJECTIVE: To evaluate the prognostic importance of TSAT in Japanese patients on maintenance hemodialysis (MHD). METHODS: A total of 398 patients on MHD were recruited and divided into 3 groups on the basis of their baseline TSAT levels (<20, 20-40, and >40%). RESULTS: There was no difference in the proportion of patients on erythropoiesis-stimulating agents or iron supplements between the 3 groups. During a mean follow-up period of 52.2 ± 1 6.3 months, 130 patients died of cardiovascular causes (n = 63, 15.8%) or infection (n = 47, 11.8%). Compared with the reference group (TSAT 20-40%), patients with a TSAT <20% had a significantly higher all-cause mortality rate (6.44 vs. 9.55 events per 100 patient-years, p = 0.0452). Kaplan-Meier analysis showed that all-cause mortality rate was significantly higher in patients with TSAT <20% than in the other 2 groups (p = 0.0353). CONCLUSIONS: Low TSAT was a significant independent risk factor for all-cause mortality in a cohort of Japanese patients on MHD. The findings of this study suggest that the adverse clinical outcomes in patients with low TSAT can be partly attributed to infection-related iron deficiency.


Assuntos
Falência Renal Crônica/terapia , Diálise Renal , Transferrina/análise , Idoso , Doenças Cardiovasculares/mortalidade , Feminino , Hematínicos/uso terapêutico , Humanos , Ferro/uso terapêutico , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Diálise Renal/mortalidade
8.
Dtsch Med Wochenschr ; 144(14): 969-977, 2019 07.
Artigo em Alemão | MEDLINE | ID: mdl-31311047

RESUMO

In recent years, considerable progress has been made in the detection and treatment of iron deficiency. The results are also relevant for many specialist areas and, in particular, for patients with chronic inflammatory diseases. In daily practice, iron deficiency is often neither identified nor consistently treated.An iron deficiency can - even before anaemia occurs - reduce the quality of life and influence the course of the underlying disease. In patients with chronic diseases , the iron status should be monitored regularly. Especially, the currently available oral iron preparations for these patients are inefficient, because of the limitated tolerability and, furthermore, because of restricted enteral iron uptake due to inflammation. For this reason, various guidelines recommend intravenous iron substitution.


Assuntos
Anemia Ferropriva , Doença Crônica , Inflamação , Ferro , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Humanos , Inflamação/complicações , Inflamação/fisiopatologia , Ferro/administração & dosagem , Ferro/uso terapêutico , Qualidade de Vida
9.
Transfus Apher Sci ; 58(4): 416-421, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31281092

RESUMO

Anemia in elderly (AE), though often mild, is quite common and independently associated with important clinical outcomes, including decreased quality of life, risk of falls and fractures, cognitive decline, increased length of hospital stay, and even mortality. AE is generally overlooked, and hence undertreated, especially when comorbidities distract the attention of physicians and caregivers. This also partially reflects difficulties in dissecting the cause(s) of AE, which is typically multifactorial, as well as our limited diagnostic approach often categorizing AE as apparently "unexplained". Therapeutic approaches have been traditionally limited to transfusions, or supplementation with hematinics, including group B vitamins and iron. The latter has been largely underutilized, because of missing diagnosis of iron deficiency using inappropriate laboratory thresholds, as well as complex schedule and adverse effects associated with traditional preparations. After decades of stagnation, new oral and intravenous iron preparations look promising, particularly in the elderly. Moreover, a number of innovative anti-anemic drugs, like hepcidin modulators, Hypoxia Inducible Factor (HIF) stabilizers, and activin type II receptor agonists are entering the clinical arena and may substantially improve our therapeutic armamentarium to AE in the near future.


Assuntos
Anemia , Serviços de Saúde para Idosos , Hematínicos/uso terapêutico , Distúrbios do Metabolismo do Ferro , Ferro , Administração Intravenosa , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/tratamento farmacológico , Humanos , Ferro/deficiência , Ferro/uso terapêutico , Distúrbios do Metabolismo do Ferro/sangue , Distúrbios do Metabolismo do Ferro/tratamento farmacológico
10.
BMJ Case Rep ; 12(5)2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31147407

RESUMO

A 50-year-old woman presented with worsening fatigue and shortness of breath. For 2 months, she has been having increased craving for unpeeled lemons and was seen in clinic about a month prior to presentation at the emergency room. At that time, she was asymptomatic except for endorsing craving for lemons. Physical exam findings at presentation noted obesity, sinus tachycardia, pallor, mild scleral jaundice and no other stigmata for chronic liver disease. Her labs suggested iron-deficiency anaemia (IDA), elevated liver enzymes and positive antimitochondrial antibody titre. Abdominal ultrasound and CT scan showed mild scarring. She was diagnosed with primary biliary cholangitis with portal hypertension complicated by oesophageal varices and IDA. Interventions included blood transfusion, oesophageal banding and treatment with ursodeoxycholic acid. Her craving for lemons, shortness of breath and fatigue resolved within 1 week. With ongoing outpatient follow-up and oesophageal variceal surveillance, she continues to do well.


Assuntos
Anemia Ferropriva/diagnóstico , Varizes Esofágicas e Gástricas/diagnóstico , Hipertensão Portal/diagnóstico , Cirrose Hepática Biliar/diagnóstico , Pica , Administração Oral , Anemia Ferropriva/sangue , Anemia Ferropriva/complicações , Anemia Ferropriva/tratamento farmacológico , Transfusão de Sangue , Colagogos e Coleréticos/administração & dosagem , Colagogos e Coleréticos/uso terapêutico , Diagnóstico Diferencial , Procedimentos Cirúrgicos do Sistema Digestório , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Varizes Esofágicas e Gástricas/cirurgia , Feminino , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico por imagem , Hipertensão Portal/terapia , Ferro/administração & dosagem , Ferro/uso terapêutico , Cirrose Hepática Biliar/complicações , Cirrose Hepática Biliar/diagnóstico por imagem , Cirrose Hepática Biliar/terapia , Pessoa de Meia-Idade , Ultrassonografia , Ácido Ursodesoxicólico/administração & dosagem , Ácido Ursodesoxicólico/uso terapêutico
11.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(6): 662-665, 2019 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-31197989

RESUMO

Objective : To investigate the effectiveness of recombinant human erythropoietin (rHuEPO) combined with iron in treatment of anemia in elderly patients with intertrochanteric fractures during perioperative period. Methods: A clinical data of 71 patients with intertrochanteric fractures met the inclusion criteria between April 2016 and October 2017 was retrospectively analyzed. All patients were treated with closed reduction and proximal femoral intramedullary nail fixation. Thirty-one patients were treated with rHuEPO and iron before operation as trial group, and 40 patients were not treated with rHuEPO and iron as control group. There was no significant difference in gender, age, body mass index, cause of injury, fracture side and classification, American Society of Anesthesiologists (ASA) classification, combined medical diseases, time from fracture to admission, preoperative hospital stay, and operation time between the two groups ( P>0.05).The hemoglobin levels before operation and at 1, 3, and 7 days after operation, number of blood transfusion, blood transfusion rate, blood transfusion volume, postoperative hospital stay, complications were recorded and compared. Results: After operation, 8 patients (25.8%) in trial group and 22 patients (55.0%) in control group received blood transfusion; the blood transfusion volume was (1.96±0.85) units in trial group and (3.19±1.61) units in control group. There were significant differences in blood transfusion rate and volume between the two groups ( P<0.05). There was no significant difference in preoperative hemoglobin level between the two groups ( P>0.05). The postoperative hemoglobin level was higher in trial group than in control group, and the difference between the two groups was significant at 7 days ( P<0.05). The postoperative hospital stay was (6.16±3.97) days in trial group and (9.25±4.47) days in control group, showing significant difference between the two groups ( P<0.05). There were 8 patients (25.8%) with pulmonary infection in trial group and 14 (35.0%) in control group after operation; 6 patients (19.4%) with deep venous thrombosis in trial group and 8 (20.0%) in control group. There was no significant difference in the incidences of complications between the two groups ( P>0.05). All patients were discharged from hospital normally, and no one died during hospitalization. Conclusion: The application of rHuEPO combined with iron before operation in elderly patients with intertrochanteric fractures can rapidly increase the hemoglobin level after operation, shorten the hospital stay, and do not increase the risk of deep venous thrombosis after operation.


Assuntos
Anemia , Eritropoetina , Fraturas do Quadril , Ferro , Idoso , Anemia/etiologia , Anemia/terapia , Eritropoetina/uso terapêutico , Fraturas do Quadril/complicações , Humanos , Ferro/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
12.
World Neurosurg ; 130: e566-e572, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31254701

RESUMO

OBJECTIVE: Patient blood management (PBM) is defined as treatment of a patient who is at risk of transfusion to minimize the need for transfusion and improve the probability of an optimal clinical outcome. We performed the present study to examine the effects of PBM in spinal fusion surgery. METHODS: A total of 154 patients who had undergone 1- and 2-level posterior lumbar interbody fusion for degenerative lumbar disease were included. We retrospectively reviewed the data from 101 patients from 2012 to 2016 as the pre-PBM group. We recruited 53 patients from 2017 to 2018 for the post-PBM group. Intravenous iron was administered 2-4 weeks before surgery, and intravenous tranexamic acid was administered intraoperatively in the post-PBM group. The primary outcome was the reduction of hemoglobin (Hb). The secondary outcomes included perioperative blood loss, Hemovac drain output, postoperative transfusion, complications, and length of hospital stay. RESULTS: Intravenous iron was administered 17.4 days before surgery in the post-PBM group. The reduction in Hb was not significantly different statistically between the 2 groups (3.06 vs. 3.33 g/dL; P > 0.05). Of the 101 patients in the pre-PBM group, 24 (24%) underwent transfusion. In contrast, no patient in the post-PBM group had required a transfusion (P < 0.001). The average hospital stay was 10.15 days in the pre-PBM group and 8.33 days in the post-PBM group (P = 0.02). The average operative time was 146 minutes in the pre-PBM group and 133 minutes in the post-PBM group (P = 0.03). The Hb decrease and total Hemovac drain output did not differ significantly between the 2 groups. CONCLUSIONS: Implementation of PBM is an effective strategy for reducing the rate of transfusion in patients undergoing lumbar spinal fusion surgery without significant complications.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Ferro/uso terapêutico , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Idoso , Transfusão de Sangue , Feminino , Humanos , Infusões Intravenosas , Degeneração do Disco Intervertebral/cirurgia , Ferro/administração & dosagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
13.
Yale J Biol Med ; 92(2): 201-204, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31249480

RESUMO

We present a totally blind adolescent with refractory insomnia due to a combination of Non-24 hour sleep-wake disorder and restless leg syndrome that was successfully treated with tasimelteon, iron replacement, and gabapentin. To our knowledge, this is the first published report of treatment of N24 with tasimelteon in an adolescent. In addition, this case highlights the importance of recognizing and treating multifactorial causes of insomnia.


Assuntos
Cegueira/complicações , Síndrome das Pernas Inquietas/complicações , Transtornos do Sono do Ritmo Circadiano/tratamento farmacológico , Distúrbios do Início e da Manutenção do Sono/complicações , Adolescente , Benzofuranos/administração & dosagem , Benzofuranos/uso terapêutico , Ciclopropanos/administração & dosagem , Ciclopropanos/uso terapêutico , Resistência a Medicamentos , Quimioterapia Combinada , Feminino , Gabapentina/administração & dosagem , Gabapentina/uso terapêutico , Humanos , Ferro/administração & dosagem , Ferro/uso terapêutico , Transtornos do Sono do Ritmo Circadiano/complicações , Transtornos do Sono do Ritmo Circadiano/fisiopatologia
14.
Parasit Vectors ; 12(1): 272, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138327

RESUMO

BACKGROUND: Toltrazuril is frequently administered for the metaphylactic control of piglet cystoisosporosis. In a previous study, the efficacy of parenteral toltrazuril (45 mg/piglet, Group Forceris®) applied on the 2nd day of life (dol), and of oral toltrazuril (20 mg/kg of body weight, Group Baycox®) applied on the 4th dol was evaluated in an experimental model with Cystoisospora suis infection on the 3rd dol (late infection, LI). In a follow-up study, efficacy and safety were evaluated against infections with C. suis on the 1st dol (early infection, EI). Parameters included oocyst excretion and faecal consistency, body weight development, bacteriological examinations and animal health. RESULTS: All control piglets (n = 12) shed oocysts and had diarrhoea, while parasite excretion was completely suppressed in both treatment groups (n = 13 each) and diarrhoea was reduced to a single animal (Forceris® group), resulting in significant differences for these parameters between the treated groups and the controls without significant differences among the treatment groups. No treatment-related adverse events were noted. Body weight gain was reduced in the control group during the acute phase of infection, resulting in significantly lower body weight on the 15th dol. Sows and piglets shed high numbers of Escherichia coli. Clostridium perfringens type A was only detected in low amounts in pooled litter samples. In comparison to the LI study oocyst shedding was more intense in the control animals in EI, while diarrhea was more frequent in LI. In both infection models a high efficacy of toltrazuril in the control of parasitological and clinical outcomes of experimental C. suis infection could be demonstrated. Since in the LI study high numbers of Cl. perfringens type A were detected, it is hypothesized that colonization with these opportunistic pathogens has synergistic effects with C. suis and may explain variable clinical outcomes in untreated animals as well as the sporadic occurrence of diarrhea in toltrazuril-treated piglets. CONCLUSIONS: Parenteral and oral toltrazuril administered on the 2nd or 4th dol is safe and effective against experimental infections with C. suis on the 1st to 3rd dol. The clinical outcome of experimental infections seems influenced by bacterial coinfections.


Assuntos
Coccidiose/veterinária , Ferro/uso terapêutico , Sarcocystidae/efeitos dos fármacos , Doenças dos Suínos/tratamento farmacológico , Triazinas/uso terapêutico , Administração Oral , Animais , Animais Lactentes , Bactérias/isolamento & purificação , Peso Corporal/efeitos dos fármacos , Coccidiose/tratamento farmacológico , Coinfecção , Modelos Animais de Doenças , Combinação de Medicamentos , Fezes/parasitologia , Feminino , Seguimentos , Injeções Intramusculares , Ferro/administração & dosagem , Oocistos/efeitos dos fármacos , Oocistos/isolamento & purificação , Distribuição Aleatória , Suínos , Doenças dos Suínos/parasitologia , Resultado do Tratamento , Triazinas/administração & dosagem , Triazinas/efeitos adversos , Ganho de Peso
15.
Int J Mol Sci ; 20(10)2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31100837

RESUMO

Ferritin is a spherical iron storage protein composed of 24 subunits and an iron core. Using biomimetic mineralization, magnetic iron oxide can be synthesized in the cavity of ferritin to form magnetoferritin (MFt). MFt, also known as a superparamagnetic protein, is a novel magnetic nanomaterial with good biocompatibility and flexibility for biomedical applications. Recently, it has been demonstrated that MFt had tumor targetability and a peroxidase-like catalytic activity. Thus, MFt, with its many unique properties, provides a powerful platform for tumor diagnosis and therapy. In this review, we discuss the biomimetic synthesis and biomedical applications of MFt.


Assuntos
Apoferritinas/metabolismo , Apoferritinas/uso terapêutico , Ferro/metabolismo , Ferro/uso terapêutico , Óxidos/metabolismo , Óxidos/uso terapêutico , Animais , Fenômenos Biomecânicos , Meios de Contraste , Sistemas de Liberação de Medicamentos , Compostos Férricos , Ferritinas , Humanos , Imagem por Ressonância Magnética , Nanopartículas de Magnetita , Neoplasias/diagnóstico por imagem , Neoplasias/tratamento farmacológico , Neoplasias/patologia
16.
Wien Klin Wochenschr ; 131(19-20): 462-467, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31098837

RESUMO

BACKGROUND: Iron deficiency anemia is common in pregnancy with a prevalence of approximately 16% in Austria; however, international guideline recommendations on screening and subsequent treatment with iron preparations are inconsistent. The aim of this study was to find out how often pregnant women take iron-containing supplements, and who recommended them. As hemoglobin data were available for a sub-group of women, hemoglobin status during pregnancy and associated consumption of iron-containing medications were also recorded. METHODS: This cross-sectional study was conducted at the Mother-Child-Booklet service center of the Styrian Health Insurance Fund in Graz, Austria. A questionnaire containing seven questions was developed. Absolute and relative numbers were determined, and corresponding 95% confidence intervals calculated using bootstrapping techniques. RESULTS: A total of 325 women completed the questionnaire, 11% had been diagnosed with anemia before becoming pregnant, 67% reported taking iron-containing compounds. The women reported taking 45 different products but 61% took 1 of 3 different supplements. Overall, 185 (57%) women had not been diagnosed with anemia before becoming pregnant but reported taking an iron-containing supplement and 89% of the women took supplements on the recommendation of their physician. Of the 202 women whose hemoglobin status was assessed, 92% were found not to be anemic. CONCLUSION: Overall, 67% of pregnant women took iron-containing compounds, irrespective of whether they were deficient in iron. Physicians were generally responsible for advising them to take them. No standardized procedure is available on which to base the decision whether to take iron during pregnancy, even in guidelines. As most guidelines only recommend taking iron supplements in cases of anemia, the high percentage of women taking them in Austria is incomprehensible.


Assuntos
Anemia Ferropriva , Suplementos Nutricionais/estatística & dados numéricos , Ferro/uso terapêutico , Complicações na Gravidez/terapia , Anemia Ferropriva/terapia , Áustria , Estudos Transversais , Feminino , Humanos , Gravidez
17.
Pak J Pharm Sci ; 32(2 (Supplementary)): 765-768, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31103969

RESUMO

Anemia is very common among end stage patients with chronic renal failure (CRF). In this investigation, hematological parameters were examined in patients with end stage chronic renal failure from Khartoum, Sudan. A total of 70 patients and additional 30 healthy subjects were included in the study. All patients were under erythropoietin therapy whereas 42% were using iron supplements. The results showed that about 98% of CRF patients had anemia. Normocytic normochromic anemia was the most common type (94%) while few were suffering from microcytic hypochromic (6%) anemia. Low levels of hemoglobin, red blood cell count, hematocrits, serum iron, serum ferritin, and platelet counts were observed in the patient group compared to healthy controls (P<0.01). However, MCV, MCH and MCHC were not different between the two groups (P > 0.05). Moreover, no significant differences in all hematological parameters between patients with and without iron supplements were observed except for hemoglobin. In conclusion, anemia is common among end stage CRF in Sudan in spite of erythropoietin and iron therapy.


Assuntos
Anemia/etiologia , Ferro/uso terapêutico , Falência Renal Crônica/sangue , Adulto , Anemia/tratamento farmacológico , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Estudos de Casos e Controles , Suplementos Nutricionais , Eritropoetina/uso terapêutico , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Sudão
18.
Chemosphere ; 226: 413-420, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30951935

RESUMO

Cd has high activity and bioavailability and is a poisonous element to plants. As a critical ecosysterm, mangroves are subjected to serious Cd pollution. In this research, the hypothesis was presented that improving Fe bioavailability would alleviate Cd phytotoxicity to Avicennia marina (Forsk.) Vierh. To test this, we examined the effect of four exogenous Fe and three Cd concentrations on A. marina. The results showed that a significant positive correlation excited between moderate exogenous Fe concentration and Cd tolerance of A. marina. Moderate exogenous Fe concentration directly or indirectly promoted the formation of Fe plaque, which immobilised more Cd on the root surface and decreased Cd absorption in roots. Furthermore, an exogenous Fe application increased plant biomass and Fe accumulation in A. marina tissues. This improved the competition between Fe and Cd within the plants. Therefore, an Fe application facilitated a decrease in Cd toxicity within A. marina. Simultaneously, a moderate Fe concentration caused an increase in low-molecular-weight organic acid (LMWOA) secretion from the roots. Meanwhile, Cd can be chelated/complexed by LMWOAs. It also played a crucial role in Cd detoxification in A. marina. In conclusion, Fe application accelerated the growth and enhanced Cd tolerance of A. marina. Therefore, improving Fe bioavailability will protect mangroves from Cd contamination.


Assuntos
Avicennia/efeitos dos fármacos , Cádmio/toxicidade , Ferro/uso terapêutico , Raízes de Plantas/efeitos dos fármacos , Avicennia/química , Ferro/farmacologia , Raízes de Plantas/química
19.
Chemosphere ; 226: 431-438, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30951937

RESUMO

Arsenic (As) contamination of drinking water is a major cause of As toxicity in many parts of the world. A study was conducted to evaluate As removal from water containing 100-700 µg/L of As and As to Fe concentration ratios of 1:5-1:1000 using the coprecipitation process with and without As/Fe adsorption onto granular activated carbon (GAC). Fe concentration required to reduce As concentrations in order to achieve the WHO standard level of 10 µg/L increased exponentially with the increase in initial As concentration. When small amounts of GAC were added to the As/Fe solutions the Fe required to remove these As concentrations reduced drastically. This decline was due to the GAC adsorption of Fe and As, enhancing the removal of these metals through coprecipitation. Predictive regression equations were developed relating the GAC dose requirement to the initial As and Fe concentrations. Zeta potential data revealed that As was adsorbed on the GAC by outer-sphere complexation whereas Fe was adsorbed by inner-sphere complexation reversing the negative charge on GAC to positive values. X-ray diffraction of the GAC samples in the presence of Fe had an additional peak characteristic of ferrihydrite (Fe oxide) compared to that of the GAC sample without Fe. The study showed that incorporating an adsorbent into the coprecipitation process has the advantage of removing As from waters at all concentrations of Fe and As compared to coprecipitation alone which does not remove As to the required levels if Fe concentration is low.


Assuntos
Arsênico/efeitos adversos , Ferro/uso terapêutico , Poluentes Químicos da Água/química , Adsorção , Ferro/farmacologia
20.
BMC Pregnancy Childbirth ; 19(1): 113, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940114

RESUMO

BACKGROUND: Iron-deficiency anemia during pregnancy is an underlying cause of maternal deaths, and reducing risk through routine iron supplementation is a key component of antenatal care (ANC) programs in most low- and middle income countries. Supplementation coverage during pregnancy is estimated from maternal self-reports in population-based household surveys, yet recall bias and social desirability bias lead to errors of unknown magnitude. METHODS: We linked data from household and health facility surveys from 16 countries to estimate input-adjusted coverage of iron supplementation during pregnancy. We assessed the validity of reported receipt of iron supplements in client exit interviews using direct observation as the gold standard across 9 countries with a recent Service Provision Assessment (SPA). Using a sample of 227 women who participated in the Nepal Oil Massage Study (NOMS), we also assessed the validity of self-reported receipt of iron folic acid (IFA) supplements. We used Poisson regression models to explore the association between client and health facility characteristics and agreement of self-reported receipt of iron supplements compared to direct observation. RESULTS: Across the 16 countries, iron supplements were in supply at most of the 9215 sampled health facilities offering ANC services (91%). We estimated that between 48 and 93% of women attended at least one ANC visit at a health facility with iron supplements available. The specificity of recall of receipt of iron supplementation immediately following a visit was 79.3% and the sensitivity was 88.7% for the entire sample. Individual-level accuracy was high (Area under the curve > 0.7) and population bias low (0.75 < inflation factor < 1.25) across all countries. By contrast, in the NOMS sub-study, the accuracy of self-reported receipt of IFA supplements after 1-2 years was poor (sensitivity 86.1%, specificity 34.3%). Adjusted regression analyses indicated that older age and higher level of education were associated with poorer agreement between self-reports and direct observation. CONCLUSIONS: These findings suggest the need for caution when using self-reported measures with an extended recall period. Further validation studies using conditions similar to widely used population-based household surveys are warranted.


Assuntos
Confiabilidade dos Dados , Suplementos Nutricionais/estatística & dados numéricos , Ferro/uso terapêutico , Cuidado Pré-Natal/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Adulto , Feminino , Humanos , Gravidez , Análise de Regressão , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
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