Serum ferritin thresholds for the diagnosis of iron deficiency in pregnancy: a systematic review.

The aim of this review was to understand the landscape of serum ferritin in diagnosing iron deficiency in the aetiology of anaemia in pregnancy. Iron deficiency in pregnancy is a major public health problem leading to the development of anaemia. Reducing the global prevalence of anaemia in women of reproductive age is a 2025 global nutrition target. Bone marrow aspiration is the gold standard test for iron deficiency but requires an invasive procedure; therefore, serum ferritin is the most clinically useful test. We undertook a systematic search of electronic databases and trial registers from inception to January 2016. Studies of iron or micronutrient supplementation in pregnancy with pre-defined serum ferritin thresholds were included. Two independent reviewers selected studies, extracted data and assessed quality. There were 76 relevant studies mainly of observational study design (57%). The most commonly used thresholds of serum ferritin for the diagnosis of iron deficiency were <12 and <15 ng mL-1 (68%). Most primary studies provided no justification for the choice of serum ferritin threshold used, but 25 studies (33%) used thresholds defined by expert consensus in a guideline development process. There were five studies (7%) using a serum ferritin threshold defining iron deficiency derived from primary studies of bone marrow aspiration. Unified international thresholds of iron deficiency for women throughout pregnancy are required for accurate assessments of the global disease burden and for evaluating effectiveness of interventions addressing this problem.

Genetic parameters and direct, maternal and heterosis effects on litter size in a diallel cross among three commercial varieties of Iberian pig.

The Iberian pig is one of the pig breeds that has the highest meat quality. Traditionally, producers have bred one of the available varieties, exclusively, and have not used crosses between them, which has contrasted sharply with other populations of commercial pigs for which crossbreeding has been a standard procedure. The objective of this study was to perform an experiment under full diallel design among three contemporary commercial varieties of Iberian pig and estimate the additive genetic variation and the crossbreeding effects (direct, maternal and heterosis) for prolificacy. The data set comprised 18 193 records for total number born and number born alive from 3800 sows of three varieties of the Iberian breed (Retinto, Torbiscal and Entrepelado) and their reciprocal crosses (Retinto × Torbiscal, Torbiscal × Retinto, Retinto × Entrepelado, Entrepelado × Retinto, Torbiscal × Entrepelado and Entrepelado × Torbiscal), and a pedigree of 4609 individuals. The analysis was based on a multiple population repeatability model, and we developed a model comparison test that indicated the presence of direct line, maternal and heterosis effects. The results indicated the superiorities of the direct line effect of the Retinto and the maternal effect of the Entrepelado populations. All of the potential crosses produced significant heterosis, and additive genetic variation was higher in the Entrepelado than it was in the other two populations. The recommended cross for the highest yield in prolificacy is a Retinto father and an Entrepelado mother to generate a hybrid commercial sow.

Effects of routine oral iron supplementation with or without folic acid for women during pregnancy.

BACKGROUND: It has been suggested that routine intake of supplements containing iron or combination of iron and folic acid during pregnancy improves maternal health and pregnancy outcomes. OBJECTIVES: To assess the efficacy, effectiveness and safety of routine antenatal daily or intermittent iron supplementation with or without folic acid during pregnancy on the health of mothers and newborns. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2005). Additionally, we contacted relevant organizations for the identification of ongoing and unpublished studies. SELECTION CRITERIA: All randomised or quasi-randomised trials evaluating the effect of routine supplementation with iron or combination of iron and folic acid during pregnancy. DATA COLLECTION AND ANALYSIS: We assessed trials for methodological quality using the standard Cochrane criteria. Two authors independently assessed the trials for inclusion and one author extracted data. We collected information on randomisation method, allocation concealment, blinding and loss to follow up. The primary outcomes included maternal and infant clinical and laboratory outcomes. MAIN RESULTS: Forty trials, involving 12706 women, were included in the review. Overall, the results showed significant heterogeneity across most prespecified outcomes. Heterogeneity could not be explained by standard sensitivity analyses including quality assessment; therefore, all results were analysed assuming random-effects. Very limited information related to clinical maternal and infant outcomes was available in the included trials. The data suggest that daily antenatal iron supplementation increases haemoglobin levels in maternal blood both antenatally and postnatally. It is difficult to quantify this increase due to significant heterogeneity between the studies. Women who receive daily antenatal iron supplementation are less likely to have iron deficiency and iron-deficiency anaemia at term as defined by current cut-off values. Side-effects and haemoconcentration are more common in women who receive daily iron supplementation. No differences were evident between daily and weekly supplementation with regards to gestational anaemia; haemoconcentration during pregnancy appears less frequent with the weekly regimen. The clinical significance of hemoconcentration defined as haemoglobin greater than 130 g/L remains uncertain. AUTHORS' CONCLUSIONS: Further studies are needed to assess the effects of routine antenatal supplementation with iron or a combination of iron and folic acid on clinically important maternal and infant outcomes.

[Wheat bran and breast cancer: revisiting the estrogen hypothesis]. / Salvado de trigo y cáncer de mama: revisitando la hipótesis del estrógeno.

Breast cancer is the most relevant form of cancer among women in Latin America. Many studies have evaluated the hormonal mechanisms involved in mammary carcinogenesis, although new focus is aimed towards factors that can potentially be used individually to reduce risk. Wheat bran seems to show a consistent protective effect in mammary carcinogenesis. Wheat bran, besides high level of insoluble fiber, also contains phytic acid and lignins, phytochemicals that have shown to inhibit in vitro and in vivo growth of mammary cancer. The protective effect of wheat bran in breast carcinogenesis is greatest at the promotional phase and when supplemented to a high fat diet. Doses of wheat bran in the 9-12% range have been consistently protective and the inconsistencies observed at higher doses may be dependent on the animal model used. This review examines the protective role of wheat bran in the development of breast cancer and the possible mechanisms involved.

Using (222)Rn as a tracer of geodynamical processes in underground environments.

Radon levels in two old mines in San Luis, Argentina, were measured and analyzed, with the aim to assess the potential use of this radioactive noble gas as a tracer of geological processes in underground environments. La Carolina gold mine and Los Cóndores tungsten mine are today used as tourism mines. CR-39 nuclear track detectors were used for this purpose. Measurements were performed during both winter and summer seasons. The findings show that in these environments, significant radon concentrations are subject to large seasonal fluctuations, due to the strong dependence on natural ventilation with the outside temperature variations. For both mines, higher concentration values of (222)Rn were observed in summer than in winter; with an extreme ratio of 2.5 times between summer and winter seasons for Los Cóndores mine. The pattern of radon transport inside La Carolina mine revealed, contrary to what was believed, that this mine behaves as a system with two entrances located at different levels. However, this feature can only be observed in the winter season, when there is a marked difference between the inside and outside temperatures of the mine. In the case of Los Cóndores mine, the radon concentration pattern distribution is principally established by air current due to chimney-effect in summer and winter seasons. In both cases, the analyses of radon pattern distribution appear as a good method to trace air currents, and then localize unknown ducts, fissures or secondary tunnels in subterranean environments.