Consensus on the clinical diagnosis, treatment, and prevention of cancer related anemia in China (2023 edition) / 中华肿瘤杂志

Cancer related anemia (CRA) is a common side effect in patients with tumors, the incidence of which is related to tumor type, treatment regimen, the duration of chemotherapy, etc. The pathogenesis of CRA has not been fully defined. CRA may lead to chemotherapy dose reduction or may even delay chemotherapy. Patients with CRA require red blood cell transfusion, thus increasing the treatment cost, reducing the efficiency of chemotherapy and the patient's quality of life, and shortening the survival time. The main treatments of CRA include red blood cell transfusion, iron supplements, erythropoietin, and so on. Based on recent literature and clinical studies, the expert committee of the China Anti-Cancer Association drew up the consensus on the diagnosis and treatment of anemia related to tumor in China (2023 edition). The 2023 consensus incorporates the latest evidence-based medicine evidence and Traditional Chinese Medicine related content and aims to provide more reliable diagnosis and treatment plans for Chinese oncologists to help improve CRA and the quality of life in patients with cancer.

Development and Validation of a Questionnaire Assessing the Knowledge and Perception of Pregnant Women about Oral Iron Consumption

@#Introduction: Good knowledge and perception regarding iron supplementation are crucial to ensure adherence to iron therapy. This study aims to develop and validate a questionnaire on the knowledge and perception among pregnant women about oral iron consumption. Method: A self-administrated questionnaire was developed in Malay language through extensive literature search and a face and content validation process. The questionnaire validation involved two parts; Validation Study 1 included item response theory (IRT) and exploratory factor analysis (EFA) for the knowledge and perception items, respectively. Validation Study 2 comprised a repeat IRT analysis for the knowledge items and confirmatory factor analysis (CFA) for the perception items. Results: For the knowledge section, the initial 22 items in Validation Study 1 were reduced to 19 items after the repeat IRT analysis. The remaining 19 items had difficulty and discrimination parameters close to or within the acceptable values. For the perception section, the original 16 items were reduced to 14 in the EFA as two items had a factor loading ≤0.3. The CFA model showed poor fit of items (chi-square p-value <0.05; CFIrobust=0.73; TLIrobust=0.68; RMSEArobust=0.20; and SRMR=0.12). The Cronbach’s alpha for both sections were >0.7, and the intra-class correlation coefficient value in the knowledge and perception sections were 0.74 and 0.87, respectively. Conclusion: The results illustrate good psychometric properties for the knowledge items. However, further confirmatory validation is needed for the perception items. This questionnaire can be a valid and reliable assessment tool for assessing the knowledge of pregnant women regarding oral iron consumption.

Palatability of micro-encapsulated iron pyrophosphate (Ferfer®)

Background:Iron deficiency is the leading cause of anemia globally and affects 20% of world adult population. The general practice for replacement of iron reserves is oral supplementation. However, the success of this strategy solely depends on drug adherence and compliance. Where many other factors contribute to compliance, the role of tasteof the medicine can also not be neglected. The aim of this study is to evaluate the palatability of micro-encapsulated iron pyrophosphate (Ferfer) and compare its taste with previously taken other oral forms of iron supplements.Methods:The study was conducted with 231 female participants of age more than 18 years. Participants had taken one sachet of micro-encapsulated iron pyrophosphate (Ferfer) for the purpose of taste. Questionnaire based on their previous experience of iron supplements and palatability of Ferfer was asked by participants based on 0-10 mmvisual analogue scale and 5 point Likert scale evaluating responses at 0 minute, 5 minute, and at 10 minute. Data was analyzed by using SPSS version 23.Results:The women previously taking some others oral form of iron supplementation scored their supplements, a mean taste score is 2.92±2.44 on the VAS. However, micro-encapsulated iron pyrophosphate (Ferfer) received a mean score of 7.66±1.32 immediately after taking it and a score of 7.96±1.37 after 5 minutes on the 0-10 mmVAS. 81.4% patients will recommend their doctors to prescribe Ferferto them in future. Conclusions: Enhanced palatability of micro-encapsulated iron pyrophosphate sachets have resulted in increased compliance to the supplementation regimen among the participants.

Challenges to rational prescribing and use of essential medicines in India.

have read the Editorial entitled ‘Challenges to rational prescribing and use of essential medicines in India’ which was published in your journal with great interest. This has prompted me to address certain issues related to rational prescription of iron supplements in pregnancy.

Progress of prevention and treatment of iron deficiency / 国际儿科学杂志

Many countries have prevented and treated iron deficiency by more and more iron nutritional fortifiers. Although technical challenges limit the amount of bioavailable iron that can be added to many foods,evidence from controlled trials has shown that iron fortification can effectively control iron deficiency. Selective plant breeding and genetic engineering are promising new approaches to improve dietary iron bioavailability.However, a major challenge is to show that they can increase iron content to nutritionally useful levels and that the additional iron is bioavailable.

The Effects of Iron Supplements and Cereal Intake on the Iron Nutritional Status in Children in Social Welfare Institutions

The study was designed to assess the effect of iron and cereal supplementation on children's iron nutritional status in social welfare institutions. Dietary survey was carried out methods of food weighing and record by interview (n = 74). A nutritional intervention study was carried out through supplementing iron supplements and cereal for 4 weeks in 4 - 12 years old children. Children received daily 40 mg elemental Fe as iron protein succinylate (n = 23) and 3.6 mg elemental Fe as 100 g cereal (n = 24), respectively. Blood samples were drawn before and after supplementation. Nutrients which children's intake was less than two-thirds of the RDA were vitamin A, vitamin B-1, vitamin B-2, calcium and iron. The mean daily intake of iron was 5.1 mg for male and 4.9 mg for female, and 52.3% for male and 45.4% for female of Korean RDA. The proportion of children with iron depletion assessed by TIBC (> 360 microgram/dl) and serum ferritin (< 20 ng/ml) were 56.6% and 58.7%, respectively. The proportion of children with the iron deficient erythropoiesis assessed by serum iron (< 70 microgram/dl), Hb (< 12 g/dl), Hct (< 36%) were 76.0%, 58.7%, 64.0%, respectively. After iron supplements treatment, Hb (p < 0.001), Hct (p < 0.001), serum iron (p < 0.001), transferrin saturation (p < 0.001) and serum ferritin (p < 0.01) increase significantly and only TIBC decreased slightly. After cereal supplementation, in anemic children, Hct (p < 0.001), serum iron (p < 0.001) and transferrin saturation (p < 0.001) were significantly increased. The effect of iron supplements and cereal supplementation in children with iron deficient erythropoiesis were more effective to improve the iron nutritional status than children with iron depletion. It was concluded that cereal supplementation program in anemic children was also effective to improve iron nutritional status.

Effects of Oral administration of Iron Supplements During Pregnancy on Maternal Hemoglobin Levels and Birth Weights / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the effects of oral administration of iron supplements during pregnancy on maternal hemoglobin concentrations and birth weights. METHOD: Data from clinical records of 141 pregnant women and their babies were analysed. Studied mothers were classified to 3 groups such as non iron supplement group (groupI), 2-3 months supplement group (group II), and over 4 months supplement group (group III) by the duration (months) of oral supplement prescribed. RESULTS: There was positive correlation between hemoglobin levels and iron supplement duration. Proportions of anemia showed decreasing basis with the increasing iron supplement duration. The maternal hemoglobin levels showed decreasing basis with the increasing birth weight. There was positive correlation between iron supplement duration and maternal hemoglobin levels, but there was no significant correlation between iron supplement duration and birth weight. For the groupI(non-supplement group), maternal hemoglobin levels were decreased with the increasing birth weight but there was no significant correlations between hemoglobin levels and birth weights with increased iron supplement duration. CONCLUSION: There was a significant inverse correlation between maternal hemoglobin levels and birth weight in non-iron supplement group but there was no significant correlations between hemoglobin levels and birth weights with increased iron supplement duration.