The efficacy and safety of intravenous sucrose iron therapy for recurrent iron deficiency anemia / 中华血液学杂志

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

Effectiveness of sucroferric oxyhydroxide in patients on on-line hemodiafiltration in real-world clinical practice: A retrospective study / Eficácia do oxihidróxido sucroférrico em pacientes em hemodiafiltração on-line na realidade da prática clínica: um estudo retrospectivo

Abstract Introduction: Hyperphosphatemia is a serious consequence of chronic kidney disease and has been associated with an increased risk for cardiovascular disease. Controlling serum phosphorus levels in patients on dialysis is a challenge for the clinicians and implies, in most cases, the use of phosphate binders (PB). Part of the reason for this challenge is poor adherence to treatment because of the high pill burden in this patient group. Objective: To assess the real-world effectiveness of sucroferric oxyhydroxide (SO) in controlling serum phosphorus levels and determine the associated pill burden. Methods: A multicenter, quantitative, retrospective, before-after study was conducted with patients receiving online hemodiafiltration. Patients who switched to SO as a part of routine care were included in the study. PB treatment, number of pills, serum phosphorus levels, and intravenous iron medication and dosage were collected monthly during the six months of treatment with either PB or SO. Results: A total of 42 patients were included in the study. After switching from a PB to SO, the prescribed pills/day was reduced 67% from 6 pills/day to 2 pills/day (p < 0.001) and the frequency of pill intake was lowered from 3 times/day to 2 times/day (p < 0.001). During the treatment with SO, the proportion of patients with serum phosphorus ≤ 5.5 mg/dL increased from 33.3% at baseline to 45% after six months of treatment. Conclusion: During the six-month follow-up with SO, serum phosphorus levels were controlled with one third of the pills/day compared to other PB.

Resumo Introdução: A hiperfosfatemia é uma grave consequência da doença renal crônica associada a risco aumentado de doença cardiovascular. O controle dos níveis séricos de fósforo dos pacientes em diálise é um desafio que requer, na maioria dos casos, o uso de quelantes de fosfato (QF). Parte da dificuldade se deve à baixa adesão ao tratamento oriunda do grande número de medicamentos receitados para esse grupo de pacientes. Objetivo: Avaliar a real eficácia do oxihidróxido sucroférrico (OHS) no controle dos níveis séricos de fósforo e determinar a carga de comprimidos associada. Métodos: Estudo multicêntrico, quantitativo, retrospectivo, antes e depois conduzido com pacientes em hemodiafiltração on-line. Pacientes remanejados para OHS como parte dos cuidados de rotina foram incluídos no estudo. Tratamento com QF, número de comprimidos, níveis séricos de fósforo, reposição férrica endovenosa e dosagens foram registrados mensalmente durante seis meses de tratamento com QF ou OHS. Resultados: Foram incluídos 42 pacientes no estudo. Após a mudança de QF para OHS, o número de comprimidos prescritos por dia caiu em 67%, de seis para duas unidades diárias (p < 0,001). A frequência de ingestão de comprimidos caiu de três para duas vezes ao dia (p < 0,001). Durante o tratamento com OHS, o percentual de pacientes com fósforo sérico ≤ 5,5 mg/dL aumentou de 33,3% no início para 45% após seis meses de tratamento. Conclusão: Durante os seis meses de seguimento com OHS, os níveis séricos de fósforo foram controlados com um terço dos comprimidos por dia em relação aos tratamentos com outros QF.

Therapeutic evaluation of magnetic hyperthermia using Fe3O4-aminosilane-coated iron oxide nanoparticles in glioblastoma animal model / Avaliação terapêutica da técnica de magneto-hipertermia utilizando nanopartículas de Fe3O4 recobertas com aminosilana em modelo animal de glioblastoma

ABSTRACT Objective: To evaluate the potential of magnetic hyperthermia using aminosilane-coated superparamagnetic iron oxide nanoparticles in glioblastoma tumor model. Methods: The aminosilane-coated superparamagnetic iron oxide nanoparticles were analyzed as to their stability in aqueous medium and their heating potential through specific absorption rate, when submitted to magnetic hyperthermia with different frequencies and intensities of alternating magnetic field. In magnetic hyperthermia in vitro assays, the C6 cells cultured and transduced with luciferase were analyzed by bioluminescence in the absence/presence of alternating magnetic field, and also with and without aminosilane-coated superparamagnetic iron oxide nanoparticles. In the in vivo study, the measurement of bioluminescence was performed 21 days after glioblastoma induction with C6 cells in rats. After 24 hours, the aminosilane-coated superparamagnetic iron oxide nanoparticles were implanted in animals, and magnetic hyperthermia was performed for 40 minutes, using the best conditions of frequency and intensity of alternating magnetic field tested in the in vitro study (the highest specific absorption rate value) and verified the difference of bioluminescence before and after magnetic hyperthermia. Results: The aminosilane-coated superparamagnetic iron oxide nanoparticles were stable, and their heating capacity increased along with higher frequency and intensity of alternating magnetic field. The magnetic hyperthermia application with 874kHz and 200 Gauss of alternating magnetic field determined the best value of specific absorption rate (194.917W/g). When these magnetic hyperthermia parameters were used in in vitro and in vivo analysis, resulted in cell death of 52.0% and 32.8%, respectively, detected by bioluminescence. Conclusion: The magnetic hyperthermia was promissing for the therapeutical process of glioblastoma tumors in animal model, using aminosilane-coated superparamagnetic iron oxide nanoparticles, which presented high specific absorption rate.

RESUMO Objetivo: Avaliar o potencial da técnica de magneto-hipertermia utilizando nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana em modelo de tumores de glioblastoma. Métodos: As nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana foram avaliadas quanto à sua estabilidade em meio aquoso e a seu potencial de aquecimento pela taxa de absorção específica, quando submetidas à magneto-hipertermia, com diferentes frequências e intensidades de campo magnético alternado. Nos ensaios de magneto-hipertermia in vitro, as células C6 cultivadas e transduzidas com luciferase foram avaliadas por bioluminescência na presença/ausência do campo magnético alternado, como também com e sem nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana. No estudo in vivo, a medida de bioluminescência foi adquirida no 21º dia após indução do glioblastoma com células C6 nos ratos. Após 24 horas, as nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana foram implantadas no animal, tendo sido realizada a magneto-hipertermia por 40 minutos, nas melhores condições de frequência e intensidade de campo magnético alternado testado no estudo in vitro (maior valor da taxa de absorção específica); foi verificada a diferença do bioluminescência antes e após a magneto-hipertermia. Resultados: As nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana se mostraram estáveis, e sua capacidade de aquecimento aumentou com o incremento da frequência e da intensidade de campo magnético alternado. A aplicação da magneto-hipertermia, com 874kHz e 200 Gauss do campo magnético alternado, determinou o melhor valor da taxa de absorção específica (194,917W/g). Quando utilizados, estes parâmetros de magneto-hipertermia in vitro resultaram em morte celular de 52,0% e in vivo de 32,8% por bioluminescência. Conclusão: A técnica de magneto-hipertermia foi promissora para o processo terapêutico de tumores de glioblastoma no modelo animal utilizando as nanopartículas superparamagnéticas de óxido de ferro recobertas com aminosilana recobertas com aminosilana, que apresentaram alta taxa de absorção específica.

Effect of ferric carboxymaltose in the management of postpartum iron deficiency anemia

Background: Iron deficiency is the most common cause of anemia, around the world, with postpartum hemorrhage one of the reasons. Different treatment options are available for correction of iron deficiency, ferric carboxymaltose being the most recent

Objective: To determine the effectiveness of ferric carboxymaltose in the management of iron deficiency anemia in the postpartum period

Methodology: An experimental study was conducted at Sheikh Zayed Medical College/Hospital Rahim Yar Khan. 30 female patients, with documented iron deficiency anemia within 10 days of post partum period and with no history of renal or hepatic disease, infection, anemia due to any other causes, severe anemia requiring blood transfusion and no parenteral iron therapy in last 20 days, were included in the study. All the patient were given ferric carboxymaltose 15mg/kg body weight [max 1000mg] intravenous infusion. Pre and post therapy complete blood picture including hemoglobin and serum ferritin levels were compared after 1 week. The data was entered and analyzed in SPSS version15

Results: Significant increase in both hemoglobin and serum ferritin levels was noted in patients with mean rise being 2.4g/dl and 338.3 ng/ml in hemoglobin and serum ferritin levels, respectively. Mild rash and fever were the only adverse events noted, in only one patient, each

Conclusion: Ferric carboxymaltose appears to be a very effective drug for the treatment of iron deficiency anemia both in terms of rise in hematological indices and low adverse event profile

Toxocara cati (Nematoda: Ascarididae) in Didelphis albiventris (Marsupialia: Didelphidae) from Brazil: a case of pseudoparasitism / Toxocara cati (Nematoda: Ascarididae) em Didelphis albiventris (Marsupialia: Didelphidae) do Brasil: um caso de pseudoparasitismo

Eggs of Toxocara cati were found in the feces of Didelphis albiventris from a peridomestic urban environment in Brazil. Negative fecal tests following short-term captivity of the opossums, as well as the absence of ascaridids during necropsy, suggest the occurrence of pseudoparasitism. Implications of the findings for the epidemiology of toxocariasis are discussed.

Ovos de Toxocara cati foram encontrados nas fezes de Didelphis albiventris oriundos de um ambiente peridomiciliar urbano no Brasil. A negatividade dos exames de fezes após um curto período de cativeiro dos gambás e a ausência de nematódeos ascaridídeos durante a necropsia sugerem a ocorrência de pseudoparasitismo. As implicações dos achados para a epidemiologia da toxocarose são discutidas.

Therapeutic mechanism of treating SMMC-7721 liver cancer cells with magnetic fluid hyperthermia using Fe2O3 nanoparticles

This study aimed to investigate the therapeutic mechanism of treating SMMC-7721 liver cancer cells with magnetic fluid hyperthermia (MFH) using Fe2O3 nanoparticles. Hepatocarcinoma SMMC-7721 cells cultured in vitro were treated with ferrofluid containing Fe2O3 nanoparticles and irradiated with an alternating radio frequency magnetic field. The influence of the treatment on the cells was examined by inverted microscopy, MTT and flow cytometry. To study the therapeutic mechanism of the Fe2O3 MFH, Hsp70, Bax, Bcl-2 and p53 were detected by immunocytochemistry and reverse transcription polymerase chain reaction (RT-PCR). It was shown that Fe2O3 MFH could cause cellular necrosis, induce cellular apoptosis, and significantly inhibit cellular growth, all of which appeared to be dependent on the concentration of the Fe2O3 nanoparticles. Immunocytochemistry results showed that MFH could induce high expression of Hsp70 and Bax, decrease the expression of mutant p53, and had little effect on Bcl-2. RT-PCR indicated that Hsp70 expression was high in the early stage of MFH (<24 h) and became low or absent after 24 h of MFH treatment. It can be concluded that Fe2O3 MFH significantly inhibited the proliferation of in vitro cultured liver cancer cells (SMMC-7721), induced cell apoptosis and arrested the cell cycle at the G2/M phase. Fe2O3 MFH can induce high Hsp70 expression at an early stage, enhance the expression of Bax, and decrease the expression of mutant p53, which promotes the apoptosis of tumor cells.

Comparison of Oral and Intravenous Iron for Treatment of Iron Deficiency Anaemia in Pregnancy.

Oral iron supplementation is standard obstetrical practice. But programmes of anaemia prophylaxis based on oral iron supplementation still remain a failure. Whether or not there is need for parenteral iron may be debated. Parenteral iron is indicated when oral iron supplementation is not possible or fails. Intravenous iron could be a good alternative in pregnant women to ensure compliance. Many workers have shown that parenteral iron therapy supplies enough iron for erythropoiesis. Therefore, In the present review, we assessed oral iron supplementation with intravenous (IV) iron sucrose in the management of iron deficiency anaemia in pregnancy. Intravenous iron sucrose appears a good alternative to oral iron in patients who are either intolerant to oral iron or are non compliant and may also reduce the incidence of blood transfusion and its associated risks.

Pulpotomías con sulfato férrico y MTA en dientes primarios: serie de casos / Ferric sulfate and MTA pulpotomies in primary teeth: a case series

En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.

In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.

Iron hydroxide polymaltose--cause of persistent iron deficiency anemia at delivery.

Ironhydroxide polymaltose (IPC) preparations were used to treat four pregnant women with iron deficiency anemia. Despite patient compliance for sufficient length of time, hemoglobin failed to rise. By the time this was noticed, pregnancy was well advanced and delivery was only few weeks away. Patients were switched over to ferrous fumarate/succinate/parenteral iron. Although hemoglobin increased, women were still iron deficient at the time of delivery. Besides exposing women to hazards of iron deficiency at the time of delivery, their new borns are exposed to the risks intrauterine growth retardation and its consequences in childhood and later life. It would be advisable to avoid the use IPC preparations in patients with iron deficiency anemia, especially pregnant women.

Efecto de la Suplementación combinada con el Hierro y Vitamina A sobre el Status deñ Hierro en Mujeres Lactantes / Effect of the Suplementary combined with the Iron and Vitamin TO on the Status of the Iron in Women Nurslings

Las carencia nutricionales por micronutrientes, principalmente vitamina A, hierro y yodo afectan a grandes poblacioens en todo el mundo, particularmente a los niños menores de cinco años, mujeres en edad reproductiva, embarazadas y lactantes. Estudios realizados en Ecuador han registrado una prevalencia de anemia por deficiencia de hierro en el 60 por ciento de las mujeres embarazadas. En el país la prevalencia de deficiencia de vitamina A es de 18 por ciento en menores de 5 años en las provincias de pobreza crítica. No se han publicado estudios sobre prevalencia de anemia y de hipovitaminosis A en mujeres lactantes.Estudios de suplementación realizados en mujeres embarazadas anémicas han demostrado incrementos significativos en la hemoglobina cuando la vitamina A fue adicionada a la suplementación con hierro

Efecto de la suplementación combinada con el hierro y vitamina A sobre el status de hierro en mujeres lactantes / Effect of the suplementary combined with the iron and vitamin to on the status of the iron in women nurslings

Las carencia nutricionales por micronutrientes, principalmente vitamina A, hierro y yodo afectan a grandes poblacioens en todo el mundo, particularmente a los niños menores de cinco años, mujeres en edad reproductiva, embarazadas y lactantes. Estudios realizados en Ecuador han registrado una prevalencia de anemia por deficiencia de hierro en el 60 por ciento de las mujeres embarazadas. En el país la prevalencia de deficiencia de vitamina A es de 18 por ciento en menores de 5 años en las provincias de pobreza crítica. No se han publicado estudios sobre prevalencia de anemia y de hipovitaminosis A en mujeres lactantes.Estudios de suplementación realizados en mujeres embarazadas anémicas han demostrado incrementos significativos en la hemoglobina cuando la vitamina A fue adicionada a la suplementación con hierro.

Infusäo de hidróxido de ferro sacarato por via endovenosa no tratamento da anemia ferropriva grave / Infusion of saccharated iron hydroxide by endovenous way in treatment of serious ferropenic anemia

Considerando-se os riscos inerentes à transfusäo de sangue , propöe-se a correçäo da anemia grave com administraçäo parenteral de hidróxido de ferro sacaratado por via I.V. Foram estudadas 19 crianças do ambulatório do Hospital Israelita Albert Einstein (H.I.A.E.), com anemia ferropriva grave, taxa de Hb abaixo de 8,8g/d1), média de idade de 19,8 meses, ambos os sexos, que receberam 100 mg de Fe3 elementar, na forma de sacarato de hidróxido de ferro, diluidos em 50 ml. de soluçäo fisiológica, via I.V., pela infusäo de 10 gotas/minuto nos primeiros 10 minutos e depois 30 gotas/minuto, até o final. Além dos exames clínicos, neurológicos e laboratoriais, com testes das funçöes hepática, renal e metabólica, houve monitorizaçäo médica, para avaliaçäo de reaçöes adversas. Os exames, clínico e laboratorial, foram feitos na admissäo e repetidos no 7§, 21§, 60§ e 90§, dias e a avaliaçäo toxicológica, no início e no 7§ dia da evoluçäo. Constatou-se aumento médio da taxa de hemoglobina, de 1,1g% (ou 15%) sobre as taxas iniciais depois de 7 dias de tratamento e 33% depois de 90 dias, valores correspondentes à uma ou duas transfusöes de glóbulos. Näo foram observadas efeitos tóxicos da medicaçäo. Conclui-se que a infusäo de 100 mg. de ferro, sob a forma de sacarato de hidróxido de ferro, na anemia grave, substituiu com vantagens a transfusäo de sangue. Para a correçäo completa do quadro anêmico, porém, há necessidade de complementaçäo e prolongamento da terapêutica com ferro