Diferentes fontes de ferro na prevenção da anemia ferropriva e no desempenho de leitões lactentes / Different sources of iron for the prevention of iron deficiency anemia and performance of suckling piglets

Com o objetivo de avaliar o uso de diferentes fontes de ferro na prevenção da anemia ferropriva e no desempenho em leitões lactentes, dividiram-se 202 leitões em cinco tratamentos: FD - aplicação intramuscular de 200mg de ferro dextrano no terceiro dia de idade; T24 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 19º dia; T48 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 10º dia e do 11º ao 19º dia, com intervalo de 48 horas; T72 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 10º dia e do 11º ao 19º dia, com intervalo de 72 horas; SA - suplemento alimentar ultraprecoce rico em ferro quelatado em pó (SAUP) fornecido do terceiro ao 11º dia, com intervalo de 48 horas. O ferro dextrano aplicado no terceiro dia de vida e a suplementação com terra e SAUP foram eficientes para garantir o desempenho de leitões no período de aleitamento e não influenciaram no consumo de ração nem na taxa de viabilidade. As diferentes fontes de ferro estudadas não influenciaram o leucograma e foram eficientes na prevenção da anemia ferropriva e no desempenho dos leitões lactentes. Com relação às concentrações de hemoglobina e hematócrito, os animais suplementados com ferro dextrano apresentaram valores superiores quando comparados aos que recebem terra e SAUP.(AU)

In order to evaluate the use of different sources of iron to prevent iron deficiency anemia and to appraise the performance of suckling piglets, we sorted 202 piglets in five treatments. ID - intramuscular injection of 200mg of iron dextran on the third day of age; T24 - free daily access to land provided to piglets every 24 hours from the third to the nineteenth day; T48 - free daily access to land provided to piglets every 24 hours from the third to the tenth day and from day 11 to day 19 with an interval of 48 hours; T72 - free daily access to land provided to piglets every 24 hours from the third to the tenth day and from day 11 to day 19 with an interval of 72 hours; FS - Food supplement rich in iron-chelating powder (SAUP) available from the third to the eleventh day with an interval of 48 hours. The iron dextran applied on the third day of life as well as the supplementation with land and SAUP were effective to ensure the performance of piglets during the lactation period and did not affect feed intake or the viability rate. The different sources of iron studied did not influence the WBC (White Blood Cell) and succeded in preventing iron deficiency anemia and performance of suckling piglets. Regarding the concentrations of hemoglobin and hematocrit, the animals supplemented with iron dextran showed higher values when compared to those who receive land and SAUP.(AU)

Optimización del tratamiento con hierro endovenoso en hemodiálisis: Estudio clínico prospectivo a largo plazo / Optimizing iron therapy in hemodialysis: a prospective long term clinical study

A pesar del amplio uso del hierro endovenoso en hemodiálisis, resta aún identificar un índice adecuado para optimizar esta terapéutica en el largo plazo. Con ese objetivo, se diseñó un estudio prospectivo de cohorte, de larga duración, que consistió en un período basal (PB) y dos períodos experimentales: PI y PII. Se infundió hierro dextran de bajo peso molecular a 100, 150 y 200 mg/mes, respectivamente, durante 6 meses y al final de cada periodo se determinaron: saturación de transferrina (TSAT), ferritina (FERR), porcentaje de eritrocitos hipocrómicos (HYPO) y contenido de hemoglobina en reticulocitos (HCr). Durante el estudio la albúmina aumentó significativamente, pero la Hgb, la dosis de EPO y la proteína C-reactiva se mantuvieron sin cambios. Los cambios en HYPO y FERR fueron inespecíficos. Sólo TSAT (desde 21.4 ± 6 en PB a 34 ± 7.1% en PII, p = 0.01) y HCr (desde 27.5 ± 1.3 en PB a 29.3 ± 1.7 pg en PII, P = 0.045) respondieron específicamente, pero el porcentaje de aumento de TSAT fue de 65% (IC95% 22), y el de HCr sólo 6% (IC95% 2.3; p = 0.0002). Esta diferencia a favor de TSAT se observó en todos los pacientes. Los resultados sugieren la utilización de 200 mg/FeIV/mes y que, de los índices estudiados, TSAT sería el más adecuado para optimizar el uso a largo plazo del hierro endovenoso en hemodiálisis.

The usefulness of intravenous iron therapy in hemodialysis is evidence-based. However, controversy still arises about the most suitable iron marker to optimize this treatment in the long term. We aimed to determine the most suitable marker with a prospective, cohort study, designed to comprise a basal period (BP) and two consecutive experimental periods (PI, PII). Low molecular weight iron dextran was infused at 100, 150 and 200 mg/month respectively, on a biweekly basis, during 6 months. At the end of each period, the following were determined: transferrin saturation (TSAT), ferritin (FERR), percentage of hypochromic eritrocytes (HYPO) and haemoglobin content in reticulocytes (HCr). During the study, albumin increased significantly, whereas no significant changes in hemoglobin, EPO doses and C-reactive protein were observed. Changes in HYPO and FERR were unspecific. Only TSAT (from 21.4 ± 6 in PB to 34 ± 7.1% in PII, p < 0.01) and HCr (from 27.5 ± 1.3 in PB to 29.3 ± 1.7 pg in PII, P < 0.05 ) responded specifically to changes in Fe doses, but change of TSAT was 65% (CI 95% 22), whereas change of HCr was just 6% (CI 95% 2.3; p = 0.0002). The difference was observed in all patients. Results suggest that 200 mg/FeIV/month is effective and that, of the markers tested in this study, TSAT would be the most suitable one to the practicing nephrologist to optimize intravenous iron in the long term.

Anemias carenciais na infancia / Nutritional deficiency-related anemias in children

Na faixa etaria pediatrica, a carencia alimentar se constitui na causa mais comum de anemia, particularmente nos paises em desenvolvimento. O acesso irregular a uma alimentacao balanceada, a elevada incidencia de parasitoses intestinais e o requerimento continuo e elevado de nutrientes devido ao crescimento, tornam as criancas propensas a desenvolver anemia carencial. Apesar de ser um problema clinico de resolucao relativamente facil apos instalado, estaria nos esforcos de prevencao a atitude mais correta dos pontos de vista medico, social e politico. Os autores fazem uma revisao da literatura abordando as tres principais deficiencias alimentares que resultam em anemia (ferropenia e as deficiencias de vitamina B12 e folato), com especial enfase as suas causas, manifestacoes clinicas, diagnostico tratamento

Feasibility of parenteral iron therapy as a field approach for management of pregnancy anaemia.

The feasibility of parenteral iron administration for treatment of pregnancy anaemia, in field conditions was investigated. High reaction rates were observed (30-40%) with either intramuscular (im) or intravenous (iv) iron-dextran complex (test dose). Mothers with lower body weight had higher reaction rates with both im or iv iron-dextran complex. In pregnancy induced hypertension (PIH) the reaction rate was significantly lower. Our study indicates that under the existing situations of the health care system in India and the poor body weight and weight gain of Indian women during pregnancy, parenteral iron therapy for controlling anaemia may not be a feasible approach, at the field level.