Cardiac Arrest During a Ferric Derisomaltose Infusion Followed by Complete Heart Block: A Case Report.

Introduction: Ferric derisomaltose is the newest available parenteral iron formulation. Studies have demonstrated a good safety profile with improved tolerability compared to alternative parenteral iron formulations. To date there have been no reported acute, life-threatening cardiac events associated with ferric derisomaltose. Case Report: An 86-year-old male who had previously tolerated routine iron infusions received a first dose of ferric derisomaltose at an outpatient infusion clinic. Six minutes into the infusion the patient became unresponsive with no palpable pulse. Return of spontaneous circulation was achieved after two minutes of chest compressions. Electrocardiogram showed complete heart block requiring transcutaneous pacing and vasopressor administration. The patient was transferred to the emergency department for stabilization and then admitted to the cardiac intensive care unit. During admission, the patient received a dual-chamber, permanent pacemaker without complication and was ultimately discharged. Conclusion: It may be reasonable to consider parenteral iron as a toxicological etiology for patients presenting with complete heart block temporally associated with parenteral iron administration, particularly in patients with underlying conduction abnormalities.

Men's migration and women's mortality in rural Mozambique.

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Men's migration and women's mortality in rural Mozambique

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Polygyny and Intimate Partner Violence in Mozambique.

Polygyny has shown a positive association with intimate partner violence (IPV), yet the nature and mechanisms of this association are not well understood. This study uses data from rural Mozambique to distinguish women in polygynous unions by rank and co-residence. Findings show that senior wives report higher rates of violence than their junior-wife and monogamously married counterparts. At the same time, no difference is detected between junior wives and women in monogamous marriages. Additionally, the analysis finds that polygynously married women living away from their co-wives report higher rates of violence than both women co-residing with co-wives and women in monogamous unions, while the difference between the latter two categories is not statistically significant. However, the results also indicate that senior wives living away from their co-wives face particularly high risks of violence. These findings illustrate the social complexity of polygynous marriages and resulting differential vulnerabilities of women in them.

Locales of Trust: How Two Forms of Community Trust are Associated with Mothers' Self-Rated Health in Indonesia.

Objectives Social trust and access to social capital serve as important mechanisms to offset gender disparities in health in low-middle-income countries (LMICs) such as Indonesia. Indonesian women may have fewer opportunities to create strong social ties outside her social sphere and thus may benefit particularly from individual-level thin trust because generalized trust lowers barriers to gaining social support. We examined the role of thin trust and thick trust, two unique forms of social trust, to better understand the links between individual- and community-level trust and maternal health. Thin trust represents generalized trust in community members while thick trust represents strong and longstanding trusting relationships. Methods We employed nationally representative data from Wave 5 of the Indonesian Family Life Survey collected in 2014-2015 (n = 7276) to identify relationships between social trust and the self-rated health (SRH) of women in Indonesia, net of both individual- and community-level controls. Results We found evidence that both thick and thin trust benefit women's health but operate at different levels. While thick trust decreased likelihoods of poor SRH at the community level, thin trust was associated with lower likelihoods of poor SRH at the individual level. Conclusions for Practice We argue that for women in LMICs, trust provides an important mechanism through which women potentially access both tangible and immaterial resources that positively influence health outcomes.

Historical Legacies, Social Capital, and Women's Decision-Making Power: Religion and Child Nutrition in Mozambique.

In sub-Saharan settings, parental religion may have important implications for children's health and well-being. Using survey data from rural Mozambique, we examine the relationship between women's religion and the likelihood of their children being chronically malnourished (stunted). Multivariate analyses show that children of religiously affiliated women are significantly less likely to be stunted than children of non-affiliated women. We also find a strong advantage of mainline Protestants, especially compared to members of Pentecostal-type denominations, net of other factors. We relate this advantage to two historically rooted characteristics of mainline Protestantism: its connections to the public health sector and higher levels of women's autonomy that it fosters.

The development of tumours under a ketogenic diet in association with the novel tumour marker TKTL1: A case series in general practice.

Since the initial observations by Warburg in 1924, it has become clear in recent years that tumour cells require a high level of glucose to proliferate. Therefore, a ketogenic diet that provides the body with energy mainly through fat and proteins, but contains a reduced amount of carbohydrates, has become a dietary option for supporting tumour treatment and has exhibited promising results. In the present study, the first case series of such a treatment in general practice is presented, in which 78 patients with tumours were treated within a time window of 10 months. The patients were monitored regarding their levels of transketolase-like-1 (TKTL1), a novel tumour marker associated with aerobic glycolysis of tumour cells, and the patients' degree of adherence to a ketogenic diet. Tumour progression was documented according to oncologists' reports. Tumour status was correlated with TKTL1 expression (Kruskal-Wallis test, P<0.0001), indicating that more progressed and aggressive tumours may require a higher level of aerobic glycolysis. In palliative patients, a clear trend was observed in patients who adhered strictly to a ketogenic diet, with one patient experiencing a stagnation in tumour progression and others an improvement in their condition. The adoption of a ketogenic diet was also observed to affect the levels of TKTL1 in those patients. In conclusion, the results from the present case series in general practice suggest that it may be beneficial to advise tumour patients to adopt a ketogenic diet, and that those who adhere to it may have positive results from this type of diet. Thus, the use of a ketogenic diet as a complementary treatment to tumour therapy must be further studied in rigorously controlled trials.

An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States.

Infertility is a condition that affects nearly 30 percent of women aged 25-44 in the United States. Though past research has addressed the stigmatization of infertility, few have done so in the context of stigma management between fertile and infertile women. In order to assess evidence of felt and enacted stigma, we employed a thematic content analysis of felt and enacted stigma in an online infertility forum, Fertile Thoughts, to analyze 432 initial threads by women in various stages of the treatment-seeking process. We showed that infertile women are frequently stigmatized for their infertility or childlessness and coped through a variety of mechanisms including backstage joshing and social withdrawal. We also found that infertile women appeared to challenge and stigmatize pregnant women for perceived immoral behaviors or lower social status. We argue that while the effects of stigma power are frequently perceived and felt in relationships between infertile women and their fertile peers, the direction of the enacted stigma is related to social standing and feelings of fairness and reinforces perceived expressions of deserved motherhood in the United States.

Diagnostic use of epitope detection in monocytes blood test for early detection of colon cancer metastasis.

A follow-up strategy in cancer aftercare can result in early detection of metastasis and/or recurrence. Therefore, sensitive and reliable diagnostic tests that are easy to perform are needed. Here, the authors present the combined use of the epitope detection in monocytes (EDIM)-TKTL1 and EDIM-Apo10 blood test in aftercare monitoring of a patient with colon carcinoma. Whereas the established tumor markers CEA and CA19-9 did not indicate metastasis even at a timepoint where clinical signs and imaging techniques already demonstrated metastasis, the combined application of the EDIM-TKTL1 and the EDIM-Apo10 blood tests was positive 9 months before detection of metastasis. These findings - taken together with recently published evaluation data of the EDIM-TKTL1 blood test - suggest that the combined application of the EDIM-TKTL1 and the EDIM-Apo10 blood tests might indicate metastasis earlier than established tumor markers and could serve as sensitive and noninvasive methods that might be used for early detection of colon cancer metastasis.

Targeted myocardial transgenic expression of HIV Tat causes cardiomyopathy and mitochondrial damage.

Cardiac effects of human immunodeficiency virus (HIV) transactivator (Tat) are unclear, but Tat decreases liver glutathione (an important mitochondrial antioxidant) when ubiquitously expressed in transgenic mice (TG). With an alpha-myosin heavy chain promoter, Tat was selectively targeted to murine cardiac myocytes. One high-expression hemizygous ((+/-)Tat(high); 12 copies) and two low-expression ((+/-)Tat(lowA,B); 2-5 copies) TG lines were created. Cardiomyopathy was documented with increased left ventricle (LV) mass, ventricular expression of atrial natriuretic factor (ANF) mRNA, mitochondrial ultrastructural defects, and myocardial depletion of glutathione. In (+/-)Tat(high) TGs, normalized LV mass (determined echocardiographically) increased 46% (90 days), 134% (240 days), and 96% (365 days) compared with wild-type littermates (WT). LV fractional shortening was decreased to 28% (90 days), 27% (240 days), and 19% (365 days). (+/-)Tat(low) LV mass was unchanged (or=210 days); however, profound mitochondrial destruction occurred in homozygous (+/+)Tat(high) hearts (10 days) and the pups died (14 days). Tat caused cardiac dysfunction in this TG and may impact on cardiomyopathy in acquired immunodeficiency syndrome.