Iron deficiency anaemia: pathophysiology, assessment, practical management

Management of noncytotoxic extravasation injuries: A focused update on medications, treatment strategies, and peripheral administration of vasopressors and hypertonic saline

Extravasation is the leakage of intravenous solutions into surrounding tissues, which can be influenced by drug properties, infusion techniques, and patient-related risk factors. Although peripheral administration of vesicants may increase the risk of extravasation injuries, the time and resources required for central venous catheter placement may delay administration of time-sensitive therapies. Recent literature gathered from the growing use of peripheral vasopressors and hypertonic sodium suggests low risk of harm for initiating these emergent therapies peripherally, which may prevent delays and improve patient outcomes. Physiochemical causes of tissue injury include vasoconstriction, pH-mediated, osmolar-mediated, and cytotoxic mechanisms of extravasation injuries. Acidic agents, such as promethazine, amiodarone, and vancomycin, may cause edema, sloughing, and necrosis secondary to cellular desiccation. Alternatively, basic agents, such as phenytoin and acyclovir, may be more caustic due to deeper tissue penetration of the dissociated hydroxide ions. Osmotically active agents cause cellular damage as a result of osmotic shifts across cellular membranes in addition to agent-specific toxicities, such as calcium-induced vasoconstriction and calcifications or arginine-induced leakage of potassium causing apoptosis. A new category has been proposed to identify absorption-refractory mechanisms of injury in which agents such as propofol and lipids may persist in the extravasated space and cause necrosis or compartment syndrome. Pharmacological antidotes may be useful in select extravasations but requires prompt recognition and frequently complex administration strategies. Historically, intradermal phentolamine has been the preferred agent for vasopressor extravasations, but frequent supply shortages have led to the emergence of terbutaline, a β2 -agonist, as an acceptable alternative treatment option. For hyperosmolar and pH-related mechanisms of injuries, hyaluronidase is most commonly used to facilitate absorption and dispersion of injected agents. However, extravasation management is largely supportive and requires a protocolized multidisciplinary approach for early detection, treatment, and timely surgical referral when required to minimize adverse events.

Metabolic Profile of Einkorn, Spelt, Emmer Ancient Wheat Species Sourdough Fermented with Strain of Lactiplantibacillus plantarum ATCC 8014

The continuous development of bakery products as well as the increased demands from consumers transform ancient grains into alternatives with high nutritional potential for modern wheat species. The present study, therefore, follows the changes that occur in the sourdough obtained from these vegetable matrices fermented by Lactiplantibacillus plantarum ATCC 8014 during a 24 h. period. The samples were analyzed in terms of cell growth dynamics, carbohydrate content, crude cellulose, minerals, organic acids, volatile compounds, and rheological properties. The results revealed significant microbial growth in all samples, with an average value of 9 log cfu/g but also a high accumulation of organic acids with the increase in the fermentation period. Lactic acid content ranged from 2.89 to 6.65 mg/g, while acetic acid recorded values between 0.51 and 1.1 mg/g. Regarding the content of simple sugars, maltose was converted into glucose, and fructose was used as an electron acceptor or carbon source. Cellulose content decreased as a result of the solubilization of soluble fibers into insoluble fibers under enzymatic action, with percentages of 3.8 to 9.5%. All sourdough samples had a high content of minerals; the highest of which-Ca (246 mg/kg), Zn (36 mg/kg), Mn (46 mg/kg), and Fe (19 mg/kg)-were recorded in the einkorn sourdough.

The Effects of Iron Deficiency on the Gut Microbiota in Women of Childbearing Age

Iron deficiency anemia (IDA) is the most prevalent and common nutritional deficiency worldwide and is a global health problem with significant risk, particularly among women of reproductive age. Oral iron supplementation is the most widely used and cost-effective treatment for iron deficiency and IDA. However, there are limitations regarding side effects such as enteritis, treatment compliance, and bioavailability. Intestinal microbiome characteristic research has been recently conducted to overcome these issues, but more is needed. Against this background, a metagenomics study on the 16S gene in the feces of young women vulnerable to IDA was conducted. As a result of analyzing 16 normal subjects and 15 IDA patients, significant differences in bacterial community distribution were identified. In particular, a significant decrease in Faecalibacterium was characteristic in IDA patients compared with normal subjects. Furthermore, in the case of patients who recovered from IDA following iron supplementation treatment, it was confirmed that Faecalibacterium significantly recovered to normal levels. However, no significance in beta diversity was seen compared with before treatment. There were also no differences in the beta diversity results between the recovered and normal subjects. Therefore, intestinal dysbiosis during the disease state was considered to be restored as IDA improved. Although the results were derived from a limited number of subjects and additional research is needed, the results of this study are expected to be the basis for developing treatment and prevention strategies based on host-microbiome crosstalk in IDA.

Association between the dietary literacy of children's daily diet providers and school-age children's nutritional status and eating behaviours: a cross-sectional study

BACKGROUND

Overweight and obesity rates have increased rapidly in Chinese school-age children, and previous studies have indicated that poor dietary literacy can lead to unhealthy eating behaviours. However, few studies have investigated the association between the dietary literacy of daily diet providers and the eating behaviours and nutritional status of school-age children raised by the providers. Thus, we aimed to explore this association.

METHODS

We collected data on the eating behaviours and nutritional status of children in two primary schools in Anhui Province, as well as the dietary literacy of their daily diet providers. T-tests, one-way ANOVA, chi-square tests, and multiple linear regression were used to analyse the association.

RESULTS

We found significant differences in the scores on the Questionnaire of Children's Daily Diet Providers' Dietary Literacy (QCDDPDL) by region, relationship with the child, age, and educational level of the daily diet provider (all p < .05). Moreover, the children in the low QCDDPDL score group were inclined to engage in unhealthy eating behaviours such as emotional undereating and overeating (p < .05). In addition, the incidence of overweight and obesity was higher in the low QCDDPDL attitude score group than in the high score group (p = .006).

CONCLUSIONS

Our study showed that the dietary literacy of diet providers may influence children's health and eating behaviours. Improving the dietary literacy of diet providers may promote the health status and eating behaviours of school-age children.

Iron deficiency in women: ways to reduce prevalence

Iron deficiency states (IDSs) are common disorders at the nexus of various fields. The etiology and pathogenesis of IDSs have been well studied in recent decades, but their prevalence is still high. The highest incidence of IDSs is reported in women of reproductive age. The timely correction of iron deficiency improves women's quality of life and reduces pregnancy complications and infant morbidity. To achieve and maintain the improvement, caution in risk groups, early diagnosis, physiology-based therapy, and follow-up are necessary. Iron sulfate agents are well known as an effective way to treat iron deficiency anemia. However, the high rate of previously reported side effects posed significant challenges to the complete course of therapy. The development of a new molecule with prolonged iron release minimizes the complications of therapy, providing new prospects for iron deficiency treatment. The combination of folic acid to iron sulfate in one tablet simplifies prevention regimens and therapy for pregnant women and those planning to become pregnant and reduces the time to improve.

Crohn's Disease and Female Infertility: Can Nutrition Play a Supporting Role?

Crohn's disease (CD) is a chronic inflammatory disease (IBD) that can affect the entire gastrointestinal tract in a non-continuous mode. CD is generally diagnosed most commonly between 15 and 35 years of age and may affect female fertility. The role of diet in supporting wellbeing outcome and reproductive potential in women is well-known; however, no effective efforts have been made to improve women's awareness in CD. Our review aims to describe the burden of CD on women's fertility, reporting the most relevant nutrients that support reproductive function to ensure women diagnosed with IBD an adequate health-related quality of life.

Biofortification of Three Cultivated Mushroom Species with Three Iron Salts—Potential for a New Iron-Rich Superfood

Mushrooms fortified with iron (Fe) can offer a promising alternative to counter the worldwide deficiency problem. However, the factors that may influence the efficiency of fortification have not yet been fully investigated. The aim of this study was to compare the effects of three Fe forms (FeCl₃ 6H₂O, FeSO₄ 7H₂O, or FeHBED) in three concentrations (5, 10, or 50 mM) for three mushroom species (Pleurotus eryngii, P. ostreatus, or Pholiota nameko) on their chemical composition, phenolic compounds, and organic acid production. The most effective metal accumulation of all the investigated species was for the 50 mM addition. FeCl₃ 6H₂O was the most favorable additive for P. eryngii and P. nameko (up to 145 and 185% Fe more than in the control, respectively) and FeHBED for P. ostreatus (up to 108% Fe more than in control). Additionally, P. nameko showed the highest Fe accumulation among studied species (89.2 ± 7.51 mg kg⁻¹ DW). The creation of phenolic acids was generally inhibited by Fe salt supplementation. However, an increasing effect on phenolic acid concentration was observed for P. ostreatus cultivated at 5 mM FeCl₃ 6H₂O and for P. eryngii cultivated at 5 mM FeCl₃ 6H₂O and 5 mM FeSO₄ 7H₂O. In the case of organic acids, a similar situation was observed. For P. ostreatus, FeSO₄ 7H₂O and FeHBED salts increased the formation of the determined organic acids in fruiting bodies. P. eryngii and P. nameko were characterized by a much lower content of organic acids in the systems supplemented with Fe. Based on the obtained results, we recommend starting fortification by preliminarily indicating which form of the element is preferred for the species of interest for supplementation. It also seems that using an additive concentration of 50 mM or higher is most effective.