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Anne Marie U, Murererehe J, Rehman M, Chittilla M, Uwambaye P, Razzaque MS. Oral manifestations of iron imbalance. Front Nutr 2023; 10:1272902. [PMID: 37899821 PMCID: PMC10611504 DOI: 10.3389/fnut.2023.1272902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/11/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Uwitonze Anne Marie
- Department of Preventive and Community Dentistry, School of Dentistry, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Julienne Murererehe
- Department of Preventive and Community Dentistry, School of Dentistry, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Mahum Rehman
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, United States
| | - Mythri Chittilla
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, United States
| | - Peace Uwambaye
- Department of Preventive and Community Dentistry, School of Dentistry, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Mohammed S. Razzaque
- Department of Preventive and Community Dentistry, School of Dentistry, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, United States
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Schats R. Developing an archaeology of malaria. A critical review of current approaches and a discussion on ways forward. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 41:32-42. [PMID: 36930997 DOI: 10.1016/j.ijpp.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/17/2023] [Accepted: 03/04/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This paper presents the current state of the art in the investigation of past malaria by providing an extensive review of previous studies and identifying research possibilities for the future. MATERIALS All previous research on the detection of malaria in human skeletal material using macroscopic and biomolecular approaches is considered. METHODS The approaches and methods used by scholars and the results they obtained are evaluated and the limitations discussed. RESULTS There is a link between malaria and porous lesions with significantly higher prevalence in malaria-endemic areas, however, they are not pathognomonic or specific for malaria. Malaria can be identified using biomolecular techniques, yet, to date there is no completely satisfactory method that is able to consistently diagnose the disease. CONCLUSIONS Using macroscopic and biomolecular techniques, malaria can be investigated in past populations and the impact of the disease studied. Yet, this is not a straightforward process and the use of multiple lines of evidence is necessary to obtain the best results. SIGNIFICANCE The extensive discussion on ways malaria can and cannot be identified in past populations and the suggestions for new approaches provide a steppingstone for future research into this debilitating, global disease. LIMITATIONS Malaria is a difficult disease to study archaeologically and successful identification depends on many intrinsic and extrinsic factors. SUGGESTIONS FOR FURTHER RESEARCH More large-scale spatial analyses of porous lesions as well as targeting different tissues or molecules for biomolecular identification may improve the archaeological understanding of malaria.
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Affiliation(s)
- Rachel Schats
- Leiden University, Faculty of Archaeology, Laboratory for Human Osteoarchaeology, Einsteinweg 2, 2333CC Leiden, the Netherlands.
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Ajsuvakova OP, Skalnaya MG, Michalke B, Tinkov AA, Serebryansky EP, Karganov MY, Medvedeva YS, Skalny AV. Alteration of iron (Fe), copper (Cu), zinc (Zn), and manganese (Mn) tissue levels and speciation in rats with desferioxamine-induced iron deficiency. Biometals 2021; 34:923-936. [PMID: 34003408 DOI: 10.1007/s10534-021-00318-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 05/08/2021] [Indexed: 11/29/2022]
Abstract
The objective of the present study was to investigate the impact of iron deficiency and iron replenishment on serum iron (Fe), copper (Cu), manganese (Mn), and zinc (Zn) speciation and tissue accumulation in a deferrioxamine-induced model of iron deficiency. A total of 26 male Wistar rats were divided into three groups: control; Fe-deficient; Fe-replenished (with iron (II) gluconate). Serum ferritin and transferrin levels were assessed using immunoturbudimetric method. Liver, spleen, and serum metal levels were assessed using ICP-MS. Speciation analysis was performed using a hyphenated HPLC-ICP-MS technique. Desferrioxamine injections resulted in a significant decrease in tissue iron content that was reversed by Fe supplementation. Iron speciation revealed a significant increase in serum transferrin-bound iron and reduced ferritin-bound Fe levels. Serum but not tissue Cu levels were characterized by a significant decrease in hypoferremic rats, whereas ceruloplasmin-bound fraction tended to increase. At the same time, Zn levels were found to be higher in liver, spleen, and serum of Fe-deficient rats with a predominant increase in low molecular weight fraction.Both iron-deficient and iron-replenished rats were characteirzed by increased transferrin-bound Mn levels and reduced low-molecular weight fraction. Hypothetically, these differences may be associated with impaired Fe metabolism under Fe-deficient conditions predisposing to impairment of essential metal handling. However, further studies aimed at assessment of the impact on Fe deficiency on metal metabolism are highly required.
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Affiliation(s)
- Olga P Ajsuvakova
- Micronutrients Ltd, Moscow, Russia. .,Odintsovo Distr., All-Russian Research Institute of Phytopathology, Bolshie Vyazemy, Moscow reg, Russia. .,Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia.
| | | | - Bernhard Michalke
- Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Alexey A Tinkov
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia.,IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.,Orenburg State University, Moscow, Russia.,K.G. Razumovsky Moscow State University of Technologies and Management, Moscow, Russia
| | | | | | - Yulia S Medvedeva
- Institute of General Pathology and Pathophysiology, 125315, Moscow, Russia
| | - Anatoly V Skalny
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia.,IM Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.,Orenburg State University, Moscow, Russia.,K.G. Razumovsky Moscow State University of Technologies and Management, Moscow, Russia
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Kassianides X, Gordon A, Sturmey R, Bhandari S. The comparative effects of intravenous iron on oxidative stress and inflammation in patients with chronic kidney disease and iron deficiency: a randomized controlled pilot study. Kidney Res Clin Pract 2021; 40:89-98. [PMID: 33745264 PMCID: PMC8041632 DOI: 10.23876/j.krcp.20.120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/25/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Concerns exist regarding the pro-oxidant and inflammatory potential of intravenous (IV) iron due to labile plasma iron (LPI) generation. This IRON-CKD trial compared the effects of different IV irons on oxidative stress and inflammation. METHODS In this randomized open-label explorative single-center study in the United Kingdom, non-dialysis-dependent chronic kidney disease (CKD) patients with iron deficiency were randomized (1:1:1:1) to receive a single infusion of 200 mg iron dextran, or 200 mg iron sucrose (IS), or 200 mg or 1,000 mg ferric derisomaltose (FDI) and were followed up for 3 months. The primary outcomes measured were induction of oxidative stress and inflammation. Secondarily, efficacy, vascular function, quality of life, and safety were monitored. RESULTS Forty patients were enrolled. No significant rise in oxidative stress existed, regardless of preparation or dose. There was a significant rise in LPI with 1,000 mg FDI at 2 hours that normalized within a week, not impacting oxidative stress or inflammation. A delayed rise in C-reactive protein was noted with IS. High-dose FDI produced a sustained serum ferritin increase (mean ± standard error of the mean of predose: 69.1 ± 18.4 μg/L, 3 months: 271.0 ± 83.3 μg/L; p = 0.007). Hemoglobin remained stable throughout. No adverse drug reactions were recorded during the study. CONCLUSION A single dose of IV iron in CKD patients does not trigger oxidative stress or inflammation biomarkers. Third-generation IV irons have a reassuring safety profile, and high-dose FDI produced a sustained serum ferritin rise and more efficient iron repletion, with no significant pro-oxidant or inflammatory signals when compared to a lower dose and other IV irons.
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Affiliation(s)
- Xenophon Kassianides
- Academic Renal Research Department, Hull University Teaching Hospitals NHS Trust and Hull York Medical School, Hull Royal Infirmary, Hull, UK
| | - Andrew Gordon
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Roger Sturmey
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Sunil Bhandari
- Academic Renal Research Department, Hull University Teaching Hospitals NHS Trust and Hull York Medical School, Hull Royal Infirmary, Hull, UK
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McDermott A, Sanderson E, Metcalfe C, Barnes R, Thomas C, Cramer H, Kessler D. Continuity of care as a predictor of ongoing frequent attendance in primary care: a retrospective cohort study. BJGP Open 2020; 4:bjgpopen20X101083. [PMID: 33051221 PMCID: PMC7880190 DOI: 10.3399/bjgpopen20x101083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/20/2020] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Frequent attenders (FAs) in primary care receive considerable resources with uncertain benefit. Only some FAs attend persistently. Modestly successful models have been built to predict persistent attendance. Nevertheless, an association between relational continuity of care and persistent frequent attendance remains unclear, and could be important considering both the UK government and Royal College of General Practitioner's (RCGP) aim of improving continuity. AIM To identify predictive measures (including continuity) for persistent frequent attendance that may be modified in future interventions. DESIGN & SETTING This is a retrospective cohort study sampling 35 926 adult patients registered in seven Bristol practices. METHOD The top 3% (1227) of patients by frequency of GP consultations over 6 months were classed as FAs. Individual relational continuity was measured over the same period using the Usual Provider Continuity (UPC) index. Attendance change was calculated for the following 6 months. Multivariable logistic regression analysis was used to determine variables that predicted attendance change. RESULTS FAs were on average 8.41 years older (difference 95% confidence interval [CI] = 7.33 to 9.50, P<0.001) and more likely to be female (65.36% versus 57.88%) than non-FAs. In total, 79.30% of FAs decreased attendance over the subsequent 6 months. No association was found between continuity and subsequent attendance. Increasing age was associated with maintained frequent attendance. CONCLUSION Continuity does not predict change in frequent attendance. In addition to improving continuity, recent government policy is focused on increasing primary care access. If both aims are achieved it will be interesting to observe any effect on frequent attendance.
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Affiliation(s)
- Adam McDermott
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily Sanderson
- Bristol Randomised Trials Collaboration, Bristol Medical School, University of Bristol, Bristol, UK
| | - Christopher Metcalfe
- Bristol Randomised Trials Collaboration, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca Barnes
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Clare Thomas
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Helen Cramer
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Kessler
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Preliminary assessment of the new Sysmex XN parameter Iron-Def for identifying iron deficiency. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 18:406-412. [PMID: 32931417 DOI: 10.2450/2020.0070-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/21/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although the clinical assessment of iron status is usually based on iron stores, a rapid and accurate diagnosis of iron deficiency is challenging since ferritin is often unavailable as an urgent test and its value is frequently increased in acute phase conditions. This study was therefore aimed at evaluating the diagnostic performance of the new Sysmex XN "Iron Deficiency?" (Iron-Def) parameter for identifying patients with iron deficiency. MATERIALS AND METHODS The study population consisted of 688 consecutive patients (median age: 71 years; 341 women and 347 men), referred for routine diagnostics to the Laboratory of Clinical Pathology of Lecco Hospital, Italy. A complete clinical chemistry profile and haematological testing were performed for identifying iron deficiency anaemia. RESULTS A significant negative correlation was found between Sysmex XN Iron-Def and ferritin, serum iron, mean cell haemoglobin concentration, mean cell haemoglobin, mean corpuscular volume and age, while a positive correlation was noted with transferrin, percentage of microcytic red cell, red blood cell count and red blood cell distribution width. The diagnostic accuracy of Iron-Def for identifying patients with a percentage of saturation of transferrin <15% (n=104) was 84%, with a sensitivity of 0.952 and specificity of 0.538. A sub-analysis of 71 patients with ferritin <20 ng/dL yielded an even better diagnostic performance (86%, with a sensitivity of 0.935 and specificity of 0.620). DISCUSSION Although additional confirmatory investigations would be needed, the preliminary findings of our study attest that Iron-Def may be an easy, inexpensive, rapid and reliable parameter for screening iron deficiency anaemia.
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The role of general practice in surgical trials. Br J Gen Pract 2017; 67:157-158. [PMID: 28360051 DOI: 10.3399/bjgp17x690137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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