Iron status and analysis of efficacy and safety of ferric carboxymaltose treatment in patients with inflammatory bowel disease

BACKGROUND AND AIMS

We analyzed iron deficiency and the therapeutic response following intravenous ferric carboxymaltose in a large single-center inflammatory bowel disease (IBD) cohort.

METHODS

250 IBD patients were retrospectively analyzed for iron deficiency and iron deficiency anemia. A subgroup was analyzed regarding efficacy and side effects of iron supplementation with ferric carboxymaltose.

RESULTS

In the cohort (n = 250), 54.4% of the patients had serum iron levels ≤60 μg/dl, 81.2% had ferritin ≤100 ng/ml, and 25.6% had hemoglobin (Hb) of ≤12 g/dl (females) or ≤13 g/dl (males). In the treatment subcohort (n = 80), 83.1% of the patients had iron ≤60 μg/dl, 90.4% had ferritin ≤100 ng/ml, and 66.7% had Hb ≤12/13 g/dl before ferric carboxymaltose treatment. After a median dose of 500 mg ferric carboxymaltose, 74.7% of the patients reached iron >60 μg/dl, 61.6% had ferritin >100 ng/ml, and 90.7% reached Hb >12/13 g/dl at follow-up (p < 0.0001 for all parameters vs. pretreatment values). The most frequent adverse event was a transient increase of liver enzymes with male gender as risk factor (p = 0.008, OR 8.62, 95% CI 1.74-41.66).

CONCLUSIONS

Iron deficiency and anemia are frequent in IBD patients. Treatment with ferric carboxymaltose is efficious, safe and well tolerated in iron-deficient IBD patients.

Diversity, distribution and role of wild crucifers in major cabbage and kale growing areas of Kenya

An investigation of the diversity and distribution of wild crucifer species and their importance for cultivated crucifers was conducted during 2005 and 2006 in the highland and mid-altitude semi-arid areas of Kenya. Thirteen species of wild crucifers in nine genera were recorded: Raphanus raphanistrum, Erucastrum arabicum, Sisymbrium officinale, Crambe kilimandscharica, Capsella bursa-pastoris, Rorippa nudiuscula, Ro. micrantha, Ro. microphylla, Lepidium bonariense, Coronopus didymus, Brassica rapa, B. juncea and an unidentified Brassica species. Highland areas had significantly higher species diversity and species richness than mid-altitude semi-arid areas. Species richness, diversity and evenness varied with season and location. Raphanus raphanistrum was the dominant non-cultivated species in the highlands followed by E. arabicum, which was also present and dominant in the semi-arid study sites. Diamondback moth (DBM) was recorded from ten wild crucifer species and R. raphanistrum and E. arabicum were the preferred host plant species. Overall, four larval, one larval-pupal and one pupal parasitoid of DBM were recorded: Diadegma semiclausum, D. mollipla, Apanteles sp., Cotesia plutellae, Oomyzus sokolowskii and Brachymeria species, respectively. Diadegma semiclausum was the most dominant species on all crucifers. We conclude that wild crucifers act as alternative hosts for DBM and provide refugia for DBM parasitoids, which risk local extinction through pesticide application or competition from introduced exotic parasitoid species. The wild crucifers also act as recolonization sites for DBM parasitoids.

Inclusive K(S);(0)K(S);(0) resonance production in ep collisions at HERA

Inclusive K_{S};{0}K_{S};{0} production in ep collisions at the DESY ep collider HERA was studied with the ZEUS detector using an integrated luminosity of 0.5 fb;{-1}. Enhancements in the mass spectrum were observed and are attributed to the production of f_{2}(1270)/a_{2};{0}(1320), f_{2};{'}(1525) and f_{0}(1710). Masses and widths were obtained using a fit which takes into account theoretical predictions based on SU(3) symmetry arguments, and are consistent with the Particle Data Group values. The f_{0}(1710) state, which has a mass consistent with a glueball candidate, was observed with a statistical significance of 5 standard deviations. However, if this state is the same as that seen in gammagamma-->K_{S};{0}K_{S};{0}, it is unlikely to be a pure glueball state.

Interspecific competition between Diadegma semiclausum Hellen and Diadegma mollipla (Holmgren), parasitoids of the diamondback moth, Plutella xylostella (L), feeding on a new host plant

Interspecific competition between an introduced parasitoid species aimed at controlling a herbivorous pest species and a native parasitoid parasitising the same host may influence the success of classical biological control programmes. In Kenya, interspecific competition between an introduced and a local parasitoid on two diamondback moth populations (DBM, Plutella xylostella) was investigated on two different host plants. We tested simultaneous and delayed competition of the local parasitoid Diadegma mollipla Holmgren and its exotic congenus D. semiclausum Hellen on a newly aquired DBM host plant (snowpea) in the laboratory. Under simultaneous competition, D. mollipla produced more progeny than D. semiclausum on snowpea. A head start of D. Mollipla, of four and eight hours before its congenus was introduced, resulted in a similar number of progeny of both species. In delayed competition (time intervals of 24 h, 48 h and 72 h), progeny production was similar for both parasitoids when the time interval was 24 h, irrespective of which species parasitized first. More progeny was produced by the species which attacked first, when the time interval was greater than 24 h, although it was only significant at 72 h. Competitive abilites of both parasitoids on the new host plant differed largely between laboratory and semi-field conditions. The influence of two host plants (snowpea and cabbage) on competition was studied in the greenhouse with different host and parasitoid densities. Parasitism levels of D. semiclausum were significantly higher than those of D. mollipla, regardless of host plant, host and parasitoid densities, but progeny production of D. mollipla on snowpea was still slightly higher than on cabbage. As compared to the confinement of parasitoids and larvae to small containers, D. mollipla parasitized very few larvae in the cages. Competitive ability of the two parasitoid species tested was influenced both by the density of the searching females and by parameters related to either the host plant and/or the herbivorous hosts.

Impact of an exotic parasitoid on Plutella xylostella (Lepidoptera: Plutellidae) population dynamics, damage and indigenous natural enemies in Kenya

Diadegma semiclausum (Hellén) (Hymenoptera: lchneumonidae), an exotic diamondback moth parasitoid, was released in two pilot areas (Werugha in Coast Region and Tharuni in Central Province) in Kenya. Fifteen month before release, observations on the diamondback moth, Plutella xylostella (Linnaeus), and local natural enemy population dynamics and pest damage were initiated in both areas and continued for three years after release. The P. xylostella population was bimodal with higher records during dry seasons. At Werugha, the peak population of P. xylostella was 16.8 per plant (October 2001); at Tharuni it was 12.8 (February 2002). Populations at Werugha declined from three months after release and decreased from 5.4 per plant (before release) to 0.8 (year 3 after release). Concurrently, average damage (1.9 to 1.5) (on a 0-5 scale), proportion of attacked plants (72 to 31%) and proportion of plants in damage group >2 (plants with head damage) decreased (21.4 to 5.3%), while total parasitism increased from 14.4 (before) to 52.5% (year 3 after release, 90% due to D. semiclausum). At Tharuni, D. semiclausum was only recovered 3 months after release. Average populations of P. xylostella declined from 5.9 per plant (before release) to 2.4 (year 3 after release) and damage scores from 2.3 to 1.7. The proportion of plants in damage group >2 declined from 39.7 to 4.5% while overall parasitism increased from 4.2 to 40.6% (98.3% by D. semiclausum). Four species of indigenous parasitoids (Diadegma mollipla (Holmgren), Oomyzus sokolowskii (Kurdjumov), Apanteles sp. and Itoplectis sp., all primary parasitoids) were almost completely displaced by D. semiclausum. Possible reasons for the different parasitoid development between the two release areas and the displacement of the indigenous species are discussed.

Host shift to peas in the diamondback moth Plutella xylostella (Lepidoptera: Plutellidae) and response of its parasitoid Diadegma mollipla (Hymenoptera: Ichneumonidae)

Host shifts in herbivorous insects are thought to sometimes provide enemy-free space on the novel host plant. A population of the diamondback moth Plutella xylostella (Linnaeus), an oligophagous pest on crucifers, recently shifted to sugar snap- and snowpeas (Pisum sativum) in Kenya, resulting in heavy damage to these crops. The impact of this host shift on the interaction with Diadegma mollipla (Holmgren), one of the most frequent parasitoid species attacking P. xylostella in this area, was investigated. Parasitism rates and development of two strains of D. mollipla, one reared from a cabbage-feeding strain of P. xylostella and the second from the new pea-feeding strain, changed based on the host-plant that P. xylostella fed upon, with both parasitoid strains more effective on the novel host plant. Parasitism by the cabbage-D. mollipla strain on P. xylostella infesting peas was four times higher than on P. xylostella infesting cabbage when a single plant species was present. However, when both crops were offered together, the level of parasitism dropped to the level seen when cabbage was offered alone. Diadegma mollipla developed on both hosts, but cabbage-D. mollipla had a longer total development time. Pupae of cabbage-feeding P. xylostella were significantly heavier than pupae of pea-feeding P. xylostella and parasitism had no influence on these differences. Diadegma mollipla preferred to parasitize the pea-feeding P. xylostella. Thus, the host shift by P. xylostella to a novel host plant did not necessarily provide enemy-free space, with the parasitoid species tested. The implications of these findings for the host-parasitoid relationship are discussed.

A PCR-based approach to distinguish important Diadegma species (Hymenoptera: Ichneumonidae) associated with diamondback moth, Plutella xylostella (Lepidoptera: Plutellidae)

The diamondback moth, Plutella xylostella (Linnaeus) has a cosmopolitan distribution and is one of the major pests on cruciferous plants. Biological control, especially with species of the genus Diadegma, has been successfully employed in several parts of the world, mainly in South East Asia. The taxonomy of this genus based on classical morphological characters is still unclear and misidentifications are reported. In the present study seven Diadegma species associated with P. xylostella were separated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analyses. The second internal transcribed spacer (ITS2) of the ribosomal DNA (rDNA) was successfully amplified in all 167 individuals and digested using 11 different restriction enzymes. One restriction enzyme (CfoI) showed different restriction profiles in all species and also between two population samples of D. mollipla (Holmgren) from eastern and southern Africa. In addition, a new Diadegma species associated with P. xylostella from Ethiopia was discovered.

Prospects for biological control of the western flower thrips, Frankliniella occidentalis, with the entomopathogenic fungus, Metarhizium anisopliae, on chrysanthemum

The potential of Metarhizium anisopliae (Metsch.) Sorok. for the control of Frankliniella occidentalis (Pergande) on chrysanthemum cuttings was evaluated in greenhouse experiments. The fungus significantly reduced both the adult and larval populations of F. occidentalis, although the level of control of larval populations was much lower than for adults. Combined application of M. anisopliae and Methomyl (Lannate), however, resulted in a significant reduction of both the larval and adult stages. The use of both control agents might be helpful in reducing the selection pressure for resistance to chemical insecticides, thereby delaying or preventing the build-up of resistant populations in greenhouses.

Ultradian and circadian rhythms of sleep-wake and food-intake behavior during early infancy

The early development of sleep-wake and food-intake rhythms in human infants is reviewed. The development of a 24 h day-night rhythm contains two observable developmental processes: the alterations in the periodic structure of behavior (decreased ultradian, increased circadian components) and the process of synchronization to external time (entrainment). The authors present the results of their studies involving 26 German children and compare them with previous investigations. In their research, it became evident that, during the first weeks of life, the time pattern of sleep-wake and food-intake behavior is characterized by different ultradian periodicities, ranging from 2 h to 8 h. In the course of further ontogenesis, the share of ultradian rhythms in the sleep-wake behavior decreases, while it remains dominant for food-intake behavior. The circadian component is established as early as the first weeks of life and increases in the months that follow. Besides, the authors' study supports the notion of broad interindividual variation in ultradian rhythms and in the development of a day-night rhythm. Examples of free-running rhythms of sleep-wake and food-intake behavior by various authors are strong indicators of the endogenous nature of the circadian rhythms in infants and show that the internal clock is already functioning at birth. It is still uncertain when the process of synchronization to external and social time cues begins and how differences in the maturation of perceptive organs affect the importance of time cues for the entrainment. Prepartally, the physiological maternal entrainment factors and mother-fetus interactions may be most important; during the first weeks of life, the social time cues gain importance, while light acts as a dominant "zeitgeber" at a later time only.

Operative treatment of prolapse of the pars membranacea of the trachea

A new method of operation for stiffening the tracheal back wall in cases of prolapse of the pars membranacea is reported; it has been applied with success on 22 cases. The advantages of this technically demanding operation starting from the neck over the method using transthoracic access with insertion of bone chips, fascia graft, or plastic prostheses are discussed.

[Prolaps of trachea as special form of asthma and its surgical correction from transcollar access (author's transl)]

A new operative method of treatment of prolaps of pars membranacea in the region from trachea is reported. One cause of this prolaps is a false breathing mechanism, mainly without respiration through the nose. The reflection of pathogenesis of this special form of asthma, the operative treatment and therapy are described.