Difference In Ferritin Levels Research Articles

Iron status in Dutch and Finnish blood donor and general populations: A cross-cohort comparison study.

Blood donors are at risk of developing iron deficiency (ID) (ferritin <15 μg/L, World Health Organization definition). Blood services implement different strategies to mitigate this risk. Although in Finland risk group-based iron supplementation is in place, no iron supplementation is provided in the Netherlands. We aim to describe differences in ferritin levels and ID prevalence in donor and general populations in these countries. Six cohorts, stratified based on sex, and for women age, in the Netherlands and Finland were used to evaluate differences in ferritin levels and ID between donor populations (Donor InSight-III and FinDonor 10,000) and general populations (Prevention of Renal and Vascular End-Stage Disease [PREVEND], FinRisk 1997 and Health 2000) and newly registered Dutch donors. Multivariable logistic regression was used to quantify associations of various explanatory factors with ID. In total, 13,443 Dutch and 13,933 Finnish subjects were included. Donors, except for women aged ≤50 years old in Finland, had lower median ferritin levels compared with the general population and new donors. Dutch regular blood donors had higher or similar prevalence of ID as compared with the Dutch general population, including new donors. In contrast, Finnish donors showed similar prevalence of ID compared with the general population, except for a markedly lower prevalence in ≤50-year-old women who routinely receive iron supplements when donating. Iron status in blood donors differs from that in the general population. The Finnish blood service donor management policy, for example, iron supplementation for risk groups, seemingly protects young female blood donors from developing ID.

Comparison of oral iron chelators in the management of transfusion-dependent β-thalassemia major based on serum ferritin and liver enzymes

Background Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in β-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in β-thalassemia major patients. Methods A cross-sectional observation was performed on 102 patients with β-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman’s rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators’ effects between those receiving short-term (≤7 years) and long-term (&gt;7 years) blood transfusion were also analyzed. Results The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 and p&lt;0.001) and AST ((r=0.569; p&lt;0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups (p=0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group (p=0.001 and 0.022, respectively). Total (p&lt;0.001), indirect (p&lt;0.001), and direct bilirubin levels (p=0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance of p=0.008 in the long-term transfusions group. Conclusions Ferritin is high in people with transfusion-dependent β-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.

Inflammatory Markers in Hemophagocytic Lymphohistiocytosis - a Single Centre Study

BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) has significant clinical and biochemical overlap with other cytokine storm syndromes including Adult-Onset Still's disease (AOSD) and COVID-19 cytokine storm (CCS). Diagnosis of HLH is based largely on the HLH-2004 criteria which carry certain limitations. Many of the tests included in these criteria such as flow cytometry for NK cell cytotoxicity and soluble CD25 levels are only available in specialized centres. Moreover, they can take days to weeks to result, leading to delays in diagnosis. Biomarkers that are unique to HLH and more readily available are needed to ensure a timelier diagnosis of this life-threatening disease. C-reactive protein (CRP) is a sensitive marker of inflammation that is driven by IL-6 activity, a cytokine that is significantly elevated in AOSD and CCS but comparatively less so in HLH. Our study sought to determine whether lower levels of CRP, in conjunction with other patterns of inflammatory markers, could reliably distinguish HLH from AOSD and CCS. METHODS This was a single-centre, retrospective study examining adult ( n=45) and pediatric ( n=12) patients with HLH, and adult patients with AOSD ( n=11) and CCS ( n=13). Patients were enrolled from Vancouver General Hospital between January 1 st, 2000, to June 28 th, 2023. CRP and ferritin levels were collected for each patient if available, and values were included in analysis only if drawn prior to HLH-specific treatment. Ferritin levels were included to add to our understanding of different patterns of inflammation seen in similar cytokine storm syndromes. The Kruskal-Wallis test was used to compare CRP and ferritin values in total HLH cases compared to AOSD and CCS. Diagnostic performance of CRP was analyzed by performing a receiver operating characteristic (ROC) curve for CRP in HLH patients using the Youden index to identify the optimal cut-off point for CRP values. RESULTS In total, eighty-one patients were included in the study. Median CRP was significantly lower in HLH compared to AOSD (68.9 mg/L versus 168.0 mg/L, p &amp;lt; 0.001) and CCS (68.9 mg/L versus 121.0 mg/L, p = 0.024) (Figure 1). Median serum ferritin levels were significantly lower in CCS compared to HLH (1,386 ng/mL versus 16,722, p &amp;lt; 0.001) and AOSD (1,3860 ng/mL versus 12,480 ng/mL, p = 0.016). There was no significant difference in ferritin levels between HLH and AOSD. The ROC curve was performed for CRP values in total HLH cases which demonstrated an Area Under the Curve (AUC) of 0.799, indicating a fair diagnostic performance in differentiating HLH, with a sensitivity of 66.1% and specificity of 87.5% for CRP values less than 94.5 mg/L, as calculated by Youden's index. CONCLUSION CRP is significantly lower in HLH compared to AOSD and CCS, suggesting that mild to moderate elevations in CRP reflect the comparatively lower IL-6 activity underlying HLH. When used in conjunction with other inflammatory markers, especially marked hyperferritinemia, a comparatively lower CRP value helps capture the unique cytokine pattern underlying HLH, and is a useful, easily accessible biomarker than can aid in the diagnosis of HLH.

Effects of Smoking on Serum Ferritin levels in adult population living in Sulaymaniyah, Iraq: A Retrospective Cross-sectional Study

Background: Smoking is a serious issue for global public health, and the prevalence of smoking use is the leading cause of early mortality globally. Serum ferritin, an intracellular protein that stores and releases iron, is considered one of the most important clinical biomarkers to assess iron status.&#x0D; Aim: The current study aims to examines the effect of smoking on serum ferritin levels of adult populations in Sulaymaniyah. &#x0D; Methods: The study was conducted on 80 smokers and 20 non-smokers, totally 100 persons. Their ages ranged from 18 to 65 years.&#x0D; Results: Result showed that the majority of smokers had elevated ferritin levels. A p-value of less than 0.05 indicated a significant difference in ferritin levels between smokers and non-smokers groups. The average ferritin level among smoker group was 227.40 mg/L, while the average ferritin level among non-smokers group was 118.3 mg/L. Regarding the associated between age groups and average ferritin levels, the average ferritin level is highest in the age groups between 51-61 years old. In addition, obesity may play a role in raising ferritin levels, people with obese conditions (BMI &gt; 30) have the highest average ferritin levels than others.&#x0D; Conclusion: This study provides evidence that smoking negatively affect serum ferritin levels, since increases in mean ferritin levels are very striking in smoking and obese group.

Effects of Smoking on Serum Ferritin levels in adult population living in Sulaymaniyah, Iraq: A Retrospective Cross-sectional Study

Objectives: The current study aims to examines the effect of smoking on serum ferritin levels of adult populations in Sulaymaniyah. &#x0D; Methods: The study was conducted on 80 smokers and 20 non-smokers, totally 100 persons. Their ages ranged from 18 to 65 years.&#x0D; Results: This study showed that the majority of smokers had elevated ferritin levels. A p-value of less than 0.05 indicated a significant difference in ferritin levels between smokers and non-smokers groups. The average ferritin level among smoker group was 227.40 mg/L, while the average ferritin level among non-smokers group was 118.3 mg/L. Regarding the associated between age groups and average ferritin levels, the average ferritin level is highest in the age groups between 51-61 years old. In addition, obesity may play a role in raising ferritin levels, people with obese conditions (BMI &gt; 30) have the highest average ferritin levels than others.&#x0D; Conclusion: This study provides evidence that smoking negatively affect serum ferritin levels, since increases in mean ferritin levels are very striking in smoking and obese group.

Association of Coffee or Green Tea with Ferritin or Hemoglobin in Premenopausal Women.

This study aimed to examine the association between coffee or green tea consumption and ferritin or hemoglobin levels in premenopausal women. We used the fifth Korea National Health and Nutrition Examination Survey (2010-2012), and a total of 4,322 individuals were surveyed. In women of reproductive age, average ferritin and hemoglobin levels were calculated according to coffee or green tea consumption. Covariates included in the analysis were demographic variables, such as age, body mass index, education, drinking, smoking, history of hypertension, history of diabetes diagnosis, physical activity, total energy intake, and daily iron intake. In 4,322 participants, the average hemoglobin level was 12.90±0.02 g/dL, and the average level of ferritin was 31.95±0.67 ng/mL. As a result of testing, correlation between ferritin and coffee intake and difference in ferritin levels according to coffee consumption was significant (P<0.05). In this study, a post hoc test indicated that ferritin level significantly differed between one and two cups, two and three cups, and three and one cup groups (overall P<0.001). Additionally, there was a negative correlation between ferritin level and coffee intake; ferritin level decreased by 2.09 ng/mL with a one-cup increase in daily coffee consumption. In premenopausal women, coffee intake is associated with low serum ferritin levels. Our results indicate that drinking >2 cups of coffee significantly affect ferritin levels in Korean premenopausal women.

Comparison of oral iron chelators in the management of transfusion-dependent β-thalassemia major based on serum ferritin and liver enzymes

Background: Excess iron deriving from a chronic transfusion and dietary intake increases the risk for cardiac complications in β-thalassemia major patients. Deferiprone and deferasirox are commonly prescribed to thalassemic patients who are at risk of iron overload. This study aimed to compare the performance and toxicity of deferiprone and deferasirox in β-thalassemia major patients. Methods: A cross-sectional observation was performed on 102 patients with β-thalassemia major. Serum ferritin along with total, indirect, and direct bilirubin levels were measured. Levels of liver enzymes, transaminase (ALT), and aspartate transaminase (AST), were also determined. Ferritin correlations with serum ALT, AST, and total bilirubin were constructed based on Spearman’s rank correlation. Statistical differences based on the serum parameters were analyzed between deferiprone and deferasirox groups. The differences of iron chelators’ effects between those receiving short-term (≤7 years) and long-term (&gt;7 years) blood transfusion were also analyzed. Results: The averaged levels of bilirubin, ALT, AST, and ferritin were found to be high. Ferritin was positively correlated with ALT (r=0.508 and p&lt;0.001) and AST ((r=0.569; p&lt;0.001). There was no statistical difference in ferritin levels between the deferiprone and deferasirox groups (p=0.776). However, higher total bilirubin and ALT were observed in the deferasirox group than in the deferiprone group (p=0.001 and 0.022, respectively). Total (p&lt;0.001), indirect (p&lt;0.001), and direct bilirubin levels (p=0.015) were significantly higher in patients with long-term transfusions than those receiving short-term transfusions. Higher ferritin was found with a statistical significance of p=0.008 in the long-term transfusions group. Conclusions: Ferritin is high in people with transfusion-dependent β-thalassemia major and positively correlated with ALT and AST. Deferasirox might pose a higher risk of developing hepatic injury as compared with deferiprone. Yet, no significant change of deferasirox efficacy (based on ferritin level) was found between those receiving short-term and long-term transfusions.

Health-related quality of life in iron deficient young women

BACKGROUND: The most important cause of anemia in the world is iron deficiency. Young women are more susceptible to the formation of latent iron deficiency and iron deficiency anemia in comparison with other population groups. Iron deficiency conditions can lead to a deterioration in exercise tolerance and adaptation to them, however, the effect of latent iron deficiency and iron deficiency anemia on cognitive functions, emotional status and quality of life is still a subject of discussion, which may be due to the small number of studies in which iron deficiency conditions are studied in the absence of concomitant chronic diseases.&#x0D; AIM: Evaluate the effect of latent iron deficiency and iron deficiency anemia on the quality of life in young women.&#x0D; MATERIALS AND METHODS: a cross-sectional simultaneous study was conducted in women aged 1821 years. The occurrence of iron deficiency conditions was assessed, a study of the quality of life was conducted using the SF-36 questionnaire. In the statistical processing of the results obtained, the assessment of normality within each group was carried out using Shapiro-Wilk test. For an intergroup comparison of the results obtained between two independent groups, MannWhitney test was used, and Wilcoxon test was used when comparing the results of two dependent groups. The intergroup comparison between the three groups was carried out using KruskalWallis test. When detecting deviations from the null hypothesis, a posteriori analysis was carried out using MannWhitney test with Bonferroni correction.&#x0D; RESULTS: 68 subjects aged 1821 took part in the study. The median age was 18 years [18; 21]. 25 (36.7%) women were diagnosed with ID, 16 (23.5%) with IDA. The level of C-reactive protein in all subjects was 5 mg/l, median 2.4 [1.2; 3.1] mg/l. During a posteriori analysis, comparable indicators of the total blood count between the groups of healthy women and those with ID were revealed. At the same time, there were no differences in ferritin levels between the ID and IDA groups. In the study of quality of life, statistically significant intergroup differences between the study groups were obtained in the scales of general health, vital activity, role functioning due to emotional state, mental health and general mental well-being. When conducting a posteriori analysis, the number of points in the questionnaire scales turned out to be comparable between groups of healthy women and those with ID.&#x0D; CONCLUSIONS: data on the high incidence of latent iron deficiency and iron deficiency anemia in young women have been obtained. The presence of latent iron deficiency does not independently affect the quality of life associated with health. Mild iron deficiency anemia moderately reduces the quality of life due to the emotional component.

Ferritin Level as Independent Predictor of Covid-19 : a Cross Sectional Study

COVID-19 is an infectious disease caused by SARS-CoV-2. In severe cases of COVID-19, it is often accompanied by a syndrome known as cytokine storm or cytokine release syndrome (CRS). Serum ferritin levels, increase as the disease worsens. This study aims to see the relationship between ferritin levels and the degree of COVID-19 and evaluate ferritin levels as a predictor of severity in COVID-19 patients at RSPI Prof Dr Sulianti Saroso. This type of research is quantitative with a cross sectional approach. Data analysis using Kruskal Wallis test. Secondary data from medical records of confirmed COVID-19 patients based on the results of PCR examinations during March 2020 to December 2020 who examined ferrittin levels as many as 554 patients. The results showed that the average ferritin level was 164.78, moderate was 524.13, severe was 1377.52 and critical was 1592.46. The results of the analysis with the Kruskal Wallis test obtained P value = 0.000 &lt; (0.05) so it can be explained that there are differences in ferritin levels of the four degrees of disease. This shows that there is an effect of the relationship between ferritin levels and the degree of disease in COVID-19 patients.

A systematic nutrition intervention for low iron status in collegiate distance runners.

Background: Iron is a trace mineral that plays a significant role in oxygen transport and energy production during exercise. In deficiency, iron can have a significant negative impact on sports performance. Due to its relative simplicity, supplementation is a common treatment to combat deficiency. However, there is a paucity of analyses combining supplementation with dietary education as a method of treatment. Objective: To assess the effectiveness of a systematic iron intervention combining nutrition education and supplementation stages to combat low ferritin levels in collegiate runners. Methods: Twenty four distance runners (13 women; 11 men; 19.5 ± 0.8 years of age) were measured for serum ferritin, daily iron, calcium and vitamin C intake at the start of the fall semester and again after 100 days of supplementation. A dependent groups t-test was applied to delineate changes in Ferritin levels and iron, vitamin C and calcium intake. Alpha levels were maintained a priori at p < 0.05. Results: Ferritin levels averaged 40.0 ± 22.6 ng/mL in Fall and 33.7 ± 14.7 ng/mL in Spring. There were no statistical differences in ferritin levels from Fall to Spring (p = 0.074). Weekly Iron intake (# of foods) significantly increased from Fall (110.8 ± 43.1) to Spring (123.3 ± 43.9), (p = 0.028). There were no significant changes in Vitamin C or Calcium intake between time points (p = 0.441), (p = 0.901). Conclusion: We found no significant differences in serum ferritin measures but dietary intake of iron increased as a result of the intervention.

The Association Between Ferritin and Vitamin D Levels in Premenopausal Fibroid Uterus Cases With Anemia.

ObjectiveThe present study aimed to evaluate the association between serum ferritin and vitamin D levels in fibroid uterus cases presenting with anemia.MethodsSixty premenopausal women with uterine fibroids (30 associated with anemia and 30 without anemia) were enrolled as cases and control. All participants were evaluated on the basis of a questionnaire, which included queries related to obstetric, medical, and sociodemographic history. Peripheral blood smear, complete blood count (CBC), hemoglobin (Hb), and serum ferritin concentration were measured by a fully automated analyzer, and 25(OH) vitamin D level was measured by enzyme-linked immunosorbent assay (ELISA).ResultsThere was a significant difference in ferritin levels between cases and control (p<0.001). The exposure to sunlight was moderate (one-hour exposure) in all subjects, eliminating the confounding effect of sunlight exposure influencing vitamin D levels. The median vitamin D level in cases was 5.0 ng/ml [interquartile range (IQR): 4.8], and that in control was 18.4 ng/ml (IQR: 7.9; p<0.001). A strong positive correlation of (r)=0.616 (p<0.001) was found between serum ferritin and vitamin D levels.ConclusionFibroid uterus cases with anemia are more prone to vitamin D deficiency as compared to cases without anemia. Vitamin D estimation in fibroid uterus cases presenting with anemia would be useful for better patient management.

Automated exchange compared to manual and simple blood transfusion attenuates rise in ferritin level after 1 year of regular blood transfusion therapy in chronically transfused children with sickle cell disease

Optimal strategies for regular blood transfusion therapy are not well defined in sickle cell disease (SCD). This analysis tested the hypothesis that in the first of year of regular transfusions, when chelation therapy use is minimal, automated exchange transfusion would be the superior method for attenuating the rise in ferritin levels compared to simple and manual exchange transfusions. The Silent Cerebral Infarct Multi-Center Clinical Trial randomly allocated children with SCD and silent cerebral infarcts to receive standard care or regular transfusions with a target pre-transfusion HbS concentration ≤ 30% and minimum hemoglobin level > 9.0 g/dL. Participants with at least nine transfusions and sufficient ferritin testing in the first year of the trial were included in a planned secondary analysis. Ferritin levels by the end of the first study year were compared between participants receiving automatic exchange transfusion, manual exchange transfusion, and simple transfusion. A total of 83 participants were analyzed. During the first year of the study, 75.9% of the participants had >80% of transfusions via one transfusion method. At baseline no significant differences in ferritin levels were observed in the three transfusion groups (p = 0.1). After 1 year of transfusions the median (interquartile range) ferritin levels in the simple transfusion (n = 40), manual exchange transfusion (n = 34) and automatic exchange transfusion (n = 9) groups were 1800 ng/mL (1426-2204 ng/mL), 1530 ng/mL (1205-1805 ng/mL), and 355 ng/mL (179-579 ng/mL), respectively (p < 0.001). Automated exchange transfusion, when compared to other transfusion methods, is the optimal transfusion strategy for attenuating increase in ferritin levels in children with SCD.

Correction of Iron Deficiency with Intravenous Iron Replacement Immediately after Left Ventricular Assist Device Implant

Iron deficiency anemia (IDA) persists after left ventricular assist device (LVAD) placement and is associated with increased hospitalizations and mortality. Correction of IDA with IV iron replacement in patients with heart failure improves quality of life (QoL), functional capacity, and reduces hospitalizations. Minimal data for IV iron replacement in patients with LVAD exists. We sought to assess the safety and efficacy of protocolized iron deficiency diagnosis and IV iron replacement in newly implanted LVAD recipients. A prospective, observational study of all patients undergoing LVAD implant from 1/1/2019-9/30/2019 was conducted. Iron studies were obtained in all patients prior to index discharge; iron deficiency was defined as ferritin <100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation (TSat) <20%. Patients with IDA received ferric gluconate (FG) 250 mg IV q12h to correction of iron deficit as calculated by the Ganzoni formula. Iron studies were repeated in 4-8 weeks in the ambulatory setting. Functional capacity and QoL were evaluated by the change in 6-minute walk test (6MWT) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) pre-implant, compared to the 3 month follow up clinic visit, respectively. Of the 16 patients who received an LVAD in the study period, 12 (75%) were found to have IDA and received IV FG. Patients were 62±10 years old, 81% were male, and 50% were Caucasian. No infusion-related adverse effects occurred. At a median follow-up of 9.9 weeks, 87.5% were no longer iron deficient. Hemoglobin (HgB), hematocrit (HCT) and Tsat increased significantly; there was no difference in ferritin levels. For the 8 patients with a 3 month post-implant clinic visit, a significant increase in MLHFQ, but not 6MWT, was observed. IV FG infusions immediately after LVAD are well-tolerated and associated with increased HgB/HCT and correction of IDA. Future studies are needed to confirm improvement in clinical outcomes.

Correlation between Serum Ferritin Levels and Liver Stiffness measured by Fibroscan in patients with Chronic Hepatitis C.

Objective:To determine correlation between transient elastography values with serum ferritin and duration of infection in patients of hepatitis C.Methods:A cross-sectional study was conducted at medical units of Civil Hospital, Karachi. The study protocol was approved by the Research Evaluation Unit of College of Physician and Surgeon Pakistan (CPSP). Patients fulfilling inclusion criteria were included after taking informed consent. Serum ferritin levels were tested by standard laboratory procedures and transient elastography by fibroscan. Regression analysis was done to see correlation of ferritin with transient elastography and duration of HCV.Results:Over all 120 patients fulfilling the selection criteria were selected after informed consent. These included 68 (56.7%) male & 52 (43.3%) female. Significant differences in ferritin levels by Fibrosis stages were observed by ANOVA (df = 3; F =12.768; p = <0.001). Serum ferritin showed linear pattern across Fibrosis stages (F = 33.948; p = <0.001). Regression analysis of ferritin and duration of HCV showed significant impact on TE scores (r2 = 0.317).Conclusions:There is significant correlation between serum ferritin and duration of HCV with TE scores.

The Effects of Patients' and Care-Givers' Knowledge, Attitude, &amp; Practice (KAP) on Quality of Life Among Thalassemia Major Patients' in Damascus-Syrian Arab Republic

Background: Thalassemia is the most common autosomal abnormality in Syria. Its complications have an important effect on education; time off school; sport; difference from friends/ siblings; social interactions; and stigmatization. Knowledge of factors associated with quality of life in thalassemia patients is necessary for forming appropriate clinical programs, social support, and improving treatment outcomes. Purpose: The study was to assess the effects of Patients' and Care-givers' Knowledge, Attitude, &amp; Practice (KAP) with Quality of Life among Thalassemia Major Patients' in Syria. Methods: Cross-sectional descriptive analytical design was conducted at the national thalassemia center in Damascus. WHOQOL-BREF and a questionnaire developed by the researcher were used to measure the participants’ knowledge, attitudes and practices of thalassemia. Results: Total of 238 thalassemia patients participated in the study. A statistical significance was found regarding improvement of skill and knowledge scores among caregivers and thalassemia patients before and after receiving the teaching guide from 12.52±1.77 to 14.07±1.01, t=11.447, p=0.000 and from 34.12±4.50 to 37.43±4.61, t=-8.58, p= .000 respectively. Stigmatization was significantly noticed among families caring for thalassemic patients. There were a significant differences in the mean score regarding nutritional status before and after teaching guide paired t test= 12.11, p= 0.000. A statistical significance was found in females regarding social domain p=0.04. However, mean scores for overall quality of life were better in females rather than males, but these mean scores were statistically insignificant p&gt;0.05. A statistical significant difference in ferritin levels and patient’s age was found. Results also revealed that no statistical significant differences was observed between overall quality of life of the four domains in relation to the two treatment groups (subcutaneous vs oral) and age groups. Conclusion: Thalassemia is a socio-economic problem. The most efficient way to reduce risks of having affected patients is by increasing the knowledge through training of parents regarding the disease. Our findings highlighted that there was lack in patients’ knowledge and skills regarding the disease, but a remarkable improvement in both knowledge and performance was found after patients received the teaching guide, which lead to an increase in overall patient's quality of life.

Assessing the Serum Levels of Ferritin and Selenium in three Important Infections of Childhood, Compared to a Control Group

The purpose of this study is to evaluate serum levels of selenium and ferritin in acute infections of childhood. Patients aged 2-15, hospitalized from autumn 2010-2011 in infectious ward of Rasoul-e-Akram hospital were recruited to the study. Patients with documented diagnosis of GI, RTI, UTI were case groups, who were compared to one control group, including patients hospitalized in the same hospital in surgery ward without any active infection. Blood samples were gathered from all patients and ferritin and selenium serum levels were measured in serum specimens. Diagnosis of the three infections was made by a unique infectious specialist. The mean and standard deviation of serum selenium concentration of GI, RTI, UTI and control groups were 64.70±21.43 µg/l, 61.60±19.25 µg/l, 66.37±22.11 µg/l and 62.20±22.08 µg/l, respectively without significant differences in serum selenium levels between these groups (P-value =0.608). The median of serum ferritin levels in GI, RTI, UTI and control groups were 60.05 (48.82-78.01), 62.00 (49.07- 79.35), 60.60 (51.78-79.52) and 58.75 (45.32-76.72), respectively. The difference in ferritin levels between these groups was statistically significant (P-value <0.001). Compared with the control, the RTI and GI groups had significantly higher levels (P<0.001); however, the UTI group was not statistically different from the control (P=0.098). None of the children had ferritin constrictions below 12. As far as selenium and ferritin deficiency is an important issue in developing countries, it would be valuable to assess the role of micronutrients in infectious diseases, as we may be able to prevent such fatal infections by micronutrient supplementations. Keywords: Selenium, ferritin, respiratory tract infections, urinary tract infections.

Iron Bioavailability of Sorghum, Cowpea, Corn and Soybean Fortified Blended Foods

Fortified blended foods (FBFs) are widely used for food aid. Corn and soybeans are the common components of FBFs. Resistance to genetically modified (GMO) foods led to interest in non-GMO commodities like sorghum and cowpea. Both sorghum and cowpea are rich in iron; however their iron bioavailability is poor due to the presence of tannins and phytates. A food processing technique, extrusion cooking reduces these anti-nutrients in foods. Hence, we developed extruded sorghum, soybean and cowpea FBFs. The objective of our study was to determine whether the iron bioavailability from extruded sorghum-cowpea and sorghum-soy FBFs is equal/ better than non-extruded corn-soy FBFs. Eighteen different FBFs; sorghum-cowpea (n=8), sorghum-soy (n=5) and corn-soy (n=5) were prepared and iron bioavailability was assessed using the in-vitro digestion/Caco-2 cell model. Iron bioavailability was determined by measuring Caco-2 cell ferritin (ng ferritin/mg cell protein) formation in response to 12 hour treatment with aqueous fraction collected from digested FBFs. Control cells were collected at time zero, to measure basal ferritin content. There was no significant difference in ferritin levels between newly developed extruded sorghum-cowpea, sorghum-soy, corn-soy and traditional corn-soy FBFs. Ferritin was higher in all the blends compared to control. Iron bioavailability of extruded sorghum-cowpea, sorghum-soy FBFs is comparable to traditional corn-soy FBFs. Supported by USDA-MFFAPP.

Early versus late prophylactic iron supplementation in VLBW infants: a randomized controlled trial.

SUMMARY In this single blinded parallel-group randomized controlled trial (RCT), preterm very-low-birth-weight (VLBW) infants received early iron (EI) supplementation (starting at 2 weeks postnatal age), or late iron (LI) supplementation (starting at 6 weeks postnatal age) [1]. The primary outcome was serum ferritin level at 12 weeks, and the secondary outcomes were the incidence of neonatal morbidities, hemoglobin level, anthropometric parameters and blood transfusion requirements. Outcomes were analyzed in 46 and 47 babies in EI and LI groups, respectively. Serum ferritin level was significantly higher (P<0.001) at 12 weeks in the EI group. Hemoglobin and mean corpuscular hemoglobin concentration (MCHC) were also significantly (P<0.001) higher at 12 weeks in the EI group. There were no significant differences in the incidences of neonatal morbidities [necrotizing enterocolitis (NEC), periventricular leukomalacia, retinopathy of prematurity (ROP)], anthropometric parameters and blood transfusion requirements between the two groups. The authors concluded that EI supplementation in preterm VLBW infants improves serum ferritin and hemoglobin levels. COMMENTARIES Evidence - based - medicine Viewpoint This RCT on early versus late enteral iron supplementation in preterm VLBW babies is timely, generalizable and well conceived. The authors concluded that EI supplementation in preterm VLBW infants improves serum ferritin, hemoglobin and MCHC at 12 weeks of postnatal age without any concomitant difference in inflammation to account for the difference in ferritin levels. The study is justified because there is still substantial uncertainty about the optimal age at which enteral iron supplementation should commence in such infants. The method of randomization and allocation concealment in the study is appropriate. Measurement bias was restricted by masking the outcome analyzers. One of the potential dangers of EI supplementation is increase in free radical mediated diseases, such as NEC and ROP. The authors rightly concluded that although their trial was not able to detect a significant difference in these diseases, the study was underpowered to do so. The study confirms the efficacy of early iron supplementation but it is inconclusive regarding the safety of the intervention. Only a large study or a metaanalysis of existing trials may be able to shed light on the equally important issue of safety.

Tiempo de pinzamiento del cordón umbilical y complicaciones neonatales, un estudio prospectivo

ObjectiveTo assess the effects of early or late clamping of the umbilical cord in term newborns, assessing the levels of hemoglobin, hematocrit, and ferritin, and their correlation with some of the complications. Patients and methodsA prospective study of healthy newborns at term or born by dystotic or eutocic delivery in our hospital between May 2009 until May 2010. Patients were assigned according to the time of clamping, group 1 (<60seconds), group 2 (1 to<2minutes), and group 3 (2 to 3minutes). Laboratory tests were performed at birth and at 48hours of life, assessing the levels of hemoglobin, hematocrit, ferritin, and bilirubin. The risk of polycythemia, respiratory distress syndrome, neonatal phototherapy or admission to the Intensive Care Unit and the hospital stay, were evaluated. ResultsA total of 242 patients were included: group 1 (g1=80), group 2 (g2=31) y group 3 (g3=131). The background maternal and neonatal characteristics were similar in all sets. The first test showed significant differences in ferritin levels in those infants with delayed clamping (g1: 111 mg/dl, g2: 125 mg/dl, g3: 173 mg/dl; p<0.01). In the second analysis the values of hemoglobin (g1: 17.3 g/dl, g2: 18.9 g/dl, g3: 19.2 g/dl; p<0.01), hematocrit (g1: 53.4%, g2: 58%, g3: 59%; p<0.01) and ferritin (g1: 254 mg/dl, g2: 254.7 mg/dl, g3: 313 mg/dl; p = 0.008) were statistically higher in this group. As regards complications, a significant increase was observed in the number of cases of polycythemia symptoms in group 3. ConclusionsThe late cord clamping is associated with an increase in hematocrit, hemoglobin and ferritin at 48hours of life, as well as an increased risk of polycythemia present with symptoms.

The Iron Status of Children and Youth in a Community Mental Health Clinic is Lower than that of a National Sample

Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects. In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples. The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95% CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis. The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.