Blood Iron Research Articles

Red blood cell transfusion and the use of intravenous iron in iron‐deficient patients presenting to the emergency department

AbstractBackground and aimsRed blood cell transfusions are often used to treat iron‐deficient patients in the emergency department (ED), while treatment with intravenous (IV) iron is preferred, as it increases hemoglobin concentration rapidly and durably. We aim to evaluate the incidence of iron deficiency anemia, frequency of blood transfusion and iron supplementation, and factors associated with blood transfusion in the ED.MethodsWe conducted a retrospective cohort study of adult patients presenting to the St. Boniface Hospital (Winnipeg, Canada) ED from 2014 to 2018. Electronic data obtained from the Emergency Department Information System and Laboratory Information Services databases identified patients presenting with iron deficiency anemia, defined as microcytic (mean corpuscular volume < 75 fL) anemia (hemoglobin < 120 g/L) with either a transferrin saturation <20% or ferritin < 30 µmol/L. Ferritin > 100 µmol excluded iron deficiency anemia. The use of blood transfusions or iron supplementation was determined for each patient. Factors associated with blood transfusion were determined using logistic regression analyses.ResultsOf 39,222 patients, 17,945 (45%) were anemic. In anemic patients, iron parameters were ordered in 1848 (10.3%) and iron deficiency anemia was diagnosed in 910 (5.1%). Ninety‐five patients (10.4%) received one red blood cell unit, and 197 patients (21.6%) received ≥2 units. Oral iron and IV iron were prescribed for 64 (7.0%) and 14 (1.5%) patients, respectively. Hemoglobin concentration was the main determinant for treatment with blood transfusion.ConclusionsIron deficiency is underinvestigated among anemic patients presenting to the ED. The only clinical factor associated with red blood cell transfusion in the ED was hemoglobin level, irrespective of symptoms or clinical stability.

Relationship Between Whole Blood Iron Levels and Lipid Profile Parameters in the General Population: Findings from Routine Physical Examination Report.

Dyslipidemia is related to the occurrence and development of many diseases and is a common problem among the general population. A significant link has been identified between dyslipidemia and ferroptosis. Lipid profile parameters are important indicators of dyslipidemia. Iron is the main cause of ferroptosis. However, the relationship between blood lipid parameters and whole blood iron levels has remained unclear. Based on a community population, the study aimed to explore the relationship between whole blood iron levels and blood lipids in Taizhou, China. The blood samples were collected from 1917 community residents, and levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and whole blood iron were measured. Pearson correlation was used to analyze the correlation between whole blood iron levels and lipids profile parameters. The results of the study showed that for both men and women, whole blood iron concentration was positively correlated with total cholesterol, triglycerides, and low-density lipoprotein cholesterol (P < 0.001), but not with high-density lipoprotein cholesterol (P = 0.618, P = 0.083). The positive correlation between whole blood iron and triglycerides was the most significant (P < 0.001, r = 0.138). The above trends were more pronounced among men than among women. Therefore, the study suggested that regulating whole blood iron levels of populations in Taizhou, China, may be a potential strategy for regulating triglycerides, total cholesterol, and low-density lipoprotein. The potential for controlling triglycerides by regulating whole blood iron is more apparent. The result of the study has some implications for the prevention and diagnosis of dyslipidemia among medical staff and residents, especially male residents.

Thalassemia in Pakistan: Addressing a Genetic Health Crisis

Thalassemia, a genetic disorder usually caused by the defective genes. These genes are responsible for production of hemoglobin, a protein necessary for the transfer of oxygen in body through blood. Prevalence of thalassemia in Pakistan is concerning to a significant level. Global prevalence of this disease has affected millions of people and their lifestyles. Moreover, the disease leads to the burden on the diseased person’s family and the medical resources of the country, causing an alarming concern. The main issue of high prevalence of this disorder in Pakistan is associated with high percentage of cousin marriages. This cultural practice between the close relatives increases the chances of inheriting mutated genes into next generations. Each year more than 5000 children in Pakistan are born with disease. The rate of thalassemia is considerably higher in first cousin marriages (76.7%) than in second cousin marriages (23.3%) [1]. Furthermore, the inadequate spread of awareness among people and the lack of preventative measure by people is contributing to the increase in the number of thalassemia cases Thalassemic patients do require blood transfusion in an adequate to survive and live a normal life. Moreover, after transfusion they need financially draining therapies like iron chelation that is being required to manage the overload of iron in blood. The limited medical resources and poor infrastructure of hospitals and clinics in the rural areas can lead to the increase of complications then reducing the problems come with this disease. This kind of public healthcare system can affect the diseased individuals to level to develop life threatening problems such as stunted growth, and organ failures etc. To address this problem, a national program stating that genetic screening before marriage is necessary can lead to the reduction in the rate if this disease. Premarital screening for inherited diseases including Thalassemia is being carried out in middle east for last more than a decade. Some countries like Iran have overcome this problem to a great level by taking these kinds of initiatives, which shows that how important is it to detect the disease occurrence through premarital screening and counseling [2]. There should be campaigns for the public awareness highlighting the importance of genetic screening so that the cause of occurrence of this disorder can be decreased. Additionally, medical advancements have provided the hope. Despite being costly and scarce, for certain patients with thalassemia, bone marrow transplants (BMT) have proven to be a curative treatment, success rates for those who satisfy the right criteria, such as younger patients with matched related donors, range approximately between 80 and 95% [3]. Future advances in repairing genetic abnormalities at their origins may be possible thanks to emerging gene-editing technologies like CRISPR. To make these remedies available in Pakistan, however, significant funding for medical infrastructure and research is needed. Despite being avoidable, thalassemia will continue to take lives and put a burden on families and communities unless immediate action is taken. Pakistan can considerably lessen the impact of this genetic health disaster and clear the path for a healthier future by placing a high priority on education, early identification, and cutting-edge treatments.

Laboratory Biochemical and Hematological Parameters: Early Predictive Biomarkers for Diagnosing Hepatitis C Virus Infection.

Hepatitis C virus (HCV) infection is a worldwide concern, causing liver damage and necessitating early detection to prevent its spread. Studies indicate that evaluating changes in biochemical and hematological parameters, which serve as suitable predictors of inflammation, can be a reasonable method for diagnosing hepatitis C infection. This study analyzed 100 samples from high-risk patients positively identified via quantitative real-time PCR (qPCR). Anti-HCV titers, biochemical and inflammatory tests, and complete blood cell counts (CBCs) were performed for these individuals. Additionally, 100 HCV-negative individuals with normal laboratory results were selected as the control group. Receiver operating characteristic (ROC) curves were plotted to determine the cutoff values of the laboratory parameters. According to the findings, the age, average white blood cell (WBC) count, platelet-to-lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), alkaline phosphatase (ALP), serum glutamic-pyruvic transaminase (SGPT), and ferritin levels were significantly higher in HCV patients. On the other hand, red blood cell (RBC) counts, neutrophils, lymphocytes, hemoglobin-to-platelet ratio (HPR), and iron (Fe) levels were significantly lower in the case group compared to those in the control group (p < 0.05). Furthermore, the ROC curve analysis revealed that lymphocyte count, neutrophil count, and PLR were very strong predictors for hepatitis C infection (p < 0.0001, AUC = 1). The study highlights significant biochemical and hematological differences between HCV patients and healthy subjects. These biomarkers are crucial for early diagnosis, potentially preventing liver damage and reducing HCV transmission.

Treatment Options for Congenital Dyserythropoietic Anemias (CDAs): Advances in Bone Marrow Transplantation, Gene Therapy, and Targeted Therapies

Congenital Dyserythropoietic Anaemia (CDA) is a rare genetic disorder that affects the maturation of red blood cells. The disorder is classified into different types, with a prevalence ranging from 1 in 100,000 to 1 in 1,000,000 individuals. Treatment strategies are designed with the primary focus on symptom management, the prevention and treatment of complications, and the underlying disease pathophysiology. The advent of bone marrow transplantation, gene therapy, and targeted therapies has considerably expanded the scope for therapeutic intervention in CDAs. Supportive care, including blood transfusions and iron chelation therapy, has demonstrated efficacy in managing iron overload and improving overall survival rates. The potential of gene therapy, targeted therapies, and hematopoietic growth factors in the treatment of CDA is currently being investigated. Further research and clinical trials are required to develop more effective and personalized therapeutic interventions.

Cocktail vaccine for the management of Hyalomma anatolicum and Rhipicephalus microplus.

Globally, ticks rank second only to mosquitoes as vectors of deadly pathogens affecting humans and first in transmitting animal pathogens, presenting a significant challenge to human wellness and sustainability of livestock-based industries. Traditional tick control via chemical acaricides impacts on the environment and has led to the emergence of multi-acaricide-resistant tick populations. Use of immunoprophylactic, along with other components of integrated tick management, holds the potential to mitigate tick infestations in a sustainable manner. To control multi-species tick infestations, the concept of a cocktail vaccine comprising of more than one antigens has emerged as a viable solution due to the inconsistent efficacy of single antigen-based immunization protocol. In this study, a dual antigen cocktail immunization protocol was developed targeting ferritin2 (FER2) and tropomyosin (TPM) proteins, which are associated with ticks' essential cellular and physiological functions, like blood iron homeostasis and muscle contractions. Dual gene silencing of FER2 and TPM genes in Hyalomma anatolicum resulted in a 75.3% reduction in infested ticks, a 95.4% decrease in egg masses, and a complete loss of egg hatching when compared to control ticks. Microscopically, an altered ovarian cellular architecture, marked by vacuolation and reduced nucleus-to-cytoplasmic ratio were noted in the gene knocked down ticks. An immunization with cocktails of 300 µg dose of each protein, rHaFER2 and rHaTPM was standardized in a rat model and was used to immunize cross-bred (Bos indicus x B. taurus) male cattle with Montanide ISA 50V2 adjuvant on days 0, 28, and 49. A significant (p < 0.001) IgG and IgG2 antibody response was observed in the immunized animals with high IgG levels sustained until day 119 post-primary immunization, showing a 4.1-fold increase over the pre-immunization period. The animals were challenged with larvae and adults of H. anatolicum and larvae of Rhipicephalus microplus. Immunization with the cocktail antigen resulted an efficacy of 70% and 76% against H. anatolicum larvae and adults, respectively, and 54% against R. microplus infestations. Compared to single-antigen immunization, the immunization with cocktail antigens demonstrated higher protection against R. microplus and H. anatolicum ticks. The results advance the development of cocktail vaccines to control multiple tick species.

Evaluation of efficacy of mentzer index for screening of beta - Thalassemia trait in antenatal women

People with thalassemia trait should be distinguished from those who have anemia due to iron deficiency since they typically have mild microcytic hypochromic anemia and are mostly asymptomatic. : To evaluate efficacy of Mentzer index for screening Beta- Thalassemia trait in pregnant women.From January 2023 to October 2023, the observational study was carried out in the Department of Gynecology &amp; Obstetrics at Sri Guru Ram Das Charitable Hospital Amritsar. The study comprised 130 pregnant women with anemia. To assess microcytic hypochromic anemia, tests like complete blood count (CBC), peripheral blood smears, iron studies, and hemoglobin electrophoresis were performed. Mentzer Index (MI) was computed, and its specificity and sensitivity assessed. Of the 130 patients, 112 had Mentzer Index greater than 13 and 18 had Mentzer Index less than 13 but only 12 out of these18 had beta thal-trait according to HPLC. There were total 15 females having beta thal-trait as per HPLC, however 3 of the 15 had Mentzer &amp;#62;13. Conserding Beta thal-trait, the Mentzer Index's sensitivity and specificity were 80% and 95.65% in this study, and 95.33% and 86.96% for IDA. Mentzer Index (MI) is a helpful tool to distinguish iron deficiency from thalassemia trait as its specificity and sensitivity is high as electrophoresis in diagnosis. In situations with limited resources, this proves to be advantageous in terms of cost-effectiveness.

Colorectal carcinoma-induced iron deficiency anemia: A literature review and a case scenario

Colorectal carcinoma (CRC) is among the leading cancers worldwide and a major cause of cancer-related mortality. Iron deficiency anemia (IDA), resulting from inadequate iron for hemoglobin production, has been increasingly linked to CRC, often leading to misdiagnosis. This study reviews the clinicopathological associations of IDA in the context of colorectal cancer, using the medical records of a septuagenarian diagnosed with both conditions as a case study. Employing the Problem-Intervention-Comparison-Outcome model, we searched for &amp;ldquo;colorectal carcinoma&amp;rdquo; and &amp;ldquo;iron deficiency anemia&amp;rdquo; as keywords. CRC ranks among the top five cancers of global health importance, with socioeconomic factors, sedentary lifestyles, and dietary choices significantly influencing both conditions. Notably, IDA is particularly associated with the right-sided CRC in individuals over 40. Upregulation of interleukin-6 in CRC cells stimulates hepcidin release, which mediates anemia of chronic disorders and IDA. The case revealed right-sided signet ring cell CRC, microcytic hypochromic anemia, bone marrow metastasis, and low serum iron and ferritin levels. This study highlights the need for increased suspicion of CRC in middle-aged and elderly patients presenting with recurrent IDA. Regular screening is essential for the early detection and improved treatment outcomes. While colonoscopy is the gold standard for prevention, its effectiveness in detecting early molecular links between neoplasia and chronic inflammation is limited. There is also no consensus on surveillance protocols, and many gastroenterologists do not adhere to recommended biopsy sampling practices. In conclusion, this study advocates for including complete blood count and iron studies as essential tests in guidelines for screening and diagnosis for CRC-related IDA to enhance diagnostic practices.

Clinical Burden and Healthcare Resource Utilization Associated With Managing Transfusion-dependent β-Thalassemia in England

PurposePatients with transfusion-dependent β-thalassemia (TDT) have reduced levels of β-globin, leading to ineffective erythropoiesis and iron overload. Patients with TDT depend on regular red blood cell transfusions (RBCTs) and iron chelation therapy for survival and management of disease- and treatment-related clinical complications. This study describes the clinical and economic burden in patients with TDT in England. MethodsThis longitudinal, retrospective study linked the Clinical Practice Research Datalink (CPRD) database with secondary care data from the Hospital Episode Statistics database to identify patients with a diagnosis of β-thalassemia between July 1, 2008, and June 30, 2018. Included patients had a diagnosis of β-thalassemia prior to the index date, ≥8 RBCTs per year for ≥2 consecutive years, and ≥1 year of follow-up data available from the index date. Each eligible patient was exact matched with up to 5 controls in the CPRD. Proportions of deaths and rates of mortality, acute and chronic complications, and healthcare resource utilization (HCRU) were calculated during the follow-up period. FindingsOf 11,359 identified patients with β-thalassemia, 237 patients with TDT met the eligibility criteria and were matched with 1184 controls. The mean age at the index date was approximately 25 years in the patient and control groups. The proportion of deaths (7.17% vs 1.18%; P < 0.05) and mortality rate (1.19 deaths per 100 person-years vs 0.20 deaths per 100 person-years) were higher among patients with TDT compared to controls. Endocrine complications and bone disorders were the most prevalent complications among patients with TDT (58.23%) and included osteoporosis (29.11%), diabetes mellitus (28.27%), and hypopituitarism (28.27%). Patients with TDT had a mean of 13.62 RBCTs per patient per year (PPPY). HCRU was substantially higher among patients with TDT, wherein patients with TDT had higher rates of prescriptions recorded in primary care (24.09 vs 8.61 PPPY), outpatient visits (16.69 vs 1.31 PPPY), and inpatient hospitalizations (17.41 vs 0.24 PPPY) than controls. Inpatient hospitalizations were primarily <1 day, with 16.62 events PPPY lasting <1 day and 0.79 events PPPY lasting ≥1 day. Patients with TDT aged ≥18 years had increased rates of mortality, clinical complications, and HCRU than those aged <18 years. ImplicationsPatients with TDT in England have higher mortality than matched controls, substantial disease-related clinical complications, and substantial HCRU. High mortality and clinical complications highlight the need for additional innovative therapies for TDT.

Association between dietary iron intake and hyperuricemia in U.S. adults: a cross-sectional study

BackgroundElevating blood iron levels may increase the risk of hyperuricemia. However, the association between dietary iron intake and hyperuricemia remains unclear. This study examines the association between dietary iron and hyperuricemia.MethodsThe data for this cross-sectional study came from the 2011–2020 National Health and Nutrition Examination Survey (NHANES), which included adults aged 20 and above in the United States. Detailed information on their demographics, dietary iron intake, serum uric acid, and other variables were gathered. This study employs a multifactorial logistic regression method to assess the relationship between dietary iron intake and hyperuricemia. Additionally, it utilizes Restricted Cubic Spline analysis to determine whether there is a non-linear relationship between dietary iron and hyperuricemia. Furthermore, sub-group analyses are conducted to further validate the robustness of this correlation.ResultsThis study included 11,441 patients, with a prevalence of hyperuricemia at 14.96%. Regardless of whether confounding factors were adjusted for, there was a positive correlation between dietary iron intake and hyperuricemia. In Model III, after adjusting for age, gender, race, educational background, body mass index, hypertension, carbohydrate intake, dietary fiber intake, total saturated fatty acid intake, vitamin K intake, vitamin C intake, marital status, poverty income ratio, smoking status, drinking status, work activity, diabetes, sodium intake, energy intake, protein intake, zinc intake, copper intake, selenium intake and total sugars intake, we found that compared to the lowest quintile of dietary iron intake (Q1, ≤ 8.03 mg/day), the odds ratios (ORs) for hyperuricemia in the second (Q2, 8.04–11.07 mg/day), third (Q3, 11.08–14.27 mg/day), fourth (Q4, 14.28–19.33 mg/day), and fifth quintiles (Q5, ≥ 19.34 mg/day) were 1.05 (95% confidence interval: 0.79–1.40), 1.30 (95% confidence interval: 0.99–1.73), 1.39 (95% confidence interval: 1.02–1.89), and 1.36 (95% confidence interval: 0.95–1.97), respectively. The study results indicate that a higher dietary iron intake is significantly positively associated with the likelihood of hyperuricemia.ConclusionIn the adult population of the United States, there is a positive correlation between dietary iron intake and hyperuricemia, with higher dietary iron intake associated with an increased likelihood of hyperuricemia.

Mid-term efficacy of single anastomosis duodenal-ileal bypass with sleeve gastrectomy in the treatment of obesity and type 2 diabetes mellitus

Objective: To evaluate the mid-term efficacy of single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) in the treatment of obesity and type 2 diabetes mellitus. Methods: The cohort of this retrospective observational study comprised 118 obese patients with body mass index (BMI) ≥40 kg/m2 with or without other related metabolic diseases and BMI of (27.5-40.0) kg/m2 with type 2 diabetes mellitus (T2DM) who had been treated with SADI-S. Patients who had undergone modified surgery or been followed up for less than 1 year were excluded. Clinical data of the included patients [56 men and 62 women aged (34.5±9.7) years], who had undergone SADI-S in China-Japan Union Hospital, Jilin University from October 2018 to August 2022, were collected. Their mean preoperative body mass was (125.9±25.0) kg and BMI (42.8±6.8) kg/m2. The 60 patients with T2DM had a mean fasting blood glucose of (9.9±3.2) mmol/L and HBA1c of (8.4±1.7) % before surgery. The main outcome measures were mid-term weight loss after surgery (body mass, BMI, excess weight loss, and total weight loss) 1, 2, 3, and 4 years after surgery and efficacy regarding diabetes mellitus (fasting blood glucose, glycated hemoglobin and diabetes remission rate at 1, 2, and 3 years after surgery). Outcomes were defined as follows. Complete remission: HbA1c <6% or fasting blood glucose <6 mmol/L without hypoglycemic medication; partial remission: HBA1c <6.5% or fasting blood glucose <7 mmol/L without hypoglycemic medication; significant improvement: HBA1c <7.0%, stable decrease of at least 1% compared with preoperative HBA1c, and postoperative dose of hypoglycemic medication significantly less; ineffective: no change in HBA1c and no reduction in dosage of hypoglycemic medication. Other outcome measures included intraoperative and postoperative adverse effects and postoperative nutritional indexes. Results: SADI-S was successful in all patients. There was no significant bleeding, conversion to open surgery, or perioperative death. The operation time was (186.1±41.5) minutes, and the postoperative hospital stay 6 (5-7) days. Surgical complications occurred in four patients, comprising peritoneal effusion, internal jugular vein thrombosis, anastomotic leakage, and gastric fistula. Body weight and BMI 1, 2, 3 and 4 years were significantly lower post- than pre-operatively (all P<0.05). Excess weight loss was (81.9±16.2) %, (82.2±15.5) %, (88.3±20.1) %, and (83.2±18.1) % at 1, 2, 3, and 4 years postoperatively, respectively. Total weight loss was (39.7±8.7) %, (40.6±10.6) %, (42.2±11.5) % and (45.4±10.2) %, respectively. The mean fasting blood glucose concentrations of the 60 patients with T2DM were (5.1±1.0) mmol/L, (5.0±0.7) mmol/L, and (5.4±0.9) mmol/L 1, 2 and 3 years postoperatively, respectively. The values for glycosylated hemoglobin were (4.9±0.6) %, (4.8±0.5) %, and (5.1±0.8) %, respectively, all of which are significantly lower than preoperatively (all P<0.05). The complete remission rate of diabetes was 95.0% (38/40), 90.0% (36/40), and 9/13 1, 2, and 3 years postoperatively, respectively. Additionally, the partial remission rate and significant improvement rate were both 100%. Two years postoperatively, the incidence of anemia was 27.8% (10/36), of hypoproteinemia 11.8% (4/34), and of ferritin deficiency 25.8% (8/31), all of which were improved by conservative treatment such as blood transfusion, iron supplementation, and adjustment of diet. Conclusion: SADI-S has a significant mid-term beneficial effect on weight loss and diabetes remission status in patients with obesity and type 2 diabetes.

Evaluation of Anti-k Antibody in a Patient Undergoing Redo Sternotomy

Abstract Introduction/Objective Introduction: The Kell blood group system, discovered in 1946, holds paramount significance in transfusion medicine and hemolytic disease of the newborn (HDN). Named after Mrs. Kelleher, who exhibited anti-Kell antibodies resulting in HDN, this system comprises 25 antigens, with the original K antigen retaining primary importance. Additionally, Levine et al. identified anti-Cellano, now known as anti-k, presenting an antibody antithetical to anti-K. Methods/Case Report Case Presentation: A 60-year-old male with a history of bioprosthetic aortic valve insufficiency, pulmonary homograft stenosis, and recurrent aortic insufficiency presents for a fourth redo sternotomy for root and ascending aorta replacement. Preoperative assessment revealed a positive antibody screen for anti-k, a clinically significant antibody associated with decreased survival of transfused red blood cells (RBCs). Given limited compatible blood units available, efforts are underway to secure additional donations before the scheduled surgery on 2/22/24. The patient’s medical history indicates no recent blood transfusions or iron therapy, with the last transfusion in 1996. He is anticoagulated with warfarin for mechanical valve and atrial fibrillation, necessitating preoperative bridging with Lovenox injections. Methods The patient’s antibody screen and initial panel demonstrated pan-reactivity with 3+ reactivity, suggesting an antibody targeting a high-frequency antigen. Further testing using polyethylene glycol (PEG) confirmed the presence of anti-k, supported by negative reactions to additional K-negative cells. The absence of other clinically significant antibodies was verified using 0.2 M Dithiothreitol (DTT) modified cells. Results (if a Case Study enter NA) NA Conclusion Conclusion: The identification of anti-k antibody underscores the critical role of preoperative antibody screening in mitigating transfusion-related complications, particularly in patients requiring complex surgical interventions. Collaborative efforts between clinical teams and transfusion medicine specialists are imperative to ensure adequate blood product availability and optimize patient outcomes.To prevent further exposure, it is recommended that patients with rare antibodies carry an Antibody ID card indicating the rare antibody they possess.k antigen blood donors are underrepresented in the general donor pool. It is recommended to develop a systematic recruitment for k antigen donors.

A young child formula supplemented with a synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V improves the gut microbiota and iron status in healthy toddlers.

Early-life gut microbiota development depends on a highly synchronized microbial colonization process in which diet is a key regulator. Microbiota transition toward a more adult-like state in toddlerhood goes hand in hand with the transition from a milk-based diet to a family diet. Microbiota development during the first year of life has been extensively researched; however, studies during toddlerhood remain sparse. Young children's requirement for micronutrients, such as dietary iron, is higher than adults. However, their intake is usually sub-optimal based on regular dietary consumption. The Child Health and Residence Microbes (CHaRM) study, conducted as an adjunct to the GUMLi (Growing Up Milk "Lite") trial, was a double-blind randomized controlled trial to investigate the effects on body composition of toddler milk compared to unfortified standard cow's milk in healthy children between 1 and 2 years of age in Brisbane (Australia). In this trial, fortified milk with reduced protein content and added synbiotics [Bifidobacterium breve M-16V, short-chain galactooligosaccharides, and long-chain fructooligosaccharides (ratio 9:1)] and micronutrients were compared to standard unfortified cow's milk. In the present study, the effects of the intervention on the gut microbiota and its relationship with iron status in toddlers were investigated in a subset of 29 children (18 in the Active group and 11 in the Control group) who completed the CHaRM study. The toddler microbiota consisted mainly of members of the phyla Firmicutes, Bacteroidota, and Actinobacteriota. The abundance of the B. breve species was quantified and was found to be lower in the Control group than in the Active group. Analysis of blood iron markers showed an improved iron status in the Active group. We observed a positive correlation between Bifidobacterium abundance and blood iron status. PICRUSt, a predictive functionality algorithm based on 16S ribosomal gene sequencing, was used to correlate potential microbial functions with iron status measurements. This analysis showed that the abundance of predicted genes encoding for enterobactin, a class of siderophores specific to Enterobacteriaceae, is inversely correlated with the relative abundance of members of the genus Bifidobacterium. These findings suggest that healthy children who consume a young child formula fortified with synbiotics as part of a healthy diet have improved iron availability and absorption in the gut and an increased abundance of Bifidobacterium in their gut microbiome.

Prevalence of iron deficiency anemia in exclusively breastfed infants after a 5-month iron supplementation

Iron deficiency anemia (IDA) is prevalent in exclusively breastfed (EBF) Thai infants. However, in Thailand, iron supplementation guidelines for EBF infants are not available. This prospective open-label study aimed to estimate the prevalence of IDA in 9-month-old EBF infants after receiving iron supplementation from 4 months of age until they consumed adequate iron-rich food. Forty-seven healthy, 4-month-old EBF infants were prescribed 1 mg/kg/day ferrous sulfate. Their complementary food records from 6 to 9 months were calculated for daily iron intake. Complete blood count and iron study were performed at 9 months of age. The results showed that the prevalence of IDA at 9 months was 6.4%. An employed caregiver and the male sex of the baby were significantly associated with iron deficiency. The food record revealed that the median daily iron intake was less than the Thai dietary reference intake recommendation. In summary, the prevalence of IDA in infants with 9 months of exclusive breastfeeding who received iron supplementation was lower than the background rate (25.7%) when iron was not prescribed. Most infants did not have adequate iron in complementary foods. Iron supplementation should be prescribed routinely during 4–9 months of age in healthy Thai EBF infants.

Complex therapy of mineral metabolism in service dogs

The high physical and functional load of service dogs causes changes not only in body systems, but also in metabolism as a whole. An integrated approach to the study of this problem and the search for a pharmacotherapeutic solution will allow us to correct biochemical changes in the body of dogs and improve the performance and quality of life of animals. The purpose of the study was to study the therapeutic effectiveness of a complex of metabolic stimulants for the correction of mineral metabolism. For the study, 16 service dogs were selected in the area of application of the general search profile, belonging to the Ministry of Internal Affairs of Russia in the Altai Territory. Blood was drawn at the beginning and end of the study to analyze red blood cell counts, hemoglobin, hematocrit, glucose, cholesterol, triglycerides, iron, magnesium, zinc, calcium, phosphorus, and chloride. According to the results of the study, it was established that a violation of homeostasis in service dogs was accompanied by changes in some indicators of red blood, as well as pathology of mineral metabolism. After a course of pharmacotherapy, an increase in red blood cells (up to 7.9±0.22*×1012 cells/l) and hemoglobin (up to 141.66±7.32 g/l) was observed in dogs. Carbohydrate metabolism in both groups was characterized by hypoglycemia (3.34±0.21–3.43±0.28 mmol/l). By the end of the study, the glucose level in the experimental group significantly increased by 31.4% relative to the animals in the control group. By the end of the study, cholesterol levels in dogs in the experimental group decreased more rapidly compared to the control group. The study of the dynamics of mineral metabolism indicators revealed a significant increase in iron levels in the experimental group of animals (up to 25.3±1.9 µmol/l), which was 22.8% higher than the control value. Changes in other indicators of mineral metabolism did not differ significantly between the groups, although dogs receiving stimulating therapy showed positive dynamics of changes in mineral metabolism indicators. The use of a complex of metabolic stimulants “Suiferrovita”, “Strolitin”, “Amber Acid” stabilized red blood counts and contributed to the development of a tendency towards the restoration of mineral metabolism.

Key biomarkers in type 2 diabetes patients: A systematic review.

Type 2 diabetes mellitus (T2DM) is not just a local health issue but a significant global health burden, affecting patient outcomes and clinical management worldwide. Despite the wealth of studies reporting T2DM biomarkers, there is an urgent need for a comparative review. This review aims to provide a comprehensive analysis based on the reported T2DM biomarkers and how these are linked with other conditions, such as inflammation and wound healing. A comparative review was conducted on 24 001 study participants, including 10 024 T2DM patients and 13 977 controls (CTL; age 30-90 years). Four main profiles were extracted and analysed from the clinical reports over the past 11 years: haematological (1084 cases vs. 1458 CTL), protein (6753 cases vs. 9613 CTL), cytokine (975 cases vs. 1350 CTL) and lipid (1212 cases vs. 1556 CTL). This review provides a detailed analysis of the haematological profile in T2DM patients, highlighting fundamental changes such as increased white blood cells and platelet counts, accompanied by decreases in red blood cell counts and iron absorption. In the serum protein profile, a reduction in albumin and anti-inflammatory cytokines was noted along with an increase in globulin levels and pro-inflammatory cytokines. Furthermore, changes in lipid profiles were discussed, specifically the decreases in high-density lipoprotein (HDL) and the increases in low-density lipoprotein (LDL) and triglycerides. Understanding the changes in these four biomarker profiles is essential for developing innovative strategies to create diagnostic and prognostic tools for diabetes management.

S1021 A Retrospective Review: The Use of Fecal Occult Blood Testing for Evaluation of Acute/Chronic Blood Loss and Iron Deficiency Anemia Despite Secondary Diagnoses

S1021 A Retrospective Review: The Use of Fecal Occult Blood Testing for Evaluation of Acute/Chronic Blood Loss and Iron Deficiency Anemia Despite Secondary Diagnoses

Impact of iron deficiency anemia on academic achievement among female university students in Saudi Arabia.

Anemia, particularly iron deficiency anemia (IDA), is a prevalent health issue globally and in Saudi Arabia, especially among young adult females. This study investigates the association between anemia and academic achievement among female students at the Female Health Campus of Jazan University, Jazan, Saudi Arabia. This cross-sectional study included 118 randomly selected participants aged 18-22. A validated questionnaire was administered to the study participants. The participants underwent blood tests for complete blood count (CBC) parameters and iron profile analysis. The study reported that 52.5% of the female students had anemia and low serum iron levels. Regarding academic performance, significant positive correlations were found between various CBC parameters including white cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, and serum iron. However, no significant correlations were observed between red blood cell count and platelet count with academic performance. Demographic variables were also associated with a higher odds ratio of anemia. The study highlights the prevalence of anemia among female students and its potential impact on academic achievement. The current study underscores the importance of addressing anemia in young adult females and implementing appropriate interventions to improve their educational outcomes.

Derivation of Russian-specific reference intervals for complete blood count, iron markers and related vitamins.

This study aimed to establish reference intervals (RIs) for Russian adults for hematological parameters including related iron markers and vitamins. Sources of variation of reference values (RVs) and needs for secondary exclusion were explored for proper derivations of RIs. Following the harmonized protocol of the IFCC Committee on Reference Intervals and Decision Limits (C-RIDL), 506 healthy Russians (age 18-80; 46% male) were recruited. Complete blood counts (CBC) and leukocyte differentials, iron markers, vitamin B12, and folate were measured by Beckman Coulter's analyzers. Sources of variation were analyzed by multiple regression analysis, and ANOVAs, and the need for partitioning RVs was decided accordingly. Two schemes of excluding latent anemia were compared: (1) latent abnormal values exclusion method (LAVE) based on associations among CBC parameters, or (2) explicit exclusion of individuals with either ferritin or iron below the respective lower limit of the manufacturer. RIs were determined by the parametric method using two-parameter Box-Cox formula. Gender-specific RIs were required for most analytes, while age-specific RIs were set only for ferritin in females. A BMI-related increase in RVs was prominently observed for reticulocyte parameters, hence we chose to exclude individuals with BMI>28 kg/m2 when establishing the RIs. The LAVE method was more effective in excluding individuals with latent anemia, than exclusion based on low ferritin and/or iron values. International comparison revealed that Russian RIs featured a lower side shift of platelet counts. Similar to African countries, Russian RIs for total leukocyte and neutrophil counts were lower compared to most of other countries. RIs for the Russian population for 34 hematological and related parameters were established using up-to-date methods proposed by C-RIDL. Reducing the influences of latent anemia and obesity on RIs was crucial for erythrocyte parameters. Low levels of Russian RIs observed for platelet and neutrophil counts need further investigation.

Prevalence of Hypothyroidism in Children with Transfusion Dependent Thalassemia Patient Attending in A Tertiary Care Hospital of Bangladesh

Background: Blood transfusions and iron chelation are standard treatments for β-thalassemia major and Hb E-Beta-Thalassemia. However, repeated transfusions raise body iron levels, leading to secondary hemosiderosis and complications in the heart, endocrine system, and liver. Thyroid dysfunction results from gland infiltration, chronic hypoxia, free radical damage, and iron overload. This study aimed to find out the prevalence of hypothyroidism in transfusion-dependent thalassemic children attending Bangladesh Shishu Hospital &amp; Institute. Methods: A descriptive cross-sectional study was conducted at the Thalassemia Centre, Department of Hematology and Oncology, Bangladesh Shishu Hospital &amp; Institute, from December 2019 to November 2020. The study included 140 children with thalassemia, aged 5 to 16 years, who were receiving blood transfusions. Data were collected using a structured questionnaire with participant consent. Statistical analysis was performed using SPSS version 23.0. Results: In this study, hypothyroidism was observed in 26.2% of patients, with 23.5% having subclinical and 2.9% overt hypothyroidism. In most of the patients (n=85), aged 11-16 years, 58.3% had normal thyroid function, 36.5% had subclinical, and 4.7% had overt hypothyroidism, which was statistically significant (p&lt;0.05). Of the 91 patients with hemoglobin levels below 11.5 g/dL, 85.7% had normal thyroid function, 13.2% had subclinical hypothyroidism, and 1.1% had overt hypothyroidism, also significant (p&lt;0.05). In the group with ferritin levels of 1200-2000 ng/mL, 78.1% had normal thyroid function, 18.8% had subclinical hypothyroidism, and 3.1% had overt hypothyroidism, which was not statistically significant (p&gt;0.05). Conclusion: Subclinical hypothyroidism is commonly seen in thalassemia patients aged 5 to 16 years who undergo regular blood transfusions. Regular physical exams and thyroid function assessments are crucial to detect overt hypothyroidism early. Timely hormone replacement can