Iron Treatment Research Articles

Six-Year Follow-up of Childhood Stimulation on Development of Children With and Without Anemia.

Previously, in 30 Bangladeshi villages, 2 groups of children with iron-deficiency anemia (IDA) and nonanemic (NA) iron sufficiency aged 6 to 24 months participated in 2 parallel cluster randomized controlled trials of the effect of psychosocial stimulation on neurodevelopment. The intervention was composed of weekly play sessions at home for 9 months. All children with anemia received iron treatment of 6 months. The intervention improved the mental development of NA but not IDA groups. Six years after end line when the children were aged 8 to 9 years, we aimed to determine if benefits were sustained in the NA group or late-onset benefits emerged in the IDA group. We relocated 372 (90%) of the initial 412 children from all the clusters (villages), and assessed their IQ with the Wechsler Abbreviated Scale of Intelligence-II, motor development, and school achievement including math, spelling, and reading. Analyses were by intention-to-treat, adjusting for clustering. There was a significant interaction between anemia groups (IDA/NA) and intervention on IQ. The intervention benefitted the NA group's Full-Scale IQ (effect size, 0.43 [95% confidence interval, 0.08-0.79]) and Perceptual Reasoning Index (effect size, 0.48 [95% confidence interval, 0.08-0.89]) but did not affect the IDA group's outcomes. No other outcomes were significant. The benefits from early childhood psychosocial stimulation on the NA group's IQ, 6 years after intervention ended, adds to the limited evidence on the sustainability of benefits in low- and middle-income countries. Reasons for lack of effect in children with anemia are unknown.

Usage of iron foliar spray in enhancing the growth and yield of the flax plant (Linum usitatissimum L)

The ideal growth and development of linseed plants depend on receiving the necessary nutrients during the growing season when they are grown. Flax's yield and oil content increase using a foliar spray containing micronutrients. This study aimed to determine how foliar iron (Fe) treatment affected flax yield and its constituents. The experiment was set up at the adoptive research farm Sargodha in a randomized block design and three replicates. At the capsule filling stages and bud initiation of the flax crop, foliar sprays with varying concentrations of Fe (5.5%, 4.5%, 3.5%, 2.5%, 1.5%) and without Fe (control) were administered. Sulphate of iron (Fe) was used as the source of Fe. All treatments resulted in notable enhancements in agronomic characteristics such as grain oil contents, harvest index, biological yield, number of capsule formations, technical stem length, plant height, as well as physiological parameters including fluorescence yield (Ft), quantum yield (YII), photosynthetically active radiation (PAR), electron transport rate (ETR), and chlorophyll contents. The results of this study suggested that the application of 3.5% to flax during the bud initiation and capsule filling stages increases the seed yield, yield attributes, and oil contents. In conclusion, foliar spray of Fe could enhance the yield of linseed crops.

Silencing of PpNRAMP5 improves manganese toxicity tolerance in peach (Prunus persica) seedlings

The natural resistance-associated macrophage protein (NRAMP) gene family assists in the transport of metal ions in plants. However, the role and underlying physiological mechanism of NRAMP genes under heavy metal toxicity in perennial trees remain to be elucidated. In Prunus persica, five NRAMP family genes were identified and named according to their predicted phylogenetic relationships. The expression profiling analysis indicated that PpNRAMPs were significantly induced by excess manganese (Mn), iron, zinc, and cadmium treatments, suggesting their potential role in heavy metal uptake and transportation. Notably, the expression of PpNRAMP5 was tremendously increased under Mn toxicity stress. Heterologous expression of PpNRAMP5 in yeast cells also confirmed Mn transport. Suppression of PpNRAMP5 through virus-induced gene silencing enhanced Mn tolerance, which was compromised when PpNRAMP5 was overexpressed in peach. The silencing of PpNRAMP5 mitigated Mn toxicity by dramatically reducing Mn contents in roots, and effectively reduced the chlorophyll degradation and improved the photosynthetic apparatus under Mn toxicity stress. Therefore, PpNRAMP5-silenced plants were less damaged by oxidative stress, as signified by lowered H2O2 contents and O2•− staining intensity, also altered the reactive oxygen species (ROS) homeostasis by activating enzymatic antioxidants. Consistently, these physiological changes showed an opposite trend in the PpNRAMP5-overexpressed peach plants. Altogether, our findings suggest that downregulation of PpNRAMP5 markedly reduces the uptake and transportation of Mn, thus activating enzymatic antioxidants to strengthen ROS scavenging capacity and photosynthesis activity, thereby mitigating Mn toxicity in peach plants.

Evaluating Preoperative Intravenous Iron and Erythropoietin Treatment and Outcomes in Cardiac Surgery Patients.

Anemia is more common in cardiac surgery patients than in other people. Severe anemia before cardiac surgery strongly predicts blood transfusion. This study aimed to evaluate the outcomes of Intravenous (IV) iron and erythropoietin (EPO) injection preoperatively in anemic patients waiting for coronary artery bypass graft (CABG) surgery. This cross-sectional study was performed between May to December 2020 at Masih Daneshvari hospital in Tehran, Iran. Anemia was described according to the WHO definition (Hb < 130 g/L in men). The study was designed in two groups of men CABG patients. Hematocrit level, platelet count, partial thromboplastin time, international normalized ratio, prothrombin time before surgery, red blood cells (RBCs) transfusion, as well as plasma and platelet units' transfusion during surgery and at the time of hospitalization were obtained from patient's files. The length of stay in the hospital and the consequences, including infection, stroke and heart attack, and mortality, were also obtained from the patient's files and recorded in the checklists. Pearson's chi-squared test, Fisher's exact test, independent samples t-test, univariate logistic regression, and odds ratio (OR) were used. All statistical analyses were performed by the SPSS software version 21. The significance level in this study was considered 0.05. In this study, the data of 64 patients were gathered, among whom 16 (25%) were injected with IV iron and EPO, and the remaining 48 (75%) did not receive any medications for stimulating erythropoiesis. The mean age of patients was 64.05 ± 8.21 years, with an age range of 51 - 91 years. Infection (P = 0.258) and mortality rate (P = 0.440) in the two groups of injection and non-injection did not show a statistically significant difference. The duration of the clamp at the time of surgery (r = 0.699, P = 0.001) and the duration of hospitalization (r = 0.399, P = 0.023) had statistically significant positive relationships with the pump duration. Red blood cell consumption in the injection and non-injection groups was 2.50 ± 2.07 and 2.90 ± 1.80 (P = 0.469), respectively. Infection (P = 0.258), mortality rate (P = 0.440), and RBC utilization (P = 0.469) in the two groups of injection and non-injection were not significantly different.

Influence of Boron, Zinc and Iron on Growth and Yield of Summer Maize (Zea mays L.)

A field trial was conducted on the crop maize in the during Zaid season of 2022 at Crop Research Farm, Department of Agronomy, SHUATS, Prayagraj (U.P). The trai was carried out to research “Influence of boron, zinc and iron on growth and yield of summer maize. The soil of experimental plot was sandy loam in texture, nearly neutral in soil reaction (pH 6.9), available N (270.81 kg/ha), available P (11.5 kg/ha) and available K (215.9 kg/ha). The trail was laid out in Randomized Block Design with nine treatments each replicated thrice on the basis of one year experimentation.The results showed that the foliar application of boron 0.6% along with 25kg/ha of zinc and 25kg/ha of iron (treatment no. 8) was recorded significantly maximum plant height (205.79 cm), Plant dry weight (179.67 g/plant), Crop growth rate (28.11 g/m2/day) No. of leaves/plant (13.93), No. of cob/plant(2.07), No. of row/cob (14.67), No. of seeds/row (26.00), Test weight (238.0 g), Grain yield (5.40 t/ha), Straw yield (9.60 t/ha), Harvest index (35.97), Gross returns (122400.0 INR/ha), Net return (77210.0 INR/ha) and benefit cost ratio (1.71) as compared to other treatments.

Oral Iron Treatment for Children with Nutritional Anaemia and Factors that Affect the Results

Background: This study aimed to investigate the efficacy of oral iron therapy in childhood nutritional anaemia and to identify the factors affecting the outcome of 100 patients. Data was collected from the medical records of the patients. The study showed that oral iron therapy was effective in treating childhood nutritional anaemia, with the majority of patients (84%) achieving complete haematological recovery. The factors associated with successful treatment included age, gender, clinical presentation, and duration of iron therapy. The study shows suggest that oral iron therapy is an effective and safe treatment option for childhood nutritional anaemia and that age, gender, clinical presentation, and duration of iron therapy may affect the outcome of treatment. Methodology: This study was conducted department of pediatric hmc hospital Peshawar from jan 2021 to jan 2022 . The study included 100 patients aged between 2 and 12 years with childhood nutritional anaemia. Data was collected from the medical records of the patients, including demographic characteristics, clinical presentation, laboratory results, duration of iron therapy, and outcome of treatment. Descriptive statistics were used to analyze the data and logistic regression analysis was used to identify the factors affecting the outcome of treatment. Results: According to the findings, 84% of the kids who received oral iron therapy for treating childhood nutritional anaemia experienced positive effects. Age (OR=2.5, 95% CI: 1.3-4.7), male gender (OR=2.1, 95% CI: 1.1-4.3), clinical presentation (OR=2.8, 95% CI: 1.3-5.8), and length of iron therapy (OR=1.2, 95% CI: 1.1-1.3) were all linked with successful treatment. Conclusion: The study shows suggest that oral iron therapy is an effective and safe treatment option for childhood nutritional anaemia and that age, gender, clinical presentation, and duration of iron therapy may affect the outcome of treatment. Further studies are needed to confirm these findings and to identify the optimal duration of iron therapy in the treatment of childhood nutritional anaemia. keywords: Childhood nutritional anaemia, Oral iron therapy, Outcome, Factors,

Synthesis and characterizations of Fe (II) phthalocyanine and Zn phthalocyanine on colon cancer, cervical cancer, and bacterial cells

Phthalocyanine is a safe and better biocompatible compound, and it has been used in diagnostic and cancer imaging. But the application in the treatment of colon and cervical cancer is elusive. In the present study, we have synthesized Iron (II) phthalocyanine and Zinc phthalocyanine respectively. The bonding, structure, and physical characteristics of the prepared products were analyzed and confirmed by FT-IR, XRD, SEM, EDX methods. We have also examined the anti-cancer properties of the compounds on two different cancer cells (colon cancer HCT-116 and cervical cancer HeLa) by MTT assay. The cell viability assay results showed that a noteworthy reduction in the cell viability post-treatments of Iron (II) phthalocyanine. However, treatment of Zinc phthalocyanine did not show any inhibitory action on both HCT-116 and HeLa cancer cells. We have also calculated the inhibitory concentration (IC50) post treatment of Zinc phthalocyanine and Iron (II) phthalocyanine on HCT-116 and HeLa cells. The IC50 was 30 µg/ml for HCT-116 cells treated with Iron (II) phthalocyanine, whereas it was 33 µg/ml for the HeLa cells. We have also examined the impact of Zinc phthalocyanine and Iron (II) phthalocyanine on non-cancerous cells (HEK-293), and MTT results showed that Iron (II) phthalocyanine and Zinc phthalocyanine induced no significant inhibitory action on HEK-293 cells. In addition, we have also examined the anti-fungal action of Zinc phthalocyanine and Iron (II) phthalocyanine. We have also examined the impact of Iron (II) phthalocyanine on cancer cells using DAPI staining, we have found that was a major reduction in cancer cells population, but there is no reduction in the Iron (II) phthalocyanine -treated cells. We have found that Iron (II) phthalocyanine induced significant antifungal activity against Candida albicans, whereas no significant antifungal activity was observed with Zinc phthalocyanine.

Multi-copper oxidases SKU5 and SKS1 coordinate cell wall formation using apoplastic redox-based reactions in roots.

The primary cell wall is a fundamental plant constituent that is flexible but sufficiently rigid to support the plant cell shape. Although many studies have demonstrated that reactive oxygen species (ROS) serve as important signaling messengers to modify the cell wall structure and affect cellular growth, the regulatory mechanism underlying the spatial-temporal regulation of ROS activity for cell wall maintenance remains largely unclear. Here, we demonstrate the role of the Arabidopsis (Arabidopsis thaliana) multicopper oxidase-like protein skewed 5 (SKU5) and its homolog SKU5-similar 1 (SKS1) in root cell wall formation through modulating ROS homeostasis. Loss of SKU5 and SKS1 function resulted in aberrant division planes, protruding cell walls, ectopic deposition of iron, and reduced nicotinamide adeninedinucleotide phosphate (NADPH) oxidase-dependent ROS overproduction in the root epidermis-cortex and cortex-endodermis junctions. A decrease in ROS level or inhibition of NADPH oxidase activity rescued the cell wall defects of sku5 sks1 double mutants. SKU5 and SKS1 proteins were activated by iron treatment, and iron over-accumulated in the walls between the root epidermis and cortex cell layers of sku5 sks1. The glycosylphosphatidylinositol-anchored motif was crucial for membrane association and functionality of SKU5 and SKS1. Overall, our results identified SKU5 and SKS1 as regulators of ROS at the cell surface for regulation of cell wall structure and root cell growth.

Effects of Iron, Phosphorus and Microbial Inoculum On Yield and Quality of the Grain of Wheat (Triticum Aestivum L.)

Effects of iron, phosphorus and microbial inoculums on yield and quality of the grain of wheat (Triticum aestivum L.) were studied during cropping seasons of 2019 and 2020 in Khorasan Razavi province, Mashhad following a split plot experiment based on Randomized Complete Block Design with three replications. Results showed that the application of phosphorus in the presence of iron increased the grain yield. The highest grain yield (516 g/m2) was obtained from both iron foliar and bacterial application and the lowest grain yield (435 g/m2) was obtained from no iron and phosphorus treatment. Foliar iron application and supply of microbial inoculum (bacteria and fungi) at rhizosphere resulted in the highest quantity and quality of grain yield. Bangladesh J. Bot. 52(1): 171-178, 2023 (March)

Effects of Chelated Iron (Eddha-Fe) Treatments on Corm And Stigma Quality in Saffron (Crocus Sativus L.)

Effects of different doses of chelated iron (EDDHA-Fe) on the yield and quality of saffron leaf, corm and stigma were investivated. The highest weight of harvested corms was obtained when treated with 2 g of iron chelate per corm, 366.57 g, and the highest number of corm was obtained when treated with 4 g of iron chelate per corm, 73.00 g. When the effects of the iron chelate treatments on the quality of the stigma studied, it was found that the treatment with 2 g of iron chelate per corm gave a yield of dry stigma 754.00 mg and the highest average amount of safranal of 1386.50 mg/kg. The treatment with iron chelate had a positive effect in increasing the yield of the corm, the yield of dry stigma, and the quality of stigma saffron. Bangladesh J. Bot. 52(1): 97-103, 2023 (March)

A randomized controlled trial of thrice-weekly versus thrice-daily oral ferrous fumarate treatment in adult patients with iron-deficiency anemia.

Iron deficiency anemia (IDA) is a common health problem in developing countries. Many studies have shown that low-dose oral iron could have similar efficacy and less gastrointestinal effects in iron deficiency without anemia. This prospective open-labeled randomized controlled study was designed to compare the response of 200 mg ferrous fumarate thrice-weekly (TIW) as not inferior to the thrice-daily (TID) regimen and to assess the incidence of adverse events (AEs) between two regimens in treating adult patients with IDA. The primary endpoint was either an increase in Hb ≥ 3 g/dL, having Hb of 12 g/dL in females or 13 g/dL in males at the 12th week of treatment. Secondary outcomes included adverse events (AEs), red blood cell indices, iron profiles, and patient compliance. Sixty-four patients were randomized: 32 in the TIW arm and the other 32 in the TID arm. The response rates were not different between two arms either with intention to treat analysis (72.0%, 95%CI 56.6-88.5 vs. 71.9%, 95%CI 53.3-86.3, p = 0.777); or per-protocol analysis (88.9%, 95%CI 70.8-97.6 vs. 88.5%, 95%CI 69.8-97.6, p = 1.0), respectively. The trial demonstrated non-inferiority at a margin of 23%. Although the iron profile response of the TID arm was earlier than the TIW arm, almost all patients recovered from anemic symptoms at week 4, and hematologic responses were not different at week 12. There were more gastrointestinal AEs in the TID arm. In conclusion, this study showed that the TIW was non-inferior to the TID iron treatment of IDA patients but less AEs and costs.

Wheat grain quality changes with water stress, zinc, and iron applications predicted by the solvent retention capacity (SRC)

Due to a lack of assessment tools for large samples, the effects of foliar Zn and Fe applications on grain nutritional and quality traits for wheat genotypes from diverse species and poloidal levels under water-limited conditions are less addressed. With the availability of simple/rapid solvent retention capacity (SRC) tests to assess a large number of samples for grain quality attributes, thirty-five wheat genotypes from 18 different species were field evaluated under four treatments of control, zinc (Zn), iron (Fe), and Zn + Fe foliar applications in two moisture regimes. Grain yield (GY) and thousand kernel weight (TKW) decreased due to water stress, while the grain quality traits including SRC values, flour protein content (FPC), Zn, and Fe content increased. Although diploid species showed higher FPC, grain Zn, and Fe than tetraploid (4x) and hexaploid (6x) species across all treatments, they presented much lower SRC values attributed to protein quality. Zinc application increased SRC profiles for 4x and 6x wheat and alleviated GY and TKW reduction due to water stress. A significant correlation between various grain and flour parameters confirmed the validity of the results and SRC quality predictions.

Ferric carboxymaltose infusion versus oral iron supplementation for preoperative iron deficiency anaemia in patients with colorectal cancer (FIT): a multicentre, open-label, randomised, controlled trial

A third of patients with colorectal cancer who are eligible for surgery in high-income countries have concomitant anaemia associated with adverse outcomes. We aimed to compare the efficacy of preoperative intravenous and oral iron supplementation in patients with colorectal cancer and iron deficiency anaemia. In the FIT multicentre, open-label, randomised, controlled trial, adult patients (aged 18 years or older) with M0 stage colorectal cancer scheduled for elective curative resection and iron deficiency anaemia (defined as haemoglobin level of less than 7·5 mmol/L (12 g/dL) for women and less than 8 mmol/L (13 g/dL) for men, and a transferrin saturation of less than 20%) were randomly assigned to either 1-2 g of ferric carboxymaltose intravenously or three tablets of 200 mg of oral ferrous fumarate daily. The primary endpoint was the proportion of patients with normalised haemoglobin levels before surgery (≥12 g/dL for women and ≥13 g/dL for men). An intention-to-treat analysis was done for the primary analysis. Safety was analysed in all patients who received treatment. The trial was registered at ClincalTrials.gov, NCT02243735, and has completed recruitment. Between Oct 31, 2014, and Feb 23, 2021, 202 patients were included and assigned to intravenous (n=96) or oral (n=106) iron treatment. Treatment began a median of 14 days (IQR 11-22) before surgery for intravenous iron and 19 days (IQR 13-27) for oral iron. Normalisation of haemoglobin at day of admission was reached in 14 (17%) of 84 patients treated intravenously and 15 (16%) of 97 patients treated orally (relative risk [RR] 1·08 [95% CI 0·55-2·10]; p=0·83), but the proportion of patients with normalised haemoglobin significantly increased for the intravenous treatment group at later timepoints (49 [60%] of 82 vs 18 [21%] of 88 at 30 days; RR 2·92 [95% CI 1·87-4·58]; p<0·0001). The most prevalent treatment-related adverse event was discoloured faeces (grade 1) after oral iron treatment (14 [13%] of 105), and no treatment-related serious adverse events or deaths were observed in either group. No differences in other safety outcomes were seen, and the most common serious adverse events were anastomotic leakage (11 [5%] of 202), aspiration pneumonia (5 [2%] of 202), and intra-abdominal abscess (5 [2%] 202). Normalisation of haemoglobin before surgery was infrequent with both treatment regimens, but significantly improved at all other timepoints following intravenous iron treatment. Restoration of iron stores was feasible only with intravenous iron. In selected patients, surgery might be delayed to augment the effect of intravenous iron on haemoglobin normalisation. Vifor Pharma.

Nutrient Availability Has a Greater Influence than Pot Host on Seedling Development of Hemiparasitic Hawaiian Sandalwood (Santalum paniculatum Hook. and Arn.)

Sandalwood (Santalum spp.) has been overharvested throughout its range, including the Hawaiian Islands, where 6 of the 19 species Santalum spp. are endemic. As hemiparasitic plant species, Hawaiian sandalwoods require a host plant for optimal forest establishment, yet the importance of a host during seedling development is unclear. Furthermore, understanding interactions between pot hosts and nutrient availability on sandalwood seedling development during nursery culture will help to promote the production of high-quality sandalwood seedlings for restoration and commercial purposes. We evaluated the effects of controlled-release fertilizer (CRF), chelated Fe treatments, and two pot host species (Acacia koa and Dodonaea viscosa) on the seedling development of Hawaiian sandalwood (Santalum paniculatum). Increased nutrient availability (CRF) led to increased dry mass, root collar diameter, shoot height, chlorophyll index, and nutrient status values, confirming that the hemiparasitic S. paniculatum can be successfully grown in early stages of cultivation by providing adequate mineral fertilizers. There was a significant interaction between the nutrient availability and chelated iron treatments associated with increased height, root collar diameter, dry mass, chlorophyll index, Fe concentration, and Fe content when chelated Fe was applied (vs. not) in a nutrient-limiting environment. The pot host treatment did not affect any growth metrics, but it did affect the total count of haustoria, with A. koa-hosted seedlings developing 60.3% more haustoria than D. viscosa-hosted and control seedlings. Our results demonstrate that high-quality S. paniculatum seedlings can be grown in containers by providing adequate nutrition and that S. paniculatum in a nutrient-limiting growing environment may benefit from chelated iron fertilizers.

Evaluation and Management of Iron Deficiency in Children Undergoing Intestinal Rehabilitation-A Position Paper From the NASPGHAN Intestinal Rehabilitation Special Interest Group.

Iron deficiency (ID) is the most common nutritional deficiency affecting children undergoing intestinal rehabilitation (IR). Patients may be asymptomatic or present with nonspecific symptoms including fatigue, irritability, and dizziness. The diagnosis of ID in this population can be complicated by the coexistence of systemic inflammation or other nutritional deficiencies which may mimic ID. Many routinely available laboratory tests lack specificity and no consensus on screening is available. Success in oral and enteral treatment is impeded by poor tolerance of iron formulations in a population already challenged with intolerance. Newer parenteral iron formulations exhibit excellent safety profiles, but their role in repletion in this population remains unclear. The following report, compiled by a multidisciplinary group of providers caring for children undergoing IR and representing the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Special Interest Group for Intestinal Rehabilitation, seeks to address these challenges. After discussing iron physiology and population-specific pathophysiology, we make recommendations on iron intake, iron status assessment, and evaluation for alternative causes of anemia. We then provide recommendations on iron supplementation and treatment of ID anemia specific to this nutritionally vulnerable population.

Synthesis and physicochemical evaluations of a novel MIL-101(Fe)-PMA-Biochar triple composite photocatalyst activated through visible-light and utilized toward degradation of organic pollutants: optimal operations and kinetics investigations.

A triple photocatalytic composite of biochar, metal-organic framework, and phosphomolybdic acid was prepared through hydrothermal treatment of iron (III) chloride hexahydrate, terephthalic acid, lavandulifolia-derived biochar, and phosphomolybdic acid. It was characterized and utilized for photodegradation of Rhodamine-B (RhB) dye under visible-light irradiation. Investigations of reaction variables confirmed that, the highest yield of 96.2% was achieved at ambient temperature using 0.07g of catalyst at pH of 7, and a dye concentration of 10ppm. Under these optimum conditions, Methyl Orange (MO) dye was also degraded to yield 93% removal. In addition, the kinetic and thermodynamic parameters for RhB were determined. It was revealed that the photodegradation of RhB followed a pseudo-first-order kinetics with no mass transfer limitations. A corresponding chemical mechanism for this process was also suggested. Adsorption isotherms were investigated for rate of adsorption as well as adsorption capacity of the catalyst under dark conditions. Notably, the catalyst could have been reused for five cycles with a loss of around 20% activity.

Intravenous Iron Sucrose versus Oral Iron in Treatment of Iron Deficiency Anemia in Pregnancy: A Randomized Clinical Trial

Intravenous Iron Sucrose versus Oral Iron in Treatment of Iron Deficiency Anemia in Pregnancy: A Randomized Clinical Trial

CHIR99021 Maintenance of the Cell Stemness by Regulating Cellular Iron Metabolism.

CHIR99021 is an aminopyrimidine derivative, which can efficiently inhibit the activity of glycogen synthesis kinase 3α (GSK-3α) and GSK-3β. As an essential component of stem cell culture medium, it plays an important role in maintaining cell stemness. However, the mechanism of its role is not fully understood. In the present study, we first found that removal of CHIR99021 from embryonic stem cell culture medium reduced iron storage in mouse embryonic stem cells (mESCs). CHIR99021-treated Neuro-2a cells led to an upregulation of ferritin expression and an increase in intracellular iron levels, along with GSK3β inhibition and Wnt/GSK-3β/β-catenin pathway activation. In addition, iron treatment activated the classical Wnt pathway by affecting the expression of β-catenin in the Neuro-2a cells. Our data link the role of iron in the maintenance of cell stemness via the Wnt/GSK-3β/β-catenin signaling pathway, and identify intermediate molecules, including Steap1, Bola2, and Kdm6bos, which may mediate the upregulation of ferritin expression by CHIR99021. These findings reveal novel mechanisms of the maintenance of cell stemness and differentiation and provide a theoretical basis for the development of new strategies in stem cell treatment in disease.

Strategic Management of Bleeding Small Bowel Gastrointestinal Angiodysplasias (GIADs): A 12 Year Retrospective Review in a Veteran Population and Cost Comparison.

Gastrointestinal angiodysplasias (GIADs), also known as gastrointestinal angioectasias, are dilated, abnormally thin-walled blood vessels that occur in the mucosa and submucosa throughout the gastrointestinal tract. As a common cause of small bowel bleeding, GIADs have a significant impact on patient's morbidity and healthcare costs. Presently, somatostatin has been used widely to treat GIADs, but it is unclear if other therapies are as beneficial and cost-effective as somatostatin in managing GIADs. (2) Methods: A retrospective chart review was performed, which included subjects treated with Lanreotide, a somatostatin analog, and other therapies at the VA Loma Linda Healthcare System (VALLHCC) from January 2006 to December 2018. Patients who had symptomatic GIADs were detected by video capsule endoscopy (VCE), a device-assisted enteroscopy (DAE) or, in our case, push enteroscopy (PE) with an Endocuff. (3) Results: Three hundred twelve patients were diagnosed with GIADs. In this group of patients, 72 underwent ablation (endoscopic BICAP) with the addition of Lanreotide (SST), 63 underwent ablation therapy, eight were treated with SST only, 128 received iron replacement only, 25 received iron plus SST therapy, and 61 were observed with no therapy. Each group was followed via their hemoglobin (Hgb) level immediately thereafter, and Hgb levels were then obtained every 3 months for a 12-month period. After ablation therapy, 63 patients maintained stable Hgb levels over the course of the study, suggesting a significant therapeutic effect by controlling active bleeding. The 27 patients receiving ablation +SST therapy did not show improvements when compared to ablation only and the 128 patients who received iron therapy alone. (4) Conclusions: Importantly, 12 years of managing these patients has given us a cost- and time-sensitive strategy to maintain the patients' Hgb levels and avoid hospital admissions for acute bleeding. Iron treatment alone is effective compared to SST treatment in recovering from GIADs. Eliminating SST treatment from therapeutic intervention would save $89,100-445,550 per patient, depending on the number of doses for private care patients and $14,286-28,772 for VA patients, respectively. A suggested therapy would be to perform DAE on actively bleeding patients, ablate the lesions using a coagulation method, and place the patient on iron. If that fails, gastroenterologists should repeat VCE and perform either PE with Endocuff or balloon enteroscopy (all DAEs).

The efficacy of oral iron treatment in Somalian nonpregnant female patients with mild/moderate iron deficiency anemia.

Objective: To evaluate the efficacy of oral ferrous sulfate therapy in non-pregnant women with iron deficiency anemia in Somalia, which is one of the poorest and undeveloped countries in the world. Study Design: Cross Sectional. Setting: Turkey Recep Tayyip Erdogan Hospital, Mogadishu, Somalia. Period: December 2018 to June 2019. Material &amp; Methods: The study included 117 ambulatory females between 18 and 41 years with iron deficiency anemia diagnosed with a hemoglobin level between 9 and 12g/dL and a serum ferritin level below of 15 ng/ml. The patients received ferrous sulfate 200 mg twice daily. Hemoglobin levels of the patients were measured at 2,4,8, and 12 weeks after the start of treatment, and ferritin levels were measured at 4,8 and 12 weeks. Results: The mean baseline hemoglobin and ferritin values were 9.71+1. 01 g/dl and 6.59+3,63 ng/ml, respectively. After 2,4,8 and 12 weeks of treatment, the mean hemoglobin values were increased to 10.58 g/dl, 11.53g/dl, 12.24g/dl and 12.85 g/dl, respectively. At 12 weeks, 79% of participants had normalized hemoglobin concentrations. (&gt;12 gr/dl). Conclusion: In conclusion, the present study also demonstrated that in patients with mild-moderate IDA oral ferrous sulfate is an effective and better-tolerated treatment. At the same time, oral ferrous sulfate treatment is cost-effective.