Altered plasma response to zinc and iron tolerance test after Roux-en-Y gastric bypass

Background: The duodenum and proximal jejunum are excluded after Roux-en-Y gastric bypass but these intestinal sites are where iron and zinc are most absorbed. Therefore, they are among the nutrients whose digestive and absorptive process can be impaired after surgery. The aim of the present study was to investigate the iron and zinc plasma response to a tolerance test before and after bariatric surgery. The study was performed at Sao Paulo University School of Medicine of Ribeirao Preto, Brazil. Methods: In a longitudinal paired study, 9 morbidly obese women (body mass index >= 40 kg/m(2)) underwent an iron and zinc tolerance test before and 3 months after surgery. The iron and zinc levels were determined at 0, 1, 2, 3, and 4 hours after a physiologic unique oral dose. The mineral concentrations in die plasma and 24-hour urine sample were assayed using an atomic absorption spectrophotometer. The anthropometric measurements and 3-day food record were also evaluated. A linear mixed model was used to compare the plasma concentration versus interval after the oral dose, before and after surgery. Results: The pre- and postoperative test results revealed a significantly lower plasma zinc response (P <.01) and a delayed response to iron intake after surgery. The total plasma iron concentration area, during the 4 hours, was not different after surgery (P >.05). The 24-hour urinary iron and zinc excretion did not differ between the pre- and postoperative phases. Conclusion: The present data showed a compromised response to the zinc tolerance test after gastric bypass surgery, suggesting an impaired absorption of zinc. More attention must be devoted to zinc nutritional status after surgery. (Surg Obes Relat Dis 2011;7:309-314.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Altered plasma response to zinc and iron tolerance test after Roux-en-Y gastric bypass

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Screening of wheat Landraces from Madeira Island for iron tolerance

Since the fifteen century, the rainfed-cultivation of wheat for grain is traditionally performed on the Island of Madeira. Under several microclimatic conditions and along very sloppy mountains, the landraces are grown on isolated terraces of Andosols with high amounts of iron. Iron oxides are the main inorganic binding agent contributing to the stability of aggregates and to soil fertility in long-term sustainable agriculture in acid and iron-rich soils. After a two day period of seedling initial growth, a screening test of sixty traditional wheat (Triticum spp.) landraces from the ISOPlexis Genebank at the University of Madeira, Funchal, was performed using nutrient solutions containing 10 or 600 mM Fe, during five days, under controlled laboratory conditions. The elongation of the longest primary root was measured for each genotype and the mean root increment relative to control (as, % relative root increment or RRI; n=28) calculated. This parameter appeared to be a sensitive indicator of Fe tolerance in wheat. Over 85% of wheat germplasm showed the RRI higher than 50%, while the RRI of seven accessions exceeded 70%. This indicates that those landraces are Fe tolerant and might be of particular interest for cultivation under acid rich iron soils of tropical and subtropical areas.

Screening of wheat Landraces from Madeira Island for iron tolerance

Since the fifteen century, the rainfed-cultivation of wheat for grain is traditionally performed on the Island of Madeira. Under several microclimatic conditions and along very sloppy mountains, the landraces are grown on isolated terraces of Andosols with high amounts of iron. Iron oxides are the main inorganic binding agent contributing to the stability of aggregates and to soil fertility in long-term sustainable agriculture in acid and iron-rich soils. After a two day period of seedling initial growth, a screening test of sixty traditional wheat (Triticum spp.) landraces from the ISOPlexis Genebank at the University of Madeira, Funchal, was performed using nutrient solutions containing 10 or 600 mM Fe, during five days, under controlled laboratory conditions. The elongation of the longest primary root was measured for each genotype and the mean root increment relative to control (as, % relative root increment or RRI; n=28) calculated. This parameter appeared to be a sensitive indicator of Fe tolerance in wheat. Over 85% of wheat germplasm showed the RRI higher than 50%, while the RRI of seven accessions exceeded 70%. This indicates that those landraces are Fe tolerant and might be of particular interest for cultivation under acid rich iron soils of tropical and subtropical areas.

Tolerance to iron chlorosis in non-grafted quince seedlings and in pear grafted onto quince plants

Grafting is a technique that may affect plant tolerance to iron chlorosis in plants cultivated for their fruit. Therefore, the objective of this study was to evaluate the tolerance of non-grafted quince seedlings and pear grafted onto quince plants cultivated in pots with alkaline soil. The experiment was conducted in a greenhouse at the University of Cordoba, Spain, in pots (3 L) filled with alkaline soil, with one plant per pot. The treatments consisted of two genotypes, quince (Cydonia oblonga Mill) semi-woody rooted cuttings, cultivar BA29, and pear (Pyrus Communis L.), cultivar Ercolini, grafted onto quince cultivar BA29 (rootstock), and two nutrient solutions with and without iron (80 mu M Fe-EDDHA) arranged in a completely random design with eight repetitions. Each pot received 250 mL of the nutrient solution on June 3rd, 2010. Chlorophyll indirect measurements and the main stem length were evaluated for six weeks after the commencement of the treatments. During the last week, the main stem dry matter weight and the leaf total iron content were determined. It was found that grafting pear seedlings onto quince rootstock resulted in a higher tolerance to iron deficiency than when quince was not grafted. Non-grafted quince plants without iron in the nutrient solution, compared to the results with its application, showed low SPAD (Soil-Plant Analyses Development) values and resulted in plants with a lower leaf iron content and lower dry matter production; however, decreased seedling stem growth was observed only in the last week of cultivation.

Replacement therapy for iron deficiency improves exercise capacity and quality of life in patients with cyanotic congenital heart disease and/or the Eisenmenger syndrome

La teràpia suplementària de ferro millora la capacitat d’exercici i la qualitat de vida en malalts amb una cardiopatia congènita cianòtica i/ o síndrome d’Eisenmenger El dèficit de ferro és una troballa comú en la cardiopatia congènita cianòtica, i pot ser la causa d’una reducció en la capacitat d’exercici. Actualment, està indicada la reposició dels dipòsits de ferro en aquest grup de malalts, éssent les evidències científiques escasses. En el present treball investiguem la seguretat i eficàcia del tractament amb ferro en malalts amb una cardiopatia congènita cianòtica. Per tal motiu, vint-i-cinc malalts amb una cardiopatia congenita cianòtica i dèficit de ferro van ser inclosos de forma prospectiva entre Agost del 2008 i Gener del 2009. El tractament utilitzat fou fumarat ferròs oral, fins a una dosi màxima de 200 mg tres vegades al dia. En l’anàlisi basal i als tres mesos de seguiment es va utilitzar el test de qualitat de vida “CAMPHOR”, el test de la marxa dels 6 minuts i la prova d’esforç amb consum d’oxigen. L’edat mitja fou 39.9+/-10.9 anys, 80% dones. Catorze malalts tenien la síndrome d’Eisenmenger, sis una malaltia cianòtica complexa i cinc circulació de Fontan. Cap d’ells va haver d'interrompre el tractament degut a efectes adversos. Després de tres mesos de tractament, l’hemoglobina (19.0+/-2.9g/dL a 20.4+/-2.7g/dL, p&0.001), ferritina (13.3+/-4.7mug/L a 54.1+/-24.2mug/L, p&0.001) i saturació de transferrina (17.8+/-9.6% a 34.8+/-23.4%, p&0.001) van augmentar significativament. També hi va haver una millora significativa en la puntuació del test de qualitat de vida (20.7+/-10.9 a 16.2+/-10.4, p=0.001) i el test de la marxa (371.7+/-84.7m a 402.8.0+/-74.9m, p=0.001). No es van evidenciar canvis significatius en els valors de consum d’oxigen (40.7+/-9.2% a 43.8+/-12.4%, p=0.15). En definitiva, la teràpia suplementària amb ferro en els malats amb una cardiopatia congènita cianòtica i dèficit de ferro és segura i millora la qualitat de vida i la capacitat funcional. En aquest grup de malalts, per tant, és aconsellable identificar el dèficit de ferro i restaurar-ne els seus dipòsits.

Iron supplementation in a large Swiss cohort of IBD patients demonstrates a shift from oral to intravenous iron over time

Background: The 2007 European Crohn's and Colitis Organization guidelines on anemia in inflammatory bowel disease (IBD) favour intravenous (iv) over oral (po) iron supplementation due to better effectiveness and tolerance. We aimed to determine the percentage of IBD patients under iron supplementation therapy and the dynamics of prescription habits (iv versus po) over time. Methods: Helsana, a leading Swiss health insurance company provides coverage for approximately 18% of the Swiss population, corresponding to about 1.2 million enrollees. Patients with Crohn's disease (CD) and ulcerative colitis (UC) were analyzed from the anonymised Helsana database. Results: In total, 629 CD (61% female) and 398 UC (57% female) patients were identified, mean observation time was 31.8 months for CD and 31.0 months for UC patients. Of the entire study population, 27.1% were prescribed iron (21.1% in males and 31.1% in females). Patients treated with IBDspecific drugs (steroids, immunomodulators, anti-TNF agents) were more frequently treated with iron compared to patients without any medication (35.0% vs. 20.9%, OR 1.91, 95%- CI 1.41 2.61). The prescription of iv iron increased from 2006/2007 (48.8% of all patients receiving any iron priscription) to 65.2% in 2008/2009 by a factor of 1.89. Conclusions: One third of the IBD population was treated with iron supplementation. A gradual shift from oral to iv iron was observed over time. This switch in prescription habits goes along with the implementation of the ECCO consensus guidelines on anemia in IBD.

Iron Supplementation Therapy in a Large Swiss Cohort of Inflammatory Bowel Disease Patients: Shift from Oral to Intravenous Therapy over Time

Background a nd A ims: T he 2 007 ECCO g uidelines o nanemia in inflammatory bowel disease (IBD) favour intravenous(iv) over oral (po) i ron supplementation due to bettereffectiveness and tolerance. Application of guidelines in clinicalpractice m ay r equire time. We a imed to determine thepercentage of IBD patients under iron supplementation therapyand its application mode over time in a large IBD cohort.Methods: Helsana, a leading Swiss health insurance companyprovides c overage f or approximately 18% of t he Swisspopulation, corresponding to about 1.2 million enrollees.Patients with Crohn's disease (CD) and ulcerative colitis (UC)were identified b y keyword search from t he a nonymisedHelsana database.Results: I n total, 6 29 CD ( 61% female) a nd 4 03 UC ( 56%female) patients w ere identified, mean retrospectiveobservation time w as 2 0.4 m onths f or CD and 13 m onths f orUC patients. Of t he entire study population, 29.3% wereprescribed iron. O ccurrence of iron prescription was 21.3% inmales a nd 31.2% in f emales ( odds r atio [OR] 1 .69, 95%-confidence interval [CI] 1.26-2.28). The prescription of iv i ronincreased from 2006/2007 ( 48.8% w ith iv i ron) to 2 008/2009(65.2% with iv iron) by a factor of 1.89.Conclusions: One third of the IBD population was treated withiron supplementation. A gradual s hift from oral t o iv iron wasobserved over time in a large Swiss IBD cohort. This switch inprescription habits g oes a long with the implementation of theECCO consensus guidelines on anemia in IBD.

Iron supplementation in a large Swiss Cohort of Inflammatory Bowel Disease patients demonstrates a shift form oral to intravenous therapy over time

Background and Aims: The 2007 European Crohn's and Colitis Organization guidelines on anemia in inflammatory bowel disease (IBD) favour intravenous (iv) over oral (po) iron supplementation due to better effectiveness and tolerance. We aimed to determine the percentage of IBD patients under iron supplementation therapy and the dynamics of prescription habits (iv versus po) over time. Methods: Helsana, a leading Swiss health insurance company provides coverage for approximately 18% of the Swiss population, corresponding to about 1.2 million enrollees. Patients with Crohn's disease (CD) and ulcerative colitis (UC) were analyzed from the anonymised Helsana database. Results: In total, 629 CD (61% female) and 398 UC (57% female) patients were identified, mean observation time was 31.8 months for CD and 31.0 months for UC patients. Of the entire study population, 27.1% were prescribed iron (21.1% in males and 31.1% in females). Patients treated with IBD-specific drugs (steroids, immunomodulators, anti-TNF agents) were more frequently treated with iron compared to patients without any medication (35.0% vs. 20.9%, OR 1.91, 95%-CI 1.41-2.61). The prescription of iv iron increased from 2006/2007 (48.8% of all patients receiving any iron priscription) to 65.2% in 2008/2009 by a factor of 1.89. Conclusions: One third of the IBD population was treated with iron supplementation. A gradual shift from oral to iv iron was observed over time. This switch in prescription habits goes along with the implementation of the ECCO consensus guidelines on anemia in IBD.

A Shift From Oral to Intravenous Iron Supplementation Therapy Is Observed Over Time in a Large Swiss Cohort of Patients With Inflammatory Bowel Disease.

BACKGROUND:: In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO). METHODS:: We analyzed anonymized data on patients with Crohn's disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals). RESULTS:: In total, 629 patients with Crohn's disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn's disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti-tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change. CONCLUSIONS:: Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.

Well-Alloyed PtFe/C Nanocatalysts of Controlled Composition and Same Particle Size: Oxygen Reduction and Methanol Tolerance

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Barshalder 2 : Studies of late Iron Age Gotland

The prehistoric cemetery of Barshalder is located along the main road on the boundary between Grötlingbo and Fide parishes, near the southern end of the island of Gotland in the Baltic Sea. The ceme-tery was used from c. AD 1-1100. The level of publication in Swedish archaeology of the first millennium AD is low compared to, for instance, the British and German examples. Gotland’s rich Iron Age cemeteries have long been intensively excavated, but few have received monographic treatment. This publication is intended to begin filling this gap and to raise the empirical level of the field. It also aims to make explicit and test the often somewhat intuitively conceived re-sults of much previous research. The analyses deal mainly with the Migration (AD 375–540), Vendel (AD 520–790) and Late Viking (AD 1000–1150) Periods. The following lines of inquiry have been prioritised. 1. Landscape history, i.e. placing the cemetery in a landscape-historical context. (Vol. 1, section 2.2.6) 2. Migration Period typochronology, i.e. the study of change in the grave goods. (Vol. 2, chapter 2) 3. Social roles: gender, age and status. (Vol. 2, chapter 3) 4. Religious identity in the 11th century, i.e. the study of religious indicators in mortuary cus-toms and grave goods, with particular emphasis on the relationship between Scandinavian paganism and Christianity. (Vol. 2, chapter 4) Barshalder is found to have functioned as a central cemetery for the surrounding area, located on pe-ripheral land far away from contemporary settle-ment, yet placed on a main road along the coast for maximum visibility and possibly near a harbour. Computer supported correspondence analysis and seriation are used to study the gender attributes among the grave goods and the chronology of the burials. New methodology is developed to distin-guish gender-neutral attributes from transgressed gender attributes. Sub-gender grouping due to age and status is explored. An independent modern chronology system with rigorous type definitions is established for the Migration Period of Gotland. Recently published chronology systems for the Vendel and Viking Periods are critically reviewed, tested and modified to produce more solid models. Social stratification is studied through burial wealth with a quantitative method, and the results are tested through juxtaposition with several other data types. The Late Viking Period graves of the late 10th and 11th centuries are studied in relation to the contemporary Christian graves at the churchyards. They are found to be symbolically soft-spoken and unobtrusive, with all pagan attributes kept apart from the body in a space between the feet of the deceased and the end of the over-long inhumation trench. A small number of pagan reactionary graves with more forceful symbolism are however also identified. The distribution of different 11th cen-tury cemetery types across the island is used to in-terpret the period’s confessional geography, the scale of social organisation and the degree of alle-giance to western and eastern Christianity. 11th century society on Gotland is found to have been characterised by religious tolerance, by an absence of central organisation and by slow piecemeal Christianisation.

Physiological and Biochemical Aspects of Iron Nutrition in Grapevine

The objective of this thesis was to study the response mechanisms of grapevine to Fe-deficiency and to potential Fe chlorosis prevention strategies. The results show that the presence of bicarbonate in the nutrient solution shifted the activity of PEPC and TCA cycle enzymes and the accumulation/translocation of organic acids in roots of Fe-deprived plants. The rootstock 140 Ruggeri displayed a typical behavior of calcicole plants under bicarbonate stress. The Fe chlorosis susceptible rootstock 101-14 reacted to a prolonged Fe-deficiency reducing the root activity of PEPC and MDH. Noteworthy, it accumulates high levels of citric acid in roots, indicating a low capacity to utilizing, transporting and/or exudating organic acids into the rhizosfere. In contrast, 110 Richter rootstock is capable to maintain an active metabolism of organic acids in roots, accumulating them to a lesser extent than 101-14. Similarly to 101-14, SO4 genotype displays a strong decrease of mechanisms associated to Fe chlorosis tolerance (PEPC and MDH enzymes). Nevertheless it is able to avoid excessive accumulation of citric acid in roots, similar as 110 Richter rootstock. Intercropping with Festuca rubra increased leaf chlorophyll content and net photosynthesis. In addition, intercropping reduces the activity of PEPC in roots, similary to Fe-chelate supply. Applications of NH4+ with nitrification inhibitor prevents efficiently Fe-deficiency, increases chlorophyll content, and induces similar root biochemical responses as Fe-EDDHA. Without the addition of nitrification inhibitors, the effectiveness of NH4+ supply on Fe chlorosis prevention resulted significantly lower. The aspects intertwined in this investigation highlight the complexity of Fe physiology and the fine metabolic tuning of grapevine genotypes to Fe availability and soil-related environmental factors. The experimental evidences reveal the need to carry out future researches on Fe nutrition maintaining a continous flow of knowledge between theoretical and agronomical perspectives for fully supporting the efforts devoted to convert science into practice.

Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose

Oral iron substitution has shown to be insufficient for treatment of severe iron deficiency anemia in pregnancy. Ferric carboxymaltose is a new intravenous (i.v.) iron formulation promising to be more effective and as safe as iron sucrose. We aimed to assess side effects and tolerance of ferric carboxymaltose compared to i.v. iron sucrose in pregnant women.

A shift from oral to intravenous iron supplementation therapy is observed over time in a large swiss cohort of patients with inflammatory bowel disease

BACKGROUND In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO). METHODS We analyzed anonymized data on patients with Crohn's disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals). RESULTS In total, 629 patients with Crohn's disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn's disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti-tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change. CONCLUSIONS Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.