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https://www.readbyqxmd.com/read/28419408/iron-chelating-therapy-with-deferasirox-in-transfusion-dependent-higher-risk-myelodysplastic-syndromes-a-retrospective-multicentre-study
#1
Pellegrino Musto, Luca Maurillo, Vittorio Simeon, Antonella Poloni, Carlo Finelli, Enrico Balleari, Alessandra Ricco, Flavia Rivellini, Agostino Cortelezzi, Giuseppe Tarantini, Oreste Villani, Giovanna Mansueto, Maria R Milella, Daniele Scapicchio, Gioacchino Marziano, Massimo Breccia, Pasquale Niscola, Alessandro Sanna, Cristina Clissa, Maria T Voso, Susanna Fenu, Adriano Venditti, Valeria Santini, Emanuele Angelucci, Alessandro Levis
Iron chelation is controversial in higher risk myelodysplastic syndromes (HR-MDS), outside the allogeneic transplant setting. We conducted a retrospective, multicentre study in 51 patients with transfusion-dependent, intermediate-to-very high risk MDS, according to the revised international prognostic scoring system, treated with the oral iron chelating agent deferasirox (DFX). Thirty-six patients (71%) received azacitidine concomitantly. DFX was given at a median dose of 1000 mg/day (range 375-2500 mg) for a median of 11 months (range 0·4-75)...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28410949/-pigmentations-of-the-oral-cavity
#2
Jean-Christophe Fricain, Vincent Sibaud
Buccal mucosa color is explained by hemoglobin in the vessels and melanin in the epithelium. Abnormal presence of melanin pigments (hypermelaninosis, hypermelanocytosis), hematic pigments (hemoglobin, hemosiderin, iron) but also some exogenous circonstancies explain pigmented lesions (figure 1). These lesions could be localized (single lesions), multifocal (multiple lesions) or diffused. In case of a localized pigmentation with melanic appearance, melanoma must be systematically eliminated with a biopsy. In the case of a more diffused lesion, systemic disease must be evoked...
April 12, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28408107/hydroxyurea-for-nontransfusion-dependent-%C3%AE-thalassemia-a-systematic-review-and-meta-analysis
#3
Ali H Algiraigri, Nicola A M Wright, Elizabeth Oddone Paolucci, Aliya Kassam
Nontransfusion-dependent β-thalassemia (NTDβT) syndromes consist of β-thalassemia intermedia and moderate hemoglobin E/β thalassemias. They are characterized by varying degrees of chronic anemia and a wide spectrum of complications due to ineffective erythropoiesis and iron overload from chronic transfusions. Hydroxyurea (HU), an oral chemotherapeutic drug, is anticipated to decrease disease severity. We performed a meta-analysis to evaluate the clinical efficacy and safety of HU in NTDβT patients of any age...
April 6, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28407219/multiple-micronutrient-supplementation-for-women-during-pregnancy
#4
REVIEW
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28405466/potentially-effective-therapy-of-heavy-menstrual-bleeding-with-an-oestradiol-nomegestrol-acetate-oral-contraceptive-a-pilot-study
#5
Edith Weisberg, Kevin McGeehan, Jane Hangan, Ian S Fraser
BACKGROUND: Heavy menstrual bleeding (HMB) exceeding 80 mL per cycle leads to considerable adverse impact on a woman's iron metabolism, incidence of iron deficiency and anaemia, as well as her functioning in society. The objective of the study is to determine the potential efficacy of a Monophasic oestradiol-17β-nomegestrol acetate (E2/Nomac) combined oral contraceptive pill on measured menstrual blood loss as a pilot study in 12 women with objectively demonstrated HMB (>80 mL per cycle)...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28404671/an-update-on-antimicrobial-resistance-in-clostridium-difficile-resistance-mechanisms-and-antimicrobial-susceptibility-testing
#6
Zhong Peng, Dazhi Jin, Hyeun Bum Kim, Charles W Stratton, Bin Wu, Yi-Wei Tang, Xingmin Sun
Oral antibiotics such as metronidazole, vancomycin and fidaxomicin are therapies of choice for CDI. Several important mechanisms for C. difficile antibiotic resistance have been described; these include the acquisition of antibiotic resistance genes via transfer of mobile genetic elements, selective pressure in vivo resulting in gene mutations, altered expression of redox-active proteins, iron metabolism and DNA repair, as well as biofilm formation. This update summarizes new information published since 2010 on phenotypic and genotypic resistance mechanisms in C...
April 12, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28403561/iron-deficiency-anemia-in-chronic-kidney-disease-uncertainties-and-cautions
#7
Rajiv Agarwal
Anemia in chronic kidney disease is common and iron deficiency is an important cause. To repair iron-deficiency anemia, replacement of iron is needed. Iron can be replaced either by the oral route or by the intravenous route. In a meta-analysis, 5 of the 6 trials were short-term, 1 to 3 months, and compared to oral iron, the mean increase in hemoglobin with intravenous iron was only 0.31 g/dL. However, one of the studies included in this meta-analysis was 6 months long and had a mean decline in hemoglobin of 0...
April 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28399017/iron-induced-hypophosphatemia-an-emerging-complication
#8
Heinz Zoller, Benedikt Schaefer, Bernhard Glodny
PURPOSE OF REVIEW: Iron-induced hypophosphatemia is a well documented side-effect but associated complications are largely neglected, because the results from single dosing studies suggest that transient decreases in plasma phosphate concentrations are asymptomatic and fully reversible. However, an increasing number of case reports and case series suggest that some patients develop severe and symptomatic hypophosphatemia. Long-term complications from hypophosphatemia include osteomalacia and bone fractures, which can result from repeated intravenous administration of certain high-dose iron preparations...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28396543/a-topical-hydrogel-with-deferiprone-and-gallium-protoporphyrin-targets-bacterial-iron-metabolism-and-has-antibiofilm-activity
#9
Katharina Richter, Nicky Thomas, Jolien Claeys, Jonathan McGuane, Clive A Prestidge, Tom Coenye, Peter-John Wormald, Sarah Vreugde
Many infectious diseases are associated with multidrug-resistant (MDR) bacteria residing in biofilms that require high antibiotic concentrations. Whilst oral drug-delivery is frequently ineffective, topical treatments have the potential to deliver higher drug concentrations to the infection-site while reducing systemic side-effects.This study determined the antibiofilm activity of a surgical wound-gel loaded with the iron-chelator deferiprone (Def) and the heme-analogue gallium-protoporphyrin (GaPP), alone and in combination with ciprofloxacin...
April 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28394491/randomized-blinded-placebo-and-positive-controlled-crossover-study-to-determine-the-effect-of-deferiprone-on-the-qtc-interval-in-healthy-subjects
#10
Caroline Fradette, Anna Rozova, Anne Stilman, Yu Chung Tsang, Mark J Allison, Fernando Tricta
This study evaluated whether deferiprone, an oral iron chelator, acts to prolong the QT interval. Fifty healthy volunteers received single doses of each of the following: therapeutic dose of deferiprone (33 mg/kg), supratherapeutic dose (50 mg/kg), placebo, or moxifloxacin, a positive control known to significantly prolong QT interval. Following each dose, subjects underwent cardiac monitoring, pharmacokinetics assessments, and safety assessments. Based on the QT interval obtained using the Fridericia correction for heart rate (QTcF), the upper bound of the 1-sided 95% confidence interval of the mean difference between deferiprone and placebo was <10 milliseconds (the threshold of concern defined by authorities) at all time points for both doses: maximum difference of 3...
April 10, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28391437/oral-sucrosomial-iron-versus-intravenous-iron-in-anemic-cancer-patients-without-iron-deficiency-receiving-darbepoetin-alfa-a-pilot-study
#11
Antonino Mafodda, D Giuffrida, A Prestifilippo, D Azzarello, R Giannicola, M Mare, R Maisano
PURPOSE: Erythropoiesis-stimulating agents (ESAs) are often used in treatment of patients with chemotherapy-induced anemia. Many studies have demonstrated an improved hemoglobin (Hb) response when ESA is combined with intravenous iron supplementation and a higher effectiveness of intravenous iron over traditional oral iron formulations. A new formulation of oral sucrosomial iron featuring an increased bioavailability compared to traditional oral formulations has recently become available and could provide a valid alternative to those by intravenous (IV) route...
April 9, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28385525/chemical-stability-and-in-vitro-release-properties-of-%C3%AE-carotene-in-emulsions-stabilized-by-ulva-fasciata-polysaccharide
#12
Ping Shao, Qiang Qiu, Jie Xiao, Yueqiong Zhu, Peilong Sun
The aim of the present study was to examine how factors (pH, temperature, iron chelators, and free radical scavengers) influence on the chemical stabilities of β-carotene encapsulated by Ulva fasciata polysaccharide (UFP)-stabilized emulsions and the bioaccessibility under in vitro oral-gastro-intestinal digestion conditions. The concentration of β-carotene in emulsions under different environments was determined. Changes in droplet properties, particle size and microstructure, throughout the oral-gastric-intestinal model were measured and the rate and extent of lipid digestion were recorded in the simulated small intestine fluid...
April 4, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28384880/efficacy-of-deferasirox-as-an-oral-iron-chelator-in-paediatric-thalassaemia-patients
#13
Shikha Jaiswal, Rajesh Hishikar, Onkar Khandwal, Manju Agarwal, Usha Joshi, Ajay Halwai, Basant Maheshwari, Raka Sheohare
INTRODUCTION: Thalassaemia Major patients require frequent blood transfusion leading to iron overload. Excessive iron gets deposited in vital organs and leads to dysfunction of the heart, liver, anterior pituitary, pancreas, and joints. Our body has limited mechanism to excrete iron, so patients with iron overload and its complications need safe and effective iron chelation therapy. AIM: To assess the efficacy of Deferasirox (DFX) as an iron chelator, with specific reference to reduction in serum ferritin level...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28371815/phase-2-studies-of-oral-hypoxia-inducible-factor-prolyl-hydroxylase-inhibitor-fg-4592-for-treatment-of-anemia-in-china
#14
Nan Chen, Jiaqi Qian, Jianghua Chen, Xueqing Yu, Changlin Mei, Chuanming Hao, Gengru Jiang, Hongli Lin, Xinzhou Zhang, Li Zuo, Qiang He, Ping Fu, Xuemei Li, Dalvin Ni, Stefan Hemmerich, Cameron Liu, Lynda Szczech, Anatole Besarab, Thomas B Neff, Kin-Hung Peony Yu, Frank H Valone
Background.: FG-4592 (roxadustat) is an oral hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor (HIF-PHI) promoting coordinated erythropoiesis through the transcription factor HIF. Two Phase 2 studies were conducted in China to explore the safety and efficacy of FG-4592 (USAN name: roxadustat, CDAN name: ), a HIF-PHI, in patients with anemia of chronic kidney disease (CKD), both patients who were dialysis-dependent (DD) and patients who were not dialysis-dependent (NDD). Methods...
March 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28370178/curcuma-decreases-serum-hepcidin-levels-in-healthy-volunteers-a-placebo-controlled-randomized-double-blind-cross-over-study
#15
Fabrice Lainé, Bruno Laviolle, Edouard Bardou-Jacquet, Nadia Fatih, Caroline Jezequel, Nicolas Collet, Martine Ropert, Jeff Morcet, Catherine Hamon, Jean-Michel Reymann, Olivier Loréal
Hepcidin, secreted by hepatocytes, controls iron metabolism by limiting iron egress in plasma. Hepcidin is up-regulated during inflammation through the activation of the signal transducer and activator of transcription 3 (STAT3) transduction pathway, which decreases iron bioavailability and may explain the anemia of chronic inflammatory disease. In vitro, it has been shown that curcumin can decrease hepcidin synthesis by decreasing STAT3 activity. We conducted a proof-of-concept study to assess the effect of curcuma on hepcidin synthesis in human...
March 30, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28369875/a-randomized-double-blind-placebo-controlled-trial-to-determine-the-efficacy-and-safety-of-lactoferrin-with-vitamin-e-and-zinc-as-an-oral-therapy-for-mild-to-moderate-acne-vulgaris
#16
Heidi Chan, Gertrude Chan, Joyce Santos, Kennie Dee, Juliene Kimberly Co
Lactoferrin is an iron-binding milk-derived protein that has shown antibacterial and anti-inflammatory effects in vitro and in vivo. The objective of this study was to determine the efficacy and safety of lactoferrin, combined with vitamin E and zinc, for mild to moderate acne vulgaris. In this randomized, double-blind, placebo-controlled trial, 168 subjects aged 13-40 years old were randomly assigned to take either a capsule formulation containing lactoferrin with vitamin E and zinc or placebo twice a day for 3 months...
March 30, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28368910/iron-supplements-modulate-colon-microbiota-composition-and-potentiate-the-protective-effects-of-probiotics-in-dextran-sodium-sulfate-induced-colitis
#17
Marco Constante, Gabriela Fragoso, Joseph Lupien-Meilleur, Annie Calvé, Manuela M Santos
BACKGROUND: Iron is an important nutrient for both the host and colonizing bacteria. Oral iron supplementation may impact the composition of the microbiota and can be particularly damaging to patients suffering from inflammatory bowel disease (IBD). However, patients with IBD may require iron supplementation to treat their anemia. METHODS: We fed mice with diets supplemented with ferrous sulfate at different doses (5, 50, and 500 mg of iron/kg chow) and with different iron formulations (ferrous sulfate, ferrous bisglycinate and ferric ethylenediaminetetraacetic acid [FEDTA]), and analyzed the effects on the composition of the gut microbiota by 16S ribosomal RNA gene sequencing...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28355988/direct-oral-anticoagulants-an-alternative-treatment-for-thrombotic-antiphospholipid-syndrome
#18
A S Resseguier, B Pereira, V Rieu, G Le Guenno, V Grobost, M Ruivard
Background Direct oral anticoagulants (DOACs) demonstrate a lower risk-benefit ratio than vitamin K antagonists (VKAs) for secondary thromboprophylaxis of thrombotic events. But there are no data on the efficacy of DOACs for the prevention of thrombotic recurrence in patients with antiphospholipid syndrome (APS). In this study, we evaluated the efficacy of DOACs to prevent recurrences of thrombotic events in patients with APS. Methods This was a single-center pilot, using a multi-step Fleming design. If seven or fewer patients presented treatment failure with rivaroxaban, the study could conclude efficacy...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28343225/clinical-trial-of-vadadustat-in-patients-with-anemia-secondary-to-stage-3-or-4-chronic-kidney-disease
#19
Edouard R Martin, Mark T Smith, Bradley J Maroni, Qing C Zuraw, Emil M deGoma
BACKGROUND: Therapeutic options for the treatment of anemia secondary to chronic kidney disease (CKD) remain limited. Vadadustat (AKB-6548) is an oral hypoxia-inducible factor prolyl-hydroxylase domain (HIF-PHD) inhibitor that is being investigated for the treatment of anemia secondary to CKD. METHODS: A phase 2a, multicenter, randomized, double-blind, placebo-controlled, dose-ranging trial (NCT01381094) was undertaken in adults with anemia secondary to CKD stage 3 or 4...
March 25, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28339831/safety-of-intravenous-ferric-carboxymaltose-versus-oral-iron-in-patients-with-nondialysis-dependent-ckd-an-analysis-of-the-1-year-find-ckd-trial
#20
Simon D Roger, Carlo A Gaillard, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, David B Van Wyck, Maureen Cronin, Yvonne Meier, Sylvain Larroque, Iain C Macdougall
Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron...
February 27, 2017: Nephrology, Dialysis, Transplantation
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