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Strategies to prevent iron deficiency and improve reproductive health.

Anemia and iron deficiency affect billions of people worldwide, especially women of reproductive age, pregnant women, and young children. Many countries have iron and folic acid supplementation programs for pregnant women. However, the impact of these programs is uncertain. Multiple-micronutrient supplementation during pregnancy has been advocated; however, it is unclear whether this has additional advantages. Overall, programs have shown only modest impact on increasing birth weight. This review discusses the present state of knowledge on interventions to improve iron status during pregnancy

[Macrocytic anemia in the last trimester of pregnancy due to dietary insufficiency--initially interpreted as the HELLP syndrome].

A case of severe macrocytic anaemia caused by cobalamin and folic acid deficiency in a 32 year-old gemellipregnant woman in gestational week 32 +2 is described. Her symptoms and the laboratory data were initially interpreted as HELLP-syndrome (haemolysis, elevated liver enzymes and low platelet count), and caesarean section was performed. None of the persons involved in her earlier prophylactic controls suspected anaemia, and no specific dietary advice were given. If she had received dietary advice early in the pregnancy, anaemia could have been avoided. This emphasizes the need for dietary ad…

[The dietetic role of mineral salts and vitamins in a group of Valencia schoolchildren].

A low-energy diet can have an insufficient content of minerals and vitamins to meet nutritional requirements. We herein report on study of the contribution of the diet to mineral and vitamin intake in a Valencia pre-school children population. The results are compared with recommended daily intakes of energy, protein, lipid, carbohydrates, Ca, Fe, I, Zn, Mg and vitamins B1, B2, Niacin, Folic acid, B12, C, A and D. Our results show that the usual diet provides intakes below the recommended values in the case of Zn, Fe, Folates and vitamin D. Nevertheless, children studied do not show deficiency

Multiple-micronutrient supplementation for women during pregnancy.

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. Since the last update of this Cochrane review, evidence from a few large trials has recently been

Nutritional status of iron, vitamin B12, folate, retinol and anemia in children 1 to 11 years old: Results of the Ensanut 2012.

OBJECTIVE: To describe the frequency of anemia, iron, vitamin B12, folate, retinol and predictors of anemia among Mexican children from Ensanut 2012. MATERIALS AND METHODS: Hemoglobin, ferritin, CRP, vitamin B12, retinol and folate concentrations were measured in 2 678 children aged 1-4 y and 4 275 children aged 5-11 y. Adjusted logistic regression models were constructed to assess the risk for anemia and micronutrient deficiencies. RESULTS: In preschoolers and scholars, the overall prevalence of anemia was 20.4 and 9.7%, iron deficiency 14 and 9.3%, low vitamin B12 (LB12S) 1.9 and 2.6%; Fol

Leg bone abnormalities and histopathology of caged and floor reared broilers fed diets devoid of selected vitamins and minerals.

Summers et al., 1978, described an experiment in which performance and leg conditions of birds fed diets devoid of synthetic biotin, choline, folic acid, manganese, and miacin were observed and recoreded. This is a report on birds from the same experiment. Dyschondroplasia of the tibia was documented and the distal end of each tibia examined histologically. Metatarsal length and condyle depth of the distal tibia were also determined. Metatarsal length was influenced by vitamin deficiencies as well as the type of floor on which binds were raised. The depth of the intercondyle space was affected

MicroRNA changes, activation of progenitor cells and severity of liver injury in mice induced by choline and folate deficiency.

Dietary deficiency in methyl-group donors and cofactors induces liver injury that resembles many pathophysiological and histopathological features of human nonalcoholic fatty liver disease (NAFLD), including an altered expression of microRNAs (miRNAs). We evaluated the consequences of a choline- and folate-deficient (CFD) diet on the expression of miRNAs in the livers of male A/J and WSB/EiJ mice. The results demonstrate that NAFLD-like liver injury induced by the CFD diet in A/J and WSB/EiJ mice was associated with marked alterations in hepatic miRNAome profiles, with the magnitude of miRNA e

Severe scoliosis in a patient with severe methylenetetrahydrofolate reductase deficiency.

Severe methylenetetrahydrofolate reductase (MTHFR) deficiency is a rare autosomal recessively inherited inborn error of folate metabolism. We report a new patient with severe MTHFR deficiency who presented at age 4 months with early onset severe scoliosis associated with severe hypotonia. Markedly decreased MTHFR enzyme activity (0.3 nmoles CHO/mg protein/h; reference range>9) and compound heterozygous mutations (c. 1304T>C; p.Phe435Ser and c.1539dup; p.Glu514Argfs∗24) in the MTHFR gene confirmed the diagnosis. She was treated with vitamin B12, folic acid and betaine supplementation and showed

Anemia and inflammatory bowel diseases.

Too often anemia is considered a rare or unimportant manifestation in inflammatory bowel disease (IBD). However, over the last 10 years a number of studies have been conducted and the most relevant conclusions obtained are: (1) anemia is quite common in IBD; (2) although in many cases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3) anemia, and also iron deficiency without anemia, have important consequences in the clinical status and quality of life of the patient; (4) oral iron can lead to g…

[Causes of anemia after kidney transplantation].

In this paper possible causes of anemia in patients after kidney transplantation were investigated. Anemia developed in 29 patients 14 to 22 months after kidney transplantation. At the time when these patients became anemic fourteen had normal graft function while the others 15 suffered chronic graft failure due to chronic rejection in 11 patients combined with cyclosporine nephrotoxicity in other four patients. Anemia in patients with normal graft function was caused by iron (in 8), folic acid deficiency (in 16) and vitamin B12 deficiency (in 2 patients). In this patients group anemia improve…

Incidental Prenatal Discovery of Anencephaly via Portable Ultrasounds in a Remote Medical Care Setting.

Anencephaly is a fatal neural tube defect often linked to folic acid deficiency and undetected in resource-limited settings. We report a case in rural Uganda where portable ultrasound revealed anencephaly with polyhydramnios in a patient who has been pregnant six times, with one term delivery, four preterm deliveries, and no abortions, and currently has one living child (G6P1401). Early detection of this anomaly enabled surgical planning and maternal counseling before stillbirth. This case highlights the impact of malnutrition and the importance of portable ultrasound use to improve prenatal c…

Elevated red cell volume in North Indian students.

In a survey for beta-thalassemia carrier status among students in the State of Punjab in India, a surprisingly large number were found to have an elevated red cell volume over 99 fl. The finding was predominantly but not exclusively in females. Similar student surveys from other states showed less macrocytosis. Follow-up tests in a group of affected students were carried out. Volunteers were asked to modify their diet then after six months they were provided with oral vitamin B12. The resulting changes are reported and the implications of the probable vitamin B12 and or folic acid deficiency a…

Factors Affecting Wound Healing in Patients with Venous Leg Ulcers: A Pilot Study.

Background/Objectives: Previous studies have compared nutritional deficiency parameters in patients with venous leg ulcers (VLUs) to healthy individuals or those with unrelated conditions. This single-center study assessed blood levels of factors involved in ulcer healing and compared patients with VLUs to those with chronic venous insufficiency without ulcers. Methods: A total of 24 patients were included: 17 with VLUs formed the study group, and 7 with lower-limb venous insufficiency without ulcers served as controls. Disease severity was assessed using the CEAP classification, and all parti

Anemia of Chronic Diseases: Wider Diagnostics-Better Treatment?

Anemia of chronic diseases is a condition that accompanies a specific underlying disease, in which there is a decrease in hemoglobin, hematocrit and erythrocyte counts due to a complex process, usually initiated by cellular immunity mechanisms and pro-inflammatory cytokines and hepcidin. This is the second most common type of anemia after iron deficiency anemia in the world. Its severity generally correlates with the severity of the underlying disease. This disease most often coexists with chronic inflammation, autoimmune diseases, cancer, and kidney failure. Before starting treatment, one sho

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… Folic acid deficiency is most often manifested by megaloblastic anemia accompanied by leukopenia and thrombocytopenia. Supplemented by women during the preconception period and during pregnancy, it reduces the risk of birth defects associated with abnormal neural tube closure. … Treatment of folic acid deficiency consists mainly of its oral supplementation and consumption of the above-mentioned products. Orally administered, it is well absorbed from the small intestine, binds to plasma proteins and goes to the liver, where it is stored and metabolized [ 60 ]. …

Cytokinesis-block micronucleus assay evolves into a "cytome" assay of chromosomal instability, mitotic dysfunction and cell death.

The cytokinesis-block micronucleus (CBMN) assay was originally developed as an ideal system for measuring micronuclei (MNi) however it can a … n between micronucleus formation, nuclear budding and NPBs (r=0.75-0.77, P<0.001) induced by either folic acid deficiency or exposure to ionising radiation is supportive of the hypothesis that folic acid deficiency and/or ionising radiation cause genomic instability and gene amplification by the initiation of breakage-fusion-bridge cycles. In its comprehensive mode, th …

Severe folate-deficiency pancytopenia.

Folate-deficiency anaemia occurs in about 4 per 100 000 people, although severe cases causing moderate pancytopenia are rarer. We present the case of a significant folate deficiency in a 50-year-old alcoholic with a background of mild liver impairment and recurrent nasal and rectal bleeding. Her blood tests showed profound macrocytic anaemia with haemoglobin 2.6 g/dl, leucopoenia with white cell count 3.2 × 10(9)/litre and thrombocytopenia with platelets 17 × 10(9)/litre. Serum folate was 0.8 ng/ml (normal 2.5-13.5 ng/ml) confirming severe deficiency. Despite these life-threatening results, th