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Introduction: few previous studies suggest that serum iron status may be associated with liver function, but the relevant evidence remains limited, especially in adolescents. Objective: we aimed to investigate the association between serum ferritin, iron, and liver transaminases in adolescents. Methods: a cross-sectional study including 3,404 adolescents aged 10-19 was performed based on the National Health and Nutrition Examination Survey. weighted multivariate regression, subgroup analysis, and sensitivity analysis were used. Results: a total of 3,404 adolescents were eventually included. Serum ferritin and iron were positively correlated to alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The association between serum ferritin and ALT remained positive in all genders and races, but only remained positive in girls and several races between serum ferritin and AST. The positive correlations kept present among girls between serum iron and ALT, and also kept present among girls and non-Hispanic whites between serum iron and AST. Additionally, serum ferritin and iron were also positively correlated to elevated ALT and elevated AST using binary logistic regression analysis. After excluding the subjects with serum ferritin levels above the upper limit of normal, the main results remained the same basically. Conclusion: the present results add novel evidences about the associations between serum ferritin, iron, and liver transaminases, which requires more confirmatory studies. [ABSTRACT FROM AUTHOR]

Background and Aims: epidermolysis bullosa (EB) is a rare disease presenting with skin fragility and formation of blisters. Constant presence of skin lesions, loss of blood, wastage of heat through the open skin, increased turnover of proteins and infections, result in increased energy, protein, and micronutrient needs. This study investigated the intake adequacy of energy, protein, zinc, iron, and dietary fiber in children with epidermolysis bullosa. Methods: this cross-sectional, analytical study was conducted with children and adolescents of up to 18 years of age with recessive dystrophic EB, severe subtype. Demographic data and clinical manifestations affecting food consumption were collected. Nutritional assessment was performed through anthropometric data. We used a formula to estimate specific energy needs for EB, and ratio of skin lesions was also evaluated to assist in estimating energy needs. A protein adequacy of 115 % to 200 % of the Recommended Dietary Allowance was considered for the adequacy of protein intake. And the Dietary Reference Intake tables according to sex and age were used as a reference for micronutrients. Intake assessment was performed using seven consecutive daily food records. Sip feed consumption was considered for intake assessment. Results: all patients showed undernutrition and presented at least three clinical symptoms that affect food consumption: pseudosyndactyly, microstomy, and blisters in the oral cavity. Sip feed constituted between 20 % and 50 % of the patients' energy intake. Intake of iron and zinc was adequate for most patients (confidence of adequacy = 0.85), while fiber intake was below the reference value. Conclusions: this study underscores the importance of nutritional monitoring for EB patients, which is often interpreted as a skin disease but has enormous nutritional repercussions. [ABSTRACT FROM AUTHOR]

Background: The most common micronutrient deficiencies in Ecuadorian schoolchildren are vitamin A (VA), zinc, and iron. The objective of the present study was to test the efficacy of cow's milk as a vehicle for VA, zinc, and iron supplementation.Methods: Three hundred twenty-eight children aged 6-10 years were included in a randomized, double blind controlled study; 173 children received 480 mL of whole milk (300 Kcals; G1) daily and 155 children received fortified milk (300 Kcals; G2) daily for 23 weeks. Participants had a nutritional evaluation before and after supplementation. Both treatment groups were comparable for gender, age, weight and height at the beginning of the study.Results: Both types of milk were well accepted by the participating children. Data showed that serum concentrations of VA, zinc, and iron significantly increased within both treatment groups. The increase in serum concentrations of the indicated micronutrients was significantly greater in children with deficiencies than in non-deficient ones. There were not significant differences in serum concentrations of VA, zinc, and iron between groups after supplementation. Data also showed that there was an increase in the percentage of children with normal BMI at the expense of a decrease of the percentage of children with excess weight at the end of the treatment period in G1 whereas in G2 it remained unchanged. Blood lipid profiles were normal before and after milk supplementation in both treatment groups.Conclusions: These data indicated that fortified and non-fortified milk are excellent options to increase serum VA, zinc, and iron concentration in schoolchildren. [ABSTRACT FROM AUTHOR]

Introducción: Existen programas que buscan mejorar el estado nutricio de la población vulnerable mediante la fortificación de alimentos. En México, el programa de leche fortificada Liconsa está dirigido a familias de bajo nivel socioeconómico. Objetivo: Evaluar el efecto del consumo de leche fortificada Liconsa en el estado de nutrición de hierro y zinc, en preescolares. Sujetos y métodos: Estudio cuasiexperimental, conducido en colonias marginadas de Hermosillo, México. Participaron 77 niños sanos, de los cuales 54 consumieron leche fortificada Liconsa (GCLFL) y 23 conformaron el grupo de referencia (GR, consumo de leche fluida de vaca, no fortificada). El estado de hierro se midió a través de hemoglobina, ferritina, hierro sérico, capacidad total de fijación de hierro, saturación de transferrina; y zinc sérico. También se estimó el consumo de leche fortificada a libre demanda, en la etapa basal y después de 6 meses. Mediante dos recordatorios de 24 horas, no consecutivos, se midió el consumo de hierro y zinc en la dieta total. Se realizó estadística descriptiva, prueba t-student para muestras independientes y prueba de ji cuadrada para diferencias de proporciones. Resultados: Los niños que consumieron leche fortificada incrementaron sus niveles de hemoglobina (1,13 g/dL, p < 0,05) y ferritina (5,83 μg/L, p < 0,05). La prevalencia de bajas reservas de hierro disminuyó de 20,4% a 4,1% (p < 0,05) y el zinc sérico aumentó en 45,2 μ/dL (p < 0,05). En el grupo de referencia, no hubo cambios significativos. El promedio diario del consumo de leche fortificada Liconsa fue de 22,7 ± 14,5 g, que suministró 2,5 mg/d de hierro y zinc. La dieta aportó 9,2 ± 3,4 mg/d de hierro y 6,9 ± 3 mg/d de zinc. Conclusiones: El consumo de leche fortificada beneficia el estado bioquímico de hierro y zinc en los niños del programa de abasto social de Liconsa.

Introduction: Iron is an essential micronutrient in the growing fetus.Objective: The purpose of this study is to find the possible correlations that may exist between maternal and fetal iron status and newborn weight.Material and Methods: The study included 97 mothers scheduled to give birth by elective caesarean section in the central maternity of Tébessa (east of Algeria) between January and August 2014. The blood collection was sampled from the antecubital vein of the mother and the umbilical vein. The mean concentrations of parameters in maternal and fetal sides, respectively, were 10.64 ± 1.37 g/dl and 14.83 ± 1.79 g/dl for hemoglobin, 51.57 ± 20.82 µg/dl and 112.47 ± 32.34 μg/dl for serum iron, and 12.37 ± 9.58 ng/ml and 109.64 ± 58.76 ng/ml for serum ferritin. Except for ferritin, other fetal parameters were correlated with those of mothers. Birth weight was only significantly correlated with maternal hemoglobin (r = 0.22, p = 0.02) and hematocrit (r = 0.2, p = 0.004).Conclusion: The fetal-maternal exchanges of iron were highlighted and iron status of the newborn was linked to that of the mother. The low maternal hemoglobin was associated with low newborn weight. [ABSTRACT FROM AUTHOR]

Background: Low-grade chronic inflammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specific nutritional deficiencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic inflammation, raising questions concerning the dosages of micronutrient supplementation.Objectives: This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on inflammation and iron metabolism in premenopausal women.Methods: This prospective study included 45 premenopausal women (aged 20-45 years; body mass index [BMI] ≥ 35 kg/m2) divided into two supplementation schemes: group 1 (n = 34): daily supplemental dose of 1 RDA 30 days before surgery and 2 RDAs during the six months following surgery; and group 2 (n = 11): daily supplementation of 1 RDA during the 6 months postsurgery. Anthropometry, dietary intake, inflammation, and iron metabolism were monitored.Results: Evident reductions in BMI, high-sensitivity C-reactive protein, and ferritin levels for both groups occurred 6 months after surgery. Additionally, anemia was 9% in both groups after surgery. However, group 1 exhibited an increased transferrin saturation index and reduced transferrin levels. Multivariate regression analysis suggested serum iron, hepcidin, and iron intake determined ferritin values before and after RYGB surgery.Conclusion: Six months after RYGB, systemic inflammation was reduced in both supplementation schemes. However, supplementation of 1 RDA before and 2 RDAs after surgery resulted in better improvements on iron metabolism. [ABSTRACT FROM AUTHOR]

Introducción: Los niños con enfermedades respiratorias crónicas (ERC) tienen mayor riesgo de desarrollar anemia ferropriva, sin embargo, la ferropenia está infradiagnosticada. Objetivos: Describir el status de hierro (Fe) en niños con ERC y evaluar la respuesta a su suplementación profiláctica. Método: Estudio prospectivo de niños con ERC y adecuada ingesta de Fe en la dieta: se realizó hemograma, velocidad de eritro-sedimentación, proteína C-reactiva y perfil de Fe. Posteriormente, aquellos con hemoglobina plasmática (Hb) normal no se suplementaron con Fe (Grupo A) y los que presentaban anemia ferropriva o factores de riesgo sí lo fueron (grupo B). Se evaluaron al 3º mes, después se suplementaron todos y se re-evaluaron al 4ºmes. Resultados: De 40 pacientes, con mediana de edad 30 meses (0,5 a 178), 60% eran hombres, 80% eutróficos. Requerían ventilación prolongada u oxigenoterapia 45%. Diagnósticos: 50% Bronquiolitis Obliterante post-infecciosa, 17,5% enfermedades de la vía aérea, 10% Displasia Broncopulmonar, 7,5% Fibrosis Quística y 15% otros. Basalmente 12,5% tuvo bajos depósitos de Fe y 20% anemia (la mayoría ferropriva). Completaron el estudio 25 niños: el grupo A disminuyó la ferritina sérica al 3ºmes (22,9 ± 30) y aumentó al 4ºmes (+12,8 ± 26) µg/L, (p = 0,013), sin cambio en la Hb. El grupo B tuvo ascenso de la Hb (91 ± 12 a 102 ± 12% del promedio para la edad, p = 0,04). Conclusión: La anemia ferropriva y la ferropenia son frecuentes en niños con ERC, quienes deterioran reversiblemente sus depósitos si no son suplementados. Sugerimos monitorizar con perfil de Fe y tratar precozmente, o suplementarlos en forma profiláctica.

Background: The nutritional therapy with enteral diets has been getting specialized and those formulations to substitute the traditional diet for those patients who need to be fed by probe. This workís aim was to study the effect of the components of enteral diet formulation: fiber, calcium and medium-chain triglycerides, seeking optimize a formulation for the best dialysability of iron by Response Surface Methodology (RSM). Methods: The ingredients used for the formulations of the diet were chosen according to the ones commercialized in the modules of a standard enteral diet, with which it was made an experimental diet and the applicability of the experimental limits. Results: The found results in the model have shown that it depends on the proportion of the nutrients that were manipulated in the experimental design. When the level curve was obtained for the iron dialysable, it could be verified that the binary interaction fiber-calcium was the one that presented more synergism for the appraised formulation. Before the analyzed facts, the best formulation of enteral diet optimized for the dialysability of the iron was the proportion of 60% of fiber and 40% of calcium, showing to be the best formulation of the enteral diet for the availability of the iron.

Objectives: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). Methods: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. Results: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01 % iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ < 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multinutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study.

Introducción: La cirugía bariátrica permite una reducción significativa de peso y mejoría de comorbilidades asociadas a la obesidad a largo plazo, pero también puede afectar negativamente el estado nutricional de algunos micronutrientes. Objetivos: Evaluar cambios en ingesta e indicadores del estado nutricional de zinc, hierro y cobre en mujeres sometidas a bypass gástrico en Y de Roux (BPG) o gastrectomía tubular (GT), hasta el segundo año postoperatorio. Métodos: Se estudió prospectivamente 45 mujeres sometidas a BPG o GT (edad promedio 35,2 ± 8,4 años, IMC promedio 39,8 ± 4,0 kg/m²), cada 6 meses se realizaron determinaciones de ingesta e indicadores del estado nutricional de zinc, hierro y cobre, y en forma anual se evaluó la composición corporal. El aporte de minerales a través de los suplementos representaba dos veces la ingesta recomendada para una mujer sana en las pacientes sometidas a GT y tres veces para BPG. Resultados: 20 mujeres se sometieron a GT y 25 a BPG. En ambos grupos se produjo una reducción significativa de peso y del porcentaje de masa grasa, que se mantuvo hasta el segundo año postoperatorio. Las mujeres sometidas a BPG presentaron un mayor compromiso del estado nutricional de zinc, hierro y cobre, que las pacientes sometidas a GT. Conclusiones: El bypass gástrico en Y de Roux produce un compromiso mayor del estado nutricional de zinc, hierro y cobre que la gastrectomía tubular. Se debería evaluar si la administración fraccionada de la suplementación mejoraría la absorción de estos nutrientes.Introduction: Bariatric surgery allows a significant reduction in weight and improvement of comorbidities associated with obesity in the long term, but it can also adversely affect the nutritional status of some micronutrients. Objectives: To evaluate changes in intake and parameters of nutritional status of zinc, iron and copper in patients undergoing Roux-en-Y gastric bypass (GBP) or sleeve gastrectomy (SG), until the second postoperative year. Methods: We prospectively studied 45 women undergoing GBP or SG (mean age 35.2 ± 8.4 years, mean BMI 39.8 ± 4.0 kg/m²), every 6 months We measured intake and status indications nutritional zinc, iron and copper, and annually evaluated body composition. The contribution of minerals through supplements represented twice the recommended intake for a healthy woman in patients undergoing GT and three times for GBP. Results: 20 women underwent GBP and 25 SG. In both groups there was a significant reduction in weight and body fat percentage, which was maintained until the second postoperative year. Women who have had a greater commitment GBP nutritional status of zinc, iron and copper, that patients undergoing SG. Conclusions: Gastric bypass Roux-Y produces a greater commitment of nutritional status of zinc, iron and copper sleeve gastrectomy. It should evaluate whether administration of supplementation fractional improve the absorption of these nutrients.

Introducción: La anemia es la anomalía hematológica y analítica más frecuente entre los pacientes críticos y quirúrgicos. Habitualmente se trata con transfusión de sangre alogénica (TSA), la cuál está relacionada con aumento de la morbimortalidad, por lo que se plantea la búsqueda de alternativas para el tratamiento de la anemia grave. Objetivos: Valorar la posible utilidad de la terapia con hierro intravenoso en pacientes con enfermedad crítica o quirúrgica que presentan anemia. Métodos: Revisión de los trabajos publicados con hierro intravenoso en este tipo de pacientes. Búsqueda en la base de datos Medline (www.ncvi.nlm.nih.gov) y búsqueda manual. Resultado y discusión: El tratamiento con hierro intravenoso no es suficiente para tratar la anemia del paciente crítico. Su asociación a eritropoyetina sí puede tener un efecto sobre la tasa de transfusiones aunque no se ha demostrado que mejore la morbimortalidad ni la estancia hospitalaria. En cirugía digestiva o traumatológica no hay evidencia que apoye el tratamiento sistemático pericirugía con hierro intravenoso, pudiendo encontrarse beneficio cuando se utiliza junto con eritropoyetina. La utilización de hierro intravenoso solo o asociado a EPO en el postoperatorio no ha demostrado ser útil para una corrección rápida de la anemia, disminuir la estancia hospitalaria ni disminuir la mortalidad.Background: Anemia is a common condition among surgical and critically ill patients and it is usually treated with allogenic blood transfusion (ABT). As ABT is associated with increased morbidity and mortality, alternative therapies for anemia in these patients are actively investigated. Objectives: To asses the potential usefulness of intravenous iron therapy in critically-ill or surgical patients with anemia. Methods: Review of published papers with intravenous iron in these patients. Bibliographical search on database Medline (www.ncvi.nlm.nih.gov). Results and discussion: Treatment with intravenous iron is not sufficient to treat the anemia of critically ill patients. Its association with erythropoietin (EPO) may have an effect on the rate of ABT, but it has not been shown to improve morbidity, mortality or length of hospital stay. In gastrointestinal or trauma surgery there is no evidence to support the routine preoperative treatment with intravenous iron, although it may be beneficial when it is used with erythropoietin. Intravenous iron alone or in combination with EPO in the postoperative period has not been proved useful for rapid correction of anemia, reduction of hospital stay or mortality.

Las mayores necesidades de hierro durante el embarazo se sitúan en el tercer trimestre, no obstante se recomienda la suplementación preventiva con hierro desde fases más tempranas. El objetivo del estudio fue comparar si la suplementación temprana con dosis moderadas de hierro previene mejor la caída de los niveles de hierro durante la gestación que la más tardía. Participaron 184 mujeres embarazadas. Recibieron suplementos de hierro desde antes de la semana 20 de gestación o posteriormente. Se determinó ferritina sérica (FS), saturación de transferrina (ST) y hemoglobina (Hb) en cada trimestre de la gestación. Se calculó la hemoglobina estandarizada por la edad gestacional (zHb). El grupo de suplementación temprana tomó una media de 40,5 ± 15,7 mg/día y el de tardía 43,1 ± 11,9 mg/día. El déficit de hierro (FS y ST alteradas) y la anemia por déficit de hierro aumentaron al avanzar la gestación, sin diferencias significativas entre los grupos de suplementación temprana y tardía. Más de la mitad de las mujeres finalizaron el embarazo con déficit de hierro y cerca de un 20% con anemia por déficit de hierro. En conclusión, aunque en la gestación se recomienda el inicio temprano de la toma de suplementos de hierro, no se observa mejor efecto preventivo sobre la caída de los niveles de hierro con la suplementación temprana respecto de la tardía, cuando se utilizan dosis de hierro moderadas.The highest iron demands during pregnancy occur in the third trimester, although preventive iron supplementation is recommended from early stages of the pregnancy. The aim of the study was to compare whether early supplementation with moderate iron doses better prevents the decrease of iron levels during gestation than the late supplementation. One hundred and eighty-four pregnant women participated. They received iron supplements before or after week 20 of pregnancy. At each quarter, serum ferritin (SF), transferrin saturation (TS) and hemoglobin (Hb) were determined. Gestational agestandardized hemoglobin (zHb) was calculated. The early supplementation group received a mean of 40.5 ± 15.7 mg/day and the late group 43.1 ± 11.9 mg/day. Iron deficiency (impaired SF and TS) iron deficiency anemia increased as pregnancy progressed without significant differences between the early and late supplementation groups. More than half of the women ended up their pregnancy with iron deficiency and more than 20% with iron deficiency anemia. In conclusion, although early intake of iron supplements is recommended in pregnancy, no better preventive effect is observed on the decrease of iron levels with early supplementation as compared to late supplementation when moderate iron doses are used.

Introducción: La cirugía bariátrica produce una reducción de peso significativa, pero se asocia a un mayor riesgo de presentar algunas deficiencias nutricionales. Una complicación frecuente, poco estudiada, que se ha relacionado principalmente con deficiencia de zinc, es la alopecia. Objetivos: comparar el estado nutricional de zinc, hierro, cobre, selenio y proteico-visceral en mujeres con distinto grado de caída del pelo al sexto mes post bypass gástrico o gastrectomía tubular. Métodos: Según el grado de caída de pelo las pacientes fueron divididas en dos grupos: grupo 1 o caída leve (n = 42) y grupo 2 o caída importante del pelo (n = 45). Se evaluó en el preoperatorio y al sexto mes postoperatorio la ingesta de zinc, hierro, cobre y selenio, además de indicadores del estado nutricional de zinc, hierro, cobre y proteico visceral. Resultados: En ambos grupos se produjo una reducción significativa del peso al sexto mes postoperatorio (-38,9 ± 16,4%). Las pacientes del grupo1 presentaron una ingesta significativamente mayor de zinc (20,6 ± 8,1 contra 17,1 ± 7,7 mg/d) y de hierro (39,7 ± 35,9 contra 23,8 ± 21,3 mg/d.), y un menor compromiso del estado nutricional de zinc y hierro que el grupo 2, pero las pacientes del grupo 2 presentaron un menor compromiso del estado nutricional de cobre. No hubo diferencias en las concentraciones plasmáticas de albúmina. Conclusiones: Las pacientes que presentan una menor caída del pelo hasta el sexto mes postoperatorio tienen una mayor ingesta de zinc y hierro, y un menor compromiso del estado nutricional de ambos minerales.Introduction: Bariatric surgery leads to a significant body weigh reduction although it is associated to a higher risk of presenting some nutritional deficiencies. A common complication, little studied and mainly related to zinc deficiency is alopecia. Objectives: To compare the nutritional status of zinc, iron, copper, selenium and protein-visceral in women with different degrees of hair loss at 6 months after gastric bypass or tubular gastrectomy. Methods: The patients were categorized into two groups according to the degree of hair loss: group 1 or mild loss (n = 42) and group 2 or severe hair loss (n = 45). Zinc, iron, copper, and selenium, as well as the indicators of the nutritional status of zinc, iron, copper, and proteinvisceral were assessed before and after 6 months of the surgery. Results: In both groups there was a significant body weight reduction at 6 months post-surgery (-38.9% ± 16.4%). Patients in group 1 presented a significantly higher intake of zinc (20.6 ± 8.1 vs. 17.1 ± 7.7 mg/d) and iron (39.7 ± 35.9 vs. 23.8 ± 21.3 mg/d.), and lower compromise in the nutritional status of zinc and iron than group 2. However, patients in group 2 had lower compromise in the nutritional status of copper. There were no differences regarding the plasma concentrations of albumin. Conclusions: The patients having lower hair loss at six months after surgery had higher zinc and iron intake and lower compromise of the nutritional status of both minerals.

Introducción: Existe una acumulación de evidencias de que niveles de nutrición deficientes o aún marginales pueden contribuir al aumento de morbilidad y mortalidad en el paciente quirúrgico. La utilidad de marcadores de vitaminas y minerales ha sido poco explorada. Objetivo: Evaluar la utilidad de indicadores de vitaminas y minerales como marcadores de riesgo quirúrgico. Métodos: Se estudió la asociación entre marcadores de vitamina A (retinol plasmático), carotenos (carotenos plasmáticos), vitamina C (vitamina C plasmática), hierro (hematocrito, hemoglobina, hierro sérico, saturación de transferrina y protoporfirina eritrocitaria), calcio (calcio/creatinina en orina basal) y zinc (zinc/creatinina en orina basal), realizados dentro de las 24 horas previas a la cirugía, y la aparición de complicaciones postoperatorias en 100 pacientes adultos sometidos a intervenciones por hernia (n = 41) o litiasis vesicular (n = 59), dos intervenciones muy frecuentes en los servicios de cirugía general. Resultados: Los pacientes se dividieron en aquellos que presentaron complicaciones postoperatorias (C; n = 26) y aquellos que evolucionaron sin complicaciones (NC; n = 74). Dos de los marcadores estudiados fueron los que presentaron las mayores diferencias entre ambos grupos: retinol plasmático y protoporfirina eritrocitaria. El retinol plasmático del grupo C fue significativamente menor al del grupo NC: 33,2 ± 13,5 μg/dl vs 40,2 ± 16,3 μg/dl; P = 0,0495 y se halló asociación significativa entre valores inferiores a 30 μg/dl y aparición de complicaciones (53,8% en C vs 30,1% en NC; P = 0,0360). La protoporfirina eritrocitaria del grupo C fue significativamente mayor a la del grupo NC: 52,0 ± 34,0 vs 36,8 ± 17,5 μg/dl g.r; P = 0,0453 y la asociación entre valores superiores a 70 μg/dl g.r. y presencia de complicaciones fue altamente significativa (25,0% vs 4,2%; P = 0,0069). Conclusiones: Dos indicadores de micronutrientes: retinol plasmático y protoporfirina eritrocitaria, resultaron marcadores promisorios de riesgo quirúrgico por haber permitido identificar pacientes en riesgo de sufrir complicaciones postoperatorias.Background: The fact that deficient or even marginal nutritional levels may contribute to increase morbidity and mortality in the surgical patient is well accepted. The usefulness of vitamin and mineral markers has not been much explored. Objective: To evaluate the usefulness of vitamin and mineral indicators as nutritional markers of surgical risk. Methods: Biomarkers of vitamin A (plasma retinol), carotenes (plasma carotenes), vitamin C (plasma vitamin C), iron (hematocrit, hemoglobin, serum iron, transferrin saturation and erythrocyte protoporphyrin), calcium (calcium/creatinine in basal urine) and zinc (zinc/creatinine in basal urine), were performed 24 ours before surgery. Appearance of complications was evaluated in 100 adult patients from programmed surgical procedures of hernia (n = 41) or gallbladder lithiasis (n = 59), two of the most frequent interventions in general surgery services. Results: Patients were grouped in those that presented postoperative complications (C; n = 26) and those who did not (NC; n=74). Two of the studied markers presented significant differences between both groups: plasma retinol and erythrocyte protoporphyrin. Plasma retinol of C was significantly lower than that obtained in NC: 33.2 ± 13.5 μg/dl vs. 40.2 ± 16.3 μg/dl; P = 0.0495 and an association between values below 30 μg/dl and postoperative complications was founded (53.8% in C vs. 30.1% in NC; P = 0.0360). Erythrocyte protoporphyrin of C was significantly higher to that obtained in NC: 52.0 ± 34.0 μg/dl RBC vs. 36.8 ± 17.5 μg/dl RBC; P = 0.0453 and the association between values higher than 70 μg/dl RBC and presence of complications were highly significant (25.0% vs. 4.2%; P = 0.0069). Conclusions: On the basis of the obtained results is concluded that plasma retinol and erythrocyte protoporphyrin would provide useful tools in evaluating surgical risk since they had been allowed to identify patients who were at risk of suffering postoperative complications.

Introduction: In 2012, the Mexican National Health Survey showed a moderate prevalence rate of vitamin D deficiency, around 16%, in a national representative sample of children. A decreasing prevalence of anemia during the last 15 years has been observed in Mexico. The aim of this study was to determine the levels of vitamin D in children 3-8 years old in four different locations within the metropolitan area of Mexico City and to compare them to levels of iron and zinc as references of nutritional status.Methods: One hundred and seventeen healthy children aged 3-8 years attending four hospitals in Mexico City were invited to participate. All children received medical and nutritional evaluation, and blood samples were obtained.Results: Children were selected in the four hospitals between April and August 2008. More than half (51.3%) were boys; their average age was 5.5 ± 1.6 years. The mean height and weight of the children were 112.1 ± 11.2 cm and 20.2 ± 4.9 kg respectively, with a body mass index [BMI] of 15.8 ± 1.7 kg/m². The mean Z-score (BMI) was 0.007 ± 0.999. The prevalence of subjects with deficient levels of 25-OH-vitamin D (<50 nmol/l) was 24.77%. None of the children had haemoglobin levels below the anaemia threshold, and zinc determination revealed 8.26% of individuals with deficient levels (<65 µg/dL). These data confirm the findings reported in the latest National Nutrition Survey (ENSANUT 2012) about the sustained reduction of anaemia prevalence among preschool and schoolchildren since 1999 and the rising rates of vitamin D deficiency in the same population. Similar to other studies, we found a link between socioeconomic status and the deficiency of micronutrients, these being markers of better nutrition, and vitamin D is remarkably related to the quality of the diet. This finding has not been considered in our population before.Conclusions: There is evidence of a sustained decrease of anaemia in Mexican children due to general enrichment of foods and focus on vulnerable populations, while vitamin D deficiency seems to have increased. More studies are needed to obtain more information on vitamin D levels at different ages and definition of susceptible groups in order to investigate the possibility of general population measures such as enrichment, which have proven to be effective. [ABSTRACT FROM AUTHOR]

La anemia ferropénica representa la anemia carencial más frecuente en nuestro medio, la primera causa de consulta hematológica y el tipo de alteración nutricional más común. Se caracteriza por la disminución o ausencia de los depósitos de hierro. La prueba deficiencia que confirma la existencia de anemia por déficit de hierro (AF) son unos niveles séricos bajos de ferritina, indicativos de una situación de depleción de hierro. Otros parámetros no permiten diferenciar la AF de la anemia trastornos crónicos. La dieta es de gran importancia en la anemia, sin embargo, ningún alimento contiene concentraciones suficientes de hierro para poder constituir un remedio práctico en los estados de carencia del mismo, por lo que el tratamiento debe realizarse por vía oral con preparados a poder ser a base de sulfato ferroso para asegurar una mejor absorción. Se recomienda una dosis inicial de 150-200 mg. de hierro elemental al día, repartido en tres tomas (3-5 mg/kg/día en niños).Anemia secondary to iron deficiency is the most frequent anaemia in our environment, the first cause of consultation in Haematology and the most common nutritional problem. It is characterized by a diminution or absence of iron deposits. The ultimate test that confirms the diagnosis of anaemia secondary to iron deficiency is a low serum level of ferritin, which indicates iron depletion. Other parameters do not allow to distinguish iron deficiency anaemia from other chronic derangements. Diet is of utmost importance in anaemia. There is not a single food product with sufficient concentration of iron capable of restoring iron deficiency situations. Therefore, treatment of iron deficiency must be made orally with iron preparates, mainly in the form of iron sulphate in order to guarantee a better absorption. The initial recommended doses are 150-200 mg of elemental iron per day split in three ingestions (in children 3-5 mg/Kg/day).

Introduction: For critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome. Objective: This prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy. Method: Full blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturation (satTRF), serum TFR receptor (sTfR), ferritin (FRT) and C-reactive protein (CRP) were measured in venous blood samples from 131 random patients admitted to the ICU for at least 24 h (Length of ICU stay, LIS; min: 1 day; max: 38 days). Results: Anaemia (Hb < 12 g/dL) was present in 76% of the patients (Hb < 10 g/dL in 33%), hypoferremia (SI < 45 µg/dl) in 69%; satTRF < 20% in 53%; FRT < 100 ng/mL in 23%; sTfR > 2.3 mg/dL in 13%; and CRP > 0.5 mg/dL in 88%. Statistically significant correlations (r of Pearson; *p < 0.05, **p < 0.01) were obtained for serum CRP levels and WBC**, Hb*, TRF**, satTRF*, and FRT**. There was also a strong correlation between TRF and FRT (-0.650**), but not between FRT and satTRF or SI. LIS correlated with Hb*, CRP**, TRF*, satTRF* and FRT**. Conclusion: A large proportion of critically ill patients admitted to the ICU presented the typical functional iron deficiency (FID) of acute inflammation-related anaemia (AIRA). This FID correlates with the inflammatory status and the length of stay at the ICU. However, 21% of the ICU patients with AIRA had an associated real iron deficiency (satTRF < 20; FRT < 100 and sTfR > 2,3). Since oral supplementation of iron seems to be ineffective, all these patients might benefit of iv iron therapy for correction of real or functional iron deficiency, which in turn might help to ameliorate their inflammatory status.Introducción: En los pacientes críticos, la inmuno-nutrición por vía enteral disminuye significativamente la tasa de infecciones y la estancia hospitalaria, pero no la mortalidad, por lo que se plantea la cuestión de sí esto es debido a la heterogeneidad de los pacientes críticos o a la ausencia o la absorción deficitaria de un nutriente específico en la mezcla administrada (p.e., hierro). La deficiencia funcional de hierro (DFH) causada por la inflamación no es sólo una de las causas de anemia en el paciente crítico, sino que también induce una respuesta inapropiada del sistema inmunitario, lo que origina una mayor duración de los episodios de respuesta inflamatoria sistémica y un peor pronóstico. Objetivo: Este estudio transversal prospectivo se inició para evaluar la prevalencia de DFH en pacientes críticos durante su estancia en la UCI, y determinar la población de pacientes que podrían beneficiarse de la administración de hierro. Métodos: Se realizaron recuentos hematológicos completos, incluyendo reticulocitos (RETIC), y determinación de los niveles séricos de hierro (SI), transferrina (TRF) y porcentaje de saturación (satTRF), receptor soluble de TFR (sTfR), ferritina (FRT) y proteína C-reactiva (CRP) en muestras de sangre venosa de 131 pacientes ingresados en UCI durante al menos 24 horas (estancia en UCI, min: 1 día; max: 38 días). Resultados: Se detectó la presencia de anemia (Hb < 12 g/dL) en el 76% de los pacientes (Hb < 10 g/dL en el 33%), de hiposideremia (SI < 45 µg/dL) en el 69%; una satTRF < 20% en el 53%; una FRT < 100 ng/mL en el 23%; un nivel de sTfR > 2,3 mg/dL en el 13%; y de CRP < 0,5 mg/dL en el 88%. Se obtuvieron correlaciones significativas (r de Pearson; *p < 0,05, **p < 0,01) entre los niveles de CRP y los de WBC**, Hb*, TRF**, satTRF*, y FRT**. Hubo también una fuerte correlación entre TRF y FRT (-0,650**), pero no entre FRT y satTRF o SI. La estancia en UCI se correlacionó con Hb*, CRP**, TRF*, satTRF*, y FRT**. Conclusiones: Una gran parte de los pacientes críticos ingresados en la UCI presentan el DFH típico de la anema relacionada con los episodios agudos (AREA). Este DFH se correlaciona con el estado inflamatorio y la duración de la estancia en UCI. Sin embargo, el 21% de los pacientes en UCI con AREA presentan además un déficit real de hierro (satTRF < 20; FRT < 100, and sTfR > 2,3). Dado que el tratamiento con hierro oral parece ser inefectivo, estos pacientes podrían beneficiarse de la terapia con hierro intravenoso para la corrección de su deficiencia real o funcional de hierro, lo que a su vez podría contribuir a una disminución de su estado inflamatorio.

Aging is associated with increased risk of developing anaemia and micronutrient deficiencies. The purpose of this study was to evaluate the daily intake of micronutrient whose deficient in diet could cause anaemia (iron, folic acid, vitamin B12) and vitamin C to establish the prevalence of anaemia in a group of institutionalized of 124 elderly subjects residing in five nursing homes in León (Spain). A precise weighing method was used to conduct the control of food intake covering seven days. Energy, alcohol, iron, folate, vitamin B12, and vitamin C intake were obtained. Weight, and Height also were measured. Serum iron, serum ferritin, haemoglobin and hematocrit were also measured. Average daily iron intake was higher than the 10 mg recommended by the National Academy of Science although significantly higher (p < 0.05) in males (17.0 ± 7.4 mg) than in females (11.8 ± 1.5 mg). Moreover, vitamin C intake in all subjects is high (118.8 ± 43.7 mg) and higher than Spanish RDA (198%). Average intakes of folate and vitamin B12 in the present study exceeded the RDA, (103% and 144%). However, 45.83% of males and 5.97% of females showed deficiencies in vitamin B12 and 53.91% of the subjects showed deficiencies in folic acid. The average haemoglobin concentration (14.28 ± 1.33 g/dL), hematocrit percentage (43.71 ± 6.31), ferritin concentration (87.01 ± 59.74 ng/mL) and serum iron (85.36 ± 33.98 µg/dL) showed similar figures to the results obtained in other studies carried out on elderly populations. It would be necessary to adequately compose the menus given in nursing homes, decreasing energy contribution, and supplying micronutrient rich foods or fortified foods.El envejecimiento comporta un mayor riesgo de anemia y deficiencias de micronutrientes. El objetivo de este estudio consistió en evaluar el aporte diario de micronutrientes, cuya carencia dietética podría ocasionar anemia (hierro, ácido fólico, vitamina B12), así como de vitamina C para conocer la prevalencia de anemia entre un grupo de 124 ancianos que vivían en cinco residencias de León (España). Se utilizó un método preciso de pesaje para controlar la ingestión de alimentos durante 7 días. Se midieron el aporte de energía, alcohol, hierro, ácido fólico, vitamina B12 y vitamina C. También se registraron el peso y la talla. Además, se analizaron el hierro sérico, la ferritina sérica, la hemoglobina y el hematócrito. El aporte diario medio de hierro resultó mayor que los 10 mg recomendados por la Academia Nacional de Ciencias, si bien la cantidad recibida por los varones (17,0 ± 7,4 mg) era significativamente superior (p < 0,05) a la de las mujeres (11,8 ± 1,5 mg). Es más, el aporte de vitamina C de todos los sujetos fue alto (118,8 ± 43,7 mg) y superior a la cantidad diaria recomendada (CDR) en España (198%). El aporte medio de ácido fólico y de vitamina B12 en este estudio excedió las CDR pertinentes (103% y 144%). Sin embargo, el 45,83% de los varones y el 5,97% de las mujeres manifestaron carencias de vitamina B12, mientras que el 53,91% de la población presentaba una deficiencia de ácido fólico. La concentración media de hemoglobina (14,28 ± 1,33 g/dl), el porcentaje del hematócrito (43,71 ± 6,31), la concentración de ferritina (87,01 ± 59,74 ng/ml) y el hierro sérico (85,36 ± 33,98 µg/dl) se asemejaron a los de otros estudios sobre poblaciones ancianas. Sería necesario organizar adecuadamente los menús de las residencias para la tercera edad, disminuyendo el aporte energético y suministrando alimentos ricos en micronutrientes o fortificados.

Introduction: despite the extensive knowledge on iron bioavailability, a Food Frequency Questionnaire (FFQ) for application in population groups predisposed to iron deficiency anaemia has not been implemented. Objectives: to design a FFQ based on enhancers and inhibitors of iron absorption and to assess its applicability in a group of women at childbearing age. Methods: the FFQ included 28 items and the time of consumption for 10 of them, breakfast (B) and lunch/dinner (LD). One hundred and seventy nine healthy young women were selected and distributed into three groups according to their iron status measured by serum ferritin: < 15, 15-30 or > 30 ng/mL. Results: the reproducibility of this FFQ was very high (Spearman coefficient > 0.500, p < 0.001 for all variables). Red meat and alcoholic beverages consumption was positively associated with ferritin, while citric fruits- LD and nuts-LD were negatively associated (p < 0.05). Citric fruits-LD was negatively associated with red meat (p < 0.05) and positively with legumes, fish, salad, vegetables, foods fortified with fiber, other fruits (p < 0.001) and brown bread (p < 0.05). The consumption of fruit juices with breakfast was lower in women with ferritin <15 ng/ml compared to ferritin 15-30 ng/ml. Conclusion: this questionnaire is simple and reproducible. Red meat is the main dietary factor related with higher iron status in young women, thus its influence on iron absorption compared to other enhancers and inhibitors is highlighted. [ABSTRACT FROM AUTHOR]

The purpose of this study is to clarify the association between serum Fe levels and Obesity using a meta-analysis approach. We searched eligible papers on the relevance published between 2006 and 2014 from the PubMed and the Chinese National Knowledge Infrastructure. Review Manage software was used to collect and analysis the date cited in the papers.6 eligible articles with 934 subjects from 40 case-control studies were identified. Overall,polled analysis indicated that subjects with obesity had lower Fe levels than healthy controls [standardized mean difference (SMD) = -0.738,95%confidence interval (CI) = (-1.228,-0.247)]. Thus, dietary supplement of Fe is recommended to prevent obesity. [ABSTRACT FROM AUTHOR]

Introduction: The α-lipoic acid (ALA) has been used as a treatment to reduce oxidative damage in Systemic Arterial Hypertension (SAH), but there are no in vivo studies reporting the effect of its mechanism of action on iron metabolism. Objective: To evaluate the antioxidant effect of α-lipoic acid on Blood cell count (CBC) and iron metabolism in hypertensive subjects with or without anemia. Method: Double-blind, randomized, placebo-controlled clinical trial. The sample consisted of 60 hypertensive patients that were randomly divided into treatment group (n = 32), receiving 600 mg / day of ALA for twelve weeks and control group (n = 28), receiving placebo for the same period. Blood cell count, serum iron, ferritin, Latent Iron-Binding Capacity (LIBC), Total Iron-Binding Capacity (TIBC), Transferrin Saturation Index (TSI) and transferrin were assessed before and after intervention. To assess changes between groups, the Student t-test and ANOVA were used, adopting a significance level of 5%.Results: After intervention, ALA supplementation showed a statistically significant (p < 0.05) association with the reduction of total leukocytes, increase in the number of neutrophils and reductions in the serum levels of iron and TSI. Conclusion: Oral administration of ALA as a therapeutic adjuvant changes the hematologic response of white blood cells and reduces the absorption of iron. It is observed that the mechanism of metals chelation by lipoic acid may be responsible for these changes and, consequently, could trigger a condition of iron deficiency anemia in hypertensive individuals. [ABSTRACT FROM AUTHOR]

The role of iron in the human body is essential, and athletes must always try to keep an adequate iron status. Hepcidin is proposed as the main hormone responsible for the control of iron reserves in the body, given its ability to induce degradation of ferroportin. The action of hepcidin on ferroportin leads to a decreased dietary iron absorption, as well as to a decrease in macrophages. Several factors such as the iron status, the amount of dietary iron, the inflammation, the hypoxia, the testosterone and the physical exercise have been pointed out as affecting the synthesis of hepcidin. This study has aimed at analysing the researches on hepcidin response to exercise, as well as designing a specific strategy to prevent a potential ferropenic status in athletes. The main findings are an association between exercise at an intensity over 65% VO2max and transient increases in the synthesis of hepcidin, and a possible regulatory effect of intermittent hypoxic stimuli in the early post-exercise recovery. Other factors such as the training volume, sex, kind of exercise or the type of surface where the training takes place do not seem to affect the response of hepcidin to exercise. [ABSTRACT FROM AUTHOR]

Introduction: Studies have shown that oxidative stress, found in patients with type 2 diabetes, may be due to changes in the metabolism of minerals, such as magnesium and iron. Data related to compartmentalization of these minerals in diabetes are scarce and controversial. Objective: This study assessed the influence of magnesium on biochemical parameters of iron and oxidative stress in patients with type 2 diabetes. Methods: A case-control study in male and female subjects aged 27-59 years, divided into two groups: type 2 diabetes (n=40) and control (n=48). Intake of magnesium and iron was assessed by three-day food record. Plasma, erythrocyte and urinary levels of magnesium, serum iron, ferritin, total iron binding capacity, fasting glucose, glycated hemoglobin, insulin, creatinine clearance and plasma thiobarbituric acid reactive substances (TBARS) were analyzed. Results and Discussion: Magnesium intake and plasma magnesium were lower in diabetic subjects. There was low urinary magnesium excretion, with no difference between groups. Although normal, the diabetic group had lower serum iron and ferritin concentrations compared to control subjects. Plasma TBARS in diabetic patients was higher than control while creatinine clearance was lower. An inverse correlation between erythrocyte magnesium and serum iron and ferritin was observed in the diabetes group. Conclusions: Diabetes induced hypomagnesemia and this, associated with chronic hyperglycemia, may have enhanced oxidative stress. Erythrocyte magnesium may have contributed to prevent iron overload and worsening of oxidative stress and hyperglycemic status. [ABSTRACT FROM AUTHOR]

Obesity and Type 2 diabetes mellitus share a strong pro-inflammatory profile. It has been observed that iron is a risk factor in the development of type 2 diabetes. The aim of this study was to evaluate the relationship between iron nutritional status and inflammation with the risk of type 2 diabetes development in obese subjects. We studied 30 obese men with type 2 diabetes (OBDM); 30 obese subjects without diabetes (OB) and 30 healthy subjects (Cn). We isolated peripheral mononuclear cells (PMCs) and challenged them with high Fe concentrations. Total mRNA was isolated and relative abundance of TNF-⍺, IL-6 and hepcidin were determined by qPCR. Iron status, biochemical, inflammatory and oxidative stress parameters were also characterized. OBDM and OB patients showed increased hsCRP levels compared to the Cn group. OBDM subjects showed higher levels of ferritin than the Cn group. TNF-⍺ and IL-6 mRNA relative abundances were increased in OBDM PMCs treated with high/Fe. Hepcidin mRNA was increased with basal and high iron concentration. We found that the highest quartile of ferritin was associated with an increased risk of type 2 diabetes when it was adjusted to BMI and HOMA-IR; this association was independent of the inflammatory status. The highest level of hepcidin gene expression also showed a trend of increased risk of diabetes, however it was not significant. Levels of hsCRP over 2 mg/L showed a significant trend of increasing the risk of diabetes. In conclusion, iron may stimulate the expression of pro-inflammatory genes (TNF-⍺ and IL- 6), and both hepcidin and ferritin gene expression levels could be a risk factor for the development of type 2 diabetes. Subjects that have an increased cardiovascular risk also have a major risk to develop type 2 diabetes, which is independent of the BMI and insulin resistance state. [ABSTRACT FROM AUTHOR]

Objectives: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). Methods: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. Results: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01% iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ< 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multi-nutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study. [ABSTRACT FROM AUTHOR]

Background: The nutritional therapy with enteral diets has been getting specialized and those formulations to substitute the traditional diet for those patients who need to be fed by probe. This workfs aim was to study the effect of the components of enteral diet formulation: fiber, calcium and medium-chain triglycerides, seeking optimize a formulation for the best dialysability of iron by Response Surface Methodology (RSM). Methods: The ingredients used for the formulations of the diet were chosen according to the ones commercialized in the modules of a standard enteral diet, with which it was made an experimental diet and the applicability of the experimental limits. Results: The found results in the model have shown that it depends on the proportion of the nutrients that were manipulated in the experimental design. When the level curve was obtained for the iron dialysable, it could be verified that the binary interaction fiber-calcium was the one that presented more synergism for the appraised formulation. Before the analyzed facts, the best formulation of enteral diet optimized for the dialysability of the iron was the proportion of 60% of fiber and 40% of calcium, showing to be the best formulation of the enteral diet for the availability of the iron. [ABSTRACT FROM AUTHOR]

Introduction: Bariatric surgery allows a significant reduction in weight and improvement of comorbidities associated with obesity in the long term, but it can also adversely affect the nutritional status of some micronutrients. Objectives: To evaluate changes in intake and parameters of nutritional status of zinc, iron and copper in patients undergoing Roux-en-Y gastric bypass (GBP) or sleeve gastrectomy (SG), until the second postoperative year. Methods: We prospectively studied 45 women undergoing GBP or SG (mean age 35.2 ± 8.4 years, mean BMI 39.8 ± 4.0 kg/m2), every 6 months We measured intake and status indications nutritional zinc, iron and copper, and annually evaluated body composition. The contribution of minerals through supplements represented twice the recommended intake for a healthy woman in patients undergoing GT and three times for GBP. Results: 20 women underwent GBP and 25 SG. In both groups there was a significant reduction in weight and body fat percentage, which was maintained until the second postoperative year. Women who have had a greater commitment GBP nutritional status of zinc, iron and copper, that patients undergoing SG. Conclusions: Gastric bypass Roux-Y produces a greater commitment of nutritional status of zinc, iron and copper sleeve gastrectomy. It should evaluate whether administration of supplementation fractional improve the absorption of these nutrients. [ABSTRACT FROM AUTHOR]

The highest iron demands during pregnancy occur in the third trimester, although preventive iron supplementation is recommended from early stages of the pregnancy. The aim of the study was to compare whether early supplementation with moderate iron doses better prevents the decrease of iron levels during gestation than the late supplementation. One hundred and eighty-four pregnant women participated. They received iron supplements before or after week 20 of pregnancy. At each quarter, serum ferritin (SF), transferrin saturation (TS) and hemoglobin (Hb) were determined. Gestational agestandardized hemoglobin (zHb) was calculated. The early supplementation group received a mean of 40.5 ± 15.7 mg/day and the late group 43.1 ± 11.9 mg/day. Iron deficiency (impaired SF and TS) iron deficiency anemia increased as pregnancy progressed without significant differences between the early and late supplementation groups. More than half of the women ended up their pregnancy with iron deficiency and more than 20% with iron deficiency anemia. In conclusion, although early intake of iron supplements is recommended in pregnancy, no better preventive effect is observed on the decrease of iron levels with early supplementation as compared to late supplementation when moderate iron doses are used. [ABSTRACT FROM AUTHOR]

Background: Anemia is a common condition among surgical and critically ill patients and it is usually treated with allogenic blood transfusion (ABT). As ABT is associated with increased morbidity and mortality, alternative therapies for anemia in these patients are actively investigated. Objectives: To asses the potential usefulness of intravenous iron therapy in critically-ill or surgical patients with anemia. Methods: Review of published papers with intravenous iron in these patients. Bibliographical search on database Medline (www.ncvi.nlm.nih.gov). Results and discussion: Treatment with intravenous iron is not sufficient to treat the anemia of critically ill patients. Its association with erythropoietin (EPO) may have an effect on the rate of ABT, but it has not been shown to improve morbidity, mortality or length of hospital stay. In gastrointestinal or trauma surgery there is no evidence to support the routine preoperative treatment with intravenous iron, although it may be beneficial when it is used with erythropoietin. Intravenous iron alone or in combination with EPO in the postoperative period has not been proved useful for rapid correction of anemia, reduction of hospital stay or mortality. [ABSTRACT FROM AUTHOR]

Introduction: Bariatric surgery leads to a significant body weigh reduction although it is associated to a higher risk of presenting some nutritional deficiencies. A common complication, little studied and mainly related to zinc deficiency, is alopecia. Objectives: To compare the nutritional status of zinc, iron, copper, selenium and protein-visceral in women with different degrees of hair loss at 6 months after gastric bypass or tubular gastrectomy. Methods: The patients were categorized into two groups according to the degree of hair loss: group 1 or mild loss (n = 42) and group 2 or severe hair loss (n = 45). Zinc, iron, copper, and selenium, as well as the indicators of the nutritional status of zinc, iron, copper, and protein-visceral were assessed before and after 6 months of the surgery. Results: In both groups there was a significant body weight reduction at 6 months post-surgery (-38.9% ± 16.4%). Patients in group 1 presented a significantly higher intake of zinc (20.6 ± 8.1 vs. 17.1 ± 7.7 mg/d) and iron (39.7 ± 35.9 vs. 23.8 ± 213 mg/d.), and lower compromise in the nutritional status of zinc and iron than group 2. However, patients in group 2 had lower compromise in the nutritional status of copper. There were no differences regarding the plasma concentrations of albumin. Conclusions: The patients having lower hair loss at six months after surgery had higher zinc and iron intake and lower compromise of the nutritional status of both minerals. [ABSTRACT FROM AUTHOR]

Background: The fact that deficient or even marginal nutritional levels may contribute to increasing morbidity and mortality in the surgery patient is well accepted. The usefulness of vitamin and mineral markers has not been much explored. Objective: To evaluate the usefulness of vitamin and mineral indicators as nutritional markers of surgical risk. Methods: Biomarkers of vitamin A (plasma retinol), carotenes (plasma carotenes), vitamin C (plasma vitamin C), iron (hematocrit, hemoglobin, serum iron, transferrin saturation and erythrocyte protoporphyrin), calcium (calcium/creatinine in basal urine) and zinc (zinc/creatinine in basal urine), were performed 24 ours before surgery. Appearance of complications was evaluated in 100 adult patients from programmed surgical procedures of hernia (n = 41) or gallbladder lithiasis (n = 59), two of the most frequent interventions in general surgery services. Results: Patients were grouped in those that presented postoperative complications (C; n = 26) and those who did not (NC; n=74). Two of the studied markers presented significant differences between both groups: plasma retinol and erythrocyte protoporphyrin. Plasma retinol of C was significantly lower than that obtained in NC: 33.2 ± 13.5 μg/dl vs. 40.2 ± 16.3 μg/dl; P = 0.0495 and an association between values below 30 μg/dl and postoperative complications was founded (53.8% in C vs. 30.1% in NC; P = 0.0360). Erythrocyte protoporphyrin of C was significantly higher to that obtained in NC: 52.0 ± 34.0 μg/dl RBC vs. 36.8 ± 17.5 μg/dl RBC; P = 0.0453 and the association between values higher than 70 μg/dl RBC and presence of complications were highly significant (25.0% vs. 4.2%; P = 0.0069). Conclusions: On the basis of the obtained results is concluded that plasma retinol and erythrocyte protoporphyrin would provide useful tools in evaluating surgical risk since they had been allowed to identify patients who were at risk of suffering postoperative complications. [ABSTRACT FROM AUTHOR]

La anemia ferropénica representa la anemia carencial más frecuente en nuestro medio, la primera causa de consulta hematológica y el tipo de alteración nutricional más común. Se caracteriza por la disminución o ausencia de los depósitos de hierro. La prueba deficiencia que confirma la existencia de anemia por déficit de hierro (AF) son unos niveles séricos bajos de ferritina, indicativos de una situación de depleción de hierro. Otros parámetros no permiten diferenciar la AF de la anemia trastornos crónicos. La dieta es de gran importancia en la anemia, sin embargo, ningún alimento contiene concentraciones suficientes de hierro para poder constituir un remedio práctico en los estados de carencia del mismo, por lo que el tratamiento debe realizarse por vía oral con preparados a poder ser a base de sulfato ferroso para asegurar una mejor absorción. Se recomienda una dosis inicial de 150-200 mg. de hierro elemental al día, repartido en tres tomas (3-5 mg/kg/día en niños).