The critical roles of iron during the journey from fetus to adolescent: Developmental aspects of iron homeostasis

Contains fulltext : 244711.pdf (Publisher’s version ) (Open Access

Prophylactic platelet transfusions: why less is more

In short, given the current evidence base, we recommend the use of restrictive platelet transfusion thresholds while awaiting the results of new/ongoing studies and large-scale epidemiologic studies. Future trialists will have an opportunity to address the identified challenges and additionally improve the efficiency and design of these trials using electronic patient data and advanced trial designs. There clearly is a need for new biomarkers and models to better predict bleeding risk for more tailored platelet transfusion decisions, implementation strategies to support evidence-based transfusion practices, and fundamental research to better understand the mechanisms of transfusion-related harm.Developmen

Adenotonsillectomy for upper respiratory infections: evidence based?

Background: Despite high rates of (adeno)tonsillectomy for upper respiratory infections in western countries, the medical literature offers the physician little support in deciding which child might benefit from the operation. Methods: A literature search was performed to identify randomised trials and non-randomised controlled studies into the efficacy of tonsillectomy with or without adenoidectomy in children under 18 years. For the outcomes sore throat episodes, sore throat associated school absence, and upper respiratory infections, pooled estimates of the incidence rate ratios and rate differences with 95% confidence intervals were calculated, assuming a Poisson distribution. Results: Six randomised trials and seven non-randomised controlled studies on the efficacy of adenotonsillectomy in children were evaluated. For sore throat episodes data for 2483 person-years were available. The pooled risk difference was –1.2 episodes per person-year (95% CI –1.3 to –1.1). For sore throat associated school absence 1669 person-years were analysed. The pooled risk difference was –2.8 days per person-year (95% CI –3.9 to –1.6). For upper respiratory infections 1596 person-years were available. The pooled risk difference was –0.5 episodes per person-year (95% CI –0.7 to –0.3). Conclusions: All available randomised trials and non-randomised controlled studies into the efficacy of (adeno)tonsillectomy had important limitations. The frequency of sore throat episodes and upper respiratory infections reduces with time whether (adeno)tonsillectomy has been performed or not. (Adeno)tonsillectomy gives an additional, but small, reduction of sore throat episodes, days of sore throat associated school absence, and upper respiratory infections compared to watchful waitin

Sierteelt in de biobased economy : Screening van siergewasextracten op werking voor de plantgezondheid en de farmacie : Ornamentals in the biobased economy

The public-private funded project “Ornamentals in the Biobased Economy” was conducted by Royal FloraHolland, Kenniscentrum Plantenstoffen, Wageningen UR, Fytagoras and Prisna. In this project, bioactivity in plant extracts against the most important pests and diseases in greenhouse cultivation were tested. In bioassays, extracts with bioactivity against powdery mildew, botrytis, aphids, spider mite and thrips were found. With LCMS, metabolic profiles of the extracts were generated. Furthermore explorative experiments with plant extracts for crop resilience were conducted, and also plant extracts were tested in a bioassay for fat metabolism in obesita

Transferrin Saturation/Hepcidin Ratio Discriminates TMPRSS6-Related Iron Refractory Iron Deficiency Anemia from Patients with Multi-Causal Iron Deficiency Anemia

Pathogenic TMPRSS6 variants impairing matriptase-2 function result in inappropriately high hepcidin levels relative to body iron status, leading to iron refractory iron deficiency anemia (IRIDA). As diagnosing IRIDA can be challenging due to its genotypical and phenotypical heterogeneity, we assessed the transferrin saturation (TSAT)/hepcidin ratio to distinguish IRIDA from multi-causal iron deficiency anemia (IDA). We included 20 IRIDA patients from a registry for rare inherited iron disorders and then enrolled 39 controls with IDA due to other causes. Plasma hepcidin-25 levels were measured by standardized isotope dilution mass spectrometry. IDA controls had not received iron therapy in the last 3 months and C-reactive protein levels were <10.0 mg/L. IRIDA patients had significantly lower TSAT/hepcidin ratios compared to IDA controls, median 0.6%/nM (interquartile range, IQR, 0.4–1.1%/nM) and 16.7%/nM (IQR, 12.0–24.0%/nM), respectively. The area under the curve for the TSAT/hepcidin ratio was 1.000 with 100% sensitivity and specificity (95% confidence intervals 84–100% and 91–100%, respectively) at an optimal cut-off point of 5.6%/nM. The TSAT/hepcidin ratio shows excellent performance in discriminating IRIDA from TMPRSS6-unrelated IDA early in the diagnostic work-up of IDA provided that recent iron therapy and moderate-to-severe inflammation are absent. These observations warrant further exploration in a broader IDA population