Search Results (1,050)

Background and Clinical Significance: Obstructive sleep apnea (OSA) is a common comorbidity in patients with cardiac and metabolic disorders. The coexistence of central sleep apnea with Cheyne–Stokes breathing (CSA-CSB) in heart failure patients, especially those with preserved ejection fraction (HFpEF), represents a diagnostic and therapeutic challenge. Data on continuous positive airway pressure (CPAP) failure and successful adaptation to servo-ventilation (ASV) in the context of complex comorbidities remain limited. Case Presentation: We present the case of a 74-year-old male with a history of type 2 diabetes mellitus, paroxysmal atrial fibrillation, HFpEF, essential hypertension, and bladder carcinoma. He was referred for pre-operative OSA screening, reporting excessive daytime sleepiness, insomnia, and witnessed apneas. Initial respiratory polygraphy revealed severe sleep-disordered breathing with dominant CSA-CSB and moderate OSA. Laboratory investigations also revealed severe iron-deficiency anemia, which was managed with parenteral iron supplementation. The patient underwent CPAP titration, which led to modest improvement and residual high apnea–hypopnea index (AHI). After persistent symptoms and an inadequate CPAP response, an ASV device was initiated with significant clinical and respiratory improvement, demonstrating normalization of hypoxic burden and optimal adherence. Conclusions: CSA-CSB in HFpEF patients with anemia poses unique therapeutic difficulties. This case highlights the importance of individualized diagnostic and therapeutic strategies, including transitioning to ASV in CPAP-refractory cases, which can lead to improved adherence, reduced hypoxia, and better overall outcomes in high-risk patients. Full article

Background/Objectives: Pica, the compulsive ingestion of non-nutritive substances, has long been observed in patients with iron deficiency anemia (IDA). This behavior is particularly noted in adults, including pregnant women, and poses both diagnostic and management challenges. We conducted a review of studies from the past decade to evaluate the epidemiology and nature of pica in adult IDA patients and the outcome of various treatment strategies on anemia and pica behaviors. Methods: We searched PubMed, Scopus, and Cochrane Library for peer-reviewed articles (including observational studies, clinical trials, and reviews) published in English between 2015 and 2025. Inclusion criteria targeted studies of adult populations with IDA that reported on pica prevalence, characteristics, or treatment outcomes. We also reviewed clinical guidelines and meta-analyses on IDA treatment in adults for recommended management approaches. Results: Pica was found to be a prevalent symptom among individuals with IDA, but was readily treatable with appropriate iron deficiency treatment. Among treatment options, both oral and parenteral iron supplementation were found to be effective in resolving iron deficiency and pica. Choice of treatment depends on tolerance to oral iron, speed of resolution required, and comorbid conditions. Conclusions: Pica is closely intertwined with IDA; our review highlighted the prevalence of pica among individuals with IDA, which serves as both a clinical clue to underlying anemia and a potential source of complications. Crucially, the treatment of IDA is also effective for pica. We recommend oral iron therapy on alternate-day dosing as first-line therapy to minimize side effects, alongside dietary optimization. If IDA and pica are resistant to oral iron supplementation or oral iron cannot be tolerated, parenteral iron therapy can be considered. Full article

Background: Cognitive decline is a growing public health concern in Latin America, driven by rapid aging, widespread micronutrient inadequacies, and socioeconomic disparities. Despite the recognized importance of nutrition, many older adults struggle to meet daily dietary micronutrients requirements, increasing the risk of mild cognitive impairment (MCI). This study aimed to establish expert consensus on the role of Multivitamin and Mineral supplements (MVMs) in promoting cognitive healthy aging among older adults in Latin America. Methods: A panel of nine experts in geriatrics, neurology, and nutrition applied a modified Delphi methodology to generate consensus statements. The panel reviewed the literature, engaged in expert discussions, and used structured voting to develop consensus statements. Results: Consensus was reached on 14 statements. Experts agreed that cognitive aging in Latin America is influenced by neurobiological, lifestyle, and socioeconomic factors, including widespread micronutrient inadequacies (vitamins B-complex, C, D, E, and minerals such as zinc, magnesium, chromium, copper, iron and selenium), which were identified as critical for global cognitive function and brain structures, yet commonly inadequate in the elderly. While a balanced diet remains essential, MVMs can be recommended as a complementary strategy to bridge nutritional gaps. Supporting evidence, including the COSMOS-Mind trials, demonstrate that MVM use improves memory and global cognition, and reduces cognitive aging by up to 2 years in older adults. Conclusions: MVMs offer a promising, accessible adjunct for cognitive healthy aging in Latin America’s elderly population, particularly where dietary challenges persist. Region-specific guidelines, public health initiatives, and targeted research are warranted to optimize outcomes and reduce health inequities. Full article

Background: Anaemia in adolescents can be influenced by parasitic infections, systemic inflammation, and nutritional status. Objective: To determine whether C-reactive protein (CRP), nutritional status, and infection with Ascaris lumbricoides, Giardia lamblia, or Trichuris trichiura are associated with anaemia in adolescent athletes from Tacna compared to non-athletes. Methods: A cross-sectional study was conducted involving 250 male football players aged 13–18 years and 150 age-matched non-athletes. Haemoglobin, haematocrit, ferritin, serum iron, CRP, and parasitic status were measured; mean comparisons and logistic regression were applied. Results: Anaemia was more prevalent among athletes than non-athletes (30% vs. 18%; p < 0.001). Infected athletes showed lower haemoglobin (11.9 ± 1.1 g/dL) and higher CRP (5.0 ± 1.9 mg/L) levels compared to non-infected athletes (13.8 ± 1.0 g/dL and 2.2 ± 1.1 mg/L; p < 0.001). Logistic regression identified CRP as an independent predictor of anaemia (adjusted OR = 1.20; 95% CI: 1.08–1.38; p < 0.001), while parasitic infections showed no direct association after adjustment. Underweight status was associated with a higher prevalence of anaemia (36%). Conclusions: Systemic inflammation emerged as the main factor associated with anaemia in this population, with parasitic infections contributing indirectly by increasing inflammation. Periodic deworming, iron supplementation, and CRP monitoring are recommended to reduce the burden of anaemia in adolescent athletes from endemic regions. Full article

The uMlazi River receives effluents from wastewater work before feeding the Shongweni Dam. However, local communities are consuming fish from this dam for protein supplements. This study was undertaken to investigate the metal concentrations in the water and sediment, the general health of Coptodon rendalli and Oreochromis mossambicus, and metal bioaccumulation. Sampling was conducted during the dry (July–August) and wet seasons (November and December) in 2021. Water was sampled using acid-pre-treated sampling bottles, whereas sediment was collected using the Van Veen grab at the inflow, middle, and dam wall. Fish were collected, and their tissues were digested using aqua regia. Metal concentrations were measured using inductively coupled plasma optical emission spectroscopy (ICP-OES). This data manuscript reports the physical parameters of the water and concentrations of antimony, arsenic, cadmium, copper, iron, manganese, lead, selenium, and strontium in the water and sediment from the Shongweni Dam. Moreover, the fish morphometric data and metal concentrations observed in the muscle are also presented. This data could be used as baseline information on metal concentrations in the Shongweni Dam. Moreover, it provides insight into the potential impact of wastewater effluents on metal increases in freshwater bodies. Full article

Background and Objectives: Anemia and stunting are major public health concerns for young Indonesian children. Limited information is available from studies on multi-micronutrient supplements in Indonesia. The objective of this study was to investigate the effect of 12-month multi-micronutrient powder (MNP) supplementation on serum hemoglobin levels, anemia, and growth. Methods: A randomized double-blinded placebo-controlled study was performed, including 232 eligible children aged 8–10 months old. Children with severe anemia or stunting/those classed as underweight were not included as subjects. The study was performed in a low-socioeconomic-status community in Jakarta. With an active-to-placebo ratio of 60:40, 139 subjects received MNP sachets twice/day, and 93 subjects received placebo sachets, mixed with complementary food. The outcome parameters were hemoglobin level, anemia, and growth indicators. Per-protocol analysis was performed for 179 (intervention: 110; control: 69) subjects. Results: There were no differences at baseline between the groups, except for the weight-for-length z-scores (WLZ). Upon intervention, the serum hemoglobin level and anemia proportion did not change significantly within the group, and no significant differences were found between the groups (p > 0.05). However, subgroup analysis of non-anemic children at baseline showed a significant increase in hemoglobin levels in the youngest age group (8.0–8.9 months old) receiving MNP compared to placebo (0.13 vs. −0.79, p = 0.031). Iron deficiency anemia proportion showed a similar upward trend upon intervention in both groups. No significant differences in growth were found between both groups. Conclusions: This study failed to find a significant effect of 12-month MNP supplementation on serum hemoglobin level, anemia, and growth. Full article

Molasses, a by-product of raw sugar production, is widely used as a cost-effective carbon and nutrient source for industrial fermentations, including the production of baker’s yeast (Saccharomyces cerevisiae). Due to the cost and limited availability of molasses, efforts have been made to replace molasses with cheaper and more readily available substrates such as corn syrup. However, the quality of dry yeast drops following the replacement of molasses with corn syrup, despite the same amount of total sugar being provided. Our understanding of how molasses replacement affects yeast physiology, especially during the dehydration step, is limited. Here, we examined changes in gene expression of a strain of baker’s yeast during fermentation with increasing corn syrup to molasses ratios at the transcriptomic level. Our findings revealed that the limited availability of the key metal ions copper, iron, and zinc, as well as sulfur from corn syrup (i) reduced their intracellular storage, (ii) impaired the synthesis of unsaturated fatty acids and ergosterol, as evidenced by the decreasing proportions of these important membrane components with higher proportions of corn syrup, and (iii) inactivated oxidative stress response enzymes. Taken together, the molecular and metabolic changes observed suggest a potential reduction in nutrient reserves for fermentation and a possible compromise in cell viability during the drying process, which may ultimately impact the quality of the final dry yeast product. These findings emphasize the importance of precise nutrient supplementation when substituting molasses with cheaper substrates. Full article

Background/Objectives: Undernutrition and intestinal parasitic infections are critical public health problems in low-income countries, with adverse effects on child growth and increasing anaemia. Madagascar, with a high prevalence of these factors, lacks comprehensive studies analysing their interaction. This study aimed to assess the nutritional status, the prevalence of anaemia, and the occurrence of intestinal parasitic infections among children and adolescents in three southern regions of Madagascar. Methods: A cross-sectional, prospective study of 289 children and adolescents (10–18 years) from three schools located in Antsoamadiro, Fianarantsoa, and Toliara was conducted. Sociodemographic, anthropometric, and haemoglobin concentration data, as well as faecal samples, were collected. Nutritional status was assessed by Nutrimetry, combining Height-for-Age and BMI-for-Age indicators. Stool samples were analysed by optical microscopy and molecular methods. Results: Nutricode 1 (short stature/stunting + thinness/wasting) was significantly more frequent in Toliara. Nutricode 1 was also significantly more prevalent in males than females. Anaemia affected 57.8% of participants and was significantly associated with Nutricode 1. The overall parasitism rate was also associated with Nutricode 1. Trichuris trichiura and Ascaris lumbricoides significantly increased the risk of stunting, wasting, and Nutricode 1. Co-infection with Trichuris trichiura + Giardia duodenalis was significantly associated with wasting and Nutricode 1. This co-infection was also related to the presence of anaemia, as was moderate-intensity infection with T. trichiura. Conclusions: There is a high co-burden of undernutrition, anaemia, and parasitic infections in southern Madagascar. These findings highlight the urgency of implementing comprehensive health programmes combining parasite control, nutritional support, and iron supplementation adapted to regional realities. Full article

The intensifying global demand for sustainable and nutrient-dense food sources necessitates the exploration of underutilized local resources. Arthrospira platensis var. toliarensis, a cyanobacterium endemic to Madagascar, was evaluated for its nutritional, functional, and environmental potential under small-scale, low-input outdoor cultivation. The study assessed growth kinetics, physicochemical parameters, and composition during two contrasting seasons. Biomass increased 7.5-fold in 10 days, reaching a productivity of 7.8 ± 0.58 g/m²/day and a protein yield of 4.68 ± 0.35 g/m²/day. The hot-season harvest showed significantly higher protein content (65.1% vs. 44.6%), enriched in essential amino acids. On a dry matter basis, mineral profiling revealed high levels of sodium (2140 ± 35.4 mg/100 g), potassium (1530 ± 21.8 mg/100 g), calcium (968 ± 15.1 mg/100 g), phosphorus (815 ± 13.2 mg/100 g), magnesium (389.28 ± 6.4 mg/100 g), and iron (235 ± 9.1 mg/100 g), underscoring its value as a micronutrient-rich supplement. The hydroethanolic extract had the highest polyphenol content (4.67 g GAE/100 g of dry extract), while the hexanic extract exhibited the strongest antioxidant capacity (IC₅₀ = 101.03 ± 1.37 µg/mL), indicating fat-soluble antioxidants. Aflatoxin levels (B1, B2, G1, and G2) remained below EU safety thresholds. Compared to soy and beef, this strain showed superior protein productivity and water-use efficiency. These findings confirm A. platensis var. toliarensis as a promising, ecologically sound alternative for improving food and nutrition security, and its local production can offer substantial benefits to smallholder livelihoods. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

Background: Iron deficiency anemia (IDA) represents a significant public health concern, particularly among female populations. Various demographic factors, including age and socioeconomic status, have a substantial impact on overall health outcomes, contributing to the prevalence of IDA. The primary objective of this study was to assess the knowledge and awareness of iron deficiency anemia among the adult population and to examine its correlation with various sociodemographic factors. Methods: A cross-sectional study was conducted in the Northern Region of Saudi Arabia between October and December 2024. Data were collected using a structured questionnaire from 385 participants aged 18 years and older. The Chi-square test was utilized to assess the association between categorical variables. Results: In this study, 42.5% of participants demonstrated good knowledge of IDA, 48.1% had moderate knowledge, and 9.4% showed poor knowledge. Knowledge levels were significantly associated with gender, age, education, and self-perceived IDA status. Women, older individuals, and those with higher levels of education had a greater knowledge of IDA. Regarding attitude, 93% of participants had a positive attitude, while only 7% exhibited a negative attitude. Interestingly, none of the explanatory variables were significantly linked to attitude, suggesting that positive attitude toward IDA was consistent across all demographic groups. Conclusions: This study highlights the need for targeted health initiatives focusing on diet, supplementation, symptom recognition, and prevention to effectively reduce the burden of IDA. Prioritizing education through symposiums and medical programs in high-prevalence regions is crucial. Full article

Ectomycorrhizal symbiosis is a cornerstone of ecosystem health, facilitating nutrient uptake, stress tolerance, and biodiversity maintenance in trees. Optimizing Pinus armandii–Tuber indicum mycorrhizal synthesis enhances the ecological stability of coniferous forests while supporting high-value truffle cultivation. This study conducted a pot experiment to compare the effects of three root nutrient regulations—Aolu 318S (containing N-P₂O₅-K₂O in a ratio of 15-9-11 (w/w%)), Aolu 328S (11-11-18), and Youguduo (19-19-19)—on the mycorrhizal synthesis of P. armandii–T. indicum. The results showed that root nutrient supplementation significantly improved the seedling crown, plant height, ground diameter, biomass dry weight, and mycorrhizal infection rate of both the control and mycorrhizal seedlings, with the slow-release fertilizers Aolu 318S and 328S outperforming the quick-release fertilizer Youguduo. The suitable substrate composition in this experiment was as follows: pH 6.53–6.86, organic matter content 43.25–43.49 g/kg, alkali-hydrolyzable nitrogen 89.25–90.3 mg/kg, available phosphorus 83.69–87.32 mg/kg, available potassium 361.5–364.65 mg/kg, exchangeable magnesium 1.17–1.57 mg/kg, and available iron 33.06–37.3 mg/kg. It is recommended to mix the Aolu 318S and 328S solid fertilizers evenly into the substrate, with a recommended dosage of 2 g per plant. These results shed light on the pivotal role of a precise N-P-K ratio regulation in fostering sustainable ectomycorrhizal symbiosis, offering a novel paradigm for integrating nutrient management with mycorrhizal biotechnology to enhance forest restoration efficiency in arid ecosystems. Full article

The presence of recalcitrant organic compounds in oilfield-produced-water poses significant challenges for conventional biological treatment technologies. In this study, an Fe³⁺-augmented composite bioreactor was developed to enhance the multi-pollutant removal performance and to elucidate the associated microbial community dynamics. The Fe³⁺-augmented system achieved efficient removal of oil (99.18 ± 0.91%), suspended solids (65.81 ± 17.55%), chemical oxygen demand (48.63 ± 15.15%), and polymers (57.72 ± 14.87%). The anaerobic compartment served as the core biotreatment unit, playing a pivotal role in microbial pollutant degradation. High-throughput sequencing indicated that Fe³⁺ supplementation strengthened syntrophic interactions between iron-reducing bacteria (Trichococcus and Bacillus) and methanogenic archaea (Methanobacterium and Methanomethylovorans), thereby facilitating the biodegradation of long-chain hydrocarbons (e.g., eicosane and nonadecane). Further metabolic function analysis identified long-chain-fatty-acid CoA ligase (EC 6.2.1.3) as a key enzyme mediating the interplay between hydrocarbon degradation and nitrogen cycling. This study elucidated the ecological mechanisms governing Fe³⁺-mediated multi-pollutant removal in a composite bioreactor and highlighted the potential of this approach for efficient, sustainable, and adaptable management of produced water in the petroleum industry. Full article

Secondary iron overload exacerbates osteoporosis by elevating reactive oxygen species (ROS), which suppress osteoblast function and enhance osteoclast activity, disrupting bone remodeling. Reducing iron overload and oxidative stress may improve bone health. Epigallocatechin-3-gallate (EGCG), the main bioactive compound in green tea extract (GTE), is recognized for its antioxidant and iron-chelating properties. This study examined the effect of GTE on bone formation and mineralization in iron-overloaded human osteoblast-like MG-63 cells. An iron-overloaded model was established using ferric ammonium citrate (FAC), followed by treatment with GTE, deferiprone (DFP), or their combination. GTE significantly reduced intracellular iron, ROS levels, and lipid peroxidation while upregulating the osteogenic marker BGLAP, the anti-resorptive marker OPG, and osteogenic mineralization, indicating restored bone health. These results suggest that EGCG-containing GTE mitigates iron-induced oxidative stress and promotes osteogenesis, highlighting its potential as a natural therapeutic supplement for managing iron-overload-associated osteoporosis. Full article

Background/Objectives: Patients undergoing hemodialysis frequently receive oral or intravenous iron supplementation to treat iron-deficiency anemia and enhance the efficacy of erythropoiesis-stimulating agents. However, this approach may lead to iron overload. Experimental studies have suggested that iron overload may contribute to the development of sarcopenia through oxidative stress and inflammation. This study aimed to investigate the association between iron status and sarcopenia in patients undergoing hemodialysis. Methods: Serum ferritin levels were measured, and sarcopenia was assessed using the Asian Working Group for Sarcopenia criteria in 104 stable outpatients undergoing maintenance hemodialysis therapy. Results: Sarcopenia was identified in 25 (24.0%) patients. Serum ferritin levels were significantly higher in patients with sarcopenia than in those without (median: 170.6 ng/mL vs. 92 ng/mL, p = 0.023). An increase of 10 ng/mL in serum ferritin levels was independently associated with sarcopenia. The high-ferritin group (≥132 ng/mL as a cutoff value determined using receiver operating characteristic curve analysis) exhibited a higher prevalence of sarcopenia compared with the low-ferritin group (37.3% vs. 11.3%, p = 0.001). Furthermore, serum ferritin levels were negatively correlated with skeletal muscle mass and skeletal muscle strength, which constitute the components of the sarcopenia diagnostic criteria. Conclusions: Elevated serum ferritin levels were independently associated with sarcopenia in patients undergoing hemodialysis. This finding implies that excessive iron supplementation may contribute to the progression of sarcopenia. Routine evaluation of iron status and careful assessment of the necessity for iron therapy are recommended in this population. Full article