Low-dose iron therapy during menstruation to prevent recurrence of iron deficiency anaemia: the role of RDW in monitoring - Irish Journal of Medical Science (1971 -)

Background To evaluate the efficacy of maintenance iron therapy focused on the menstrual period in preventing anaemia recurrence in women of reproductive age and to examine the accuracy of red cell distribution width (RDW) change in predicting recurrence. Aim To evaluate the efficacy of low-dose iron supplementation administered only during menstruation in preventing recurrence of iron deficiency anaemia and to assess the predictive value of RDW dynamics for early detection of relapse. Methods One hundred and twenty-four female patients who had completed treatment for iron deficiency anaemia (IDA) were divided into maintenance (n = 62) and control (n = 62) groups using Propensity Score Matching (PSM). The maintenance group received only 100 mg of elemental iron during menstruation; the control group was followed without treatment. Patients were followed up for 12 months in terms of haematological parameters. Results At the end of the twelve-month follow-up, the anaemia recurrence rate was determined to be 8.1% in the maintenance group and 32.3% in the control group (p < 0.001). The maintenance strategy reduced the risk of recurrence by 78% (HR: 0.22; 95% CI: 0.08–0.58). While a progressive decrease in ferritin levels and a marked increase in RDW values were observed in the control group, the parameters remained stable in the maintenance group. ROC analysis determined that a ≥ 0.8% relative increase in RDW predicted anaemia recurrence (Hb < 12 g/dL) approximately three months in advance with 82% sensitivity and 90% specificity (AUC: 0.89). In multivariate analysis, not receiving maintenance therapy and a baseline RDW > 14.8% were identified as independent risk factors. Conclusions Low-dose maintenance iron therapy synchronised with the menstrual cycle is highly effective in preventing IDA recurrence. RDW, a routine haematological parameter, is a dynamic and inexpensive biomarker that reflects depletion of iron stores months before a decrease in haemoglobin. This proactive approach offers clinicians an important intervention opportunity in the management of chronic iron deficiency.

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Normal spermatogenesis in older men is associated with compensatory transcriptome changes - GeroScience

Male reproductive ageing is a complex process involving progressive and detrimental histological and physiological alterations to the testis and beyond. Age-related morbidities often confound reproduc...

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Empirische Kommunalpolitikforschung

Dieses Lehrbuch bietet Lehrenden und Studierenden eine kompakte Einführung in die empirische Kommunalpolitikforschung.

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Mindfulness and Informed Consent: Navigating Ethical Complexity Across Contexts - Mindfulness

Recent concerns about meditation-related adverse effects (MRAEs) have led to calls for more rigorous informed consent in mindfulness-based interventions (MBIs). This paper examines whether consent pro...

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The effect of cannabis use on the time course of positive and negative affect in the daily life of youth - Psychopharmacology

Rationale Contemporary theories of addiction postulate that persistent cannabis use develops in part through the positive and negative reinforcing effects on affect regulation. However, while much research has focused on affect as a stimulus for use, a dearth of research has explored acute cannabis effects on changes in affect in the natural environment. Objectives The present study tested the acute effects of cannabis use on positive and negative affect in daily life and explored interactions with cannabis use disorder (CUD) symptoms, among 85 youth aged 15 to 24 years (M = 19.8, SD = 2.1; 41 females, 48%) during a 1-week pre-treatment monitoring period using autoregressive multilevel models with ecological momentary assessment data (observations = 1,570). Results Cannabis use was associated with increased positive affect and decreased negative affect after use. There was a significant quadratic lagged Positive Affect x Cannabis Use interaction, such that recent cannabis use was associated with greater positive affect specifically when previous moment positive affect was significantly lower- or higher-than-average positive affect levels. There was also a significant cross-level lagged quadratic Negative Affect x Cannabis Use x CUD severity interaction, such that recent cannabis use was associated with decreased negative affect specifically when previous moment negative affect was significantly lower- or higher-than-average negative affect levels, but most prominently among those with greater CUD symptoms. Conclusions The results support reinforcement models of cannabis use, suggesting that cannabis use may be both positively reinforcing generally, and negatively reinforcing for those with severe CUD.

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Axillary management in patients with cN + breast cancer undergoing neoadjuvant chemotherapy: pattern of practice in Italy - Clinical and Translational Oncology

Purpose To assess the current practices concerning the axillary management of clinically node-positive (cN +) breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NAC), among radiation oncologists (ROs) practicing in Italy. Methods An online 24-question survey was distributed via SurveyMonkey to ROs between December 2024 and February 2025. This survey was developed through a multistep process by the Clinical Oncology Breast Cancer Group (COBCG) and AIRO Breast Cancer study groups’ experts, focusing on axillary lymph node dissection (ALND) omission after pathological complete response (pCR) and its implications for regional nodal irradiation (RNI). The survey followed the CHERRIES statement and ESTRO guidelines and was revised and approved by the scientific committee of AIRO (Nr. 21/2024). Results 119/195 (61%) Italian Radiotherapy Centers, mostly public hospitals, completed the survey. Regarding cN + disease at diagnosis and node-negative disease (ypN0) on sentinel lymph node biopsy (SLNB) after NAC, ALND was omitted a) always, b) when three sentinel nodes were removed, c) never, and d) only in selected cases, in 26.05%, 45.38%, 2.52% and 26.05%, respectively. Most respondents (80%) said ALND omission was a multidisciplinary decision. According to 48.60%, ALND was omitted in cN1 disease. RNI indications varied in patients not undergoing ALND. Among 70 respondents defining RNI target volumes in cN2–3 patients without ALND, 62.86% treated all nodal levels (I–IV). Key factors influencing RNI included pre-NAC lymph node burden (56.72%), extracapsular nodal extension (43.94%), and tumor size (40.63%). Conclusions Axillary management of BC patients undergoing NAC in Italy is moving toward treatment de-escalation, with relevant variability, supporting the need for multidisciplinary harmonization.

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