Iron deficiency is one of the most common nutritional deficiencies worldwide. It is more prevalent when iron requirements are increased during pregnancy and during growth spurts of infancy and adolescence. The last stage in the process of iron depletion is characterized by a decrease in hemoglobin concentration, resulting in iron deficiency anemia. Iron deficiency, even before it is clinically identified as anemia, compromises the immune response, physical capacity for work, and intellectual functions such as attention level. Therefore, interventions addressing iron deficiency should be based on prevention rather than on treatment of anemia. The aim of this study was to compare short- and medium-term effects on ferritin concentration of daily supplementation with ferrous sulfate or iron bis-glycinate chelate in schoolchildren with iron deficiency but without anemia.

PURPOSE The purpose of the study was to determine the variables associated with postoperative pain and the clinical response of patients with uncomplicated hemorrhoidal disease treated with stapled rectal mucosectomy in the medium term. METHODS Patients with Grade II to IV, uncomplicated hemorrhoidal disease who underwent stapled rectal mucosectomy were prospectively included. The basal characteristics of the population were evaluated and level of stapling and placement of hemostatic suture determined. Histologically, the type of resected epithelium and presence of muscle fibers was evaluated. Postoperative pain was evaluated by means of a visual analog scale. Complications and clinical response were evaluated. RESULTS One hundred patients with a mean age of 43.9 years were included. Only columnar epithelium was resected in 48, transitional epithelium in 47, and squamous epithelium in 5 patients. Smooth muscle fragments were found in 55 patients, and, in 12 of these, fibers from the external muscular layer of rectum were also seen. Follow-up was 12.6 +/- 3.4 (range, 7-24) months. A total of 79 patients were completely asymptomatic at the end of follow-up. Resected squamous epithelium was associated with a higher postoperative pain level in the multivariate analysis (coefficient beta = 1.16 (95 percent confidence interval, 0.08-2.24); P = 0.035). CONCLUSIONS Rectal mucosectomy with stapler is an effective method for the treatment of uncomplicated prolapsing hemorrhoidal disease. Intensity of postoperative pain was associated with the type of resected epithelium. This suggests that low transection of hemorrhoids must be avoided.

Hepcidin regulates iron metabolism. Its synthesis increases in infection and decreases in iron deficiency. The aim of this study was to evaluate the relationship between H. pylori infection and iron deficiency by levels of hepcidin in children. A total of 350 school-age children participated in this cross-sectional study. Determinations of serum ferritin, hemoglobin, hepcidin, C-reactive protein, and α-1-acid-glycoprotein were done. Active H. pylori infection was performed with a ¹³C-urea breath test. In schoolchildren without H. pylori infection, hepcidin was lower in those with iron deficiency compared to children with normal iron status (5.5 ng/mL vs. 8.2 ng/mL, p = 0.017); while in schoolchildren with H. pylori infection the levels of hepcidin tended to be higher, regardless of the iron nutritional status. Using multivariate analysis, the association between H. pylori infection and iron deficiency was different by hepcidin levels. The association between H. pylori and iron deficiency was not significant for lower values of hepcidin (Odds Ratio = 0.17; 95% Confidence Interval [CI] 0.02–1.44), while the same association was significant for higher values of hepcidin (OR = 2.84; CI 95% 1.32–6.09). This joint effect is reflected in the adjusted probabilities for iron deficiency: Individuals with H. pylori infection and higher levels of hepcidin had a probability of 0.24 (CI 95% 0.14–0.34) for iron deficiency, and this probability was 0.24 (CI 95% 0.14–0.33) in children without H. pylori infection and lower levels of hepcidin. In children with H. pylori infection and iron deficiency, the hepcidin synthesis is upregulated. The stimulus to the synthesis of hepcidin due to H. pylori infection is greater than the iron deficiency stimulus.

Physical inactivity and a sedentary lifestyle are risk factors for excess weight and obesity in childhood. It is, therefore, necessary to adopt strategies which can modify these behaviors during childhood, the age at which habits are formed. This study aimed to evaluate the impact of an educational intervention using digital media and face-to-face activities involving children, parents, and the school community on the level of physical activity and sedentary behavior among schoolchildren. This was a secondary analysis of data obtained from a community trial in which students from four primary schools in Mexico City participated. Two schools were assigned to the intervention group (IG) and two to the control group (CG). The intervention lasted 12 months and included a face-to-face component, which involved sessions and workshops for parents and children, as well as visual material for children and a distance component utilizing electronic means (web portal and text messages to mobile phones) for parents. Anthropometric measurements were taken and information was collected on moderate to vigorous physical activity performed by the children and on the time that the schoolchildren spent in front of screens at the beginning of the study and at 6 and 12 months. Information on 201 children from the IG and 167 children from the CG was included in the analysis. At 12 months, the IG showed a mean decrease of 33.4 min/d [95% CI: −53.5 to −13.3] in screen time, while the CG showed an increase of 12.5 min/d [CI 95%: −10.5 to 35.6], p = 0.003. After 12 months of follow-up, applying this educational intervention reduced the time that schoolchildren spent in front of screens. Educational intervention is a feasible and accessible strategy for promoting changes in sedentary behaviors in the school-age population.