RESUMEN
Although mineral chelates are widely produced to be used as food fortifiers, the proof that these complexes are chelates is still missing. In our present work, iron II complexes using citric acid in different ratios are produced, and the occurrence of chelation is investigated along with its behavior according to a molar ratio between the ligand and the mineral. High performance liquid chromatography (HPLC), flame atomic absorption spectroscopy (FAAS), ultraviolet-visible spectroscopy (UV-Vis), Fourier-transform infrared (FTIR), and near infrared spectroscopy (NIR) were used for a non-structural characterization of these complexes. In contrast to published work, our findings show that the chelation of citric acid is achieved in the liquid form and at a low pH and that the molar ratio is very important in setting the direction of the reaction, either toward chelation or dimer formation. The ratio citric acid:iron 1:4 seems to be the most convenient ratio in which no free citric acid remains in the solution, while the 1:3 ratio behaves differently, requiring further investigations by such techniques as extended X-ray absorption fine structure spectroscopy (EXAFS), among others, in order to deeply identify the structural organization occurring in this ratio. NIR, extensively used in industries, proved to be very useful in the demonstration and characterization of chelates. These findings are particularly advantageous for pharmaceutical and food industries in offering an innovative competent fortifying agent to be used in combatting iron deficiency.
RESUMEN
BACKGROUND: Venous thromboembolism (VTE) is associated with substantial mortality as well as morbidity and is largely preventable among hospitalized obstetric women. However, thromboprophylaxis is underutilized in most hospitalized patients. OBJECTIVES: To evaluate VTE risk and adherence to local thromboprophylaxis protocol among hospitalized pre- and postnatal women. METHODS: This retrospective study was conducted at East Jeddah Hospital, Jeddah, Saudi Arabia, in 2020. The electronic record database of the hospitalized pregnant Saudi women during the years 2018 and 2019 was reviewed. Based on the local hospital protocol, the risk stratification was reassessed by researchers, and the hospital adherence to the prophylaxis was reviewed separately for antenatal and postnatal women. RESULTS: One thousand and ninety-five electronic records (539 antenatal and 556 postnatal) were reviewed. The postnatal group showed a significantly higher risk compared with an antenatal group (62.2% vs. 11.7%) (P = 0.000). There was a highly significant difference between risk categories assessment by the physicians and the researchers in both groups (P = 0.000). Thromboprophylaxis was overutilized in the low risk (5% heparin and 41.4% heparin and mechanical devices for antenatal and 17.08% heparin and 6.1% heparin and a mechanical device for the postnatal group) and underutilized in intermediate groups (50% no prophylaxis in antenatal and 51.5% mechanical devices in the postnatal group). There was less adherence to documentation in postnatal as compared to antenatal group (83.6% vs. 95%, P = 0.000) for risk documentation and 85.3% versus 91.5% for physician signature (P = 0.001). Thromboprophylaxis was ordered for 21.3% of antenatal (12.2 heparin, 3.5% mechanical, and 5.6% both) and 23.7% of postnatal patients (16.5 heparin, 2% mechanical, and 5.2% both). There were no reported VTE events or bleeding complications. CONCLUSION: There was a considerable VTE risk among hospitalized obstetric patients which peaked during the postnatal period. Physicians showed good compliance to local VTE protocol with no reported VTE events or drug-induced bleeding. However, the implementation of prophylaxis is associated with both under and overutilization. There is a need for increasing the physicians' awareness of optimizing VTE risk assessment and documentation for hospitalized obstetric patients.
RESUMEN
Food fortification has been used for many years to combat micronutrient deficiencies; the main challenge with food fortification is the combination of a bioavailable, affordable fortificant with the best (food) vehicle as a carrier to reach at-risk populations. This paper considers mineral deficiencies, especially iron, food fortification, target populations, and the use of chelates in food fortification, as well as different types of mineral-chelate complexes, advantages and limitations of previous trials, methods used for analysis of these complexes, bioavailability of minerals, factors influencing it, and methods particularly those in vitro for predicting outcomes. Three innovative methods (encapsulation, nanoparticulation, and chelation) were explored, which aim to overcome problems associated with conventional fortification, especially those affecting organoleptic properties and bioavailability; but often lead to the emergence of new limitations (for example instability, impracticality and high costs) requiring further research.