Search

Some, but not all, intravenous iron formulations have been recognized to induce renal phosphate wasting syndrome. Most commonly this has been reported following treatment of iron deficiency anemia (IDA) with ferric carboxymaltose (FCM). A search of PubMed identified relevant randomized controlled trials (RCTs), and case studies evaluating hypophosphatemia (HPP) resulting from intravenous iron treatment. While more recent larger comparative RCTs have confirmed that the majority of patients receiving FCM, especially those with normal renal function, may experience severe HPP, complete documentation is hampered by inconsistent reporting of serum phosphate in such trials. Similarly, while case series and RCTs have documented the persistence of HPP for several weeks or even months, the lack of studies lasting beyond 5-6 weeks has constrained full understanding of the duration of effect. Clinical trials have established that the mechanism involves the bone/metabolic axis with the elevation of intact fibroblast growth factor 23 playing the central role. Reports continue to accumulate of the clinical consequences of severe HPP which are, most commonly, bone abnormalities following repetitive dosing. Case reports and studies, however, have also shown that symptomatic hypophosphatemia can occur after a single FCM dose. The frequency of such events remains unknown, in part due to lack of awareness of hypophosphatemia coupled with the fact that the most common acute symptoms of HPP (fatigue and weakness) are the same for IDA and for many of the chronic diseases that cause IDA. Changes to US and European prescribing information for FCM should raise awareness of the potential for HPP and need to monitor patients at risk for it.

New generations come and go, and people shouldn't be surprised that each thinks differently from the previous, but they do. Boomers haven't quite figured out Generation X. What they think they have figured out, they often don't respect or appreciate for its significance in shaping the future. Right now, significant changes are happening in K-12 classrooms, in the teacher corps, in the administration offices, in homes and in state and local governance as the older generation is gradually giving way to its successors. The consequences of these transitions help explain much of what is going on in K-12 education today. They also offer insights into what is likely to happen on America's campuses by the end of this decade and how the ranks of school superintendents are likely to change. Before the author explores the implications of this transition of generations, he defines them: (1) G.I. Generation: Born 1901-1924, currently ages 80-104; (2) Silent Generation: Born 1925-1942, currently ages 62-80; (3) Boom Generation: Born 1943-1960, currently ages 44-62; (4) Generation X: Born 1961-1981, currently ages 23-44; and (5) Millennial Generation: Born since 1982, currently ages 23 and younger. The latter four generations are central to the story of today's K-12 education. Administrators should foster a climate of respect for each generation's strengths and of help and support for their weaknesses. They should encourage Gen-X teachers to appreciate the boomer approach to curriculum, values and the civic purposes of their profession. And they should encourage boomers to appreciate how well Gen-Xers handle technology, parents and No Child Left Behind. Each generation brings something new and important to teaching and learning. That's why it's so important for school administrators to understand, respect and address the generational differences in today's schools.

The article identifies social categories inhabited by age groups to calculate how consumer and employee opinions and behavior will change, and how this will impact economic development and corporate growth.