Efeito do uso de leite fortificado com ferro e vitamina C sobre os níveis de hemoglobina e condição nutricional de crianças menores de 2 anos

The impact of the use of fortified powdered whole milk (9 mg of iron and 65 mg of vitamin C/100 g of milk) on the hemoglobin levels of children under 2 years of age was evaluated, over a period of 6 months, in 107 children enrolled in municipal Day Care Centers (DCC) and in 228 seen at a Basic Health Care Unit (BHCU). Before the beginning of the intervention 66.4% of the children in the DCC and 72.8% of those seen at the BHCU had hemoglobin levels ender 11.0 g/dl. After 6 months of fortified milk intake, these percentages fell to 20.6% and 18.0% respectively. the average hemoglobin before the intervention was 10.3 g/dl in the DCC and 10.5 in the BHCU. After 6 months these increased to 11.6 g/dl in the populations studied. Concerning the nutritional condition, evaluated according to Gomez's criteria, 57% of the DCC children presented an improvement, 41.1% showed changens and only 1.9% became worse. in the BHCU, 11.4% presented better condition, 70.6% remained the same and 18% worsened, which demonstrated differences in response regarding improvement of nutritional condition, when fortified milk was used in closed and open environments. the authors conclude that the utilization of enriched foods is an excellent alternative in the treatment of iron deficiency in populations of children under 2 years of age.Universidade Federal de São Paulo,DEPT PREVENT MED,São Paulo,BRAZILFAC MED BOTUCATU,DEPT PEDIAT,BOTUCATU,BRAZILUniversidade Federal de São Paulo,DEPT PREVENT MED,São Paulo,BRAZILWeb of Scienc

Efeito do uso de leite fortificado com ferro e vitamina C sobre os níveis de hemoglobina e condição nutricional de crianças menores de 2 anos

The impact of the use of fortified powdered whole milk (9 mg of iron and 65 mg of vitamin C/100 g of milk) on the hemoglobin levels of children under 2 years of age was evaluated, overa period of 6 months, in 107 children enrolled in municipal Day Care Centers (DCC) and in 228 seen at a Basic Health Care Unit (BHCU). Before the beginning of the intervention, 66.4% of the children in the DCC and 72.8% of those seen at the BHCU had hemoglobin levels under 11.0g/dl. After 6 months of fortified milk intake, these percentages fell to 20.6% and 18.0% respectively. The average hemoglobin before the intervention was 10.3 g/dl in the DCC and 10.5 in the BHCU. After 6 months these increased to 11.6g/dl in the populations studied. Concerning the nutritional condition, evaluated according to Gomez's criteria, 57% of the DCC children presented an improvement, 41.1% showed changens and only 1.9% became worse. In the BHCU, 11.4% presented better condition, 70.6% remained the same and 18% worsened, which demonstrated differences in response regarding improvement of nutritional condition, when fortified milk was used in closed and open environments. The authors conclude that the utilization of enriched foods is an excellent alternative in the treatment of iron deficiency in populations of children under 2 years of age.Foi avaliado o impacto do uso do leite em pó integral fortificado com 9 mg de ferro e 65 mg de vitamina C para cada 100 g de pó, sobre os níveis de hemoglobina de crianças menores de 2 anos, em 107 crianças de creches municipais e 228 de uma Unidade Básica de Saúde (UBS), por um período de 6 meses. Antes de se iniciar a intervenção, 66,4% das crianças das creches e 72,8% da UBS apresentavam níveis de hemoglobina inferiores a 11,0 g/dl. Ao final dos 6 meses de uso do leite fortificado, esses percentuais reduziram-se para 20,6% nas creches e 18,0% na UBS. A média da hemoglobina, antes de se iniciar o experimento, foi de 10,3 g/dl nas creches e 10,5 g/dl na UBS. Decorridos 6 meses esses valores subiram para 11,6 g/dl nas duas populações estudadas. Em relação à condição nutricional, avaliada pelo critério de Gomez, verificou-se que, nas creches, 57% das crianças acompanhadas apresentaram melhoria na sua condição nutricional, 41,1% ficaram inalteradas e apenas 1,9% pioraram. Na UBS, 11,4% apresentaram melhora, 70,6% ficaram inalteradas e 18% pioraram, o que mostrou uma diferença de resposta quanto à recuperação da condição nutricional, quando o leite enriquecido foi utilizado em ambiente aberto e fechado. Concluiu-se que a utilização de alimentos fortificados apresenta-se como excelente alternativa para o controle da carência de ferro em populações de crianças menores de 2 anos

Promoting growth and development of infants by a multidisciplinary team, in the community of Paraisópolis

Objective: To present the results of a Health and NutritionPromotion Program for Infants carried out by the Program Einsteinin the Community of Paraisópolis. Methods: Application of aprogram based on strengthening mother-infant bonding, promotingexclusive breastfeeding up to six months of age, and educationalactions performed by a multidisciplinary team. Results: The teamfollowed up 318 mother-infant dyads. Among the beneficiaries,61.6% were enrolled in the program with less than 30 days of age.Exclusive breastfeeding rates were 82.8%, 63.6%, and 56.1% at 2,4 and 6 months of age, respectively. The weight gain observedrepresented a mean weight of the infants above the 50th percentileof NCHS standard from immediately after enrollment in the programto 6 months of age. Conclusions: The results obtained effectivelycontributed to promoting health and improving nutrition status ofthe infants who were followed in the Program

Acute Effects of Whole-Body Vibration Exercise on Pain Level, Functionality, and Rating of Exertion of Elderly Obese Knee Osteoarthritis Individuals: A Randomized Study

Introduction: Among chronic diseases, knee osteoarthritis (KOA) is a joint disease that causes important progressive alterations in the articular and periarticular structures, including synovial inflammation. Exercise has been suggested as an intervention to KOA individuals, and studies suggest that whole-body vibration (WBV) exercise decreases pain levels and favours the functionality of KOA individuals. Objective: The aim of the present study is to analyze the acute effects of WBV exercise on pain levels, functionality (Timed Up and Go (TUG test), anterior trunk flexion (ATF)), and rating of exertion of elderly obese KOA individuals. Methods: Thirty-seven individuals with KOA were allocated to a WBV exercise group (WBVEG), n = 19 (15 females/4 males), and a control group (CG), n = 18 (15 females/3 males). WBVEG performed one session of WBV exercise (11 min, using 5 Hz, 2.5, 5.0, and 7.5 mm, 0.12, 0.25, and 0.37 g). Three bouts were performed (working time of 3 min and rest time of 1 min) using a side-alternating vibrating platform (VP). The same position was used in CG; however, the VP was turned off and there was equipment coupled to the VP that emitted a sound like the vibrations. The pain level was evaluated using a visual analog scale (VAS). Functionality was evaluated with a TUG test and ATF. The rating of subjectively perceived exertion was measured with the category ratio CR-10 (BORG Scale CR-10), Results: A reduction of pain levels in WBVEG after the intervention (p = 0.001) and intergroups (p = 0.041) was found. A decrease of TUG test time in both groups (p = 0.001) and intergroups (p = 0.045) was found, while no statistical changes were observed in the Borg Scale score. Significant improvements of flexibility in both groups (p = 0.001) and intergroups (p = 0.043) were found. Conclusion: One session of WBV exercise can lead to important improvements in individuals with KOA, possibly triggered by physiological responses. However, more studies are needed, in this clinical context, to confirm these results

Doença de Moyamoya

Uma paciente de 49 anos, feminina e procedente de Porto Alegre internou na equipe da neurologia geral do HCPA com um quadro neuropsiquiátrico de 5 anos de evolução, sem diagnóstico, apesar de múltiplas investigações. Na internação, recusava alimentar-se, apresentava disfunção de esfíncteres, tetraparesia, desorientação e mutismo. As imagens do encéfalo por ressonância magnética (IRM)  evidenciaram atrofia cerebral importante, várias lesões isquêmicas e uma pequena área hemorrágica. A angiografia cerebral foi diagnóstica para doença de moyamoya

The pharmacological management of psychiatric comorbidities in patients with epilepsy.

Psychiatric disorders represent a frequent comorbidity in patients with epilepsy affecting quality of life, morbidity and mortality. Evidence-based data on the management of these conditions are limited but a number of recommendations are now available to guide clinical practice. The present paper reviews the pharmacological treatment of psychiatric problems in epilepsy with special attention to data coming from randomised controlled trials (RCTs), pharmacological interactions with AEDs and the issue of seizure worsening during treatment with psychotropic drugs. Epidemiologically or clinically relevant psychiatric conditions are discussed namely mood and anxiety disorders, psychoses and attention deficit hyperactivity disorder