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- ItemAcesso aberto (Open Access)Absorção do ferro da fórmula para lactentes e do leite de vaca fortificado: modelo experimental em ratos recém-desmamados(Sociedade Brasileira de Pediatria, 2009-10-01) Costa, Mariana de Lima [UNIFESP]; Freitas, Karine de Cássia [UNIFESP]; Amancio, Olga Maria Silverio [UNIFESP]; Paes, Ângela T. [UNIFESP]; Silva, Sylvia Maria Affonso [UNIFESP]; Luz, Jacqueline [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To compare iron absorption from infant formula and iron-fortified cow's milk. METHODS: Twenty-four weanling Wistar rats were maintained in metabolic cages during the whole experiment (10 days). On the first day, the animals were divided into three similar groups according to their weight, length, hematocrit and hemoglobin levels: 1) infant formula; 2) powdered whole cow's milk fortified with iron in the same quantity and type as the formula; 3) control - powdered whole cow's milk not fortified with iron. Deionized water and diet were offered ad libitum, and the volume consumed was measured. Weight, hematocrit, and hemoglobin levels were measured on the fifth and 10th days when length, fecal occult blood, and hepatic iron levels were also analyzed. RESULTS: Group 1 consumed less diet (450.5±26.50 mL) than group 2 (658.8±53.73 mL) and control group (532.7±19.06 mL, p < 0.001). Hemoglobin levels were higher (p < 0.001) in group 1 (12.1±1.13 g/dL) than in group 2 (9.6±1.59 g/dL) and in control group (6.2±0.97 g/dL). Hepatic iron level showed the same pattern as hemoglobin (p < 0.001). There was no difference in weight and length between the three groups (p = 0.342). There was no fecal occult blood in the any of the animals. CONCLUSIONS: Despite the lower volume consumed, the group that received formula presented higher iron absorption and hemoglobin levels than the group fed with fortified whole cow's milk. Growth was similar in the three groups.
- ItemAcesso aberto (Open Access)Anemia em lactentes de baixa renda em aleitamento materno exclusivo(Sociedade Brasileira de Pediatria, 2006-08-01) Torres, Marco Antonio A. [UNIFESP]; Braga, Josefina Aparecida Pellegrini [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Nóbrega, Fernando J. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To verify the behavior of hemoglobin levels and anemia prevalence in full term infants, aged 3 to 6 months and on exclusive breastfeeding. METHODS: A cross-sectional study of 242 infants aged 3 to 6 months with birth weights of more than 2,500 g, on exclusive breastfeeding and monitored by the Program for the Promotion of Infant Growth and Development, part of the Paraisópolis Einstein Community Program. Hemoglobin was assayed by finger prick between the third and sixth months of life. Anemia was defined as Hb < 10.3 g/dL (Saarinen) or Hb < 10 g/dL (Brault-Dubuc) for infants aged 3 to 5 months and as Hb < 11.0 g/dL (WHO) for infants aged 6 months. RESULTS: Mean hemoglobin concentration was 11.3 and 11.4 g/dL at 3 and 4 months and 11.2 and 11.1 g/dL at 5 and 6 months, respectively. The percentage of anemic infants varied depending on age and the cutoff adopted, being 11.8, 10.2 and 8.3% at 3, 4 and 5 months, respectively, according to the Brault-Dubuc criteria, and 20.6, 14.8 and 10.4% by the Saarinen criteria. Anemia prevalence at 6 months was 37.5%. CONCLUSIONS: Anemia prevalence rates observed among infants aged between 3 and 6 months varied from 8.3 to 37.5%, justifying increased attention on the part of pediatricians to the hemoglobin levels of infants who are on exclusive breastfeeding, come from low-income families and present risk factors for iron deficiency.
- ItemSomente MetadadadosAsymptomatic giardiasis does not affect iron absorption in children with iron deficiency anemia(Amer Coll Nutrition, 1996-10-01) Morais, Mauro Batista de [UNIFESP]; Suzuki, Helena Ueta [UNIFESP]; Corral, José N. [UNIFESP]; Machado, Nelson Lourenço [UNIFESP]; Fagundes Neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: Malabsorption of iron has been reported in children with symptomatic giardiasis. The aim of this study was to evaluate intestinal absorption of iron in children with asymptomatic giardiasls and iron deficiency anemia.Subjects: Based upon results of blood hemoglobin and stool examination, two groups were established: asymptomatic giardiasis and anemia, and anemia without intestinal parasitosis (control group). Patients were aged 1-6 years. There was no difference in age, weight, height, or iron nutritional status between the asymptomatic giardiasis and control groups on admission to the study.Measures: Intestinal absorption of iron was evaluated using the iron tolerance test and the hemoglobin response to iron therapy. The serum iron tolerance test was based on the increment of iron level 2 hours after administering an iron load of 1 mg/kg of elemental iron in the form of ferrous sulfate, in comparison to the fasting iron level. Hemoglobin response to oral iron therapy was determined by the increment of hemoglobin on day 30 of therapy with ferrous sulfate (5 mg/kg/day of elemental iron).Results: There was no statistical difference between the asymptomatic giardiasis and control groups with reference to the iron tolerance test (159.1 +/- 73.1 mu g/dl and 154.5 +/- 76.5 mu g/dl, respectively) and to the hemoglobin response to iron therapy (1.5 +/- 0.7 g/dl and 1.8 +/- 1.1 g/dl, respectively), The presence or absence of trophozoites of Giardia lamblia on duodenal aspirate did not affect intestinal absorption of iron.Conclusion: Asymptomatic giardiasis did not affect the intestinal absorption of iron and the hemoglobin response to oral iron therapy in iron-deficient anemic children.
- ItemAcesso aberto (Open Access)Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age(Associação Médica Brasileira, 2014-02-01) Marques, Rosa Fátima da Silva Vieira [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Lopez, Fábio Ancona [UNIFESP]; Braga, Josefina Aparecida Pellegrini [UNIFESP]; State University of Pará Department of Integral Health Professor; Universidade Federal de São Paulo (UNIFESP)Objective The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors. Methods This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum. Results At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity. Conclusion According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.
- ItemAcesso aberto (Open Access)Diagnóstico diferencial da deficiência de ferro(Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2010-06-01) Vicari, Perla [UNIFESP]; Figueiredo, Maria Stella [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Iron deficiency is considered to be the commonest hematological pathology in humans. Thus, the essential steps in an adequate approach of iron deficiency include: the proper identification of its causes and the differentiation between iron deficiency and other conditions. This article briefly describes other conditions that may present with microcytic anemia such as thalassemia, anemia of chronic diseases, sideroblastic anemia and lead intoxication. These diseases should be considered during the investigation of iron deficiency anemia.
- ItemSomente MetadadadosHelicobacter pylori and Iron-deficiency Anemia in Adolescents in Brazil(Lippincott Williams & Wilkins, 2010-10-01) Araf, Litza Neves [UNIFESP]; Pereira, Carlos Alberto de Bragança; Machado, Rodrigo Strehl [UNIFESP]; Raguza, Daniele [UNIFESP]; Kawakami, Elisabete [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Aim: the aim of the study was to evaluate the association between Helicobacter pylori infection and iron deficiency (ID) in adolescents attending a public school.Patients and Methods: From March to June 2001, a cross-sectional study was conducted among adolescents (10-16 years) enrolled in a single public school in São Paulo, Brazil. of 400 eligible students, 195 agreed to participate, but 1 was excluded due to sickle cell disease. A blood sample was collected from each subject to measure hemoglobin and ferritin. H pylori status was investigated with the 13 C-urea breath test. All of the subjects with either anemia or ID were given iron therapy.Results: H pylori prevalence was 40.7% (79/194), being higher in male subjects (45/90 vs 34/104, P = 0.014). There was no relation between infection and nutritional status. Abnormally low serum ferritin was observed in 12 subjects, half of whom were positive for H pylori (odds ratio [OR] 1.49, 95% confidence interval [CI] 0.38-5.81). the median serum ferritin was 33.6 ng/mL (interquartile range 23.9-50.9) in infected subjects and 35.1 ng/mL (interquartile range 23.7-53.9) in uninfected subjects. Anemia was detected in 2% (4/194) of the students, half of whom were infected (OR 1.47, 95% CI 0.1-20.6). the mean hemoglobin value in infected subjects was 13.83 g/dL +/- 1.02 versus 14 g/dL +/- 1.06 in uninfected subjects.Conclusions: the study was not able to find a relation between H pylori infection and ID or anemia.
- ItemAcesso aberto (Open Access)O impacto da fortificação de alimentos na prevenção da deficiência de ferro(Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2010-06-01) Vellozo, Eliana P. [UNIFESP]; Fisberg, Mauro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Among strategies used for the prevention of micronutrient deficiencies, especially iron-deficiency anemia, considered the most prevalent nutritional disorder worldwide, food fortification is a priority in terms of cost benefit. In recent decades food fortification policies have been adopted in many developed and developing countries. The introduction of such measures was achieved only by political decisions that culminated in enforced fortification. Thus, several foods are efficiently used for fortification as they are well accepted and tolerated and do not necessarily require the cooperation of the recipient. Addition of nutrients should occur in foods that are regularly eaten in the specific region after assessment of the nutritional status of the target population. Every food fortification program should be monitored as fortified foods should: 1. be consumed in quantities that do not vary greatly between individuals; 2. not have significant changes in color, odors or taste; 3. not be significantly more expensive; and 4. have had their effectiveness proven by scientific studies.
- ItemSomente MetadadadosIntestinal blood loss as an aggravating factor of iron deficiency in infants aged 9 to 12 months fed whole cow's milk(Lippincott Williams & Wilkins, 2008-02-01) Fernandes, Sandra Maria Rodrigues [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Amancio, Olga Maria Silverio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Goals: To verify the occurrence of occult intestinal blood loss and iron deficiency in infants aged 9 to 12 months.Study: A consecutive sample of 98 infants of the Pediatric Public Health Primary Care Unit in the town of Arapongas, Parana State, Brazil was involved in this cross-sectional study. Dietary history, hemoglobin, serum iron, transferrin saturation, ferritin, and an occult fecal blood loss investigation, by the immune chromatographic method specific for human hemoglobin were performed.Results
- ItemAcesso aberto (Open Access)Iron stores and coagulation parameters in patients with hypoxemic polycythemia secondary to chronic obstructive pulmonary disease: the effect of phlebotomies(Associação Paulista de Medicina - APM, 1997-04-01) Martinez, José Antônio Baddini [UNIFESP]; Guerra, Celso Carlos de Campos [UNIFESP]; Nery, Luiz Eduardo [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This study was designed to determine the effects of phlebotomy on iron body contents and coagulation tests of COPD patients with polycythemia secondary to hypoxemia. Seventeen patients with COPD and hematocrits higher than 54 percent (mean Hct: 57 ± 0.49 percent ), who had not received anti-inflammatory or antiplatelet aggregation agents recently. Their mean forced expiratory volume at 1 second (FEV1) was 0.92 ± 0.11 L. Intervention: Blood work was collected to evaluate the following: serum iron and ferritin levels, total iron binding capacity, transferrin saturation index, fibrinogen plasma levels, activated partial thromboplastin time, platelet count, platelet aggregation measurements, and thromboelastography coagulation parameters. The blood samples were obtained before and about 7 days after the hematocrit correction by 300-400 ml phlebotomies done every other day. The mean number of phlebotomies done for each patient was 4.4. Postphlebotomy iron serum levels decreased from 90.1 ± 14.8 to 59.7 ± 9.9 mg/dl and the ferritin serum levels from 133.8 ± 37.9 to 70.8 ± 32.7 ng/ml (p< 0.05). Regarding the coagulation studies, there were significant increases in the platelet count, from 227,300 ± 13,900 to 312,500 ± 30,200 per mm³, and in the maximum clot amplitude (a) obtained by thromboelastography ( from 53.6 ± 1.4 percent to 60.4 ± 1.1 percent). The coagulation time (k) of the thromboelastography also decreased significantly, from 7.5 ± 0.7mm prephlebotomy to 4.5 ± 0.3mm postphlebotomy. Although the coagulation changes were small amount, the observed significant decrease in iron contents may have important clinical implications.
- ItemAcesso aberto (Open Access)Práticas alimentares e estado nutricional de crianças no segundo semestre de vida atendidas na rede pública de saúde(Pontifícia Universidade Católica de Campinas, 2007-08-01) Modesto, Simone Paula [UNIFESP]; Devincenzi, Macarena Urrestarazu [UNIFESP]; Sigulem, Dirce Maria [UNIFESP]; Prefeitura Municipal de Taboão da Serra; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To assess the nutritional status and feeding practices of children in the second semester of life who receive care in public health facilities of the city of Taboão da Serra, SP. METHODS: This is a cross-sectional study done in basic healthcare units divided into two groups: downtown and suburb. The sample was comprised of 180 children, 90 in each group. Food consumption was determined by the 24-hour recall. Weight and hemoglobin (by the capillary puncture method) were recorded. RESULTS: The prevalence of anemia was 30.5% with no difference between the groups. The median scores-Z (weight-for-age) were: 0.02 and 0.03, for the downtown and suburb groups, respectively. The use of iron supplements was different between the groups (p=0.001): the suburb group used it more often. Meanwhile, vitamin A supplementation was significantly higher in the downtown group (p=0.044). Foods other than breast milk were introduced early. There was a significant difference between the groups regarding the age when other foods were introduced, such as tea, juice, soup and soup with meat. In relation to nutrient intake, energy and protein intake were adequate but among the studied micronutrients, intake of vitamin C and iron were likely to be inadequate. CONCLUSION: The prevalence of anemia is relatively low when compared with data obtained from other places and the weaning diet is inadequate when compared with the current recommendations. The use of nutrient supplements should be reviewed.
- ItemSomente MetadadadosPrevalência e fatores associados à anemia e deficiência de ferro em crianças de 18 a 24 meses(Archivos Latinoamericanos Nutricion, 2006-09-01) Pereira Netto, Michele; Priore, Silvia Eloiza [UNIFESP]; Sant'Ana, Helena Maria Pinheiro; Peluzio, Maria do Carmo Gouveia; Sabarense, Cephora Maria; Silva, Danielle Goes da [UNIFESP]; Franceschini, Sylvia do Carmo Castro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A transversal study was carried out with 101 18- to 24-month old infants, attended at public health services in Vicosa, MG, Brazil, The objective of this study was to verify the prevalence and factors associated to anemia and iron deficiency among infants. Data were obtained by interviews of the infants' parents or guardians at their households. Hemoglobin and ferritin analyses were peformed using an automatic counter and the immunometric dosage method, respectively. Feces samples were analyzed by the Hoffman, Faust and Ritchie methods. Anemia was characterized by hemoglobin concentration and iron deficiency by ferritin. For dietary practice, the 24-hour recall was used. Linear regression and logistics analyses were conducted to evaluate the variables associated to hemoglobin and iron deficiency, respectively. Anemia, iron deficiency and intestinal parasite prevalences were 30.1; 38.4, and 21%, respectively. The number of household members, age infants were introduced to juices/or fruit, mother's level of instruction, and total breastfeeding period were associated to the levels of hemoglobin plasma. The associated variables for iron deficiency were milk consumption near meals and number of household members.
- ItemSomente MetadadadosRisks of anemia in infants according to dietary iron density and weight gain rate(Elsevier B.V., 2004-10-01) Hadler, MCCM; Colugnati, FAB; Sigulem, D. M.; Fed Univ Goias; Universidade Federal de São Paulo (UNIFESP)Background. the objective of the study was to identify risk factors of infant anemia and to assess a new indirect method to identify the risks of anemia using a probability curve based on dietary iron density and weight gain rate.Methods. A cross-sectional study was conducted on 110 term infants in a public health unit in Goiania, Brazil. A socioeconomic, demographic, anthropometric survey and dietary assessment were performed. Hemoglobin, red blood cell distribution width (RDW), ferritin, and C-reactive protein were determined.Results. the risk factors identified by final adjusted logistic regression were male infants (OR = 2.38), infants whose mothers were housewives (OR = 5.01), and households with more than three members (OR = 3.08). Another risk factor was the introduction of meat after 6 months (OR = 3.3). There was a positive dose-response effect between milk consumption and prevalence of anemia adjusted for sex and age (Effect = 0.120; 95% CI: 0.015, 0.225). Dietary iron density (from 6 to 9 months) and weight gain rate (from 9 to 12 months) significantly affected the probability of the infant having anemia.Conclusions. the probability curve for anemia obtained from dietary iron density and weight gain rate can be used to identify the risks of anemia, and together with the risk factors identified are important for anemia prevention programs. (C) 2004 the Institute for Cancer Prevention and Elsevier Inc. All rights reserved.