Carlos Alberto Garcia Oliva

Estado nutricional, ferro, cobre e zinco em escolares de favelas da cidade de São Paulo

OBJECTIVE: To assess the anthropometry, body composition and iron, copper and zinc nutritional status, according to gender, of institutionalized children and adolescents living in two shantytowns in the city of Sao Paulo. METHODS: A cross sectional study using weight, height, arm circumference, skinfolds, electrical bioimpedance, Z scores for the relationships: height to age, body mass index, middle-upper arm circumference, muscle area of the arm and fat area of the arm was carried out; the body fat and lean mass percentages were analyzed according to the formulas proposed by Siri and Slaughter. Hemoglobin, hematocrit, serum iron ferritin, copper and zinc were determined. RESULTS: Body weight, middle-upper arm circumference, triceps and subescapular skinfolds, electric resistance, Z scores of the arm area, muscle area of the arm, and body fat percentage of girls were higher in relation to boys. Low stature was found in 8% of the girls and in 5.6% of the boys, without differences according to gender. There was a lower prevalence of malnutrition (2% of the girls and 5.6% of the boys), than of overweight and obesity (30% and 11.2%, respectively). Anemia was observed in 24.4% and iron deficiency in 10.5% of the schoolchildren with or without anemia. Values were below the lower limit of the reference standard for serum copper and zinc, respectively, for 3 and 7 individuals. CONCLUSION: In the studied population, institutionalized and of low social economic level, a process of nutritional transition and high prevalence of anemia takes place which does not result from an interaction of iron, copper and zinc.

[Nutritional status and body composition of two South American native populations -- Alto Xingu and Ikpeng].

OBJECTIVES To assess the nutritional and body composition of two Brazilian indigenous populations by comparing their nutritional status. METHODS 95 children from Alto Xingu and 69 from Ikpeng were evaluated, ages ranged from 24 to 117 months. The study was performed in the Xingu Indigenous Park. Data collected were: age, weight, height, skin folds, arm circumference, resistance and reactance. The z-scores were calculated and classified according to the parameters defined by the National Center for Health Statistics (NCHS 2000). Shortness was defined as length or stature below -2, underweight as body mass index below -2, and overweight as body mass index above 2. RESULTS Among children from Alto Xingu, the prevalence of shortness was 8.4%, while among Ikpengs the prevalence was 37.7% (p < 0.001). Underweight was diagnosed in 12.5% of Ikpeng s children. Values of fat-free mass were greater for children from Alto Xingu and no case of obesity was found. CONCLUSION In this study, Ikpengs children showed higher incidences of short stature and low weight than the Altoxingus children. Data regarding body composition have greater values among children from Alto Xingu, thus we conclude that nutritional status among children from Alto Xingu is better than the one found among the Ikpengs children.

Diarréia aguda grave associada à Escherichia coli enteropatogênica clássica (EPEC): características clínicas e perdas fecais em lactentes hospitalizados

UNLABELLED Enteropathogenic Escherichia coli (EPEC) strains are the most prevalent enteropathogenic agents isolated in the stools of hospitalized infants with severe acute diarrhea in São Paulo. These microorganisms induce a severe intestinal secretion of fluids and electrolytes that can cause dehydration leading to hospital admission in the majority of the cases. OBJECTIVES This investigation aims at the following objectives: 1) to study the clinical features of acute diarrhea in male infants who were hospitalized owing to EPEC infection; 2) to determine the fecal fluid losses, formula intake and variation of the body weight during the evolution of the disease. PATIENTS AND METHODS Thirty eight male infants with acute diarrhea due to EPEC strains were studied. The clinical and epidemiological features of the patients were recorded and the different EPEC serogroups were identified. The infants were kept in a metabolic bed in order to allow the collection of stools and urine separately during the whole period of the disease, and daily metabolic balances were also obtained. The mean duration of the metabolic study was 5.8 days, and during this period of time 220 daily metabolic balances were accumulated and analyzed. RESULTS The main clinical features of the studied group were as follows: age below 12 months; low birth weight; precocious weaning; severe protein-calorie malnutrition. EPEC 0111 was the most frequent serogroup identified, present in 68.4% of the infants. The average daily fecal fluid losses were 66 ml/kg and the mean daily formula intake was 85.2 ml/kg. Cows milk was the most precocious food utilized and the infants who received cows milk feeding presented the largest stool losses in comparison with lactose free formulas and total parenteral nutrition. CONCLUSION EPEC strains are able to induce moderate to severe fecal fluid losses in infants and the duration of diarrhea is usually below 15 days, although in several circumstances diarrhea can show a protracted evolution owing to food intolerance associated or not with intestinal secretion.Enteropathogenic Escherichia coli (EPEC) strains are the most prevalent enteropathogenic agents isolated in the stools of hospitalized infants with severe acute diarrhea in Sao Paulo. These microorganisms induce a severe intestinal secretion of fluids and electrolytes that can cause dehydration leading to hospital admission in the majority of the cases. OBJECTIVES. This investigation aims at the following objectives: 1) to study the clinical features of acute diarrhea in male infants who were hospitalized owing to EPEC infection; 2) to determine the fecal fluid losses, formula intake and variation of the body weight during the evolution of the disease. PATIENTS AND METHODS. Thirty eight male infants with acute diarrhea due to EPEC strains were studied. The clinical and epidemiological features of the patients were recorded and the different EPEC serogroups were identified. The infants were kept in a metabolic bed in order to allow the collection of stools and urine separately during the whole period of the disease, and daily metabolic balances were also obtained. The mean duration of the metabolic study was 5.8 days, and during this period of time 220 daily metabolic balances were accumulated and analyzed. RESULTS. The main clinical features of the studied group were as follows: age below 12 months; low birth weight; precocious weaning; severe protein-calorie malnutrition. EPEC O111 was the most frequent serogroup identified, present in 68.4% of the infants. The average daily fecal fluid losses were 66 ml/kg and the mean daily formula intake was 85.2 ml/kg. Cows milk was the most precocious food utilized and the infants who received cows milk feeding presented the largest stool losses in comparison with lactose free formulas and total parenteral nutrition. CONCLUSION. EPEC strains are able to induce moderate to severe fecal fluid losses in infants and the duration of diarrhea is usually below 15 days, although in several circumstances diarrhea can show a protracted evolution owing to food intolerance associated or not with intestinal secretion.

Check-up and cardiovascular risk progression: is there a room for innovation?

ABSTRACT Objective: To evaluate the impact of traditional check-up appointment on the progression of the cardiovascular risk throughout time. Methods: This retrospective cohort study included 11,126 medical records of asymptomatic executives who were evaluated between January, 2005 and October, 2008. Variables included participants’ demographics characteristics, smoking habit, history of cardiovascular diseases, diabetes, dyslipidemia, total cholesterol, HDL, triglycerides, glucose, c-reactive protein, waist circumference, hepatic steatosis, Framingham score, metabolic syndrome, level of physical activity, stress, alcohol consumption, and body mass index. Results: A total of 3,150 patients was included in the final analysis. A worsening was observed in all risk factors, excepting in smoking habit, incidence of myocardial infarction or stroke and in the number of individuals classified as medium or high risk for cardiovascular events. In addition, a decrease in stress level and alcohol consumption was also seen. Conclusion: The adoption of consistent health policies by companies is imperative in order to reduce the risk factors and the future costs associated with illness and absenteeism.

Financial cost of the admissions for simultaneous pancreas-kidney transplant in a Brazilian hospital.

PURPOSE To perform a cost analysis of simultaneous pancreas-kidney transplantation (SPKT) in a Brazilian hospital. METHODS Between January 2008 and December 2011, 105 consecutive SPKTs at the Hospital of Kidney and Hypertension in Sao Paulo were evaluated. We evaluated the patient demographics, payment source (public health system or supplementary system), and the impact of each hospital cost component. The evaluated costs were corrected to December 2011 values and converted to US dollars. RESULTS Of the 105 SPKT patients, 61.9% were men, and 38.1% were women. Eight patients died, and 97 were discharged (92.4%). Eighty-nine procedures were funded by the public health system. The cost for the patients who were discharged was

A Localized Adherence-Like Pattern as a Second Pattern of Adherence of Classic Enteropathogenic Escherichia coli to HEp-2 Cells That Is Associated with Infantile Diarrhea

18.352.27; the cost for the deceased patients was

Breath Hydrogen Test in the Diagnosis of Environmental Enteropathy in Children Living in an Urban Slum

18.449.96 (p = 0.79). The FOR for SPKT during this period was positive at

Evaluation of the nutritional status of Indian children from Alto Xingu, Brazil

5,620.65. The costs were distributed as follows: supplies, 36%; administrative costs, 20%; physician fees, 15%; intensive care unit, 10%; surgical center, 10%; ward, 9%. CONCLUSION Mortality did not affect costs, and supplies were the largest cost component.