ABSTRACT
BACKGROUND: Improvements in the iron status of a population as result of food fortification are expected at the long term. In Brazil, the effectiveness of mandatory flour fortification with iron has been evidenced mostly from surveys on gestational anemia after 1 or 2 years from its implementation, in 2004. Our aim was to assess hemoglobin (Hb) concentrations and the prevalences of anemia and linked erythrocyte morphology patterns among pregnant women in 2006 and 2008.METHODS: The study design was retrospective and cross-sectional. The analysis was based on secondary data in 546medical records from women at the times of their first prenatal attendance in 13 public primary healthcare units of the Butantan Administrative Region from São Paulo (SP), Brazil. Anemia was evaluated from Hb concentration (cut-off <11.0 g/dL) and erythrocyte morphology patterns from mean corpuscular volume (MCV), mean corpuscular Hb concentration (MHC), and red cell distribution widths (RDW). Recorded sociodemographic and obstetric data included maternal age, gestational age, ethnoracial self-classification, and residence type. Student's t tests, analysis of variance, Chi-squared tests, and multiple linear and logistic regressions were employed in the statistical analysis using a significance level of 5 %.RESULTS:The prevalence of anemia was 9.7 % in 2006 and 9.4 % in 2008 (P= 0.922), with no significant difference in mean Hb concentrations (P= 0.159). Normocytosis (normal MVC), normochromia (normal MHC), and anisocytosis (high RDW) were found in most anemia cases, suggesting that the low Hb concentrations resulted from mixed causes. In multiple regression analysis, gestational age at the first prenatal attendance was an independent predictor of low Hb and of having anemia. Moreover, black ethnoracial self-classification was associated with lower Hb. CONCLUSIONS: The prevalence of gestational anemia was low among women in both of the studied periods, representing a mild public health problem. Our results highlight the importance of early prenatal care as a means of reducing gestation-associated risks. The erythrocyte morphology pattern found in most cases of low Hb levels suggests that, besides iron deficiency, hemoglobin pathies and nutritional deficiencies of folate and vitamin B12 are common complicating factors of gestational anemia in our setting.
Subject(s)
Humans , Female , Pregnancy , Anemia, Iron-Deficiency/prevention & control , Erythrocytes/metabolism , Erythrocytes/physiology , Prenatal Care , Primary Health CareABSTRACT
Se presentan seis casos de granuloma anular (GA) en pacientes HIV positivos. Tres pacientes eran de sexo masculino y tres de sexo femenino. Los seis pacientes presentaban pequeñas pápulas diseminadas que involucionaron en corto tiempo y precedieron a un notable deterioro de su estado general. La histopatología fue vinculable a GA. El GA es una dermatosis inflamatoria benigna cuya etiología es desconocida. En pacientes HIV positivos se ha informado que particulas virales de HIV circulantes serían un factor precipitante del GA. La alteración de los CD4 y CD8 podría ser responsable del curso de esta patología
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Granuloma Annulare/diagnosis , Granuloma Annulare/complications , Granuloma Annulare/physiopathology , Granuloma/diagnosis , Acquired Immunodeficiency Syndrome/complicationsABSTRACT
Paciente de 29 años de edad, quien presenta desde el nacimiento almohadillas articulares interfalángicas proximales y distales en los pies. Se intenta tratamiento con infiltraciones locales de esteroides, pero la paciente decide abandonar las mismas por el dolor que éstan le producen. Se hace además una revisión de los trabajos ya publicados
Subject(s)
Humans , Female , Adult , Foot Dermatoses/pathology , Hand Dermatoses/history , Keratosis/diagnosis , Toe Joint/pathology , Finger Joint/abnormalities , Keratoderma, Palmoplantar/pathologyABSTRACT
Se explica la técnica de injerto de piel total, como opción en el tratamiento de lesiones malignas. Se la desarrolla paso a paso y se brindan conceptos generales de injertos
Subject(s)
Humans , Female , Aged , Skin Transplantation , Carcinoma, Basal Cell/surgery , Skin Transplantation/classificationABSTRACT
El colgajo a lo 9, es una técnica quirúrgica que se realiza por deslizamiento y transposición, descripta por el Prof. Grinspan Bozza. Es útil, práctica, de fácil manejo y permite lograr buenos resultados estéticos
Subject(s)
Humans , Female , Aged , Carcinoma, Basal Cell/surgery , Surgical Flaps , Head and Neck Neoplasms/surgery , Surgical FlapsABSTRACT
Se presentan tres pacientes del sexo femenino, con metástasis cutáneas. En dos de ellas, se determiná la mama como órgano de asiento del tumor primitivo y en la restante, el tubo digestivo (recto). A raíz de estos casos, se revisan los distintos aspectos clínicos e histopatológicos a que pueden dar lugar las metástasis cutáneas así como la correlación entre el tipo de tumor primitivo y las características de la lesión metastósica, punto éste importante para una correcta orientación diagnóstica