ABSTRACT
This study aimed to identify variables associated with the appropriate recall of indications and the drug classes that represented the most unmatching medications (i.e., when the individual who used it had not reported any illness that matched its indications). Community-dwelling individuals aged ≥60 years using ≥1 medication, from Santa Cruz da Esperança-SP, Brazil, were home-interviewed. Logistic regression models were used to evaluate the association between the appropriate recall of the indications for all medications in use and the following: gender, age, education, individual income, living arrangement, self-perceived health, and medication number, administration, payment, and identification. Medications whose indications were inappropriately recalled were classified as matching or unmatching. One hundred seventeen individuals used an average of 5.1 (standard deviation, 3.3) medications. Sixty-one (52.1%) appropriately recalled all indications. The appropriate recall of all indications was negatively associated with the number of medications in use (e.g., individuals taking 5-6 medications were 25 times less likely to appropriately recall all indications than those taking 1-2). Antithrombotic, acid-related disorder and psychoanaleptic classes showed greater frequencies of unmatching than matching medications. Therefore, counseling the elderly about drug indications should focus on those using ≥3 medications and/or antithrombotic, acid-related disorder, and psychoanaleptic agents.
Subject(s)
Humans , Male , Female , Middle Aged , World Health Organization , Aged/physiology , Pharmaceutical Preparations/administration & dosage , Logistic Models , Residence Characteristics/classification , Patient Education as Topic/classification , Counseling/ethics , IncomeABSTRACT
BACKGROUND: In July 2004, the Brazilian Ministry of Health through the National Health Surveillance Agency made the fortification of wheat flour and cornmeal (maize flour) with iron and folic acid mandatory, with the intention of reducing the rate of diseases such as neural tube defects. OBJECTIVE: The aim of the study was to investigate the impact of the folic acid fortified wheat flour and cornmeal on serum and red blood cell folate levels and on the reduction of neural tube defects in different Brazilian studies. METHODS: In order to compare folate concentrations in the Brazilian population prior to and following the implementation of mandatory fortification of wheat and cornmeal, studies that involved blood draws between January 1997 and May 2004 (pre-fortification period), and from June 2004 to the present (post-fortification period) were chosen. The data search included PubMed and Scopus databases as well as the Brazilian Digital Library of Theses and Dissertations. The following keywords were employed for the query: folate, folic acid, fortification, Brazil, healthy population, the elderly, children and pregnant women. RESULTS: A total of 47 Brazilian studies were selected; 26 from the pre-fortification period and 22 after the fortification implementation. The studies were classified according to the cohort investigated (pregnant women, children, adolescents, adults and the elderly). After the implementation of flour fortification with folic acid in Brazil, serum folate concentrations increased in healthy populations (57% in children and adolescents and 174% in adults), and the incidence of neural tube defects dropped. CONCLUSION: Folic acid fortification of wheat flour and cornmeal increased the blood folate concentrations and reduced the incidence of neural tube defects...
Subject(s)
Humans , Adult , Blood , Folic Acid , Edible Grain , Flour Benefactor , Food, Fortified , Pteroylpolyglutamic AcidsABSTRACT
El estado nutricional pregestacional y durante el embarazo fue evaluado en 372 gestantes, a través del indice de masa corporal y la Gráfica de Rosso, prospectivamente. Mitad de las mujeres presentó peso pregestacional normal, aún así 17,7 por ciento tenía bajo peso y 31,3 por ciento sobrepeso. En el tercer trimestre, 18,8 por ciento tenía bajo peso y 28,2 por ciento sobrepeso. El peso al nacer aumentó conforme la gestante fue nutricionalmente mejor natada. Estos resultados señalan que un control antropométrico adecuado posibilita monitorear nutricionalmente las embarazadas, preveniendo y/o controlando la ocurrencia de condiciones materno-fetales indeseables, hecho que reafirma la importancia de la ejecución de esta actividad como rutina en todo el control prenatal
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Nutrition Assessment , Pregnancy , Prenatal Nutrition , Pregnant WomenABSTRACT
The relative effectiveness of daily supplementation of iron deficiency during pregnancy using 15 mg/day of iron from iron-bis-glycinate chelate (71 pregnant women), or 40 mg iron from ferrous sulfate (74 pregnant women) was evaluated by measuring hemoglobin, transferrin saturation and serum ferritin, at the beginning of the study (< 20 weeks of pregnancy) and at 20-30 weeks and 30-40 weeks thereafter. Ingestion for 13 weeks or more was considered adequate. Seventy three percent of the Ferrochel consuming group and 35 of the ferrous sulfate consuming group were considered to have taken the treatment adequately. The decrease in levels of all the measured parameters was significantly less pronounced in the group that consumed Ferrochel in spite of the lower treatment dose. Iron depletion was found in 30.8 of the women treated with Ferrochel and in 54.5 of the women than consumed ferrous sulfate. Of the factors responsible for non compliance taste was reported in 29.8 of the ferrous sulfate consumers and none in the groups that consumed Ferrochel. It is concluded that daily supplementation with Ferrochel was significantly more effective, in spite of the lower dose, than supplementation with ferrous sulfate.
Subject(s)
Humans , Female , Pregnancy , Anemia, Iron-Deficiency , Pregnancy Complications/prevention & control , Ferrous Compounds , Glycine , Iron Chelating Agents , Dietary Supplements , Ferritins , Hemoglobins , Iron , Longitudinal Studies , Prospective Studies , Transferrin , Treatment OutcomeABSTRACT
O controle da qualidade é um conjunto de normas e procedimentos que visa minimizar os erros, tendo como fim garantir que o resultado dos exames reflita o mais próximo possível as condições laboratoriais da amostra, dando ao clínico subsídios para as intervenções necessárias. A proposta deste trabalho foi realizar um estudo de variação inter-observador a partir da análise da morfologia de oito esfregaços sanguíneos por dez examinadores diferentes. Não foram oferecidos os dados da hematimetria, da contagem dos leucócitos totais e das plaquetas, sendo solicitado aos dez examinadores que fizessem a analise da série vermelha, série leucocitária e das plaquetas. No contato com o examinador, foi exposto o objetivo do trabalho; havendo concordância em particular, foi sorteado um número de 1 a 10, sendo que somente o examinador saberia o seu número para posterior conferência de desempenho. Dois examinadores apresentaram mais tendência a descrever bastonetes e células brancas jovens do que os demais, 3 examinadores não observaram a presença de granulações tóxicas nos leucócitos em dois esfregaços sanguíneos. Dos dez examinadores, cinco não observaram a presença de eritroblastos em um esfregaço sanguíneo, sendo que dois não a observaram em dois esfregaços. A avaliação da série vermelha mostrou que existe grande dificuldade em descrever o tamanho do eritrócito (macrocitose e microcitose) e 6 observadores não observaram ponteados basófilos em dois esfregaços sanguíneos A dificuldade maior residiu no reconhecimento da policromasia. Conclui-se que o modelo de pequenos painéis já oferece evidência de tendenciosidade de análise e que há necessidade de estágios supervisionados desde a graduação até como reciclagem do pessoal que atua na prática diagnóstica, padronização das técnicas de execução e coloração dos esfregaços, e por fim propor situações que motivem todos a participar do controle de qualidade
Subject(s)
Humans , Blood Cell Count/methods , Quality ControlABSTRACT
Foram estudadas as proteínas da membrana eritrocitária de quarenta e seis espécies diferentes à treze ordens da classe Mammalia, através de eletroforese em gel de poliacrilamida.