ABSTRACT
Avaliar a eficácia e tolerabilidade da terapêutica com hidróxido de ferro III polimaltosado na anemia ferropriva em crianças. Método: Foram avaliadas 400 crianças menores de 6 anos de idade, residentes no Município de Carrancas, MG. Pelo teste rápido de hemoglobina (Hemocue) amostras de sangue foram colhidas por punção digital, sendo o ponto de corte de 11,0 q/dL para anemia recomendado pela OMS, sendo este valor acrescido de 0,6, para ajustes de altitude e variabilidade do aparelho. Para confirmação do diagnóstico de anemia ferropriva foi realizado eritrograma para determinar o nível de hemoglobina, considerando anemia os valores 11g/dL com hipocromia e microcitose à hematoscopia e dosagem da ferritina sérica (valores 10 mg/dl). Nas crianças anêmicas, exames parasitológicos de fezes foram realizados para avaliar parasitose intestinal. Resultados: Cento e noventa e sete (49%) crianças tinham valores de hemoglobina abaixo do ponto de corte, sendo consideradas anêmicas. O diagnóstico de anemia ferropriva somente foi confirmado em 50, considerando-se os critérios estabelecidos acima. O tratamento foi feito com hidróxido de ferro III polimaltosado na dose de 4md/Kg/peso/dia, por via oral, durante 90 dias. Ao final deste período, foi possível avaliação de 40 crianças quanto à eficácia e tolerância. Os níveis médios de hemoglobina antes do tratamento elevaram de 9,6 ± 1,0g/dL para 11.0 ± 1,4g/dL ao final do tratamento, diferença estatisticamente significativa p < 0,001. O exame parasitológico de fezes foi positivo em 35 das 38 crianças, sendo as parasitoses mais comuns ascaridíase e giardíase. Índice de 66% de erradicação dos parasitas após o tratamento específico com mebendazol e metronidazol. Conclusão: Encontrou-se elevada prevalência de anemia em crianças, com boa resposta e tolerância à terapêutica instituída.
To know the prevalence of anaemia and iron deficiency in children in the city of Carrancas, Minas Gerais, Brazil. Method: Cross-sectional study with 400 children, with age from 6 months to 6 years. Hematological parameter used for screening was 11.0g/dL cut-off point for hemoglobin, measured by HemoCue, with a blood obtained by digital punction as recommended by WHO. Children with hemoglobin lower than this value had venous blood collected to determine hemoglobin, hematocrit, red blood cells count, and determination of plasmatic ferritin concentration. Results: Children with hemoglobin levels lower than 11.6g/dL were considered anemic according to HemoCue evaluation. However, only 50 children were confirmed as anemic due to iron deficiency. They were treated with ferrous polymaltose in oral doses of 4mg/kg of weight, dayly, during 90 days. Mean hemoglobin levels increased from 9,6 ± 1,0g/dL before treatment to 11,0 ± 1,4g/dL at the end of 90 days of treatment. Such difference was statistically significant (p<0,001). Intestinal parasites most prevalent were Ascaris and Giardia, which were treated adequately with mebendazol and metronidazol. Conclusion: A high prevalence of iron deficiency anemia in children under six years was observed years. Therefore, it is an important public health matter in Carrancas. Treatment was effective in increasing the hemoglobin levels to normal values and was well tolerated by children.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Anemia, Iron-Deficiency , Hydroxides/therapeutic use , Anemia, Iron-Deficiency , Brazil , Feces/parasitology , Hematocrit , Hemoglobins/analysisABSTRACT
PURPOSE--To evaluate the antihypertensive efficacy and safety of cilazapril compared to nifedipine retard in mild to moderate hypertension. METHODS--forty randomized out-patients with mild moderate hypertension, diastolic pressure (DP) between 95 and 115 mmHg, with placebo for 15 days were randomized and allocated for treatment, double-blind, once daily with cilazapril 2.5 mg (n = 20) or nifedipine retard 20 mg (20 = n) for four weeks. The non-responders (DP > 90mmHg) had the dosage increased twice, b.i.d., while responders were maintained up to 10 weeks. Clinical visits were performed before, at baseline and every two weeks and the laboratory test was performed after placebo run-in, 4th and 10th weeks of treatment. RESULTS--The blood pressure (BP) were similar between groups at the end of the placebo (cilazapril 151 +/- 14/103 +/- 5 - nifedipine 157 +/- 17/108 +/- 7mmHg, p > 0.05). DP decreased already at second weeks (cilazapril 95 +/- 9 - nifedipine 96 +/- 11mmHg, p < 0.05, compared to week 0) in both groups at the end of study with no difference inter groups. BP normalization was obtained in 58 per cent of the patients with cilazapril and in 61 per cent in the nifedipine group. Adverse biochemical effects were not observed in any group. Six (16 per cent) patients of the cilazapril and 15 (39per cent) of nifedipine related collateral events, although no difference were observed between groups. CONCLUSION--Cilazapril 2.5 to 25mg normalized BP in 58 per cent of mild and moderate hypertension patients, and this efficacy was similar to sustained-release nifedipine 20 to 40mg. Cilazapril had no adverse effects on the biochemical parameters with low incidence of collateral effects
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Nifedipine/administration & dosage , Cilazapril/administration & dosage , Hypertension/drug therapy , Time Factors , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Nifedipine/adverse effects , Treatment Outcome , Cilazapril/adverse effects , Hypertension/physiopathology , Double-Blind Method , Arterial PressureABSTRACT
Objetivo - Comparar o efeito anti-hipertensivo e alterações metabólicas da associação captopril + hidroclorotiazida (C+HCTZ) contra clortalidona (CT) para tratamento de hipertensão arterial primária leve e moderada. Métodos - cinqüenta e cinco pacientes que tiveram a sua medicação anti-hipertensiva suspensa por 15 dias ou sem tratamento prévio, foram randomizados para tratamentos com a associação captopril 50mg + hidroclorotiazida 25mg (n=29) ou clortalidona 50mg (n=26). A avaliação clínica foi realizada previamente à medicação e mensalmente durante 3 meses e os exames laboratoriais foram feitos no início e ao final do estudo. Resultados - A pressão arterial (PA) no período placebo não foi diferente entre os grupos (C+CHTZ: 161 ± 25/102 ± 6 - CT: 155 ± 18/101 ± 6 mmHg), porém a diminuição da pressão diastólica já no 1° mês foi estatisticamente significante no grupo C+HCTZ (89±8 mmHg) comparado ao grupo CT (94±8 mmHg, p<0,05). O perceptual de queda da PA diastólica em média, de 12% no grupo C+HCTZ e no grupo CT variou de 7 (1° e 2° mês) a 11% (3° mês). Embora sem diferença estatística, obteve-se normalização pressórica em 69% dos pacientes com captopril associado ao diurético e, em 50%, com clortalidona. Observou-se uma redução significativa da potassemia com clortalidona (4,2±0,7 para 3,7±0,4 mEq/L, p<0,01) e manutenção dos níveis de potássio com associação captopril e tiazídico. Este último tratamento também reduziu significativamente os níveis de colesterol (219±39 mg/dl para 202±39 mg/dl, p<0,04). Conclusão - Os resultados mostraram que a associação de captopril com dose baixa de tiazídico normaliza a PA em 69% de pacientes portadores de hipertensão arterial primária leve e moderada e age mais rapidamente que a clortalidona no controle pressórico, apresentando efeito metabólico benéfico de reduzir os níveis de colesterol sem alterar a potassemia
Purpose - To compara the antihypertensive and metabolic effects of captopril combined with hydrochlorothiazide (C+HCTZ) versus chlorthalidone (CT) in mild and moderate primary hypertensive patients. Methods - Fifty five patients, whithout treatment or treated with 15 days placebo were randomized for treatment with the combination of captopril 50mg and hydrochlorothiazide 25mg (n=29) against chlorthalidone (n=26). The clinical evaluation was done during placebo and monthly throughout three months, and the laboratory tests were done before and at the end of the study. Results - The blood pressure were similar between groups during placebo period (C+HCTZ: 161±25/102±6 - CT: 155±18/101±6 mmHg); the diastolic blood pressure decreases significantly at first month already in the group C+HCTZ (89±8 mmHg) comparad to group CT (94±8 mmHg, p<0,05). The percentile diastolic and mean blood pressure dropped, in average, 12% in C+HCTZ group and in CT varied between 7 (1st and 2nd month) to 11% (3rd month). Without statistical difference, the blood pressure normalization was obtained in 69% of the patients with the association captopril and diuretic and in 50% of the patients in the chlorthalidone group. It was observed a significant reduction of potassium in patients treated with chlorthalidone (4,2±0,7 to 3,7±0,4 mEq/L, p<0,01) that was not observed with the captopril and the thyazide associated. The last treatment also significantly reduced the cholesterol levels (219±39mg/dl to 202±39mg/dl, p<0,04). Conclusion - Our results indicate that captopril combined with low diuretic dose normalize the blood pressure in 69% mild to moderate primary hypertensive patients, and acts faster than chlorthalidone in this control. In addition has metabolic benefits reducing cholesterol levels with no alteration in potassium levels