Asistencia nutricional del paciente pediátrico quemado / Nutritional care of burned pediatric patient

El cuidado del niño quemado demanda una atención detallada de todas sus necesidades, desde el inicio del daño hasta su recuperación; esto incluye maniobras iniciales de resucitación, procedimientos quirúrgicos, apoyo en unidades especializadas, terapia nutricional y de rehabilitación. La quemadura es provocada por múltiples agentes, las más comunes ocurren por efecto térmico (fuego y líquidos calientes), el grupo etario más afectado está contituido por niños de 0 a 5 años (1). En nuestro país fallecen por esta causa, según constancia en certificados de defunción un número total de 60 niños entre 0 y 19 años (2). La mejoría de las técnicas de resucitación, ha permitido la supervivencia de estos pacientes durante la crítica etapa inicial. Durante este lapso, entre otros factores, la instalación de un apropiado apoyo nutricional ha mejorado el pronóstico y disminuido las complicaciones intrahospitalarias. Las posibilidades de sobrevivir tras un traumatismo térmico entre otros factores, están determinadas por la intensidad y extensión de la quemadura, la reserva cardiopulmonar y metabólica, estas últimas depdendientes de la edad (3)

Micronutrient regulation in pregnant and lactating wome from Rio de Janeiro / Regulación de micrnutrientes en embarazadas y mujeres lactantes de Río Janeiro

Studies with low-income pregnant and lactating women from the city of Rio de Janeiro, conceened mainly with the changes in micronutrient homeostasis during pregnancy and lactation in the absence of overt clinical deficiencies, are reported. These studies focused on folate, cobalamin, iron, zinc and vitamin A. Factors that may effect the maternal micronutrient state, such as dietary intakes, use of supplements and interrelationships of micronutrients have been considered, as well as the implications of changes for maternal-fetal transfer and milk composition. Although these studies were not designed to evaluate the prevalence of sub-clinical micronutrient deficiencies in pregnant and women, they indicate that high frequencies of sub-clinical deficiencies of folate, iron, zinc and vitamin A, especially in pregnant women, are expected to be found in Rio de Janeiro

Zinc in urban infants and children from Brasilia / Zinc en infantes y niños urbanos de Brasilia

The substandard living conditions of the poor families in the growing urban population of Brazilian cities puts children in the more vulnerable group of micronutrient deficiency. The chemical analysis of milk diets consumed by infants showed that zinc is insufficiently provided in bottle-fed infants and possibly a first-limiting nutrient in breast-fed babies, at least during the first 6 months of life

Micronutrients and urban life-style: lessons from Guatemala / Micronutrientes y estilo de vida urbana: lección de Guatemala

Guatemala is a nation of 10 million persons, at the northern point of the chain of five Republics derived from Spanish colonies on the Ishmus of Central America. The country is diverse in its ethnicities, its climate and terrain, and its agricultural pursuits. The majority of its population is poor, illiterate, and under-employed. It has had aunique and turbulent political history, and only recently has emerged. The traditional basis of the diet, dating to Mayan times, is maize and beans. Guatemala City, with its population in excess of 2 million inhabitants, having doubled since the Earthquake of 1976, is the only major metropolis. The pattern of dietary selection and the format of eating meals is changing in relationship to the size, congestion, economic evolution, and modernization of the capital city. A wider selection of foods is consumed in the city, but preparation follows the traditions of the cuisine. Street vendors play an ever larger role in the feeding of the urban poor. Quantitative data are only available for vitamin A and zinc, and only in certain subsegment of the population. The vitamin A in fortified foods, notably table sugar which is fortified with retinyl palmitate by legal mandate, makes up over one-third of the intake. The maize tortilla is an important sources of calcium, iron, zinc and copper. Average zinc intakes are appropriate, but the biological availability of the metal is low. The intake of iodine is totally dependent upon table salt which is inconsistently fortified. Data on micronutrient status exists for vitamin A, iron, iodine, riboflavin and zinc. With respect to rural areas, no major advantages or disadvantages in the adequacy of micronutrient nutriture can be calimed for the urban population. IT is probable that, in the metropolitan area, vitamin A nutriture is slightly better and riboflavin status somewhat poorer than in the countryside. The prospects for tuture directions in urban lifestyle, in micronutrient status and in their interaction are uncertain. The pressures of growth are straining the ability of the municipal infrastructure and the industrial base to respond with provision of services and employment

Micronutrient deficiency in urban Indonesia / Deficiencia de micronutrientes en area urbana de Indonesia

The economic situation of characterized by a large increase in the gross national product which has been on average 7 por ciento annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40 por ciento of the preschool children are stunted. The main stable food and source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fidth of preschool children and one fourth of elderly take micronutriens. Nevertheless are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retino <0.70 mmol/L) and 50 por ciento of pregnant women are anemic. More information is necessary on other micronutrient deficiencies. For example, a small study revealed that nearly two thirds of non-institutionalized alderly living in Jakarta experience thiamine deficiency. Appropriate interventions to reduce micronutrient deficienies should sensitiza the urban population to the fact that the government should restrict itself no use its resources to assist only the poorest individuals and groups, whereas it must be expected from the middle class to spend more to solve their own problemas