The use of sweet rolls fortified with iron bis-glycinate chelate in the prevention of iron deficiency anemia in preschool children.

The effectiveness of bread fortified with iron bis-glycinate chelate for the control of iron deficiency and iron deficiency anemia was evaluated in 89 preschool children from families of low socioeconomic level attending 2 day nurseries of the Sao Paulo City Council. During the intervention's time of 6 months the children received besides their usual center's diet, a daily supplement of two sweet rolls fortified with 2 mg each of iron from the chelate for a total daily iron intake of 4 mg. After six months of intervention there was a significant decrease in the prevalence of iron deficiency anemia from 62 to 22%. There was a mean hemoglobin improvement of 1.1 g/dL, and in children with initial hemoglobin levels < 11 g/dL the mean increase in hemoglobin was 1.42 g/dL. The total mean plasma ferritin values increased from 11.34 to 20.2 micrograms/L, and in those children originally iron depleted the ferritin values normalized. A significant increase in the "z" score for weight/height was also observed. We concluded that the use of sweet rolls fortified with 2 mg of iron from the bis-glycinate chelate is highly effective for the control of iron deficiency and iron deficiency anemia in young children.

The use of sugar fortified with iron tris-glycinate chelate in the prevention of iron deficiency anemia in preschool children.

In the present work, the effectiveness of consumption for 6 months of iron fortified sugar in the prevention or control of iron deficiency anemia was evaluated in 93 children (10-48 months old) attending a day care center in São Paulo, Brazil. Each child consumed 20 g of fortified sugar per day for 5 days a week in orange juice during breakfast. Two levels of fortification were tested using iron tris-glycinate chelate as the source of iron. Level one sugar contained 10 mg of iron/kg of sugar, and level 2, 100 mg of iron/kg. The children were assigned to either of the two groups. The first group (n = 42) received level 1 sugar, and those of group two (n = 52) received level 2 sugar. The daily iron intake corresponded to 2 and 20% of the RDA. At the end of the 6 months trial period, significant increases in weight/height ratio was observed in both groups. In the group consuming level 1 fortified sugar the mean change in hemoglobin concentration was 0.4 g/dL (from 11.3 grams to 11.7 g/dL), and in the group consuming level two fortified sugar the mean hemoglobin increase was also 0.4 g/dL (from 11.6 to 12.0 g/dL). Both changes were highly significant (p < 0.001). When only the anemic children were considered (32/93), the increment of hemoglobin was 1.4 g/dL. In anemic children there was a significant increase in the levels of serum ferritin. The increase was more notorious in group 2 children. We verified that the acceptability of the iron-fortified sugar was excellent. There were no detectable changes in the organoleptic characteristics of the fortified sugar as compared with unfortified sugar. No differences in response were observed between the two groups indicating that probably the lower level of iron was absorbed more efficiently that the higher level. The iron tris-glycinate chelate was very well tolerated with no side effects registered. It was concluded that even with low iron levels, the consumption of iron fortified sugar is an effective, low cost intervention for the control and prevention of iron deficiency anemia in preschool children.

The use of sweet rolls fortified with iron bis-glycinate chelate in the prevention of iron deficiency anemia in preschool children

The effectiveness of bread fortified with iron bis-glycinate chelate for the control of iron deficiency and iron deficiency anemia was evaluated in 89 preschool children from families of low socioeconomic level attending 2 day nurseries of the Sao Paulo City Council. During the intervention's time of 6 months the children received besides their usual center's diet, a daily supplement of two sweet rolls fortified with 2 mg each of iron from the chelate for a total daily iron intake of 4 mg. After six months of intervention there was a significant decrease in the prevalence of iron deficiency anemia from 62 to 22. There was a mean hemoglobin improvement of 1.1 g/dL, and in children with initial hemoglobin levels < 11 g/dL the mean increase in hemoglobin was 1.42 g/dL. The total mean plasma ferritin values increased from 11.34 to 20.2 micrograms/L, and in those children originally iron depleted the ferritin values normalized. A significant increase in the "z" score for weight/height was also observed. We concluded that the use of sweet rolls fortified with 2 mg of iron from the bis-glycinate chelate is highly effective for the control of iron deficiency and iron deficiency anemia in young children.

Laparoscopic transhiatal esophagectomy with esophagogastroplasty.

Twelve patients with benign and malignant esophageal diseases were treated by transhiatal esophagectomy, without thoracotomy, using abdominal-mediastinal dissection conducted by videolaparoscopy. A cervical approach was used to retrieve the esophagus and to perform the esophagogastric anastomosis. The procedure was indicated in patients with advanced achalasia of the esophagus, severe reflux stenosis, squamous cell carcinoma, and adenocarcinoma of the esophagus. Three pleural perforations occurred during surgery. Blood loss was minimal. One patient required conversion to open surgery, two patients were submitted to chest drainage, and three had transitory dysphonia. One patient had an anastomotic leak with subsequent stenosis requiring endoscopic dilatation. No mortality occurred in this small series.

[Hemobilia due to chronic cholecystitis. A case report]. / Hemobilia decorrente de colecistite crônica. Relato de caso.

The authors report a case of hemobilia in which a fistula was created by corrosion of the cystic artery into the gallbladder. The value of arteriography in diagnosis is emphasized. Cholecystectomy was the definitive treatment.