Prevalência de anemia em pré-escolares e resposta ao tratamento com suplementação de ferro / Prevalence of anemia among preschoolers and response to iron supplementation

OBJETIVOS: Avaliar a prevalência de anemia entre os pré-escolares da rede pública de Ilhabela (SP) e a resposta ao tratamento instituído. MÉTODOS: Estudo com 667 pré-escolares, entre 2007 e 2008. As crianças foram avaliadas na escola quanto ao peso, estatura e concentração de hemoglobina. As anêmicas foram tratadas com sulfato ferroso por 12 semanas, com uma consulta intermediária e outra ao final. RESULTADOS: A prevalência de anemia foi de 25,6 por cento (170 crianças). A concentração de hemoglobina mais baixa foi de 9,5 g/dL. A maior prevalência de anemia (36 por cento) ocorreu em crianças de 60 a 65 meses de idade. A mediana da concentração de hemoglobina evoluiu de 10,5 g/dL para 11,8 g/dL ao final do tratamento, recuperando 76 por cento das crianças. CONCLUSÃO: A identificação de crianças anêmicas nas escolas, o pronto tratamento da anemia e o acompanhamento durante o tratamento mostrou ser estratégia eficaz no combate a esse importante problema de saúde pública.

OBJECTIVES: To assess the prevalence of anemia among children attending public preschools in Ilhabela, state of São Paulo, Brazil, and their response to a treatment regimen. METHODS: Between 2007 and 2008, the weight, height, and hemoglobin levels of 667 children were measured in the school setting. Anemic children were prescribed a 12-week course of ferrous sulfate, and follow-up assessment visits were scheduled for halfway through this course and the end of treatment. RESULTS: The prevalence of anemia was 25.6 percent (N = 170). The lowest hemoglobin level measured was 9.5 g/dL. Anemia was most prevalent (36 percent) in children between the ages of 60 and 65 months. Median hemoglobin levels rose to 11.8 g/dL from 10.5 g/dL after treatment; 76 percent of children recovered from anemia. CONCLUSION: Screening for anemia in the school setting and prompt therapy, including mid-treatment follow-up, proved to be an effective strategy for facing this major public health issue.

Prevalence of anemia among preschoolers and response to iron supplementation.

OBJECTIVES: To assess the prevalence of anemia among children attending public preschools in Ilhabela, state of São Paulo, Brazil, and their response to a treatment regimen. METHODS: Between 2007 and 2008, the weight, height, and hemoglobin levels of 667 children were measured in the school setting. Anemic children were prescribed a 12-week course of ferrous sulfate, and follow-up assessment visits were scheduled for halfway through this course and the end of treatment. RESULTS: The prevalence of anemia was 25.6% (N = 170). The lowest hemoglobin level measured was 9.5 g/dL. Anemia was most prevalent (36%) in children between the ages of 60 and 65 months. Median hemoglobin levels rose to 11.8 g/dL from 10.5 g/dL after treatment; 76% of children recovered from anemia. CONCLUSION: Screening for anemia in the school setting and prompt therapy, including mid-treatment follow-up, proved to be an effective strategy for facing this major public health issue.

Combining stimulus direction and waveform for optimization of threshold stimulation of isolated ventricular myocytes.

Electric field stimulation is widely used for heart pacing and arrhythmia reversion. In this study, we analysed the influence of waveform and direction of external stimulating electric field on the excitation threshold of isolated ventricular myocytes. The threshold field (E(T)) was lower when the field was applied longitudinally (E(T,L)) rather than transversally (E(T,T)) to the cell major axis. Rheobase was greater for transversal stimulation, but chronaxie and estimated membrane polarization were similar for both directions. The calculated maximal variation in membrane potential at the threshold (DeltaV(T) approximately 15 mV) was insensitive to field direction. As DeltaV(T) values were similar, we assumed that the E(T,T)/E(T,L) ratio might be described solely as the ratio of the major and minor cell semi-axes. Accordingly, the ratio thus estimated was comparable to that determined experimentally. Stimulus waveform significantly affected both E(T) and DeltaV(T), which were greater for monophasic versus biphasic stimuli. Direction and waveform effects were independent. We conclude that (a) direction affects E(T) by its influence on the ability of a given field intensity to cause threshold membrane polarization and (b) threshold-lowering effects of longitudinal stimulation and biphasic waveforms apparently depend on different mechanisms, are additive and thus may be combined to decrease the energy requirement for myocardial stimulation.