Acute effects of foam rolling on ankle dorsiflexion and squat exercise patterns in extreme conditioning program practitioners: A randomized clinical trial.

BACKGROUND/OBJECTIVES: Joint and muscle overloads commonly occur in extreme conditioning programs (ECP), which require great physical fitness for their practice. For its execution, good functional performance, mobility and adequate movement patterns are required. The fascial system plays a fundamental role in performance in ECP and one of the techniques used to improve joint mobility and movement pattern is the self-myofascial release using a foam roller (FR). Our objective of this study was to evaluate the effect of FR in ankle dorsiflexion (DF) range of motion (ROM), assessed with the Lunge Test, and also in the squat movement pattern, assessed using the Technique smartphone application, in ECP practitioners. METHODS: The study was carried out with 18 ECP practitioners who practiced for over four months and had a mean age of 30.94 years. The participants were randomized and allocated into two groups: control and intervention. The FR was self-applied bilaterally in the sural triceps region for 90 seconds. Tests to assess DF ROM and squat movement pattern were applied before and immediately after using FR (intervention group) or after three-minute rest (control group). RESULTS: The use of the FR promoted an immediate increase in ankle DF ROM during the Lunge Test and during the squat and a decrease in dynamic knee valgus during the squat. CONCLUSION: The FR can be used as a tool for an acute increase in DF ROM and a decrease in dynamic knee valgus, having a positive impact in improving movement patterns.

Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain.

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. OBJECTIVES: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. METHOD: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. RESULTS: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

Dietary Intake of Flaxseed Oil since Early Stages of Life Promotes Femur Quality in Male Rats.

BACKGROUND: Flaxseed oil (FO) is an alpha linolenic acid source important for growth and body development. However, there is little literature on the role of FO in critical stages of bone development and formation. OBJECTIVE: This study evaluated the influence of a diet containing FO on rat femurs. METHODS: After birth, mothers and pups were divided into control and flaxseed groups (n = 6 pups each) fed diets containing 7% soybean oil (C) or 7% FO. At 21 days, pups were weaned and separated from the mothers, and control or experimental diets were continued. At 67 days, the following were analyzed: osteocalcin and osteoprotegerin (OPG) levels, bone mineral density (BMD) and content, and bone area; the dimension, BMD, head radiodensity, and biomechanical proprieties of the right femur; and histomorphometric parameters of the left femur. RESULTS: Compared to the C group, the FO group presented (p < 0.05) a lower body mass (-3.7%) and medullary area (-10.1%) and higher osteocalcin (+36.7%), OPG (+52.5%), femur width (+3.8%), absolute mass (+2.3%), femur BMD (+3.6%), head radiodensity (+6.1%), maximum force (+7.4%), breaking strength (+17.3), and cortical thickness (+7.0). CONCLUSION: The FO diet contributed to femur quality in healthy male Wistar rats.

El cuidado humanizado en oncología pediátrica y la aplicación del juego por la enfermería / Humanised care in paediatric oncology and the application of play by nurses

Resumen Objetivo: Discutir el cuidado humanizado en oncología pediátrica, entendiendo la percepción y aplicación del juego por parte del equipo de enfermería. Método: Este fue un estudio cualitativo realizado con 13 profesionales del equipo de enfermería de un hospital oncológico brasileño. Los datos fueron recopilados de octubre de 2017 a febrero de 2018, a través de un guion de entrevista. Resultados: Se elaboraron tres categorías: el significado del cuidado en oncología pediátrica para el equipo de enfermería, percepción del juego para el equipo de enfermería en el cuidado de niños y niñas con cáncer y estrategias que contribuyen a la aplicación del juego en el cuidado. Estas últimas indicaban que el juego es una herramienta importante que favorece la comunicación, permitir la expresión de sentimientos y permiten el rescate del mundo infantil. Conclusión: Los profesionales de enfermería perciben la importancia del uso de estrategias lúdicas en el cuidado en oncología pediátrica, ya que permiten la aproximación de las niñas y los niños con el mundo infantil. Para ello, se evidenció la importancia del uso de las tecnologías leves y duras en la atención, permitiendo el ejercicio de la humanización.

Abstract Objective: To discuss humanised care in paediatric oncology, understanding the perception and application of the game by the nursing team. Methods: This was a qualitative study carried out with 13 professionals from the nursing team of a Brazilian oncology hospital. The data was collected from October 2017 to February 2018, through an interview script. Results: Three categories were developed: the meaning of care in paediatric oncology for the nursing team, perception of play for the nursing team in the care of children with cancer and strategies that contribute to the application of play in care. The latter indicated that play is an important tool that promotes communication, allows the expression of feelings and allows the rescue of the child's world. Conclusion: Nursing professionals perceive the importance of the use of playful strategies in paediatric oncology care, since they allow the approach of children to the child's world. For this purpose, the importance of the use of light and hard technologies in the care was evidenced, allowing the exercise of humanization.

Resumo Objetivo: Discutir o cuidado humanizado em oncologia pediátrica, compreendendo a percepção e aplicação do lúdico pela equipe de enfermagem. Métodos: Este foi um estudo qualitativo realizado com 13 profissionais da equipe de enfermagem de um hospital de oncologia brasileiro. Os dados foram coletados entre Outubro de 2017 e Fevereiro de 2018, através de entrevista guiada por um roteiro. Resultados: Foram elaboradas três categorias: o significado dos cuidados em oncologia pediátrica para a equipe de enfermagem, a percepção do jogo para a equipe de enfermagem no cuidado de crianças com câncer e estratégias que contribuem para a aplicação do lúdico nos cuidados. Este último indicou que o jogo é um instrumento importante que favorece a comunicação, permite a expressão de sentimentos e permite o resgate do mundo da criança. Conclusão: Os profissionais de enfermagem percebem a importância da utilização de estratégias lúdicas nos cuidados oncológicos pediátricos, uma vez que permitem a aproximação ao mundo da criança. Para tal, foi evidenciada a importância do uso de tecnologias leves e duras nos cuidados, permitindo o exercício da humanização.

Effect of maternal and postnatal cocoa supplementation on testicles of adult Wistar rats.

Early weaning can lead to changes in the morphology of organs in adulthood, and the consumption of functional foods during lactation and postnatal life is believed to prevent these changes. However, it is not known if early weaning affects testicular morphology and if the use of cocoa can prevent that. We studied the effects of maternal and postnatal supplementation of cocoa powder on the testicular morphology of early weaned adult rats. The animals were divided into four groups (n = 6 each), control group, cocoa control group, early weaning (EW) group, and cocoa early weaning (EWCa) group, and were analyzed for 90 d, after which they were euthanized. The animals from the EW group showed a reduction in the tubular diameter and height of the seminiferous epithelium, a decrease in epithelial surface density (Sv), and an increase in the lumen and proper tunic. However, the animals from the EWCa group showed an increase in the diameter and height of the epithelium, an increase in the epithelium Sv, and a decrease in the lumen and the proper tunic. The early weaning promotes morphological changes in the testicles; however, supplementation with cocoa powder can preserve the testicular histoarchitecture.

Prevalência de anemia e deficiência de vitamina A e consumo de ferro e de vitamina A entre crianças usuárias do Sistema Único de Saúde na cidade do Rio de Janeiro, Brasil / Prevalence of anemia and vitamin A deficiency and iron and vitamin A intake in children that use the Brazilian Unified National Health System in Rio de Janeiro, Brazil / Prevalencia de anemia, deficiencia de vitamina A, y consumo de hierro y de vitamina A entre niños pacientes del Sistema Único de Salud en la ciudad de Río de Janeiro, Brasil

Estratégias nacionais para o controle de anemia e deficiência de vitamina A em crianças estão baseadas em estimativas de suas prevalências produzidas em âmbito nacional em 2006 com métodos não validados para este grupo etário e com nível de desagregação para macrorregiões. Com o intuito de subsidiar a gestão local para o (re)direcionamento de medidas de controle desses agravos, o presente trabalho apresenta estimativas de sua prevalência e, também, de marcadores de consumo alimentar de fontes de micronutrientes e do uso de suplementos de vitaminas e minerais em amostra probabilística de crianças de 6 a 59 meses, usuárias da atenção básica de saúde do Município do Rio de Janeiro, Brasil (n = 536). Foram coletadas amostras de sangue venoso para análise de hemoglobina, ferritina e retinol sérico e dados sobre o consumo alimentar, o uso de suplementos de vitaminas e minerais e as características sociodemográficas. As prevalências de anemia, anemia ferropriva e deficiência de vitamina A foram de, respectivamente, 13,7%, 5,5% e 13%. Quase todas as crianças haviam consumido alimentos ricos em ferro no dia anterior à entrevista, sendo altas as prevalências de consumo de fontes de origem animal. Somente 49,4% haviam consumido alimentos ricos em vitamina A. As prevalências de uso de algum suplemento, de suplemento com ferro e com vitamina A foram de, respectivamente, 51%, 14,7% e 24,4%. Os resultados apontam a necessidade de redirecionamento das estratégias de prevenção e controle de anemia e deficiência de vitamina A. Estudos futuros são necessários para examinar a evolução desses indicadores, tendo em vista as políticas de austeridade que entraram em vigor nos últimos anos e a crise econômica decorrente da pandemia da COVID-19.

Brazilian national strategies for the control of anemia and vitamin A deficiency in children are based on estimates of their nationwide prevalence rates in 2006 with methods not validated for this age group and with disaggregation at the level of major geographic regions. To back local administrations in (re)directing control measures for these two disorders, the current study presents estimates of their prevalence and markers of dietary intake of sources of micronutrients and use of vitamin and mineral supplements in a probabilistic sample of children 6 to 59 months of age, users of primary healthcare in the city of Rio de Janeiro, Brazil (n = 536). Venous blood samples were drawn for analysis of hemoglobin, ferritin, and serum retinol, besides collection of data on food consumption, use of vitamin and mineral supplements, and sociodemographic characteristics. Prevalence rates for anemia, iron deficiency anemia, and vitamin A deficiency were 13.7%, 5.5%, and 13%, respectively. Nearly all the children had consumed iron-rich food the day before the interview, with high prevalence of animal sources. Only 49.4% had consumed foods high in vitamin A. The prevalence rates for use of any supplement, iron supplements, and vitamin A supplements were 51%, 14.7%, and 24.4%, respectively. The findings point to the need to redirect the strategies for prevention and control of anemia and vitamin A deficiency. Future studies are necessary to examine trends in these indicators, focusing on austerity policies implemented in recent years and the economic crisis resulting from the COVID-19 pandemic.

Las estrategias brasileñas para el control de anemia y deficiencia de vitamina A en niños están basadas en estimaciones de sus prevalencias, producidas en el ámbito nacional en 2006 con métodos no validados para este grupo etario, y con un nivel de desagregación en las macrorregiones. Con el fin de apoyar la gestión local para la (re)orientación de medidas de control de esos problemas de salud, este trabajo presenta estimaciones de su prevalencia y, también, de los marcadores de consumo alimentario de fuentes de micronutrientes y del uso de suplementos de vitaminas y minerales, en una muestra probabilística de niños de 6 a 59 meses, pacientes de atención básica de salud del Municipio de Río de Janeiro, Brasil (n = 536). Se recogieron muestras de sangre venosa para el análisis de hemoglobina, ferritina y retinol sérico, así como datos sobre el consumo alimentario, de suplementos de vitaminas y minerales, así como de características sociodemográficas. Las prevalencias de anemia, anemia ferropénica y deficiencia de vitamina A fueron de, respectivamente, 13,7%, 5,5% y 13%. Casi todos los niños habían consumido alimentos ricos en hierro el día anterior a la entrevista, siendo altas las prevalencias de consumo de fuentes de origen animal. Solamente un 49,4% habían consumido alimentos ricos en vitamina A. Las prevalencias de consumo de algún suplemento, de suplemento con hierro y de suplemento con vitamina A fueron de, respectivamente, 51%, 14,7% y 24,4%. Los resultados apuntan la necesidad de reorientar las estrategias de prevención y control de la anemia y deficiencia de vitamina A. Se necesitan estudios futuros para examinar la evolución de esos indicadores, teniendo en vista las políticas de austeridad que entraron en vigor en los últimos años y la crisis económica a consecuencia de la pandemia de COVID-19.

Saúde dos trabalhadores de enfermagem: revisando as estratégias de promoção à saúde / The health of nursing professionals: reviewing health promotion strategies / Salud de los trabajadores de enfermería: revisando las estrategias de promoción a la salud

Objective: The study's purpose has been to further understand the health promotion strategies towards nursing professionals. Methods: It is an integrative literature review with a qualitative approach, which is composed of 23 articles that answer the following guiding question: What are the health promotion strategies developed for nursing professionals? Results: The findings were gathered into four strategy groups, as follows: Promoting the Work Planning, which are based on regulating the workload and salary relationship; Promoting Knowledge, which are focused on the professional update through the use of technologies; Promoting Physical Activity, aiming to guarantee the access to physical exercise, both intra and extra the work environment; and, Promoting Integrative and Complementary Practices, indicating music therapy, relaxation techniques and yoga, which together with the other ones might contribute to reduce work stress, musculoskeletal and cardiovascular problems. Conclusion: The work planning can be considered the main strategy of health promotion for nursing professionals, since it is associated with the development of the others

Objetivo: Conhecer as estratégias de promoção à saúde para os trabalhadores de enfermagem. Método: Revisão integrativa composta por 23 artigos que respondem a questão norteadora: Quais as estratégias de promoção à saúde, desenvolvidas para os trabalhadores de enfermagem? Aplicou-se uma abordagem qualitativa. Resultados: As estratégias para Promoção da Organização do Trabalho pautam-se na regulação da relação carga de trabalho e salário. As do Conhecimento, na atualização profissional com uso de tecnologias. Já as da Atividade Física, na garantia do acesso ao exercício físico, intra e extra, ambiente de trabalho. As de Promoção de Práticas Integrativas e Complementares indica a musicoterapia, as técnicas de relaxamento e yoga, que em conjunto com as demais, contribuem para reduzir o estresse laboral e problemas musculoesqueléticos e cardiovasculares. Conclusão: A organização do trabalho pode ser considerada a principal estratégia de promoção à saúde para trabalhadores de enfermagem, pois a ela associa-se o desenvolvimento das demais

Objetivo: Conecer las estrategias de promoción a la salud para los trabajadores de enfermería. Método: Revisión integrativa compuesta por 23 artículos que responden a la cuestión orientadora: ¿Cuáles son las estrategias de promoción a la salud, desarrolladas para los trabajadores de enfermería? Se aplicó un enfoque cualitativo. Resultados: Las estrategias para Promoción de la Organización del Trabajo se basan en la regulación de la relación carga de trabajo y salario. Las del Conocimiento, en la actualización profesional con uso de tecnologías. Las de la Actividad Física, en la garantía del acceso al ejercicio físico, intra y extra, ambiente de trabajo. Las de Promoción de Prácticas Integrativas y Complementarias indica la musicoterapia, las técnicas de relajación y yoga, que en conjunto con las demás, contribuyen para reducir el estrés laboral y problemas musculoesqueléticos y cardiovasculares. Conclusión: La organización del trabajo puede ser considerada la principal estrategia de promoción a la salud para trabajadores de enfermería, pues a ella se asocia el desarrollo de las demás

Effects of red wine, grape juice and resveratrol consumption on bone parameters of Wistar rats submitted to high-fat diet and physical training / Efectos del consumo de vino rojo, jugo de uva y reservatrol sobre los parámetros óseos de las ratas Wistar presentadas con dieta rica en grasas y entrenamiento físico

Introduction: intake of diets with high saturated fat may produce deleterious effects on bone mineralization. Lifestyle changes help reduce the bone loss observed in osteoporosis. Resveratrol, present in grape juice and red wine, has osteogenic and osteoinductive effects, being potentially beneficial for bone health. Objective: to evaluate the effects of red grape juice, red wine and resveratrol consumption on bone parameters in Wistar rats submitted to a high-fat diet and physical training. Method: female Wistar rats, with 90 days of age, were divided into five groups and followed up for 60 days: a) control group; b) high-fat group; c) grape juice group; d) red wine group; and e) resveratrol group. The different groups of animals performed a physical training protocol. Animal's weight and consumption were monitored weekly. After 60 days, femoral dimensions, bone mineral density (BMD) and bone mineral content (BMC) were evaluated. Results: there was no difference in body mass; however, all groups consuming the high-fat diet had higher consumption (p < 0.05). RWG presented a greater distance between the epiphyses, femoral mass and BMC (p < 0.05). RWG and RG presented greater mean diaphysis point width and BMD (p < 0.05). Conclusion: the results suggest that the bioactive compounds present in red wine and resveratrol solution together with regular exercise were able to promote beneficial effects on bone health, even when associated with a high saturated fat diet

Introducción: el consumo de dietas ricas en grasas saturadas puede producir efectos nocivos sobre la mineralización ósea. Los cambios en el estilo de vida ayudan en la reducción de la pérdida ósea que se produce en la osteoporosis. El resveratrol, presente en el zumo de uva y el vino tinto, tiene efectos osteogénicos y osteoinductores, y es potencialmente beneficioso para la salud ósea. Objetivo: evaluar los efectos del consumo de zumo de uva roja, vino tinto y resveratrol sobre los parámetros óseos en ratas sometidas a una dieta alta en grasa y entrenamiento físico. Métodos: ratas Wistar, hembras, con 90 días, fueron divididas en cinco grupos y monitorizadas durante 60 días: a) grupo de control; b) grupo hiperlipidemia; c) grupo zumo de uva roja; d) grupo de vino tinto; y e) grupo de resveratrol. Los distintos grupos de animales fueron sometidos a un protocolo de entrenamiento físico. El peso y el consumo de los animales se monitorizaron semanalmente. Después de 60 días, se evaluaron el tamaño del fémur, la densidad mineral ósea (DMO) y el contenido mineral óseo (CMO). Resultados: no hubo diferencias en el consumo, sin embargo, todos los grupos que consumieron la dieta rica en grasas tenían un mayor consumo (p < 0,05). GV tenía una mayor distancia entre las epífisis, mayor tamaño del fémur y un mayor CMO (p < 0,05). SGS y GR tenía mayor anchura media de diáfisis y una mayor DMO (p < 0,05). Conclusión: Los resultados sugieren que los compuestos bioactivos presentes en el vino tinto y la solución de resveratrol, combinados con el ejercicio físico regular, fueron capaces de promover efectos beneficiosos sobre la salud ósea, incluso cuando se asocian con una dieta alta en grasas saturadas

Health and Labour from the Perspective of Railway Dock workers in Rio Grande do Sul, Brazil / Saúde e Trabalho na visão de trabalhadores da estiva do Porto Ferroviário, Rio Grande do Sul, Brasil

The main goal of this study is to understand and analyse the perspective of dockworkers on health and labour at the Railway Dry Port of the Municipality of Uruguaiana in the State of Rio Grande do Sul (RS), Brazil. Sixteen dockworkers participated in the study under the methodological approach of qualitative research. The fieldwork was conducted through individual interviews by applying a semi-structured research script with open-ended questions. For the data analysis, the "discourse analysis" method was adopted, leading to the definition of five thematic categories of interpretation. From the perspective of dockworkers, dock work differs in both the weight of toil, which is hard and intense, and the sense of satisfaction regarding the collaborative and collective aspect of labour, emphasising the human side of labour. Several reports on work accidents and the identification of hazards that may be avoided by implementing changes in the organisation and work conditions were also noted.

O objetivo principal deste artigo é conhecer e analisar a visão dos trabalhadores da estiva sobre a saúde e o trabalho no Porto Seco Ferroviário, do Município de Uruguaiana, no Estado do Rio Grande do Sul. Participaram do estudo dezesseis estivadores sob a perspectiva metodológica da pesquisa qualitativa. O trabalho de campo ocorreu mediante a realização de entrevistas individuais, por meio da aplicação de um roteiro de pesquisa semiestruturado com perguntas abertas. Quanto à análise dos dados, foi adotada a técnica de "análise do discurso", chegando-se à definição de cinco categorias temáticas de interpretação. Constatou-se que, na perspectiva dos trabalhadores, o trabalho na estiva se distingue tanto pelo peso da labuta, árdua e intensa, quanto pelo sentido de satisfação no tocante ao aspecto colaborativo e coletivo do trabalho, enfatizando o lado humano do labor. Observaram-se ainda muitos relatos sobre acidentes de trabalho e a identificação de riscos que podem ser evitados mediante a implementação de mudanças na organização e nas condições de trabalho.

Análise clínica e radiográfica pré e pós-tratamento conservador na escoliose idiopática do adolescente: estudo de caso / Clinical and radiographic analysis before and after conservative treatment in adolescent idiopathic scoliosis: a case study

Introdução: Escoliose Idiopática do Adolescente (EIA) é uma doença de causa desconhecida e diagnosticada em indivíduos com idade igual ou superior a 10 anos. A base do tratamento é uma avaliação fidedigna, compreendendo anamnese, exame físico e obtenção de radiografia. A avaliação clínica compreende o teste de Adams, análise postural e cálculo do ângulo de Cobb. Objetivo: Analisar alterações clínicas e radiográficas pré e pós-tratamento conservador em paciente portador de EIA. Métodos: Os recursos terapêuticos utilizados foram técnicas de iso-streching, terapia manual e órtese toracolombossacra. Resultados: Ao finalizar 30 sessões, os dados foram analisados por comparação entre as avaliações pré e pós-tratamento fisioterapêutico, e teve como parâmetros os resultados do teste de Adams, do ângulo de Cobb e da análise fotográfica. A paciente apresentou diminuição da gibosidade no teste de Adams, redução do ângulo de Cobb em 6º e melhora postural. Conclusão: Com o tratamento conservador da EIA, obtiveram-se resultados clínicos e radiográficos significativos.

Introduction: Idiopathic Adolescent Scoliosis (IAS) is a disease of unknown cause and diagnosed in individuals at the age of 10 years or over. The base of the treatment is a reliable assessment, including medical history, physical examination and radiographs. The clinical evaluation includes Adams test, postural analysis and calculation of the Cobb?s angle. Objective: To analyze clinical and radiographic changes before and after conservative treatment in patient with IAS. Methods: The resources used were therapeutic techniques for isostretching, manual therapy and thoracolumbar sacral orthosis. Results: After 30 sessions of physiotherapy, the results were analyzed by a comparison of ratings pre and post treatment, and the parameters used were the results of Adams test, Cobb?s angle and photographic assessment. The patient presented the gibbosity reduction in Adams test, decrease of Cobb angle of 6 degrees and postural improvement. Conclusion: The conservative treatment of IAS achieved significant clinical and radiographic results.

Efetividade da suplementação diária ou semanal com ferro na prevenção da anemia em lactentes / Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants / Efectividad en el suplemento diario o semanal de hierro en la prevención de anemia en lactantes

OBJETIVO: Avaliar a efetividade da suplementação universal profilática com sulfato ferroso, em administração diária ou semanal, na prevenção da anemia em lactentes. MÉTODOS: Ensaio de campo randomizado com crianças de seis a 12 meses de idade, atendidas em unidades básicas de saúde do município do Rio de Janeiro, em 2004-2005. Foram formadas três coortes concorrentes com suplementação universal com sulfato ferroso com grupos: diário (n=150; 12,5mgFe/dia), semanal (n=147; 25mgFe/semana) e controle (n=94). A intervenção durou 24 semanas e foi acompanhada por ações educativas promotoras de adesão. A concentração de hemoglobina sérica foi analisada segundo sua distribuição, média e prevalência de anemia (Hb<110,0g/L) aos 12 meses de idade. A avaliação da efetividade foi realizada segundo intenção de tratar e adesão ao protocolo, utilizando-se análises de regressão múltipla (linear e de Poisson). RESULTADOS: Os grupos mostraram-se homogêneos quanto às variáveis de caracterização. A intervenção foi operacionalizada com sucesso, com elevada adesão ao protocolo em ambos os grupos expostos a ela, sem diferença estatística entre eles. Após ajuste, somente o esquema diário apresentou efeito protetor. Na análise por adesão, o esquema diário apresentou evidente efeito dose-resposta para média de hemoglobina sérica e prevalência de anemia, não sendo observado nenhum efeito protetor do esquema semanal. CONCLUSÕES: Apenas o esquema diário de suplementação universal com sulfato ferroso dos seis aos 12 meses de idade foi efetivo em aumentar a concentração de hemoglobina sérica e em reduzir o risco de anemia.

Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants.

OBJECTIVE: To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants. METHODS: Randomized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro, Brazil, between 2004 and 2005. Three concurrent cohorts were compared: daily group (n=150; 12.5mg Fe/day); weekly group (n=147; 25mg Fe/week) and control group. The intervention consisted of universal supplementation with iron sulfate for 24 weeks, combined with educational adherence-promoting measures. OUTCOME: mean serum hemoglobin concentration, distribution and prevalence of anemia (Hb<110.0 g/l) at age 12 months. Effectiveness was evaluated considering both intent to treat and adherence to protocol, using multiple regression analysis (linear and Poisson). RESULTS: Groups were homogeneous in terms of descriptive variables. The intervention was implemented successfully, with high adhesion to protocol in both groups, and no statistical difference between them. After adjustment, only the daily regimen showed a protective effect. Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen. No protective effect was detected for the weekly regimen. CONCLUSIONS: Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis.