A study of the interleukin-1 gene cluster polymorphisms and inflammatory external root resorption in replanted permanent teeth.

AIM: To investigate whether single nucleotide polymorphisms (SNPs) within the interleukin-1 gene cluster (IL1) are associated with the occurrence and severity of inflammatory external root resorption (IERR) after replantation of avulsed permanent teeth. METHODOLOGY: Indexes of IERR were radiographically assessed in 182 mature replanted permanent teeth from 146 patients at the onset of endodontic therapy. DNA was extracted from buccal mucosa cells and genotyped using TaqMan probes-based assays for the SNPs IL1A -889C/T (rs 180058), IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598). Teeth were grouped into two categories: IERR absent to mild (indexes ≤ 4) and moderate to severe IERR (indexes > 4). Genetic variations in the IL1 gene cluster were tested for their effect on the occurrence and extension of IERR using the GEE model (generalized estimation equation). Patient's age at the moment of injury, timing of pulpectomy, extra-alveolar period and storage condition of the avulsed teeth was included as possible confounders. RESULTS: No association was found between SNPs IL1A -889C/T, IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598) and IERR indexes. Timing of pulpectomy (OR 3.5 IC 95% 2.0-6.2 P < 0.001) and patient's age at the moment of trauma (OR 0.29 IC 95% 0.12-0.67 P = 0.004) significantly affected the risk of developing severe IERR. CONCLUSIONS: While timing of pulpectomy and patient's age at the moment of trauma were confirmed as important risk factors, SNPs within the IL1 gene cluster did not affect the susceptibility for IERR after replantation of permanent teeth.

Plantas medicinais da Bacia do Rio das Velhas: avaliação das condições para produção e uso em saúde pública / Medicinal plants of the Rio das Velhas watershed region: potential for production and use in public health

RESUMO O desenvolvimento de projetos que contemplem o cultivo e beneficiamento de plantas medicinais, com qualidade, é urgente e necessário, especialmente quando se considera a expansão da oferta desses produtos para o Sistema Único de Saúde (SUS). Nesta pesquisa, foi avaliada a existência de iniciativas que produzem e disponibilizam plantas medicinais de interesse do SUS, em municípios que compõem a Bacia Hidrográfica do Rio das Velhas (BHRV), em Minas Gerais. Foram visitados 45 municípios da Bacia buscando informações sobre atividades já existentes de produção e uso coletivo de plantas medicinais. Os dados sobre plantas medicinais já existentes foram posteriormente confrontados com informações epidemiológicas, como as principais causas de internações hospitalares e cobertura de equipes da Estratégia da Saúde da Família (ESF). A pesquisa evidenciou a existência de atividades filantrópicas e comerciais, relativas à utilização coletiva de plantas medicinais, apenas em Belo Horizonte, Capim Branco, Curvelo, Lassance, Nova Lima e Sete Lagoas. Vinte e sete espécies, nativas e exóticas, presentes na RDC 10/2010 da Anvisa são produzidas nessas iniciativas, e elas ocorrem tanto de forma espontânea como por meio de cultivo. A correlação das principais causas de internação hospitalar com as espécies vegetais disponíveis revelou potenciais locais de aproveitamento das plantas, inclusive pela ESF. O desenvolvimento da cadeia produtiva, trabalhando desde o cultivo até a dispensação aos usuários do SUS, pode representar uma oportunidade de integração de diferentes atores e instituições da região, além de incrementar o desenvolvimento econômico-social e a preservação da biodiversidade local.

ABSTRACT The development of projects that include the cultivation and processing of medicinal plants with quality is urgent and necessary, especially when considering the offer increase of these products to the Unified Health System (SUS). In this study, we evaluated the potential of the Rio das Velhas" watershed region (BHRV) in producing and using medicinal plants. We visited 45 cities of the watershed, seeking information about existing production and collective use of medicinal plants. Afterwards, the data obtained in the fieldwork were confronted with epidemiological information, such as hospitalization rates and coverage of the Family Health Strategy. The research showed the existence of commercial and philanthropic activities in Belo Horizonte, Capim Branco, Curvelo, Lassance, Nova Lima and Sete Lagoas. Twenty-seven species, native and exotic ones, included in the 10/2010 Resolution edited by the Brazilian Health Surveillance Agency (Anvisa), are produced in these initiatives, and they occur both spontaneously and through cultivation. The correlation of the leading causes for hospitalization and the available plant species showed potential use of local plants, including by the Family Health Strategy. The development of the production chain, from the plants" cultivation to the medicines" dispensation for the SUS users, may represent an opportunity of integration of different actors and institutions in the region, besides increasing the economic and social development and contributing to the preservation of local biodiversity.

Screening for congenital hypothyroidism in extreme premature and/or very low birth weight newborns: the importance of a specific protocol.

BACKGROUND: Neonatal screening for congenital hypothyroidism (CH) in premature infants is not as well established as in term newborns regarding age and number of samples. AIMS: 1. To evaluate the effectiveness of the protocol recommended by the Neonatal Screening Program of the State of Minas Gerais (PETN-MG) for CH neonatal screening in very low birth weight premature infants. 2. To estimate the prevalence of delayed TSH elevation and thyroid function alterations in the target population. METHODS: TSH was assessed by ELISA on the 5th, 10th and 30th days of life in all newborns with gestational age <32 weeks and/or very low birth weight (VLB) (<1,500 g) in the period from October 2004 to September 2006. RESULTS: Out of the 14,462 newborns screened, 2,647 were premature with gestational age <32 weeks and/or VLB. Forty-four cases of altered TSH were found and 11 infants underwent treatment. Delayed TSH elevation was detected in 66% of altered cases. Five out of the 11 cases were detected in the second sample and five cases were only detected in the third sample. CONCLUSION: The high prevalence of thyroid function alterations that demanded treatment (1:242) and delayed TSH elevation in VLB premature infants reinforce the need for a specific protocol, based on retesting procedures, for CH neonatal screening.

Efficacy of glutamine-supplemented parenteral nutrition on short-term survival following allo-SCT: a randomized study.

Fifty-three patients with hematological malignancies who underwent Allo-SCT from HLA-identical siblings were randomly assigned to receive glutamine-enriched parenteral nutrition-PN (GlPN, n=27) or standard PN (PN, n=26), in isonitrogenous solutions. Deaths (D+100 and D+180), infections, acute GVHD, length of stay, time of neutropenia and intestinal permeability (IP) were studied. Ages, gender, diagnosis, disease status and treatment variables were equally distributed between groups. Survival on D+180 was increased in GlPN (74%) vs PN (46%), P=0.03 (log-rank), as on D+100 (P=0.05). Most deaths occurred before D+100, especially in PN (10/26, 39%) vs GlPN (4/27, 15%). GVHD was the most frequent cause of death (8/21, 38%), especially in PN (n=6, five before D+100). Other outcomes were not affected. IP was affected on admission, was not affected by glutamine enrichment, but consistently worsened throughout the study. Results showed that GlPN was efficacious in increasing short-term survival after Allo-SCT. Benefits of glutamine seem to be independent of mucosal protection, as IP was not affected by its use. A trend to a lower incidence of GVHD deaths may suggest an immunomodulatory role of glutamine.

Long term follow up of rheumatic fever and predictors of severe rheumatic valvar disease in Brazilian children and adolescents.

OBJECTIVES: To investigate the progress of rheumatic fever (RF) and the predictors of severe chronic valvar disease. DESIGN: Patients prospectively followed up since their first attack of acute RF (ARF). SETTING: Universidade Federal de Minas Gerais, Brazil. PATIENTS: 258 children and adolescents who met the revised Jones criteria for RF. The follow up period ranged from 2-15 years. MAIN OUTCOME MEASURES: The presence and severity of mitral or aortic valvar disease were determined by both clinical and Doppler echocardiographic examinations. The variables associated with severe chronic valvar disease were initially identified by the Kaplan-Meier method and, later, by multivariate analysis. RESULTS: Doppler echocardiography of 258 patients studied showed that 186 (72.1%) developed chronic valvar disease and 41 (15.9%) progressed to severe chronic mitral or aortic lesions. Of 146 patients who developed carditis, 49 (33.6%) had a normal clinical examination in the chronic phase but only nine (6.2%) had normal Doppler echocardiographic findings--that is, 40 (27.4%) patients progressed to chronic subclinical valvar disease. Moderate or severe carditis, recurrences of ARF, and mother's low educational level were risk factors in predicting severe chronic valvar diseases. CONCLUSION: The increased risk of progressing to severe chronic valvar disease was associated with moderate or severe carditis, recurrences of ARF, and mother's low educational level. Hence, in a country such as Brazil, the options available for disease control are mainly primary and secondary prophylaxis.

Arterial blood pressure of term newborns during the first week of life.

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 +/- 6, 24 +/- 6 and 72 +/- 24 h and on the 7th +/- 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement.

Arterial blood pressure of term newborns during the first week of life

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 ± 6, 24 ± 6 and 72 ± 24 h and on the 7th ± 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement

Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children

The objective of the present study was to evaluate associations between fiber intake, colonic transit time and stool frequency. Thirty-eight patients aged 4 to 14 years were submitted to alimentary evaluation and to measurement of colonic transit time. The median fiber intake of the total sample was age + 10.3 g/day. Only 18.4 percent of the subjects presented a daily dietary fiber intake below the levels recommended by the American Health Foundation. In this group, the median left colonic transit time was shorter than in the group with higher dietary fiber intake (11 vs 17 h, P = 0.067). The correlation between stool frequency and colonic transit time was negative and weak for left colon (r = -0.3, P = 0.04), and negative and moderate for rectosigmoid and total colon (r = -0.5, P<0.001 and r = -0.5, P<0.001, respectively). The stool frequency was lower in the group with slow transit time (0.8 vs 2.3 per week, P = 0.014). In conclusion, most patients with chronic functional constipation had adequate dietary fiber intake. The negative correlation between stool frequency and colonic transit time increased progressively from proximal segments to distal segments of the colon. Patients with normal and prolonged colonic transit time differ in terms of stool frequency

Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children.

The objective of the present study was to evaluate associations between fiber intake, colonic transit time and stool frequency. Thirty-eight patients aged 4 to 14 years were submitted to alimentary evaluation and to measurement of colonic transit time. The median fiber intake of the total sample was age + 10.3 g/day. Only 18.4% of the subjects presented a daily dietary fiber intake below the levels recommended by the American Health Foundation. In this group, the median left colonic transit time was shorter than in the group with higher dietary fiber intake (11 vs 17 h, P = 0.067). The correlation between stool frequency and colonic transit time was negative and weak for left colon (r = -0.3, P = 0.04), and negative and moderate for rectosigmoid and total colon (r = -0.5, P<0.001 and r = -0.5, P<0.001, respectively). The stool frequency was lower in the group with slow transit time (0.8 vs 2.3 per week, P = 0.014). In conclusion, most patients with chronic functional constipation had adequate dietary fiber intake. The negative correlation between stool frequency and colonic transit time increased progressively from proximal segments to distal segments of the colon. Patients with normal and prolonged colonic transit time differ in terms of stool frequency.

[Postneonatal infant mortality and quality of medical care: a case-control study] / Mortalidade infantil pós-neonatal e qualidade da assistência médica: um estudo caso-controle.

OBJECTIVE: To identify the risk factors for postneonatal infant mortality caused by diarrhea and pneumonia in relation to the quality of medical assistance. METHODS: Population-based case-control study of 277 postneonatal infant deaths caused by diarrhea and pneumonia occurring in the metropolitan area of Belo Horizonte, Brazil, between May/1991 and April/1992. The cases were compared with hospitalized controls, and matched by pathology, age and hospital. Information on cases and controls were collected from medical records and through home interviews. Some variables related to the quality of medical care were analyzed. McNemar test and conditional logistic regression were used to define the risk factors for postneonatal deaths. RESULTS: Multiple logistic regression analysis showed the following factors independently associated with increased risk of postneonatal death induced by diarrhea and pneumonia: delayed immunization (OR = 2.48; 95%CI=1.17-5.23), general status (serious) on hospital admission (OR=10.94; 95%CI=4.91-24.34), unaccomplished hospital procedures (OR=10.08; 95%CI = 3.55-20.59) and malnutrition on hospital admission (OR=3.58; 95%CI=1.42-9.07). CONCLUSIONS: The results indicate the low quality of medical assistance as an important risk factor for avoidable causes of postneonatal deaths. The authors highlight the lack of integration between the outpatient clinic and hospital activities as an important determinant of low quality. It is necessary that the performance of health services and their effect on avoidable infant mortality be widely discussed, also taking into consideration the preponderant role of socioeconomic variables

[Association between socioeconomic factors and infant deaths due to diarrhea, pneumonia, and malnutrition in a metropolitan area of Southeast Brazil: a case-control study]. / Associação entre fatores sócio-econômicos e mortalidade infantil por diarréia, pneumonia e desnutrição em região metropolitana do Sudeste do Brasil: um estudo caso-controle.

A population-based case-control study was carried out to identify determinant factors for post-neonatal infant deaths due to diarrhea, pneumonia, and malnutrition in Greater Metropolitan Belo Horizonte, Southeast Brazil. From May 1, 1991, to April 30, 1992, 511 post-neonatal deaths due to diarrhea, pneumonia, and malnutrition were selected after investigation of medical records to validate cause of death. Of this total, 396 deaths were compared to a neighborhood control group, matched for age. The study was carried out in a low-income area with a high proportion of families living in shantytowns. The article discusses the methodology and selected socioeconomic factors. Logistic regression analysis indicated that number of household appliances, mother's and father's education, and mother's marital and work status were significantly associated with risk of infant death, i.e., they were determinants of infant deaths due to avoidable causes.

[Undergraduate students of "Universidade Federal de Minas Gerais": profile and trends]. / O estudante de medicina da Universidade Federal de Minas Gerais: perfil e tendências.

OBJECTIVE: this study was made with the medical students of the "Universidade Federal de Minas Gerais" (UFMG), to get their social economic profile, and their reasons for studying medicine, choosing the specialty, doing medical residence, and showing preferences for being a liberal professional or a salaried employee. METHODS: In 1997, a study was made comparing UFMG's medical students beginning their clinical practice (5th semester) and those medical students during the internship in the last term of clinical practice. Both groups were given questionnaires for evaluation. RESULTS: The results were similar for both groups and showed that women constituted almost 50% of the students and about 50% of them were from Belo Horizonte, the State capital of Minas Gerais, Brazil, and from small families with less than three children, and whose parents held a college degree. These students passed the college entrance exams on their first try. Two thirds of their families had income of about 10 to 50 Brazilian minimum wages, and approximately 12% of the families had an income of less than 10 minimum wages. The majority of the students decided to study medicine for altruism or vocational reason; very few (<5%) chose to study medicine for financial reasons. Almost all students (98%) preferred a liberal medical practice; however 80% would accept civil-service employment as an alternative. Nearly all of them (98%) chose to do medical residence to specialize. Most students would prefer to be specialists and only less than 20% would prefer to do general practice in areas such as adult and pediatric clinic, gynecology-obstetric and general surgery. CONCLUSION: This study shows that medical students from UFMG have an elite social economic profile and a preference for specialized medical practice.

Pressure pain threshold in children with recurrent abdominal pain.

BACKGROUND: Experimental studies on humans have shown that recurrent pain is associated with altered pain perception. We measured the pressure pain threshold in regions of the body surface in a group of children who had recurrent abdominal pain and in a group of children with chronic or recurrent disease but with no pain. METHODS: Each group consisted of 45 boys and 55 girls ranging in age from 5 to 15.8 years. The regions of the body were the trapezius, deltoid, and supraspinous muscles, nine areas on the abdominal wall, and the median part of the tibias. Using an algometer, pressure was applied through a rubber disc with a surface area of 1 cm2 at a rate of 0.5 kg/cm2/s. The pressure values recorded with the algometer when the children communicated that they started to feel pain were considered as pressure pain thresholds. RESULTS: The pain thresholds were reduced in all regions investigated in children with recurrent pain. The median thresholds for all regions of the patients with and without pain were 1.60 and 2.2 kg/cm2, respectively. The diseases of children with pain did not influence the pain thresholds. CONCLUSION: There was an association between recurrent abdominal pain and a lower pressure pain threshold, with no influence of the type of disease, and there was a central nervous system alteration in the perception of pain in these patients.

O estudante de medicina da Universidade Federal de Minas Gerais: perfil e tendências / Undergraduate students of \"Universidade Federal de Minas Gerais\": profile and trends

OBJETIVOS: A proposta deste trabalho é investigar o perfil socioeconômico, o motivo de estudar medicina, a opçao por especialidade e residência médica e a preferência em trabalhar como profissional liberal ou assalariado entre os estudantes de medicina da Universidade Federal de Minas Gerais (UFMG). MÉTODO: Durante o ano de 1997, realizou-se estudo comparativo entre os estudantes de medicina da UFMG do 5o. período, iniciando o ciclo clínico, e aqueles do internato, terminando o ciclo clínico. Como instrumento foi utilizado um questionário distribuído a todos alunos das duas turmas. RESULTADOS: Houve grande semelhança entre os estudantes de 5o. período e os do internato. Em torno de 50 por cento dos estudantes eram do sexo feminino, mais da metade procedeu da capital do Estado, em Belo Horizonte, nasceu em família pequena com menos de três filhos, foi aprovada no primeiro vestibular e o pai cursou escola superior. A renda familiar situou-se entre 10 e 50 salários em 2/3 dos casos. Estes dados sao compatíveis com a origem de classe média alta, embora em aproximadamente 12 por cento a renda familiar foi inferior a 10 salários. A grande maioria estudou medicina por vocaçao ou altruísmo (80 por cento), raramente por questoes de mercado (<5 por cento). Houve grande preferência pela medicina como profissao liberal (98 por cento), mas em torno de 80 por cento aceitaria o emprego público como alternativa. Quase todos (98 por cento) pretendiam fazer residência médica e se tornar especialistas, poucos (<20 por cento) indicaram entre estas as especialidades de área geral, como clínica médica, gineco-obstetrícia, pediatria e cirurgia. CONCLUSAO: O estudo mostrou perfil socioeconômico relativamente elevado do estudante de medicina da UFMG e preferência pela prática especializada da medicina

[Breastfeeding in Montes Claros, Minas Gerais: a representative sample study] / A situação do aleitamento materno em Montes Claros, Minas Gerais: estudo de uma amostra representativa.

OBJECTIVE: To evaluate the situation of breast-feeding in Montes Claros, among under-two-year-old children, and to determine variables associated to major risk for early weaning. METHODS: In this cross-sectional study interviews were carried out by trained personnel with 602 mothers selected randomly in the urban area of Montes Claros, from September to November, 1996. The survival analysis was the method used to calculate the prevalence and the median duration of breast-feeding. The chi-square test was conducted to compare the proportions, and the level of significance was set at 5%. The prevalence ratio (PR) was used to measure the strength of the associations, with a 95% confidence interval. The logistic regression analysis was used to identify the risk factors for early weaning. RESULTS: The median duration of breast-feeding in general was 8.7 months; however the median duration of exclusive breastfeeding was only 27 days. The risk factors for early weaning were low birth weight (OR=2.65; CI95%=1.10-6.40), mothers with difficulties to breast-feed in the first days (OR=1.86; CI95%=1.21-2.85) and lack of posnatal medical incentive to breast-feed (OR=1.75; CI95%=1.15-2.66). CONCLUSIONS: For breast-feeding in general there is a better situation than that showed by other national reports, but it is still below recommended by WHO. There is a critical exclusive breastfeeding pattern. The factors related with early weaning denote a weak support of the maternal-infant health services to breast-feeding.

[Pain threshold and age in childhood and adolescence] / Limiar de dor e idade na infância e adolescência.

OBJECTIVE: The few investigations about pressure pain threshold in corporeal surface areas and children age showed no correlation between these parameters in all areas. In this research the existence of correlation between age and pressure pain threshold in seventeen areas of the corporeal surface of children was investigated. METHODS: A descriptive research was made with one hundred children from the Clinical Hospital of the Federal University of Minas Gerais. The selection of patients was made by directed search. There were forty five boys and fifty five girls with ages varying between 5.3 and 15.8 years old, and a mean (-/+ standard deviation) of 9.6 (-/+ 2.7) years old. The seventeen corporeal areas studied were regions of the trapezium, deltoid and supraspinal muscles, nine areas of the abdomen and the median part of the tibias. The pressure of 0.5 kg/cm(2)/s was made using a mechanical algometer. The pressure values that were recorded in the equipment when the children started to complain about the pain, by verbal communication, were considered as pressure pain thresholds. RESULTS: Positive correlations with significant statistic values were found between pressure pain threshold and age in every area investigated: trapezium, r = 0.36; deltoid, r = 0.34; supraspinal, r=0.42; hypochondrium, r=0.41; epigastrium, r=0.41; flank, r = 0.48; periumbilical, r = 0,40; iliac fossa, r = 0.49; hypogastrium, r = 0.45 and tibia, r = 0,29. CONCLUSIONS: Since correlations between age and pressure pain threshold were found in all areas studied, the age of a patient must be taken into consideration during clinical investigations and pain evaluations in children and adolescents. The younger the patient, the lower the pain thresholds.

[Infantile nutritional evaluation with the software EPI INFO (version 6.0), taking into consideration collective and individual approaches, degree and type of malnutrition]. / A avaliação nutricional infantil no software EPI INFO* (versão 6.0), considerando-se a abordagem coletiva e a individual, o grau e o tipo da desnutrição.

OBJECTIVE: A systematization for an anthropometric infantile evaluation is proposed, employing the software Epi Info, version 6.0, considering the collective and individual approaches, as well as the degree and type of malnutrition. METHODS: The software Epi Info, sponsored by the World Health Organization, provides an infantile nutritional evaluation, which is based on three anthropometric indicators: weight-for-age, height-for-age and weight-for-height. In order to quantify the observed data of each individual, three scales can be used. Among them, the Z score, which discriminates more efficiently the severe cases, is employed as a first choice. The reference pattern of the NCHS is used. Many cutoff points between eutrophy and malnutrition can be chosen, but the -2 Z score is the most employed. The child can be classified in three diagnostic categories: stunting, for height-for- age deficits; wasting, for weight-for-height deficits; underweight, for weight-for-age deficits. Besides this, in a collective approach, the Epi Info software calculates the proportion of individuals in each populational group which have their anthropometric data deviated from the reference curve, constituting the percentage of observed abnormality (called standardized prevalence). RESULTS: In this paper, in which the analysis of a data file is presented as an example, the organization of the information provided by Epi Info is proposed, with the characteristics described below. In order to increase the diagnostic sensitivity, the collective approach is valued. Concerning the type of malnutrition, the English term "stunting" is substituted by "chronic malnutrition", "wasting" by "acute malnutrition" and "underweight" by "isolated weight deficit". Concerning the degree of malnutrition, the -2 and -3 Z scores are employed as cutoffs in order to define, respectively, a threshold between the moderate and severe forms. CONCLUSIONS: The proposed approach takes into account the identification of all forms of malnutrition, from the mildest to the most severe cases, takes into consideration both height and weight deficits and if the process is acute or chronic. Therefore, it is a tool for organizing data available with the use of the computer.

Prevalence of anemia among school-children from Rio Acima (State of Minas Gerais, Brazil): use of the standardized prevalence method and evaluation of iron deficiency.

The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47%) boys and 176 (53%) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3%), 218 were mulatto (65.7%), and 40 were black (12%). Mean hemoglobin level was 12.75 +/- 0.75 g/dl. Lower values were determined for black children (12.32 +/- 0.87g/dl) compared to white (12.76 +/- 0.99 g/dl) and mulatto (12.81 +/- 0.94 g/dl) children. The prevalence of anemia was 16.6% when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2% when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13% for the population in general and 20% for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.

Prevalence of anemia among school-children from Rio-Acima (State of Minas Gerais, Brazil): use of the standardized prevalence method and evaluation of iron deficiency

The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47 per cent) boys and 176 (53 per cent) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3 per cent), 218 were mulatto (65.7 per cent), and 40 were black (12 per cent). Mean hemoglobin level was 12.75 ñ 0.75 g/ dl. Lower values were determined for black children (12.32 + 0.87 g/dl) compared to white (l2.76 ñ 0.99 g/dl) and mulatto (12.81 ñ 0.94 g/dl) children. The prevalence of anemia was 16.6 per cent when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2 per cent when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13 per cent for the population in general and 20 per cent for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.

[Analysis of the efficacy of the maternal breast-feeding incentive program in a peripheric district of Belo Horizonte (Brazil): 1980/1986/1992]. / Análise da eficácia do Programa de Incentivo ao Aleitamento Materno em um bairro periférico de Belo Horizonte (Brasil): 1980/1986/1992.

Three institutions worked together in order to combat early weaning in a peripheric district of Belo Horizonte (Brazil): the Department of Pediatrics of the Faculty of Medicine (Federal University of Minas Gerais), the Secretary of Health of Belo Horizonte and a Brazilian assistential institution ("LBA"). One initial survey, in 1980, documented breast-feeding practices in this community, when there were no systematized actions of incentive to human milk, at local or national levels. Two similar surveys were also conducted, in 1986 and in 1992. In each one, 152 mothers with children under two years old were randomly selected and interviewed. The results showed significant progress in the breast-feeding period in the first six years, and a stabilization between 1986 and 1992. For example: if only 39.0% of the children received human milk for six months or more in 1980, 54.3% received it in 1986 and 52.4% in 1992. In 1980, 80.6% of the children were nourished with cow's milk before three months of age, to 56.5% in 1986 and 56.3% in 1992. Prenatal influence to increase the level of breast-feeding has always been weak. Besides, a reflux was detected in the last few years with regard to the participation of the maternity hospital in the educative process.