Reduction of vitamin A deficiency and anemia in pregnancy after implementing proposed prenatal nutritional assistance / Reducción de avitaminosis A y anemia en el embarazo después de la implementación propuesta de asistencia nutricional prenatal

Introduction: Micronutrient deficiency is an unquestionable public health problem, specially anemia and vitamin A deficiency (VAD). This is due to the collective dimension of these carencies, which reflects on morbimortality rates in the maternal and infant group. Objective: to evaluate the impact of a proposal for prenatal nutritional assistance, comparing the prevalence of anemia and VAD, in pre-intervention (GI) and intervention(GII) groups. Methods: this is a prospective intervention study in a cohort of pregnant women. The GI group was made up of 225 the GII group of 208 pregnant adults and their respective newborns, attended a Public Maternity Wardin Rio de Janeiro, Brazil. Concentration of hemoglobin was used to diagnose anemia and a standardized interview to diagnose night blindness (XN) .Results and conclusion: after adjusting for confounding variables, through logistic regression, the protective effect of intervention at the on set of anemia (OR = 0.420;IC 95% = 0.251-0.702), with a significant reduction in prevalence, of 28.4% in the GI to 16.8% in the GII, also observed at the on set of XN (OR = 0.377; IC95% = 0.187-0.759), with a reduction in prevalence of 18.7 % in the GIto 6.2% in the GII. Nutritional intervention has a beneficial effect on maternal health, reducing nutritional deficiencies most prevalent during pregnancy and the impact of these on the obstetric ailment (AU)

Introducción: La deficiencia de micronutrientes es un problema de indudable de salud pública, especialmente la anemia y deficiencia de vitamina A (DVA). Esto es debido a la dimensión colectiva de estos carencies, que se refleja en las tasas de morbi-mortalidad en el grupo materno infantil. Objetivo: Evaluar el impacto de un proyecto de atención nutricional prenatal, comparando la prevalencia de anemia y DVA, en la pre-intervención (GI) y la intervención (GII).Métodos: se trata de una intervención prospectiva de un grupo de mujeres embarazadas. El GI consistió de 225 mujeres en el posparto y GII en 208 mujeres embarazadas y sus recién nacidos inscritos en una maternidad pública de Rio de Janeiro, Brasil. Se utilizó la concentración de hemoglobina en el diagnóstico de la anemia durante el embarazo y la entrevista estandarizada para diagnosticar la ceguera nocturna (XN). Resultados y conclusión: Tras ajustar por variables de confusión, por la regresión logística, se verificó el efecto protector de la intervención sobre la anemia (OR = 0,420,95% CI = 0.251-0.702), con reducción significativa en la prevalencia, 28,4 en el GI y 16,8% en el GII, que también se observó en los resultados XN (OR = 0,377, IC del 95%desde 0,187 hasta 0,759), con una reducción en la prevalencia, el 18,7% al 6,2% en el GI y GII. La intervención dietética tiene efectos beneficiosos sobre la salud materna, reducir las deficiencias nutricionales más prevalentes durante el embarazo y el impacto de estos sobre el resultado del embarazo (AU)

Adherence of pregnant women to dietary counseling and adequacy of total gestational weight gain.

INTRODUCTION: in scientific literature there are not published researches which have used a validated assessment method of adherence to dietary counseling capable of being reproduced. OBJECTIVE: to evaluate the adherence of pregnant women to dietary counseling during the prenatal period using a validated instrument according to the outcome of total gestational weight gain. METHODS: two hundred and eight adult pregnant women participated in the research. The instrument for adherence classification to dietary counseling was elaborated according to four evaluation criteria: food quantity and quality, meal pattern and adjustment to weekly weight gain. We classified as poor adherence when zero-one criterion was observed, good adherence when 2-3 aspects were observed and excellent when the amount was 4 aspects. RESULTS: Pregnant women with good or excellent adherence had a higher adjustment proportion of the total gestational weight gain in comparison to those who presented poor adherence in the second and fourth visits, respectively (p < 0.006; p < 0.007). Women with poor adherence to dietary counseling in the second visit presented about three times more chances of having poor adherence in the fourth visit (OR = 3.11; CI = 1.46-6.36). CONCLUSION: Adherence of pregnant women to dietary counseling had a positive association with the adjustment of total gestational weight gain.

Adherence of pregnant women to dietary counseling and adequacy of total gestational weight gain / Adhesión de gestantes a los consejos dietéticos y adecuación del aumento de peso en toda la gestación

Introduction: in scientific literature there are not published researches which have used a validated assessment method of adherence to dietary counseling capable of being reproduced.Objective: to evaluate the adherence of pregnant women to dietary counseling during the prenatal periodusing a validated instrument according to the out come of total gestational weight gain. Methods: two hundred and eight adult pregnant women participated in the research. The instrument for adherence classification to dietary counseling was elaborated according to four evaluation criteria: food quantity and quality,meal pattern and adjustment to weekly weight gain. We classified as poor adherence when zero-one criterion wasobserved, good adherence when 2-3 aspects were observed and excellent when the amount was 4 aspects. Results: Pregnant women with good or excellent adherence had a higher adjustment proportion of the total gestational weight gain in comparison to those who presented poor adherence in the second and fourth visits,respectively (p < 0.006; p < 0.007). Women with poor adherence to dietary counseling in the second visit presented about three times more chances of having pooradherence in the fourth visit (OR = 3.11; CI = 1.46-6.36).Conclusion: Adherence of pregnant women to dietary counseling had a positive association with the adjustment of total gestational weight gain (AU)

Introducción: en la literatura científica no se han publicado investigaciones que han utilizado un método validado de avaluación de la adhesión de gestantes a los consejosdietéticos.Objetivo: avaluar la adhesión de gestantes a los consejos dietéticos, durante periodo prenatal, mediante un instrumento válido según los resultados del aumento de peso en toda la gestación. Métodos: participaron de la encuesta 208 gestantes adultas en el período entre 2005 y 2006. El instrumento para la clasificación de la adhesión fue elaborado partiendo de 4 criterios de evaluación: cantidad, calidad alimentar,padrón de comidas, la adecuación de ganancia de peso semanal. Se clasificó como baja adhesión cuando se observó entre 0 y 1 criterios, como buena adhesión, entre2 y 3 criterios, y óptima con 4 criterios.Resultados: las gestantes con buena u óptima adhesión tuvieron una mayor proporción de adaptación del aumento de peso total durante la gestación, comparándose con las que presentaron baja adhesión (p < 0,006;p < 0,007). Las mujeres con baja adhesión en la segunda consulta presentaron 3 veces más probabilidad de tener baja adhesión en la cuarta consulta (OR = 3,11; IC = 1,46-6,36).Conclusiones: la adhesión de las gestantes tuvo asociación positiva con la adaptación precoz al aumento de peso total durante la gestación, demostrando la importancia del cuidado alimentar precoz, fundamento de la advertencia dietética (AU)

Reduction of vitamin A deficiency and anemia in pregnancy after implementing proposed prenatal nutritional assistance.

INTRODUCTION: Micronutrient deficiency is an unquestionable public health problem, specially anemia and vitamin A deficiency (VAD). This is due to the collective dimension of these carencies, which reflects on morbimortality rates in the maternal and infant group. OBJECTIVE: to evaluate the impact of a proposal for prenatal nutritional assistance, comparing the prevalence of anemia and VAD, in pre-intervention (GI) and intervention (GII) groups. METHODS: this is a prospective intervention study in a cohort of pregnant women. The GI group was made up of 225 the GII group of 208 pregnant adults and their respective newborns, attended a Public Maternity Ward in Rio de Janeiro, Brazil. Concentration of hemoglobin was used to diagnose anemia and a standardized interview to diagnose night blindness (XN). RESULTS AND CONCLUSION: after adjusting for confounding variables, through logistic regression, the protective effect of intervention at the onset of anemia (OR = 0.420; IC 95% = 0.251-0.702), with a significant reduction in prevalence, of 28.4% in the GI to 16.8% in the GII, also observed at the onset of XN (OR = 0.377; IC95% = 0.187- 0.759), with a reduction in prevalence of 18.7 % in the GI to 6.2% in the GII. Nutritional intervention has a beneficial effect on maternal health, reducing nutritional deficiencies most prevalent during pregnancy and the impact of these on the obstetric ailment.

[An influence of combined treatment of laryngeal cancer on thyroid gland activity]. / Wplyw skojarzonego leczenia raka krtani na czynnosc gruczolu tarczycowego.

The aim of the research work was to estimate the risk of functional complications arising within thyroid after radiotherapy, when thyroid of patients being ill with carcinoma of head and neck area skin was afflicted with radiation beam as well as to examine whether the circadian rhythmand concentration of hypophysis and thyroid hormones are dependent on combined treatment. The group contained 18 pilot patients treated with combined method, which were examined for concentration and circadian rhythm of TSH, T3, T4, fT3, fT4 three times: before commencement of treatment, one month and six months after completion of treatment. Results of circadian rhythm and concentration of thyroid hormones examinations proved that in case of all hormones the circadian rhythm exist which undergoes a dysrrythmia after one month and six months from completion of combined treatment.

[Circadian rhythm disorders of the calcitonin and parathormone in the patients with cancer of the larynx after the complex treatment (surgery and radiotherapy)]. / Zaburzenia rytmu dobowego wydzielania kalcytoniny i parathormonu u chorych z rakiem krtani po leczeniu skojarzonym (chirurgia i radioterapia).

The aim of the study was to estimate the influence of combined therapy (surgery and radiotherapy) on the level and circadian rhythm of thyroid and parathyroid hormones that regulate calcium and phosphate balance. A group of 18 patients with the laryngeal cancer was considered for the purpose of this study. In all the patients a total laryngectomy and postoperative radiotherapy had been performed. The level of hormones (calcitonin and parathormone) and inorganic phosphates were measured before operation as well as one and six months after the end of combined treatment. The significant disorders of calcitonin and parathormone circadian rhythms were find.

Psychosomatic aspects of urinary incontinence.

Psychosomatic aspects of urogynecological disorders may play an important role in their clinical presentation. 72 patients presenting to the urogynecological clinics and a control group of 34 healthy women were included in this study. After informed consent had been obtained, all patients were subjected to (1) a detailed enquiry about personal- and medical history (2) psychological tests (Freiburg's personality inventory, a questionnaire focused on anxiety and anger, and Beck's depression inventory) and (3) routine urodynamic measurement. Patients with stress incontinence had a mean duration of symptoms of 59 months. In 67% there was a combination with clinical urge symptoms. 53% of the patients did not have regular sexual intercourse. Of those who had regular intercourse 23% had incontinence during intercourse and 25% were anorgasmic. 59% of the patients had dysmenorrhea and a negative attitude to their menarche. Urodynamic evaluation showed stress, urge or no incontinence in 39%, 12% and 39%, respectively. Analysis of the psychosomatic tests did not show a specific psychosomatic influence. Negative sexual life correlated with depressive mood, which was not based on the urogynecological problem. There was no causal relationship between personality traits and urogynecological problems. The individual perception of incontinence, however, may depend on or influence personality structure.