This study aimed to identify variables associated with the appropriate recall of indications and the drug classes that represented the most unmatching medications (i.e., when the individual who used it had not reported any illness that matched its indications). Community-dwelling individuals aged ≥60 years using ≥1 medication, from Santa Cruz da Esperança-SP, Brazil, were home-interviewed. Logistic regression models were used to evaluate the association between the appropriate recall of the indications for all medications in use and the following: gender, age, education, individual income, living arrangement, self-perceived health, and medication number, administration, payment, and identification. Medications whose indications were inappropriately recalled were classified as matching or unmatching. One hundred seventeen individuals used an average of 5.1 (standard deviation, 3.3) medications. Sixty-one (52.1%) appropriately recalled all indications. The appropriate recall of all indications was negatively associated with the number of medications in use (e.g., individuals taking 5-6 medications were 25 times less likely to appropriately recall all indications than those taking 1-2). Antithrombotic, acid-related disorder and psychoanaleptic classes showed greater frequencies of unmatching than matching medications. Therefore, counseling the elderly about drug indications should focus on those using ≥3 medications and/or antithrombotic, acid-related disorder, and psychoanaleptic agents.

BACKGROUND: In July 2004, the Brazilian Ministry of Health through the National Health Surveillance Agency made the fortification of wheat flour and cornmeal (maize flour) with iron and folic acid mandatory, with the intention of reducing the rate of diseases such as neural tube defects.OBJECTIVE: The aim of the study was to investigate the impact of the folic acid fortified wheat flour and cornmeal on serum and red blood cell folate levels and on the reduction of neural tube defects in different Brazilian studies.METHODS: In order to compare folate concentrations in the Brazilian population prior to and following the implementation of mandatory fortification of wheat and cornmeal, studies that involved blood draws between January 1997 and May 2004 (pre-fortification period), and from June 2004 to the present (post-fortification period) were chosen. The data search included PubMed and Scopus databases as well as the Brazilian Digital Library of Theses and Dissertations. The following keywords were employed for the query: folate, folic acid, fortification, Brazil, healthy population, the elderly, children and pregnant women.RESULTS: A total of 47 Brazilian studies were selected; 26 from the pre-fortification period and 22 after the fortification implementation. The studies were classified according to the cohort investigated (pregnant women, children, adolescents, adults and the elderly). After the implementation of flour fortification with folic acid in Brazil, serum folate concentrations increased in healthy populations (57% in children and adolescents and 174% in adults), and the incidence of neural tube defects dropped.CONCLUSION: Folic acid fortification of wheat flour and cornmeal increased the blood folate concentrations and reduced the incidence of neural tube defects.

O estado nutricional antes e durante a gestação foi avaliado prospectivamente em 372 gestantes através do índice de massa corporal e ou gráfico de Rosso. Metade das mulheres apresentou peso pré-gestacional normal, porém 17,7% estava abaixo e 31,3% acima do peso normal. No terceiro trimestre, 18,8% tinha peso abaixo e 28,2% acima do normal. O peso ao nascer aumentou de acordo com o melhor provimento nutricional da gestante. Estes resultados indicam que um controle antropométrico adequado permite monitorar nutricialmente as gestantes, prevenindo e/ou controlando a ocorrência de condições materno-fetais indesejáveis, fato que reafirma a importância da execução desta atividade como rotina no controle pré-natal.

Nutritional conditions in the pre-gestacional period and during pregnancy were evaluated in 372 pregnant women based on the body mass index and Rosso's Graph. Approximately half (51%) the pregnant women presented normal pre-gestacional weight; however, 17.7% were underweight and 31.3% overweight. In the third trimester, 18.8% were underweight and 28.2% overweight. The weight at birth increased as nutritional conditions during pregnancy improved. These results show the importance of appropriate anthropometric control in order to prevent a bad neonatal prognosis and reaffirms the importance of such activity during the whole routine of pre-natal control.

El estado nutricional pregestacional y durante el embarazo fue evaluado en 372 gestantes, a través del indice de masa corporal y la Gráfica de Rosso, prospectivamente. Mitad de las mujeres presentó peso pregestacional normal, aún así 17,7% tenía bajo peso y 31,3% sobrepeso. En el tercer trimestre, 18,8% tenía bajo peso y 28,2% sobrepeso. El peso al nacer aumentó conforme la gestante fue nutricionalmente mejor natada. Estos resultados señalan que un control antropométrico adecuado posibilita monitorear nutricionalmente las embarazadas, preveniendo y/o controlando la ocurrencia de condiciones materno-fetales indeseables, hecho que reafirma la importancia de la ejecución de esta actividad como rutina en todo el control prenatal.

Nutritional conditions in the pre-gestacional period and during pregnancy were evaluated in 372 pregnant women based on the body mass index and Rosso's Graph. Approximately half (51%) the pregnant women presented normal pre-gestacional weight; however, 17.7% were underweight and 31.3% overweight. In the third trimester, 18.8% were underweight and 28.2% overweight. The weight at birth increased as nutritional conditions during pregnancy improved. These results show the importance of appropriate anthropometric control in order to prevent a bad neonatal prognosis and reaffirms the importance of such activity during the whole routine of pre-natal control.

El estado nutricional pregestacional y durante el embarazo fue evaluado en 372 gestantes, a través del indice de masa corporal y la Gráfica de Rosso, prospectivamente. Mitad de las mujeres presentó peso pregestacional normal, aún así 17,7% tenía bajo peso y 31,3% sobrepeso. En el tercer trimestre, 18,8% tenía bajo peso y 28,2% sobrepeso. El peso al nacer aumentó conforme la gestante fue nutricionalmente mejor natada. Estos resultados señalan que un control antropométrico adecuado posibilita monitorear nutricionalmente las embarazadas, preveniendo y/o controlando la ocurrencia de condiciones materno-fetales indeseables, hecho que reafirma la importancia de la ejecución de esta actividad como rutina en todo el control prenatal.

O estado nutricional antes e durante a gestação foi avaliado prospectivamente em 372 gestantes através do índice de massa corporal e ou gráfico de Rosso. Metade das mulheres apresentou peso pré-gestacional normal, porém 17,7% estava abaixo e 31,3% acima do peso normal. No terceiro trimestre, 18,8% tinha peso abaixo e 28,2% acima do normal. O peso ao nascer aumentou de acordo com o melhor provimento nutricional da gestante. Estes resultados indicam que um controle antropométrico adequado permite monitorar nutricialmente as gestantes, prevenindo e/ou controlando a ocorrência de condições materno-fetais indesejáveis, fato que reafirma a importância da execução desta atividade como rotina no controle pré-natal.

Efectividad relativa del hierro bis-glicinato quelado (Ferrochel) y del sulfato ferroso en el control de la deficiencia de hierro en mujeres embarazadas. La efectividad relativa de la suplementación diaria con sulfato ferroso (FeSO4) o con hierro aminoquelado (Ferrochel, FeAAC) se estudió en 145 mujeres de menos de 20 semanas de embarazo distribuidas en dos grupos. Un grupo (71 mujeres) the suplementado con 15 mg de hierro por día provenientes de Ferrochel, y el otro (74 mujeres) con 40 mg de hierro por día provenientes de sulfato ferroso. Se efectuaron mediciones de hemoglobina, ferritina y saturación de trasferrina al ingreso al programa (<20 semanas de embarazo), entre 20-30 semanas y entre 30-40 semanas. La ingesta ininterrumpida por 13 semanas o más se consideró adecuada. La disminución en los valores de todos los parámetros medidos the menor en el grupo tratado con Ferrochel, a pesar de que la dosis the mas pequeña. Depauperación de hierro se encontró en 30.8% de las mujeres tratadas con Ferrochel y en 54.5% de aquellas tratadas con sulfato ferroso. Entre los factores informados como responsables del abandono del tratamiento se encontró que el sabor the el factor mas importante para las consumidoras de sulfato. Sabor indeseable no the informado por las mujeres que consumieron Ferrochel. Se concluye que la suplementación diaria con Ferrochel the significativamente mas efectiva a pesar que la dosis usada the menor que la dosis de sulfato ferroso.

The relative effectiveness of daily supplementation of iron deficiency during pregnancy using 15 mg/day of iron from iron-bis-glycinate chelate (71 pregnant women), or 40 mg iron from ferrous sulfate (74 pregnant women) was evaluated by measuring hemoglobin, transferrin saturation and serum ferritin, at the beginning of the study (<20 weeks of pregnancy) and at 20-30 weeks and 30-40 weeks thereafter. Ingestion for 13 weeks or more was considered adequate. Seventy three percent of the Ferrochel consuming group and 35% of the ferrous sulfate consuming group were considered to have taken the treatment adequately. The decrease in levels of all the measured parameters was significantly less pronounced in the group that consumed Ferrochel in spite of the lower treatment dose. Iron depletion was found in 30.8% of the women treated with Ferrochel and in 54.5% of the women than consumed ferrous sulfate. Of the factors responsible for non compliance taste was reported in 29.8% of the ferrous sulfate consumers and none in the groups that consumed Ferrochel. It is concluded that daily supplementation with Ferrochel was significantly more effective, in spite of the lower dose, than supplementation with ferrous sulfate.

Objetivo: verificar os níveis de folatos, vitamina B12 e ferritina em pacientes cujos fetos apresentaram defeitos de tubo neural (DTN). O folato sangüíneo e a vitamina B12 atuam como cofatores para as enzimas envolvidas na biossíntese do DNA. A interrupção deste processo pode impedir o fechamento do tubo neural. A suplementação vitamínica contendo folato pode reduzir as taxas de ocorrência de defeitos de tubo neural, embora exista a preocupação de que esta prevenção possa mascarar a deficiência de vitamina B12. Métodos: dosagens de vitamina B12 e ferritina pelo método de enzimaimunoensaio com micropartículas e a dosagens de ácido fólico pelo método de captura iônica (IMx ABBOTT). Resultados: a porcentagem de gestantes com deficiência de vitamina B12 (níveis séricos < 150 pg/ml) foi de 11,8%. Não houve nenhum caso de deficiência de folato (níveis séricos < 3,0 ng/ml). A prevalência de gestantes com deficiência nos estoques de ferro foi de 47,1% (níveis séricos < 12 ng/ml). Conclusões: com os resultados encontrados neste estudo (prevalência de 11,8% de deficientes em vitamina B12 e 0% de deficiência de folato), sugerimos que a suplementação se realize após a determinação da vitamina B12 sérica.

Purpose: to determine folate, vitamin B12 and ferritin levels in patients whose fetuses presented neural-tube defects (NTD). Blood folate and vitamin B12 act as cofactors of enzymes involved in DNA biosynthesis. Interruption of this process may block neural-tube closing. Vitamin supplementation with folate may reduce occurrence rates and recurrence of NTD, although there is concern about the fact that this prevention may mask vitamin B12 deficiency. Methods: vitamin B12 and ferritin determinations by enzyme immunoassay with microparticles and folic acid determination using the ion capture method (IMx ABBOTT). Results: the percentage of pregnant women with vitamin B12 deficirncy (serum levels < 150 pg/ml) was 11.8%. There was no case of folate deficiency (serum levels < 3.0 ng/ml) and prevalence of pregnant women with iron store deficiency was 47.1% (serum levels < ng/mg). Conclusions: occording to the results obtained in this study (prevalence of 11.8% of vitamin B12 and 0% of folate deficient pregnant women) we suggest that supplementation should be administered after serum vitamin B12 determination.