Avaliação de megadoses de retinol palmitato no pós-parto imediato sobre o retinol do leite de puérperas atendidas no hospital josé pedro bezerra, Natal-RN

Vitamin A deficiency (VAD) is a serious public health problem in developing countries, and as a therapeutic and prophylactic measure retinil palmitate is being supplemented. Nevertheless its efficacy has been questioned. The objective of the study was to evaluate the supplementation of two retinil palmitate megadosis on the serum retinol levels of post partum healthy mothers from Dr. José Pedro Bezerra (Hospital Santa Catarina) hospital, Natal - RN. The enrolled women (n=199) were randomly distributed into three studied groups and supplemented with retinil palmitate immediately after delivery with a single 200,000 IU dose (group S1), two 200,000 IU dose (group S2) with 24h difference between the doses, or no supplementation (group C). Among women selected, 143 remained until the end of the study. The influence of vitamin A dietary intake was evaluated during pregnancy and after 30 days of delivery. The average intake of the population was reasonable, but a high prevalence of inadequate intake was found. Retinol in colostrums and mature milk was determined by high performance liquid chromatography (HPLC). The retinol average in colostrums and mature milk in the supplemented and control groups were adequate according to the reference values. In colostrums, women from groups C, S1 and S2 presented retinol averages by milk volume of 94.8 ± 40.2 µg/dL, 92.2 ± 50.0 µg/dL and 91.8 ± 53.7 µg/dL, respectively. No difference was found between these averages (p=0.965), this was also seen when the values where expressed as µg/g of fat (p=0.905). After 30 days of delivery, retinol per milk volume differed between the control group (36.6 ± 17.5 µg/dL) and groups supplemented with 200,000 IU (51.0 ± 28.8 µg/dL) or 400,000 IU (55.2 ± 31.6 µg/dL) of retinil palmitate (p<0,05). Nevertheless, when S1 and S2 groups where compared, no significant difference was found (p=0.97). Considering retinol/g of fat, the means were 12.7 ± 6.7 µg/g, 15.6 ± 8.3 µg/g and 17.2 ± 8.9 µg/g for groups C, S1 and S2, respectively, with significant difference between groups S2 and C (p=0,01). Subclinical VAD prevalence showed a serious public health problem in the study population (32% in colostrums and 31.5% in mature milk). When analyzing the groups separately, the group which received two doses (200,000 IU + 200,000 IU) presented the lowest VAD prevalence (20.7%). Retinil palmitate supplementations of 200,000 IU and 400,000 IU (divided in two doses) in the immediate post partum showed no significant difference. Nevertheless, the 400,000 IU (divided in two doses) supplementation showed a reduction in VAD

Influência da suplementação de retinol palmitato sobre os níveis de vitamina A no leite de puérperas saudáveis

The tendency towards reduction of serum retinol levels, an existing placental barrier and the increase of retinol demand, are factors that place puerperal and lactating women at risk for Vitamin A deficiency. This micronutrient is an essential component of vital processes such as differentiation, cellular proliferation, and apoptosis. The objective of this study is to evaluate the effect of palmitate retinol supplementation (100.000UI) upon the milk retinollevels in puerperal women at the Januário Cicco University Maternity Hospital. This intervention has been adopted by the Ministry of Health since 2002. The longitudinal experiment was conducted with 106 puerperal women (68 comprised the supplemented group and 38 the control group). The High Performance Liquid Chromatography (HPLC) method was used to dose the retinol of the milk and serum samples, and the creamtocrit method to determine the milk fat levels. The retinol means for the colostrums were 99.0 ± 64.4 ug/dL and 160.1 ± 94,4 ug/dl 6 hours afier supplementation; 68.9 ± 33.5 ug/dL for the transitional milk, and 30.6 ± 15.2 ug/dL for the mature milk of the supplemented group. Ali the difterences between means were statistically significant. The difterence between retinol means in the control group were also significant, with these being greater in the colostrum, 88.6 ± 62.1 ug/dL with 61.9 ± 30.1 ug/dl in the transition milk and 32.9 ±32.9 ± 17.6 ug/dL in the mature milk. No significant difference was observed in the retinol means of the three types ot milk in the supplemented group when compared to their respective means in the control group. The prevalence in serum (35.1 % and 81.1 % for the cutting point 20 ug/dL, respectively) and in milk (51.4%) revealed vitamin A deficiency as a public health problem. COlostrum, transition, and mature milk tats varied similarly in the supplemented group (1,92 ± 0,96; 3,25 ± 1,27 and 3,31 ± 1,36 grams) and in the control group (1,87 ± 1,14; 3,25 ± 1,31 and 3,36 ± 1,67 grams), with an observed difference between the colostrum/transition milk and the colostrum/mature milk fats. No difference was observed between the groups. The study showed that the 200.000UI supplementation was not sufficient to increase the milk retinol to the desired levels nor to meet the demands of the mothers with deprived hepatic reserves. It is suggested that another similar dose be offered within 30 days or less, and within 2 months post-partum, while continual/y monitoring for possible pregnancy

Estrutura populacional e aspectos reprodutivos do Octopus insularis Cephalopodas: Octopodidae: implicações para o manejo da pesca de polvo no município de Rio de Fogo-RN

In northeastern Brazil, Octopus insularis is the most commercially important cephalopod species and its capture has been performed for several years by the lobster fishermen in the region. In order to obtain information about the reproductive biology, 1108 specimens were collected between November 2009 and September 2011 in the landings and fish markets of Rio do Fogo (RN). For each specimen the mantle length (CM) and total fresh weight (PT) were recorded. Gonads of 264 males and 295 females were examined macroscopically and histologically to assess sexual maturation and determine reproductive indices. Four reproductive stages were determined for males (immature, maturing, mature and post-mature) and females (immature, early maturing, late maturing and mature). The average of eggs recorded in the female s gonads was 93.820 and 39 was the average of spermatophores found in male Needham s complex. Spermathecae with sperm were found in females with 69 mm CM (immature). Males and females become sexually mature at 64.41 and 98.50 mm of CM, respectively. The weight at sexual maturity was 270 g for males and 630 g for females. The values of the size and weight at sexual maturity found in this study show that males mature at smaller sizes than females. For both sexes the maturation peaks occurred in February and November 2010 and also in September 2011. The periods of maximum reproductive activity lasted about 3 months and it seems to occur every 7 10 months. Only one spent female (stage V) was found and the number of mature females was low. Presumably, mature females migrate to deep waters with complex habitat to protect the offspring, indicating that fishery by snorkeling with maximum depth of 15 meters is not reaches this part of the stock. Finally, it is noticeable the importance of the establishment of management strategies for the exploitation of O. insularis different of the ones used for O. vulgaris, once the species have distinct biological features

Biossegurança e a saúde do trabalhador na assistência a pacientes em tratamento onco-hematológico

In recent years, the biosafety has been made possible a new look which are based the conceptions of health and illness process, as well as human needs. This new vision is focused on health vigilance that is referenced specifically in this study to the worker s health. The health of workers is essential for the prevention and control of epidemics and outbreaks of diseases as well as emerging and reemerging diseases. The present study wants to show the importance of biosafety measures for health workers, showing them through the concepts in their daily work. It is also to direct the use of biosafety measures in the care of oncology and hematology patients care, because of its infection susceptibility. OBJECTIVES: To analyze the conceptions of health workers in the biosafety pratice to the patients in oncological and hematological treatment in an oncological institution in Natal / RN, as well as make a socio-demographic profile of these workers and to know their difficulties to adequate biosafety measures. METODOLOGIA: The research is exploratory descriptive with qualitative approach, using the technique of oral history. The use of this technique is justified for the possibility of analyze the conceptions of health workers in the face of biosafety measures. From the definition of analysis categories that have emerged in the study. The categories were: daily work, education, occupational risk and onco-hematological care. The research population was the health workers who provide care to patients in oncological and hematological treatment. The study was conducted in the League against Cancer, in Natal / RN, specifically in the unit Luiz Antonio Hospital. Data collections were conducted from June to August of 2011 and were interviewed sixteen employees who assist in oncology and hematology. Structured interviews were conducted in three shifts, given the prospects of expanding the possibilities of analysis of the biosafety concepts. After data collection, the interviews were analyzed qualitatively by the technique of oral history. This genre, thematic oral history is a modern resource used for preparation of documents, files and studies concerning the social experience of people and groups with the construction of a script prior to the interview moment (MEIHY, 2002). ANALYSIS OF INFORMATION: It was made a reflection about the concepts and practices of professionals who take care of patients in oncology and hematology as well as its relation to biosafety measures. The speech of employees revealed that the adoption has been very supportive of these standards, although some have been highlighted gaps in the understanding of employees in relation to biosafety and the proposed categories. CONCLUSION: The analysis of information showed that biosafety has been cited by employees as an immeasurable benefit to safety and occupational health. And the strengths marks in their understanding were: the excellence of care and safety in occupational diseases risk reduction and infections resulting from their work activities, despite some difficulties in adopting appropriate biosafety standards

Estudo da fibra de coco como reforço em tijolo de solocimento

To take care of to the demand of the new constructions in the low income communities and to develop the production of a strengthened alternative brick with staple fibers of coconut, capable to contribute mainly with the recycling of the green and mature coconut in the urban and agricultural lexes, this research was developed, to confection bricks of soil-cement with coconut fiber. Ecologically correct material and of low cost, since the greenhouse use of or oven for burning will be manufactured without. The study it presents a set of tables and graphs that prove good indices found in the values of the density, water absorption, axial compressive strength and isolation term acoustics, with evidential results that make possible the production in industrial character with press mechanics or the place of the workmanship with manual form. The preparation of coconut staple fibers was made of natural form without use of chemical products not to deprive of characteristics the properties mechanical physicist-chemistries and of the same ones. The sixty bricks produced in simple and manual press had been carried through in four lots of fifteen units. The mixture of aggregates was made in four different traces composites for: ground erinaceous, cement, fiber of dry coconut and water; the bricks had been compact in the press and cured in natural way under an area covered during the minimum time of seven days

Dinâmica reprodutiva e parasitária de quatro espécies de peixes das águas costeiras do Sudoeste do Oceano Atlântico, Brasil

The present study investigated the reproductive dynamics and parasitism of four species of marine fishes: serra Spanish mackerel, Scomberomorus brasiliensis, Atlantic leatherjacks, Oligoplites saurus and O. palometa,, and Atlantic bumper, C. chrysurus, during the period of August, 2005 to July, 2007, in the coastal waters of Southwest Atlantic Ocean, Brazil. The collected fish samples were measured, weighed, dissected, the gonads were weighed and examined to separate the sex. The gonadosomatic index (GSI), fecundity, type of spawning, the breeding season, the macro and microscopic characterization of the gonads were determined. The ectoparasites from the branchial chambers and bucal cavity of the fish were collected, measured, weighed and identified. The sex ratio of the study fish species were approximately 1M:1F, however, there was a predominance of males of O. palometa (3M:2F). The GSI of fishes varied according to their reproductive cycle and the stage of gonadal maturation. The highest values of GSI and the spawning period coincided with the rainy period of the region. The females presented total spawning and the fecundity was positively correlated with the weight of the ovary and the body. Four stages of development of the gonads immature, maturing, mature and spent were identified macroscopically and histological analyses of ovaries revealed the different phases of oocyte development. Three species of isopod parasites were identified in the study fishes: Livoneca redmmanni, Rocinela signata and Cimothoa spinipalpa. The first two species occurred in the branchial cavities of C. chrysurus and S. brasiliensis. The isopod C.spinipalpa (a new species) was registered for the first time in the bucal cavity of O. saurus and O. palometa. The parasitic isopods preferred the branchial chambers and the bucal cavity of the host fishes as these were protected microhabitats. The isopods parasitized the immature, maturing and mature fishes. The prevalence of infection of isopods in the hosts varied from 16 to 21%, though in O. palometa it was 60%. In the rainy period the highest isopod parasitic occurrence was registered, however, this did not prejudice the normal reproductive cycle of the host fish.

Análise das avaliações realizadas na disciplina de arquitetura atômica e molecular no curso de química, modalidade a distância da UFRN

The field of education is very rich and allows us to research in various aspects. The area of chemical education has been growing more and more, and an important aspect that has been researching this area is about the learning difficulties of students. The approach of the themes atomic structure and chemical bonds are developed in high school and have many problems that are often brought to higher education becoming an obstacle to the advancement of learning. It is necessary for these initial themes - the atomic structure and chemical bonds - are well understood by the student to the other contents of Chemistry will be understood more easily. This paper aims to describe, analyze errors and difficulties presented in the assessments of the discipline Atomic and Molecular Architecture, the students of the degree course in Chemistry - EAD, with respect to the contents of " Atomic Structure and Chemical Bonding ", by of the assessments made by the students and the Virtual Learning Environment (VLE), taking into account the activities , discussion forum and access to materials . AVA allows obtaining reports which were used to analyze regarding access / participation to assess their contribution to learning and its relation to the final result (pass / fail). It was observed that the most frequent errors in the assessments are related to the early part of the chemistry that is the understanding of atomic structure and evolution models. Students who accessed the extra material and participated in the activities and forums were students who achieved success in the course. Ie, the difficulties were emerging and the use of available teaching strategies, students could minimize such difficulties, making their performance in activities and assessments were better. Was also observed by attending the AVA, the discipline began with a large withdrawal from the page access as well as the frequency of face- evidence from observation in Listing presence of classroom assessments

Avaliação do potencial da fibra e casca de coco maduro, casca de coco verde e cacto pré-tratados visando à produção de etanol

The present work investigated the potential of different residual lignocellulosic materials generated in rural and urban areas (coconut fibre mature, green coconut shell and mature coconut shell), and vegetable cultivated in inhospitable environments (cactus) aimed at the production of ethanol, being all materials abundant in the Northeast region of Brazil. These materials were submitted to pretreatments with alkaline hydrogen peroxide followed by sodium hydroxide (AHP-SHP), autohydrolysis (AP), hydrothermal catalyzed with sodium hydroxide (HCSHP) and alkali ethanol organosolv (AEOP). These materials pretreated were submitted to enzymatic hydrolysis and strategies of simultaneous saccharification and fermentation (SSF) and saccharification and fermentation semi-simultaneous (SSSF) by Saccharomyces cerevisiae, Zymomonas mobilis and Pichia stipitis. It was also evaluated the presence of inhibitory compounds (hydroxymethylfurfural, furfural, acetic acid, formic acid and levulinic acid) and seawater during the fermentative process. Materials pretreated with AHP-SHP have resulted in delignification of the materials in a range between 54 and 71%, containing between 51.80 and 54.91% of cellulose, between 17.65 and 28.36% of hemicellulose, between 7.99 and 10.12% of lignin. Enzymatic hydrolysis resulted in the conversions in glucose between 68 and 76%. Conversion yields in ethanol using SSF and SSSF for coconut fibre mature pretreated ranged from 0.40 and 0.43 g/g, 0.43 and 0.45 g/g, respectively. Materials pretreated by AP showed yields of solids between 42.92 and 92.74%, containing between 30.65 and 51.61% of cellulose, 21.34 and 41.28% of lignin. Enzymatic hydrolysis resulted in glucose conversions between 84.10 and 92.52%. Proceeds from conversion into ethanol using green coconut shell pretreated, in strategy SSF and SSSF, were between 0.43 and 0.45 g/g. Coconut fibre mature pretreated by HCSHP presented solids yields between 21.64 and 60.52%, with increased in cellulose between 28.40 and 131.20%, reduction of hemicellulose between 43.22 and 69.04% and reduction in lignin between 8.27 and 89.13%. Enzymatic hydrolysis resulted in the conversion in glucose of 90.72%. Ethanol yields using the SSF and SSSF were 0.43 and 0.46 g/g, respectively. Materials pretreated by AEOP showed solid reductions between 10.75 and 43.18%, cellulose increase up to 121.67%, hemicellulose reduction up to 77.09% and lignin reduced up to 78.22%. Enzymatic hydrolysis resulted in the conversion of glucose between 77.54 and 84.27%. Yields conversion into ethanol using the SSF and SSSF with cactus pretreated ranged from 0.41 and 0.44 g/g, 0.43 and 0.46 g/g, respectively. Fermentations carried out in bioreactors resulted in yields and ethanol production form 0.42 and 0.46 g/g and 7.62 and 12.42 g/L, respectively. The inhibitory compounds showed negative synergistic effects in fermentations performed by P. stipitis, Z. mobilis and S. cerevisiae. Formic acid and acetic acid showed most significant effects among the inhibitory compounds, followed by hydroxymethylfurfural, furfural and levulinic acid. Fermentations carried out in culture medium diluted with seawater showed promising results, especially for S. cerevisiae (0.50 g/g) and Z. mobilis (0.49 g/g). The different results obtained in this study indicate that lignocellulosic materials, pretreatments, fermentative processes strategies and the microorganisms studied deserve attention because they are promising and capable of being used in the context of biorefinery, aiming the ethanol production.

Avaliação da suplementação de vitamina E sobre a concentração de alfa-tocoferol no leite materno em mulheres com partos prematuros

The term vitamin E refers to a group of eight molecular compounds which differ in structure and bioavailability, and the RRR-alpha-tocopherol more biologically active form. The composition of vitamin E in breast milk undergoes variations during lactation, colostrum and milk richer in this micronutrient compared to transitional and mature milk. Newborns, especially premature infants are more susceptible to vitamin E deficiency and to prevent the damage caused by this deficiency has been proposed supplementation of neonates with this micronutrient, however, there is no consensus to carry out this intervention. Thus, maternal supplementation with RRRalpha-tocopherol in the postpartum period can be a good alternative to try to raise the alpha-tocopherol levels in breast milk and therefore provide the premature newborn adequate amounts of vitamin E. This study to evaluate the effect of supplementation with 400 UI acetate RRR-alpha-tocopherol in women with premature births, on the concentration of alpha-tocopherol in breast milk colostrum, transitional and mature. The study included 89 healthy adult women were enrolled in the control group (n = 51) and supplemented group (n = 38). Blood samples were collected and milk colostrum soon after birth (0h milk) twenty-four hours, new rate of colostrum milk was collected (24h milk). The transitional and mature milk were collected in seven days (7d milk) and thirty days (30d milk) after delivery, respectively. Supplementation in the supplemented group was held after the collection of blood and 0h milk. The alpha-tocopherol analyzes were performed by high-performance liquid chromatography. Serum levels of alpha-tocopherol less than 516 μg/dL were considered indicative of nutritional deficiency. The average concentration of alphatocopherol in the serum of the control group mothers was 1159.8 ± 292.4 μg/dL and the supplemented group was 1128.3 ± 407.2 μg/dL (p = 0.281). All women had nutritional status in vitamin E suitable. In both groups, it was observed that the concentration of vitamin E in colostrum milk was higher compared to transitional and mature milk. In the supplemented group, the concentration of alpha-tocopherol in the milk increased 60 % after supplementation, from 1339.3 ± 414.2 μg/dL (0h milk) to 2234.7 ± 997.3 μg/dL (24h milk). While the control group values in colostrum 0h and colostrum 24h were similar (p = 0.681). In the control group the follow-on milk alphatocopherol value was 875.3 ± 292.4 μg/dL and in the group supplemented 1352.8 ± 542.3 μg/dL, an increase of 35% in the supplemented group compared to control (p <0.001). In mature milk alpha-tocopherol concentrations between the control group (426.6 ± 187.5 μg/dL) and supplemented (416.4 ± 214.2 μg/dL) were similar (p = 0.853). Only 24h milk supplemented group answered the nutritional requirement of alpha-tocopherol (4 mg/day) of the newborn. These results show that the transport of this micronutrient for milk occurs in a controlled and limited way. Thus, the native vitamin E supplementation increases the concentration of alpha-tocopherol in colostrum and milk and transition does not influence the concentration in mature milk. Only the increase in colostrum milk was sufficient to meet the nutritional requirement of premature newborns.

Avaliação da concentração de vitamina A materna e de neonatos prematuros e a termo

Vitamin A is an essential nutrient for many physiological processes such as growth and development, so that their adequate nutritional state is essential during pregnancy and lactation. Lactating women and children in breastfeeding are considered risk groups for vitamin A deficiency and some factors may increase the risk of vitamin A deficiency, such as prematurity. The aim of this work was to evaluate the vitamin A concentration in preterm and term lactating women and newborns by determination of retinol in maternal serum, umbilical cord serum and breast milk collected until 72 hours postpartum. 182 mothers were recruited and divided into preterm group (GPT; n = 118) and term group (GT, n = 64). In preterm group were also analyzed transition milk (7th-15th day; n = 68) and mature milk (30th-55th day; n = 46) samples. Retinol was analyzed by high-performance liquid chromatography (HPLC). Maternal retinol concentration in serum was 48.6 ± 12.3 µg/dL in GPT and 42.8 ± 16.3 µg/dL in the GT (p <0.01). Cord serum retinol was 20.4 ± 7.4 µg/dL in GPT and 23.2 ± 7.6 µg/dL in GT (p> 0.05). Among newborns, 43% of premature and 36% of term had low levels of serum retinol in umbilical cord (<20 µg/dL). In colostrum, the retinol in preterm and term groups had an average of 100.8 ± 49.0 µg/dL and 127.5 ± 65.1 µg/dL, respectively (p <0.05). The retinol average in preterm milk increased to 112.5 ± 49.7 µg/dL in transition phase and decreased to 57.2 ± 23.4 µg/dL in mature milk, differing significantly in all stages (p <0.05). When comparing with the recommendation of vitamin A intake (400 µg/day) GT colostrum reached the recommendation for infants, but in GPT the recommendation was not achieved at any stage. Mothers of premature infants had higher serum retinol than mothers at term; however, this was not reflected in serum retinol of umbilical cord, since premature had lower concentration of retinol. Such condition can be explained due to lower maternal physiological hemodilution and placental transfer of retinol to the fetus during preterm gestation. Comparison of retinol in colostrum showed lower concentrations in GPT; however the transition phase there was a significant increase of retinol content released by the mammary gland of preterm mothers. This situation highlights a specific physiological adaptation of prematurity, likely to more contribute to formation of hepatic reserves of retinol in premature infants.

Serviço de nuvem pública e sua relação com os arranjos de governança de TI e o alinhamento estratégico

Increasingly, the Information Technology (IT) has been used to sustain the business strategies, causing increased its relevance. Therefore IT governance is seen as one of the priorities of organizations at the time. The search for strategic alignment between business and IT is debated as a factor for business success, but even with that importance, usually the main business managers are reluctant to take responsibility for decisions involving IT, mainly due to the complexity of your infrastructure. Since cloud computing is being seen as an element capable of assisting in the implementation of organizational strategies, because their characteristics enable greater efficiency and agility in IT, and is considered as a new computing paradigm. The main objective of the analyze the relationship between IT governance arrangements and strategic alignment with the infrastructure as a service (IaaS) of public cloud computing. Therefore, an exploratory, descriptive and inferential was developed, with approach to the problem of quantitatively research, with descriptive survey method and cross section. An electronic questionnaire that was applied to the ISACA chapters Associates of São Paulo and the Distrito Federal, totaling 164 respondents was used. The instrument used based on the theories of Weill and Ross (2006) for array of IT governance arrangement; Henderson and Venkatraman (1993) and Luftman (2000), for maturity of the strategic alignment model; and NIST (2011 b), ITGI (2007) and CSA (2010) for infrastructure maturity as a service (IaaS) public in its essential characteristics. As regards the main results, this research proved that with public IaaS decision-making structures have changed, with a greater participation of senior executives in all five key IT decisions (IT governance arrangement array) including more technical decisions as architecture and IT infrastructure. With increased participation of senior executives the decrease was also observed in the share of IT specialists, characterizing the decision process with the duopoly archetype (shared decision). With regard to strategic alignment, it was observed that it changes with cloud computing, and organizations with public IaaS, a maturity of strategic alignment with statistically significant and greater difference when compared to organizations without IaaS. The maturity of public IaaS is at the intermediate level (level 3 - "defined process"), with the elasticity and measurement achieved level 4 - "managed and measurable" It was also possible to infer in organizations with public IaaS, there are positive correlations between the key decisions and the maturity of IaaS, especially at the beginning, architecture and infrastructure, and the archetypes involving senior executives and IT specialists. In the correlation between the maturity and mature strategic alignment of public IaaS therefore the higher the strategic alignment, the greater the maturity of the public IaaS and vice versa.

Avaliação de megadoses de retinol palmitato no pós-parto imediato sobre o retinol do leite de puérperas atendidas no Hospital José Pedro Bezerra, Natal-RN

Vitamin A deficiency (VAD) is a serious public health problem in developing countries, and as a therapeutic and prophylactic measure retinil palmitate is being supplemented. Nevertheless its efficacy has been questioned. The objective of the study was to evaluate the supplementation of two retinil palmitate megadosis on the serum retinol levels of post partum healthy mothers from Dr. José Pedro Bezerra (Hospital Santa Catarina) hospital, Natal - RN. The enrolled women (n=199) were randomly distributed into three studied groups and supplemented with retinil palmitate immediately after delivery with a single 200,000 IU dose (group S1), two 200,000 IU dose (group S2) with 24h difference between the doses, or no supplementation (group C). Among women selected, 143 remained until the end of the study. The influence of vitamin A dietary intake was evaluated during pregnancy and after 30 days of delivery. The average intake of the population was reasonable, but a high prevalence of inadequate intake was found. Retinol in colostrums and mature milk was determined by high performance liquid chromatography (HPLC). The retinol average in colostrums and mature milk in the supplemented and control groups were adequate according to the reference values. In colostrums, women from groups C, S1 and S2 presented retinol averages by milk volume of 94.8 ± 40.2 µg/dL, 92.2 ± 50.0 µg/dL and 91.8 ± 53.7 µg/dL, respectively. No difference was found between these averages (p=0.965), this was also seen when the values where expressed as µg/g of fat (p=0.905). After 30 days of delivery, retinol per milk volume differed between the control group (36.6 ± 17.5 µg/dL) and groups supplemented with 200,000 IU (51.0 ± 28.8 µg/dL) or 400,000 IU (55.2 ± 31.6 µg/dL) of retinil palmitate (p<0,05). Nevertheless, when S1 and S2 groups where compared, no significant difference was found (p=0.97). Considering retinol/g of fat, the means were 12.7 ± 6.7 µg/g, 15.6 ± 8.3 µg/g and 17.2 ± 8.9 µg/g for groups C, S1 and S2, respectively, with significant difference between groups S2 and C (p=0,01). Subclinical VAD prevalence showed a serious public health problem in the study population (32% in colostrums and 31.5% in mature milk). When analyzing the groups separately, the group which received two doses (200,000 IU + 200,000 IU) presented the lowest VAD prevalence (20.7%). Retinil palmitate supplementations of 200,000 IU and 400,000 IU (divided in two doses) in the immediate post partum showed no significant difference. Nevertheless, the 400,000 IU (divided in two doses) supplementation showed a reduction in VAD

Influência da suplementação de retinol palmitato sobre os níveis de vitamina A no leite de puérperas saudáveis

The tendency towards reduction of serum retinol levels, an existing placental barrier and the increase of retinol demand, are factors that place puerperal and lactating women at risk for Vitamin A deficiency. This micronutrient is an essential component of vital processes such as differentiation, cellular proliferation, and apoptosis. The objective of this study is to evaluate the effect of palmitate retinol supplementation (100.000UI) upon the milk retinollevels in puerperal women at the Januário Cicco University Maternity Hospital. This intervention has been adopted by the Ministry of Health since 2002. The longitudinal experiment was conducted with 106 puerperal women (68 comprised the supplemented group and 38 the control group). The High Performance Liquid Chromatography (HPLC) method was used to dose the retinol of the milk and serum samples, and the creamtocrit method to determine the milk fat levels. The retinol means for the colostrums were 99.0 ± 64.4 ug/dL and 160.1 ± 94,4 ug/dl 6 hours afier supplementation; 68.9 ± 33.5 ug/dL for the transitional milk, and 30.6 ± 15.2 ug/dL for the mature milk of the supplemented group. Ali the difterences between means were statistically significant. The difterence between retinol means in the control group were also significant, with these being greater in the colostrum, 88.6 ± 62.1 ug/dL with 61.9 ± 30.1 ug/dl in the transition milk and 32.9 ±32.9 ± 17.6 ug/dL in the mature milk. No significant difference was observed in the retinol means of the three types ot milk in the supplemented group when compared to their respective means in the control group. The prevalence in serum (35.1 % and 81.1 % for the cutting point 20 ug/dL, respectively) and in milk (51.4%) revealed vitamin A deficiency as a public health problem. COlostrum, transition, and mature milk tats varied similarly in the supplemented group (1,92 ± 0,96; 3,25 ± 1,27 and 3,31 ± 1,36 grams) and in the control group (1,87 ± 1,14; 3,25 ± 1,31 and 3,36 ± 1,67 grams), with an observed difference between the colostrum/transition milk and the colostrum/mature milk fats. No difference was observed between the groups. The study showed that the 200.000UI supplementation was not sufficient to increase the milk retinol to the desired levels nor to meet the demands of the mothers with deprived hepatic reserves. It is suggested that another similar dose be offered within 30 days or less, and within 2 months post-partum, while continual/y monitoring for possible pregnancy