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Biomedical subjects

Dirce Maria Sigulem

Publications and source records attributed to Dirce Maria Sigulem.

8 recordsLinked to original sources

Bacterial contamination and nutrient content of home-prepared milk feeding bottles of infants attending a public outpatient clinic.

To evaluate the bacterial contamination and the nutrient content of home-prepared milk feeding bottles, 48 samples of their lacteal contents were collected; of these, 29 samples were cultured and 48 were analyzed to determine their macronutrients composition by chemical analyses. The medians (percentiles 25 and 75) of the counts (bacteria/ml) were mesophilic bacteria, 78,000 (500-1,125,000) and coliforms, 600 (0-44,000). Adding sugar (41/48) and cereals (39/48) to the milk was a common practice. The medians of the macronutrients contents (g/dl or kcal/dl) of the feeding bottles with and without the addition of cereals were, respectively: protein, 2.8/2.4; fat, 1.1/2.2; carbohydrate, 14.5/8.6; energy, 88.7/57.2. Feeding bottles with the addition of cereals had carbohydrate and energy contents significantly higher. Home-prepared milk feeding bottles were heavily contaminated. Most milk feeding bottles met or exceeded the recommended values proposed by European Society of Pediatric Gastroenterology and Nutrition for follow-up formulas, except for fat.

Animals↗

A training course on food hygiene for butchers: measuring its effectiveness through microbiological analysis and the use of an inspection checklist.

The effectiveness of food hygiene training for a group of retail butchers was evaluated with the aim of verifying whether the butchers modified their behavior in the light of knowledge gained and whether their acquired knowledge or behavior change was sustained over a period of time. Microbiological analysis (enumeration of mesophilic and coliform bacteria and Escherichia coli) of a raw semiprocessed product (stuffed rolled beef) was conducted, and an inspection checklist was issued before the training course (T0). Initial results were later compared with results obtained 1 month (T1) and 6 months (T6) after the training. The checklist comprised 89 items classified into five categories: A, approved suppliers and product reception; B, storage conditions and temperature control; C, flow process, food handling procedures, and conditions of the window display unit; D, facility design and proper cleaning and sanitizing of equipment, utensils, and work surfaces; and E, pest control system, water supply control, and garbage disposal. The inspection results were recorded as "yes" or "no" for each item. Compliance with food safety procedures was recorded as the percentage of "yes" answers. The bacterial counts were significantly higher at T0. At T6, there was no significant increase in bacterial counts. There was a significant improvement in food safety practices at T1 and T6 compared with T0 for all categories. When comparing T0 and T1, the largest increases in the compliance scores were seen within categories C and D. No significant decrease in scores for compliance with food safety practices was observed at T6. Supervision and refresher activities may be necessary to maintain behavioral changes for a longer period of time.

Animals↗

[Protective factors for iron deficiency anemia: prospective study in low-income infants].

This study was performed to assess both risk and protective factors associated with iron deficiency anemia in 130 infants with age below 24 months, with low socio-economic status and followed since their births by a primary health care program in the city of São Paulo, Brazil. Growth, morbidity and dietary factors were analysed as well as hemoglobin levels (Hb) at regular intervals (6, 9, 12, 18 and 24 months). The portable Hemocue photometer was employed to measure hemoglobin levels and anemia was considered when Hb values were below 11 g/dL. Simple logistic regression was used with socio-economic variables, age group, nutritional status, morbidity, breastfeeding and food intake. Risk factors for anemia in the studied group were intake of cow's milk at 4 months and who has 3 or more old brothers (OR approximately = 2). The protective factors for anemia were age between 18 and 24 months and intake of infant formula, vitamin C, meat and beans at 6 months (OR approximately = 0.5). The prevention of iron deficiency anemia includes encouraging healthy feeding practices starting at 6 months of life.

Anemia, Iron-Deficiency↗

[Comparison of nutritional status of low-income children in the second year of life, before and after primary health care program implantation].

The so-called "Slum Project" or Projeto Favela at the São Paulo School of Medicine, Federal University in São Paulo, conducts numerous primary health care activities in low-income communities in the city of S o Paulo to prevent and control nutritional deficiencies. The aim of this study was to compare the nutritional status of children from 12 to 26 months of age before and after preventive intervention. The study was conducted with two groups, before and after intervention, with 57 and 65 children, respectively. Anthropometric measures and hemoglobin values were obtained. In the before-intervention group, the prevalence of malnutrition as measured by weight for age and weight for height was 12.3% and 1.8% respectively, whereas there were no cases of malnutrition in the after-intervention group. There was a reduction in the prevalence of anemia, especially the severe form, from 33% to 7%. Mean hemoglobin increased from 10.1 to 11.0 g/dl, and the duration of breastfeeding was greater (> 180 days) after intervention.

Adolescent↗

[Food composition tables: laboratory comparative analysis].

OBJECTIVE: To evaluate the agreement between macronutrients and food energy values analyzed in laboratory and data of food composition tables and software available in Brazil. METHODS: Eleven types of food were analyzed totaling 701 samples. Student's t-test was performed consisting of the comparison between the mean values obtained in laboratory and the unique constant value of each table or software at 5% confidence level. RESULTS: It was noted that depending on the type of food, nutrient and table or software selected for comparison, there were significant statistically differences between laboratory and tables and software data. Concerning the studied types of food it was observed a trend of overestimating protein and carbohydrate content in two tables while carbohydrate content was overestimated in a third table. One of the software programs showed overestimated lipid content and, consequently, the total energetic values while a second software program underestimated all nutrients when compared to laboratory results. CONCLUSIONS: The results showed it is essential to create a Brazilian food composition table from laboratory data to assure more accurate data.

Analysis of Variance↗

Effects of an oxalate load on urinary oxalate excretion in calcium stone formers.

OBJECTIVE: To investigate the oxalate intake and the effect of an oxalate load on urinary oxalate excretion in calcium stone-forming (CSF) patients. DESIGN: Prospective study. SETTING: University-affiliated outpatient Renal Lithiasis Unit. PATIENTS AND CONTROLS: Seventy (70) CSF and 41 healthy subjects (HS) collected a 24-hour urine sample and were submitted to a 3-day dietary record to determine mean oxalate (Ox), calcium (Ca) and vitamin C intake. Fifty-eight (58) CSF patients were randomly selected to receive milk (N = 28) or dark (N = 30) chocolate as an oxalate load. INTERVENTION: Administration of either milk (94 mg Ox + 430 mg Ca) or dark chocolate (94 mg Ox + 26 mg Ca) for 3 days. A 24-hour urine sample was obtained before and after the load to determine calcium, oxalate, sodium, potassium, urea, and creatinine. MAIN OUTCOME MEASURE: Oxalate intake and excretion. RESULTS: CSF patients presented mean Ox intake of 98 +/- 137 mg/d, similar to that of HS (108 +/- 139 mg/d). Mean Ox and vitamin C intake was directly correlated with Ox excretion only in CSF. The consumption of dark chocolate induced a significant increase in mean urinary Ox (36 +/- 14 versus 30 +/- 10 mg/24 hr) not observed in the milk chocolate group. Thus, a 2-fold increase in Ox intake in this population of CSF patients produced a significant 20% increase in oxaluria, not observed when Ca was consumed simultaneously. CONCLUSION: The present study suggests that even small increases in Ox intake affect oxalate excretion and the mitigation of urinary oxalate increase by Ca consumption reinforces that Ca and Ox intakes for CSF patients should be in balance. Further studies are necessary to assess whether or not a 20% increase in oxaluria will lead to a higher risk of stone formation.

Adult↗

Determination of macronutrients, by chemical analysis, of home-prepared milk feeding bottles and their contribution to the energy and protein requirements of infants from high and low socioeconomic classes.

OBJECTIVES: To determine the macronutrients composition of home-prepared milk feeding bottles, by chemical analysis, and assess their contribution to the energy and protein requirements of children under two years of age from high (HSE) and low (LSE) socioeconomic classes. METHODS: 72 samples were analyzed for energy density and protein, fat and carbohydrate content: 41 from the LSE group and 31 from the HSE group. The assessment of the percentages of the energy and protein requirements met by the consumption of the milk bottles was calculated as follows: the energy and protein per 100 mL obtained through chemical analysis were multiplied by the volume consumed at each feeding, then by the number of feedings per day, the results divided by the energy and protein requirements and multiplied by 100. Energy and protein requirements were those recommended by the FAO/WHO/UNU Committee and the Food and Nutrition Board. The children's weight-for-age index was assessed. RESULTS: Unmodified cow's milk was largely consumed by both groups. The addition of sugar and other ingredients to the milk was significantly higher in the LSE group. Moisture, protein and fat content were lower in the LSE group, whereas carbohydrate and energy content were higher. The percentages of energy and protein requirements provided by feeding bottles were higher in the LSE group. Children in the LSE group had lower z-scores for weight-for-age. CONCLUSIONS: Differences in the preparation practices led to differences in the chemical results. The feeding bottles in the LSE group were high in energy, due to the addition of sugar and cereals to the milk in the bottle. The milk feeding bottles were an important weaning food providing more than 50% and 100% of the children's energy and protein requirements, respectively. The children's weight-for-age index was within the normal limits.

Animals↗