[Birth weight and later nutritional status, cognitive development and job status: a critical revision]

The impact of prenatal nutritional status, assessed through birth weight (BW) and their effects in the short, medium and long-term on nutritional status, cognitive development and job status in the adult life, has been a problem of interest for several researchers; as regards, some of these report a positive and significant association between these variables and others do not find any relation. Children with insufficient, low or very low BW despite the early more deteriorate nutritional status should present higher risk for brain maturation, failure cognitive development and lowered head circumference which implies both lowered brain volume and intellectual development. In the short and medium-term, this situation damages the learning process at school-age, while in the long-term this might condition the quality of jobs. At present, the body of knowledge pinpoints that findings related to these associations is not conclusive verifying a great controversy in these matters. This review article has the purpose of analyzing the current evidence, in order to stimulate research about to these aspects which are relevant for child development and their future life.

Twelve-year follow-up study of the impact of nutritional status at the onset of elementary school on later educational situation of Chilean school-age children

OBJECTIVE

To determine the impact of nutritional status in a multicausal approach of socio-economic, socio-cultural, family, intellectual, educational and demographic variables at the onset of elementary school in 1987 on the educational situation of these children in 1998, when they should have graduated from high school.

SETTING

Chile's Metropolitan Region.

DESIGN

Prospective, observational and 12-year follow-up study.

METHODS

A representative sample of 813 elementary first grade school-age children was randomly chosen in 1987. The sample was assessed in two cross-sectional studies. The first cross-sectional study was carried out in at the onset of elementary school in 1987 and the second was carried out in 1998, 12-years later, when they should be graduating from high school. In 1998, 632 adolescent students were located and their educational situation was registered (dropout, delayed, graduated and not located). At the onset of elementary school were determined the nutritional status, socio-economic status (SES), family characteristics, intellectual ability (IA), scholastic achievement (SA) and demographic variables. Statistical analysis included variance tests and Scheffe's test was used for comparison of means. Pearson correlation coefficients and logistic regression were used to establish the most important independent variables at the onset of elementary school in 1987 that affect the educational situation 1998. Data were analysed using the statistical analysis system (SAS).

RESULTS

Logistic regression revealed that SES, IA, SA and head circumference-for-age Z score at the onset of elementary school in 1987 were the independent variables with the greatest explanatory power in the educational situation of school-age children in 1998.

CONCLUSIONS

These parameters at an early school age are good predictors of the educational situation later and these results can be useful for nutrition and educational planning in early childhood.

A health promotion programme in Adventist and non-Adventist women based on Pender's model: A pilot study

OBJECTIVE

In the last decades, the epidemiological and demographic transition in Chile has resulted in a considerable increase in diet-related non-communicable chronic diseases. The aim of this study was to determine the impact of a health promotion programme (HPP) on behaviour in terms of the dimensions of the health-promoting lifestyle profile (HPLP) based on Pender's model. Pender based his research on the development of a model that explains, predicts and modifies forms of behaviour that promote health; an HPP based on this model may achieve positive changes that promote a healthy lifestyle.

STUDY DESIGN

This was a comparative study and the participants were Seventh-Day Adventist Church women (SDAW) and non-Seventh-Day Adventist Church women (NSDAW) aged 20-45 years from the urban area of Villarrica, Ninth Region of Chile. From a population of 300 women (150 SDAW and 150 NSDAW), a random sample of 18 SDAW and 18 NSDAW was chosen. Both groups were comparable in age and socio-economic status. An HPP was undertaken for both groups between April and September 2002. The response rate was 100%.

METHODS

The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using the Sign test and Wilcoxon's test. Data were processed using the statistical analysis system.

RESULTS

In both groups, the median scores increased significantly between the pre- and post-test periods for the overall HPLP score and the scores of the six dimensions. When comparing the median scores in SDAW with NSDAW, only the score for nutrition was significantly higher in SDAW than NSDAW in both the pre-test (P<0.0001) and post-test (P<0.0005) periods.

CONCLUSIONS

These findings demonstrate that an HPP based on Pender's model improves behaviour related to a health-promoting lifestyle in both groups, but more so for the NASDW.

Development of liquid chromatographic method for fosinoprilat determination in human plasma using microemulsion as eluent

Fosinopril sodium presents a prodrug for the active angiotensin converting enzyme (ACE) inhibitor, fosinoprilat. The dual elimination of fosinoprilat by the liver and the kidney distinguishes fosinopril from other angiotensin converting enzyme inhibitors. Such ways of elimination are important for antihypertensive therapy of patients on haemodialysis. The paper presents development and evaluation of a new and sensitive liquid chromatographic (LC) method for the analysis of fosinoprilat in plasma obtained from patients on haemodialysis. A microemulsion system mixture as mobile phase has been used for the separation and analysis of fosinoprilat in plasma samples. The plasma samples were injected directly onto the HPLC system (Waters Breeze) after appropriate sample dilution with mobile phase. Separations were performed on the Bakerbond ENV 4.6 mm x 150 mm, 5 microm particle size column with UV detection at 220 nm. The flow rate was 1.00 mL min(-1). The mobile phase consisted of 1.0% (w/v) of diisopropyl ether, 2.0% (w/v) of sodium dodecyl sulphate (SDS), 6.0% (w/v) of n-propanol and 91% (w/v) of aqueous 25 mM di-sodium hydrogen phosphate, pH adjusted to 2.8 with 85% orthophosphoric acid. The developed method was then subjected to method validation according to the criteria stated in the FDA bioanalytical method validation guidance. The results for specificity, linearity, low limit of quantification (LLOQ), precision, accuracy and stability were within the accepted criteria. The unique approach applied in this paper makes possible the determination of fosinoprilat even in the presence of metabolites of other drugs, so the method can be used for obtaining the reliable results in a fast and simple way.

Development and validation of RP–HPLC method for cetrimonium bromide and lidocaine determination

The simple and rapid RP-HPLC method, for the simultaneous determination of lidocaine and cetrimonium bromide in the presence of pellet color corrigent, was developed. Separations were performed on a Beckman Ultrasphere ODS 4.6 mm x 15 cm, 5 microm particle column at 40 degrees C. The mobile phase consisted of water phase and acetonitrile (72:28 V/V), pH value of the mobile phase was adjusted to 2.0 with 85% ortophosphoric acid. Bisacodil was used as an internal standard. The flow rate was 1 ml/min and UV detection was performed at 208 nm. The proposed RP-HPLC method was validated and all the parameters for the validation of the method are given. According to the obtained results, the developed method was found to be suitable and accurate for the determination of these drugs in commercial formulations.

Experimental design in reversed-phase high-performance liquid chromatographic analysis of imatinib mesylate and its impurity

For the determination of the optimal RP-HPLC chromatographic conditions for the separation of imatinib mesylate and its impurity STI 509-00 experimental design 2(4) was applied. All the factors that affect imatinib mesylate/STI 509-00 separation, as well as their mutual interactions were investigated. Methanol and triethylamine content in the mobile phase, pH of the mobile phase and column temperature were independent variables or factors to be investigated in two levels: "low" and "high". Capacity factor was chosen as a dependent variable. From the experimentally determined capacity factor values, it was defined the factors that affect to chromatographic system the most. Applying response surface methodology the appropriate graphs were constructed from experimental points and optimal chromatographic conditions for the separation were defined. Optimal conditions for the separation of imatinib mesylate and STI 509-00 were obtained using X Terra 150 mm x 4.6 mm, particle size 5 microm column at 25 degrees C. Mobile phase consisted of 250 ml of methanol, 740 ml of water and 10 ml of triehylamine. pH of water phase was adjusted to 2.4 with 85% orthophosphoric acid and then methanol was added.

Reversed-phase liquid chromatography analysis of imatinib mesylate and impurity product in Glivec® capsules

The reversed-phase high-performance liquid chromatographic (RP-HPLC) method has been developed and validated for the simultaneous determination of imatinib mesylate and of the impurity product in Glivec capsules (Novartis, Switzerland). Separations were performed on a X Terra 150 mm x 4.6 mm, 5 microm particle size column at 25 degrees C. The mobile phase was a mixture of methanol-water-triethylamine (25:74:1, v/v/v) with flow rate of 1.0 ml min(-1). pH value of water-triethylamine (TEA) was adjusted to 2.4 with orthophosphoric acid before adding of methanol. UV detection was performed at 267 nm. Acetaminophen was used as an internal standard. The method was validated statistically for its selectivity, linearity, precision, accuracy and robustness. Due to its speed and accuracy, the method may be used for quality control analyses.

Optimization of the RP-HPLC method for multicomponent analgetic drug determination

The optimization of RP-HPLC method defined the simultaneous influence of some important conditions, such as the mobile phase composition, pH of the mobile phase and temperature, on the separation and determination. The RP-HPLC method was done for the determination of paracetamol, caffeine and propyphenazone in a multicomponent pharmaceutical dosage form. The separation factor values define the optimal conditions, which were confirmed by analysing the appropriate mathematical models. The chromatographic system Hewlett Packard 1100 consisted of a HP 1100 pump, HP 1100 UV-VIS detector and HP integrator. Separations were performed on a Beckman Ultrasphere ODS 4.6 x 150 mm, 5 microns particle size column. Samples were introduced through a Rheodyne injector valve with a 20 microL sample loop. UV detection was performed at 265 nm and phenobarottons was used as an internal standard. The optimization was performed within the pH range from 2.5 to 6.0; temperature range from 20 degrees C to 55 degrees C and composition of the mobile phase methanol-water from (30:70 V/V) to (65:35 V/V). The three-D graphs, constructed with sixty-four experimental points, confirmed the optimal conditions for the determination of the investigated analgetic drugs.

Second-derivative spectrophotometric assay of pseudoephedrine, ibuprofen and loratadine in pharmaceuticals

In this paper the second-derivative spectrophotometric method for the simultaneous determination of pseudoephedrine (CAS 90-82-4) in the combinations with ibuprofen (CAS 15687-27-1) and loratadine (CAS 79794-75-5) is described. Optimal conditions for the quantitative analysis of coated tablets (Test I) and tablets (Test II) were settled. The second-derivative order of the spectra in ethanol with the wavelength modulation was used. For the quantitative assay for all of the investigated substances in the laboratory mixture or in respective pharmaceutical dosage forms the "zero-crossing" technique was applied. The authors propose this second-derivative spectrophotometry for a rapid, simple, precise and accurate determination of the mentioned tests or a corresponding multicomponent mixture.

Statistical optimization of a reversed-phase liquid chromatographic method for the analysis of amiloride and hydrochlorothiazide in tablets

A method has been developed for the separation of hydrochlorothiazide and amiloride by high-performance liquid chromatographic (HPLC) method on a C18 column with detection at 280 nm. The optimal conditions of separation were determined with the aid of 'window diagram' technique of Laub and Purnell. The effect of simultaneously varying the pH, proportion aqueous acetic acid and methanol in the mobile phase were studied to optimize the separation. A response surface diagram was used to optimize the experimental conditions for the separation. The mobile phase composition that provides an acceptable resolution hydrochlorothiazide and amiloride in a short elution time is water:methanol (60:40) and pH 3.2 (pH adjusted to 3.2 with CH3COOH). A method is applied for the quantitative analysis of Moduretic tablets (Merck Sharp & Dokme International). The powdered tablets are extracted with methanol, containing caffeine as the internal standard, and assayed by comparison of peak areas after liquid chromatography.

[Food and nutrition knowledge of school-age children's mothers from elementary and high school from different socioeconomic levels]

The objective of this study was to determine the degree of knowledge on food and nutrition of school-age children's mothers from Chile's Metropolitan Region and to measure the impact of socioeconomic, sociocultural and demographic variables on knowledge. A representative and proportional sample of 4,509 school-age children was chosen from Chile's Metropolitan Region and the degree of knowledge on food and nutrition on mothers of 1,985 of them was determined. The sample was stratified according to grade (I, II, IV, VI, VIII elementary school grades and I and IV high school grades), sex, type of school and geographic area. Socioeconomic status (SES) was determined through Graffar's modified method. The degree of knowledge on food and nutrition was assessed by a test based on the specific objectives pursued by the elementary school curriculum programs of the Ministry of Education and submitted to adequate statistical proofs for its content validity and reliability. Mother's schooling level mean was 9.7 +/- 4.0 y. The field study was carried out on 1986-1987. Statistical procedures included analysis of variance, Student "t" test for comparison of the means, correlation and regression. Results revealed that mothers did not know food and nutrition matters in fundamental aspects related to the observance of a healthy lifestyle, both, for themselves and their family. The degree of knowledge of food and nutrition significantly and positively correlated with SES, mother's schooling and occupation level, housing conditions (quality and sanitation) and age, and significantly and inversely correlated with the number of sons and crowding, besides of being significantly higher in urban than rural mothers. Mother's schooling level and geographic area were the independent variables with the greatest explanatory power in the food and nutrition knowledge variance (r2 = 0.1723), but mother's schooling level explains 93.2% of the explained variance. Results suggest the need to introduce, during school age, nutrition education programs focused on mother and children to improve the population life quality.

[Food and nutrition knowledge of elementary and high school-age children from Chile's Metropolitan Region]

BACKGROUND

In Chile there is scarce food and nutrition knowledge among school age children.

AIM

To determine the degree of food and nutrition knowledge of elementary and high school children and its relationship to socioeconomic status, sex, type of school and geographic area.

SUBJECTS AND METHODS

Between 1986 and 1987, a representative and proportional sample of 4509 children was chosen from the Metropolitan Region. This sample was stratified according to school grade, sex, type of school and geographical area. Graffar's modified method was used to measure socioeconomic status. Food and nutrition knowledge was assessed by a specific test for each grade, based on the objectives pursued by the curricular programs of the Ministry of Education.

RESULTS

The test was applied to 4197 children. Food and nutrition knowledge was significantly lower in the second subcycle of elementary school, in males, in older children from each grade, in rural areas, in children of low socioeconomic status and in public schools.

CONCLUSIONS

School age children were unaware of fundamental aspects related to food and nutrition and curriculum programs of the Ministry of Education should be reformulated to overcome these deficiencies.

[Head circumference in Chilean school children 5 to 18 years of age and socioeconomic status]

The objectives of this study were to determine the head circumference (HC) values of a representative sample of 4,346 school children aged 5 to 18 years from Chile's Metropolitan Region, to carry out a comparative study with international reference data of Tanner, Nellhaus and Roche et al and to compare the HC values by socioeconomic status (SES). The sample included school children of both sexes, from public, private subsidized and private non-subsidized schools and from urban and rural areas. HC was measured according to Jelliffe norms and SES through Graffar's Modified Method. Results showed a high correlation between HC values of school-age children from Chile's Metropolitan Region and Tanner, Nellhaus and Roche et al Tables, with similar growth curves; from this manner, HC values of school-age children from Chile's Metropolitan Region not differ significantly from international reference data. HC values were, in general, significantly higher in males than females in all age groups, in students from high SES to compare with other socioeconomic strata and in older school children. This fact was tested too in 1992, in a representative sample of 605 poor school children beneficiaries from the School Feeding Program in Peñalolen and Pirque Counties from Chile's Metropolitan Region with similar results. It can be concluded that HC values of school-age children from Chile's Metropolitan Region were higher in males than females, in high SES compared with medium and low SES and in older students and does not differ significantly from international reference data.

[Nutritional status of school children in poverty conditions from urban and rural areas. Metropolitan region. Chile. 1986-1987]

The aim of this study was to compare the nutritional status of poor children from urban and rural areas and to quantify the impact of socioeconomic, sociocultural and family variables on nutritional status. Weight/age, height/age, weight/height and head circumference percentages were measured in a representative sample of 4509 school children, 39% belonging to a low socioeconomic status and living in the Metropolitan region, chosen according to grade, type of school, sex and geographic area. Children coming from rural areas had significantly higher percentages of undernutrition than children from urban areas according to weight/age (47 vs 34%, and weight/height (7.7 vs 4.6%); likewise they had a higher proportion of height/age ratios below 90% (10.3 vs 5.2%). Head circumference was below 100% in 77 and 65% of rural and urban children. Brachial anthropometric variables were also lower in rural children. The number of siblings and family size were the independent variables with the greatest explanatory power for weight/age and height/age variations. Mother's instruction in urban areas and crowding, family alcoholism and mother's instruction in rural areas, were the independent variables with the greatest explanatory power for head circumference variation. It is concluded that the significant relationship found between socioeconomic, sociocultural and family variables ad nutritional status is relevant, considering that the sample was homogeneous in each geographic area.

Poisoning with 2,4-dichlorophenoxyacetic acid treated by hemodialysis

In this paper four patients are presented who had been poisoned by 2,4-dichlorophenoxyacetic acid (2,4-D). The first patient, aged 51 years, had attempted to commit suicide by taking orally 400 ml of a 40% solution of 2,4-D. He was admitted in a coma, 6.5 h after poisoning. Extracorporal hemodialysis was performed and the course of the illness was satisfactory. The second patient, aged 80 years, had accidentally drunk 100 ml of a 40% solution of 2,4-D. He was admitted in a coma a few hours after poisoning. Hemodialysis and resin hemoperfusion were performed and the course of the illness was satisfactory. Prior to the above therapy the patient had a 2,4-D serum concentration of 177 mg/100 ml. 2,4-D clearance was 56.3 ml/min during this therapy. The third patient, aged 24 years, had drunk 200 ml of a 40% solution of 2,4-D in a suicide attempt, and paraquat poisoning was also suspected. He was admitted 10 h after poisoning and immediately hemodialysis and hemoperfusion were carried out: the course of the illness was satisfactory. On admittance the concentration of 2,4-D in serum was 122.5 mg/100 ml, and clearance was 72.9 ml/min during treatment. The fourth patient, aged 50 years, had accidentally drunk 100-200 ml of a 40% solution of 2,4-D. He was admitted in a coma 3 h after poisoning. Hemodialysis was performed and the course of the illness was satisfactory. On admittance the concentration of 2,4-D in serum was 37 mg/100 ml and clearance was 68.7 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)

Nutrition and education. III. Educational achievement and food habits of Chilean elementary and high school graduates

The objective of this study was to correlate the educational achievement (EA) of Chilean elementary and high-school graduates with their food habits. For this purpose, a random sample of 550 schoolers from the Metropolitan Area of Santiago, Chile, graduating from elementary and high school (1:1) of both sexes (1:1), from public and private schools and from high, medium and low socioeconomic status (SES) (1:1:1), was selected. Food habits were determined through a specially designed questionnaire and defined as the frequency of consumption of the food groups, expressed as days per week. The EA was established through the Achievement Evaluation Program (AEP) and Academic Aptitude Test (AAT) in elementary-and high-school graduates-, respectively. Results revealed that EA was found significantly and positively correlated with the frequency of consumption of dairy products, meat products and eggs, in both elementary and high school graduates. A significant and inverse correlation between EA and the frequency of vegetables and fruits consumption was observed in both educational levels, and with miscellaneous products, only in elementary school graduates. Food habits explained 24.4% and 16.6% of the EA variance, in elementary and high school graduates, respectively. The frequency of consumption of dairy products was the independent variable with the greatest explanatory power in EA variance (approximately above 70% of the explained variance). These results are important to consider for educational planning focused on the School Feeding Program.

Nutrition and education. II. Educational achievement and nutrient intake of Chilean elementary and high school graduates

The interrelationships between educational achievement (EA) and nutrient intake were investigated in 550 Chilean adolescent schoolers graduating from elementary and high school. The random sample included schoolers from both educational levels (1:1), from public and private schools (1:1), and from high, medium, and low socioeconomic status (SES) (1:1:1). Standard procedures for 24-hour dietary recall interviews were used to collect data, and adequacy of intake was assessed by the FAO/WHO Pattern. EA was measured by means of the Achievement Evaluation Program (AEP) and Academic Aptitude Test (AAT) in elementary and high school, respectively. In elementary school graduates, results showed a significant and positive correlation between EA (AEP) and energy, protein, riboflavin, ascorbic acid, calcium and vitamin A intake (Multiple r = 0.456 p less than 0.01; r2 = 0.208). The School Feeding Program beneficiaries who belonged to the low SES presented the lowest EA (AEP) together with a deficient nutrient intake, especially for energy, riboflavin, niacin, vitamin A and calcium, at the same time that they registered the lowest values for those anthropometric parameters, indicators of past nutrition, that is to say height-for-age, weight-for-age, head circumference-for-age and a higher upper-to-lower segment ratio, as compared with non-beneficiaries from the same SES and with those from the higher strata. In high-school graduates, EA (AAT) was found to be significantly and positively correlated with protein, calcium, riboflavin and iron intake (Multiple r = 0.438 p less than 0.001; r2 = 0.192). Nevertheless, these interrelationship are strongly related to SES and sex. Results showed that educational achievement (EA) is significantly and positively associated with nutrient intake, this fact being important for educational planning related to the School Feeding Program.

[Body weight and height in students from the metropolitan area of Chile: impact of the socioeconomic level]

The purpose of this study was to assess the impact of socioeconomic (SE) status over weight and height of school children aged 5-18 years. A representative sample of 4509 school children was randomly chosen from Chile's Metropolitan Region (representative of 38% of the Chilean school population), according to grade, sex, type of school and geographic area. Weight and height were expressed as percentages derived from tables from the WHO. SE status was measured by the Graffar's modified method. Weight and height significantly decreased with SE status in all age groups. No difference was found in weight and height between males and females within SE and age groups. Weight and height in all SE groups were higher in this study compared to previously reported findings. This difference may be related to improvements in socioeconomic and cultural conditions in the last decades.

[Nutritional status of students according to sex and age. Metropolitan area of Santiago, Chile, 1986-1987]

A representative sample of 4509 schoolers from elementary and high schools in the Metropolitan area of Santiago was randomly chosen and their nutritional status analyzed by anthropometric measurements. Percentages of weight for age (W/A), height for age (H/A) and weight for height (W/H) were evaluated according to WHO tables. Undernutrition (low W/A) was diagnosed in 31% of males and 28% of females, obesity (increased W/H) in 9% of males and 17% of females and overweight in 18% and 22%, respectively. Undernutrition increased while obesity decreased with age. To a large extent, differences found in nutritional status could be explained by mild growth failure which existed in 27% of males and 28% of females. Therefore, W/H better expresses the nutritional status of these schoolers. The high prevalence of obesity and overweight is a serious health problem demanding preventive measures in order to avoid complications in later life.

Digoxin-like substance in the serum of uremic patients before and after hemodialysis

Digoxin concentrations in serum samples were measured before and after hemodialysis of 31 uremic patients (pts) who either never took digoxin or who had not taken digoxin for at least 1 year. False positive digoxin was found in 22 of 31 patients (71%) before hemodialysis and in 14 of 31 patients (45%) after hemodialysis. The concentrations ranged from 0.1 to 0.5 nmol/L, mean value was 0.20 +/- 0.16 before hemodialysis and after hemodialysis ranged 0.1 to 0.4 nmol/L mean value was 0.11 +/- 0.14 nmol/L. The difference before and after hemodialysis is statistically significant. Some of the patients had a constant value before and after hemodialysis. None had a higher value after hemodialysis than they did before. Eight patients, who had positive serum digoxin before hemodialysis with concentrations up to 0.5 nmol/L, became negative after hemodialysis. Our results indicate that a digoxinlike substance in uremic serum could be at least partly dialyzable.