Abstract This article is a critical review of the act of handing over power and submission attributed to Motecuhzoma Xocoyotzin, in favor of Carlos I of Spain, through the intermedition of Captain Hernando Cortés. This fundamental passage in the history of the conquest of Tenochtitlan has had significant legal, political and historiographic implications to this day; therefore, it has been the subject of various analyzes from the perspective of European culture. However, the problem has been little explored, not only from the Spanish legal, political, documentary and historiographical perspective, but also not about what is known about the institutions, beliefs and political practices of the ancient Nahuas. This paper studies the Nahuatl perspective of the matter.

Resumen Este artículo es una revisión crítica de la acción de entrega del poder y sumisión atribuida a Motecuhzoma Xocoyotzin, en favor de Carlos I de España, por intermediación del capitán Hernando Cortés. Este pasaje fundamental en la historia de la conquista de Tenochtitlan ha tenido importantes y trascendentes implicaciones legales, políticas e historiográficas hasta el día de hoy, y por ello ha sido objeto de diversos análisis desde la perspectiva de la cultura europea. Sin embargo, poco se ha explorado el problema, no ya desde la perspectiva jurídica, política, documental e historiográfica española, sino desde lo que se sabe acerca de las instituciones, creencias y prácticas políticas de los antiguos nahuas. Este trabajo estudia la perspectiva náhuatl de la cuestión.

Abstract A multivariate characterization and subsequent cartography of the profiles of a sample of 164 environmental criminals of the Barinas state, Venezuela, was carried out, based on information coming from the sentences published by the courts of this state, during the 2005-2014 period. To develop the profiles, the two-stage cluster analysis was used. The multivariate sociodemographic profiling showed four types of ecological offenders: 1) Mixed group (men and women); 2) Young group, which is the largest with 43.5% of individuals in the sample; 3) Group of married; and 4) Group of foreigners, which is the lowest (12.9%). The other result shows that the commission of environmental crimes presents a marked geospatial dependence since they tend to be concentrated on the central and southwestern municipalities of the state.

Resumen Se realizó una caracterización multivariante y una posterior cartografía de los perfiles de una muestra de 164 delincuentes ecológicos del estado de Barinas, Venezuela, con base en información proveniente de las sentencias publicadas por los tribunales de este estado, durante el período 2005-2014. Para elaborar los perfiles se utilizó el análisis clúster bietápico. El perfilamiento sociodemográfico multivariante arrojó cuatro tipos de delincuentes ecológicos: 1) Grupo mixto (hombres y mujeres); 2) Grupo joven, que es el más numeroso con 43.5% de individuos de la muestra; 3) Grupo de casados; y 4) Grupo de extranjeros, que es el menos numeroso (12.9%). El otro resultado evidencia que la comisión de los delitos ecológicos presenta una acentuada dependencia geoespacial, pues tienden a concentrarse en los municipios del centro y del suroeste del estado.

The floristic diversity of the riparian forest of the Chili River along the riverbed that crosses the city of Arequipa (province and department of Arequipa) in the districts of Alto Selva Alegre, Cayma, Yanahuara, Cercado, Sachaca, Tiabaya and Uchumayo was studied. Forty-five sampling areas were selected where 245 species of flora (Magnoliophyta and Pteridophyta), divided into 177 genera and 66 families, were identified. An alliance and two associations are described as new syntaxonomic units according to the Braun-Blanquet phytosociological school and classified using the TWINSPAN software. The diversity of endemic species occurs in areas of rocky outcrops where the valley is narrower or encased, while the diversity of native species occurs along the entire riverbed. However, the presence of introduced species is higher in the middle part of the portion of the river that crosses the city. The correlation between environmental variables and floristic species with respect to the sampling locations was evaluated using the Canoco 5.0 software. Likewise, a trend assessment in case of flood due to increase in river flow has been carried and how it could affect the riparian forest, as happened in 1989, 1999 and 2012. In reference to conservation, it is suggested to preserve the fluvial and terrestrial ecosystems coexisting in the urban section and to lead to a sustainable development to improve the quality of life of the inhabitants. The different planning and management processes within the Chili river basin require an autonomous authority that could indicate the lines of action, continuous evaluation, monitoring and that include in the programs the active participation of citizens, and conduct and enhance the management and conservation plans of the riparian forest in the medium and long term period

Se estudió la diversidad florística del monte ribereño del río Chili a lo largo del cauce que atraviesa la ciudad de Arequipa (provincia y departamento de Arequipa) en los distritos de Alto Selva Alegre, Cayma, Yanahuara, Cercado, Sachaca, Tiabaya y Uchumayo. Se seleccionaron 45 áreas de muestreo donde se identificaron 245 especies de flora (Magnoliophyta y Pteridophyta) divididas en 177 géneros y 66 familias. Se describe una alianza y dos asociaciones como nuevas unidades sintaxonómicas según la escuela fitosociológica de Braun-Blanquet y clasificadas mediante el software TWINSPAN. La diversidad de especies endémicas se da en zonas de afloramientos rocosos donde el valle es más estrecho o encañonado, mientras que la diversidad de especies nativas se da a lo largo de todo el cauce; sin embargo, la presencia de especies introducidas es más elevada en la parte media del tramo del río que cruza la ciudad. La correlación entre variables ambientales y especies florísticas con respecto a las localidades de muestreo se evaluó mediante el software Canoco 5,0. Asimismo, se ha realizado una evaluación de tendencia en caso de inundación por aumento de caudal del río y cuán afectado podría verse el monte ribereño, como lo ocurrido en los años 1989, 1999 y 2012. En referencia a conservación, se sugiere la preservación de los ecosistemas fluviales y terrestres coexistentes en el tramo urbano y conllevar a un desarrollo sostenible para mejorar la calidad de vida de los habitantes. Los diferentes procesos de planificación y gestión dentro de la cuenca del río Chili requieren de una autoridad autónoma que pueda señalar las líneas de acción, evaluación continua, seguimiento y que incluya en los programas la participación activa de los ciudadanos, y conduzca y perfeccione los planes de gestión y de conservación del monte ribereño a mediano y largo plazo

Abstract: Some of the incantations compiled by Hernando Ruiz de Alarcón in his Tratado de las supersticiones y costumbres gentílicas (1629) correspond to the “disseases and sicknesses that come from illicit love affairs”, and more precisely, to “harm caused by love and desire”. This article analyses those sexual incantations from two points of view: that of ethnopoetics, with the strictly poetic problems emerging from Alarcón’s medical and magical incantations, and as an attempt, that of an ethnopsycoanalysis in search of the roots of the death drive.

Resumen: Entre los conjuros recopilados por Hernando Ruiz de Alarcón, en su Tratado de las supersticiones y costumbres gentílicas (1629), algunos corresponden a los “males y enfermedades que proçeden de amores illíçitos” y, más precisamente, a los “daños del amor y del deseo”. Este artículo analiza esos conjuros sexuales desde dos puntos de vista: el de la etnopoética, con los problemas propiamente poéticos de los conjuros médico-mágicos por Alarcón, y, de modo tentativo, el de un etnopsicoanálisis que investiga las raíces de la pulsión de muerte.

AbstractBackground: Congenital central alveolar hypoventilation syndrome (CCAHS) is a rare sleep-related breathing disorder. Although increasingly frequently diagnosed in sleep clinics and pediatric pulmonology services, its epidemiology is not known. There are about 300 reported cases reported in the literature with an incidence of 1 case per 200,000 live births. CCAHS is characterized by alveolar hypoventilation that occurs or worsens during sleep and is secondary to a reduction/absence of the ventilatory response to hypercapnia and/or hypoxemia. In 90% of the cases it is due to a PARM-type mutation of the PHOX2B gene. Treatment includes mechanical ventilation and diaphragmatic pacemaker. If therapy is not initiated promptly the patient can evolve to chronic respiratory failure, pulmonary hypertension, cor pulmonale and death.Case reports: In this paper we present three cases of CCAHS diagnosed, treated and followed up at the Sleep Disorders Clinic of the National Institute of Respiratory Diseases in Mexico.Conclusions: Early diagnosis is important to initiate ventilatory support so as to prevent any complications and to reduce mortality.

ResumenIntroducción: El síndrome de hipoventilación alveolar central congénita (SHACC) es un raro trastorno respiratorio del dormir, aunque cada vez más frecuentemente diagnosticado en clínicas de sueño y servicios de neumología pediátrica. Si bien se desconoce su epidemiología, en la literatura médica existen cerca de 300 casos reportados, y su incidencia es de 1 caso por cada 200,000 recién nacidos vivos. Se caracteriza por hipoventilación alveolar que se presenta o empeora durante el sueño. Es secundario a la disminución/ausencia de la respuesta ventilatoria a la hipercapnia o hipoxemia, y en el 90% de los casos es debido a una mutación tipo PARM del gen PHOX2B. Su tratamiento incluye ventilación mecánica y marcapasos diafragmático. Si la terapéutica no se inicia en forma temprana, el paciente desarrollará insuficiencia respiratoria crónica, hipertensión arterial pulmonar, cor pulmonale y la muerte.Casos clínicos: Se presentan tres casos de SHACC diagnosticados, tratados y en seguimiento en la Clínica de Trastornos Respiratorios del Dormir del Instituto Nacional de Enfermedades Respiratorias.Conclusiones: El diagnóstico temprano es importante para el inicio del soporte ventilatorio, y para prevenir el desarrollo de complicaciones y reducir la mortalidad.

Abstract The technical efficiency of 30 bean farms located in Portuguesa State, Venezuela was evaluated considering five inputs and one product that was related to socioeconomic and geospatial variables. The Data Envelopment Analysis (DEA) method was used, a product-oriented model. According to the results, on average, the overall technical efficiency (ETG) was 81.2%, broken down into pure technical efficiency (PTE) of 86% and scale efficiency (EE) of 95.1%. Inefficiencies caused by technology are higher than those generated by a suboptimal size or scale of production. According to the planning goals, we can increase the aggregate bean production by 23.1% without increasing the amount of current applied inputs. The socioeconomic and geospatial variables did not determined the levels of technical efficiency on the farms.

Resumen Se evaluó la eficiencia técnica de 30 explotaciones de frijol ubicadas en el estado Portuguesa, Venezuela, considerando cinco insumos y un producto, que fue relacionada con variables de tipo socioeconómico y geoespacial. Se empleó el método Análisis Envolvente de Datos (DEA), por sus siglas en inglés, con un modelo orientado al producto. Según los resultados, en promedio, la eficiencia técnica global (ETG) fue 81.2%, desglosada en una eficiencia técnica pura (ETP) de 86.0% y una eficiencia de escala (EE) de 95.1%. Las ineficiencias causadas por la tecnología son mayores que las generadas por un tamaño o escala de producción subóptimo. Según las metas de planificación se puede elevar la producción agregada de frijol en 23.1%, sin aumentar la cantidad de insumos aplicados actualmente. Las variables socioeconómicas y las de tipo geoespacial no determinaron los niveles de eficiencia técnica de las fincas.

Pain and stress experienced by the newborn have not been addressed adequately. Infants in neonatal intensive care units often undergo painful and stressful invasive procedures, and inappropriate treatment increases morbidity and mortality. At the 5th Clinical Consensus of the Ibero-American Society of Neonatology, 32 neonatologists from the region were invited to establish recommendations for the diagnosis and treatment of neonatal pain and stress. Key themes were explored based on the best scientific evidence available in indexed databases. All attendees participated actively in a meeting in Santiago, Chile, with the objective of reaching a consensus on recommendations and conclusions. Pain and neonatal stress affect neurological development and long-term behavior and require timely diagnosis and appropriate management and treatment, including the use of drugs with an appropriate balance between effectiveness and toxicity. The Consensus emphasized the importance of assessing pain in the newborn from a multidimensional viewpoint, and provided recommendations on the indications and limitations for an individualized pharmacological therapy. The use of analgesics has precise indications but also important limitations; there is a lack of randomized studies in newborns, and adverse effects need to be considered. Nonpharmacological measures to mitigate pain were proposed. Stress management should begin in the delivery room, including maternal contact, stimulus reduction and the implementation of intervention reduction protocols. Recommendations for improving clinical practices related to neonatal pain and stress are presented.

El dolor y estrés en el recién nacido (RN) se ha tratado en forma insuficiente; los recién nacidos que ingresan a las unidades de cuidados intensivos neonatales (UCIN), a menudo deben someterse a procedimientos invasivos, dolorosos y estresantes y el tratamiento inadecuado incrementa la morbimortalidad. El V Consenso Clínico de la Sociedad Iberoamericana de Neonatología convocó a 32 neonatólogos de Iberoamérica para establecer las recomendaciones sobre diagnóstico y terapéutica del dolor y estrés neonatal. Se desarrollaron temas de relevancia, utilizando la mejor evidencia científica disponible en bases de datos indizadas. Todos participaron en forma activa en una reunión presencial en Santiago de Chile para consensuar las recomendaciones y conclusiones. El dolor y el estrés neonatal afectan el neurodesarrollo y la conducta a largo plazo, requieren el diagnóstico oportuno, el manejo y la terapéutica adecuada, incluso con fármacos que permitan balancear la efectividad y toxicidad. El Consenso señala la importancia de evaluar el dolor en el RN en forma multidimensional y proporciona recomendaciones de las indicaciones y limitaciones para la terapia farmacológica individualizada. El uso de los analgésicos tiene indicaciones precisas y debe limitarse por la carencia de estudios aleatorizados en RN, ya que en todos los casos existen efectos adversos a considerar. Se proponen medidas no farmacológicas para mitigar el dolor. El manejo del estrés debe comenzar en la sala de partos e incluir el contacto materno, la reducción de estímulos, la implementación de protocolos de intervención reducida, entre otros. SIBEN propone las recomendaciones para mejorar las prácticas clínicas relacionadas con el dolor y el estrés neonatal.

OBJETIVO: Esta pesquisa teve como objetivo avaliar a eficácia de flocos desidratados de abóbora na elevação dos níveis séricos de retinol e a resposta relativa à dose em pré-escolares. MÉTODOS: A ingestão de vitamina A foi avaliada por meio de inquérito dietético. Os flocos foram analisados quanto às características microbiológicas e ao conteúdo de carotenoides. As crianças estudadas receberam diariamente 6g do produto no almoço, durante 90 dias. Elas foram submetidas ao teste de resposta relativa à dose no início e no final do estudo. Amostras de sangue foram colhidas em jejum, para análise do retinol sérico por espectro-fotometria, no início do estudo, aos 30 dias de consumo e aos 90 dias. RESULTADOS: Quanto às análises microbiológicas, os flocos encontravam-se adequados para consumo. O nível médio de retinol sérico nas crianças aumentou de M=1,438, DP=0,45µmol/L (tempo 0) para M=1,659, DP=0,51µmol/L (30 dias) e M=1,928, DP=0,70µmol/L (90 dias). No início do estudo, 18,5% das crianças apresentavam níveis de retinol sérico abaixo do ponto de corte de 1,05µmol/L, proporção que caiu para 7,6% depois de 30 dias e para 0% após 90 dias. No final do período de estudo (90 dias) nenhuma criança apresentou resposta relativa à dose positiva. CONCLUSÃO: Os flocos de abóbora são eficazes na elevação do retinol sérico e na reserva hepática da vitamina em pré-escolares.

OBJECTIVE: This study assessed the effectiveness of dehydrated pumpkin flakes for elevating serum retinol and the relative dose response in preschoolers. METHODS: Vitamin A intake was determined by dietary survey. The flakes were analyzed microbiologically and for carotenoid content. The children were then given 6 grams of flakes per day during lunch for 90 days. The relative dose response essay was done at baseline and end of intervention. Fasting blood samples were collected at baseline, 30 and 90 days to determine serum retinol levels by spectrophotometry. RESULTS: Microbiological analyses showed that the flakes were suitable for consumption. The mean serum retinol level of the children increased from M=1.438 (SD=0.45µmol/L) at baseline to M=1.659 (SD=0.51µmol/L) at 30 days and M=1.928 (SD=0.70µmol/L) at 90 days. At the beginning of the study, 18.5% of the children had serum retinol levels below 1.05µmol/L. This percentage dropped to 7.6% after 30 days and 0% after 90 days. At the end of the study period (90 days), no child had a positive relative dose response. CONCLUSION: Pumpkin flakes efficiently increase serum retinol levels and hepatic vitamin A reserves in preschoolers.

This study reports on the process and results of the Second Clinical Consensus of the Ibero-American Society of Neonatology. Eighty neonatologists from 23 countries were invited to collaborate and participate in the event. Several questions of clinical-physiological importance in the hemodynamic management of newborns were addressed. Participants were divided into groups to facilitate interaction and teamwork, with instructions to respond to three to five questions by analyzing the literature and local factors. Meeting in Mar del Plata, Argentina, the Consensus Group served as a form for various presentations and discussions. In all, 54 neonatologists from 21 countries attended, with the objective of reaching a consensus on such matters as concepts and definitions of hemodynamic instability, the physiopathology of hemodynamic compromise, recommended therapy strategies, and hemodynamic monitoring. It is hoped that this international experience will serve as a useful initiative for future consensus building and reduction of the existing disparities among the countries of the Region in terms of treatment and outcomes.

Este trabajo informa acerca del proceso y los resultados del Segundo Consenso Clínico de la SIBEN (Sociedad Iberoamericana de Neonatología), en el cual 80 neonatólogos de 23 países fueron invitados a participar y colaborar. Se desarrollaron varias preguntas de importancia clínico-fisiológica sobre el manejo hemodinámico del recién nacido. Los participantes fueron distribuidos en grupos, facilitando así la interacción y el trabajo conjunto, con la consigna de responder de tres a cinco preguntas mediante el análisis de bibliografía y factores locales. El Grupo de Consenso se reunió en Mar del Plata, Argentina, donde se llevaron a cabo diversas ponencias, debates y presentaciones. En total participaron 54 neonatólogos de 21 países, con el objetivo de desarrollar un consenso sobre aspectos que incluyeron conceptos y definiciones de inestabilidad hemodinámica, la fisiopatología del cuadro de compromiso hemodinámico, las estrategias terapéuticas recomendadas y el monitoreo hemodinámico. Se espera que esta experiencia internacional sirva como una iniciativa útil tanto para la búsqueda de futuros consensos como para reducir las disparidades existentes entre los tratamientos y resultados de los diferentes países de la Región.

The aim of the present study was to assess socioeconomic characteristics, dietary intake, nutritional status and cardiovascular risk (using anthropometric indicators of central obesity) in lacto-ovo vegetarians and non-vegetarians. Two non-vegetarians were selected for each vegetarian (paired for gender and age) in order to increase the power of the statistical tests. The sample was made up of 87 individuals (58.6% males; 29 vegetarians and 58 non-vegetarians) with a mean age of 40 + 13 years. Among the socioeconomic characteristics, only the number of residents per household differed between groups, with a greater percentage of homes with five or more residents in the vegetarian group. Concerning lifestyle, the groups differed with regard to smoking habits (p < 0.001), with a higher proportion of smokers among the non-vegetarians. There were no significant differences between groups in any of the anthropometric variables studied. Concerning dietary intake, no difference between groups was found with regard to total calorie intake, but the consumption of proteins, total lipids, saturated fat and cholesterol was higher among the non-vegetarians, whereas carbohydrate and fiber intake was higher among the vegetarians. The results of the present study suggest that, although a lacto-ovo vegetarian diet is considered healthier due to the lower consumption of total fat, saturated fatty acids and cholesterol, there are no significant differences in nutritional status or anthropometric indicators of cardiovascular risk when lifestyle and total calorie intake are similar.

O objetivo do presente trabalho foi avaliar características sócioeconômicas, estilo de vida, consumo alimentar, estado nutricional e o risco cardiovascular através de indicadores antropométricos de obesidade central de ovolactovegetarianos e onívoros. Para cada ovolactovegetariano foram selecionados dois onívoros de mesmo sexo e idade semelhante, visando ao pareamento das amostras nesses critérios e ao aumento do poder dos testes estatísticos. A amostra foi composta por 87 indivíduos, sendo 29 ovolactovegetarianos e 58 onívoros, com média geral de idade de 40 + 13 anos e 58,6% do sexo masculino. Dentro das características socioeconômicas, apenas o número de moradores por domicílio diferiu; os ovolactovegetarianos apresentaram um percentual maior na categoria de 5 ou mais pessoas. Quanto ao estilo de vida, os grupos diferiram apenas no hábito do tabagismo (p < 0,001), onde os onívoros apresentaram maior proporção de fumantes. Não houve diferença significativa nos valores médios entre os grupos em nenhuma das variáveis antropométricas estudadas. Nas variáveis de consumo, não foi encontrada diferença na ingestão calórica, porém o consumo de proteínas, lipídios totais, gordura saturada e colesterol foram maiores na dieta dos onívoros. Já o consumo de carboidratos e fibras foi maior nos ovolactovegetarianos. O presente estudo sugere que embora o perfil de consumo alimentar entre os ovolactovegetarianos seja considerado mais saudável, pelo menor consumo de gordura total, ácidos graxos saturados e colesterol, quando o estilo de vida e o consumo calórico total são semelhantes não há diferenças significativas no estado nutricional e nos indicadores antropométricos de risco cardiovascular.

OBJETIVO: Investigou-se a associação entre deficiência de vitamina A (DVA) e condições sociodemográficas em 291 puérperas de diferentes estratos socioeconômicos e seus respectivos recém-nascidos (RN), atendidos em uma maternidade pública do município do Rio de Janeiro, Brasil. MÉTODOS: Os níveis séricos de retinol materno e no sangue de cordão umbilical foram determinados segundo o método Bessey et al. modificado. RESULTADOS: As prevalências de DVA (retinol sérico <1,05 µmol/L) nas puérperas e RN foram de 22% e 54,2%, respectivamente. A DVA materna apresentou-se fortemente associada com a DVA nos RN (p<0,0001). A DVA materna não apresentou associação estatisticamente significativa com as variáveis sociodemográficas - escolaridade materna e renda familiar per capita. Tal achado leva a pensar que mesmo em populações nas quais a DVA subclínica seja a forma mais prevalente, o concepto também tem risco aumentado de nascer deficiente. CONCLUSÃO: A carência em questão é um problema significativo entre as puérperas e seus RN e a sua investigação deve ser incorporada às rotinas de assistência pré-natal. Modificação das práticas e da qualidade da dieta como estratégias de combate à DVA, dirigidas aos grupos populacionais vulneráveis, devem dedicar especial atenção às gestantes, independentemente do nível sociodemográfico.

BACKGROUND: Retinol was determined spectrophotometrically in the blood of 291 mothers at delivery and in the umbilical cord of the newborn. The mothers came from different socioeconomic strata in Rio de Janeiro. METHODS: Levels of retinol were determined using spectrophotometry (Bessey et al). RESULTS: The circulation levels of retinol were low (below 1.05 µmol/L) in 22.0% of the mothers and in 54.2% of the newborn. A close association was found between low levels in the mothers' serum and those in the children's' umbilical cord (p <0.0001). There was no association between maternal vitamin A deficiency (DVA) and socioeconomic stratum, family income or level of education. CONCLUSIONS: DVA is a distressing health problem among mothers and newborns and its diagnosis must be included in antenatal care. This reinforces the concept that intervention programs must emphasize changes in feeding practices and focus on the most vulnerable groups, of which pregnant women warrant special attention, regardless of socioeconomic stratum.

A vitamina A é essencial à preservação e ao funcionamento normal dos tecidos, assim como, ao crescimento e desenvolvimento. No humano há evidência indireta que a vitamina A em excesso, durante as primeiras semanas de gestação é teratogênica. Do contrário, não há dúvidas sobre os efeitos deletérios, de uma alimentação carente neste micronutriente e sobre a disponibilidade do conhecimento técnico para evitá-los. A preocupação com o fato de que a vitamina A conduziria a teratogenia em humanos, tem retardado a implementação de programas de combate a carência de vitamina A, atingindo principalmente os programas de enriquecimento de alimentos. A literatura é controvertida e dispõe de poucas informações sobre as doses para suplementação de gestantes. Como o retinol circulante materno é controlado homeostaticamente após o consumo de alimentos fonte de vitamina A, espera-se a mesma resposta metabólica após o consumo de alimentos fortificados, indicando que não há risco de teratogenia. Consequentemente, parece altamente improvável que o consumo de alimentos enriquecidos ou de suplementos de vitamina A pré-formada, nas doses unitárias habituais, tenha efeito teratogênico no homem.

The vitamin A is essential to the preservation and the normal functioning of tissues, as well as, to the growth and development. In the human being it has indirect evidence that the vitamin A in excess, during the first weeks of gestation is teratogenic. Of the opposite, it does not have doubts on the deleterious effect, of a devoid feeding in this micronutrient and on the availability of the knowledge technician to prevent them. The concern with the fact of that the vitamin A would lead it the teratogenicity in human beings, has delayed the implementation of combat programs the vitamin A lack, mainly reaching the programs of food enrichment. Literature is controverted and makes use of few information on the doses for supplementation of pregnant. As retinol circulating maternal is controlled homeostatic after the food consumption vitamin source, it expects after same metabolic reply the strengthened food consumption, indicating that it does not have teratogenicity risk. Consequently, highly seems improbable that the consumption of enriched foods or vitamin supplements the daily pay-formed one, in habitual the single doses, has teratogenic effect in the man.

A deficiência de vitamina A é considerada um dos problemas de saúde pública de fácil prevenção mais importantes em diversos países, inclusive o Brasil. Assim, o objetivo do presente trabalho foi revisar a literatura sobre carência de vitamina A publicada entre 1970 e 2000, disponível nas bases de dados MEDLINE e LILACS, e avaliar a hipovitaminose A na América Latina e no Brasil. A pesquisa revelou que até os anos 1980, a atenção dada pela saúde pública à vitamina A se concentrou na importância dessa vitamina para a visão. Na segunda metade dessa década, estudos epidemiológicos sugeriram que, em nível populacional, a deficiência sub-clínica de vitamina A também poderia ser deletéria para certas etapas do metabolismo, com grande influência sobre os índices de morbidade e mortalidade infantil. Em todas as regiões brasileiras para as quais existem dados, foi constatada a carência marginal de vitamina A, com alta prevalência em diferentes faixas etárias, o que não se justifica com a tecnologia e os recursos atualmente disponíveis. É preciso que se assuma o compromisso de reduzir a deficiência de vitamina A para garantir o desenvolvimento adequado das próximas gerações.

Vitamin A deficiency is considered one of the most important of the easily preventable public health problems in a number of countries, including Brazil. The objective of this study was to review the scientific literature in the MEDLINE and LILACS databases that was published between 1970 and 2000 concerning vitamin A deficiency, and to assess the occurrence of hypovitaminosis A in Latin America, especially Brazil. Our research showed that until around 1980 the public health concerns focused mainly on the importance of vitamin A in ensuring good vision. In the second half of the 1980s, epidemiological studies suggested that, on a population level, subclinical vitamin A deficiency could also have a negative effect on metabolic functions, with a great impact on childhood morbidity and mortality. Marginal vitamin A deficiency has been reported in all the regions of Brazil for which there are data available, with high prevalences in various age groups. This situation is inexcusable, given the health care technology and resources that are now available. There must be a commitment to reducing vitamin A deficiency in order to ensure the adequate development of future generations.

Foi avaliado o impacto da suplementação com doses maciças de vitamina A (200.000 UI) em pré-escolares atendidos em unidade de saúde do Rio de Janeiro. Inicialmente avaliou-se o nível de retinol sérico e as medidas antropométricas em 175 pré-escolares atendidos pelo Serviço Materno-infantil da Universidade Federal do Rio de Janeiro. Forneceu-se, então, uma dose maciça de 200.000 UI de vitamina A solicitando o retorno após 30 dias. Nas crianças que retornaram após este período (n=99), refez-se a avaliação de retinol sérico. A prevalência de hipovitaminose A (< 1,05 mimol/L) foi de 34,3% em todas as crianças avaliadas na primeira visita. Após a administração do suplemento vitamínico, a prevalência de hipovitaminose A nas crianças que voltaram ao serviço reduziu de 42,4 % para 3,0%. A dose maciça beneficiou preferencialmente as crianças com níveis inadequados. Na amostra, apenas 4,6% das crianças apresentavam desnutrição avaliada por medidas antropométricas. Não houve associação entre hipovitaminose A e renda familiar ou escolaridade dos pais. As taxas de prevalência encontradas indicaram que as crianças desta faixa etária são um grupo de risco para este problema nutricional. A reversão do quadro de carência provocada pelo suplemento vitamínico parece indicar que a ingestão inadequada de alimentos fonte de vitamina A seja um importante fator etiológico da hipovitaminose A. A prevalência encontrada também demonstrou que o problema não é exclusivo das áreas tradicionalmente pobres do país.

The impact of a massive dose of vitamin A on preschool children attended in a health unit from Rio de Janeiro was evaluated. Initially, serum retinol levels and anthropometric measurements were determined in 175 preschool children attended in the Children's Service of the Universidade Federal do Rio de Janeiro, after which a massive (200.000 IU) dose of vitamin A was provided. The children were requested to return to the unit after 30 days. Serum retinol levels were measured in the children who returned (n=99). The prevalence of low (below 1.05 µmol/L) levels of circulating retinol was of 34.3% in all children evaluated in the first attendance. After 30 days the prevalence was reduced from 42.4 to 3.0%. The lower the initial retinol levels the better the benefit from the massive dose. The proportion of children with protein-energy malnutrition was of 4.6%, but no clear association was found between vitamin A deficiency and protein-energy malnutrition. Vitamin A deficiency was independent of the household income and educational level of the parents. The response of children with vitamin A deficiency to the massive dose indicates that a low vitamin A intake may play an important role in the etiology of the problem. The prevalence figures also demonstrate that this problem is not exclusive of the traditionally poor areas of the country.