RESUMEN
OBJECTIVE: To evaluate the effect of zinc supplementation on growth and development during infancy. DESIGN: We randomized 150 term neonates of low socioeconomic status to receive supplemental zinc 5 mg/d (SG) or a lactose placebo (PG); 112 completed a 1-year follow-up. All were breast-fed and given cow milk formula after weaning; solid foods and iron were added at 5 months. Anthropometry measured monthly, psychomotor development (PDI), mental development (MDI), and behavior including motor quality factor were assessed by Bayley Scales at 6 and 12 months. The groups were comparable in maternal characteristics, birth weight, home environment, and mother-infant interaction. RESULTS: No effects of zinc on weight, length, and weight for length at 12 months were found controlling for sex and breast-feeding. The mean PDI (SG: 84.5 +/- 11.5 vs PG: 87.6 +/- 9.9) and MDI (90.9 +/- 10.5 vs 88.9 +/- 9.1) were similar; however, 46 of 52 infants in the PG scored <100 in MDI vs 42 of 57 in the SG (P <.05). A smaller proportion of the SG, 2 of 57, scored low in motor quality factor at 6 months compared with the PG, 8 of 52 (P =.02). The mean at 12 months for the SG was 31.9 +/- 2.8 and for the PG 30.8 +/- 2.9 (P <.05); zinc supplementation entered the multiple regression at 12 months (P =.037). CONCLUSIONS: Zinc supplementation may have a beneficial effect on mental development and motor quality behavior of healthy term infants.
Asunto(s)
Desarrollo Infantil/efectos de los fármacos , Crecimiento/efectos de los fármacos , Zinc/administración & dosificación , Chile , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Procesos Mentales/efectos de los fármacos , Desempeño Psicomotor/efectos de los fármacos , Factores Socioeconómicos , Zinc/deficiencia , Zinc/farmacologíaRESUMEN
BACKGROUND/PURPOSE: Nutritional support of surgical patients has improved in recent years because of the possibility of modulating catabolism and anabolism, thus enhancing the immune response and repair processes. The objective of this study was to evaluate metabolic effects of early parenteral nutrition (PN) after major surgery. METHODS: The authors studied 63 children aged 4 to 14 years with diffuse peritonitis caused by perforated-suppurative appendicitis. They were assigned randomly to a study group (SG, n = 31), which received PN for 5 days, starting 24 to 48 hours after surgery or to a control group (CG, n = 32), that received standard treatment (fluids). Weight, C-reactive protein (CRP), albumin, prealbumin, glycemia, nitrogen balance (NB), and insulinlike growth factor (IGF-I), were evaluated on postoperative days 1, 4, and 6. RESULTS: Early nutritional support was associated with a significant improvement in NB and IGF-I (Repeat measures analysis of variance IGF-I, P<.001 and NB P<.01). CONCLUSIONS: The authors conclude that early parenteral nutrition has a positive effect on the anabolic response as shown by improved NB and higher IGF-I levels in pediatric patients after major surgery.