RESUMEN
OBJECTIVE: To determine the effects of dietary supplements containing bovine serum concentrate (BSC, a source of immunoglobulins) and/or multiple micronutrients (MMN) on children's growth velocity, rates of common infections, and MN status. DESIGN: Randomized, controlled, community-based intervention trial. SETTING: Low-income, peri-urban Guatemalan community. SUBJECTS: Children aged 6-7 months initially. INTERVENTIONS: Children received one of four maize-based dietary supplements daily for 8 months, containing: (1) BSC, (2) whey protein concentrate (WPC, control group), (3) WPC+MMN, or (4) BSC+MMN. RESULTS: There were no significant differences in growth or rates of morbidity by treatment group. Children who received MMN had lower rates of anemia and (in the group that received WPC+MMN) less of a decline in serum ferritin than those who did not, but there were no differences in other biochemical indicators of MN status by treatment group. CONCLUSIONS: MMN supplementation reduced anemia and iron deficiency in this population, but the MMN content and source of protein in the supplements did not affect other indicators of MN status, growth or morbidity.
Asunto(s)
Desarrollo Infantil/efectos de los fármacos , Suplementos Dietéticos , Crecimiento/efectos de los fármacos , Micronutrientes/farmacología , Estado Nutricional , Albúmina Sérica Bovina/farmacología , Anemia/tratamiento farmacológico , Anemia/epidemiología , Anemia/mortalidad , Enfermedades Carenciales/tratamiento farmacológico , Enfermedades Carenciales/epidemiología , Enfermedades Carenciales/mortalidad , Método Doble Ciego , Femenino , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/mortalidad , Trastornos del Crecimiento/prevención & control , Guatemala , Humanos , Lactante , Alimentos Infantiles , Fenómenos Fisiológicos Nutricionales del Lactante , Masculino , Micronutrientes/administración & dosificación , Proteínas de la Leche , Morbilidad , Prevalencia , Albúmina Sérica Bovina/administración & dosificación , Factores Socioeconómicos , Resultado del Tratamiento , Proteína de Suero de LecheRESUMEN
OBJECTIVE: To examine correlates of fasting glucose, a precursor for type 2 diabetes mellitus, in young adults in Guatemala, a country undergoing an epidemiologic transition. DESIGN: Cross-sectional. METHODS: Anthropometric, lifestyle, dietary, serum lipid, and socioeconomic characteristic data were collected on 189 men and 201 women (mean age 24.4 years) born in four villages in Eastern Guatemala. We used linear regression to identify parsimonious predictive models, including 2-way interactions. RESULTS: In men, mean fasting glucose was 87.3 mg/dL (SD 10.2); our model explained 30% of variance. Body mass index (BMI), abdomen-to-hip ratio (AHR), and total cholesterol showed graded positive effects. BMI and AHR interacted (P<.001); men with high BMI and high AHR had the highest fasting glucose levels. No dietary factors independently predicted fasting glucose. In women, mean fasting glucose was 83.9 mg/dL (SD 8.5); 22% of variance was explained by BMI, energy-adjusted fat intake, physical activity, birth village, and current residence (rural/urban). BMI and fasting glucose were positively related. Urban residence interacted with birth village (P=.06) and physical activity (P=.13). CONCLUSIONS: The major conclusion drawn from this study is that increased adiposity, even among lean individuals, is the largest environmental predictor of fasting glucose. Prevention and control of obesity in young adults in transitioning countries are key strategies for the prevention of diabetes.
Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 2/sangre , Ayuno/sangre , Adulto , Antropometría , Colesterol/sangre , HDL-Colesterol/sangre , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Dieta , Economía , Femenino , Intolerancia a la Glucosa/sangre , Intolerancia a la Glucosa/etnología , Guatemala/epidemiología , Humanos , Estilo de Vida , Masculino , Modelos Estadísticos , Obesidad/complicaciones , Obesidad/epidemiología , Factores de RiesgoRESUMEN
Dietary and nutritional recommendations made in 1993 by a group of Latin American specialists are still valid. They were based on physiological maturation, nutritional requirements, desirable eating habits, and cultural and economic patterns. Exclusive breast-feeding for 4-6 months is ideal for every child. It should continue as part of a mixed diet that is culturally acceptable. Other foods must be added to satisfy nutritional needs and expose the child to different textures and flavors. When breast-feeding is not possible, the following options should be used, in order of preference: 1) Milk from a wet nurse; 2) Milk formulas designed in accordance to gastrointestinal and renal maturation; 3) Cow's mil properly diluted, reconstituted and boiled, o; 4) Vegetable base formulas. These foods must be fortified or supplemented with certain vitamins, minerals and essential fatty acids. The first semi-solid foods should be cereals without gluten, tubers and fruits with low allergenic potential. Additional animal and vegetable foods should be added after six months, withholding those associated with a higher allergenic risk until after 8 or 12 months. All foods accustomed in the household must be introduced gradually in the second year, making sure to provide adequate intakes of energy and nutrients. Other important aspects are hygienic handling of foods, frequency of feeding, and a positive attitude of parents and child-carers during meals to avoid rejection of certain foods or stimulation of over-eating.
Asunto(s)
Conducta Alimentaria , Fenómenos Fisiológicos Nutricionales del Lactante , Lactancia Materna , Preescolar , Alimentos Fortificados , Humanos , Lactante , Recién NacidoRESUMEN
BACKGROUND: Subclinical alterations of small intestinal function have been reported frequently in tropical countries. Studies of small intestinal permeability to lactulose and mannitol were therefore completed in Guatemalan infants from a low-income, periurban community to assess the prevalence of altered intestinal function and the factors associated with this condition. METHODS: Two hundred studies were successfully completed in 158 infants who had been free of diarrhea for at least 1 week before the day of study. Urinary concentrations of lactulose and mannitol during the 5-hour period after ingestion of 400 mg/kg body weight of lactulose and 100 mg/kg body weight of mannitol were measured by gas-liquid chromatography and compared by age group, feeding practices, anthropometric indexes, and serum iron and zinc concentrations. RESULTS: The overall prevalence of altered intestinal permeability (defined as a ratio of urinary recovery of lactulose to mannitol [L/M] > or =0.07) was 30%. The urinary L/M recovery ratio was positively associated with age; low weight for age; and, in infants less than 6 months of age, non-breast-feeding. Children with serum iron concentrations less than 7.16 microM/l (40 [microg/dl) had higher median L/M ratios (L/M = 0.068; 95% confidence interval [CI], 0.054, 0.085) than those with iron levels higher than this cutoff (L/M = 0.052; CI = 0.046, 0.058; p = 0.038). The median urinary L/M recovery ratio in 10 currently asymptomatic infants who had diarrhea during the week before testing (0.087; CI = 0.49, 0.154) was higher than that in children who had been free from diarrhea for at least 1 week (0.052; CI = 0.048, 0.056; p = 0.01). CONCLUSION: Age, feeding practices, low weight-for-age, low serum iron concentration, and recent diarrhea were all associated with altered intestinal function in this group of Guatemalan infants.
Asunto(s)
Absorción Intestinal , Enfermedades Intestinales/epidemiología , Lactulosa/farmacocinética , Manitol/farmacocinética , Envejecimiento , Lactancia Materna , Permeabilidad de la Membrana Celular , Diarrea/metabolismo , Guatemala/epidemiología , Humanos , Lactante , Enfermedades Intestinales/metabolismo , Mucosa Intestinal/metabolismo , Intestino Delgado/metabolismo , Hierro/sangre , Lactulosa/orina , Manitol/orina , Factores de Riesgo , Clima Tropical , Zinc/sangreRESUMEN
A community-based, randomized trial was conducted to evaluate a locally available diet for the management of acute diarrhea (n = 99 episodes) in 90 Guatemalan children, 4-42 months of age. The Test Diet (TD), a combination of a semi-solid pap (maize flour, black beans, oil) and a liquid gruel, Incaparina (maize flour, cotton seed flour, sugar), in addition to breast-milk and other home foods (group TD, n = 45 episodes) was offered for 14 d and compared to usual home feeding (group HF, n = 54 episodes). Diarrhea episodes after admission were significantly shorter for group TD (median 2.0 d) than group HF (median 4.4 d, p = 0.003) after adjusting for potential confounders. Weight gains did not differ significantly between groups. We conclude that community-based dietary management of acute childhood diarrhea using energy-dense, locally available foods is feasible and may shorten diarrhea duration. This may encourage mothers to follow recommendations for continued feeding during diarrhea in developing country environments.
Asunto(s)
Diarrea/dietoterapia , Enfermedad Aguda , Preescolar , Servicios de Salud Comunitaria , Ingestión de Energía , Femenino , Guatemala , Humanos , Lactante , Masculino , Salud Rural , Aumento de PesoRESUMEN
A 32-mo-long, double-blind field study involving one highland control community receiving only vitamin A-fortified sugar and three vitamin A- and FeNaEDTA-sugar-fortified communities, two in the lowlands and one in the highlands of Guatemala, was undertaken to test the effectiveness of this approach in controlling iron deficiency. The communities' population ranged between 1200 and 17000. Sugar fortified with 1 g FeNaEDTA and 15 mg retinol as retinyl palmitate/kg was stable, did not segregate, and was well accepted by the communities. The impact of fortification on iron nutrition was estimated at 8, 20, and 32 mo of intervention. All pregnant women and subjects with severe anemia received supplements or treatment and were excluded from the analysis. Iron stores in the fortified communities increased significantly except for women 18-48 y of age in one lowland community and > 49 y in the highland community. Iron stores in the control community remained unchanged except for a rise among adult males.
Asunto(s)
Anemia Ferropénica/tratamiento farmacológico , Carbohidratos de la Dieta/farmacología , Ácido Edético/farmacología , Compuestos Férricos/farmacología , Hierro/sangre , Adolescente , Adulto , Anemia Ferropénica/sangre , Anemia Ferropénica/epidemiología , Niño , Preescolar , Estudios de Cohortes , Carbohidratos de la Dieta/análisis , Carbohidratos de la Dieta/uso terapéutico , Diterpenos , Método Doble Ciego , Ácido Edético/análisis , Ácido Edético/uso terapéutico , Estudios de Factibilidad , Femenino , Compuestos Férricos/análisis , Compuestos Férricos/uso terapéutico , Alimentos Fortificados , Guatemala/epidemiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estado Nutricional , Aceptación de la Atención de Salud , Ésteres de Retinilo , Población Rural , Vitamina A/análogos & derivados , Vitamina A/uso terapéuticoRESUMEN
PIP: Consumption of insufficient quantities of food would result to energy deficiency in children, and this can be prevented by early assessment of changes in physical activity. This paper focuses on the effects of general undernutrition on physical activity and on growth, behavior, and cognitive development in Mexico, Uganda, Colombia, and Guatemala. The paper contains studies investigating the influence of undernutrition on physical activity; total energy expenditure; level of physical fitness; influence of physical activity and growth; and relationship of physical activity with behavior and cognitive development. The level of energy expenditure between nutritional groups could be accounted for the smaller size of the body among undernourished children. On the other hand, physiological potential to physically perform work can be maintained by children with mild or moderate malnutrition, but their smaller size limits their output. Lastly, increased physical activity of children receiving food supplementation was associated with exploratory and behavioral differences compared with nonsupplemented children.^ieng
Asunto(s)
Conducta , Desarrollo Infantil , Fenómenos Fisiológicos Nutricionales Infantiles , Protección a la Infancia , Niño , Adolescente , África , África del Sur del Sahara , África Oriental , Factores de Edad , Américas , Biología , América Central , Colombia , Demografía , Países en Desarrollo , Guatemala , Salud , América Latina , México , América del Norte , Fenómenos Fisiológicos de la Nutrición , Población , Características de la Población , América del Sur , UgandaRESUMEN
To determine whether rice cereal could be used to complement a cow milk-based diet in the nutritional management of infants with acute diarrhea, we assessed its digestion and absorption in eight affected male infants, 69 to 131 days of age. They received cow milk formula with 5.4% lactose (diluted 1:1 with water and precooked rice cereal) 5 to 22 hours after admission and rehydration. The first feeding consisted of milk diluted with carbon 13-enriched rice cereal. A 48-hour fecal collection and balance study was performed. Rice cereal was reasonably well absorbed (84.0% to 95.8%) by seven of the eight infants. The study was repeated in seven of the infants after they had recovered. Our results indicated that rice cereal is well absorbed by young infants with acute diarrhea and that it is an adequate nutrient supplement for this patient population.
Asunto(s)
Gastroenteritis/metabolismo , Alimentos Infantiles , Absorción Intestinal , Oryza , Enfermedad Aguda , Animales , Isótopos de Carbono , Diarrea Infantil/metabolismo , Diarrea Infantil/terapia , Ingestión de Alimentos , Heces , Humanos , Lactante , Masculino , LecheRESUMEN
Diarrhoeal diseases are a major cause of malnutrition, partly due to poor dietary practices. Misconceptions among the general population and medical personnel lead to withholding of food or avoiding the use of nutritious, locally available and affordable foods. Breast-feeding should not be interrupted during diarrhoea. Many recent studies have shown that when cow's milk is used, full-strength milk should be fed throughout the disease and in convalescence. The concept of diluting milk with water should be altogether avoided. If necessary, full-strength milk should be mixed with equal amounts of other foods. Other recent studies have shown that several diets based on local staples are excellent choices for the dietary management of diarrhoea. An all-vegetable diet commonly eaten in Guatemala produced a sharp decrease in the duration of acute diarrhoea (median duration after feeding began: 1.8 d) and its macronutrients were reasonably well absorbed. Practical recommendations are given, including nutritional, physiological, cultural and economic considerations.
Asunto(s)
Países en Desarrollo , Diarrea/dietoterapia , Enfermedad Aguda , Animales , Lactancia Materna , Preescolar , Diarrea Infantil/dietoterapia , Humanos , Lactante , Alimentos Infantiles , Leche , Leche HumanaRESUMEN
From March 1987 to February 1988, fecal excretion of adenovirus types 40 and 41 and rotavirus serotypes in 194 children (age, 0 to 3 years) from a rural community of Guatemala was monitored. In total, 458 samples taken during 385 episodes of diarrhea and 191 specimens obtained during symptom-free periods were examined by enzyme-linked immunosorbent assay. Fifty-seven children hospitalized because of diarrhea were also studied. Among the rural children, 43 (22.2%) excreted adenovirus types 40 and 41 and 20 (10.3%) shed rotaviruses. Adenovirus types 40 and 41 were associated with 54 (14.0%) illnesses, and rotaviruses were associated with 18 (4.7%) illnesses. Asymptomatic infections with adenovirus types 40 and 41 were documented in nine children and with rotaviruses in two children. Fifteen typeable rotaviruses were identified as serotype 2. In the hospital population, 36 (63.2%) children had viral infections. Rotaviruses were identified in 29 (50.9%) and adenovirus types 40 and 41 were identified in 15 (31.2%) of 48 subjects tested. Dual infections by these viruses were found in eight children. Of 22 typeable strains of rotaviruses, 9 (34.6%) were serotype 1, 12 (46.1%) were serotype 2, and 1 (3.8%) was serotype 3. All the children infected with serotype 2 rotavirus were coinfected with other enteric pathogens, while only three (37.5%) of those infected with rotavirus serotype 1 excreted another pathogen. Adenovirus types 40 and 41 are an important cause of gastroenteritis in both ambulatory and hospitalized Guatemalan children. There seems to be a difference in the pathogenicity among rotavirus serotypes.
Asunto(s)
Infecciones por Adenoviridae/epidemiología , Infecciones por Adenovirus Humanos/epidemiología , Adenovirus Humanos/aislamiento & purificación , Diarrea/microbiología , Infecciones por Rotavirus/epidemiología , Rotavirus/aislamiento & purificación , Infecciones por Adenovirus Humanos/complicaciones , Preescolar , Diarrea/complicaciones , Gastroenteritis/complicaciones , Gastroenteritis/epidemiología , Guatemala , Hospitales Rurales , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Infecciones por Rotavirus/complicaciones , Población RuralRESUMEN
Physical activity is affected by nutritional modifications and, in turn, influences growth, cognition, social behavior, work performance and other functions. Studies in preschool children showed that: 1. A decrease in energy intake during four to seven days reduced the time allocated to energy-demanding activities and increased sedentary activities. 2. Children with mild weight deficit were more sedentary than well-nourished counterparts. 3. Children became more active when nutritional status improved. 4. A 10% reduction in energy intake reduced total energy expenditure by 15% without affecting weight gain nor basal metabolism. Studies of men working in non-mechanized agriculture showed that: 1. Dietary improvements led to faster salaried work, reduction of napping time and greater physical activity after work. 2. An increase in energy intake increased total daily energy expenditure, tending to maintain energy balance and relatively stable body weight within the cyclic variations of the agricultural year. 3. Food supplementation did not necessarily improve productivity. Other labor incentives without dietary improvements increased energy expenditure during working hours, which resulted in weight loss. In conclusion, good health and nutrition provide the biological basis for adequate physical activity that may improve cognitive development, social interactions, economic productivity and the quality of life of an individual or a population, but other incentives are required for the optimal expression of that biologic potential.
Asunto(s)
Ingestión de Energía/fisiología , Estado Nutricional/fisiología , Esfuerzo Físico/fisiología , Adulto , Peso Corporal , Preescolar , Metabolismo Energético , Humanos , Lactante , Masculino , Desnutrición Proteico-Calórica/complicaciones , Estudios de Tiempo y MovimientoRESUMEN
The diet should, ideally, provide adequate amounts of all nutrients. The traditional foods of many Latin American countries, however, must be fortified or enriched with certain nutrients to satisfy the needs of the whole population. These measures should be considered as temporary, until improvements are achieved in dietary diversification, economic conditions, nutrition education and food processing and storage. Restoration of nutrients lost during cooking or processing and equalization of new foods with the nutrients present in traditional foods, are also important. Conditions for a successful program of fortification or enrichment include a widespread and regular intake of the dietary vehicle, high bioavailability of the added nutrient, low costs of the nutrient and the fortified vehicle, central processing, organoleptic characteristics that ensure acceptability, stability of the product during storage and cooking, no risk of toxicity, and adequate control during the process, distribution, marketing and consumption of the fortified vehicle or food. Control measures must be supported by legal sanctions to those who do not comply with the norms for obligatory fortification or enrichment. Control measures must also identify the necessary modifications due to changes in dietary habits or public health interventions. In Latin America there are fortification and enrichment programs with various nutrients in which local diets are scarce. Many Latin American scientists have been pioneers in this field.
Asunto(s)
Alimentos Fortificados , Trastornos Nutricionales/prevención & control , Necesidades Nutricionales , Dieta , Conducta Alimentaria , Manipulación de Alimentos , Alimentos Fortificados/economía , Alimentos Fortificados/normas , Humanos , América Latina , Legislación Alimentaria , Programas Nacionales de Salud , Factores SocioeconómicosRESUMEN
Diets must supply enough nitrogen and essential amino acids to satisfy human needs. A diet's protein quality is associated to its digestibility, amino acid composition, protein concentration and dietary and preparation factors that enhance or reduce essential amino acid and protein bioavailability. Dietary energy intake also affects the utilization efficiency of dietary proteins. Protein quality of Latin American diets varies between countries and between socioeconomic groups in a given country. Most poor and lower-middle income persons consume diets with strong predominance of vegetable proteins. These diets are usually bulky, with relatively low protein concentration and energy density, and sometimes do not provide enough of one or more essential amino acids. In some countries and in some population groups, over 50% of the dietary proteins are of animal origin. This may be a risk factor of cardiovascular disease. Protein quality of Latin American diets, however, can be improved by modifying the proportions of some foods in order to achieve amino acid complementation, increase protein concentration and, in some instances, increase digestibility. Examples of diets that are satisfactory for preschool children and adults are given. Nevertheless, improvement of the overall nutritional quality of the diets is of foremost importance, so that they may provide the energy and all essential nutrients required for humans.
Asunto(s)
Aminoácidos Esenciales , Dieta , Proteínas en la Dieta , Adolescente , Adulto , Aminoácidos Esenciales/administración & dosificación , Aminoácidos Esenciales/deficiencia , Disponibilidad Biológica , Niño , Preescolar , Ingestión de Energía , Metabolismo Energético , Conducta Alimentaria , Femenino , Humanos , Lactante , América Latina , Nitrógeno/metabolismo , Necesidades Nutricionales , Embarazo , Desnutrición Proteico-Calórica/etiología , Desnutrición Proteico-Calórica/prevención & controlRESUMEN
The percentage of peripheral blood lymphocytes forming rosettes with sheep erythrocytes (E-rosettes) was determined in 33 severely malnourished Guatemalan children, and in two groups of clinically well but mildly growth retarded children from the same environment. Mean E-rosettes in the acutely ill patients was lower than the value observed in the mildly malnourished children, although there was considerable overlap between groups. These data differ from previously published studies of severely malnourished children from other parts of the world in that not all patients had decreased values for E-rosettes, in contrast to the uniform depression reported by others. As all patients were clinically similar, the results suggest that there may be specific nutrient defects associated with protein-energy malnutrition that particularly affect immune function. In addition, in vitro incubation of lymphocytes from the acutely malnourished children with the thymic factor, thymosin fraction 5, increased the percentage of E-rosettes in a dose-dependent fashion. These data suggest that immature, thymosin-responsive T cells are present in circulation. It is possible that in vivo thymosin administration may be beneficial for malnourished individuals.
Asunto(s)
Linfocitos/inmunología , Desnutrición Proteico-Calórica/inmunología , Diferenciación Celular , Células Cultivadas , Preescolar , Femenino , Humanos , Lactante , Linfocitos/efectos de los fármacos , Masculino , Formación de Roseta , Timosina/análogos & derivados , Timosina/farmacologíaRESUMEN
A long-term energy supplementation program was carried out to determine its effect on the productivity of agricultural workers in Guatemala. The program provided, free of charge, a low-energy (24 Kcal) and a high-energy (350 Kcal) bottled, orange-flavored soft drink to two groups of long-term resident sugar-cane cutters who worked on the same plantation, located in the Pacific Coast. Previous to, and periodically thereafter during implementation of the program, data relative to energy intake and anthropometry were collected. Through data obtained from payroll lists, a longitudinal series of average productivity (tons of sugar cane cut and loaded per day) covering 48 weeks of pre-supplementation, 90 weeks of supplementation and 21 weeks post-supplementation, was constructed. Control of the supplement consumption was daily observed. Random assignment of workers to the high-energy supplement (HES) and the low-energy (LES) groups, was not possible. Prior to supplementation both groups presented the same characteristics in terms of age, energy intake level, weight, height, tricipital adiposity and daily productivity. Little variation was found throughout the time the supplement was consumed by the HES Group. Energy intake of workers increased significantly in absolute terms in relation to the LES Group, except towards the end of the 28 months' supplementation period. Energy balance was maintained by workers throughout the study period. A time series of the difference in mean productivity of the two supplement groups (Yt) was modeled using the ARIMA techniques. No auto-regressive term was present in the Yt series. The ARIMA (0,0,1) model was fitted and expanded with different intervention components. None of the estimated parameters of the intervention components were statistically significant. It was therefore concluded that no abrupt, or gradual and sustained energy supplementation effect on productivity was present.
Asunto(s)
Agricultura , Eficiencia , Ingestión de Energía , Adolescente , Adulto , Anciano , Antropometría , Bebidas , Citrus , Alimentos Fortificados , Guatemala , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Procesos EstocásticosRESUMEN
Obligatory N losses through feces (FN) and urine (UN) were measured in five children and N balance was measured in them and in five others (23 +/- 4 months old) using four levels of cow's milk intake. FN, UN and FN +UN were 19.5 +/- 6.9, 34.0 +/- 5.3, and 53.7 +/- 8.1 mg N/kg/day, respectively. The ratios of FN, UN and total obligatory losses (FN + UN + sweat and integumental N) to basal energy expenditure were 0.38, 0.64 and 1.11 mg N/basal kcal, respectively. The two latter values are 32 and 45% lower than the 1971 FAO/WHO estimates. Mean N requirement determined by factorial calculations using a correction factor of 1.3 and by N balance techniques was 98 mg N or 0.61 g milk protein/kg/day, which is 33% lower than the FAO/WHO estimates. Depending on the allowances made for inter-individual variability, safe levels of protein intake ranged from 0.79 to 0.94 g/kg/day, 33 to 21% lower than FAO/WHO recommendations. Apparent and "true" milk protein digestibilities were 80 +/- 4% and 94 +/- 4%, respectively.