Jornal de Pediatria (Vers?o em Português)最新文献_第5页

Influence of nutritional factors and the PON1 C(‐107)T polymorphism on paraoxonase‐1 activity in childhood 营养因素和PON1 C(‐107)T多态性对儿童对氧磷酶‐1活性的影响

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.012

Tainá S. Sigales , Gabriela Uliano , Ludmila Muniz , Carlos Barros , Augusto Schneider , Sandra C. Valle

Objective

The cardioprotective enzyme paraoxonase‐1 (PON1) suffers an important influence from genetic polymorphisms and nutritional factors. The aim of this study was to investigate the influence of diet, nutritional status, and the C(‐107)T polymorphism on PON1 arylesterase activity in children.

Methods

This was a cross‐sectional study with 97 children, aged between 5 and 8 years, of both genders, from a pediatric outpatient clinic in southern Brazil. A sociodemographic, behavioral, and food consumption questionnaire was applied, and anthropometric measurements and laboratory blood samples were taken. PON1 arylesterase activity was measured by phenol extinction (U/mL), and DNA extraction and analysis of the PON1 C(‐107)T polymorphism were performed. The Hardy–Weinberg equilibrium was tested with the chi‐squared test and linear regression was used to estimate PON1 activity according to four adjustment models, with an acceptable error of 5%.

Results

In the sample, the male gender accounted for 50.5%, 39.2% were 6 years of age, 54.5% had normal weight, and 51.5% had PON1 activity below the median (90.0, 15–30 U/mL). Genotype frequency was 54.6% (53/97), 31.0% (30/97), and 14.4% (14/97), respectively, for CT, CC, and TT, consistent with the Hardy–Weinberg equilibrium (p = 0.22). In the regression analysis, the model that included sociodemographic variables as well as frequency of consumption of fruits, vegetables, legumes, dairy products, and beans estimated a variability of 14.8% in PON1 activity combined with the PON1 C(‐107)T polymorphism.

Conclusions

During childhood, a good‐quality diet with greater inclusion of healthy foods was important to predict the activity of the cardioprotective enzyme PON1 combined with the C(‐107)T polymorphism of the PON1 gene.

目的心脏保护酶对氧磷酶- 1 (PON1)受遗传多态性和营养因素的重要影响。本研究的目的是探讨饮食、营养状况和C(‐107)T多态性对儿童PON1芳基酯酶活性的影响。方法:这是一项横断面研究，来自巴西南部儿科门诊的97名儿童，年龄在5至8岁之间，男女均有。采用了社会人口学、行为和食物消费问卷，并采集了人体测量数据和实验室血液样本。采用苯酚消光法测定PON1芳基酯酶活性(U/mL)，并进行DNA提取和PON1 C(‐107)T多态性分析。采用卡方检验检验Hardy-Weinberg平衡，并根据四种调整模型采用线性回归估计PON1活性，可接受误差为5%。结果男性占50.5%，6岁占39.2%，体重正常占54.5%，PON1活性低于中位数(90.0,15 ~ 30 U/mL)的占51.5%。CT、CC和TT的基因型频率分别为54.6%(53/97)、31.0%(30/97)和14.4%(14/97)，符合Hardy-Weinberg平衡(p = 0.22)。在回归分析中，该模型包括社会人口学变量以及水果、蔬菜、豆类、乳制品和豆类的消费频率，结合PON1 C(‐107)T多态性，PON1活性的变异性估计为14.8%。结论:在儿童时期，高质量的饮食和更多的健康食品对于预测心脏保护酶PON1的活性和PON1基因的C(‐107)T多态性是重要的。

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引用次数: 0

Sarcopenia in children and adolescents with chronic liver disease 患有慢性肝病的儿童和青少年肌肉减少症

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.011

Ionar Figueredo Bonfim Rezende , Maria Ester P. Conceição‐Machado , Viviane Sahade Souza , Elisana M. dos Santos , Luciana R. Silva

Objective

To investigate the occurrence of sarcopenia in children and adolescents with chronic liver disease.

Methods

A series of cases, with patients aged 6‐19 years of both genders, who were treated in Liver Outpatient Clinics. Weight, height, muscle strength (assessed by manual grip strength), and muscle mass (estimated through dual‐energy X‐ray absorptiometry) were measured. Sarcopenia was diagnosed based on the simultaneous presence of muscle mass and muscle strength déficits, defined as the values below the mean for muscle mass and strength of the studied population, according to gender. A descriptive analysis (mean and standard deviation) was performed, and the difference of means was calculated by Student's t‐test.

Results

A total of 85 patients were studied, mostly females (64.7%), with a mean age of 11.7 (SD = 3.4) years. Sarcopenia was identified in 40% of the patients. Muscle strength déficit was found in 54.1% of the subjects, and 50.6% showed muscle mass déficit. The mean muscle mass for males was higher than that for females (6.07; SD = 1.22 kg/m² vs. 5.42; SD = 1.10 kg/m²; p = 0.016). However, there was no significant difference in sex‐related muscle strength (male = 0.85; SD = 0.52 kgf/kgm² and female = 0.68; SD = 0.30 kgf/kgm²; p = 0.113).

Conclusion

The research findings identified that sarcopenia is a condition found in pediatric patients treated at a public referral institution for chronic liver disease.

目的探讨儿童和青少年慢性肝病患者肌肉减少症的发生情况。方法选取在肝脏门诊接受治疗的6 ~ 19岁患者，男女均可。测量了体重、身高、肌肉力量(通过手动握力评估)和肌肉质量(通过双能X射线吸收仪评估)。肌肉减少症的诊断是基于同时存在的肌肉质量和肌肉力量障碍，定义为根据性别，研究人群的肌肉质量和力量低于平均值。进行描述性分析(均值和标准差)，并通过Student's t检验计算均值之差。结果共85例患者，女性居多(64.7%)，平均年龄11.7 (SD = 3.4)岁。40%的患者出现了肌肉减少症。54.1%的受试者存在肌肉力量障碍，50.6%的受试者存在肌肉质量障碍。男性平均肌肉质量高于女性(6.07;SD = 1.22 kg/m2 vs. 5.42;SD = 1.10 kg/m2;p = 0.016)。然而，与性别相关的肌力没有显著差异(男性= 0.85;SD = 0.52 kgf/kgm2，女性= 0.68;SD = 0.30 kgf/kgm2;p = 0.113)。结论:研究结果表明，骨骼肌减少症是在公立转诊机构治疗慢性肝病的儿科患者的一种疾病。

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引用次数: 0

Neonatal screening tests in Brazil: prevalence rates and regional and socioeconomic inequalities 巴西新生儿筛查试验:流行率与区域和社会经济不平等

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.007

Mariana B. Mallmann , Yaná T. Tomasi , Antonio Fernando Boing

Objective

To identify the prevalence and associated factors with the performance of the Guthrie test, hearing, and red reflex screening tests in Brazil.

Methods

This was a population‐based, cross‐sectional study that analyzed data on 5,231 children under 2 years of age participating in the National Health Survey of 2013. The study described the prevalence and Confidence Intervals (95% CI) of the three neonatal screening tests performed, in any period, and their association with the country's regions, skin color/ethnicity, private health insurance, and per capita household income. Logistic regression models were used, and odds ratios were calculated by incorporating sample weights.

Results

The prevalence of Guthrie test screening in Brazil at any time of life was 96.5%, that of the newborn hearing screening was 65.8% and that of the red reflex screening test was 60.4%. The performance of the three screening tests was significantly higher among children whose mothers/guardians reported higher per capita household income, who lived in the South and Southeast regions, and who had private health insurance (p < 0.001). There was no statistically significant difference regarding the performance of the tests according to skin color/ethnicity (p > 0.05). The same inequalities were verified when the tests were performed during the recommended periods, with a strong socioeconomic gradient.

Conclusions

There are inequalities in the performance of neonatal screening tests in the country, and also in the performance of these tests during the periods established in the governmental guidelines. The guarantee of the performance of these tests in a universal and public health system, as in Brazil, should promote equity and access to the entire population.

目的确定巴西格思里试验、听力和红色反射筛查试验的患病率及其相关因素。方法:这是一项基于人群的横断面研究，分析了参与2013年全国健康调查的5231名2岁以下儿童的数据。该研究描述了在任何时期进行的三种新生儿筛查试验的流行率和置信区间(95% CI)，以及它们与国家地区、肤色/种族、私人医疗保险和人均家庭收入的关系。采用Logistic回归模型，结合样本权重计算比值比。结果巴西各年龄段Guthrie试验筛查率为96.5%，新生儿听力筛查率为65.8%，红色反射筛查率为60.4%。在母亲/监护人报告的人均家庭收入较高、居住在南部和东南部地区以及拥有私人医疗保险的儿童中，三项筛查测试的表现明显较高(p <0.001)。根据肤色/种族的不同，测试的表现没有统计学上的显著差异(p >0.05)。在建议的期间进行测试时，也证实了同样的不平等现象，而且社会经济梯度很大。结论:全国新生儿筛查试验的执行情况存在不平等，在政府指导方针规定的期间内，这些试验的执行情况也存在不平等。在巴西这样的全民公共卫生系统中保证这些检测的执行，应促进公平并使所有人都能获得检测。

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引用次数: 0

Pediatric sarcopenia: exploring a new concept in children with chronic liver disease 儿童肌肉减少症:探索儿童慢性肝病的新概念

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.09.002

Manuela Merli

引用次数: 0

Asthma mortality in children and adolescents of Brazil over a 20‐year period 20年来巴西儿童和青少年哮喘死亡率

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.014

Raquel Reis Pitchon , Cristina Gonçalves Alvim , Cláudia Ribeiro de Andrade , Laura Maria de Lima Belizário Facury Lasmar , Álvaro Augusto Cruz , Adriana Pitchon dos Reis

Objective

To evaluate the number of asthma deaths and the temporal trend of the asthma‐specific mortality rate in children and adolescents up to 19 years of age in Brazil.

Methods

This is an ecological time‐series study of asthma deaths reported in Brazil, in the population up to 19 years of age, between 1996 and 2015. The specific asthma mortality rate and its temporal trend were analyzed.

Results

There were 5014 deaths during the 20 years evaluated, with the majority, 68.1%, being recorded in children under 5 years of age. The specific asthma mortality rate ranged from 0.57/100,000 in 1997 to 0.21/100,000 in 2014, with a significant reduction of 59.8%. Regarding the place of death, 79.4% occurred in a hospital setting. In this sample, the adolescents had a 1.5‐fold higher chance of death out‐of‐hospital than children up to nine years of age. There was no significant difference in the temporal trend between the genders and no significant decrease in out‐of‐hospital deaths.

Conclusions

This study found a temporal trend for a reduction in asthma deaths over 20 years in children and adolescents in Brazil. Mortality rates varied across the geographic regions of the country and were higher in the Northeast. The prevalence of deaths under 5 years of age may be associated with the greater vulnerability of this age group in low‐income countries. In adolescence, deaths outside the hospital environment are noteworthy. Asthma deaths are rare but unacceptable events, considering the treatable nature of the disease and the presence of avoidable factors in most of fatal outcomes.

目的评估巴西19岁以下儿童和青少年哮喘死亡人数和哮喘特异性死亡率的时间趋势。方法:这是一项针对1996年至2015年间巴西19岁以下人群哮喘死亡的生态时间序列研究。分析了哮喘的具体死亡率及其时间趋势。结果20年间共发生5014例死亡，其中5岁以下儿童占68.1%。哮喘特定死亡率从1997年的0.57/10万下降到2014年的0.21/10万，显著下降59.8%。至于死亡地点，79.4%发生在医院。在这个样本中，青少年在医院外死亡的几率是9岁以下儿童的1.5倍。性别间的时间趋势没有显著差异，院外死亡也没有显著减少。结论:本研究发现巴西儿童和青少年哮喘死亡率在20年内呈下降趋势。全国各地理区域的死亡率各不相同，东北部的死亡率较高。在低收入国家，5岁以下儿童的死亡率可能与这一年龄组的脆弱性更大有关。在青少年中，医院环境之外的死亡是值得注意的。考虑到该疾病的可治疗性以及在大多数致命结果中存在可避免因素，哮喘死亡是罕见但不可接受的事件。

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引用次数: 0

Can simple and low-cost motor function assessments help in the diagnostic suspicion of Duchenne muscular dystrophy? 简单和低成本的运动功能评估能帮助诊断杜氏肌营养不良症吗?

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.013

Aline Chacon Pereira , Alexandra Prufer de Queiroz Campos Araújo , Márcia Gonçalves Ribeiro

Objective

Duchenne muscular dystrophy, an X-linked genetic disease, leads to progressive muscle weakness mainly in the lower limbs. Motor function tests help to monitor disease progression. Can low-cost, simple assessments help in the diagnostic suspicion of Duchenne muscular dystrophy? The authors aim to define the sensitivity of time to rise from the floor, time to walk 10 meters, and time to run 10 meters, evaluating them as eventual diagnostic screening tools.

Methods

This is an analytical, observational, retrospective (1998–2015), and prospective study (2015–2018). Cases were recruited from the database of the pediatric neurology department and the healthy, from child care consultations, with normal gait development (up to 15 months) and without other comorbidities (neuromuscular, pulmonary, heart diseases) from the same university hospital.

Results

128 Duchenne muscular dystrophy patients and 344 healthy children were analyzed, equally distributed in age groups. In Duchenne muscular dystrophy, there is a progressive increase in the means of the times to perform the motor tests according to the age group, which accelerates very abruptly after 7 years of age. Healthy children acquire maximum motor capacity at 6 years and stabilize their times. The time to rise showed a p-value <0.05 and a strong association (effect size [ES] >0.8) in all age groups (except at 12 years), with time to walk 10 meters from 9 years, and with time to run 10 meters, from 5 years. The 100% sensitivity points were defined as follows: time to rise, at 2 s; time to walk 10 meters, 5 s; time to walk 10 meters, 4 s.

Conclusions

Time to rise is a useful and simple tool in the screening of neuromuscular disorders such as Duchenne muscular dystrophy, a previously incurable disease with new perspectives for treatment.

目的杜氏肌营养不良症是一种x连锁遗传病，主要导致进行性肌肉无力，主要发生在下肢。运动功能测试有助于监测疾病进展。低成本、简单的评估能帮助诊断杜氏肌营养不良症吗?作者的目标是确定从地板上站起来的时间、走10米的时间和跑10米的时间的敏感性，并评估它们最终作为诊断筛查工具。方法采用分析性、观察性、回顾性(1998-2015)和前瞻性(2015-2018)研究。病例从同一所大学医院的儿童神经科数据库和儿童保健咨询中招募，步态发育正常(长达15个月)，无其他合并症(神经肌肉、肺部、心脏疾病)。结果分析杜氏肌营养不良症患者128例，健康儿童344例，年龄分布均匀。在杜氏肌营养不良症中，按年龄组进行运动测试的次数逐渐增加，在7岁后急剧增加。健康儿童在6岁时获得最大的运动能力并稳定时间。在所有年龄组(12岁除外)中，上升时间与步行10米的时间从9岁开始，与跑10米的时间从5岁开始，p值为<0.05，且有很强的相关性(效应量[ES] >0.8)。100%的敏感点定义如下:上升时间，在2秒;步行时间10米，5秒;该走10米了，4秒。结论time to rise是一种简便、有效的神经肌肉疾病筛查工具，如杜氏肌营养不良症，这是一种以前无法治愈的疾病，具有新的治疗前景。

{"title":"Can simple and low-cost motor function assessments help in the diagnostic suspicion of Duchenne muscular dystrophy?","authors":"Aline Chacon Pereira , Alexandra Prufer de Queiroz Campos Araújo , Márcia Gonçalves Ribeiro","doi":"10.1016/j.jpedp.2019.05.013","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.013","url":null,"abstract":"<div><h3>Objective</h3><p>Duchenne muscular dystrophy, an X-linked genetic disease, leads to progressive muscle weakness mainly in the lower limbs. Motor function tests help to monitor disease progression. Can low-cost, simple assessments help in the diagnostic suspicion of Duchenne muscular dystrophy? The authors aim to define the sensitivity of time to rise from the floor, time to walk 10meters, and time to run 10meters, evaluating them as eventual diagnostic screening tools.</p></div><div><h3>Methods</h3><p>This is an analytical, observational, retrospective (1998–2015), and prospective study (2015–2018). Cases were recruited from the database of the pediatric neurology department and the healthy, from child care consultations, with normal gait development (up to 15 months) and without other comorbidities (neuromuscular, pulmonary, heart diseases) from the same university hospital.</p></div><div><h3>Results</h3><p>128 Duchenne muscular dystrophy patients and 344 healthy children were analyzed, equally distributed in age groups. In Duchenne muscular dystrophy, there is a progressive increase in the means of the times to perform the motor tests according to the age group, which accelerates very abruptly after 7 years of age. Healthy children acquire maximum motor capacity at 6 years and stabilize their times. The time to rise showed a <em>p</em>-value <0.05 and a strong association (effect size [ES] >0.8) in all age groups (except at 12 years), with time to walk 10 meters from 9 years, and with time to run 10 meters, from 5 years. The 100% sensitivity points were defined as follows: time to rise, at 2s; time to walk 10 meters, 5s; time to walk 10 meters, 4s.</p></div><div><h3>Conclusions</h3><p>Time to rise is a useful and simple tool in the screening of neuromuscular disorders such as Duchenne muscular dystrophy, a previously incurable disease with new perspectives for treatment.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 503-510"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bladder and bowel symptoms experienced by children with osteogenesis imperfecta 成骨不全症患儿的膀胱和肠道症状

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2018.12.002

Gisele Martins , Maia Siedlikowski , Anna Kristina Silva Coelho , Frank Rauch , Argerie Tsimicalis

Objective

To estimate the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms experienced by children with osteogenesis imperfecta and to describe the socio‐demographic and clinical profile of these children.

Method

A descriptive study was conducted with a convenience sample of parent‐child pairs of toilet‐trained children aged from 3 to 18 years. Pairs were interviewed using three tools: (1) Socio‐Demographic and Clinical Questionnaire; (2) Dysfunctional Voiding Scoring System; (3) Rome III Criteria along with the Bristol Stool Scale. Data were stratified by socio‐demographic and clinical variables and analyzed using descriptive statistics.

Results

Thirty‐one parent‐child pairs participated in the study; 38.7% (n = 12) children reported bowel symptoms, 19.4% (n = 6) reported a combination of bladder issues (such as holding maneuvers and urgency) and bowel symptoms (such as hard or painful bowel movements and large diameter stools). There were no reports of isolated bladder issues. Among the child participants, 16 (51.7%) identified as female and 20 (64.5%) were 5–14 years old. The most prevalent type of osteogenesis imperfecta was type III (n = 12; 38.7%) and eight (25.8%) children reported using a wheelchair.

Conclusion

This is the first study to examine the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms in children with osteogenesis imperfecta, offering a preliminary socio‐demographic and clinical profile of these children. This research is an important step toward effective screening, detection, and access to care and treatment, especially for clinicians working with this group of very fragile patients.

目的评估成骨不全儿童膀胱、肠道及膀胱和肠道联合症状的患病率和表现，并描述这些儿童的社会人口统计学和临床特征。方法采用一项描述性研究，对3 - 18岁接受过如厕训练的儿童进行父母-子女配对。使用三种工具对研究对象进行访谈:(1)社会人口统计学和临床问卷;(2)排空评分系统功能失调;(3)罗马III标准和布里斯托大便量表。根据社会人口统计学和临床变量对数据进行分层，并使用描述性统计进行分析。结果31对亲子对参与本研究;38.7% (n = 12)的儿童报告了肠道症状，19.4% (n = 6)的儿童报告了膀胱问题(如抓握和尿急)和肠道症状(如排便困难或疼痛和大便直径大)的组合。没有孤立的膀胱问题的报告。在儿童参与者中，16名(51.7%)为女性，20名(64.5%)为5-14岁。最常见的成骨不全类型为III型(n = 12;38.7%)和8名(25.8%)儿童报告使用轮椅。结论:这是第一个研究成骨不全儿童膀胱、肠道及膀胱和肠道联合症状的患病率和表现的研究，提供了这些儿童的初步社会人口统计学和临床概况。这项研究是朝着有效筛查、检测和获得护理和治疗迈出的重要一步，特别是对与这群非常脆弱的患者一起工作的临床医生来说。

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引用次数: 0

Factors associated with current tobacco use among adolescents and young students 与青少年和年轻学生当前烟草使用相关的因素

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.01.001

Samara Barreto Cunha , Rodrigo Cappato de Araújo , Jéssica Vanessa Barros de Oliveira , Rachel Mola , Ana Carolina Rodarti Pitangui

Objectives

To determine the prevalence of current tobacco use and its association with sociodemographic factors and risk behaviors among adolescents and young students, according to gender.

Methods

The sample consisted of students from the state public school network aged between 12 and 24 years, who answered the Brazilian version of the Youth Risk Behavior Survey questionnaire. The data were analyzed in SPSS software (v. 20.0), using Poisson regression to evaluate the prevalence ratio (PR) of the independent variables in relation to the outcome. p < 0.05 was established as the significance level.

Results

The final analysis consisted of 1275 adolescents, of whom 716 (56.2%) were girls and 559 (43.8%) were boys. The prevalence of current tobacco use was 6.6% among girls and 9.7% among boys. In females, consuming alcohol in the last 30 days (3.91 [1.54–9.94]) and being 14 years old or younger (0.50 [0.26–0.96]) influenced current tobacco use. In the male gender, tobacco use in the last 30 days was influenced by current alcohol consumption (2.92 [1.21–7.08]) and involvement in physical fighting in the last 12 months (2.32 [1.32–4.09]).

Conclusion

Although the prevalence of current tobacco use was low in both genders, the assessed population still presents a risk, since male involvement in physical fighting and current consumption of alcohol in both genders increased the probability of this population becoming regular tobacco users.

目的按性别确定青少年和年轻学生中当前烟草使用的流行程度及其与社会人口因素和危险行为的关系。方法样本包括来自国家公立学校网络的12至24岁的学生，他们回答了巴西版的青少年风险行为调查问卷。数据在SPSS软件(v. 20.0)中进行分析，采用泊松回归评估自变量与结果的患病率(PR)。p & lt;以0.05为显著性水平。结果共纳入1275名青少年，其中女生716人(56.2%)，男生559人(43.8%)。目前的烟草使用率在女孩中为6.6%，在男孩中为9.7%。在女性中，最近30天内饮酒(3.91[1.54-9.94])和14岁或以下(0.50[0.26-0.96])影响当前的烟草使用。在男性中，最近30天内的烟草使用受到当前饮酒(2.92[1.21-7.08])和过去12个月参与斗殴(2.32[1.32-4.09])的影响。结论:虽然目前吸烟的流行率在两性中都很低，但被评估的人群仍然存在风险，因为男性参与身体打架和目前饮酒增加了这一人群成为常规烟草使用者的可能性。

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引用次数: 0

Comparison of birth weight, length, and head circumference between the BRISA-RP and Intergrowth‐21st cohorts BRISA-RP和Intergrowth‐21队列新生儿出生体重、体长和头围的比较

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.05.022

João Roberto R. Pimenta , Carlos Grandi , Davi C. Aragon , Viviane Cunha Cardoso

Objectives

(a) To determine the 3rd, 50th, and 97th percentiles of weight, length, and head circumference of newborns from the Ribeirão Preto BRISA cohort, according to gender and gestational age, and compare them with the Intergrowth‐21st standard; (b) To estimate the small for gestational age ( < 3rd percentile), large for gestational age ( > 97th percentile), stunting (length < 3rd percentile), and wasting (body mass index < 3rd percentile).

Methods

Observational study of a cohort of 7702 newborns between 01/01/2010 and 12/31/2010 in the city of Ribeirão Preto, SP, Brazil. The 3rd, 50th, and 97th percentiles were determined for the anthropometric measurements using fractional polynomial regression.

Results

The weight difference between Ribeirão Preto and Intergrowth-21st was small, being more pronounced in preterm infants (mean difference between the two populations of +266 g); for full‐term newborns, there was a mean difference of +66 g, and for post‐term infants, of −113 g. For length, the mean variation was always <1 cm; whereas for head circumference, preterm newborns showed a variation >1 cm, and full‐term and post‐term newborns showed a variation of <1 cm. The small and large for gestational age detection rates were 2.9% and 4.3%, respectively. Stunting affected 6.5% of all newborns and wasting, 1.5%, with a predominance in girls and in full‐term pregnancies; both conditions were present in 0.4% of the sample.

Conclusions

Newborns from Ribeirão Preto, when compared to the Intergrowth‐21 standard, are heavier, longer, and have a larger head circumference until they reach full‐term.

(a)根据性别和胎龄，确定ribebe o Preto BRISA队列中新生儿体重、身高和头围的第3、50和97百分位，并与Intergrowth‐21标准进行比较;(b)估计胎龄(<第三百分位)，胎龄较大(>第97百分位)，发育迟缓(长度<第三百分位)和消瘦(体重指数<第三百分位)。方法对2010年1月1日至12月31日在巴西SP市ribebe o Preto出生的7702名新生儿进行观察性研究。使用分数多项式回归确定人体测量值的第3、第50和第97百分位。结果ribebe o Preto与intergrowth -21体重差异较小，在早产儿中更为明显(两种群平均差异为+266 g);足月新生儿的平均差异为+66 g，足月后婴儿的平均差异为- 113 g。对于长度，平均变化总是<1 cm;而对于头围，早产儿的变化幅度为1厘米，足月新生儿和足月新生儿的变化幅度为1厘米。小胎龄检出率为2.9%，大胎龄检出率为4.3%。发育迟缓影响6.5%的新生儿，消瘦影响1.5%，主要发生在女孩和足月妊娠;这两种情况都出现在0.4%的样本中。结论:与Intergrowth‐21标准相比，ribebe o Preto的新生儿在足月前体重更重、体长更长、头围更大。

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引用次数: 0

High‐flow nasal cannula as a post‐extubation respiratory support strategy in preterm infants: a systematic review and meta‐analysis 高流量鼻插管作为早产儿拔管后呼吸支持策略:系统综述和荟萃分析

Jornal de Pediatria (Vers?o em Português)

Pub Date : 2020-07-01 DOI: 10.1016/j.jpedp.2019.10.009

José Colleti Junior , Rafael de Azevedo , Orlei Araujo , Werther Brunow de Carvalho

Objective

Perform a systematic review and meta‐analysis to assess the effectiveness and complications caused by the use of the high‐flow nasal cannula in relation to the post‐extubation continuous positive airway pressure system in preterm newborns.

Data Sources

The searches were performed from January 2013 to December 2018 in the PubMed and Embase databases, as well as a manual search on the internet.

Data Synthesis

Two reviewers independently conducted the search, and a third reviewer resolved questions that arose. Ninety‐eight articles from the chosen sources were evaluated, and 66 were discarded because they did not meet the inclusion criteria (inadequate topic, age range, or design, in addition to the duplicates). Fifteen articles were read in full, and five more were discarded due to inadequacy to the topic or design. There were ten articles left for systematic review and four for meta‐analysis. The study showed non‐inferiority in terms of therapeutic failure of the high‐flow nasal cannula in relation to continuous positive airway pressure after extubation of preterm newborns. In the meta‐analysis, nasal trauma was significantly lower in patients submitted to the high‐flow nasal cannula compared to those using continuous positive airway pressure (p < 0.00001).

Conclusion

The high‐flow nasal cannula is not inferior to continuous positive airway pressure for post‐extubation respiratory support in preterm newborns with a gestational age of 32 weeks or less and greater than 28 weeks, in addition to resulting in less nasal trauma.

目的:对早产儿拔管后持续气道正压通气系统中使用高流量鼻插管的效果和并发症进行系统回顾和meta分析。数据来源搜索于2013年1月至2018年12月在PubMed和Embase数据库中进行，以及在互联网上进行手动搜索。数据综合两名审稿人独立进行了搜索，第三名审稿人解决了出现的问题。对所选来源的98篇文章进行了评估，其中66篇因不符合纳入标准(主题、年龄范围或设计不充分，以及重复)而被丢弃。15篇文章被完整阅读，另有5篇文章因选题或设计不合适而被丢弃。有10篇文章用于系统评价，4篇用于荟萃分析。该研究显示，在早产新生儿拔管后，高流量鼻插管治疗失败与持续气道正压相关方面，无劣势。在荟萃分析中，与使用持续气道正压通气的患者相比，使用高流量鼻插管的患者鼻外伤显著降低(p <0.00001)。结论高流量鼻插管对胎龄小于或等于28周的早产儿拔管后呼吸支持的效果不低于持续气道正压通气，且鼻外伤较小。

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