Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.04.003
Edner F. Zanuto , Raphael M. Ritti‐Dias , William R. Tebar , Catarina C. Scarabottolo , Leandro D. Delfino , Juliano Casonatto , Luiz Carlos M. Vanderlei , Diego Giulliano Destro Christofaro
Objective
Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls.
Method
The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self‐reported and used to adjust the analysis, through hierarchical linear regression.
Results
Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14).
Conclusion
The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.
{"title":"Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders","authors":"Edner F. Zanuto , Raphael M. Ritti‐Dias , William R. Tebar , Catarina C. Scarabottolo , Leandro D. Delfino , Juliano Casonatto , Luiz Carlos M. Vanderlei , Diego Giulliano Destro Christofaro","doi":"10.1016/j.jpedp.2019.04.003","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.04.003","url":null,"abstract":"<div><h3>Objective</h3><p>Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls.</p></div><div><h3>Method</h3><p>The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self‐reported and used to adjust the analysis, through hierarchical linear regression.</p></div><div><h3>Results</h3><p>Total physical activity was associated with low RHR in boys (<em>β</em> <!-->=<!--> <!-->−0.52; 95% CI: −0.92, −0.12) and girls (<em>β</em> <!-->=<!--> <!-->−0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (<em>β</em> <!-->=<!--> <!-->−0.58; 95% CI: −1.05, −0.11) and girls (<em>β</em> <!-->=<!--> <!-->−0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (<em>β</em> <!-->=<!--> <!-->−1.56; 95% CI: −2.99, −0.14).</p></div><div><h3>Conclusion</h3><p>The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 247-254"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162716","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2018.11.018
Riquelane B.M. Lima , Haroldo S. Ferreira , Andressa L. Cavalcante , Laíse Gabrielly M.L. Santos , Regina Coeli S. Vieira , Monica L. Assunção
Objectives
To estimate the coverage of the National Vitamin A Supplementation Program (Programa Nacional de Suplementação de Vitamina A) in children from Alagoas, to identify factors associated with this coverage, and to analyze the adequacy of nutrition education actions.
Methods
Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers (n = 509). Coverage was defined by the percentage of children with supplementation records in the last semester. The association between the independent variables (socioeconomic, demographic, and health) and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95% CI. The mothers’ knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions.
Results
Program coverage was 91.9% in children aged 6‐11.9 months and 38.6% in children aged 12‐59 months. In the adjusted analysis, the factors that were associated with greater coverage were: age between 6‐11.9 months (PR = 2.50, 95% CI: 2.10‐2.96), living in rural areas (PR = 1.45, 95% CI: 1.20‐1.76) and living in a house with ≤ 4 rooms (PR = 1.33, 95% CI: 1.09‐1.63). Only 26.1% of the mothers were able to mention some food source of vitamin A and only 19.2% were aware of the consequences of vitamin deficiency for health.
Conclusions
The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health (except for children < 12 months). The factors associated with greater coverage indicate an adequate focus of the program. The nutrition education activities have not demonstrated satisfactory results. This information should guide actions to improve the program.
目的评估国家维生素A补充计划(Programa Nacional de supplement A o de Vitamina A)在阿拉戈斯州儿童中的覆盖率，确定与该覆盖率相关的因素，并分析营养教育行动的充足性。方法对阿拉戈斯州6 ~ 59个月的儿童及其母亲进行有代表性的概率抽样调查(n = 509)。覆盖范围由上学期有补充记录的儿童的百分比确定。独立变量(社会经济、人口统计和健康)与国家维生素A补充计划覆盖率之间的关联基于患病率及其95% CI进行了分析。母亲对维生素A相关问题的了解程度被认为是营养教育行动是否充分的一个指标。结果6 - 11.9月龄儿童的计划覆盖率为91.9%，12 - 59月龄儿童的计划覆盖率为38.6%。在调整后的分析中，与更大的覆盖率相关的因素是:年龄在6 - 11.9个月之间(PR = 2.50, 95% CI: 2.10 - 2.96)，居住在农村地区(PR = 1.45, 95% CI: 1.20 - 1.76)，居住在一个≤4个房间的房子里(PR = 1.33, 95% CI: 1.09 - 1.63)。只有26.1%的母亲能够提到一些维生素A的食物来源，只有19.2%的母亲知道维生素缺乏对健康的影响。结论:国家维生素A补充方案的覆盖率低于卫生部设定的目标(儿童除外);12个月)。与更大的覆盖率相关的因素表明该计划有足够的重点。营养教育活动效果不理想。这些信息应该指导改进程序的行动。
{"title":"Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas","authors":"Riquelane B.M. Lima , Haroldo S. Ferreira , Andressa L. Cavalcante , Laíse Gabrielly M.L. Santos , Regina Coeli S. Vieira , Monica L. Assunção","doi":"10.1016/j.jpedp.2018.11.018","DOIUrl":"https://doi.org/10.1016/j.jpedp.2018.11.018","url":null,"abstract":"<div><h3>Objectives</h3><p>To estimate the coverage of the National Vitamin A Supplementation Program (Programa Nacional de Suplementação de Vitamina A) in children from Alagoas, to identify factors associated with this coverage, and to analyze the adequacy of nutrition education actions.</p></div><div><h3>Methods</h3><p>Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers (n<!--> <!-->=<!--> <!-->509). Coverage was defined by the percentage of children with supplementation records in the last semester. The association between the independent variables (socioeconomic, demographic, and health) and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95% CI. The mothers’ knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions.</p></div><div><h3>Results</h3><p>Program coverage was 91.9% in children aged 6‐11.9 months and 38.6% in children aged 12‐59 months. In the adjusted analysis, the factors that were associated with greater coverage were: age between 6‐11.9 months (PR<!--> <!-->=<!--> <!-->2.50, 95% CI: 2.10‐2.96), living in rural areas (PR<!--> <!-->=<!--> <!-->1.45, 95% CI: 1.20‐1.76) and living in a house with ≤ 4 rooms (PR<!--> <!-->=<!--> <!-->1.33, 95% CI: 1.09‐1.63). Only 26.1% of the mothers were able to mention some food source of vitamin A and only 19.2% were aware of the consequences of vitamin deficiency for health.</p></div><div><h3>Conclusions</h3><p>The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health (except for children <<!--> <!-->12 months). The factors associated with greater coverage indicate an adequate focus of the program. The nutrition education activities have not demonstrated satisfactory results. This information should guide actions to improve the program.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 184-192"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2018.11.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162094","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2018.08.018
Lara Silvia Oliveira Conegundes , Juliana Y. Valente , Camila Bertini Martins , Solange Andreoni , Zila M. Sanchez
Objective
To analyze the sociodemographic, school, and family factors associated with the patterns of binge drinking and frequent or heavy drinking among adolescents.
Methods
This was a cross‐sectional study, nested in a randomized controlled trial, of 6285 seventh and eighth grade adolescent students from Brazilian public schools. The associations between binge drinking (consumption of five or more doses of alcohol on a single occasion) in the last 12 months and frequent or heavy drinking (alcohol consumption on six or more days) in the last month and the several factors were analyzed through weighted logistic regression.
Results
16.5% of the students reported binge drinking in the year before the interview and 2.2% reported frequent/heavy drinking in the previous month. The factors associated with binge drinking were cigarette smoking (OR = 6.7, 95% CI = 3.96; 11.23), use of marijuana (OR = 2.2, 95% CI = 1.17; 4.31), use of inhalant drugs (OR = 3.0, 95% CI = 1.98; 4.43), exposure to a drunk relative (OR = 2.1, 95% C = 1.67; 2.53), practice of bullying (OR = 1.8, 95% CI = 1.47; 2.17), verbal aggression (OR = 1.7, 95%CI = 1.40; 2.14), and intermediate/low school grades (OR = 1.7, 95% CI = 1.35; 2.20). The factors associated with frequent/heavy drinking were cigarette smoking (OR = 2.5, 95% CI = 1.16; 5.22), use of marijuana (OR = 3.2, 95% CI = 1.32; 7.72), and physical aggression (OR = 2.2, 95% CI = 1.36; 3.50).
Conclusions
The analyzed outcomes showed an association between the risk consumption of alcohol in early adolescence and low academic performance, involvement with other drugs, aggressiveness, and witnessing episodes of a family member's drunkenness. Considering the impact on public health of the damages caused by alcohol consumption during adolescence, these factors that showed such association should be considered in the development of preventive interventions.
目的分析与青少年暴饮、频繁或重度饮酒模式相关的社会人口、学校和家庭因素。方法:这是一项横断面研究，随机对照试验，来自巴西公立学校的6285名七年级和八年级青少年学生。通过加权logistic回归分析近12个月的酗酒(单次饮酒5次及以上)与上月频繁或重度饮酒(6天及以上)之间的关系及相关因素。结果16.5%的学生在访谈前一年报告有酗酒行为，2.2%的学生在访谈前一个月报告有频繁或重度饮酒行为。与酗酒相关的因素有吸烟(OR = 6.7, 95% CI = 3.96;11.23)，大麻的使用(OR = 2.2, 95% CI = 1.17;4.31)，吸入性药物的使用(OR = 3.0, 95% CI = 1.98;4.43)，暴露于醉酒的亲属(OR = 2.1, 95% C = 1.67;2.53)，欺凌行为(OR = 1.8, 95% CI = 1.47;2.17),言语攻击(或= 1.7,95% ci = 1.40;2.14)，中低年级(OR = 1.7, 95% CI = 1.35;2.20)。与频繁/重度饮酒相关的因素是吸烟(OR = 2.5, 95% CI = 1.16;5.22),使用大麻(或= 3.2,95% CI = 1.32;7.72)，身体攻击(OR = 2.2, 95% CI = 1.36;3.50)。结论:分析结果表明，青少年早期饮酒的风险与学习成绩差、吸毒、攻击性强以及目睹家人醉酒之间存在关联。考虑到青少年时期饮酒造成的损害对公众健康的影响，在制定预防干预措施时应考虑到这些表明这种关联的因素。
{"title":"Binge drinking and frequent or heavy drinking among adolescents: prevalence and associated factors","authors":"Lara Silvia Oliveira Conegundes , Juliana Y. Valente , Camila Bertini Martins , Solange Andreoni , Zila M. Sanchez","doi":"10.1016/j.jpedp.2018.08.018","DOIUrl":"https://doi.org/10.1016/j.jpedp.2018.08.018","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the sociodemographic, school, and family factors associated with the patterns of binge drinking and frequent or heavy drinking among adolescents.</p></div><div><h3>Methods</h3><p>This was a cross‐sectional study, nested in a randomized controlled trial, of 6285 seventh and eighth grade adolescent students from Brazilian public schools. The associations between binge drinking (consumption of five or more doses of alcohol on a single occasion) in the last 12 months and frequent or heavy drinking (alcohol consumption on six or more days) in the last month and the several factors were analyzed through weighted logistic regression.</p></div><div><h3>Results</h3><p>16.5% of the students reported binge drinking in the year before the interview and 2.2% reported frequent/heavy drinking in the previous month. The factors associated with binge drinking were cigarette smoking (OR<!--> <!-->=<!--> <!-->6.7, 95% CI<!--> <!-->=<!--> <!-->3.96; 11.23), use of marijuana (OR<!--> <!-->=<!--> <!-->2.2, 95% CI<!--> <!-->=<!--> <!-->1.17; 4.31), use of inhalant drugs (OR<!--> <!-->=<!--> <!-->3.0, 95% CI<!--> <!-->=<!--> <!-->1.98; 4.43), exposure to a drunk relative (OR<!--> <!-->=<!--> <!-->2.1, 95% C<!--> <!-->=<!--> <!-->1.67; 2.53), practice of bullying (OR<!--> <!-->=<!--> <!-->1.8, 95% CI<!--> <!-->=<!--> <!-->1.47; 2.17), verbal aggression (OR<!--> <!-->=<!--> <!-->1.7, 95%CI<!--> <!-->=<!--> <!-->1.40; 2.14), and intermediate/low school grades (OR<!--> <!-->=<!--> <!-->1.7, 95% CI<!--> <!-->=<!--> <!-->1.35; 2.20). The factors associated with frequent/heavy drinking were cigarette smoking (OR<!--> <!-->=<!--> <!-->2.5, 95% CI<!--> <!-->=<!--> <!-->1.16; 5.22), use of marijuana (OR<!--> <!-->=<!--> <!-->3.2, 95% CI<!--> <!-->=<!--> <!-->1.32; 7.72), and physical aggression (OR<!--> <!-->=<!--> <!-->2.2, 95% CI<!--> <!-->=<!--> <!-->1.36; 3.50).</p></div><div><h3>Conclusions</h3><p>The analyzed outcomes showed an association between the risk consumption of alcohol in early adolescence and low academic performance, involvement with other drugs, aggressiveness, and witnessing episodes of a family member's drunkenness. Considering the impact on public health of the damages caused by alcohol consumption during adolescence, these factors that showed such association should be considered in the development of preventive interventions.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 193-201"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2018.08.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162095","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2018.11.017
Vanesca P.A. de Arruda , Maria A. Bellomo‐Brandão , Joaquim M. Bustorff‐Silva , Elizete Aparecida Lomazi
Objective
To compare the clinical evolution in patients with refractory functional constipation undergoing different therapeutic regimens: oral laxatives and antegrade enemas via appendicostomy or clinical treatment with oral laxatives and rectal enemas.
Methods
Analysis of a series of 28 patients with a mean age of 7.9 years (2.4–11), followed‐up in a tertiary outpatient clinic. Refractory functional constipation was defined as continuous retentive fecal incontinence after at least a 12‐month period of consensus therapy. After the diagnosis of refractory condition, appendicostomy was proposed and performed in 17 patients. Outcomes: (1) persistence of retentive fecal incontinence despite the use of enemas, (2) control of retentive fecal incontinence with enemas, and (3) control of retentive fecal incontinence, spontaneous evacuations, with no need for enemas.
Results
Six and 12 months after the therapeutic option, control of retentive fecal incontinence was observed only in patients who underwent surgery, 11/17 and 14/17, p = 0.001 and p = 0.001, respectively. At 24 months, control of retentive fecal incontinence was also more frequent in operated patients: 13/17 versus 3/11 with clinical treatment, p = 0.005. In the final evaluation, the median follow‐up times were 2.6 and 3 years (operated vs. clinical treatment, p = 0.40); one patient in each group was lost to follow‐up and 9/16 operated patients had spontaneous bowel movements vs. 3/10 in the clinical treatment group, p = 0.043. Surgical complications, totaling 42 episodes, were observed 14/17 patients.
Conclusion
Appendicostomy, although associated with a high frequency of complications, controlled retentive fecal incontinence earlier and more frequently than clinical treatment. The choice of one of the methods should be made by the family, after adequate information about the risks and benefits of each alternative.
{"title":"Refractory functional constipation: clinical management or appendicostomy?","authors":"Vanesca P.A. de Arruda , Maria A. Bellomo‐Brandão , Joaquim M. Bustorff‐Silva , Elizete Aparecida Lomazi","doi":"10.1016/j.jpedp.2018.11.017","DOIUrl":"https://doi.org/10.1016/j.jpedp.2018.11.017","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the clinical evolution in patients with refractory functional constipation undergoing different therapeutic regimens: oral laxatives and antegrade enemas via appendicostomy or clinical treatment with oral laxatives and rectal enemas.</p></div><div><h3>Methods</h3><p>Analysis of a series of 28 patients with a mean age of 7.9 years (2.4–11), followed‐up in a tertiary outpatient clinic. Refractory functional constipation was defined as continuous retentive fecal incontinence after at least a 12‐month period of consensus therapy. After the diagnosis of refractory condition, appendicostomy was proposed and performed in 17 patients. Outcomes: (1) persistence of retentive fecal incontinence despite the use of enemas, (2) control of retentive fecal incontinence with enemas, and (3) control of retentive fecal incontinence, spontaneous evacuations, with no need for enemas.</p></div><div><h3>Results</h3><p>Six and 12 months after the therapeutic option, control of retentive fecal incontinence was observed only in patients who underwent surgery, 11/17 and 14/17, <em>p</em> <!-->=<!--> <!-->0.001 and <em>p</em> <!-->=<!--> <!-->0.001, respectively. At 24 months, control of retentive fecal incontinence was also more frequent in operated patients: 13/17 <em>versus</em> 3/11 with clinical treatment, <em>p</em> <!-->=<!--> <!-->0.005. In the final evaluation, the median follow‐up times were 2.6 and 3 years (operated <em>vs.</em> clinical treatment, <em>p</em> <!-->=<!--> <!-->0.40); one patient in each group was lost to follow‐up and 9/16 operated patients had spontaneous bowel movements <em>vs.</em> 3/10 in the clinical treatment group, <em>p</em> <!-->=<!--> <!-->0.043. Surgical complications, totaling 42 episodes, were observed 14/17 patients.</p></div><div><h3>Conclusion</h3><p>Appendicostomy, although associated with a high frequency of complications, controlled retentive fecal incontinence earlier and more frequently than clinical treatment. The choice of one of the methods should be made by the family, after adequate information about the risks and benefits of each alternative.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 210-216"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2018.11.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162111","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.06.003
Tomáš Seeman , Terezie Šuláková
{"title":"Brazilian pediatricians need to use national blood pressure reference values for their adolescents","authors":"Tomáš Seeman , Terezie Šuláková","doi":"10.1016/j.jpedp.2019.06.003","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.06.003","url":null,"abstract":"","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 135-137"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162718","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.04.004
Armando Almeida‐Junior , Fernando Augusto Lima Marson , Celize Cruz Bresciani Almeida , Maria Ângela Gonçalves Oliveira Ribeiro , Ilma Aparecida Paschoal , Marcos Mello Moreira , José Dirceu Ribeiro
Objective
To compare the values of the markers for volumetric capnography and spirometry and their ability to classify children and adolescents with asthma, cystic fibrosis (CF), and healthy controls.
Methods
This was a cross‐sectional study that included 103 patients with controlled persistent allergic asthma, 53 with CF and a healthy control group with 40 volunteers (aged 6–15 years), of both sexes. The individuals underwent volumetric capnography and spirometry.
Results
Phase III slope (SIII), SIII standardized by exhaled tidal volume (SIII/TV) and capnographic index (SIII/SII) × 100 (KPIv) were different among the three groups assessed, with highest values for CF. The relation between the forced expiratory volume in one second and the forced vital capacity (FEV1/FVC) was the only spirometric marker that presented difference on the three groups. On individuals with normal spirometry, KPIv and FEV1/FVC were different among the three groups. The ROC curve identified the individuals with asthma or CF from the control group, both through volumetric capnography (better to identify CF in relation to the control using KPIv) and through spirometry (better to identify asthma in relation to the control). KPIv was the best parameter to distinguish asthma from CF, even in individuals with normal spirometry.
Conclusion
Volumetric capnography and spirometry identified different alterations in lung function on asthma, CF, and healthy controls, allowing the three groups to be distinguished.
{"title":"Volumetric capnography versus spirometry for the evaluation of pulmonary function in cystic fibrosis and allergic asthma","authors":"Armando Almeida‐Junior , Fernando Augusto Lima Marson , Celize Cruz Bresciani Almeida , Maria Ângela Gonçalves Oliveira Ribeiro , Ilma Aparecida Paschoal , Marcos Mello Moreira , José Dirceu Ribeiro","doi":"10.1016/j.jpedp.2019.04.004","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.04.004","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the values of the markers for volumetric capnography and spirometry and their ability to classify children and adolescents with asthma, cystic fibrosis (CF), and healthy controls.</p></div><div><h3>Methods</h3><p>This was a cross‐sectional study that included 103 patients with controlled persistent allergic asthma, 53 with CF and a healthy control group with 40 volunteers (aged 6–15 years), of both sexes. The individuals underwent volumetric capnography and spirometry.</p></div><div><h3>Results</h3><p>Phase III slope (SIII), SIII standardized by exhaled tidal volume (SIII/TV) and capnographic index (SIII/SII)<!--> <!-->×<!--> <!-->100 (KPIv) were different among the three groups assessed, with highest values for CF. The relation between the forced expiratory volume in one second and the forced vital capacity (FEV<sub>1</sub>/FVC) was the only spirometric marker that presented difference on the three groups. On individuals with normal spirometry, KPIv and FEV<sub>1</sub>/FVC were different among the three groups. The ROC curve identified the individuals with asthma or CF from the control group, both through volumetric capnography (better to identify CF in relation to the control using KPIv) and through spirometry (better to identify asthma in relation to the control). KPIv was the best parameter to distinguish asthma from CF, even in individuals with normal spirometry.</p></div><div><h3>Conclusion</h3><p>Volumetric capnography and spirometry identified different alterations in lung function on asthma, CF, and healthy controls, allowing the three groups to be distinguished.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 255-263"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162688","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.04.008
William E. Benitz
{"title":"Unwinding old habits: deimplementation of treatment regimens for patent ductus arteriosus in preterm infants","authors":"William E. Benitz","doi":"10.1016/j.jpedp.2019.04.008","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.04.008","url":null,"abstract":"","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 138-141"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162717","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.10.005
Paula Andrade Alvares , Marcelo Jenné Mimica
Objective
To collect the most up‐to‐date information regarding pediatric osteoarticular infections, including the epidemiological and microbiological profiles, diagnosis, and treatment.
Source of data
A non‐systematic review was performed on the search engines PubMed, SciELO, Lilacs, and Google Scholar, using the keywords “bone and joint infection”, “children”, “pediatric”, “osteomyelitis”, “septic arthritis” and “spondylodiscitis” over the last ten years. The most relevant articles were selected by the authors to constitute the database.
Synthesis of data
Osteoarticular infections are still a major cause of morbidity in pediatrics. Their main etiology is Staphylococcus aureus, but there has been an increase in the detection of Kingella kingae, especially through molecular methods. Microbiological identification allows treatment direction, while evidence of inflammatory activity assists in treatment follow‐up. Imaging tests are especially useful in the initial diagnosis of infections. Empirical treatment should include coverage for the main microorganisms according to the age and clinical conditions of the patient, while considering the local resistance profile. Surgical procedures can be indicated for diagnosis, focus control, and function preservation. Acute complications include sepsis, deep venous thrombosis, and pulmonary embolism. Deaths are rare. Late complications are uncommon but may lead to deformities that compromise motor development.
Conclusion
A correct and early diagnosis, prompt implementation of adequate antimicrobial therapy, and focus control, when indicated, are critical to a better prognosis.
{"title":"Osteoarticular infections in pediatrics","authors":"Paula Andrade Alvares , Marcelo Jenné Mimica","doi":"10.1016/j.jpedp.2019.10.005","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.10.005","url":null,"abstract":"<div><h3>Objective</h3><p>To collect the most up‐to‐date information regarding pediatric osteoarticular infections, including the epidemiological and microbiological profiles, diagnosis, and treatment.</p></div><div><h3>Source of data</h3><p>A non‐systematic review was performed on the search engines PubMed, SciELO, Lilacs, and Google Scholar, using the keywords “bone and joint infection”, “children”, “pediatric”, “osteomyelitis”, “septic arthritis” and “spondylodiscitis” over the last ten years. The most relevant articles were selected by the authors to constitute the database.</p></div><div><h3>Synthesis of data</h3><p>Osteoarticular infections are still a major cause of morbidity in pediatrics. Their main etiology is <em>Staphylococcus aureus</em>, but there has been an increase in the detection of <em>Kingella kingae</em>, especially through molecular methods. Microbiological identification allows treatment direction, while evidence of inflammatory activity assists in treatment follow‐up. Imaging tests are especially useful in the initial diagnosis of infections. Empirical treatment should include coverage for the main microorganisms according to the age and clinical conditions of the patient, while considering the local resistance profile. Surgical procedures can be indicated for diagnosis, focus control, and function preservation. Acute complications include sepsis, deep venous thrombosis, and pulmonary embolism. Deaths are rare. Late complications are uncommon but may lead to deformities that compromise motor development.</p></div><div><h3>Conclusion</h3><p>A correct and early diagnosis, prompt implementation of adequate antimicrobial therapy, and focus control, when indicated, are critical to a better prognosis.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 ","pages":"Pages 58-64"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.10.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137132043","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.10.006
Ana Cristina Simões e Silva , Eduardo A. Oliveira , Robert H. Mak
Objective
This review aimed to provide a critical overview on the pathogenesis, clinical findings, diagnosis, imaging investigation, treatment, chemoprophylaxis, and complications of urinary tract infection in pediatric patients.
Source of data
Data were obtained independently by two authors, who carried out a comprehensive and non‐systematic search in public databases.
Summary of findings
Urinary tract infection is the most common bacterial infection in children. Urinary tract infection in pediatric patients can be the early clinical manifestation of congenital anomalies of the kidney and urinary tract (CAKUT) or be related to bladder dysfunctions. E. coli is responsible for 80–90% of community‐acquired acute pyelonephritis episodes, especially in children. Bacterial virulence factors and the innate host immune systems may contribute to the occurrence and severity of urinary tract infection. The clinical presentation of urinary tract infections in children is highly heterogeneous, with symptoms that can be quite obscure. Urine culture is still the gold standard for diagnosing urinary tract infection and methods of urine collection in individual centers should be determined based on the accuracy of voided specimens. The debate on the ideal imaging protocol is still ongoing and there is tendency of less use of prophylaxis. Alternative measures and management of risk factors for recurrent urinary tract infection should be emphasized. However, in selected patients, prophylaxis can protect from recurrent urinary tract infection and long‐term consequences. According to population‐based studies, hypertension and chronic kidney disease are rarely associated with urinary tract infection.
Conclusion
Many aspects regarding urinary tract infection in children are still matters of debate, especially imaging investigation and indication of antibiotic prophylaxis. Further longitudinal studies are needed to establish tailored approach of urinary tract infection in childhood.
{"title":"Urinary tract infection in pediatrics: an overview","authors":"Ana Cristina Simões e Silva , Eduardo A. Oliveira , Robert H. Mak","doi":"10.1016/j.jpedp.2019.10.006","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.10.006","url":null,"abstract":"<div><h3>Objective</h3><p>This review aimed to provide a critical overview on the pathogenesis, clinical findings, diagnosis, imaging investigation, treatment, chemoprophylaxis, and complications of urinary tract infection in pediatric patients.</p></div><div><h3>Source of data</h3><p>Data were obtained independently by two authors, who carried out a comprehensive and non‐systematic search in public databases.</p></div><div><h3>Summary of findings</h3><p>Urinary tract infection is the most common bacterial infection in children. Urinary tract infection in pediatric patients can be the early clinical manifestation of congenital anomalies of the kidney and urinary tract (CAKUT) or be related to bladder dysfunctions. <em>E. coli</em> is responsible for 80–90% of community‐acquired acute pyelonephritis episodes, especially in children. Bacterial virulence factors and the innate host immune systems may contribute to the occurrence and severity of urinary tract infection. The clinical presentation of urinary tract infections in children is highly heterogeneous, with symptoms that can be quite obscure. Urine culture is still the gold standard for diagnosing urinary tract infection and methods of urine collection in individual centers should be determined based on the accuracy of voided specimens. The debate on the ideal imaging protocol is still ongoing and there is tendency of less use of prophylaxis. Alternative measures and management of risk factors for recurrent urinary tract infection should be emphasized. However, in selected patients, prophylaxis can protect from recurrent urinary tract infection and long‐term consequences. According to population‐based studies, hypertension and chronic kidney disease are rarely associated with urinary tract infection.</p></div><div><h3>Conclusion</h3><p>Many aspects regarding urinary tract infection in children are still matters of debate, especially imaging investigation and indication of antibiotic prophylaxis. Further longitudinal studies are needed to establish tailored approach of urinary tract infection in childhood.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 ","pages":"Pages 65-79"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137132044","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}
Pub Date : 2020-03-01DOI: 10.1016/j.jpedp.2019.07.003
Daniela Caldas Teixeira , Lilian Martins Oliveira Diniz , Nathalia Sernizon Guimarães , Henrique Morávia de Andrade Santos Moreira , César Caldas Teixeira , Roberta Maia de Castro Romanelli
Objective
The aim of this study was to systematically review the literature and answer the following central question: “What are the risk factors associated with worse clinical outcomes of pediatric bacterial meningitis patients?”
Methods
The articles were obtained through literary search using electronic bibliographic databases: Web of Science, Scopus, MEDLINE, and LILACS; they were selected using the international guideline outlined by the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Protocols.
Results
The literature search identified 1,244 articles. After methodological screening, 17 studies were eligible for this systematic review. A total of 9,581 patients aged between 0 days and 18 years were evaluated in the included studies, and several plausible and important prognostic factors are proposed for prediction of poor outcomes after bacterial meningitis in childhood. Late diagnosis reduces the chances for a better evolution and reinforces the importance of a high diagnostic suspicion of meningitis, especially in febrile pictures with nonspecific symptomatology. S.pneumoniae as a causative pathogen was demonstrated to be related to clinical severity.
Conclusions
Early prediction of an adverse outcome may help determine which children require more intensive or longer follow‐up and may provide the physician with rationale for parental counseling about their child's prognosis in an early phase of the disease.
目的本研究的目的是系统地回顾文献并回答以下中心问题:“与儿童细菌性脑膜炎患者临床预后较差相关的危险因素是什么?”方法采用Web of Science、Scopus、MEDLINE、LILACS等电子书目数据库进行文献检索;他们是根据系统评价和Meta分析方案的首选报告项目概述的国际指南进行选择的。结果共检索文献1244篇。经过方法学筛选，17项研究符合本系统评价的要求。在纳入的研究中，共评估了9581例年龄在0天至18岁之间的患者，并提出了几个合理且重要的预后因素来预测儿童期细菌性脑膜炎后的不良预后。晚期诊断减少了更好发展的机会，并加强了对脑膜炎的高度诊断怀疑的重要性，特别是在具有非特异性症状的发热图像中。肺炎链球菌作为致病病原体被证明与临床严重程度有关。结论:早期预测不良结果可能有助于确定哪些儿童需要更密集或更长时间的随访，并可能为医生在疾病早期提供有关其儿童预后的家长咨询提供依据。
{"title":"Risk factors associated with the outcomes of pediatric bacterial meningitis: a systematic review","authors":"Daniela Caldas Teixeira , Lilian Martins Oliveira Diniz , Nathalia Sernizon Guimarães , Henrique Morávia de Andrade Santos Moreira , César Caldas Teixeira , Roberta Maia de Castro Romanelli","doi":"10.1016/j.jpedp.2019.07.003","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to systematically review the literature and answer the following central question: “What are the risk factors associated with worse clinical outcomes of pediatric bacterial meningitis patients?”</p></div><div><h3>Methods</h3><p>The articles were obtained through literary search using electronic bibliographic databases: Web of Science, Scopus, MEDLINE, and LILACS; they were selected using the international guideline outlined by the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Protocols.</p></div><div><h3>Results</h3><p>The literature search identified 1,244 articles. After methodological screening, 17 studies were eligible for this systematic review. A total of 9,581 patients aged between 0 days and 18 years were evaluated in the included studies, and several plausible and important prognostic factors are proposed for prediction of poor outcomes after bacterial meningitis in childhood. Late diagnosis reduces the chances for a better evolution and reinforces the importance of a high diagnostic suspicion of meningitis, especially in febrile pictures with nonspecific symptomatology. <em>S.</em> <em>pneumoniae</em> as a causative pathogen was demonstrated to be related to clinical severity.</p></div><div><h3>Conclusions</h3><p>Early prediction of an adverse outcome may help determine which children require more intensive or longer follow‐up and may provide the physician with rationale for parental counseling about their child's prognosis in an early phase of the disease.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 2","pages":"Pages 159-167"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137162679","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}
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