Pub Date : 2015-12-01DOI: 10.1016/j.rppede.2015.09.001
Jon A. Vanderhoof
{"title":"In time: misuse and overuse of amino acid formulas in cow milk allergy","authors":"Jon A. Vanderhoof","doi":"10.1016/j.rppede.2015.09.001","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.09.001","url":null,"abstract":"","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 379-380"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636755","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.03.001
Gerson Luis de Moraes Ferrari , Victor Keihan Rodrigues Matsudo , Mauro Fisberg
Objective
To analyze and compare the changes in physical fitness according to the nutritional status and gender of schoolchildren during a period of 30 years (1980–2010).
Methods
Four cross-sectional evaluations were performed every 10 years in a period of 30 years from 1978 to 1980 (baseline), 1988–1990 (10 years), 1998–2000 (20 years) and 2008–2010 (30 years). The sample consisted of 1291 schoolchildren (188 in baseline, 307 in 10 years; 375 in 20 years; 421 in 30 years) of 10 and 11 years old. The variables assessed were: body weight (kg), height (cm), upper limb strength (ULS; kg), lower limb strength (LLS; cm), agility (seconds) and velocity (seconds). Schoolchildren were classified as normal weight and overweight according to World Health Organization reference of body mass index for age and gender. Comparisons among periods applied ANOVA followed by Bonferroni test, with a significance level set at of p<0.01. Variation between baseline and 30 years was assessed by the percentage delta. Seven different percentile values were presented for each variable.
Results
In eutrophic boys and girls, mean values of ULS (−16.7%; −3.2%), agility (−1.5%; −1.6%) decreased significantly after 30 years (p<0.001). In the overweight boys and girls, only the average ULS (−15.5%; −12.5%) decreased significantly over time (p<0.001). After 30 years, the ULS percentile changed in boys.
Conclusions
The decline in physical fitness was greater in schoolchildren with normal weight than in those with overweight.
{"title":"Changes in physical fitness and nutritional status of schoolchildren in a period of 30 years (1980–2010)","authors":"Gerson Luis de Moraes Ferrari , Victor Keihan Rodrigues Matsudo , Mauro Fisberg","doi":"10.1016/j.rppede.2015.03.001","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze and compare the changes in physical fitness according to the nutritional status and gender of schoolchildren during a period of 30 years (1980–2010).</p></div><div><h3>Methods</h3><p>Four cross-sectional evaluations were performed every 10 years in a period of 30 years from 1978 to 1980 (baseline), 1988–1990 (10 years), 1998–2000 (20 years) and 2008–2010 (30 years). The sample consisted of 1291 schoolchildren (188 in baseline, 307 in 10 years; 375 in 20 years; 421 in 30 years) of 10 and 11 years old. The variables assessed were: body weight (kg), height (cm), upper limb strength (ULS; kg), lower limb strength (LLS; cm), agility (seconds) and velocity (seconds). Schoolchildren were classified as normal weight and overweight according to World Health Organization reference of body mass index for age and gender. Comparisons among periods applied ANOVA followed by Bonferroni test, with a significance level set at of <em>p</em><0.01. Variation between baseline and 30 years was assessed by the percentage delta. Seven different percentile values were presented for each variable.</p></div><div><h3>Results</h3><p>In eutrophic boys and girls, mean values of ULS (−16.7%; −3.2%), agility (−1.5%; −1.6%) decreased significantly after 30 years (<em>p</em><0.001). In the overweight boys and girls, only the average ULS (−15.5%; −12.5%) decreased significantly over time (<em>p</em><0.001). After 30 years, the ULS percentile changed in boys.</p></div><div><h3>Conclusions</h3><p>The decline in physical fitness was greater in schoolchildren with normal weight than in those with overweight.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 415-422"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636751","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.008
Alessandra Terra Vasconcelos Rabelo, Fernanda Rodrigues Campos, Clarice Passos Friche, Bárbara Suelen Vasconcelos da Silva, Amélia Augusta de Lima Friche, Claudia Regina Lindgren Alves, Lúcia Maria Horta de Figueiredo Goulart
Objective
To investigate the prevalence of oral language, orofacial motor skill and auditory processing disorders in children aged 4–10 years and verify their association with age and gender.
Methods
Cross-sectional study with stratified, random sample consisting of 539 students. The evaluation consisted of three protocols: orofacial motor skill protocol, adapted from the Myofunctional Evaluation Guidelines; the Child Language Test ABFW – Phonology; and a simplified auditory processing evaluation. Descriptive and associative statistical analyses were performed using Epi Info software, release 6.04. Chi-square test was applied to compare proportion of events and analysis of variance was used to compare mean values. Significance was set at p≤0.05.
Results
Of the studied subjects, 50.1% had at least one of the assessed disorders; of those, 33.6% had oral language disorder, 17.1% had orofacial motor skill impairment, and 27.3% had auditory processing disorder. There were significant associations between auditory processing skills’ impairment, oral language impairment and age, suggesting a decrease in the number of disorders with increasing age. Similarly, the variable “one or more speech, language and hearing disorders” was also associated with age.
Conclusions
The prevalence of speech, language and hearing disorders in children was high, indicating the need for research and public health efforts to cope with this problem.
{"title":"Speech and language disorders in children from public schools in Belo Horizonte","authors":"Alessandra Terra Vasconcelos Rabelo, Fernanda Rodrigues Campos, Clarice Passos Friche, Bárbara Suelen Vasconcelos da Silva, Amélia Augusta de Lima Friche, Claudia Regina Lindgren Alves, Lúcia Maria Horta de Figueiredo Goulart","doi":"10.1016/j.rppede.2015.08.008","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.008","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the prevalence of oral language, orofacial motor skill and auditory processing disorders in children aged 4–10 years and verify their association with age and gender.</p></div><div><h3>Methods</h3><p>Cross-sectional study with stratified, random sample consisting of 539 students. The evaluation consisted of three protocols: orofacial motor skill protocol, adapted from the Myofunctional Evaluation Guidelines; the Child Language Test ABFW – Phonology; and a simplified auditory processing evaluation. Descriptive and associative statistical analyses were performed using Epi Info software, release 6.04. Chi-square test was applied to compare proportion of events and analysis of variance was used to compare mean values. Significance was set at <em>p</em>≤0.05.</p></div><div><h3>Results</h3><p>Of the studied subjects, 50.1% had at least one of the assessed disorders; of those, 33.6% had oral language disorder, 17.1% had orofacial motor skill impairment, and 27.3% had auditory processing disorder. There were significant associations between auditory processing skills’ impairment, oral language impairment and age, suggesting a decrease in the number of disorders with increasing age. Similarly, the variable “one or more speech, language and hearing disorders” was also associated with age.</p></div><div><h3>Conclusions</h3><p>The prevalence of speech, language and hearing disorders in children was high, indicating the need for research and public health efforts to cope with this problem.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 453-459"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636752","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.015
Nelson Rosário Filho
{"title":"Early introduction of food to prevent food allergy. The LEAP study (Learning Early about Peanut)","authors":"Nelson Rosário Filho","doi":"10.1016/j.rppede.2015.08.015","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.015","url":null,"abstract":"","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 493-494"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136827254","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.006
Neiva Leite, Leilane Lazarotto, Gerusa Eisfeld Milano, Ana Claudia Kapp Titski, Cássio Leandro Mühe Consentino, Fernanda de Mattos, Fabiana Antunes de Andrade, Lupe Furtado-Alle
Objective
To investigate the association of Arg16Gly and Gln27Glu polymorphisms of β2-adrenergic receptor gene (ADRB2) with the occurrence of asthma and overweight and the gene's influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents.
Methods
Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI), BMI Z-score, waist circumference (WC), pubertal stage, resting heart rate (HRres), blood pressure (BP), total cholesterol (TC), glucose, insulin, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TG), Homeostasis Metabolic Assessment (HOMA2-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) and maximal oxygen uptake (VO2max). The participants were divided in four groups: overweight asthmatic (n=39), overweight non-asthmatic (n=115), normal weight asthmatic (n=12), and normal weight non-asthmatic (n=40).
Results
Regarding the Gln27Glu polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (p=0.04). No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The Arg16 allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (p=0.02), and the Glu27 allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (p=0.03).
Conclusions
The association of Arg16 allele with the occurrence of asthma and of the Glu27 allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma.
{"title":"Beta 2-adrenergic receptor gene association with overweight and asthma in children and adolescents and its relationship with physical fitness","authors":"Neiva Leite, Leilane Lazarotto, Gerusa Eisfeld Milano, Ana Claudia Kapp Titski, Cássio Leandro Mühe Consentino, Fernanda de Mattos, Fabiana Antunes de Andrade, Lupe Furtado-Alle","doi":"10.1016/j.rppede.2015.08.006","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.006","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the association of <em>Arg16Gly</em> and <em>Gln27Glu</em> polymorphisms of β2-adrenergic receptor gene (<em>ADRB2</em>) with the occurrence of asthma and overweight and the gene's influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents.</p></div><div><h3>Methods</h3><p>Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI), BMI <em>Z</em>-score, waist circumference (WC), pubertal stage, resting heart rate (HRres), blood pressure (BP), total cholesterol (TC), glucose, insulin, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TG), Homeostasis Metabolic Assessment (HOMA2-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) and maximal oxygen uptake (VO<sub>2max</sub>). The participants were divided in four groups: overweight asthmatic (<em>n</em>=39), overweight non-asthmatic (<em>n</em>=115), normal weight asthmatic (<em>n</em>=12), and normal weight non-asthmatic (<em>n</em>=40).</p></div><div><h3>Results</h3><p>Regarding the <em>Gln27Glu</em> polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (<em>p</em>=0.04). No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The <em>Arg16</em> allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (<em>p</em>=0.02), and the <em>Glu27</em> allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (<em>p</em>=0.03).</p></div><div><h3>Conclusions</h3><p>The association of <em>Arg16</em> allele with the occurrence of asthma and of the <em>Glu27</em> allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 381-386"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136556219","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.014
Joana Marcela Sales de Lucena , Luanna Alexandra Cheng , Thaísa Leite Mafaldo Cavalcante , Vanessa Araújo da Silva , José Cazuza de Farias Júnior
Objective
To determine the prevalence of excessive screen time and to analyze associated factors among adolescents.
Methods
This was a cross-sectional school-based epidemiological study with 2874 high school adolescents with age 14–19 years (57.8% female) from public and private schools in the city of João Pessoa, PB, Northeast Brazil. Excessive screen time was defined as watching television and playing video games or using the computer for more than 2 h/day. The associated factors analyzed were: sociodemographic (gender, age, economic class, and skin color), physical activity and nutritional status of adolescents.
Results
The prevalence of excessive screen time was 79.5% (95%CI 78.1–81.1) and it was higher in males (84.3%) compared to females (76.1%; p<0.001). In multivariate analysis, adolescent males, those aged 14-15 year old and the highest economic class had higher chances of exposure to excessive screen time. The level of physical activity and nutritional status of adolescents were not associated with excessive screen time.
Conclusions
The prevalence of excessive screen time was high and varied according to sociodemographic characteristics of adolescents. It is necessary to develop interventions to reduce the excessive screen time among adolescents, particularly in subgroups with higher exposure.
{"title":"Prevalence of excessive screen time and associated factors in adolescents","authors":"Joana Marcela Sales de Lucena , Luanna Alexandra Cheng , Thaísa Leite Mafaldo Cavalcante , Vanessa Araújo da Silva , José Cazuza de Farias Júnior","doi":"10.1016/j.rppede.2015.08.014","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.014","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the prevalence of excessive screen time and to analyze associated factors among adolescents.</p></div><div><h3>Methods</h3><p>This was a cross-sectional school-based epidemiological study with 2874 high school adolescents with age 14–19 years (57.8% female) from public and private schools in the city of João Pessoa, PB, Northeast Brazil. Excessive screen time was defined as watching television and playing video games or using the computer for more than 2<!--> <!-->h/day. The associated factors analyzed were: sociodemographic (gender, age, economic class, and skin color), physical activity and nutritional status of adolescents.</p></div><div><h3>Results</h3><p>The prevalence of excessive screen time was 79.5% (95%CI 78.1–81.1) and it was higher in males (84.3%) compared to females (76.1%; <em>p</em><0.001). In multivariate analysis, adolescent males, those aged 14-15 year old and the highest economic class had higher chances of exposure to excessive screen time. The level of physical activity and nutritional status of adolescents were not associated with excessive screen time.</p></div><div><h3>Conclusions</h3><p>The prevalence of excessive screen time was high and varied according to sociodemographic characteristics of adolescents. It is necessary to develop interventions to reduce the excessive screen time among adolescents, particularly in subgroups with higher exposure.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 407-414"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636748","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.017
Pedro Luiz Spinelli Coelho , Gustavo Lacerda da Silva Calestini , Fernando Salgueiro Alvo , Jefferson Michel de Moura Freitas , Paula Marcela Vilela Castro , Tulio Konstantyner
Objective
To identify and quantify the adverse effects associated with the recombinant human papillomavirus (types 6, 11, 16 and 18) vaccine in adolescents.
Data source
Systematic review of randomized clinical trials from PubMed, SciELO and Lilacs databases. Articles investigating the safety of the vaccine in subjects under 18 years and comparing the recombinant human papillomavirus types 6, 11, 16 and 18 vaccine with a control group were included. Meta-analyses were performed for the outcomes of pain, erythema, swelling and fever, using clinical trials with maximum Jadad score.
Data synthesis
Fourteen studies were included. The most common adverse effects related to the human papillomavirus vaccine were effects with no severity (pain, erythema, edema, and fever). Five studies were used for the meta-analyses: pain–risk difference (RD)=11% (p<0.001); edema–RD=8% (p<0.001); erythema–RD=5% (p<0.001); fever–RD=2% (p<0.003).
Conclusions
The recombinant human papillomavirus types 6, 11, 16 and 18 vaccine was safe and well tolerated. The main adverse effects related to vaccination were pain, erythema, edema and fever. The low frequency of severe adverse effects encourages the administration of the vaccine in the population at risk.
{"title":"Safety of human papillomavirus 6, 11, 16 and 18 (recombinant): systematic review and meta-analysis","authors":"Pedro Luiz Spinelli Coelho , Gustavo Lacerda da Silva Calestini , Fernando Salgueiro Alvo , Jefferson Michel de Moura Freitas , Paula Marcela Vilela Castro , Tulio Konstantyner","doi":"10.1016/j.rppede.2015.08.017","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.017","url":null,"abstract":"<div><h3>Objective</h3><p>To identify and quantify the adverse effects associated with the recombinant human papillomavirus (types 6, 11, 16 and 18) vaccine in adolescents.</p></div><div><h3>Data source</h3><p>Systematic review of randomized clinical trials from PubMed, SciELO and Lilacs databases. Articles investigating the safety of the vaccine in subjects under 18 years and comparing the recombinant human papillomavirus types 6, 11, 16 and 18 vaccine with a control group were included. Meta-analyses were performed for the outcomes of pain, erythema, swelling and fever, using clinical trials with maximum Jadad score.</p></div><div><h3>Data synthesis</h3><p>Fourteen studies were included. The most common adverse effects related to the human papillomavirus vaccine were effects with no severity (pain, erythema, edema, and fever). Five studies were used for the meta-analyses: pain–risk difference (RD)=11% (<em>p</em><0.001); edema–RD=8% (<em>p</em><0.001); erythema–RD=5% (<em>p</em><0.001); fever–RD=2% (<em>p</em><0.003).</p></div><div><h3>Conclusions</h3><p>The recombinant human papillomavirus types 6, 11, 16 and 18 vaccine was safe and well tolerated. The main adverse effects related to vaccination were pain, erythema, edema and fever. The low frequency of severe adverse effects encourages the administration of the vaccine in the population at risk.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 474-482"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636756","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}
To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care.
Methods
A retrospective cohort study of 219 asthmatic patients (3–17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level.
Results
50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids.
Conclusions
The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.
目的评价在初级卫生保健机构登记的儿童和青少年哮喘的临床演变及营养状况与哮喘严重程度的关系。方法回顾性队列研究2007 - 2011年在Embu das Artes (SP)初级保健服务(PCSs)就诊的219例哮喘患者(3-17岁)。次要资料:性别、年龄、哮喘严重程度诊断、其他特应性疾病、特应性家族史和体重指数。为了评估哮喘的临床结果，收集了6个月和12个月随访期间哮喘发作次数、急诊室就诊次数和吸入皮质类固醇剂量的数据。结果50.5%的患者在2岁前出现喘息，99.5%的患者有变应性鼻炎，65.2%的患者有特应性家族史。就严重程度而言，间歇性哮喘更为常见(51.6%)，而就营养状况而言，65.8%的患者体重正常。营养状况与哮喘严重程度无相关性(p=0.409)。经过1年的随访，25.2%的患者病情恶化和急诊室就诊减少，16.2%的患者吸入皮质类固醇的量减少。结论在初级保健服务中对哮喘患者进行监测，临床结果有所改善，病情加重次数、急诊室就诊次数和吸入皮质类固醇剂量均有所减少。本研究未观察到营养状况与哮喘严重程度之间的关联。
{"title":"Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care","authors":"Rosinha Yoko Matsubayaci Morishita, Maria Wany Louzada Strufaldi, Rosana Fiorini Puccini","doi":"10.1016/j.rppede.2015.08.007","DOIUrl":"https://doi.org/10.1016/j.rppede.2015.08.007","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care.</p></div><div><h3>Methods</h3><p>A retrospective cohort study of 219 asthmatic patients (3–17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level.</p></div><div><h3>Results</h3><p>50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (<em>p</em>=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids.</p></div><div><h3>Conclusions</h3><p>The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"33 4","pages":"Pages 387-393"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91636871","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 : 2015-12-01DOI: 10.1016/j.rppede.2015.08.011
Anísio Luiz da Silva Brito , Carla Meneses Hardman , Mauro Virgílio Gomes de Barros
Objective
To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents.
Methods
A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4207, 14–19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model.
Results
Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9–11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors.
Conclusions
The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).
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