Pub Date : 2016-06-01DOI: 10.1016/j.rppede.2015.10.005
Ana Luisa Oenning Martins , Deisy da Silva Fernandes Nascimento , Ione Jayce Ceola Schneider , Fabiana Schuelter-Trevisol
Objective
To estimate the incidence of community-acquired infections of the lower respiratory tract and the risk factors associated with its occurrence in infants, in their first year of life.
Methods
A prospective cohort study of infants who were followed up during the first 12 months of life. Interviews were conducted with their mothers, and children were clinically monitored bimonthly to investigate the occurrence of the incidence density of community-acquired infections of the lower respiratory tract. Cox regression analysis was used to estimate the crude and adjusted relative risk of the variables associated with the outcome.
Results
The mean age of the mothers was 26 years, 62% of them had more than 11 years of schooling, and 23.5 were at risk of social exclusion regarding economic income. The incidence density of pneumonia and bronchiolitis were, respectively, 0.51 and 3.10 episodes per 100 children-months. Children who had low birth weight (<2500g) were 5.96 (95%CI 1.75–20.40) times more likely to have pneumonia than infants weighing 2500g or over.
Conclusions
The incidence of acute lower respiratory tract infection in children was similar to that found in other studies. Only low birth weight was an independent risk factor for the occurrence of pneumonia.
{"title":"Incidence of community-acquired infections of lower airways among infants","authors":"Ana Luisa Oenning Martins , Deisy da Silva Fernandes Nascimento , Ione Jayce Ceola Schneider , Fabiana Schuelter-Trevisol","doi":"10.1016/j.rppede.2015.10.005","DOIUrl":"10.1016/j.rppede.2015.10.005","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the incidence of community-acquired infections of the lower respiratory tract and the risk factors associated with its occurrence in infants, in their first year of life.</p></div><div><h3>Methods</h3><p>A prospective cohort study of infants who were followed up during the first 12 months of life. Interviews were conducted with their mothers, and children were clinically monitored bimonthly to investigate the occurrence of the incidence density of community-acquired infections of the lower respiratory tract. Cox regression analysis was used to estimate the crude and adjusted relative risk of the variables associated with the outcome.</p></div><div><h3>Results</h3><p>The mean age of the mothers was 26 years, 62% of them had more than 11 years of schooling, and 23.5 were at risk of social exclusion regarding economic income. The incidence density of pneumonia and bronchiolitis were, respectively, 0.51 and 3.10 episodes per 100 children-months. Children who had low birth weight (<2500g) were 5.96 (95%CI 1.75–20.40) times more likely to have pneumonia than infants weighing 2500g or over.</p></div><div><h3>Conclusions</h3><p>The incidence of acute lower respiratory tract infection in children was similar to that found in other studies. Only low birth weight was an independent risk factor for the occurrence of pneumonia.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 2","pages":"Pages 204-209"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.10.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55271069","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 : 2016-06-01DOI: 10.1016/j.rppede.2016.03.012
Jorge Amil Dias
{"title":"In time: celiac disease – some current aspects of epidemiology and research","authors":"Jorge Amil Dias","doi":"10.1016/j.rppede.2016.03.012","DOIUrl":"10.1016/j.rppede.2016.03.012","url":null,"abstract":"","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 2","pages":"Pages 139-140"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.03.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55274550","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.06.023
Marcele Giacomin Gonçalves, Isabela Heineck
Objective
To determine the frequency of prescriptions of off-label drugs and drugs not approved for pediatric use in primary health care in medium-sized municipality of Rio Grande do Sul, Brazil.
Methods
Cross-sectional study with retrospective data collection, which analyzed prescriptions issued to 326 patients from August to December/2012 in two basic health units in the city of Viamão, state of Rio Grande do Sul. It included all prescriptions of patients whose medical records or service records were available and complete in relation to the date of presence, weight and date of birth. Off-label prescriptions were those which, in relation to the drug leaflet, showed dose different the recommended range, frequency of prescription and/or different form of administration and younger age than the indicated range. Descriptive statistics with absolute frequencies, means and standard deviations were used.
Results
During the study period, a total of 731 drug prescriptions were issued and the frequency of off-label medications prescribed was 31.7%, especially antihistamines and antiasthmatics (32.3% and 31.5%, respectively). The main type of off-label prescription was dose (38.8%), followed by age range (31.5%) and frequency of administration (29.3%). Regarding the dose off-label prescription, overdose was more frequent (93.3%) than the underdose (6.7%). Prescriptions of unapproved drugs were not identified.
Conclusions
The study showed that off label prescription is common in both assessed units. The observed percentage of off label prescription was higher than that reported by European studies carried out in primary care. On the other hand, the prescription of drugs not approved for children was not observed.
{"title":"Frequency of prescriptions of off-label drugs and drugs not approved for pediatric use in primary health care in a southern municipality of Brazil","authors":"Marcele Giacomin Gonçalves, Isabela Heineck","doi":"10.1016/j.rppede.2015.06.023","DOIUrl":"10.1016/j.rppede.2015.06.023","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the frequency of prescriptions of off-label drugs and drugs not approved for pediatric use in primary health care in medium-sized municipality of Rio Grande do Sul, Brazil.</p></div><div><h3>Methods</h3><p>Cross-sectional study with retrospective data collection, which analyzed prescriptions issued to 326 patients from August to December/2012 in two basic health units in the city of Viamão, state of Rio Grande do Sul. It included all prescriptions of patients whose medical records or service records were available and complete in relation to the date of presence, weight and date of birth. Off-label prescriptions were those which, in relation to the drug leaflet, showed dose different the recommended range, frequency of prescription and/or different form of administration and younger age than the indicated range. Descriptive statistics with absolute frequencies, means and standard deviations were used.</p></div><div><h3>Results</h3><p>During the study period, a total of 731 drug prescriptions were issued and the frequency of off-label medications prescribed was 31.7%, especially antihistamines and antiasthmatics (32.3% and 31.5%, respectively). The main type of off-label prescription was dose (38.8%), followed by age range (31.5%) and frequency of administration (29.3%). Regarding the dose off-label prescription, overdose was more frequent (93.3%) than the underdose (6.7%). Prescriptions of unapproved drugs were not identified.</p></div><div><h3>Conclusions</h3><p>The study showed that off label prescription is common in both assessed units. The observed percentage of off label prescription was higher than that reported by European studies carried out in primary care. On the other hand, the prescription of drugs not approved for children was not observed.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 11-17"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.06.023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55269697","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.06.024
Ilanna Fragoso Peixoto Gazzaneo , Camila Maia Costa de Queiroz , Larissa Clara Vieira Goes , Victor José Correia Lessa , Reinaldo Luna de Omena Filho , Diogo Lucas Lima do Nascimento , Reginaldo José Petroli , Susane Vasconcelos Zanotti , Isabella Lopes Monlleó
Objective
To describe the profile of patients with genitourinary abnormalities treated at a tertiary hospital genetics service.
Methods
Cross-sectional study of 1068 medical records of patients treated between April/2008 and August/2014. A total of 115 cases suggestive of genitourinary anomalies were selected, regardless of age. A standardized clinical protocol was used, as well as karyotype, hormone levels and genitourinary ultrasound for basic evaluation. Laparoscopy, gonadal biopsy and molecular studies were performed in specific cases. Patients with genitourinary malformations were classified as genitourinary anomalies (GUA), whereas the others, as Disorders of Sex Differentiation (DSD). Chi-square, Fisher and Kruskal–Wallis tests were used for statistical analysis and comparison between groups.
Results
80 subjects met the inclusion criteria, 91% with DSD and 9% with isolated/syndromic GUA. The age was younger in the GUA group (p<0.02), but these groups did not differ regarding external and internal genitalia, as well as karyotype. Karyotype 46,XY was verified in 55% and chromosomal aberrations in 17.5% of cases. Ambiguous genitalia occurred in 45%, predominantly in 46,XX patients (p<0.006). Disorders of Gonadal Differentiation accounted for 25% and congenital adrenal hyperplasia, for 17.5% of the sample. Consanguinity occurred in 16%, recurrence in 12%, lack of birth certificate in 20% and interrupted follow-up in 31% of cases.
Conclusions
Patients with DSD predominated. Ambiguous genitalia and abnormal sexual differentiation were more frequent among infants and prepubertal individuals. Congenital adrenal hyperplasia was the most prevalent nosology. Younger patients were more common in the GUA group. Abandonment and lower frequency of birth certificate occurred in patients with ambiguous or malformed genitalia. These characteristics corroborate the literature and show the biopsychosocial impact of genitourinary anomalies.
{"title":"Profile of patients with genitourinary anomalies treated in a clinical genetics service in the Brazilian unified health system","authors":"Ilanna Fragoso Peixoto Gazzaneo , Camila Maia Costa de Queiroz , Larissa Clara Vieira Goes , Victor José Correia Lessa , Reinaldo Luna de Omena Filho , Diogo Lucas Lima do Nascimento , Reginaldo José Petroli , Susane Vasconcelos Zanotti , Isabella Lopes Monlleó","doi":"10.1016/j.rppede.2015.06.024","DOIUrl":"10.1016/j.rppede.2015.06.024","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the profile of patients with genitourinary abnormalities treated at a tertiary hospital genetics service.</p></div><div><h3>Methods</h3><p>Cross-sectional study of 1068 medical records of patients treated between April/2008 and August/2014. A total of 115 cases suggestive of genitourinary anomalies were selected, regardless of age. A standardized clinical protocol was used, as well as karyotype, hormone levels and genitourinary ultrasound for basic evaluation. Laparoscopy, gonadal biopsy and molecular studies were performed in specific cases. Patients with genitourinary malformations were classified as genitourinary anomalies (GUA), whereas the others, as Disorders of Sex Differentiation (DSD). Chi-square, Fisher and Kruskal–Wallis tests were used for statistical analysis and comparison between groups.</p></div><div><h3>Results</h3><p>80 subjects met the inclusion criteria, 91% with DSD and 9% with isolated/syndromic GUA. The age was younger in the GUA group (<em>p</em><0.02), but these groups did not differ regarding external and internal genitalia, as well as karyotype. Karyotype 46,XY was verified in 55% and chromosomal aberrations in 17.5% of cases. Ambiguous genitalia occurred in 45%, predominantly in 46,XX patients (<em>p</em><0.006). Disorders of Gonadal Differentiation accounted for 25% and congenital adrenal hyperplasia, for 17.5% of the sample. Consanguinity occurred in 16%, recurrence in 12%, lack of birth certificate in 20% and interrupted follow-up in 31% of cases.</p></div><div><h3>Conclusions</h3><p>Patients with DSD predominated. Ambiguous genitalia and abnormal sexual differentiation were more frequent among infants and prepubertal individuals. Congenital adrenal hyperplasia was the most prevalent nosology. Younger patients were more common in the GUA group. Abandonment and lower frequency of birth certificate occurred in patients with ambiguous or malformed genitalia. These characteristics corroborate the literature and show the biopsychosocial impact of genitourinary anomalies.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 91-98"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.06.024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55269889","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 factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns.
Methods
Prospective cohort of live births with gestational age of 230/7–316/7 weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression.
Results
Of the 627 newborns enrolled in the study, 179 (29%) died within 168 hours after birth, of which 59 (33%) up to 24 hours and 97 (54%) up to 48 hours after birth. The variables associated with death <24h were: weight <1000g (2.94; 1.32–6.53), 5th minute Apgar <7 (7.17; 3.46–14.88), male gender (2.99; 1.39–6.47). A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71).
Conclusions
The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred.
{"title":"Mortality in the first 24h of very low birth weight preterm infants in the Northeast of Brazil","authors":"Eveline Campos Monteiro de Castro , Álvaro Jorge Madeiro Leite , Ruth Guinsburg","doi":"10.1016/j.rppede.2015.12.008","DOIUrl":"10.1016/j.rppede.2015.12.008","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate factors associated with neonatal death within 24 hours after birth in very low birth weight preterm newborns.</p></div><div><h3>Methods</h3><p>Prospective cohort of live births with gestational age of 23<sup>0/7</sup>–31<sup>6/7</sup> weeks, birth weight of 500–1499g without malformations, in 19 public maternity hospitals in nine capitals in northeastern Brazil from July to December 2007. The 19 hospitals were assessed in relation to physical resources, equipment, human resources and aiming at quality in care initiatives. Hospital, maternal and neonatal characteristics, neonatal morbidity, neonatal procedures and interventions were compared between preterm newborns that died or survived up to 24 hours of life. The variables associated with death within 24 hours after birth were determined by logistic regression.</p></div><div><h3>Results</h3><p>Of the 627 newborns enrolled in the study, 179 (29%) died within 168 hours after birth, of which 59 (33%) up to 24 hours and 97 (54%) up to 48 hours after birth. The variables associated with death <24h were: weight <1000g (2.94; 1.32–6.53), 5th minute Apgar <7 (7.17; 3.46–14.88), male gender (2.99; 1.39–6.47). A better hospital structure was a protective factor for early neonatal death (odds ratio: 0.34; 95% confidence interval: 0.17–0.71).</p></div><div><h3>Conclusions</h3><p>The high neonatal mortality on the first day of life in capital cities of Northeast Brazil is associated with biological variables such as weight and gender of the newborn, as well as low vitality at birth and a worse infrastructure of the hospital where the birth occurred.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 106-113"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55271815","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.06.020
Patrícia Morais de Oliveira, Fabiana Almeida da Silva, Renata Maria Souza Oliveira, Larissa Loures Mendes, Michele Pereira Netto, Ana Paula Carlos Cândido
Objective
To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais.
Methods
Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage.
Results
Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference.
Conclusions
Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.
目的描述米纳斯吉拉斯州Juiz de Fora市青少年脂肪质量指数和无脂肪质量指数值与心血管危险相关因素之间的关系。方法对403名10 ~ 14岁的公立和私立学校青少年进行横断面研究。获得了人体测量、临床和生化测量，以及自我报告的进行体育锻炼、久坐活动和性成熟阶段的时间。结果在营养状况方面，66.5%的青少年体重正常，19.9%的青少年体重超重，10.2%的青少年肥胖。无论男女，血清甘油三酯、体重指数和腰围较高的青少年的脂肪质量指数都较高。结论具有人体测量学、临床和生化特征被认为有心血管疾病发生危险的青少年脂肪质量指数较高。评估身体成分的不同方法使促进健康和预防疾病更加有效。
{"title":"Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents","authors":"Patrícia Morais de Oliveira, Fabiana Almeida da Silva, Renata Maria Souza Oliveira, Larissa Loures Mendes, Michele Pereira Netto, Ana Paula Carlos Cândido","doi":"10.1016/j.rppede.2015.06.020","DOIUrl":"10.1016/j.rppede.2015.06.020","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais.</p></div><div><h3>Methods</h3><p>Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage.</p></div><div><h3>Results</h3><p>Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference.</p></div><div><h3>Conclusions</h3><p>Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 30-37"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.06.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55269205","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.06.021
Cássio Leandro Mühe Consentino , Lupe Furtado-Alle , Larissa Rosa da Silva , Wendell Arthur Lopes , Luciane Viater Tureck , Gerusa Einsfeld Milano , Leilane Lazarotto , Cláudia Regina Cavaglieri , Neiva Leite
Objective
To determine the influence of polymorphisms of the beta-2 adrenergic receptor (ADRB2) in triggering exercise-induced bronchospasm (EIB) in adolescents.
Methods
The subjects were divided into two groups: present EIB (EIB+) (n=45) and absent EIB (EIB−) (n=115). The bronchial provocation test with exercise was performed with a protocol that consisted of walking/running for at least eight minutes at high intensity, i.e., >85% of maximum heart rate, considering EIB+ as a 10% decrease in forced expiratory volume in one second (FEV1). The genotyping of the ADRB2 gene was performed by the Taqman method, using the Step One Plus system. Independent t-test, Mann–Whitney and Chi-square tests, as well as Spearman's correlation coefficient were used for the statistical analysis.
Results
Age, body weight, height, FEV1, FVC and FEV1/FVC ratio were lower in the EIB+ group when compared to EIB− (p<0.05). There were no significant differences in the proportion of the allele at position 27 and Arg16Gly and Gln27Glu genotypes between the EIB+ and EIB− groups (p=0.26; p=0.97 and p=0.43, respectively). However, there was a trend toward statistical significance regarding the greater proportion of the Gly16 allele for the EIB+ when compared to the EIB− group (p=0.08).
Conclusions
The presence of polymorphisms associated with the Glu27 allele and Arg16Gly and Gln27Glu genotypes had no influence on EIB. However, the statistical trend toward greater frequency of the Gly16 allele in individuals with EIB+ can be considered evidence of the influence of polymorphisms of the ADBR2 gene on EIB in adolescents.
{"title":"Influence of polymorphisms of the beta-2 adrenergic receptor on the presence of exercise-induced bronchospasm in adolescents","authors":"Cássio Leandro Mühe Consentino , Lupe Furtado-Alle , Larissa Rosa da Silva , Wendell Arthur Lopes , Luciane Viater Tureck , Gerusa Einsfeld Milano , Leilane Lazarotto , Cláudia Regina Cavaglieri , Neiva Leite","doi":"10.1016/j.rppede.2015.06.021","DOIUrl":"10.1016/j.rppede.2015.06.021","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the influence of polymorphisms of the beta-2 adrenergic receptor (ADRB2) in triggering exercise-induced bronchospasm (EIB) in adolescents.</p></div><div><h3>Methods</h3><p>The subjects were divided into two groups: present EIB (EIB+) (n=45) and absent EIB (EIB−) (n=115). The bronchial provocation test with exercise was performed with a protocol that consisted of walking/running for at least eight minutes at high intensity, i.e., >85% of maximum heart rate, considering EIB+ as a 10% decrease in forced expiratory volume in one second (FEV<sub>1</sub>). The genotyping of the <em>ADRB2</em> gene was performed by the Taqman method, using the Step One Plus system. Independent <em>t</em>-test, Mann–Whitney and Chi-square tests, as well as Spearman's correlation coefficient were used for the statistical analysis.</p></div><div><h3>Results</h3><p>Age, body weight, height, FEV<sub>1</sub>, FVC and FEV<sub>1</sub>/FVC ratio were lower in the EIB+ group when compared to EIB− (<em>p</em><0.05). There were no significant differences in the proportion of the allele at position 27 and <em>Arg16Gly</em> and <em>Gln27Glu</em> genotypes between the EIB+ and EIB− groups (<em>p</em>=0.26; <em>p</em>=0.97 and <em>p</em>=0.43, respectively). However, there was a trend toward statistical significance regarding the greater proportion of the Gly16 allele for the EIB+ when compared to the EIB− group (<em>p</em>=0.08).</p></div><div><h3>Conclusions</h3><p>The presence of polymorphisms associated with the Glu27 allele and <em>Arg16Gly</em> and <em>Gln27Glu</em> genotypes had no influence on EIB. However, the statistical trend toward greater frequency of the <em>Gly16</em> allele in individuals with EIB+ can be considered evidence of the influence of polymorphisms of the <em>ADBR2</em> gene on EIB in adolescents.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 24-29"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.06.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55269257","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.10.004
Ana Paula Grotti Clemente , Bárbara Dal Molin Netto , Joana Pereira de Carvalho-Ferreira , Raquel Munhoz da Silveira Campos , Aline de Piano Ganen , Lian Tock , Marco Túlio de Mello , Ana Raimunda Dâmaso
Objective
To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC.
Methods
Cross-sectional study that involved 247 obese adolescents aged 12–19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender.
Results
NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents.
Conclusions
In conclusion, the results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.
{"title":"Waist circumference as a marker for screening nonalcoholic fatty liver disease in obese adolescents","authors":"Ana Paula Grotti Clemente , Bárbara Dal Molin Netto , Joana Pereira de Carvalho-Ferreira , Raquel Munhoz da Silveira Campos , Aline de Piano Ganen , Lian Tock , Marco Túlio de Mello , Ana Raimunda Dâmaso","doi":"10.1016/j.rppede.2015.10.004","DOIUrl":"10.1016/j.rppede.2015.10.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC.</p></div><div><h3>Methods</h3><p>Cross-sectional study that involved 247 obese adolescents aged 12–19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent <em>t</em>-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender.</p></div><div><h3>Results</h3><p>NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents.</p></div><div><h3>Conclusions</h3><p>In conclusion, the results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 47-55"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55271037","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.12.002
Ana Claudia de Almeida , Larissa da Costa Mendes , Izabela Rocha Sad , Eloane Gonçalves Ramos , Vânia Matos Fonseca , Maria Virginia Marques Peixoto
Objective
To assess the use of a health monitoring tool in Brazilian children, with emphasis on the variables related to growth and development, which are crucial aspects of child health care.
Data source
A systematic review of the literature was carried out in studies performed in Brazil, using the Cochrane Brazil, Lilacs, SciELO and Medline databases. The descriptors and keywords used were “growth and development”, “child development”, “child health record”, “child health handbook”, “health record and child” and “child handbook”, as well as the equivalent terms in Portuguese. Studies were screened by title and summary and those considered eligible were read in full.
Data synthesis
Sixty-eight articles were identified and eight articles were included in the review, as they carried out a quantitative analysis of the filling out of information. Five studies assessed the completion of the Child's Health Record and three of the Child's Health Handbook. All articles concluded that the information was not properly recorded. Growth monitoring charts were rarely filled out, reaching 96.3% in the case of weight for age. The use of the BMI chart was not reported, despite the growing rates of childhood obesity. Only two studies reported the completion of development milestones and, in these, the milestones were recorded in approximately 20% of the verified tools.
Conclusions
The results of the assessed articles disclosed underutilization of the tool and reflect low awareness by health professionals regarding the recording of information in the child's health monitoring document.
{"title":"Use of a monitoring tool for growth and development in Brazilian children – systematic review","authors":"Ana Claudia de Almeida , Larissa da Costa Mendes , Izabela Rocha Sad , Eloane Gonçalves Ramos , Vânia Matos Fonseca , Maria Virginia Marques Peixoto","doi":"10.1016/j.rppede.2015.12.002","DOIUrl":"10.1016/j.rppede.2015.12.002","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the use of a health monitoring tool in Brazilian children, with emphasis on the variables related to growth and development, which are crucial aspects of child health care.</p></div><div><h3>Data source</h3><p>A systematic review of the literature was carried out in studies performed in Brazil, using the Cochrane Brazil, Lilacs, SciELO and Medline databases. The descriptors and keywords used were “growth and development”, “child development”, “child health record”, “child health handbook”, “health record and child” and “child handbook”, as well as the equivalent terms in Portuguese. Studies were screened by title and summary and those considered eligible were read in full.</p></div><div><h3>Data synthesis</h3><p>Sixty-eight articles were identified and eight articles were included in the review, as they carried out a quantitative analysis of the filling out of information. Five studies assessed the completion of the Child's Health Record and three of the Child's Health Handbook. All articles concluded that the information was not properly recorded. Growth monitoring charts were rarely filled out, reaching 96.3% in the case of weight for age. The use of the BMI chart was not reported, despite the growing rates of childhood obesity. Only two studies reported the completion of development milestones and, in these, the milestones were recorded in approximately 20% of the verified tools.</p></div><div><h3>Conclusions</h3><p>The results of the assessed articles disclosed underutilization of the tool and reflect low awareness by health professionals regarding the recording of information in the child's health monitoring document.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 122-131"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55271513","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 : 2016-03-01DOI: 10.1016/j.rppede.2015.06.022
Arthur Loguetti Mathias , Ana Cristina Aoun Tannuri , Mariana Aparecida Elisei Ferreira , Maria Mercês Santos , Uenis Tannuri
Objective
Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life.
Methods
The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control.
Results
At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t-test). There were also significant differences between the results of children with ARMs and children with HD.
Conclusions
QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment.
{"title":"Validation of questionnaires to assess quality of life related to fecal incontinence in children with anorectal malformations and Hirschsprung's disease","authors":"Arthur Loguetti Mathias , Ana Cristina Aoun Tannuri , Mariana Aparecida Elisei Ferreira , Maria Mercês Santos , Uenis Tannuri","doi":"10.1016/j.rppede.2015.06.022","DOIUrl":"10.1016/j.rppede.2015.06.022","url":null,"abstract":"<div><h3>Objective</h3><p>Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life.</p></div><div><h3>Methods</h3><p>The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control.</p></div><div><h3>Results</h3><p>At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (<em>p</em><0.05, Student's <em>t</em>-test). There were also significant differences between the results of children with ARMs and children with HD.</p></div><div><h3>Conclusions</h3><p>QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 1","pages":"Pages 99-105"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2015.06.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55269345","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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