Jornal de pediatria最新文献

Objective: To assess the impact of microplastics/nanoplastics (MiP/NP) on human health.

Data source: The authors conducted a narrative review of articles published in English, Portuguese, French and Spanish in the last decade in the following databases: PubMed, Google Scholar, EMBASE and SciELO. The keywords used in this search were: microplastics OR nanoplastics OR marine litter OR toxicology OR additives AND human health OR children OR adults.

Data synthesis: MiP is a group of emerging contaminants that have attracted increasing scientific interest and attention from society in the last decade due to their ubiquitous detection in all environments. Humans can be mainly exposed to MiP and NP orally, by inhalation, by dermal contact, as well as through systemic routes and cannot be neglected, especially in young children. The possible toxic effects in different systems are due to plastic particles, often combined with leachable additives and adsorbed contaminants.

Conclusions: Unless the plastics value chain is transformed in the next two decades, the risks to species, marine ecosystems, climate, health, economies and communities will become unmanageable. However, alongside these risks lie unique opportunities to lead the transition to a more sustainable world.

Objectives: To identify the dietary patterns of Brazilian adolescents and to verify their associated factors.

Methods: Cross-sectional study with data from the 2019 National Survey of School Health. Students aged 13 to 17 participated in the survey, totaling a sample of 125,123 adolescents. The variables were divided into two groups: healthy and unhealthy diet. Principal component analysis was used to identify the dietary patterns. To evaluate the association, logistic regression was used, estimated by the Odds Ratio, with the respective 95 % confidence intervals.

Results: Two main components were identified: first related to regular consumption of fruits, vegetables, and beans; the second related to non-regular consumption of sweet treats, soft drinks, and fast food. The highest likelihood of regularly consuming the first was observed among adolescents residing in the Central-West and Southeast regions, with higher maternal education, who abstained from alcohol, engaged in physical activity, were not sedentary, ate breakfast, had lunch or dinner with their parents, refrained from eating while engaging in other activities, and participated in school meal programs. The lowest likelihood of not regularly consuming the second was found among male adolescents aged 16 to 17, attending public schools, who abstained from alcohol, and were not sedentary.

Conclusions: This study identified two dietary patterns, both linked to socioeconomic factors and healthy lifestyle habits. Recognizing these patterns among adolescents enables health surveillance efforts aimed at reducing diseases and health problems.

Objective: There is a pressing need for public health practitioners to understand cultural values influencing parents on the uptake of human papillomavirus (HPV) vaccination for their daughters, which is presenting a growing challenge to close the immunization gap worldwide. Parental decisions were predominantly shaped by cultural norms and values. This systematic review encompasses parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters.

Method: This systematic review was registered on PROSPERO CRD42020211324. Eligible articles were selected from CINAHL, PsycINFO, EMBASE, PubMed and Science Direct. Original qualitative studies exploring parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters under the age of 18, published in the English language with no restriction dates were reviewed. Two authors independently screened abstracts, conducted the fill-text review, extracted information using a standardized form, and assessed study quality. A third author is needed to resolve the disagreements if necessary.

Results: Of the 1552 citations, 22 were included, with information on 639 parents. Five themes emerged from the data: sexuality-related concerns; upbringing and moral values; obligation to protect; external influences; and vaccine-related concerns.

Conclusion: This systematic review is beneficial to identify and understand the culturally related facilitators and barriers to HPV vaccination among young women for the development of strategies to optimize HPV vaccine coverage among this population group by the policymakers.

Objective: To assess the frequency and potential influencing factors of the remission phase (RP) in Type 1 Diabetes (T1D) as well as the associations between various criteria used for its definition.

Methods: This was a retrospective cohort study based on data collected from medical records. Three criteria were used to evaluate RP: (1) Glycated hemoglobin (HbA1c) < 7.5 % with an insulin dose < 0.5 U/Kg/day, (2) HbA1c < 7 % with an insulin dose < 0.5 U/Kg/day, and (3) Insulin Dose Adjusted A1c (IDAA1c) ≤ 9, calculated as IDAA1c = HbA1c (%) + [4 x insulin dose (U/Kg/day)]. Statistical analyses included the Mann-Whitney U Test, Chi-Square Test, and Spearman Correlation.

Results: The sample consisted of 144 T1D patients, with a mean age of 26.22 ± 8.30 years and a mean age of onset of 13.30 ± 8.50 years. Of these, 52.9 % were female, 60.3 % were Caucasoid, and 31 % experienced diabetic ketoacidosis (DKA) at disease onset. One year after diagnosis, the occurrence of RP ranged from 27.2 % to 46.8 %, depending on the criteria used. Three patients experienced RP even after seven years, according to criterion 3. No association was found between RP and age, DKA, or pubertal status at onset. The three RP criteria were highly associated with each other (p < 0.001).

Conclusion: A significant proportion of patients in this sample experienced RP within 12 months of diagnosis. The three criteria for defining RP were strongly associated, indicating their reliability in both clinical and research contexts.

Objectives: This article discusses heatwaves (HWs), their definitions, and increasing frequencies associated with climate change, as well as their effects on human health, especially on children and vulnerable groups. It emphasizes the need for interdisciplinary studies to better understand the effects of HWs and preventive actions to mitigate the effects caused by this phenomenon.

Data source: The data were obtained from recent studies, conducted in Brazil and abroad, on the impacts of HWs. The figures were attained with data provided by the Climate Change Knowledge Portal.

Data summary: HWs are periods of extreme heat, modulated by climate phenomena such as El Niño and the Pacific Decadal Oscillations. The frequency and intensity of HWs have increased since the 1950s, driven by climate change. HWs affect public health by increasing the risk of mortality from respiratory and cardiovascular diseases. Children are more vulnerable to problems such as fever caused by heatstroke, respiratory and kidney infections, as well as risks such as sudden infant death syndrome. Almost half of the HW episodes observed in South America in this century occurred in Brazil, mainly in socioeconomically vulnerable regions.

Conclusions: The increase in the number of HWs is a direct consequence of climate change and has severe impacts on public health and biodiversity. Vulnerable groups suffer more from these phenomena, and social inequalities aggravate the problems. It is essential to promote awareness, implement effective public policies and encourage interdisciplinary research to mitigate the effects of HWs on society.

Objective: To identify and describe pollutants with carcinogenic potential that contaminate indoor and outdoor air, food and soil.

Data source: The descriptors environmental pollutants, occupational cancer, prevention and soil pollutants were used to conduct the research for literature review. Articles published from 2003 to 2024 in the electronic databases Pubmed Medline, Lilacs and Scielo, in Portuguese and English, were included.

Summary of findings: There are multiple sources of pollution in the external and internal environments, including motor vehicles, industrial facilities, smoke from tobacco products, agricultural activities, fires and domestic combustion devices. The most important pollutants related to chemical substances include all forms of asbestos, benzene, exhaust gases from gasoline engines, food and water contaminants, such as arsenic and inorganic arsenic compounds, in addition to persistent organic pollutants, such as dioxins. The use of fossil fuels and biomass for domestic heating are also important sources of pollution. The carcinogenic potential of pollutants varies according to the sources of pollution, climate conditions and the region's topography.

Conclusions: Global environmental pollution is an international public health problem with multiple health effects. Many environmental pollutants are proven to be carcinogenic to adults, while few causes have been scientifically established for children. Pollution is mainly caused by uncontrolled urbanization and industrialization. Preventing environmental exposure to carcinogenic pollutants requires both government regulation and community action and commitment.

Objective: Adverse Childhood Experiences (ACEs) have been associated with negative health outcomes. Screening for ACEs is crucial for improving health results, however, there is a shortage of standardized tools designed for children in Brazilian Portuguese. This study aimed to translate, culturally adapt, and validate the Pediatrics ACES and Related Life Event Screener (PEARLS) for use in Brazil.

Method: The study followed a methodological design for cross-cultural adaptation and psychometric evaluation. The PEARLS was translated and culturally adapted following a methodology that includes translation, synthesis, expert committee evaluation, target audience evaluation, and back-translation. After adaptation, a pilot cross-sectional study was conducted at a Multidisciplinary Health Care Clinical Center and a General Hospital-Reference Center for Child and Adolescent Care to assess the instrument's internal consistency, convergent validity, content validity and test-retest reliability.

Results: The PEARLS-Br versions for Children, Teens, and Teen Self-Report were developed and subjected to pilot testing with 202 subjects. Participants demonstrated excellent comprehension, with Verbal Rating Scale median scores of 4 (IQR 4-5). Internal consistency was high, with Cronbach's alpha coefficients ranging from 0.78 to 0.81. Content validity, assessed by Kappa, indicated slight to almost perfect agreement across constructs. Test-retest reliability, assessed by Spearman's correlation coefficient, ranged from 0.89 to 0.94.

Conclusions: PEARLS-BR (Child, teen, and teen self-report versions) were successfully translated, culturally adapted, and validated for assessing ACEs in Brazilian children and adolescents. This tool fills a crucial gap in ACE assessment in the Brazilian context, aligning with global recommendations for screening ACEs to improve overall health outcomes.

Objective: The development of specific growth charts for Turner Syndrome (TS) promotes adequate assessment of growth and weight gain, and earlier diagnosis of comorbidities, and may help to analyze the effectiveness of treatments to promote growth and puberty. The aim of this study was to construct a growth chart with the largest possible series of patients with a cytogenetic diagnosis of TS from a Brazilian reference center.

Methods: This is a longitudinal study, with 259 cases of TS born between 1957 and 2014 and followed between 1975 and 2019, without the use of GH or oxandrolone. 3,160 height measurements and 2,918 wt measurements were used, with subsequent calculation of the Body Mass Index (BMI). For data analysis, the "GAMLSS" package of the "R" software was used.

Results: The mean target height was 157.8 cm (standard deviation 5.2; median 160.4 cm). The mean height of patients with TS at 20 years of age was 145.6 cm (standard deviation 5.9; median 146.7 cm). Height, weight, and BMI by age graphs were developed for TS girls between 2 and 20 years.

Conclusion: These growth charts may be used to monitor the growth of girls with TS and to verify the effect of adjuvant treatments on promoting growth.

Objective: The present study's objective is to assess whether sleep duration affects Early Childhood Development (ECD). A prospective cohort study was carried out with 278 mother-child dyads in the city of Fortaleza, northeastern Brazil, with data collection every 6 months.

Method: The data used in this study are from the third (18 months) and fourth (24 months) survey waves. Information on sleep duration was collected using the Brief Infant Sleep Questionnaire (BISQ) and information on ECD using the Caregiver Reported Early Development Instrument (CREDI). Crude and adjusted regression models were run for each CREDI domain as an outcome with 5 % significance.

Results: The authors found that after adjusting for maternal age and schooling, family income, and the presence of other children in the house, night sleep duration was associated with better ECD scores (cognitive: coef. 0.14; 95 % CI 0.04,0.24; language: coef. 0.10; 95 % CI 0.01,0.19; motor: coef. 0.10; 95 % CI 0.03,0.18; socio-emotional: coef. 0.16; 95 % CI 0.06,0.25; overall: coef. 0.14; 95 % CI 0.04,0.24), and the time awake at night associated with worse scores (cognitive: coef. -0.12; 95 % CI -0.23,0.02; motor: coef. -0.09; 95 % CI -0.17,-0.01; socio-emotional: coef. -0.11; 95 % CI -0.21,-0.01; overall: coef. -0.11; 95 % CI -0.21,-0.01).

Conclusions: Nocturnal sleep duration affects ECD as expressed in all CREDI scores (cognitive, language, motor, social-emotional, and overall).