Jornal de pediatria最新文献_第3页

Tuberculosis preventive treatment in newborns 新生儿结核病预防治疗。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.06.009

Tony TannousTahan , Andrea Maciel de Oliveira Rossoni , Giuliana Lugarini , Simoni Pimenta de Oliveira , Juliana Taques , Mauricio Bedim dos Santos , Betina Mendez Alcântara Gabardo , Tatiane Emi Hirose , Cristina de Oliveira Rodrigues

Objective

To describe the reported cases of newborns subjected to tuberculosis preventive treatment (TPT) in the state of Paraná, Brazil, and to evaluate the safety and effectiveness in preventing the progression of TB disease in this population.

Method

Observational, descriptive case series, with secondary data. The characteristics of the participants were analyzed from the information systems of preventive treatment of TB (of Paraná), between 2009 and 2016. To evaluate which children had developed tuberculosis later or died, we used the data from the information systems of TB (in Brazil), and mortality (in Paraná), covering the years 2009 to 2018.

Results

A total of 24 children underwent TPT with the age at treatment onset ranging from 0 to 87 days (median: 23 days). In 95.8 %, the exposure occurred at home, and in 33.3 % of cases, the mother was the source of the infection. A total of 20.8 % of the children tested positive for tuberculosis test at 3 months of age, 83.3 % completed treatment, and 2 experienced adverse events (gastrointestinal issues). No children developed TB or died during the minimum of a 2-year evaluation period through the official databases.

Conclusions

In this case series, the adherence to the plan was high, with few adverse events and 100 % protection against infection.

目的描述巴西巴拉那州新生儿接受肺结核预防性治疗（TPT）的报告病例，并评估预防该人群肺结核病恶化的安全性和有效性：方法：观察性、描述性病例系列，使用二手数据。从（巴拉那州）结核病预防治疗信息系统中分析了2009年至2016年间参与者的特征。为了评估哪些儿童后来患上肺结核或死亡，我们使用了（巴西）肺结核信息系统和（巴拉那州）死亡率信息系统的数据，时间跨度为 2009 年至 2018 年：共有 24 名儿童接受了 TPT 治疗，开始治疗的年龄从 0 天到 87 天不等（中位数：23 天）。95.8%的感染发生在家中，33.3%的感染源是母亲。共有 20.8% 的儿童在 3 个月大时肺结核检测呈阳性，83.3% 的儿童完成了治疗，2 名儿童出现了不良反应（肠胃问题）。在官方数据库至少两年的评估期内，没有儿童患上结核病或死亡：在这个病例系列中，计划的依从性很高，不良事件很少，对感染的保护率达到 100%。

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引用次数: 0

Genetic polymorphisms (FTO rs9939609 and TMEM18 rs6548238), adipokines (leptin and adiponectin) and adiposity in children and adolescents with asthma 哮喘儿童和青少年的基因多态性（FTO rs9939609 和 TMEM rs6548238）、脂肪因子（瘦素和脂肪连通素）和脂肪含量。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.006

Marta Evangelho Machado , Luis C. Porto , Jeane S. Nogueira , Clemax C. Sant´Anna , José R. Lapa e Silva

Objective

To describe independent factors related to the interaction of FTO rs9939609, TMEM18 rs6548238, leptin, and adiponectin in children/adolescents with asthma, under the influence of obesity.

Methods

The authors performed a cross-sectional study with 57 children/adolescents, ages 8–19 years, at a tertiary hospital, from 2017 to 2018. Participants were classified by nutritional status, performed spirometry with a bronchodilator test and completed an asthma questionnaire, higher scores indicated more asthma symptoms. Two asthma groups were formed: Group 1(G1)-normal-weight; Group 2(G2)-overweight/obese. Serum was collected for adipokines (n = 32) and genetic polymorphisms (n = 53) dosages.

Results

Age and body mass index (BMI) correlated directly in normal-weight (p = 0.009) and obese participants (p = 0.004). Girls reported more asthma complaints (p = 0.044). Participants with negative bronchodilator responses presented lower BMI (14.55–17.16) than responders (19.4–26.84) (p = 0.049). Leptin dosages are related directly to BMI (5,34–40 ng/ml in obese × 0,54–42 ng/ml in nonobese) (p = 0.003). Levels were high in girls (4.78–17.55 µg/ml) (p = 0.029) and low in nonobese boys (0.54–6.92 µg/ml) (p = 0.006). In obese, low leptin levels (< 10 ng/ml) were found in small airway dysfunction carriers (p = 0.025); elevated adiponectin (> 5 µg/ml) correlated with FEV1/FVC > 80 % (p = 0.035) and positive bronchodilator tests (8.84–13 µg/ml) (p = 0.039); and FTO A allele correlated with low adiponectin 0–8.84 µg/ml (p = 0.021) and low FEV1/FVC (46 %-88 %) (p = 0.023).

Conclusion

BMI correlated directly with age and leptin levels. Obese participants presented high serum levels of leptin and FTO A allele correlated with low FEV1/FVC. Larger cohorts are necessary for better elucidation of the role of adipokines and polymorphisms in the pathophysiology of asthma and obesity.

目的描述肥胖影响下哮喘儿童/青少年中与FTO rs9939609、TMEM18 rs6548238、瘦素和脂肪连通素相互作用相关的独立因素：作者于2017年至2018年在一家三甲医院对57名8-19岁的儿童/青少年进行了横断面研究。研究人员根据营养状况对参与者进行分类，通过支气管扩张剂测试进行肺活量测定，并填写哮喘调查问卷，得分越高表示哮喘症状越多。共分为两个哮喘组：第一组（G1）--正常体重；第二组（G2）--超重/肥胖。收集血清以检测脂肪因子（32 人）和基因多态性（53 人）的剂量：结果：体重正常者（p = 0.009）和肥胖者（p = 0.004）的年龄与体重指数（BMI）直接相关。女孩报告的哮喘症状较多（p = 0.044）。支气管扩张剂反应呈阴性的参与者的体重指数（14.55-17.16）低于反应者（19.4-26.84）（p = 0.049）。瘦素剂量与体重指数直接相关（肥胖者为 5,34-40 纳克/毫升×非肥胖者为 0,54-42 纳克/毫升）（p = 0.003）。女孩的瘦素水平较高（4.78-17.55 微克/毫升）（p = 0.029），而非肥胖男孩的瘦素水平较低（0.54-6.92 微克/毫升）（p = 0.006）。在肥胖者中，小气道功能障碍携带者的瘦素水平较低（< 10 ng/ml）（p = 0.025）；脂肪连素升高（> 5 µg/ml）与 FEV1/FVC > 80 %相关（p = 0.035）和支气管扩张剂试验阳性（8.84-13 µg/ml）（p = 0.039）；FTO A等位基因与低脂联素0-8.84 µg/ml（p = 0.021）和低FEV1/FVC（46 %-88 %）相关（p = 0.023）：结论：体重指数与年龄和瘦素水平直接相关。结论：体重指数与年龄和瘦素水平直接相关，肥胖者血清中瘦素水平高，FTO A 等位基因与低 FEV1/FVC 相关。为了更好地阐明脂肪因子和多态性在哮喘和肥胖的病理生理学中的作用，有必要进行更大规模的队列研究。

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引用次数: 0

Effectiveness of physiological flexion swaddling and oromotor interventions in improving preterm infants' oral feeding ability in the NICU: a randomized controlled trial 生理性屈曲襁褓和口腔运动干预对提高新生儿重症监护室早产儿口腔喂养能力的效果：随机对照试验。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.06.014

Luh K. Wahyuni , Irawan Mangunatmadja , Risma K. Kaban , Elvie Zulka K. Rachmawati , Rizky K. Wardhani , Budiati Laksmitasari , Boya Nugraha

Objective

This study aimed to prove the effectiveness of physiological flexion swaddling and oromotor interventions in terms of the duration needed to achieve the oral feeding ability of preterm infants in the NICU.

Methods

A randomized clinical trial in five Neonatal intensive care units (NICU) was performed involving 70 preterm infants born at 28–34 weeks gestational age. Participants were allocated to 1) the experimental group (n = 39) received physiological flexion swaddling and oromotor interventions, and 2) the control group (n = 31) received conventional swaddling and oromotor interventions. Mann-Whitney U analysis was used to determine the effectiveness of each group according to the duration needed to achieve oral feeding ability, while Kaplan-Meier survival analysis was applied to compare the duration of both groups.

Results

The experimental group had a significantly shorter duration in achieving oral feeding ability [4 (1–15) vs. 7 (2–22) days; p = 0.02]. The Kaplan-Meier survival curve analysis showed that infants in the experimental group achieved full oral feeding ability earlier than those in the control group (15 vs. 22 days).

Conclusions

Physiological flexion swaddling and oromotor interventions have been proven to be effective in shortening the number of days needed to achieve the oral feeding ability of preterm infants in the NICU.

研究目的本研究旨在证明生理性屈曲襁褓和口腔运动干预对新生儿重症监护室早产儿达到口腔喂养能力所需时间的有效性：在五个新生儿重症监护室（NICU）进行了一项随机临床试验，共有 70 名胎龄 28-34 周的早产儿参加。参与者被分配到：1）实验组（39 人）接受生理屈曲襁褓和口运动干预；2）对照组（31 人）接受常规襁褓和口运动干预。根据达到口喂能力所需的持续时间，采用 Mann-Whitney U 分析法确定各组的有效性，同时采用 Kaplan-Meier 生存分析法比较两组的持续时间：结果：实验组达到口服喂养能力的时间明显更短[4 (1-15) 天 vs. 7 (2-22) 天；p = 0.02]。卡普兰-米尔生存曲线分析表明，实验组婴儿比对照组婴儿更早（15 天 vs. 22 天）完全具备口腔喂养能力：事实证明，生理屈曲襁褓和口腔运动干预能有效缩短新生儿重症监护室早产儿达到口腔喂养能力所需的天数。

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引用次数: 0

Epidemiological profile trends and cost of pediatric sickle cell disease in Brazil from 2008 to 2022 2008 至 2022 年巴西小儿镰状细胞病的流行病学概况趋势和费用。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.010

Luiza Telles , Paulo Henrique Moreira Melo , Luana Baptistele Dornelas , Gabriele Eckerdt Lech , Natália Zaneti Sampaio , Ayla Gerk , Madeleine Carroll , Cristina Pires Camargo

Objective

This study aimed to investigate the epidemiological trends of Pediatric Sickle Cell Disease (SCD) in Brazil over the period 2008–2022, with a focus on understanding the incidence, mortality rates, and associated healthcare costs. The study explored potential associations between patient characteristics and the occurrence of crises in pediatric SCD cases.

Methods

A cross-sectional study was conducted, analyzing national annual rates of pediatric SCD hospitalizations using data from the FioCruz platform. Descriptive and inferential analyses, including time series and ARIMA regression, were employed. Economic dimensions were assessed using cost categorization. The study followed STROBE reporting guidelines.

Results

Data on 81,942 pediatric SCD hospitalizations were collected, with a predominance of crisis-related cases (74.08 %). Males and children under five years old were most affected. Regional disparities were observed, with the Southwest region recording the highest hospitalization rates. ICU costs were higher for crisis-related hospitalizations. Mortality rates were significantly higher for crisis-related cases (p < 0.001), with ARIMA regression indicating a significant association between hospitalizations for crisis-related cases and mortality.

Conclusion

This study highlights the significant burden of pediatric SCD in Brazil, particularly crisis-related cases, suggesting a need for focused interventions. By prioritizing early detection, equitable access to healthcare, and evidence-based interventions, Brazil can mitigate the burden of SCD and improve patient outcomes. These findings contribute to informing public health policies and interventions aimed at addressing the challenges of pediatric SCD management in Brazil.

研究目的本研究旨在调查 2008-2022 年间巴西小儿镰状细胞病（SCD）的流行趋势，重点了解其发病率、死亡率和相关医疗费用。该研究探讨了小儿镰状细胞病病例中患者特征与危机发生之间的潜在关联：该研究采用 FioCruz 平台的数据，对全国儿科 SCD 住院率进行了分析。研究采用了描述性和推论性分析，包括时间序列和ARIMA回归。使用成本分类对经济方面进行了评估。研究遵循了 STROBE 报告指南：研究收集了 81,942 例儿科 SCD 住院病例的数据，其中危机相关病例占绝大多数（74.08%）。男性和五岁以下儿童受影响最大。地区之间存在差异，西南地区的住院率最高。危机相关住院的重症监护室费用较高。危机相关病例的死亡率明显更高（P 结论：该研究强调了儿科危机对儿童健康造成的巨大负担：本研究强调了巴西小儿 SCD 的沉重负担，尤其是与危机相关的病例，这表明有必要采取重点干预措施。通过优先考虑早期检测、公平获得医疗保健和循证干预，巴西可以减轻 SCD 的负担并改善患者的预后。这些发现有助于为旨在应对巴西小儿 SCD 管理挑战的公共卫生政策和干预措施提供信息。

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引用次数: 0

Investigation of newborn blood metabolomics in varying intrauterine growth conditions 不同宫内生长条件下新生儿血液代谢组学研究。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.009

Shengwen Wang , Xiaofei Lin , Yu Zhou , Xin Yang , Mingming Ou , Linxin Zhang , Yumei Wang , Jing Gao

Objectives

This study aimed to investigate changes in the blood metabolic profiles of newborns with varying intrauterine growth conditions. Specifically, we analyzed the levels of amino acids, carnitine, and succinylacetone among full-term newborns, including small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). We aim to identify differential metabolites and metabolic pathways that may offer insights into clinical interventions.

Methods

A total of 5106 full-term newborns were included in the study. Blood samples were obtained from all newborns between 3 and 5 days after birth and analyzed using tandem mass spectrometry to detect blood metabolites. Subsequently, we screened for different metabolites and metabolic pathways among the groups using the MetaboAnalystR package (Version 1.0.1) in R software (R-3.6.0).

Results

The levels of blood amino acids and carnitine metabolism differed significantly among newborns with varying intrauterine growth conditions. Full-term SGA newborns exhibited a decrease in multiple amino acids and an increase in multiple carnitines, while full-term LGA newborns showed an increase in multiple amino acids and acylcarnitines.

Conclusion

Continuous monitoring of the short-term and long-term growth and metabolic status of full-term SGA and LGA newborns is warranted with individualized dietary and nutritional adjustments to promote healthy growth in a timely manner. The findings of this research contribute to the broader understanding of SGA/LGA and shall inform future research on metabolomics, interventions, and long-term outcomes.

研究目的本研究旨在调查不同宫内生长条件下新生儿血液代谢谱的变化。具体来说，我们分析了足月新生儿（包括小胎龄新生儿（SGA）、适龄胎龄新生儿（AGA）和大胎龄新生儿（LGA））血液中氨基酸、肉毒碱和琥珀酰丙酮的水平。我们的目标是找出不同的代谢物和代谢途径，从而为临床干预提供启示：研究共纳入了 5106 名足月新生儿。所有新生儿都在出生后 3 到 5 天内采集了血液样本，并使用串联质谱法检测血液代谢物。随后，我们使用 R 软件（R-3.6.0）中的 MetaboAnalystR 软件包（1.0.1 版）筛选了各组间不同的代谢物和代谢途径：不同宫内生长条件的新生儿血液中氨基酸和肉碱代谢水平差异显著。足月 SGA 新生儿的多种氨基酸含量降低，多种肉碱含量升高，而足月 LGA 新生儿的多种氨基酸和酰基肉碱含量升高：结论：应持续监测足月 SGA 和 LGA 新生儿的短期和长期生长及代谢状况，并进行个性化的饮食和营养调整，以便及时促进健康成长。这项研究的结果有助于人们更广泛地了解 SGA/LGA，并将为今后有关代谢组学、干预措施和长期结果的研究提供参考。

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引用次数: 0

Social vulnerability among Brazilian children in early childhood: a scoping review 巴西幼儿期儿童的社会脆弱性：范围审查。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.06.012

Alcina M. Brito , Deisiane O. Souto , Luana C. Silva , Hércules R. Leite , Rosane L.S. Morais

Objective

To identify, map, and describe studies involving Brazilian children in early childhood in situations of social vulnerability.

Source of data

A scoping review including full articles published in Portuguese and English up to March 2023, with no temporal restrictions. Searches were conducted in the MEDLINE/PubMed, Scielo, EMBASE, Cochrane, Scopus, CINAHL, Web of Science, PEDro, and LILACS databases. Journal metrics, sample characteristics, study area, characterization of the situation of social vulnerability, and study outcomes were extracted.

Summary of the findings

Seventy-six articles involving a total of 107.740 children in early childhood were included in this study. These studies presented relevant findings, including the temporal publication trend, the variability of social vulnerability indicators, the scarcity of intervention studies, and the fact that 100% of eligible studies were from the health area. Negative outcomes were associated with the condition of social vulnerability in almost the entire sample, reinforcing the need for government policies capable of protecting early childhood from the effects of social vulnerability.

Conclusion

This scoping review mapped important findings involving Brazilian children in social vulnerability. It also identified literature gaps such as the need for intervention and multisectoral studies among health, education, and social protection.

目的确定、绘制并描述涉及处于社会弱势地位的巴西幼儿期儿童的研究：范围界定综述包括截至 2023 年 3 月用葡萄牙语和英语发表的完整文章，无时间限制。在 MEDLINE/PubMed、Scielo、EMBASE、Cochrane、Scopus、CINAHL、Web of Science、PEDro 和 LILACS 数据库中进行了检索。提取了期刊指标、样本特征、研究地区、社会脆弱性情况的特征以及研究结果：本研究共收录了 76 篇文章，涉及 107 740 名幼儿期儿童。这些研究提供了相关的结果，包括发表的时间趋势、社会脆弱性指标的可变性、干预研究的稀缺性，以及符合条件的研究 100%来自卫生领域这一事实。在几乎所有的样本中，负面结果都与社会脆弱性条件有关，这就更加说明政府需要制定能够保护幼儿免受社会脆弱性影响的政策：本次范围界定研究对巴西儿童社会脆弱性的重要发现进行了梳理。它还发现了一些文献空白，如需要在卫生、教育和社会保护之间进行干预和多部门研究。

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引用次数: 0

Analysis of agreement between specialists for the evaluation of radiological findings of necrotizing enterocolitis 分析专科医生对坏死性小肠结肠炎放射学检查结果的一致评价。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.008

Erica Cristina Scarpa , João C. Lyra , Pedro L.T. de A. Lourenção , Andréa S. Hachem , Geraldo H.S. da Silva , Glauce R.F. Giacóia , Erika V.P. Ortolan , Camila de Paula Silva , Guilherme L. da Silveira , Maria R. Bentlin

Objective

The analysis of abdominal radiography is essential for the diagnosis and management of necrotizing enterocolitis (NEC) in newborns (NB). Studies, however, show a lack of agreement among physicians in the interpretation of images. This study aims to evaluate the agreement in the radiological interpretation of the NEC between examiners from different specialties (interexaminer analysis) and between the same examiner at different times (intraexaminer analysis).

Methods

Cross-sectional study for concordance analysis using plain radiographs of the abdomen of NB with suspected or confirmed NEC. The study included two neonatologists (Neo), two surgeons (SU), and two radiologists (RD). The participants filled out a form with questions about the radiographic findings; regarding the presence of intestinal loop distension, the specialists answered subjectively (yes or no) and objectively (calculation of the ratio between loop diameter and lumbar vertebrae measurements). Kappa coefficients were calculated for agreement analysis.

Results

A total of 90 radiological images were analyzed. For the interexaminer evaluation, the agreement was low (kappa<0.4) in 30 % of the answers (Neo versus SU), 38 % (Neo versus RD), and 46 % (SU versus RD). In the intraexaminer evaluation, the neonatologist and the surgeon presented substantial or almost perfect agreement in 92 % of the answers, and the radiologist in 77 %. In the evaluation of intestinal loop distention, the greatest agreement between the specialties occurred when done objectively.

Conclusion

The results confirmed the low intra- and interexaminer agreement in the radiological analysis of the NEC, reinforcing the importance of standardizing the methods of radiological interpretation of the disease.

目的：腹部放射线检查分析对于新生儿（NB）坏死性小肠结肠炎（NEC）的诊断和治疗至关重要。但研究表明，医生之间在图像解读方面缺乏一致性。本研究旨在评估来自不同专业的检查医师（检查医师间分析）和同一检查医师在不同时间（检查医师内分析）对新生儿坏死性小肠结肠炎的放射学解释的一致性：方法：横断面研究，使用疑似或确诊 NEC 的 NB 腹部平片进行一致性分析。研究对象包括两名新生儿科医生（Neo）、两名外科医生（SU）和两名放射科医生（RD）。参与者填写了一份表格，其中包含有关放射学检查结果的问题；对于是否存在肠套叠胀气，专家们给出了主观回答（是或否）和客观回答（计算肠套叠直径与腰椎测量值的比率）。计算卡帕系数用于一致性分析：共分析了 90 张放射图像。结果：共分析了 90 张放射影像，检查者之间的一致性较低（卡帕系数）：结论：结果证实，在对 NEC 进行放射学分析时，检查者内部和检查者之间的一致性较低，这进一步说明了对该疾病的放射学解释方法进行标准化的重要性。

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引用次数: 0

Cross-cultural adaptation and validation of the CFAbd-Score for gastrointestinal symptoms in patients with cystic fibrosis 囊性纤维化患者胃肠道症状 CFAbd-Score 的跨文化适应性和验证。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.004

Flávia N.S. Infante , Elizete A. Lomazi , Carlos Zagoya , Franziska Duckstein , Daniela O. Magro , Fernando Pessotto , Antônio F. Ribeiro , José D. Ribeiro , Jochen G. Mainz

Objective

Translating and cross-culturally adapting the CFAbd-Score, Cystic Fibrosis (CF) Abdominal Score, to use in Brazilian spoken Portuguese. The CFAbd-Score is a questionnaire for assessing CF-related abdominal symptoms and their influence on the quality of life (QoL). It comprises 28 questions on five domains: abdominal pain, bowel movements, eating and appetite, gastroesophageal reflux symptoms, and the impact of gastrointestinal (GI) symptoms on QoL.

Method

Cross-cultural adaptation included assessment of conceptual and item equivalence, semantic, operational, and measurement equivalence. Content validity was assessed. The validation and psychometric analysis phase included 97 people with CF (pwCF), median age:14.58y (IQR 9/19), and 105 healthy individuals, 15.10y (IQR 9/20). Exploratory factor analysis (FA) identified retained factors. Internal consistency of the extracted domains was evaluated using Cronbach's α, and the Kaiser-Meyer-Olkin test (KMO) was used to check the sample adequacy. Bartlett's test tested the null hypothesis that the correlation matrix is an identity matrix.

Results

All items were considered relevant to the construct and good semantic equivalence of the version was recognized. FA showed the appropriate weight of all items and good internal consistency, with Cronbach's alpha 0.89. Bartlett's test significance level (p < 0.001) and KMO coefficient of 0.72 indicated good adequacy for structure. Internal consistency coefficients (Cronbach's alpha) were good for abdominal pain: 0.84; abdominal bloating: 0.73; flatulence: 0.76; heartburn: 0.81, and low for reflux: 0.54.

Conclusion

The CFAbd-Score was adapted to the Brazilian spoken Portuguese and demonstrated content and semantic equivalence. The final version showed appropriate validity, and internal consistency, preserving the psychometric properties of the original version.

目的：将囊性纤维化（CF）腹部评分（CFAbd-Score）翻译成巴西葡萄牙语口语并进行跨文化改编。CFAbd-Score 是一份用于评估 CF 相关腹部症状及其对生活质量（QoL）影响的问卷。它包括五个方面的 28 个问题：腹痛、肠蠕动、进食和食欲、胃食管反流症状以及胃肠道（GI）症状对 QoL 的影响：方法：跨文化调整包括概念和项目等效性、语义、操作和测量等效性评估。对内容效度进行了评估。验证和心理测量分析阶段包括 97 名 CF 患者（中位年龄：14.58 岁（IQR 9/19））和 105 名健康人（中位年龄：15.10 岁（IQR 9/20））。探索性因子分析（FA）确定了保留因子。使用 Cronbach's α 评估了所提取领域的内部一致性，并使用 Kaiser-Meyer-Olkin 检验（KMO）检查样本的充分性。巴特利特检验（Bartlett's test）检验了相关矩阵为同一矩阵的零假设：结果：所有项目都被认为与建构相关，版本的语义等同性良好。财务分析表明，所有项目的权重适当，内部一致性良好，Cronbach's alpha 为 0.89。巴特利特检验显著性水平（p < 0.001）和 KMO 系数为 0.72，显示出良好的结构适当性。腹痛的内部一致性系数（Cronbach's alpha）为 0.84；腹胀的内部一致性系数为 0.73；胀气的内部一致性系数为 0.73：0.73；胀气结论：根据巴西葡萄牙语口语对 CFAbd-Score 进行了调整，其内容和语义具有等效性。最终版本显示出适当的有效性和内部一致性，保留了原始版本的心理测量特性。

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引用次数: 0

Association of BMI and WC for insulin resistance and type 2 diabetes among Brazilian adolescents 巴西青少年的 BMI 和 WC 与胰岛素抵抗和 2 型糖尿病的关系。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.07.007

Cesar Pirajá Bandeira , Beatriz D. Schaan , Felipe Vogt Cureau

Objective

To investigate how body mass index (BMI) and waist circumference (WC) may be associated with insulin resistance and type 2 diabetes (T2DM) in Brazilian adolescents.

Methods

Cross-sectional study using data from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA) including adolescents aged 12–17 years. The relationship between adiposity and T2DM was investigated using ordinal logistic regression models. To study the association between adiposity categories and the occurrence of insulin resistance, linear regression models were used.

Results

The prevalence of T2DM for the same BMI category did not increase with the presence of high WC. Regarding insulin resistance, for the same BMI categories, having a high WC resulted in a higher prevalence of insulin resistance (HOMA-IR). The only groups significantly associated with prediabetes and T2DM were those with obesity by BMI with elevated WC (POR 1.68, 95 % CI 1.45; 1.94) and obesity with normal WC (POR 1.58, 95 % CI 1.01; 2.46). Similar findings were observed concerning insulin resistance, where the increased WC had its greatest effect when associated with obesity by BMI (β Coefficient 2.20, 95 % CI 1.89; 2.50).

Conclusion

The combination of BMI and WC is better for assessing adolescents at risk of developing T2DM.

目的研究巴西青少年的体重指数（BMI）和腰围（WC）与胰岛素抵抗和 2 型糖尿病（T2DM）之间的关系：使用巴西青少年心血管风险研究（ERICA）的数据进行横断面研究，研究对象包括 12-17 岁的青少年。采用序数逻辑回归模型研究了肥胖与 T2DM 之间的关系。为了研究肥胖类别与胰岛素抵抗发生率之间的关系，采用了线性回归模型：结果：在同一体重指数类别中，T2DM 的患病率并没有随着高 WC 的存在而增加。在胰岛素抵抗方面，对于相同的体重指数类别，高腹围会导致更高的胰岛素抵抗发生率（HOMA-IR）。唯一与糖尿病前期和 T2DM 有明显相关性的组别是那些体重指数（BMI）为肥胖且腹围升高的组别（POR 1.68，95 % CI 1.45; 1.94）和腹围正常的肥胖组别（POR 1.58，95 % CI 1.01; 2.46）。在胰岛素抵抗方面也观察到类似的结果，当体重指数（BMI）与肥胖相关时，WC 的增加影响最大（β 系数 2.20，95 % CI 1.89；2.50）：结论：结合体重指数和腹围来评估青少年患 T2DM 的风险更好。

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引用次数: 0

Central auditory system assessment in children and adolescents with cystic fibrosis: electrophysiology and central auditory processing 囊性纤维化儿童和青少年的中枢听觉系统评估：电生理学和中枢听觉处理。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2025-01-01 DOI: 10.1016/j.jped.2024.06.013

Paula Maria Martins-Duarte, Gabriel Hessel, Antônio Fernando Ribeiro, Fernando Augusto Lima Marson, Maria Francisca Colella-Santos

Objective

This study aims to evaluate the central auditory system of children and adolescents with cystic fibrosis through behavioral assessment of central auditory processing and electrophysiological tests to investigate short and long-latency auditory potentials, comparing them with the results obtained in the control group.

Methods

117 from 7 to 21 years old patients were evaluated, 57 of them with cystic fibrosis and 60 of the control group, using behavioral evaluation of central auditory processing, auditory brainstem response and long latency auditory evoked potential. The comparison of the research groups was performed using ANOVA for Auditory Brain Response and P300 responses and Wilcoxon and Mann-Whitney tests for Central Auditory Processing responses.

Results

A statistically significant difference was found in the results of the GIN test between the groups and in the auditory brainstem response latency responses in waves I and V in the comparison between the groups with higher latencies in the study group. A difference was also found between latencies in the interpeak intervals I-III and III-V. The long latency auditory evoked potential analysis shows a statistically significant difference in the latency of the P300 potential, with higher latencies in the study group.

Conclusion

Cystic fibrosis participants presented worse performance in the gaps-in-noise test compared to the control group in the evaluation of central auditory processing, which indicates impairment of temporal resolution auditory ability. They also showed increased latency in I and V waves of auditory brainstem response, as well as an increase P300 latency in long latency auditory evoked potential.

研究目的本研究旨在通过行为评估中央听觉处理和电生理测试研究短时和长时听觉电位，评估患有囊性纤维化的儿童和青少年的中央听觉系统，并将其与对照组的结果进行比较。方法：通过行为评估中央听觉处理、听觉脑干反应和长时听觉诱发电位，对117名7至21岁的患者进行评估，其中57名为囊性纤维化患者，60名为对照组患者。研究组之间的比较对听觉脑干反应和 P300 反应采用方差分析，对中枢听觉处理反应采用 Wilcoxon 和 Mann-Whitney 检验：各组之间的 GIN 测试结果以及听觉脑干反应 I 波和 V 波的潜伏期反应在统计学上存在明显差异，研究组的潜伏期更高。此外，I-III 波间期和 III-V 波间期的潜伏期也存在差异。长潜伏期听觉诱发电位分析表明，P300 电位的潜伏期在统计学上有显著差异，研究组的潜伏期更高：结论：与对照组相比，囊性纤维化患者在噪声间隙测试中的中枢听觉处理评估表现较差，这表明他们的听觉时间分辨能力受损。他们还表现出听觉脑干反应的 I 波和 V 波潜伏期延长，以及长潜伏期听觉诱发电位的 P300 潜伏期延长。

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引用次数: 0