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Respiratory system parameters in children with low severity cystic fibrosis: is there early involvement in relation to healthy peers? 低度囊性纤维化儿童的呼吸系统参数:与健康儿童相比,是否存在早期参与?
IF 1.7 Q3 Medicine Pub Date : 2023-12-11 DOI: 10.1590/1984-0462/2024/42/2023030
Gabriela Castilhos Ducati, Juliana Cardoso, Elaine Paulin Ferrazeane, C. Schivinski
ABSTRACT Objective: To compare and analyze pulmonary function and respiratory mechanics parameters between healthy children and children with cystic fibrosis. Methods: This cross-sectional analytical study included healthy children (HSG) and children with cystic fibrosis (CFG), aged 6–13 years, from teaching institutions and a reference center for cystic fibrosis in Florianópolis/SC, Brazil. The patients were paired by age and sex. Initially, an anthropometric evaluation was undertaken to pair the sample characteristics in both groups; the medical records of CFG were consulted for bacterial colonization, genotype, and disease severity (Schwachman-Doershuk Score — SDS) data. Spirometry and impulse oscillometry were used to assess pulmonary function. Results: In total, 110 children were included, 55 in each group. In the CFG group, 58.2% were classified as excellent by SDS, 49.1% showed the ΔF508 heterozygotic genotype, and 67.3% were colonized by some pathogens. Statistical analysis revealed significant differences between both groups (p<0.05) in most pulmonary function parameters and respiratory mechanics. Conclusions: Children with cystic fibrosis showed obstructive ventilatory disorders and compromised peripheral airways compared with healthy children. These findings reinforce the early changes in pulmonary function and mechanics associated with this disease.
摘要目的:比较分析囊性纤维化患儿与健康患儿肺功能及呼吸力学参数。方法:本横断面分析研究纳入健康儿童(HSG)和囊性纤维化儿童(CFG),年龄6-13岁,来自巴西Florianópolis/SC的教学机构和囊性纤维化参考中心。这些患者按年龄和性别进行配对。最初,对两组的样本特征进行了人体测量评估;查阅CFG患者的医疗记录,了解细菌定植、基因型和疾病严重程度(Schwachman-Doershuk Score - SDS)数据。肺活量测定法和脉冲振荡测定法评估肺功能。结果:共纳入患儿110例,每组55例。在CFG组中,58.2%被SDS评为优秀,49.1%为ΔF508杂合子基因型,67.3%被某些病原体定植。两组肺功能参数及呼吸力学指标差异均有统计学意义(p<0.05)。结论:与健康儿童相比,囊性纤维化儿童表现为阻塞性通气障碍和周围气道受损。这些发现强化了与该疾病相关的肺功能和力学的早期改变。
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引用次数: 0
Pediatricians’ focus of sight at pain assessment during a neonatal heel puncture 儿科医生在新生儿足跟穿刺时评估疼痛的视线焦点
IF 1.7 Q3 Medicine Pub Date : 2023-12-11 DOI: 10.1590/1984-0462/2024/42/2023089
Erica Souza Silva, Marina C. M. Barros, Julia Baptista Lopes Borten, L. Carlini, R. Balda, R. Orsi, T. Heiderich, C. Thomaz, R. Guinsburg
ABSTRACT Objective: To evaluate the focus of pediatricians’ gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians’ pain perception: absent/mild (score: 0–5) and moderate/intense (score: 6–10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5–8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.
【摘要】目的:评价儿科医生在新生儿刺足时的注视焦点。方法:前瞻性研究中,儿科医生戴眼动仪眼镜评估新生儿疼痛前后脚跟戳。儿科医生用语言模拟数值量表对他们在新生儿身上感受到的疼痛进行评分(0=无疼痛;10 =最大痛苦)。测量结果是在穿刺前(前)和穿刺后(后)两个10秒的时间内,上脸、下脸和手的视觉注视次数和时间。根据儿科医生的疼痛感知,将这些结果进行比较:无/轻度(评分:0-5)和中度/强烈(评分:6-10)。结果:24名儿科医生(31岁,92%为女性)对24名新生儿进行了评估。新生儿足跟刺痛的中位评分为7.0(四分位数范围:5-8)。与孕前相比,在产后,更多的儿科医生将目光集中在下脸(63% vs. 92%;P =0.036),下面部的视觉固定次数更多(2.0 vs. 5.0;p = 0.018)。根据疼痛的强度,视觉注视的次数和时间没有差异。结论:在床边,儿科医生对新生儿手术后面部的关注焦点发生了变化,主要集中在面部的下半部。
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引用次数: 0
Acute exogenous intoxications in childhood: factors related to hospitalization 儿童急性外源性中毒:与住院治疗有关的因素
IF 1.7 Q3 Medicine Pub Date : 2023-12-11 DOI: 10.1590/1984-0462/2024/42/2023028
Juliana Gabriela Burgardt Werner, V. Platt
ABSTRACT Objective: To describe the profile of children assisted in the Emergency Room of a Children reference Hospital in the South of Brazil, victims of acute poisoning between 2016 and 2021, to characterize the toxic agents and to present the factors related to hospitalization. Methods: Retrospective, descriptive and observational study with data collection from medical records at a children’s hospital from July 2016 to June 2021 based on the compulsory notification forms. The characteristics of victims, of the incident, the type and class of the substance involved, the procedures demanded and the need for the Intensive Care Unit were evaluated. The outcome considered was hospitalization. Absolute and relative frequencies were calculated for the categorical variables and measures of central tendency and dispersion for the numerical ones. Binary logistic regression was performed to identify variables related to hospitalization. Results: There were 411 consultations, with the mean age of 7.2±5.5 years, and predominance of females (59.9%). Most of the poisoning occurred at home (82.1%) and orally (93.7%). Chemicals or cleaning products were the main agents in children up to 1 year of age, whereas in the other age groups accidents occurred most frequently with medicines. Hospital admission occurred in 38.7% of the cases, with related variables being: number of agents, type of substance involved, medication that acts on the Central Nervous System, recurrence, motivation (accidental/intentional), and performance of simple exams. Conclusions: More preventive actions are needed, such as legislation, as well as greater guidance to parents on how to store products in the domestic environment, in order to reduce the number of exogenous intoxications in the pediatric population.
摘要:目的:描述2016年至2021年间在巴西南部儿童参考医院急诊室协助的急性中毒儿童的概况,描述毒性物质的特征,并提出与住院相关的因素。方法:采用回顾性、描述性和观察性研究,收集某儿童医院2016年7月至2021年6月的病案资料,采用强制通报表格。评估了受害者的特点、事件、所涉物质的类型和类别、所需的程序和对重症监护病房的需要。考虑的结果是住院治疗。计算了分类变量的绝对频率和相对频率,并计算了数值变量的集中趋势和离散度。采用二元逻辑回归来确定与住院相关的变量。结果:共就诊411例,平均年龄7.2±5.5岁,以女性为主(59.9%)。中毒主要发生在家中(82.1%)和口服(93.7%)。化学品或清洁产品是一岁以下儿童的主要致癌物,而在其他年龄组中,事故最常与药物有关。38.7%的病例住院,相关变量为:药物数量、涉及的物质类型、作用于中枢神经系统的药物、复发、动机(意外/故意)和简单检查的表现。结论:需要采取更多的预防措施,如立法,以及对父母如何在家庭环境中储存产品的更多指导,以减少儿科人群中外源性中毒的数量。
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引用次数: 0
Patau and Edwards Syndromes in a University Hospital: beyond palliative care 大学医院的帕陶综合征和爱德华兹综合征:超越姑息关怀
IF 1.7 Q3 Medicine Pub Date : 2023-12-11 DOI: 10.1590/1984-0462/2024/42/2023053
Ligia Marçola, Ivete Zoboli, Rita Tiziana Verardo Polastrini, S. Barbosa, Mário Cícero Falcão, Paula de Vicenzi Gaiolla
ABSTRACT Objective: To describe the newborn population with Patau (T13) and Edwards Syndrome (T18) with congenital heart diseases that stayed in the Intensive Care Unit (ICU) of a quaternary care hospital complex, regarding surgical and non-surgical medical procedures, palliative care, and outcomes. Methods: Descriptive case series conducted from January/2014 to December/2018 through analysis of records of patients with positive karyotype for T13 or T18 who stayed in the ICU of a quaternary hospital. Descriptive statistics analysis was applied. Results: 33 records of eligible patients were identified: 27 with T18 (82%), and 6 T13 (18%); 64% female and 36% male. Eight were preterm infants with gestational age between 30–36 weeks (24%), and only 4 among the 33 infants had a birth weight >2500 g (12%). Four patients underwent heart surgery and one of them died. Intrahospital mortality was 83% for T13, and 59% for T18. The majority had other malformations and underwent other surgical procedures. Palliative care was offered to 54% of the patients. The median hospitalization time for T18 and T13 was 29 days (range: 2–304) and 25 days (13–58), respectively. Conclusions: Patients with T13 and T18 have high morbidity and mortality, and long hospital and ICU stays. Multicentric studies are needed to allow the analysis of important aspects for creating protocols that, seeking therapeutic proportionality, may bring better quality of life for patients and their families.
【摘要】目的:对一家综合医院重症监护病房(ICU)的新生儿帕陶综合征(T13)和爱德华兹综合征(T18)先天性心脏病患者进行手术和非手术治疗、姑息治疗和预后分析。方法:对2014年1月至2018年12月在某第四医院ICU住院的T13或T18核型阳性患者的记录进行描述性病例系列分析。采用描述性统计分析。结果:共纳入符合条件的患者33例:T18 27例(82%),T13 6例(18%);女性占64%,男性占36%。8名是胎龄在30-36周之间的早产儿(24%),33名婴儿中只有4名出生体重>2500克(12%)。4名患者接受了心脏手术,其中一人死亡。T13组院内死亡率为83%,T18组为59%。大多数患者有其他畸形,并接受了其他手术治疗。54%的患者接受了姑息治疗。T18和T13的中位住院时间分别为29天(2-304天)和25天(13-58天)。结论:T13和T18患者发病率和死亡率高,住院和ICU时间长。需要进行多中心研究,以便分析制定方案的重要方面,寻求治疗的相称性,从而为患者及其家属带来更好的生活质量。
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引用次数: 0
Assessment of maternal knowledge of solar exposure and vitamin D in the neonatal period 评估产妇对新生儿期日晒和维生素 D 的了解程度
IF 1.7 Q3 Medicine Pub Date : 2023-12-11 DOI: 10.1590/1984-0462/2024/42/2023040
Sandra Mara Witkowski, Catarina Pfitzer, Emanueli Rudolf, Gabriela de Souza, Aline Didoni Fajardo, Flávia Maestri Nobre Albini, Fabricio Sbroglio Lando, Marco Otilio Duarte Rodrigues Wilde
ABSTRACT Objective: To assess mothers’ knowledge on sun exposure related to serum vitamin D levels in the neonatal period. Methods: Observational, analytical and cross-sectional study, carried out from August 2020 to May 2021 through a questionnaire directed to mothers of newborns, in a maternity hospital in Southern Brazil. Results: From 141 interviewees, 132 (93.6%) believe it is important to expose the neonate to sun, 101 (71.6%) think this exposure can increase vitamin D levels, 86 (61%) received such information from a doctor, 108 (76.6%) believe there are no risks of sun exposure, 88 (62.4%) claim it isn´t necessary to use any kind of protection, 96 (68.1%) said that only exposure to the sun was necessary to maintain adequate levels of vitamin D during the neonatal period. Only two mothers (1.4%) claim that you should not exposure the neonate to the sun, and only one (0.7%) stated that sun expose can cause skin problems. Conclusions: Most mothers lack satisfactory knowledge about sun exposure related to serum vitamin D levels in the neonatal period. The need to inform and clarify the population about sun exposure during this period is remarkable, in addition to disseminating the proper way to maintain serum levels of vitamin D.
目的:了解母亲对新生儿期日晒与血清维生素D水平关系的认知情况。方法:从2020年8月至2021年5月,通过对巴西南部一家妇产医院的新生儿母亲进行问卷调查,进行观察性、分析性和横断面研究。结果:在141名受访者中,132人(93.6%)认为让新生儿晒太阳很重要,101人(71.6%)认为晒太阳可以增加维生素D水平,86人(61%)从医生那里得到了这样的信息,108人(76.6%)认为晒太阳没有风险,88人(62.4%)声称没有必要使用任何保护措施,96人(68.1%)说只有晒太阳才能在新生儿时期保持足够的维生素D水平。只有两位母亲(1.4%)认为不应该让新生儿暴晒,只有一位母亲(0.7%)认为暴晒会导致皮肤问题。结论:大多数母亲对新生儿期日晒与血清维生素D水平的关系缺乏满意的认识。除了传播维持血清维生素D水平的正确方法外,还需要告知和澄清这一时期的日照情况。
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引用次数: 0
Association between childhood anthropometric indicators and bone mineral density in adulthood 儿童时期人体测量指标与成年后骨矿物质密度之间的关系
IF 1.7 Q3 Medicine Pub Date : 2023-10-23 DOI: 10.1590/1984-0462/2024/42/2023026
M. C. M. D. Freitas, Julio Cesar da Costa, Cynthia Correa Lopes Barbosa, Lidyane Ferreira Zambrin, C. Romanzini, M. Romanzini, E. R. Ronque
ABSTRACT Objective: This study aimed to verify the association between childhood anthropometric indicators and areal bone mineral density (aBMD) in adulthood. Methods: Repeated measures of 137 subjects (68 females) were obtained in childhood (9.2±1.5 years of age) and adulthood (22.3±1.7 years of age). aBMD (g/cm 2 ) was assessed for whole body, lumbar spine, upper and lower limbs, and femoral neck in adulthood using dual-energy X-ray absorptiometry. Anthropometric measurements of body weight (BW), height, triceps and subscapular skinfolds were obtained in childhood. The anthropometric indicators used were BW, body mass index (BMI), and sum of skinfolds (ΣSF). Simple linear regression was used to assess the association between childhood anthropometric indicators and aBMD in adulthood, controlled by chronological age and stratified by sex, with 5% statistical significance. Results: In females, multiple associations were observed between anthropometric indicators and aBMD, with higher coefficients for BMI (β=0.020; R 2 =0.20; p<0.01 for right femoral neck to β=0.008; R 2 =0.16; p<0.01 for upper limbs), followed by BW (β=0.003; R 2 =0.21; p<0.01 for upper limbs to β=0.008; R 2 =0.20; p<0.01 for right femoral neck) and ΣSF (β=0.001; R 2 =0.06; p<0.01 for upper limbs to β=0.005; R 2 =0.12; p<0.01 for right femoral neck). In males, associations were observed only for the lumbar spine region (β=0.016; R 2 =0.09 for BMI to β=0.004; R 2 =0.06; p<0.01 for ΣSF). Conclusions: Anthropometric indicators of childhood proved to be sensitive predictors of aBMD in adulthood, especially in females. BMI indicated a greater association with aBMD in both sexes.
摘要 目的本研究旨在验证儿童期人体测量指标与成年期平均骨矿物质密度(aBMD)之间的关联。方法:对 137 名受试者(68 名女性)进行重复测量:采用双能 X 射线吸收测量法评估成年后全身、腰椎、上下肢和股骨颈的骨密度(g/cm 2)。体重(BW)、身高、肱三头肌和肩胛下皮褶等人体测量指标是在儿童时期获得的。使用的人体测量指标包括体重、体重指数(BMI)和皮褶总和(ΣSF)。采用简单线性回归评估童年期人体测量指标与成年期 aBMD 之间的关系,按年代年龄进行控制,并按性别进行分层,统计显著性为 5%。结果显示在女性中,人体测量指标与 aBMD 之间存在多重关联,BMI 的系数较高(β=0.020;R 2 =0.20;p<0.01,从右股骨颈到β=0.008;R 2 =0.16;p<0.01),其次是体重(β=0.003;R 2 =0.21;上肢与β=0.008的P<0.01;R 2 =0.20;右股骨颈与β=0.008的P<0.01)和ΣSF(β=0.001;R 2 =0.06;上肢与β=0.005的P<0.01;R 2 =0.12;右股骨颈与β=0.005的P<0.01)。在男性中,仅腰椎区域观察到相关性(β=0.016;BMI 的 R 2 =0.09,β=0.004;R 2 =0.06;ΣSF 的 p<0.01)。结论童年时期的人体测量指标被证明是成年后骨胳密度的敏感预测指标,尤其是对女性而言。体重指数(BMI)在男女两性中都显示出与 aBMD 的更大关联。
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引用次数: 0
Tuberculosis in adolescence: an integrative review focusing on patient-centered care 青少年肺结核:注重以患者为中心的护理的综合评论
IF 1.7 Q3 Medicine Pub Date : 2023-10-23 DOI: 10.1590/1984-0462/2024/42/2023027
Clara Carvalho Mendes, Roberto José Gervásio Unger, T. Araújo-Jorge, A. C. C. Carvalho
ABSTRACT Objective: To identify how patient-centered care has been addressed in tuberculosis studies with adolescents. Data source: We searched for articles published in Portuguese, Spanish and English in the Virtual Health Library (LILACS), PubMed (MedLine), and Scopus (Elsevier) databases, from 2000 to 2020, using descriptors (DeCS, MeSH) in Portuguese and English. Data synthesis: 1,322 studies were identified, of which 18 were selected. The main themes found were related to adherence to tuberculosis treatment, knowledge, attitudes and practices, health education, and public policies. Conclusions: We observed that both the number of researchers dedicated to the topic and the presence of a truly person-centered view are still scarce elements in tuberculosis among adolescents research.
摘要 目的确定在针对青少年的结核病研究中如何解决以患者为中心的护理问题。数据来源:我们在虚拟健康图书馆 (LILACS)、PubMed (MedLine) 和 Scopus (Elsevier) 数据库中使用葡萄牙语和英语的描述符(DeCS、MeSH)检索了 2000 年至 2020 年期间以葡萄牙语、西班牙语和英语发表的文章。数据综述:共确定了 1,322 项研究,并从中选出了 18 项。发现的主要专题涉及坚持结核病治疗、知识、态度和实践、健康教育以及公共政策。结论:我们注意到,在青少年结核病研究中,无论是致力于该主题的研究人员数量,还是真正以人为本的观点的存在,都仍然是稀缺要素。
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引用次数: 0
Ankyloglossia severity in infants: maternal pain, self-efficacy, and functional aspects of breastfeeding 婴儿口唇强直的严重程度:母亲的疼痛、自我效能感和母乳喂养的功能方面
IF 1.7 Q3 Medicine Pub Date : 2023-10-23 DOI: 10.1590/1984-0462/2024/42/2022203
C. L. C. Batista, Alex Luiz Pozzobon Pereira
ABSTRACT Objective: To analyze functional aspects of breastfeeding, self-efficacy, and pain reported by mothers during breastfeeding, in newborns with severe and mild ankyloglossia. Methods: This is an observational study, carried out with 81 babies with ankyloglossia, assessed by the Bristol Tongue Assessment Tool (severe: scores 0–3; mild: scores 4–6) nested in a cohort carried out at the University Hospital of the Federal University of Maranhão, São Luis, Brazil. The functional aspects of breastfeeding were analyzed using the Breastfeeding Observation Form of the United Nations Children's Fund (BOF-UNICEF) and the LATCH Scoring System. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale — Short-Form. Pain indicators were evaluated by the Short-Form McGill Pain Questionnaire. The significance level adopted was 5%. Results: Maternal age was 26.7±0.8 years, and 64.2% reported high school education. Most babies were male (67.9%), and the birth weight was 3232±60g. A significant association was detected in the sucking aspect evaluated by the BOF-UNICEF [β=0.22 (95%CI 0.07; 0.73), p-value=0.013]. However, the groups did not differ in the assessment of breastfeeding performed by the LATCH scale. The groups had no differences in the assessment of breastfeeding self-efficacy reported by mothers, and in pain scores. Conclusions: Despite the observation of sucking difficulty in infants with severe ankyloglossia., the quality of breastfeeding in general, maternal pain, and self-efficacy reported by mothers do not differ when compared with infants with mild ankyloglossia. Therefore, the severity of ankyloglossia seems not to affect the breastfeeding indicators.
摘要 目的分析患有重度和轻度强直性舌后裂的新生儿的母乳喂养功能、自我效能以及母亲在母乳喂养过程中报告的疼痛。研究方法这是一项观察性研究,研究对象是巴西圣路易斯马拉尼昂联邦大学大学医院的一个队列中的 81 名患有舌侧畸形的婴儿,他们均通过布里斯托尔舌评估工具进行了评估(重度:0-3 分;轻度:4-6 分)。使用联合国儿童基金会母乳喂养观察表(BOF-UNICEF)和 LATCH 评分系统分析了母乳喂养的功能方面。母乳喂养自我效能感采用母乳喂养自我效能感简易量表进行测量。疼痛指标通过短式麦吉尔疼痛问卷进行评估。采用的显著性水平为 5%。结果产妇年龄为(26.7±0.8)岁,64.2%接受过高中教育。大多数婴儿为男性(67.9%),出生体重为(3232±60)克。根据 BOF-UNICEF 评估,吸吮方面存在明显关联[β=0.22 (95%CI 0.07; 0.73),p 值=0.013]。然而,在使用 LATCH 量表进行母乳喂养评估方面,两组没有差异。在母亲的母乳喂养自我效能评估和疼痛评分方面,两组没有差异。结论尽管观察到患有重度强直性舌后裂的婴儿吸吮困难,但与患有轻度强直性舌后裂的婴儿相比,母乳喂养的总体质量、母亲的疼痛感以及母亲的自我效能感都没有差异。因此,强直性口吃的严重程度似乎不会影响母乳喂养的指标。
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引用次数: 0
Temporal trends in vaccination coverage in the first year of life in Brazil 巴西婴儿出生后第一年疫苗接种覆盖率的时间趋势
IF 1.7 Q3 Medicine Pub Date : 2023-10-23 DOI: 10.1590/1984-0462/2024/42/2023020
Ana Beatriz Batista Neves, Lucas Silva, Gabriela Morais Celestino Amaral, Maria de Lourdes Nascimento da Silva, Claudio José dos Santos Júnior
ABSTRACT Objective: The aim of this study was to analyze the temporal trends in vaccination coverage (VC) during the first year of life of children in Brazil. Methods: Data on VC for the first year of life from 2011 to 2020 for Bacille Calmette-Guerin (BCG), hepatitis B, polio, pentavalent, and triple viral vaccines at the national, regional, and state levels were obtained from the Information System of the National Immunization Program. Trends were analyzed using Prais-Winsten generalized linear regression models and average annual percent change (APC) estimates. Results: Decreasing trends were observed for the BCG (APC −3.58%; p<0.05), pentavalent (APC −4.10%; p<0.05), polio (APC −2.76%; p<0.05), and triple viral (APC −2.56%; p<0.05) vaccines in the country. Hepatitis B vaccine was the only vaccine that displayed stationary behavior (APC −4.22%; p>0.05). During the study period, no increasing trends were observed in any territory or vaccine. Conclusions: This study shows a recent significant reduction and decreasing trends in VC during the first year of life of children in Brazil, indicating the need for interventions to curb this ongoing phenomenon and to recover acceptable VC rates in the country.
摘要 目的本研究旨在分析巴西儿童出生后第一年内疫苗接种覆盖率(VC)的时间趋势。研究方法从国家免疫计划信息系统中获取了 2011 年至 2020 年期间全国、地区和州一级的卡介苗、乙肝疫苗、脊髓灰质炎疫苗、五联疫苗和三联病毒疫苗出生后第一年的接种率数据。使用普拉伊斯-温斯顿广义线性回归模型和年均百分比变化 (APC) 估计值对趋势进行了分析。结果显示卡介苗呈下降趋势(APC -3.58%;P0.05)。在研究期间,没有观察到任何地区或疫苗呈上升趋势。结论:这项研究表明,巴西儿童在出生后第一年内接种的 VC 最近明显减少,并呈下降趋势,这表明有必要采取干预措施来遏制这一持续存在的现象,并恢复该国可接受的 VC 接种率。
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引用次数: 0
Barriers to medication adherence by caregivers of children with leukemia: an observational study 白血病患儿照顾者坚持用药的障碍:一项观察研究
IF 1.7 Q3 Medicine Pub Date : 2023-10-23 DOI: 10.1590/1984-0462/2024/42/2022214
Fernanda Alves França, Ana Catarina Fernandes Figueredo, Luiza Tessmann, V. Tiziani, José Carlos Martins Córdoba, Isis Magalhães, N. U. L. Tavares, Patrícia Medeiros-Souza
ABSTRACT Objective: To identify barriers to adherence to home oral maintenance chemotherapy in children with leukemia treated at a specialized cancer center. Methods: We used the Brief Medication Questionnaire (BMQ) as a tool for screening barriers to adherence. The level of adherence was calculated considering at least one positive response in each BMQ domain, defined as Regimen Screen, Belief Screen, and Recall Screen. A positive screening for belief barriers (PSB) indicates that the caregiver reports not understanding the medication's mechanism of action and adverse effects. Results: Three important barriers to adherence were identified: beliefs, number of children of the caregiver, and age of the caregiver. The primary caregivers included 32 mothers (80%), four fathers (10%), three grandmothers (7.5%), and one unrelated caregiver (2.5 %). Most caregivers with a PSB were mothers. A PSB indicates that the caregiver reports not understanding the medication's mechanism of action and adverse effects. Caregivers with two or more children (median, three) had more barriers to adherence. Caregivers with potential non-adherence tended to be older than those with potential adherence, although without statistical significance (p=0.079, Mann-Whitney U test). Conclusions: The main barriers to adherence to home oral maintenance chemotherapy in children with leukemia identified through interviews with their caregivers, most often mothers, were lack of understanding of the treatment regimen, a greater number of children, and older age.
摘要 目的找出在一家专业癌症中心接受治疗的白血病患儿在坚持家庭口服维持化疗过程中遇到的障碍。方法:采用简短用药问卷(BMQ)作为研究工具:我们使用简要用药问卷(BMQ)作为筛查依从性障碍的工具。计算依从性水平时考虑了 BMQ 各领域中至少一个阳性反应,即 "疗程筛查"、"信念筛查 "和 "回忆筛查"。信念障碍筛查(PSB)呈阳性表示护理人员不了解药物的作用机制和不良反应。结果:确定了影响坚持用药的三个重要障碍:信念、护理人员的子女人数和护理人员的年龄。主要照顾者包括 32 名母亲(80%)、4 名父亲(10%)、3 名祖母(7.5%)和 1 名无关照顾者(2.5%)。大多数有 PSB 的照顾者是母亲。有 PSB 表示照护者不了解药物的作用机制和不良反应。有两个或两个以上子女(中位数为三个)的护理人员在坚持用药方面遇到的障碍较多。有可能不坚持用药的护理人员往往比有可能坚持用药的护理人员年龄大,但无统计学意义(P=0.079,Mann-Whitney U 检验)。结论通过对白血病患儿的护理人员(多为母亲)进行访谈,发现患儿坚持家庭口服维持化疗的主要障碍是对治疗方案缺乏了解、患儿人数较多以及年龄较大。
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引用次数: 0
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Revista Paulista De Pediatria
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