Revista Paulista De Pediatria最新文献

英文中文

Relação entre o uso seguro de medicamentos e Serviços de Farmácia Clínica em Unidades de Cuidados Intensivos Pediátricos 儿科重症监护病房药物安全使用与临床药学服务的关系

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-08-12 DOI: 10.1016/j.rpped.2016.03.004

Lucas Miyake Okumura , Daniella Matsubara da Silva , Larissa Comarella

Objective

Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).

Methods

This is a cross‐sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.

Results

Of 53 patients accompanied, we detected 141 preventable drug‐related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non‐optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.

Conclusions

Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence‐based strategies to reduce morbidity related to medications.

临床药学服务(CPS)被认为是标准的护理，并得到了国际联合委员会、美国儿科学会和美国临床药学学院的认可。在巴西，单身经验已经悄然出现，这些服务对儿童和青少年护理的重要性已经产生了有趣的结果，但肯定没有得到报道。这篇简短的报告旨在讨论在巴西儿科重症监护病房(PICU)实施床边CPS的效果。方法本研究是在巴西Campo Largo一家有12个床位的PICU社区医院进行的一项横断面研究。18岁入住PICU的受试者如果接受了CPS干预，则纳入描述性分析。结果在53名患者中，我们发现了141个可预防的药物相关问题(DRPs)，这些问题在临床医生的指导下得到了解决(89%的患者接受了所有干预措施)。最常见的改善药物治疗的干预措施包括:预防不相容的静脉输液(21%)和剂量不足的组合(17%由于低、高和非优化剂量)。在与DRPs相关的前10种药物中，有5种是抗菌素。通过分析drp与PICU住院时间之间的相关性，我们发现74%的住院时间变化与drp的数量有关。结论:通过与其他卫生保健专业人员的多方面合作，CPS可以预防可避免的DRPs引起的药物不良反应，他们应该尝试使用积极和基于证据的策略来减少与药物相关的发病率。

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引用次数: 0

Estágios de mudança de comportamento para atividade física em adolescentes catarinenses: prevalência e fatores associados 圣卡塔琳娜青少年身体活动行为改变的阶段:患病率和相关因素

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-04-16 DOI: 10.1016/j.rpped.2016.03.005

Jaqueline Aragoni da Silva, Kelly Samara da Silva, Adair da Silva Lopes, Markus Vinícius Nahas

Objective

Verify the prevalence and sociodemographic and economic factors associated with behavior change stages for habitual physical activity practice in adolescents from Santa Catarina.

Methods

Secondary analysis of a study on the Behavior of Adolescents from Santa Catarina (CompAC 2). Cross‐sectional school‐based study of 6,529 high‐school students (males, n=2,903) from the state of Santa Catarina public education system in 2011, aged 15 to 19 years. Multinomial logistic regression (crude and adjusted) was used to measure the association.

Results

The highest and lowest prevalence rates were found in the maintenance (43.9%) and precontemplation stages (7.0%), respectively. The stages of action, preparation and contemplation showed similar results: 16.2%; 17.0% and 15.6%; respectively. Male adolescents show higher prevalence in the maintenance stage in relation to females and these show a higher prevalence in preparation, contemplation and precontemplation. All the assessed variables (gender, age, area of residence, employment status, family income, maternal education and school grade), with the exception of school shift, were associated with at least one of the stages.

Conclusions

A large proportion of adolescents are in the pre‐adoption stages and most of these have the intention to start regular physical activity. With the exception of school shift, the assessed variables were associated with stages in different ways, showing different profiles in relation to sociodemographic and economic characteristics in each subgroup.

目的验证圣卡塔琳娜州青少年习惯性体育锻炼行为改变阶段的患病率及社会人口和经济因素。方法对《圣卡塔琳娜州青少年行为研究》(CompAC 2)进行二次分析。2011年，对圣卡塔琳娜州公立教育系统中15 - 19岁的6529名高中生(男，n= 2903)进行了基于学校的横断面研究。采用多项逻辑回归(原始和调整)来衡量相关性。结果维持期患病率最高(43.9%)，预观期患病率最低(7.0%)。行动、准备和思考阶段的结果相似:16.2%;17.0%和15.6%;分别。男性青少年在维持阶段的患病率高于女性，在准备阶段、沉思阶段和预沉思阶段的患病率高于女性。所有被评估的变量(性别、年龄、居住地区、就业状况、家庭收入、母亲教育程度和学校年级)，除了转学外，都至少与其中一个阶段有关。结论大部分青少年处于领养前阶段，其中大多数有开始定期体育活动的意向。除了学校转换，评估的变量以不同的方式与阶段相关联，在每个亚组中显示出与社会人口和经济特征相关的不同概况。

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引用次数: 4

Eficácia e segurança do hidrato de cloral na sedação de lactentes para testes de função pulmonar 水合氯醛在婴儿肺功能试验中的镇静作用和安全性

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-06-22 DOI: 10.1016/j.rpped.2016.05.002

Gustavo Falbo Wandalsen , Fernanda de Cordoba Lanza , Márcia Cristina Pires Nogueira , Dirceu Solé

Objective

To describe the efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests.

Methods

All sedation attempts for pulmonary function tests in infants carried out between June 2007 and August 2014 were evaluated. Obstructive sleep apnea and heart disease were contraindications to the exams. Anthropometric data, exam indication, used dose, outcomes of sedation and clinical events were recorded and described.

Results

The sedation attempts in 277 infants (165 boys) with a median age of 51.5 weeks of life (14 to 182 weeks) were evaluated. The main indication for the tests was recurrent wheezing (56%) and the chloral hydrate dose ranged from 50 to 80mg/kg (orally). Eighteen (6.5%) infants had some type of clinical complication, with the most frequent being cough and/or airway secretion (1.8%); respiratory distress (1.4%) and vomiting (1.1%). A preterm infant had bradycardia for approximately 15 minutes, which was responsive to tactile stimulation. All observed adverse effects were transient and there was no need for resuscitation or use of injectable medications.

Conclusions

The data demonstrated that chloral hydrate at the employed doses is a safe and effective medicament for sedation during short procedures in infants, such as pulmonary function tests. Because of the possibility of severe adverse events, recommendations on doses and contraindications should be strictly followed and infants should be monitored by trained staff.

目的探讨水合氯醛镇静用于婴儿肺功能检查的有效性和安全性。方法对2007年6月至2014年8月间进行的所有婴儿肺功能检查镇静尝试进行评估。阻塞性睡眠呼吸暂停和心脏病是检查的禁忌症。记录和描述人体测量数据、检查指征、使用剂量、镇静结果和临床事件。结果对277例新生儿(男婴165例)的镇静尝试进行了评估，这些婴儿的中位年龄为51.5周(14 ~ 182周)。试验的主要指征是反复喘息(56%)，水合氯醛剂量范围为50至80mg/kg(口服)。18例(6.5%)婴儿出现某种类型的临床并发症，最常见的是咳嗽和/或气道分泌物(1.8%);呼吸窘迫(1.4%)和呕吐(1.1%)。早产儿有大约15分钟的心动过缓，这是对触觉刺激的反应。所有观察到的不良反应都是短暂的，不需要复苏或使用注射药物。结论水合氯醛是一种安全有效的药物，用于婴儿短时间的镇静，如肺功能检查。由于可能发生严重不良事件，应严格遵守有关剂量和禁忌症的建议，并由训练有素的工作人员对婴儿进行监测。

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引用次数: 6

Aleitamento materno, introdução precoce de leite não materno e excesso de peso na idade pré‐escolar 母乳喂养、早期引入非母乳和学龄前超重

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-06-16 DOI: 10.1016/j.rpped.2016.05.004

Viviane Gabriela Nascimento , Janaína Paula Costa da Silva , Patrícia Calesco Ferreira , Ciro João Bertoli , Claudio Leone

Objective

Investigate associations between excess weight in preschool children, breastfeeding duration and age of non‐breast milk introduction.

Methods

Cross‐sectional study of a representative sample of 817 preschool children, aged 2 to 4 years, attending municipal day care centers in the city of Taubaté. The weight and height of children were measured in the day care centers in 2009, 2010 and 2011. The body mass index z‐score (BMIz) was calculated and children were classified as risk of overweight (BMIz≥1 to<2) or excess weight (BMIz≥2). Data analysis was carried out by comparison of proportions, coefficient of correlation and multivariate linear regression.

Results

The prevalence of risk of overweight was 18.9% and of excess weight (overweight or obesity) was 9.3%. The median duration of breastfeeding and age of introduction of non‐breast milk was 6 months. The child's BMIz showed direct correlation with birth weight (r=0.154; p<0.001) and maternal Body Mass Index (BMI) (r=0.113; p=0.002). The correlation was inverse with the total duration of breastfeeding (r=−0.099; p=0.006) and age at non‐breast milk introduction (r=−0.112; p=0.002). There was no correlation between the child's BMIz with birth length, duration of exclusive breastfeeding and mother's age.

Conclusions

The earlier the introduction of non‐breast milk, the higher the correlation with excess weight at preschool age.

目的探讨学龄前儿童超重与母乳喂养时间和非母乳喂养年龄的关系。方法对taubat市日托中心的817名2至4岁学龄前儿童的代表性样本进行横断面研究。分别于2009年、2010年和2011年测量日托中心儿童的体重和身高。计算体重指数z评分(bmi - score, BMIz)，并将儿童分为超重风险(bmi≥1 ~ 2)或超重风险(bmi≥2)。采用比例法、相关系数法和多元线性回归法对数据进行分析。结果超重危险率为18.9%，超重(超重或肥胖)危险率为9.3%。母乳喂养的中位持续时间和引入非母乳的年龄为6个月。新生儿bmi与出生体重呈直接相关(r=0.154;p<0.001)和母亲身体质量指数(BMI) (r=0.113;p = 0.002)。与总母乳喂养时间呈负相关(r= - 0.099;P =0.006)和非母乳喂养时的年龄(r= - 0.112;p = 0.002)。婴儿的bmi与出生长度、纯母乳喂养持续时间和母亲年龄之间没有相关性。结论越早引入非母乳喂养与学龄前超重的相关性越高。

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引用次数: 0

Conhecimento do pediatra sobre o manejo da constipação intestinal funcional 儿科医生对功能性肠便秘处理的知识

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-06-17 DOI: 10.1016/j.rpped.2016.05.003

Mario C. Vieira , Isadora Carolina Krueger Negrelle , Karla Ulaf Webber , Marjorie Gosdal , Sabine Krüger Truppel , Solena Ziemer Kusma

Objective

To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation.

Methods

A descriptive cross‐sectional study was performed with the application of a self‐administered questionnaire concerning a hypothetical clinical case of childhood functional constipation with fecal incontinence to physicians (n=297) randomly interviewed at the 36th Brazilian Congress of Pediatrics in 2013.

Results

The majority of the participants were females, the mean age was 44.1 years, the mean time of professional practice was 18.8 years; 56.9% were Board Certified by the Brazilian Society of Pediatrics. Additional tests were ordered by 40.4%; including abdominal radiography (19.5%), barium enema (10.4%), laboratory tests (9.8%), abdominal ultrasound (6.7%), colonoscopy (2.4%), manometry and rectal biopsy (both 1.7%). The most common interventions included lactulose (26.6%), mineral oil (17.5%), polyethylene glycol (14.5%), fiber supplement (9.1%) and milk of magnesia (5.4%). Nutritional guidance (84.8%), fecal disimpaction (17.2%) and toilet training (19.5%) were also indicated.

Conclusions

Our results show that pediatricians do not adhere to current recommendations for the management of childhood functional constipation, as unnecessary tests were ordered and the first‐line treatment was not prescribed.

目的评价儿科医生对儿童功能性便秘的诊断和治疗方法的认识。方法采用自填问卷对2013年第36届巴西儿科大会上随机采访的297名医生进行描述性横断面研究，问卷涉及一个假设的儿童期功能性便秘伴大便失禁的临床病例。结果调查对象以女性居多，平均年龄44.1岁，平均执业时间18.8年;56.9%的人获得了巴西儿科协会的认证。40.4%的人要求进行额外的检查;包括腹部x线摄影(19.5%)、钡灌肠(10.4%)、实验室检查(9.8%)、腹部超声(6.7%)、结肠镜检查(2.4%)、测压和直肠活检(均为1.7%)。最常见的干预措施包括乳果糖(26.6%)、矿物油(17.5%)、聚乙二醇(14.5%)、纤维补充剂(9.1%)和氧化镁乳(5.4%)。营养指导(84.8%)、排便(17.2%)和如厕训练(19.5%)。结论:我们的研究结果表明，儿科医生不坚持目前对儿童功能性便秘的治疗建议，因为不必要的检查被要求进行，一线治疗没有规定。

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引用次数: 0

Associação dos parâmetros de crescimento e nutricionais com função pulmonar na fibrose cística: revisão da literatura 囊性纤维化中生长和营养参数与肺功能的关系:文献综述

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-04-16 DOI: 10.1016/j.rpped.2015.12.002

Renan Marrichi Mauch, Arthur Henrique Pezzo Kmit, Fernando Augusto de Lima Marson, Carlos Emilio Levy, Antonio de Azevedo Barros‐Filho, José Dirceu Ribeiro

Objective

To review the literature addressing the relationship of growth and nutritional parameters with pulmonary function in pediatric patients with cystic fibrosis.

Data source

A collection of articles published in the last 15 years in English, Portuguese and Spanish was made by research in electronic databases – PubMed, Cochrane, Medline, Lilacs and Scielo – using the keywords cystic fibrosis, growth, nutrition, pulmonary function in varied combinations. Articles that addressed the long term association of growth and nutritional parameters, with an emphasis on growth, with pulmonary disease in cystic fibrosis, were included, and we excluded those that addressing only the relationship between nutritional parameters and cystic fibrosis and those in which the aim was to describe the disease.

Data synthesis

Seven studies were included, with a total of 12,455 patients. Six studies reported relationship between growth parameters and lung function, including one study addressing the association of growth parameters, solely, with lung function, and all the seven studies reported relationship between nutritional parameters and lung function.

Conclusions

The review suggests that the severity of the lung disease, determined by spirometry, is associated with body growth and nutritional status in cystic fibrosis. Thus, the intervention in these parameters can lead to the better prognosis and life expectancy for cystic fibrosis patients.

目的回顾有关儿童囊性纤维化患者生长和营养参数与肺功能关系的文献。数据来源通过PubMed、Cochrane、Medline、Lilacs和Scielo等电子数据库的研究，收集了近15年来以英语、葡萄牙语和西班牙语发表的文章，关键词为囊性纤维化、生长、营养、肺功能，并进行了不同的组合。涉及生长和营养参数的长期关系的文章，重点是生长，囊性纤维化肺部疾病，被纳入，我们排除了那些只涉及营养参数和囊性纤维化之间关系的文章，以及那些旨在描述疾病的文章。数据综合纳入7项研究，共12455例患者。六项研究报道了生长参数与肺功能之间的关系，其中一项研究仅报道了生长参数与肺功能之间的关系，七项研究均报道了营养参数与肺功能之间的关系。结论本综述提示，肺量测定法确定的肺疾病严重程度与囊性纤维化患者的身体生长和营养状况有关。因此，干预这些参数可以改善囊性纤维化患者的预后和预期寿命。

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引用次数: 2

Necessidades de assistência à criança com deficiência – Uso do Inventário de Avaliação Pediátrica de Incapacidade 残疾儿童的护理需求-使用儿科残疾评估清单

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-03-28 DOI: 10.1016/j.rpped.2016.02.007

Fernanda Moreira Teles, Rosa Resegue, Rosana Fiorini Puccini

Objective

To describe the care needs reported by caregivers of children with disabilities going through the school inclusion process using the Pediatric Evaluation of Disability Inventory.

Methods

Cross‐sectional study with 181 children aged 7 to 10 years with physical or mental disabilities, undergoing the inclusion process in Elementary school in 2007. Location: 31 schools of the Regional Education Board ‐ District of Penha, East Side the city of São Paulo. The children's care needs according to the caregivers were assessed in three areas ‐ self‐care, mobility and social function, using the Pediatric Evaluation of Disability Inventory, according to the following score: 5, Independent; 4, Supervision; 3, Minimum Assistance; 2, Moderate Assistance; 1, Maximum Assistance and 0, Total Assistance. For statistical analysis, we used Student's t‐test and analysis of variance (ANOVA), with p<0.05 being statistically significant.

Results

The lower means, with statistically significant differences, were observed for the items related to social function (55.8 to 72.0), followed by self‐care functions (56.0 to 96.5); for all types of disabilities, except for children with physical disabilities, who had lower means for self‐care (56.0) and mobility (63.8).

Conclusions

Social function was the area referred to as the one that needed a higher degree of assistance from the caregiver and the Pediatric Evaluation of Disability Inventory is a tool that can help identify these needs and develop a more targeted intervention.

目的利用《儿童残疾评估量表》描述残疾儿童入学融合过程中照顾者报告的照顾需求。方法采用横断面研究方法，对2007年在小学接受融合治疗的181名7 ~ 10岁身体或精神残疾儿童进行研究。地点:31所学校的区域教育委员会-区Penha，东侧的城市圣保罗。采用《儿童残疾评估量表》，从自我护理、行动能力和社会功能三个方面评估照顾者对儿童的照顾需求，得分为:5分(独立);4、监督;3、最低援助;2、适度援助;1，最大援助和0，总援助。对于统计分析，我们使用学生t检验和方差分析(ANOVA)， p<0.05具有统计学意义。结果社会功能(55.8 ~ 72.0)得分较低，自我照顾功能(56.0 ~ 96.5)得分次之，差异有统计学意义;对于所有类型的残疾，除了身体残疾的儿童，他们的自我照顾能力(56.0分)和行动能力(63.8分)都较低。社会功能被认为是需要照顾者更高程度帮助的领域，儿科残疾评估量表是一个工具，可以帮助识别这些需求并制定更有针对性的干预措施。

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引用次数: 5

Relação entre aptidão cardiorrespiratória e adiposidade corporal em meninas 女孩心肺健康与体脂的关系

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-03-28 DOI: 10.1016/j.rpped.2016.02.006

Giseli Minatto , Thiago Ferreira de Sousa , Wellington Roberto Gomes de Carvalho , Roberto Régis Ribeiro , Keila Donassolo Santos , Edio Luiz Petroski

Objective

To estimate the prevalence of low cardiorespiratory fitness and its association with excess body fat, considering the sexual maturation and economic level in female adolescents.

Methods

Cross‐sectional, epidemiological study of 1,223 adolescents (10‐17 years) from the public school system of Cascavel, PR, Brazil, in 2006. We analyzed the self‐assessed sexual maturation level (prepubertal, pubertal and post‐pubertal), the Economic Level (EL) (high and low) through a questionnaire and body fat (normal and high) through triceps and subscapular skinfolds. The 20‐meter back‐and‐forth test was applied to estimate maximum oxygen consumption. Cardiorespiratory fitness was assessed according to reference criteria and considered low when the minimum health criterion for age and sex was not met. Chi‐square test and logistic regression were applied, with a significance level of 5%.

Results

The prevalence of low cardiorespiratory fitness was 51.3%, being associated with all study variables (p<0.001). At the crude analysis, adolescents with high body fat were associated with low cardiorespiratory fitness, when compared to those with normal body fat (OR=2.76; 95%CI: 2.17–3.52). After adjustment by sexual maturation, this association remained valid and showed an effect that was 1.8‐fold higher (95%CI: 1.39–2.46) and after adjusting by EL, the effect was 1.9‐fold higher (95%CI: 1.45–2.61).

Conclusions

Approximately half of the assessed girls showed unsatisfactory levels of cardiorespiratory fitness for health, which was associated with high body fat, regardless of sexual maturation level and EL. Effective public health measures are needed, with particular attention to high‐risk groups.

目的在考虑性成熟和经济水平的情况下，评估女性青少年低心肺适能的患病率及其与体脂过剩的关系。方法对2006年巴西卡斯卡维尔公立学校系统1223名(10 - 17岁)青少年进行横断面流行病学研究。我们分析了自我评估的性成熟水平(青春期前、青春期和青春期后)，通过问卷调查分析了经济水平(EL)(高和低)，并通过三头肌和肩胛下皮肤褶分析了体脂(正常和高)。20米来回测试用于估计最大耗氧量。心肺健康是根据参考标准评估的，当年龄和性别的最低健康标准未达到时，被认为是低的。采用卡方检验和logistic回归，显著性水平为5%。结果低心肺适能患病率为51.3%，与所有研究变量相关(p<0.001)。在粗略分析中，与体脂正常的青少年相比，体脂高的青少年与较低的心肺适能相关(OR=2.76;95%置信区间:2.17—-3.52)。经性成熟校正后，这种关联仍然有效，其效果高出1.8倍(95%CI: 1.39-2.46)，经EL校正后，其效果高出1.9倍(95%CI: 1.45-2.61)。结论:在接受评估的女孩中，大约有一半的人表现出不满意的心肺健康水平，这与高体脂有关，与性成熟水平和EL无关。需要采取有效的公共卫生措施，特别注意高风险群体。

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引用次数: 0

Impacto da vacina antipneumocócica 10‐valente na redução de hospitalização por pneumonia adquirida na comunidade em crianças 10价肺炎球菌疫苗对减少儿童社区获得性肺炎住院的影响

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-03-30 DOI: 10.1016/j.rpped.2016.02.003

Sandra Rodrigues da Silva , Luane Marques de Mello , Anderson Soares da Silva , Altacílio Aparecido Nunes

Objective

To describe and analyze the occurrence of hospitalizations for community‐acquired pneumonia in children before and after the pneumococcal 10‐valent conjugate vaccine implementation into the National Immunization Program.

Methods

This is an ecological study that includes records of children younger than one year old, vaccinated and not vaccinated with the pneumococcal 10‐valent conjugate vaccine in the periods pre‐ and post‐inclusion of the vaccine in the National Immunization Program in the area covered by the Regional Health Superintendence of Alfenas, state of Minas Gerais, Brazil. Vaccination was considered as the exposure factor and hospitalization for community‐acquired pneumonia as the endpoint, using secondary annual data by municipality. The prevalence ratio and its 95% confidence interval (95%CI) were used to verify the association between variables. The Z test was used to calculate the difference between proportions.

Results

Considering the 26 municipalities of the Regional Health Superintendence of Alfenas, there was a significant reduction in hospitalizations for community‐acquired pneumonia in children younger than one year of age, with prevalence ratio (PR)=0.81 (95%CI: 0.74 to 0.89; p<0.05), indicating a 19% lower prevalence of hospitalization for community‐acquired pneumonia in the post‐vaccination period.

Conclusions

The results suggest the effectiveness of the pneumococcal 10‐valent conjugate vaccine in preventing severe cases of community‐acquired pneumonia in children younger than one year of age.

目的描述和分析国家免疫规划实施肺炎球菌10价结合疫苗前后儿童社区获得性肺炎住院情况。方法:这是一项生态学研究，包括在巴西米纳斯吉拉斯州阿尔菲纳斯地区卫生监督局覆盖的区域内，接种和未接种肺炎球菌10价结合疫苗的1岁以下儿童在疫苗纳入国家免疫规划之前和之后的记录。接种疫苗被认为是暴露因素，社区获得性肺炎的住院治疗被认为是终点，使用的是各城市的次级年度数据。使用患病率及其95%置信区间(95% ci)来验证变量之间的相关性。采用Z检验计算比例之间的差异。结果在阿尔菲纳斯地区卫生监督26个市中，1岁以下儿童社区获得性肺炎住院率显著降低，患病率(PR)=0.81 (95%CI: 0.74 ~ 0.89;P<0.05)，表明接种疫苗后社区获得性肺炎住院率降低了19%。结论肺炎球菌10价结合疫苗对预防1岁以下儿童重症社区获得性肺炎有一定的疗效。

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引用次数: 9

Em tempo: Esofagite eosinofílica: quando suspeitar e como diagnosticá‐la em crianças e adolescentes 及时:嗜酸性食管炎:何时怀疑及如何诊断儿童和青少年

IF 1.7 Q3 PEDIATRICS

Revista Paulista De Pediatria

Pub Date : 2016-12-01 Epub Date: 2016-08-06 DOI: 10.1016/j.rpped.2016.07.002

Mirna Chehade

引用次数: 0

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