Pub Date : 2022-06-10DOI: 10.1590/1984-0462/2022/40/2021087IN
C. Okamoto, Hanne Lise Chaves, Mateus José Schmitz
ABSTRACT Objective: To describe clinical, diagnostic and therapeutic characteristics of the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. Data source: Literature review in the PubMed database by using specific descriptors to identify all articles published in the English language in the last three years; 38 articles were found. After performing selection of titles and abstract analysis, 13 out of the 38 articles were fully read. Relevant studies found in the references of the reviewed articles were also included. Data synthesis: The PFAPA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis and cervical Adenitis) is a medical condition grouped among the periodic fever syndromes. The etiology is uncertain, but possibly multifactorial, and its symptoms are accompanied by recurrent febrile episodes although weight and height development are preserved. It is a self-limiting disease of benign course with remission of two to three years without significant interference in the patient's overall development. Treatment consists of three pillars: interruption of febrile episodes, increase in the interval between episodes, and remission. Conclusions: Despite several attempts to establish more sensitive and specific criteria, the diagnosis of PFAPA syndrome is still clinical and reached by exclusion, based on the modified Marshall's criteria. The most common pharmacological options for treatment include prednisolone and betamethasone; colchicine may be used as prophylaxis, and surgical treatment with tonsillectomy can be considered in selected cases.
{"title":"Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome in children: a brief literature review","authors":"C. Okamoto, Hanne Lise Chaves, Mateus José Schmitz","doi":"10.1590/1984-0462/2022/40/2021087IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021087IN","url":null,"abstract":"ABSTRACT Objective: To describe clinical, diagnostic and therapeutic characteristics of the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. Data source: Literature review in the PubMed database by using specific descriptors to identify all articles published in the English language in the last three years; 38 articles were found. After performing selection of titles and abstract analysis, 13 out of the 38 articles were fully read. Relevant studies found in the references of the reviewed articles were also included. Data synthesis: The PFAPA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis and cervical Adenitis) is a medical condition grouped among the periodic fever syndromes. The etiology is uncertain, but possibly multifactorial, and its symptoms are accompanied by recurrent febrile episodes although weight and height development are preserved. It is a self-limiting disease of benign course with remission of two to three years without significant interference in the patient's overall development. Treatment consists of three pillars: interruption of febrile episodes, increase in the interval between episodes, and remission. Conclusions: Despite several attempts to establish more sensitive and specific criteria, the diagnosis of PFAPA syndrome is still clinical and reached by exclusion, based on the modified Marshall's criteria. The most common pharmacological options for treatment include prednisolone and betamethasone; colchicine may be used as prophylaxis, and surgical treatment with tonsillectomy can be considered in selected cases.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46440521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-10DOI: 10.1590/1984-0462/2022/40/2021062IN
A. D. D. C. E. Silva, C. O. Machado, Aichely Rodrigues da Silva, D. A. Höfelmann
ABSTRACT Objective: To assess the association between the presence of public outlets selling fruits and vegetables and the regular intake of these foods by adolescents from public schools in the city of Curitiba, Paraná, Brazil. Methods: Data collection was carried out by a questionnaire answered by the adolescents. Regular intake was defined as eating fruits and vegetables five or more times a week. Environmental data were obtained by assessing the availability and prices of fruits and vegetables traded in public outlets within a 1.6-km radius from 30 randomly selected public schools. Results: A total of 1,232 students from 30 public schools participated in the study. 43.4% of the adolescents reported a regular intake of fruits; 67.0% of them reported a regular intake of vegetables. In the schools, fruit intake ranged from 26.8 to 68.0%, and the vegetables intake ranged from 54.8 to 82.2%. A total of 22 schools had fruit and vegetables being traded in their surroundings. Regular intake of vegetables was positively correlated with their variety (r=0.82; p=0.007). The Moran’s local index indicated low fruit intake in a high-supply region; in other three regions with low supply, there was a high intake of fruits; and there was a high consumption of vegetables in a high-supply region. Conclusions: There are differences in the supply of fruits and vegetables of public outlets in the school’s surroundings as well as in the distribution of regular intake among regions. The density of public outlets and the variety were both associated with greater intake of fruits and vegetables among adolescents of public school.
{"title":"Availability of public outlets and regular consumption of fruits and vegetables among adolescents in public schools","authors":"A. D. D. C. E. Silva, C. O. Machado, Aichely Rodrigues da Silva, D. A. Höfelmann","doi":"10.1590/1984-0462/2022/40/2021062IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021062IN","url":null,"abstract":"ABSTRACT Objective: To assess the association between the presence of public outlets selling fruits and vegetables and the regular intake of these foods by adolescents from public schools in the city of Curitiba, Paraná, Brazil. Methods: Data collection was carried out by a questionnaire answered by the adolescents. Regular intake was defined as eating fruits and vegetables five or more times a week. Environmental data were obtained by assessing the availability and prices of fruits and vegetables traded in public outlets within a 1.6-km radius from 30 randomly selected public schools. Results: A total of 1,232 students from 30 public schools participated in the study. 43.4% of the adolescents reported a regular intake of fruits; 67.0% of them reported a regular intake of vegetables. In the schools, fruit intake ranged from 26.8 to 68.0%, and the vegetables intake ranged from 54.8 to 82.2%. A total of 22 schools had fruit and vegetables being traded in their surroundings. Regular intake of vegetables was positively correlated with their variety (r=0.82; p=0.007). The Moran’s local index indicated low fruit intake in a high-supply region; in other three regions with low supply, there was a high intake of fruits; and there was a high consumption of vegetables in a high-supply region. Conclusions: There are differences in the supply of fruits and vegetables of public outlets in the school’s surroundings as well as in the distribution of regular intake among regions. The density of public outlets and the variety were both associated with greater intake of fruits and vegetables among adolescents of public school.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47356057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-10DOI: 10.1590/1984-0462/2022/40/2021030IN
C. Menezes, Eduardo Rodrigues Alves Junior, G. N. O. Costa, T. Dombroski, R. T. Mattos, J. A. Gomes, F. Rios-Santos
ABSTRACT Objective: The aim of this study was to compare the anthropometric, biochemical, and hormonal characteristics and the presence of genetic polymorphisms of leptin, adiponectin, and tumor necrosis factor alpha (TNF-α) between eutrophic and obese children and adolescents. Methods: This is a case–control study involving 104 children and adolescents. All subjects were assessed for anthropometric characteristics and clinical, laboratory, and genetic polymorphism parameters. The sample was selected from the pediatric endocrinology outpatient clinic specialized in the treatment of obesity in children and adolescents according to the Centers for Disease Control and Prevention (CDC) classification, and controls were selected from the same location in the general pediatric outpatient clinic. Results: As a result, the parameters, such as black color, obese parents, hypertensive parents, and early weaning, were found to be associated with obesity. Increased levels of insulin, triglyceride, total cholesterol, LDL cholesterol, CRP-U, AST, ALT, GGT, free T4, IGF-1, and uric acid and low levels of HDL cholesterol are found to be associated with a higher chance of obesity. The presence of AG/AA polymorphisms in the leptin is associated with a 290% (OR 3.9) higher chance of obesity, and for adiponectin genes, the chances are 740% (OR 8.4) higher. In these obese children and adolescents with AG/AA haplotypes, serum leptin levels were increased and adiponectin levels were decreased in eutrophic individuals, whereas serum TNF-α levels did not change. Conclusions: The AG/AA polymorphisms in the leptin and adiponectin genes alter the serum levels of these adipokines and predispose them to obesity, and many anthropometric, biochemical, and hormonal markers are altered, demonstrating early consequences for the health of these obese children and adolescents.
{"title":"Genetic polymorphisms and plasma concentrations of leptin (rs7799039) and adiponectin (rs17300539) are associated with obesity in children and adolescents","authors":"C. Menezes, Eduardo Rodrigues Alves Junior, G. N. O. Costa, T. Dombroski, R. T. Mattos, J. A. Gomes, F. Rios-Santos","doi":"10.1590/1984-0462/2022/40/2021030IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021030IN","url":null,"abstract":"ABSTRACT Objective: The aim of this study was to compare the anthropometric, biochemical, and hormonal characteristics and the presence of genetic polymorphisms of leptin, adiponectin, and tumor necrosis factor alpha (TNF-α) between eutrophic and obese children and adolescents. Methods: This is a case–control study involving 104 children and adolescents. All subjects were assessed for anthropometric characteristics and clinical, laboratory, and genetic polymorphism parameters. The sample was selected from the pediatric endocrinology outpatient clinic specialized in the treatment of obesity in children and adolescents according to the Centers for Disease Control and Prevention (CDC) classification, and controls were selected from the same location in the general pediatric outpatient clinic. Results: As a result, the parameters, such as black color, obese parents, hypertensive parents, and early weaning, were found to be associated with obesity. Increased levels of insulin, triglyceride, total cholesterol, LDL cholesterol, CRP-U, AST, ALT, GGT, free T4, IGF-1, and uric acid and low levels of HDL cholesterol are found to be associated with a higher chance of obesity. The presence of AG/AA polymorphisms in the leptin is associated with a 290% (OR 3.9) higher chance of obesity, and for adiponectin genes, the chances are 740% (OR 8.4) higher. In these obese children and adolescents with AG/AA haplotypes, serum leptin levels were increased and adiponectin levels were decreased in eutrophic individuals, whereas serum TNF-α levels did not change. Conclusions: The AG/AA polymorphisms in the leptin and adiponectin genes alter the serum levels of these adipokines and predispose them to obesity, and many anthropometric, biochemical, and hormonal markers are altered, demonstrating early consequences for the health of these obese children and adolescents.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46964770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-10DOI: 10.1590/1984-0462/2022/40/2021061IN
V. Dutra, J. Sampaio, Camila de Souza Caputo, Raphael Mendonça Guimarães
ABSTRACT Objective: To describe the spatio-temporal distribution of infant mortality and its components in the city of Rio de Janeiro, Brazil, in 2010 and 2019. Methods: Infant mortality rate and the neonatal and postneonatal components were estimated. The standardized mortality rate was calculated to detect excess child mortality in the planning areas. Poisson regression was performed to estimate the effect of these planning areas on the years 2010 and 2019. Spatial analysis per neighborhoods was performed to identify the spatial autocorrelation rates, using the Moran’s Index and local indicator of spatial association (LISA). Results: The planning areas are very heterogeneous, depending on the history and evolution of occupation. There is an excess of mortality in planning areas with greater social vulnerability. In the Poisson model, it was observed that in all components, the planning area (PA) of residence was statistically significant as well as the year. Moran’s index did not show global spatial autocorrelation. However, when applying the LISA method, autocorrelation was observed at the local level and spatial clusters in the municipality of Rio de Janeiro. Conclusions: The spatial heterogeneity of the infant mortality rate in Rio de Janeiro suggests that local health policy strategies of each region consist in an efficient measure for reducing this rate.
{"title":"Spatio-temporal analysis of infant mortality in the city of Rio de Janeiro, 2010–2019","authors":"V. Dutra, J. Sampaio, Camila de Souza Caputo, Raphael Mendonça Guimarães","doi":"10.1590/1984-0462/2022/40/2021061IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021061IN","url":null,"abstract":"ABSTRACT Objective: To describe the spatio-temporal distribution of infant mortality and its components in the city of Rio de Janeiro, Brazil, in 2010 and 2019. Methods: Infant mortality rate and the neonatal and postneonatal components were estimated. The standardized mortality rate was calculated to detect excess child mortality in the planning areas. Poisson regression was performed to estimate the effect of these planning areas on the years 2010 and 2019. Spatial analysis per neighborhoods was performed to identify the spatial autocorrelation rates, using the Moran’s Index and local indicator of spatial association (LISA). Results: The planning areas are very heterogeneous, depending on the history and evolution of occupation. There is an excess of mortality in planning areas with greater social vulnerability. In the Poisson model, it was observed that in all components, the planning area (PA) of residence was statistically significant as well as the year. Moran’s index did not show global spatial autocorrelation. However, when applying the LISA method, autocorrelation was observed at the local level and spatial clusters in the municipality of Rio de Janeiro. Conclusions: The spatial heterogeneity of the infant mortality rate in Rio de Janeiro suggests that local health policy strategies of each region consist in an efficient measure for reducing this rate.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46564847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-03DOI: 10.1590/1984-0462/2022/40/2021133IN
Gabriela Rodrigues Ullmann, Dayane Pêdra Batista de Faria, K. Zihlmann, P. G. Speridião
ABSTRACT Objective: To verify the attitudes and practices of dietary management for cow's milk allergy by caregivers according to the stages of behavior change. Methods: Observational, cross-sectional study involving 30 caregivers of children with cow's milk allergy who were followed up in a specialized outpatient clinic, from July 2018 to May 2019. Data collection included a structured questionnaire about sociodemographic aspects, social classification and an adapted algorithm to classify the stages of behavior change based on a trans-theoretical model. Results: Most caregivers (26/30) were females aged 20 to 48 years and belonging to social classes C, D and E. Regarding the stages of behavior change for the dietary management of cow's milk allergy according to the model, 80% of the participants (24/30) were in the action stage, while 20% (6/30) were in the maintenance stage. Conclusions: The attitudes and practices of caregivers for the dietary management of cow's milk allergy are influenced by feelings and emotions that can interfere with communication and the understanding of dietary guidelines; however, these caregivers are in different stages of action and maintenance to change behavior that correspond to their attitudes and practices.
{"title":"Attitudes and practice of caregivers for cow's milk allergy according to stages of behavior change","authors":"Gabriela Rodrigues Ullmann, Dayane Pêdra Batista de Faria, K. Zihlmann, P. G. Speridião","doi":"10.1590/1984-0462/2022/40/2021133IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021133IN","url":null,"abstract":"ABSTRACT Objective: To verify the attitudes and practices of dietary management for cow's milk allergy by caregivers according to the stages of behavior change. Methods: Observational, cross-sectional study involving 30 caregivers of children with cow's milk allergy who were followed up in a specialized outpatient clinic, from July 2018 to May 2019. Data collection included a structured questionnaire about sociodemographic aspects, social classification and an adapted algorithm to classify the stages of behavior change based on a trans-theoretical model. Results: Most caregivers (26/30) were females aged 20 to 48 years and belonging to social classes C, D and E. Regarding the stages of behavior change for the dietary management of cow's milk allergy according to the model, 80% of the participants (24/30) were in the action stage, while 20% (6/30) were in the maintenance stage. Conclusions: The attitudes and practices of caregivers for the dietary management of cow's milk allergy are influenced by feelings and emotions that can interfere with communication and the understanding of dietary guidelines; however, these caregivers are in different stages of action and maintenance to change behavior that correspond to their attitudes and practices.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48773490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-27DOI: 10.1590/1984-0462/2022/40/2020412IN
Ana-Lídia-Soares Cota, Emilly Alves da Silva, N. Freitas, José Sarmento Lins Irmão Bisneto, Gabriella Marinho Buriti, Júlia Quintella Lessa Maia Valente, Mariana Alencar Nemezio
Abstract Objective: Based on scientific evidence, the objective of the present study is to report the possible risks and benefits of the amber teething necklace for children who use it. Data source: This is an integrative literature review, carried out based on the following guiding question: “Does the amber teething necklace have therapeutic properties that justify its usage during tooth eruption?”. The consulted databases were LILACS (Latin American and Caribbean Health Sciences Literature) and PubMed (National Center for Biotechnology Information), with the following descriptors: “Amber,” “Deciduous teeth,” “Strangulation,” and “Local symptoms.” Data synthesis: A total of five scientific articles were selected, which indicates an insufficient basis regarding the benefits associated with the use of the amber teething necklace. Conversely, there is a convergence regarding the possibility of health risks such as strangulation, asphyxiation, and swallowing of beads. Conclusions: Health professionals should discourage the use of the amber teething necklace by children insofar more studies on the topic are carried out.
{"title":"Use of the amber teething necklace by the child population: risks versus benefits","authors":"Ana-Lídia-Soares Cota, Emilly Alves da Silva, N. Freitas, José Sarmento Lins Irmão Bisneto, Gabriella Marinho Buriti, Júlia Quintella Lessa Maia Valente, Mariana Alencar Nemezio","doi":"10.1590/1984-0462/2022/40/2020412IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2020412IN","url":null,"abstract":"Abstract Objective: Based on scientific evidence, the objective of the present study is to report the possible risks and benefits of the amber teething necklace for children who use it. Data source: This is an integrative literature review, carried out based on the following guiding question: “Does the amber teething necklace have therapeutic properties that justify its usage during tooth eruption?”. The consulted databases were LILACS (Latin American and Caribbean Health Sciences Literature) and PubMed (National Center for Biotechnology Information), with the following descriptors: “Amber,” “Deciduous teeth,” “Strangulation,” and “Local symptoms.” Data synthesis: A total of five scientific articles were selected, which indicates an insufficient basis regarding the benefits associated with the use of the amber teething necklace. Conversely, there is a convergence regarding the possibility of health risks such as strangulation, asphyxiation, and swallowing of beads. Conclusions: Health professionals should discourage the use of the amber teething necklace by children insofar more studies on the topic are carried out.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42286591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-27DOI: 10.1590/1984-0462/2022/40/2021004IN
M. Melo, G. Santana, Matheus Henrique Almeida Rocha, R. Lima, Talles Alberto Bispo da Silva, C. D. F. Souza, Amanda Karine Barros Ferreira Rodrigues
Abstract Objective: To describe the epidemiological profile and to analyze the trend in the incidence rate of exogenous poisoning concerning children and adolescents (0–19 years old) in the city of Arapiraca, Alagoas, Brazil, in the period from 2007 to 2015. Methods: Observational study with data extracted from the Notifiable Diseases Information System. The variables sex, age group, toxic agent, and circumstance were analyzed using descriptive statistics. For temporal analysis, cut-off rates of incidence/10,000 inhabitants were calculated and the inflection point regression model was used for analysis. Results: There were 5,539 cases of exogenous intoxication in individuals aged 0–19 years in the city, of which 53.1% (n=2,944) occurred in girls and 61.5% (n=3,405) in children aged 0–9 years. Medicines consisted in the main agent responsible for intoxications (28.5%; n=1,580), mainly by accidental use (18.2%; n=1,010). There was a significant increase in the events during the study period (Average Annual Percent Change: 12.7; 95%CI 1.1–25.6; p<0.001), with rates increasing from 56.52/10,000 inhabitants in 2007 to 56.64/10,000 inhabitants in 2015. The incidence of cases in girls increased from 57.34/10,000 inhabitants in 2007 to 62.27/10,000 inhabitants in 2015. In boys, the incidence of cases was stationary: 55.69/10,000 inhabitants to 50.9 /10,000 inhabitants in the same period. Conclusions: The study showed a higher frequency of cases in girls aged 0 to 4 years and an increasing trend in the incidence rate during the study period. Implementation of actions and strategies, with emphasis on health education, is needed in order to prevent cases of exogenous intoxication.
{"title":"Epidemiological profile and temporal trend of exogenous intoxications in children and adolescents","authors":"M. Melo, G. Santana, Matheus Henrique Almeida Rocha, R. Lima, Talles Alberto Bispo da Silva, C. D. F. Souza, Amanda Karine Barros Ferreira Rodrigues","doi":"10.1590/1984-0462/2022/40/2021004IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021004IN","url":null,"abstract":"Abstract Objective: To describe the epidemiological profile and to analyze the trend in the incidence rate of exogenous poisoning concerning children and adolescents (0–19 years old) in the city of Arapiraca, Alagoas, Brazil, in the period from 2007 to 2015. Methods: Observational study with data extracted from the Notifiable Diseases Information System. The variables sex, age group, toxic agent, and circumstance were analyzed using descriptive statistics. For temporal analysis, cut-off rates of incidence/10,000 inhabitants were calculated and the inflection point regression model was used for analysis. Results: There were 5,539 cases of exogenous intoxication in individuals aged 0–19 years in the city, of which 53.1% (n=2,944) occurred in girls and 61.5% (n=3,405) in children aged 0–9 years. Medicines consisted in the main agent responsible for intoxications (28.5%; n=1,580), mainly by accidental use (18.2%; n=1,010). There was a significant increase in the events during the study period (Average Annual Percent Change: 12.7; 95%CI 1.1–25.6; p<0.001), with rates increasing from 56.52/10,000 inhabitants in 2007 to 56.64/10,000 inhabitants in 2015. The incidence of cases in girls increased from 57.34/10,000 inhabitants in 2007 to 62.27/10,000 inhabitants in 2015. In boys, the incidence of cases was stationary: 55.69/10,000 inhabitants to 50.9 /10,000 inhabitants in the same period. Conclusions: The study showed a higher frequency of cases in girls aged 0 to 4 years and an increasing trend in the incidence rate during the study period. Implementation of actions and strategies, with emphasis on health education, is needed in order to prevent cases of exogenous intoxication.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41633999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-27DOI: 10.1590/1984-0462/2022/40/2021007IN
C. Schivinski, R. Wamosy, P. Parazzi, A. Morcillo
Abstract Objective: This study aims to present standard reference for values of maximum respiratory pressures of healthy schoolchildren, according to gender. Methods: This is a cross-sectional study involving healthy children aged 7–10 years. Data of body mass and height were evaluated to calculate body mass index (BMI). In addition, forced expiratory volume in 1 second (FEV1) and maximal expiratory pressure values were evaluated according to the American Thoracic Society. The maximal inspiratory pressure (MIP) and data of maximal expiratory pressure (MEP) obtained in the study showed normal distribution and curves were built by the Lambda–Mu–Sigma (LMS) method, as well as the values of MIP and MEP percentiles 3, 10, 25, 50, 75, 90, and 97 for each gender. Results: MIP and MEP data were collected from 399 schoolchildren. All schoolchildren in the sample had adequate FEV1 and BMI. The study showed an increase in respiratory pressure values with age progression. The MIP and MEP values of girls were of 53.4±11.0 and 61.8±12.5cmH2O, respectively, and those of boys were 59.9±13.6 and 69.6±15.7cmH2O, respectively. Conclusions: Normal curves and percentiles were developed for MIP and MEP values of healthy schoolchildren. The extreme percentiles (3rd and 97th) were determined, and a specific graph was elaborated for each group. These graphs may help clinical follow-up and therapeutic monitoring of different pediatric populations.
{"title":"Standard reference and percentiles of maximum respiratory pressures values of healthy children aged 7–10 years","authors":"C. Schivinski, R. Wamosy, P. Parazzi, A. Morcillo","doi":"10.1590/1984-0462/2022/40/2021007IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021007IN","url":null,"abstract":"Abstract Objective: This study aims to present standard reference for values of maximum respiratory pressures of healthy schoolchildren, according to gender. Methods: This is a cross-sectional study involving healthy children aged 7–10 years. Data of body mass and height were evaluated to calculate body mass index (BMI). In addition, forced expiratory volume in 1 second (FEV1) and maximal expiratory pressure values were evaluated according to the American Thoracic Society. The maximal inspiratory pressure (MIP) and data of maximal expiratory pressure (MEP) obtained in the study showed normal distribution and curves were built by the Lambda–Mu–Sigma (LMS) method, as well as the values of MIP and MEP percentiles 3, 10, 25, 50, 75, 90, and 97 for each gender. Results: MIP and MEP data were collected from 399 schoolchildren. All schoolchildren in the sample had adequate FEV1 and BMI. The study showed an increase in respiratory pressure values with age progression. The MIP and MEP values of girls were of 53.4±11.0 and 61.8±12.5cmH2O, respectively, and those of boys were 59.9±13.6 and 69.6±15.7cmH2O, respectively. Conclusions: Normal curves and percentiles were developed for MIP and MEP values of healthy schoolchildren. The extreme percentiles (3rd and 97th) were determined, and a specific graph was elaborated for each group. These graphs may help clinical follow-up and therapeutic monitoring of different pediatric populations.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46065166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-27DOI: 10.1590/1984-0462/2022/40/2020429IN
Érika Ozela Augusto, Vânia Guimarães Bonucci, Rafaela Valente Cardoso, M. B. Morais
Abstract Objective: To evaluate the diet and nutritional status of infants on an elimination diet of cow’s milk proteins. Methods: Observational and cross-sectional study that compared: Infants on a cow’s milk protein elimination diet (n=60) assisted at a hypoallergenic formula distribution unit and a control group of same age and gender without dietary restrictions (n=60). Age ranged from 6 to 24 months. The diet was evaluated using the 24-hour food survey and weight and height were measured. Results: The macronutrient intake of both groups reached nutritional recommendations. The proportions of infants in the group of elimination of cow’s milk proteins with insufficient intake were lower, compared to controls, for iron (13.3 and 31.7%; p=0.029), zinc (5.0 and 18.3%; p=0.047), and vitamin D (25.0 and 71.7%; p<0.001). The hypoallergenic formula contributed to a greater supply of nutrients than dairy foods for the control group. Between 12 and 24 months, the number of infants on a restriction diet who never consumed meat, fish, cereals, and eggs was higher than in the control group (p<0.05). The length-age Z scores in infants on a cow’s milk protein elimination diet (-0.4±1.6) were lower (p=0.039) than in the control group (+0.2±1.3). Conclusions: The diet of infants with exclusion of cow’s milk protein was adequate despite the delay in the introduction of some complementary foods. Infants on an elimination cow’s milk protein diet showed lower linear growth without weight deficit.
{"title":"Complementary feeding and nutritional status of infants on cow’s milk proteins elimination diet","authors":"Érika Ozela Augusto, Vânia Guimarães Bonucci, Rafaela Valente Cardoso, M. B. Morais","doi":"10.1590/1984-0462/2022/40/2020429IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2020429IN","url":null,"abstract":"Abstract Objective: To evaluate the diet and nutritional status of infants on an elimination diet of cow’s milk proteins. Methods: Observational and cross-sectional study that compared: Infants on a cow’s milk protein elimination diet (n=60) assisted at a hypoallergenic formula distribution unit and a control group of same age and gender without dietary restrictions (n=60). Age ranged from 6 to 24 months. The diet was evaluated using the 24-hour food survey and weight and height were measured. Results: The macronutrient intake of both groups reached nutritional recommendations. The proportions of infants in the group of elimination of cow’s milk proteins with insufficient intake were lower, compared to controls, for iron (13.3 and 31.7%; p=0.029), zinc (5.0 and 18.3%; p=0.047), and vitamin D (25.0 and 71.7%; p<0.001). The hypoallergenic formula contributed to a greater supply of nutrients than dairy foods for the control group. Between 12 and 24 months, the number of infants on a restriction diet who never consumed meat, fish, cereals, and eggs was higher than in the control group (p<0.05). The length-age Z scores in infants on a cow’s milk protein elimination diet (-0.4±1.6) were lower (p=0.039) than in the control group (+0.2±1.3). Conclusions: The diet of infants with exclusion of cow’s milk protein was adequate despite the delay in the introduction of some complementary foods. Infants on an elimination cow’s milk protein diet showed lower linear growth without weight deficit.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47567418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-20DOI: 10.1590/1984-0462/2022/40/2021177IN
Ana Paula Kulig Godinho, Amanda de Oliveira da Conceição, Elisa Leite Rodrigues, Ilanna Mirela Becker Jorge Siqueira, C. Taconeli, S. Crispim, M. R. M. G. Dias, C. Almeida
ABSTRACT Objective: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil. Methods: The parents or guardians of the 135 children were asked about their children’s eating habits and the family’s socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations. Results: Two dietary patterns were observed: “unhealthy” and “healthy.” The “unhealthy” pattern was significantly associated with maternal age, the child’s corrected age, and gestational age at birth. The “healthy pattern” was associated with the child’s corrected age. Maternal age and child’s corrected age remained significant after multiple regression analyses. For the “unhealthy” pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child’s age increases and less intense for children with mothers aged 30 years or older. For the “healthy” dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns. Conclusions: These results indicate the importance of nutritional education for younger mothers regarding their children’s eating practices, especially as the child grows.
{"title":"Dietary patterns and associated factors of children under two years of age born prematurely","authors":"Ana Paula Kulig Godinho, Amanda de Oliveira da Conceição, Elisa Leite Rodrigues, Ilanna Mirela Becker Jorge Siqueira, C. Taconeli, S. Crispim, M. R. M. G. Dias, C. Almeida","doi":"10.1590/1984-0462/2022/40/2021177IN","DOIUrl":"https://doi.org/10.1590/1984-0462/2022/40/2021177IN","url":null,"abstract":"ABSTRACT Objective: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil. Methods: The parents or guardians of the 135 children were asked about their children’s eating habits and the family’s socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations. Results: Two dietary patterns were observed: “unhealthy” and “healthy.” The “unhealthy” pattern was significantly associated with maternal age, the child’s corrected age, and gestational age at birth. The “healthy pattern” was associated with the child’s corrected age. Maternal age and child’s corrected age remained significant after multiple regression analyses. For the “unhealthy” pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child’s age increases and less intense for children with mothers aged 30 years or older. For the “healthy” dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns. Conclusions: These results indicate the importance of nutritional education for younger mothers regarding their children’s eating practices, especially as the child grows.","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47883486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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