To describe the factors associated with dental caries among students from Santa Cruz do Sul, Rio Grande do Sul, Brazil.
A cross‐sectional study was conducted in a random sample of 623 students of both genders, aged 10–17 years old. Tooth decay was performed using the index of the World Health Organization (1997), DMFT (permanent dentition) that expresses the sum of decayed, missing and filled teeth per person. The maternal educational level was rated using criteria of the Brazilian Association of Market Research Companies. The remaining variables were obtained by a structured questionnaire. Poisson regression analysis was used to test the association between variables using robust models and a subsequently adjusted model. Data were expressed as prevalence ratio (PR).
Multivariate analysis identified the following factors related to the experience of dental caries: residence in rural municipalities (PR: 1.15; 95%CI: 1.0–1.3), attending a city school (PR: 3.30; 95%CI: 1.1–9.4) or a state school (PR: 3.40; 95%CI: 1.1–9.6); and having an illiterate mother or a mother that only attended up to the 4th year of school (PR: 1.67; 95%CI: 1.1–2.4) or high school (PR: 1.54; 95%CI: 1.1–2.2).
The presence of caries in students in southern Brazil was associated with residence in rural areas, mother with little education and attendance to a public school.
To report the case of a child with bilateral chylothorax due to infrequent etiology: thoracic duct injury after severe vomiting.
Girl, 7 years old, with chronic facial swelling started after hyperemesis. During examination, she also presented with bilateral pleural effusion, with chylous fluid obtained during thoracentesis. After extensive clinical, laboratory, and radiological investigation of the chylothorax etiology, it was found to be secondary to thoracic duct injury by the increased intrathoracic pressure caused by the initial manifestation of vomiting, supported by lymphoscintigraphy findings.
Except for the neonatal period, chylothorax is an infrequent finding of pleural effusion in children. There are various causes, including trauma, malignancy, infection, and inflammatory diseases; however, the etiology described in this study is poorly reported in the literature.
To evaluate the immediate improvement rate of irritative cough in patients treated with the combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group).
Pragmatic, double‐blind, randomized, parallel‐group study with children aged between 2 and 15 years, with irritative cough for at least 24 hours. The double‐blind assessment of cough was through the number of observed coughing episodes and intensity score for a period of 10 minutes of observation. The decrease of one point in the mean total score was considered as a therapeutic effect.
There was a reduction in coughing episodes in both groups, as well as in the cough score after 30 minutes of drug or honey administration. The change in clinical score above two points, which could indicate marked improvement, occurred in five patients in the bromelin group and only in one in the placebo group, but without significant difference. There were no adverse events.
The immediate improvement rate of irritative cough was similar in patients treated with combination of Ananas comosus extract and honey (Bromelin®) compared with the use of honey alone (placebo group). It is possible that honey has a therapeutic effect on mucus and cough characteristics (Clinical Trials: NCT01356693).
Compare the non‐verbal communication of children before and during interaction with clowns and compare their vital signs before and after this interaction.
Uncontrolled, intervention, cross‐sectional, quantitative study with children admitted to a public university hospital. The intervention was performed by medical students dressed as clowns and included magic tricks, juggling, singing with the children, making soap bubbles and comedic performances. The intervention time was 20minutes. Vital signs were assessed in two measurements with an interval of one minute immediately before and after the interaction. Non‐verbal communication was observed before and during the interaction using the Non‐Verbal Communication Template Chart, a tool in which nonverbal behaviors are assessed as effective or ineffective in the interactions.
The sample consisted of 41 children with a mean age of 7.6±2.7 years; most were aged 7 to 11 years (n=23; 56%) and were males (n=26; 63.4%). There was a statistically significant difference in systolic and diastolic blood pressure, pain and non‐verbal behavior of children with the intervention. Systolic and diastolic blood pressure increased and pain scales showed decreased scores.
The playful interaction with clowns can be a therapeutic resource to minimize the effects of the stressing environment during the intervention, improve the children's emotional state and reduce the perception of pain.
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).
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.
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.
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.
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