Revista Paulista de Pediatria (English Edition)最新文献

{"title":"In time: the persistence of congenital syphilis in Brazil – More progress needed!","authors":"Joshua M. Cooper , Ian C. Michelow , Phillip S. Wozniak , Pablo J. Sánchez","doi":"10.1016/j.rppede.2016.06.004","DOIUrl":"10.1016/j.rppede.2016.06.004","url":null,"abstract":"","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 251-253"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34752881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School environment, sedentary behavior and physical activity in preschool children","authors":"Sara Crosatti Barbosa ,&nbsp;Diogo Henrique Constantino Coledam ,&nbsp;Antonio Stabelini Neto ,&nbsp;Rui Gonçalves Marques Elias ,&nbsp;Arli Ramos de Oliveira","doi":"10.1016/j.rppede.2016.02.003","DOIUrl":"10.1016/j.rppede.2016.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze physical activity and sedentary behavior in preschool children during their stay at school and the associated factors.</p></div><div><h3>Methods</h3><p>370 preschoolers, aged 4–6 years, stratified according to gender, age and school region in the city of Londrina, PR, participated in the study. A questionnaire was applied to principals of preschools to analyze the school infrastructure and environment. Physical activity and sedentary behavior were estimated using accelerometers for five consecutive days during the children's stay at school. The odds ratio (OR) was estimated through binary logistic regression.</p></div><div><h3>Results</h3><p>At school, regardless of age, preschoolers spend relatively more time in sedentary behaviors (89.6–90.9%), followed by light (4.6–7.6%), moderate (1.3–3.0%) and vigorous (0.5–2.3%) physical activity. The indoor recreation room (OR 0.20, 95%CI 0.05–0.83) and the playground (OR 0.08, 95%CI 0.00–0.80) protect four-year-old schoolchildren from highly sedentary behavior. An inverse association was found between the indoor recreation room and physical activity (OR 0.20, 95%CI 0.00–0.93) in five-year-old children. The indoor recreation room (OR 1.54, 95%CI 1.35–1.77), the playground (OR 2.82, 95%CI 1.14–6.96) and the recess (OR 1.54, 95%CI 1.35–1.77) are factors that increase the chance of six-year-old schoolchildren to be active.</p></div><div><h3>Conclusions</h3><p>The school infrastructure and environment should be seen as strategies to promote physical activity and reduce sedentary behavior in preschool children.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 301-308"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55273089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist circumference as a mediator of biological maturation effect on the motor coordination in children","authors":"Leonardo G.O. Luz ,&nbsp;André Seabra ,&nbsp;Cristina Padez ,&nbsp;João P. Duarte ,&nbsp;Ricardo Rebelo-Gonçalves ,&nbsp;João Valente-dos-Santos ,&nbsp;Tatiana D.D. Luz ,&nbsp;Bruno C.M. Carmo ,&nbsp;Manuel Coelho-e-Silva","doi":"10.1016/j.rppede.2016.02.004","DOIUrl":"10.1016/j.rppede.2016.02.004","url":null,"abstract":"<div><h3>Objective</h3><p>The present study aimed to: 1) examine the association of biological maturation effect on performance at a motor coordination battery and 2) to assess whether the association between biological maturation and scores obtained in motor coordination tests is mediated by some anthropometric measurement.</p></div><div><h3>Methods</h3><p>The convenience sample consisted of 73 male children aged 8 years old. Anthropometric data considered the height, body mass, sitting height, waist circumference, body mass index, fat mass and fat-free mass estimates. Biological maturation was assessed by the percentage of the predicted mature stature. Motor coordination was tested by the Körperkoordinationstest für Kinder. A partial correlation between anthropometric measurements, <em>z</em>-score of maturation and the motor coordination tests were performed, controlling for chronological age. Finally, causal mediation analysis was performed.</p></div><div><h3>Results</h3><p>Height, body mass, waist circumference and fat mass showed a slight to moderate inverse correlation with motor coordination. Biological maturation was significantly associated with the balance test with backward walking (<em>r</em>=−0.34). Total mediation of the waist circumference was identified in the association between biological maturation and balance test with backward walking (77%).</p></div><div><h3>Conclusions</h3><p>We identified an association between biological maturation and KTK test performance in male children and also verified that there is mediation of waist circumference. It is recommended that studies be carried out with female individuals and at other age ranges.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 352-358"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55273530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and screen time in children and adolescents in a medium size town in the South of Brazil","authors":"João Paulo de Aguiar Greca ,&nbsp;Diego Augusto Santos Silva ,&nbsp;Mathias Roberto Loch","doi":"10.1016/j.rppede.2016.01.001","DOIUrl":"10.1016/j.rppede.2016.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the associations between sex and age with behaviour related to physical activity practice and sedentary behaviour in children and adolescents.</p></div><div><h3>Methods</h3><p>A cross-sectional study with 480 (236 boys) subjects enrolled in a public school in the city of Londrina, in the south of Brazil, aged 8–17 years. Measures of physical activity, sports practice and screen times were obtained using the Physical Activity Questionnaire for Older Children. The Mann–Whitney <em>U</em> test was used to compare variables between boys and girls. The Chi squared test was used for categorical analysis and Poisson regression was used to identify prevalence.</p></div><div><h3>Results</h3><p>Girls (69.6%; PR=1.05 [0.99–1.12]) spent more time with sedentary behaviour than boys (62.2%). Boys (80%; PR=0.95 [0.92–0.98]) were more physically active than girls (91%). Older students aged 13–17 showed a higher prevalence of physical inactivity (91.4%; PR=1.06 [1.02–1.10]) and time spent with sedentary behaviour of ≥2h/day (71.8%; PR=0.91 [0.85–0.97]) when compared to younger peers aged 8–12 (78.7 and 58.5%, respectively).</p></div><div><h3>Conclusions</h3><p>The prevalence of physical inactivity was higher in girls. Older students spent more screen time in comparison to younger students.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 316-322"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55271975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of abdominal obesity in adolescents: association between sociodemographic factors and lifestyle","authors":"João Antônio Chula Castro,&nbsp;Heloyse Elaine Gimenes Nunes,&nbsp;Diego Augusto Santos Silva","doi":"10.1016/j.rppede.2016.01.007","DOIUrl":"10.1016/j.rppede.2016.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the prevalence of abdominal obesity and verify the association with sociodemographic factors (gender, school shift, ethnicity, age, maternal education and economic status) and lifestyle (alcohol consumption, sleep, soft drink consumption, level of physical activity and sedentary behavior) in adolescents in Southern Brazil.</p></div><div><h3>Methods</h3><p>This was a cross-sectional epidemiological study of 930 adolescents (490 girls) aged 14–19 years, living in the city of São José, SC, Brazil. A self-administered questionnaire was used to collect sociodemographic and lifestyle data. Abdominal obesity was measured through the waist circumference and analyzed according to gender and age. Descriptive statistics (absolute and relative frequency, mean and standard deviation) and binary logistic regression, expressed as <em>Odds Ratios</em> (OR) and 95% confidence interval (95%CI) were employed, with <em>p</em>&lt;0.05 being considered statistically significant; the SPSS 17.0 software was used for the statistical analyses.</p></div><div><h3>Results</h3><p>The prevalence of abdominal obesity was 10.6% for the total sample (10.5% male, 10.8% female). Adolescents that watched television daily for two or more hours (OR=2.11, 95%CI 1.08–4.13) had a higher chance of having abdominal obesity and adolescents whose mothers had fewer than eight years of schooling (OR=0.56; 95%CI from 0.35 to 0.91) had a lower chance of having abdominal obesity.</p></div><div><h3>Conclusions</h3><p>Approximately one in 10 adolescents had abdominal obesity; the associated factors were maternal schooling (≥8 years) and television screen time (≥2h/day).</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 343-351"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.01.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55272855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of varicella vaccination on varicella-related hospitalization rates: global data review","authors":"Maki Hirose,&nbsp;Alfredo Elias Gilio,&nbsp;Angela Esposito Ferronato,&nbsp;Selma Lopes Betta Ragazzi","doi":"10.1016/j.rppede.2016.03.001","DOIUrl":"10.1016/j.rppede.2016.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease.</p></div><div><h3>Data source</h3><p>We identified countries that implemented universal vaccination against varicella at the <span>http://apps.who.int/immunization_monitoring/globalsummary/schedules</span><svg><path></path></svg> site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords “varicella”, “vaccination/vaccine” and “children” (or) “hospitalization”. Publications in English published between January 1995 and May 2015 were included.</p></div><div><h3>Data synthesis</h3><p>24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4%–99.2% reduction in hospitalization rates in children younger than four years, 6–14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1–4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1–4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1–4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1–4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age &lt;5 years) in four years, coverage of 77.2% and Italy 69.7%–73.8% decrease (general population), coverage of 60%–95%.</p></div><div><h3>Conclusions</h3><p>The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 359-366"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55273902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family relationships with pediatricians: the maternal views","authors":"Simone de Carvalho,&nbsp;José Martins Filho","doi":"10.1016/j.rppede.2016.03.015","DOIUrl":"10.1016/j.rppede.2016.03.015","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the perception of pediatric guidelines by mothers at the time of consultation in private offices, in order to know how they assimilate, process and use the information received from the pediatricians.</p></div><div><h3>Methods</h3><p>Data collection was carried out by a questionnaire sent to participants by a total of 200 mothers from a virtual community in social networks participated in the research. The answers were transcribed using the Discourse of the Collective Subject method. The analyses were supported by the research qualitative perspective, from the viewpoint of the social representation theory.</p></div><div><h3>Results</h3><p>Three categories were obtained through data analysis: (1) assessing the pediatric guidelines, (2) confronting theory and practice and (3) developing a critical view of the pediatric guidelines. These categories have elucidated that the level of knowledge of pediatric issues by mothers and their ability to use them when making decisions about the care of their babies, have a direct association between following or not the pediatric guidelines.</p></div><div><h3>Conclusions</h3><p>The mother's decision on following the pediatrician's recommendations depends on two main factors: (a) certification of the updated and proven recommendations, according to the official health agencies; (b) support and recognition by the pediatrician of the maternal empowerment during the follow-up process. The mothers’ practice of accessing knowledge through social networks hinders the pediatric monitoring.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 330-335"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.03.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55274632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triage and risk classification protocols in Pediatric emergency","authors":"Emílio Carlos Elias Baracat","doi":"10.1016/j.rppede.2016.06.005","DOIUrl":"10.1016/j.rppede.2016.06.005","url":null,"abstract":"","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 249-250"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55275457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLARIPED: a new tool for risk classification in pediatric emergencies","authors":"Maria Clara de Magalhães-Barbosa ,&nbsp;Arnaldo Prata-Barbosa ,&nbsp;Antonio José Ledo Alves da Cunha ,&nbsp;Cláudia de Souza Lopes","doi":"10.1016/j.rppede.2016.02.002","DOIUrl":"10.1016/j.rppede.2016.02.002","url":null,"abstract":"<div><h3>Objective</h3><p>To present a new pediatric risk classification tool, CLARIPED, and describe its development steps.</p></div><div><h3>Methods</h3><p>Development steps: (i) first round of discussion among experts, first prototype; (ii) pre-test of reliability, 36 hypothetical cases; (iii) second round of discussion to perform adjustments; (iv) team training; (v) pre-test with patients in real time; (vi) third round of discussion to perform new adjustments; (vii) final pre-test of validity (20% of medical treatments in five days).</p></div><div><h3>Results</h3><p>CLARIPED features five urgency categories: Red (Emergency), Orange (very urgent), Yellow (urgent), Green (little urgent) and Blue (not urgent). The first classification step includes the measurement of four vital signs (VIPE score); the second step consists in the urgency discrimination assessment. Each step results in assigning a color, selecting the most urgent one for the final classification. Each color corresponds to a maximum waiting time for medical care and referral to the most appropriate physical area for the patient's clinical condition. The interobserver agreement was substantial (kappa=0.79) and the final pre-test, with 82 medical treatments, showed good correlation between the proportion of patients in each urgency category and the number of used resources (<em>p</em>&lt;0.001).</p></div><div><h3>Conclusions</h3><p>CLARIPED is an objective and easy-to-use tool for simple risk classification, of which pre-tests suggest good reliability and validity. Larger-scale studies on its validity and reliability in different health contexts are ongoing and can contribute to the implementation of a nationwide pediatric risk classification system.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 254-262"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55272999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital intrahepatic portosystemic shunt diagnosed during intrauterine life","authors":"Camila Vieira Bellettini ,&nbsp;Rafaela Wagner ,&nbsp;Aleocídio Sette Balzanelo ,&nbsp;André Luis de Souza Andretta ,&nbsp;Arthur Nascimento de Moura ,&nbsp;Catia Carolina Fabris ,&nbsp;Eduardo Maranhão Gubert","doi":"10.1016/j.rppede.2016.03.016","DOIUrl":"10.1016/j.rppede.2016.03.016","url":null,"abstract":"<div><h3>Objective</h3><p>To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans.</p></div><div><h3>Case description</h3><p>17-Day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram were performed to investigate possible co-morbidities or associated complications, and were normal. We chose conservative shunt treatment, as there were no disease-related complications and this was intrahepatic shunt, which could close spontaneously by the age of 2 years.</p></div><div><h3>Comments</h3><p>Portosystemic shunt can lead to various complications such as hepatic encephalopathy, hypergalactosemia, liver tumors, and hepatopulmonary syndrome. Most diagnoses are done after one month of age, after such complications occur. The prenatal diagnosis of this patient provided greater security for the clinical picture management, as well as regular monitoring, which allows the anticipation of possible complications and perform interventional procedures when needed.</p></div>","PeriodicalId":101120,"journal":{"name":"Revista Paulista de Pediatria (English Edition)","volume":"34 3","pages":"Pages 384-387"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppede.2016.03.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55274692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}