Jornal de pediatria最新文献_第4页

Exclusive breastfeeding modifies the association between maternal education and child development: a cross-sectional study nested in a cohort. 纯母乳喂养改变了母亲教育和儿童发展之间的关系：一项嵌套在队列中的横断面研究。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-04-07 DOI: 10.1016/j.jped.2025.02.004

Luiza Alves Ford, Gabriela Buccini, Amanda Castelo Saragosa, Isadora de Araújo Martins, Janaína Matos Moreira, Stela Maris Aguiar Lemos, Claudia Regina Lindgren Alves, Vivian Mara Gonçalves de Oliveira Azevedo

{"title":"Exclusive breastfeeding modifies the association between maternal education and child development: a cross-sectional study nested in a cohort.","authors":"Luiza Alves Ford, Gabriela Buccini, Amanda Castelo Saragosa, Isadora de Araújo Martins, Janaína Matos Moreira, Stela Maris Aguiar Lemos, Claudia Regina Lindgren Alves, Vivian Mara Gonçalves de Oliveira Azevedo","doi":"10.1016/j.jped.2025.02.004","DOIUrl":"10.1016/j.jped.2025.02.004","url":null,"abstract":"<p><strong>Objective: </strong>Low maternal education is a risk factor for early childhood development (ECD), while exclusive breastfeeding (EBF) is a protective factor. This study examined the association between maternal education and ECD outcomes such as cognitive, language, and motor domains and whether EBF modifies this association in Brazil.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from a non-probabilistic sample of 12-month-old infants born during the COVID-19. Moderation analyses using the Mann-Whitney test examined the effect of EBF at 6 months (effect modifier) on the relationship between Bayley-III cognitive, language, and motor scores as well as Bayley Global Score (BGS) (outcomes) and maternal education (independent variable). The effect size (r) from the sensitivity analysis of the effect modifier was estimated.</p><p><strong>Results: </strong>A total of 269 full-term infants were evaluated. Higher maternal education was associated with better cognitive, language, and BGS (p < 0.00). EBF was associated with higher cognitive (p < 0.01), language (p < 0.02), and BGS (p < 0.00). EBF modified the effect of low maternal education (<10 years; and 10-12 years) on cognitive score and BGS. Among mothers with >10 years of education, a large effect size of EBF was observed on the BGS (r = 0.51), and a medium effect size was noted in the cognitive domain (r = 0.38).</p><p><strong>Conclusion: </strong>Higher maternal education is associated with better scores on Bayley-III domains, and EBF can modify the effect of lower maternal education on ECD in Brazil. This is the first study to identify EBF as a mechanism to protect ECD in adverse conditions such as low maternal education.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immediate effect of food intake by the nursing mother on the macronutrient content of colostrum. 哺乳母亲摄入食物对初乳中宏量营养素含量的直接影响。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-04-03 DOI: 10.1016/j.jped.2025.03.004

Regina C F A Nascimento, Virgínia G A Hochman, Camila B M da Silva, Bernardo V do Valle, Yasmin N di V do Amaral, Manuela Dolinsky, Alan A Vieira

{"title":"Immediate effect of food intake by the nursing mother on the macronutrient content of colostrum.","authors":"Regina C F A Nascimento, Virgínia G A Hochman, Camila B M da Silva, Bernardo V do Valle, Yasmin N di V do Amaral, Manuela Dolinsky, Alan A Vieira","doi":"10.1016/j.jped.2025.03.004","DOIUrl":"10.1016/j.jped.2025.03.004","url":null,"abstract":"<p><strong>Objective: </strong>Human milk has a dynamic composition that is ideal for the needs of infants. However, the factors that affect the nutritional content of human milk are still unclear. This study aimed to evaluate the immediate effect of maternal food intake (lunch) on the macronutrient composition of colostrum.</p><p><strong>Methods: </strong>This prospective study performed a paired analysis of macronutrient concentrations in the colostrum of healthy postpartum women. Three milliliters of colostrum were collected from 65 participants 30 min before and 2 h after a meal (lunch) by manual expression. The nutritional content of the meal was similar for all mothers. Colostrum analysis was performed using a Human Milk Analyzer (Miris®).</p><p><strong>Results: </strong>The fat content was significantly higher in colostrum samples collected 2 h after lunch than in those collected 30 mins before lunch (2.3 ± 1.1 vs. 2.8 ± 1.4 g %, p = 0.002). No significant differences were observed in the protein (1.9 ± 0.7 vs. 1.9 ± 1.0) and carbohydrate (6.4 ± 0.8 vs. 6.4 ± 0.8) content.</p><p><strong>Conclusions: </strong>Two hours after the mother had lunch, the colostrum fat concentration increased by 20 %.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physical activity and quality of life of children and adolescents with juvenile idiopathic arthritis, juvenile systemic lupus erythematosus and juvenile dermatomyositis during the COVID-19 pandemic COVID-19大流行期间患有幼年特发性关节炎、幼年系统性红斑狼疮和幼年皮肌炎的儿童和青少年的身体活动和生活质量

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-04-01 DOI: 10.1016/j.jped.2025.01.011

Renata Soares, Fabiana de Carvalho Silva, Jade Dib Fernandez, Melissa Mariti Fraga, Maria Teresa Terreri, Claudio Arnaldo Len

{"title":"Physical activity and quality of life of children and adolescents with juvenile idiopathic arthritis, juvenile systemic lupus erythematosus and juvenile dermatomyositis during the COVID-19 pandemic","authors":"Renata Soares, Fabiana de Carvalho Silva, Jade Dib Fernandez, Melissa Mariti Fraga, Maria Teresa Terreri, Claudio Arnaldo Len","doi":"10.1016/j.jped.2025.01.011","DOIUrl":"10.1016/j.jped.2025.01.011","url":null,"abstract":"<div><h3>Objectives</h3><div>1) To assess the level of physical activity of children and adolescents with IMRD (juvenile idiopathic arthritis – JIA, juvenile systemic lupus erythematosus—JSLE, or juvenile dermatomyositis - JDM) throughout the COVID-19 pandemic in a tertiary reference service, and 2) To assess the HRQoL and fatigue in these patients.</div></div><div><h3>Methods</h3><div>The authors included 57 children and adolescents with JIA, JSLE, and JDM, who were clinically inactive according to the assisting physician evaluation. The control group consisted of healthy children. Data was collected during the period of social isolation. The instruments used for the assessments were the International Physical Activity Questionnaire (IPAQ), the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), and the Pediatric Quality of Life Inventory – Fatigue Module (PedsQL – Fatigue Module).</div></div><div><h3>Results</h3><div>About 68.5 % of patients and 79.3 % of controls were considered active regarding physical activity, without any difference between physical activity intensity scores between the groups. Regarding HRQoL, the authors observed lower scores in patients' physical, social, and school functioning domains. The authors observed that patients had higher levels of fatigue according to parents and caregivers.</div></div><div><h3>Conclusion</h3><div>The impact on physical activity levels of children and adolescents with IMRD throughout the COVID-19 pandemic was positive, with the majority of patients being classified as active, according to the IPAQ questionnaire. Furthermore, the patients engaged in moderate and light physical activities, similar to healthy controls. Regarding HRQoL, the present data showed that patients had lower scores in most of the dimensions assessed.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 451-457"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative efficacy of LifeVac® and Heimlich maneuver in simulated airway obstruction LifeVac®与海姆利克手法治疗气道阻塞的疗效比较。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-21 DOI: 10.1016/j.jped.2025.02.002

Maria Lucia S. Hristonof , Marina C. Amantéa , Fernando J. Lazzaretti , Marina M. Bernardes , Luiza F. Xavier , Sérgio Luis Amantéa

{"title":"Comparative efficacy of LifeVac® and Heimlich maneuver in simulated airway obstruction","authors":"Maria Lucia S. Hristonof , Marina C. Amantéa , Fernando J. Lazzaretti , Marina M. Bernardes , Luiza F. Xavier , Sérgio Luis Amantéa","doi":"10.1016/j.jped.2025.02.002","DOIUrl":"10.1016/j.jped.2025.02.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Foreign body airway obstruction is a significant cause of morbidity and mortality, especially in infants and young children. This study aims to compare the efficacy of the Heimlich maneuver and LifeVac® in a simulated environment.</div></div><div><h3>Methods</h3><div>A prospective experimental study was conducted using the Choking Charlie (Laerdal®) mannequin, which simulates the trunk from an adult male and is considered suitable for simulating choking events in young children. The study involved four operators: one Pediatric Advanced Life Support (PALS) instructor and professor of Trauma and Emergency Medicine, along with three members of the university's Pediatric Academic League, all previously trained in Basic Life Support (BLS). The primary outcome was the success rate of foreign body removal. Intracavitary pressures generated during the maneuvers were measured using a digital manometer.</div></div><div><h3>Results</h3><div>A total of 200 anti-choking maneuvers were performed, and both techniques successfully relieved airway obstruction in all cases. The LifeVac® device generated significantly lower intracavitary pressure differentials compared to the Heimlich maneuver (<em>p</em> < 0.000). Additionally, both techniques exhibited significant variability in applied pressure among different examiners (<em>p</em> < 0.000).</div></div><div><h3>Conclusions</h3><div>Both the Heimlich maneuver and LifeVac® are effective in relieving foreign body airway obstruction when performed by specialists in a simulated environment. Heimlich generated higher positive pressure gradients, while LifeVac® produced lower negative pressure gradients.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 473-478"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between exanthematous diseases and earlier age at Type 1 diabetes diagnosis: a Brazilian cohort study 一项巴西队列研究：1型糖尿病早期诊断与出疹性疾病之间的关系

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-20 DOI: 10.1016/j.jped.2024.11.012

Lucas C.P. Lopes , Lenita Zajdenverg , Rodrigo L.M. Martins , Gabriel Araujo Medeiros , Marina D. Louro , João V.M. Lanzarin , Carlos A. Negrato

{"title":"Association between exanthematous diseases and earlier age at Type 1 diabetes diagnosis: a Brazilian cohort study","authors":"Lucas C.P. Lopes , Lenita Zajdenverg , Rodrigo L.M. Martins , Gabriel Araujo Medeiros , Marina D. Louro , João V.M. Lanzarin , Carlos A. Negrato","doi":"10.1016/j.jped.2024.11.012","DOIUrl":"10.1016/j.jped.2024.11.012","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between exanthematous diseases, and an earlier age at Type 1 diabetes mellitus diagnosis (T1DM) in a cohort of Brazilian patients.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study including 812 patients diagnosed with T1DM in Bauru, São Paulo, Brazil, between 1981 and 2023. Data regarding sociodemographic parameters such as age, sex, ethnicity, socioeconomic status, as well as the occurrence of a previous exanthematous diseases, such as chickenpox, measles, rubella, mumps and scarlet fever were collected. An adapted survival analysis was performed to evaluate the impact of each variable on the age of T1DM diagnosis.</div></div><div><h3>Results</h3><div>Overall, 596 patients were evaluated. Their average age at T1DM diagnosis was 12 ± 7.69 years. It was found that presenting rubella, measles, and mumps, as well as belonging to non-high socioeconomic class, were associated with 35%, 40%, 39%, and 34% lower age at T1DM diagnosis, respectively.</div></div><div><h3>Conclusions</h3><div>This study has found that rubella, measles, mumps, and belonging to non-high socioeconomic classes were significantly associated with earlier age at T1DM diagnosis in a cohort of Brazilian patients with T1DM. Future studies with other populations are warranted to confirm our findings.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 349-355"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neonatal screening for congenital hypothyroidism: 28-year experience in the state of Minas Gerais, Brazil 新生儿先天性甲状腺功能减退筛查：巴西米纳斯吉拉斯州28年的经验

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-18 DOI: 10.1016/j.jped.2024.12.007

Nathalia Teixeira Palla Braga , Debora Patrícia da Silva Sousa Alves , Enrico Antônio Colosimo , Vera Maria Alves Dias , José Nélio Januário , Ivani Novato Silva

{"title":"Neonatal screening for congenital hypothyroidism: 28-year experience in the state of Minas Gerais, Brazil","authors":"Nathalia Teixeira Palla Braga , Debora Patrícia da Silva Sousa Alves , Enrico Antônio Colosimo , Vera Maria Alves Dias , José Nélio Januário , Ivani Novato Silva","doi":"10.1016/j.jped.2024.12.007","DOIUrl":"10.1016/j.jped.2024.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to determine the incidence of congenital hypothyroidism (CH) in Minas Gerais, Brazil, and evaluate the development of the Minas Gerais Neonatal Screening Program (PTN-MG) over the past 30 years.</div></div><div><h3>Method</h3><div>This was a retrospective longitudinal cohort study since the implementation of neonatal screening for CH, in 1994. Bloodspots on filter paper are collected, between the third and fifth day of life, at primary healthcare units, with a TSH threshold of 10 mIU/L. The identification of an abnormal result triggers an active search for the child to confirm the diagnosis. The incidence of CH and its variation over the years, the percentage of permanent cases, and the age at sample collection and treatment initiation were analyzed.</div></div><div><h3>Results</h3><div>The incidence of CH was 1:3,298 live births among 6,864,719 newborns screened, with no trend of change over the years (<em>p</em> = 0.08). The median age at sample collection decreased from 11 to 5 days (<em>p</em> < 0.01) and at treatment initiation from 88 to 16 days (<em>p</em> < 0.01). Among the confirmed patients, 77 % had permanent CH, thyroid dysgenesis accounted for 43.6 % of cases, gland-<em>in-situ</em> for 56.3 %.</div></div><div><h3>Conclusion</h3><div>The incidence of CH has remained stable in Minas Gerais over the past 28 years. The PTN-MG is a public health program with an active monitoring and control sector that has shown significant improvements in its indicators since its implementation. The experience of the program has shown that rigorous monitoring and follow-up of infants have been an essential strategy for achieving satisfactory results.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 430-437"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Volume-targeted on high-frequency oscillatory ventilation in preterm infants: a systematic review 以体积为目标的早产儿高频振荡通气：一项系统综述。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-17 DOI: 10.1016/j.jped.2025.01.012

Eduardo Antonio de Sousa Orlandin , Thais Iwashita-Lages , Luis Kanhiti Oharomari-Junior , Milena Ramos Tomé , Mariana Tosato Zinher , Sofia Oliveira Dias , Walusa Assad Gonçalves-Ferri

{"title":"Volume-targeted on high-frequency oscillatory ventilation in preterm infants: a systematic review","authors":"Eduardo Antonio de Sousa Orlandin , Thais Iwashita-Lages , Luis Kanhiti Oharomari-Junior , Milena Ramos Tomé , Mariana Tosato Zinher , Sofia Oliveira Dias , Walusa Assad Gonçalves-Ferri","doi":"10.1016/j.jped.2025.01.012","DOIUrl":"10.1016/j.jped.2025.01.012","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aimed to analyze, in neonates, the effects of high-frequency oscillatory ventilation (HFOV) with volume-targeted (VT) compared with conventional HFOV.</div></div><div><h3>Sources</h3><div>The authors searched PubMed, EMBASE, Cochrane, and ClinicalTrials.gov from inception until August 4th, 2024, to identify studies comparing HFOV with and without VT in neonates under 44 weeks corrected age. Outcomes analyzed were VThf, amplitude and carbon dioxide partial pressure (PCO<sub>2</sub>) variability, episodes of hypoxemia, hypocarbia or hypercarbia, duration of mechanical ventilation, rates of bronchopulmonary dysplasia (BPD) or intraventricular hemorrhage (IVH), and mortality. ROB-2 and ROBINS were used for risk of bias assessment.</div></div><div><h3>Summary of the findings</h3><div>This systematic review included 260 preterm infants from two crossover and four cohort studies. Five studies were considered as having a relevant risk of bias. Meta-analysis could not be performed, due to the differences in study design and incomplete reporting. The report of included studies indicates that HFOV with VT, compared with HFOV, may reduce VThf variability, hypocarbia and hypercarbia incidence. Findings on hypoxemia incidence and mechanical ventilation duration are mixed. Two studies found no difference in BPD rates, while one noted higher survival without BPD grades 2–3 under HFOV with VT. IVH, leukomalacia, and mortality outcomes were similar.</div></div><div><h3>Conclusions</h3><div>Inclusion of VT during HFOV may reduce VThf variability, hypocarbia and hypercarbia incidence. However, there is a need for randomized trials to compare clinical outcomes from both ventilatory strategies.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 332-340"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A public health success: newborn screening for congenital adrenal hyperplasia in a middle-income Brazilian state 公共卫生的成功：巴西中等收入州新生儿先天性肾上腺增生筛查。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-16 DOI: 10.1016/j.jped.2025.02.001

Scott D. Grosse

引用次数: 0

Lessons of screening two million newborns for congenital adrenal hyperplasia: 10-year experience of the Minas Gerais Public Health Program 200万新生儿先天性肾上腺增生症筛查的经验教训：米纳斯吉拉斯州公共卫生方案的10年经验。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-15 DOI: 10.1016/j.jped.2024.10.012

Cristina Botelho Barra , Gabrielly Souza Sena , Helena Pereira Oliveira , Ana Luiza Ataíde Carneiro de Paula Gonzaga , Raquel Ferreira Araújo , Thais Ramos Villela , Rafael Machado Mantovani , José Nélio Januário , Ivani Novato Silva

{"title":"Lessons of screening two million newborns for congenital adrenal hyperplasia: 10-year experience of the Minas Gerais Public Health Program","authors":"Cristina Botelho Barra , Gabrielly Souza Sena , Helena Pereira Oliveira , Ana Luiza Ataíde Carneiro de Paula Gonzaga , Raquel Ferreira Araújo , Thais Ramos Villela , Rafael Machado Mantovani , José Nélio Januário , Ivani Novato Silva","doi":"10.1016/j.jped.2024.10.012","DOIUrl":"10.1016/j.jped.2024.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>This is a 10-year period, descriptive and retrospective evaluation of a Brazilian State NBS-CAH public program, bringing light to the prior discussion concerning its implementation, by sharing the screening-240,000 babies annually practices.</div></div><div><h3>Methods</h3><div>The Minas Gerais (MG) NBS program has been coordinated by NUPAD, a neonatal screening, monitoring care, and genetics center at the Federal University of Minas Gerais (UFMG), intermediating all necessary actions, under the management of the State Health Administration, and following the Brazilian universal program. The dataset was used to calculate sensitivity, specificity, positive predictive value (PPV), incidence, number of carriers, and false-positive rates.</div></div><div><h3>Results</h3><div>About 2,094,588 newborns were screened, and the incidence was 1:14,647; PPV was 10.5%. Most samples were collected on the fifth day after birth (interquartile range 4–6 days); 1352 babies were referred for clinical evaluation; 1210 were false positives (0.06%), and 142 presented the classic form; 22% of newborns were hospitalized due to salt-loss symptoms before or at the first visit.</div></div><div><h3>Conclusions</h3><div>The MG NBS-CAH success as a public program comes from the Brazilian unified public health system, with integrated care, and from the newborn screening center offering timely referred screened positive cases and its outstanding state coverage. Appropriate cutoffs and close monitoring of hospitalized newborns have been pivotal for reducing the high false-positive rates.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 341-348"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transforming tallness: how sex steroids influence final height in Marfan syndrome 改变身高：性类固醇如何影响马凡氏综合征患者的最终身高。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2025-03-13 DOI: 10.1016/j.jped.2025.01.007

Adriana Banhos Carneiro Yamaguchi , Adriana Aparecida Siviero-Miachon , Paola Matiko Martins Okuda , Lívia Cristina Oliveira e Silva , Talita de Faria Bustamante , Angela Maria Spinola-Castro

{"title":"Transforming tallness: how sex steroids influence final height in Marfan syndrome","authors":"Adriana Banhos Carneiro Yamaguchi , Adriana Aparecida Siviero-Miachon , Paola Matiko Martins Okuda , Lívia Cristina Oliveira e Silva , Talita de Faria Bustamante , Angela Maria Spinola-Castro","doi":"10.1016/j.jped.2025.01.007","DOIUrl":"10.1016/j.jped.2025.01.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of hormonal treatment with sex steroids on the final height of patients with tall stature, including those diagnosed with Marfan Syndrome (MS), over 15 years in an outpatient setting.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed the medical records of patients referred for tall stature. Descriptive statistics characterized the samples, while independent and paired <em>t</em>-tests assessed changes in final height (FH) and height at the start of treatment (HTS). One-way analysis of variance (ANOVA) evaluated the impact of chronological age at the initiation of therapy, bone age at the start of treatment, and pubertal stage on FH and HTS.</div></div><div><h3>Results</h3><div>A total of 55 individuals with tall stature (51 % male) were included, among whom 35 (64 %) had clinically confirmed MS. Of these, 34 (62 %) received low-dose steroid treatment. Patients treated during pre-puberty exhibited an average height increase of 25.56 cm (95 %CI 20.40–30.73; <em>p</em> < 0.001; d = 2.86), while those treated during puberty showed an average gain of 11.93 cm (95 %CI 8.69–15.18; <em>p</em> < 0.001; d = 1.72). Early treatment before the age of 10 resulted in height gains of 13.92 cm (95 %CI 4.90–22.93; <em>p</em> = 0.006; d = 1.82) with estrogen and 6.8 cm (95 %CI 1.71–11.88; <em>p</em> = 0.010; d = 0.73) with testosterone.</div></div><div><h3>Conclusions</h3><div>Early intervention with low doses of steroids significantly reduced final height in individuals with tall stature, including those with MS, while also minimizing dose-dependent adverse effects.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 424-429"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0