Jornal de pediatria最新文献

{"title":"Exclusive breastfeeding and length of hospital stay in premature infants at a Brazilian reference center for kangaroo mother care","authors":"Patrícia de Padua Andrade Campanha ,&nbsp;Maria Clara de Magalhães-Barbosa ,&nbsp;Arnaldo Prata-Barbosa ,&nbsp;Gustavo Rodrigues-Santos ,&nbsp;Antônio José Ledo Alves da Cunha","doi":"10.1016/j.jped.2024.01.004","DOIUrl":"10.1016/j.jped.2024.01.004","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in preterm infants undergoing or not the Kangaroo-Mother Care Method (KMC).</p></div><div><h3>Methods</h3><p>A retrospective cohort study was conducted including preterm infants &lt; 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders.</p></div><div><h3>Results</h3><p>115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, <em>p</em> &lt; 0.001), a higher number of prenatal visits (median 6 vs. 3.5, <em>p</em> &lt; 0.001), higher gestational ages (median 32 vs. 31 weeks, <em>p</em> &lt; 0.05), higher birth weights (median 1530 vs. 1365 g, <em>p</em> &lt; 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, <em>p</em> &lt; 0.05), parenteral nutrition (50% vs. 73%, <em>p</em> &lt; 0.05), and deep vascular access (49.7% vs. 78.4%, <em>p</em> &lt; 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, <em>p</em> &lt; 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, <em>p</em> &lt; 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85–109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76–0.86) compared to the non-KMC group.</p></div><div><h3>Conclusions</h3><p>The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000287/pdfft?md5=4263a0d984a94e7ebabc39965c8f0a66&pid=1-s2.0-S0021755724000287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal complications of ascariasis in childhood","authors":"","doi":"10.1016/j.jped.2024.02.001","DOIUrl":"10.1016/j.jped.2024.02.001","url":null,"abstract":"<div><h3>Objective</h3><p>Complications of ascariasis are a significant cause of abdominal pain in pediatric emergencies, especially where it is endemic. A literature review was conducted with the aim of improving diagnostic and therapeutic approaches for these patients.</p></div><div><h3>Data sources</h3><p>A PubMed search was conducted using the key terms “ascariasis complications” and “hepatobiliary ascariasis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, case reports, and reviews published up to December 2023.</p></div><div><h3>Summary of findings</h3><p>Obstruction of the small bowel is the most common complication. Others that are, rarer and more difficult to properly identify and treat, such as biliary, hepatic, and pancreatic complications, acute appendicitis, Meckel's diverticulitis, or peritoneal granulomas. Hepatic and pancreatic complications are rarer and more serious in children than in adults. While plain radiography is usually the only option in cases of intestinal obstruction, ultrasonography is the examination of choice in cases of hepatobiliary, pancreatic, and appendicular ascariasis complications in childhood. The treatment is clinical and conservative in most patients. Surgical treatment is indicated if conservative therapy fails, or if there are signs of complications. Laparoscopy has been used as an excellent technical alternative in adults with hepatobiliary complications of ascariasis, but further studies on its use in children are still needed.</p></div><div><h3>Conclusion</h3><p>The creation of protocols and greater debate on this subject should be encouraged for a better understanding of the disease and to establish an early diagnosis and adequate treatment for children with complications resulting from massive infestation by <em>Ascaris lumbricoides</em>.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000275/pdfft?md5=9a5a116bf9bd1db62371d56473ceb5a1&pid=1-s2.0-S0021755724000275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing pediatric healthcare in Brazil: establishing reliable reference intervals for serum immunoglobulins","authors":"Khosrow Adeli","doi":"10.1016/j.jped.2024.03.001","DOIUrl":"10.1016/j.jped.2024.03.001","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000196/pdfft?md5=41f7816c48ea04e7084e09d2f5f8463f&pid=1-s2.0-S0021755724000196-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alert for the high prevalence of vitamin D deficiency in adolescents in a large Brazilian sample","authors":"Vanessa Radonsky ,&nbsp;Marise Lazaretti-Castro ,&nbsp;Maria Izabel Chiamolera ,&nbsp;Rosa Paula Mello Biscolla ,&nbsp;José Viana Lima Junior ,&nbsp;José Gilberto Henriques Vieira ,&nbsp;Cynthia Maria Alvares Brandão ,&nbsp;Rodrigo Fernandes Ramalho ,&nbsp;Sergio Setsuo Maeda ,&nbsp;Marcia Wehba Esteves Cavichio","doi":"10.1016/j.jped.2024.01.003","DOIUrl":"10.1016/j.jped.2024.01.003","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the prevalence of vitamin D deficiency and severe deficiency in children and adolescents, in a large Brazilian sample.</p></div><div><h3>Methodology</h3><p>Results of 413,988 25(OH)D measurements in children and adolescents aged 0 to 18 years collected between 01/2014 and 10/2018 were obtained from the database of a Clinical Laboratory. In this population, 25 hydroxyvitamin D concentrations below 20 ng/mL are considered deficient, and below 12 ng/mL as severe deficiency. All measurements were performed by immunoassay and the results were distributed by gender, age group, seasonality, and latitude.</p></div><div><h3>Results</h3><p>The mean of 25(OH)D levels was 29.2 ng/mL with a standard deviation of 9.2 ng/mL. Of the total samples, 0.8% had a concentration &lt; 12 ng/mL, and 12.5% of the samples had a concentration &lt; 20 ng/mL, with a higher prevalence in females. Children under 2 years of age had the lowest prevalence. The effects of latitude and seasonality were quite evident. In samples of female adolescents from the southern region in winter, 36% of vitamin D deficiency and 5% of severe deficiency were found.</p></div><div><h3>Conclusion</h3><p>In this large number of measurements of 25(OH)D in children and adolescents, 12.5% had a deficiency and 0.8% had severe deficiency. A greater deficiency was observed among adolescents, especially females, which raises questions about the need for supplementation during this period of life.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000184/pdfft?md5=69926cf505e0314015b69da3856fa491&pid=1-s2.0-S0021755724000184-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child undernutrition in Brazil: the wound that never healed","authors":"Maria Paula de Albuquerque,&nbsp;Paola Micheloni Elvira Ibelli,&nbsp;Ana Lydia Sawaya","doi":"10.1016/j.jped.2023.09.014","DOIUrl":"10.1016/j.jped.2023.09.014","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the scenario of child undernutrition in Brazil and its determinants.</p></div><div><h3>Data source</h3><p>Narrative review of the literature with inclusion of data from population surveys, surveillance and monitoring systems, and active search in favelas and underserved communities carried out by CREN.</p></div><div><h3>Data synthesis</h3><p>Household surveys carried out from 1974 to 2019 indicate that undernutrition (&lt;5 years) decreased until 2006. Underweight (W/A ≤-2 Z) and stunting (H/A ≤-2 Z) showed a decrease of 17% to 3% and 37% to 7%, respectively. After 2006, there was an increase in underweight of 53% and 76% for wasting (BMI/<em>A</em> ≤-2 Z), with the prevalence of stunting being stagnant at around 7%. Active search data in favelas and underserved communities show that the prevalence of stunting is 11% in those &lt;5 years. In 2021, 30% of the population lived in poverty, 73% of which were black or brown. Stunting in black and brown children &lt;5 years old is, respectively, 9% and 12% higher when compared to white children. Poverty decreased between 2012 and 2015 (27 to 25%), but increased again (2016=26% to 2021=30%), in parallel with food insecurity, which decreased between 2004 and 2013 (12% to 6%), but reached its worst level in the historical series (2022:15%).</p></div><div><h3>Conclusion</h3><p>Despite advances, Brazil's social protection system was not able to reduce inequalities and the reversal of the trend towards decreasing child undernutrition could be observed from 2006 onwards.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001353/pdfft?md5=df78b613a3b652f7ce9f26fac4602fb7&pid=1-s2.0-S0021755723001353-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72209390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effectiveness of different high-flow devices in neonatal care","authors":"Diogo Machado Kaminski ,&nbsp;Graziela Ferreira Biazus ,&nbsp;Rita C. Silveira ,&nbsp;Renato Soibelmann Procianoy","doi":"10.1016/j.jped.2023.10.006","DOIUrl":"10.1016/j.jped.2023.10.006","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the success rate of high-flow nasal cannula (HFNC) therapy using an adapted obsolete mechanical ventilator (MV), Optiflow™ and Vapotherm™ in newborns (NBs).</p></div><div><h3>Method</h3><p>This was a retrospective observational study conducted in the neonatal intensive care unit (NICU). The sample comprised NBs who underwent HFNC therapy due to ventilatory dysfunction, for weaning from non-invasive ventilation (NIV), or post-extubation. The three groups, stratified according to gestational age (GA) and birth weight, and corrected GA and weight at the beginning of HFNC use, were as follows: Optiflow ™, Vapotherm ™, and obsolete Mechanical Ventilator (MV) adapted for high flow therapy. Subsequently, the NBs were divided into a success group (SG) and a failure group (FG). HFNC success was defined as a therapy duration exceeding 72 h.</p></div><div><h3>Results</h3><p>A total of 209 NBs were evaluated, with 31.1 % using HFNC due to ventilatory dysfunction, 2.4 % after extubation, and 66.5 % after NIV weaning. HFNC success rate was observed in 90.9 % of the NBs, with no difference between equipment types (Vapotherm ™, Optiflow ™, and adapted VM).</p></div><div><h3>Conclusion</h3><p>Different types of HFNC equipment are equally effective when used in neonatology for respiratory dysfunction, as a method of weaning from NIV and post-extubation. Adapted obsolete MV can be an alternative for HFCN therapy in resource-constrained settings.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001407/pdfft?md5=53fc5246f227a11bde078f6b44c32705&pid=1-s2.0-S0021755723001407-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of dietary supplements by children and adolescents","authors":"Junaura Rocha Barretto ,&nbsp;Mara Alves da Cruz Gouveia ,&nbsp;Crésio Alves","doi":"10.1016/j.jped.2023.09.008","DOIUrl":"10.1016/j.jped.2023.09.008","url":null,"abstract":"<div><h3>Objectives</h3><p>Narrative review evaluating the use of dietary supplements by children and adolescents.</p></div><div><h3>Data source</h3><p>The terms “dietary supplements”, “children” and “adolescents” were used in combination in the PubMed, MEDLINE, and SciELO databases, between 2000 and 2023, evaluating studies in humans, published in Portuguese, English, French and Spanish.</p></div><div><h3>Data synthesis</h3><p>The use of dietary supplements by children and adolescents has increased in recent decades. The most commonly used supplements are vitamins, minerals, trace elements, proteins, amino acids, melatonin, fatty acids, probiotics and energy drinks.</p></div><div><h3>Conclusion</h3><p>Despite having specific indications, most of the time they are not prescribed by a healthcare professional. The reasons for use are varied. In children, the main reasons are protection against infections, stimulating growth, and poor food intake, with multivitamins and minerals being the most commonly used supplements. In adolescents, they are used to improve athletic performance and attain the “ideal body”, with proteins and amino acids being the most often used nutrients. As they are not regulated by health agencies and are sold without a prescription, their unsupervised use can lead to inadequate doses, with inefficiency or overdose risk. As for compounding formulations, or when available in preparations with multiple nutrients, the chance of errors increases. It is essential that pediatricians advise parents and patients about the indications, risks and benefits, prescribing them when necessary.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001237/pdfft?md5=f581ee8c0a1ad5a95bc3308b3b3c54ee&pid=1-s2.0-S0021755723001237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-life nutrition and adult-life outcomes","authors":"João Guilherme Bezerra Alves ,&nbsp;Lucas Victor Alves","doi":"10.1016/j.jped.2023.08.007","DOIUrl":"10.1016/j.jped.2023.08.007","url":null,"abstract":"<div><h3>Objectives</h3><p>To verify the association between early-life nutrition and chronic adult diseases.</p></div><div><h3>Data Sources</h3><p>Medline, Embase, Cochrane Database, and Lilacs.</p></div><div><h3>Summary of finds</h3><p>The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that a mismatch between early-life circumstances and later-life situations may have an impact on chronic diseases. In this review, the authors emphasize the research supporting the impact of early nutrition on the origins of adult height, obesity and metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and reproductive outcomes.</p></div><div><h3>Conclusion</h3><p>Even though this is a new topic and there are still many research questions to be answered, there is strong evidence that both deficiency and excess nutrition in early life can cause epigenetic changes that have effects that last a lifetime and contribute to the development of chronic diseases. Public health efforts to protect adults from getting chronic diseases should focus on nutrition in the first 1000 days of life, from conception to the end of the second year of life.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001079/pdfft?md5=2e0e93ab9245ecfc149e8639630baa6f&pid=1-s2.0-S0021755723001079-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of dysphagia in a population of infants born pre-term: characteristic risk factors in a tertiary NICU","authors":"Dwi Juliana Dewi ,&nbsp;Elvie Zulka Kautzia Rachmawati ,&nbsp;Luh Karunia Wahyuni ,&nbsp;Wei-Chung Hsu ,&nbsp;Susyana Tamin ,&nbsp;Rahmanofa Yunizaf ,&nbsp;Joedo Prihartono ,&nbsp;R. Adhi Teguh Permana Iskandar","doi":"10.1016/j.jped.2023.09.004","DOIUrl":"10.1016/j.jped.2023.09.004","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the prevalence and characteristics of dysphagia and suck-swallow-breath incoordination as phenotypes of oral feeding difficulties.</p></div><div><h3>Method</h3><p>A cross-sectional study with secondary data collected consecutively over 2 years from October 2020 to October 2022 to measure the prevalence of swallowing and oral feeding difficulty in preterm infants using Flexible endoscopic evaluation of swallowing examination at the tertiary Integrated Dysphagia Clinic.</p></div><div><h3>Results</h3><p>The prevalence of swallowing disorders was 25 % and the prevalence of suck-swallow-breath incoordination was 62.5 %. The significant risk factor that may show a possible correlation with oral feeding difficulty was mature post-menstrual age (<em>p</em> = 0.006) and longer length of stay (<em>p</em> = 0.004). The dominant percentage of upper airway abnormality and disorder were retropalatal collapse (40 %), laryngomalacia (42.5 %), paradoxical vocal cord movement (12.5 %), and gastroesophageal reflux disease (60 %). The dominant characteristic of oral motor examination and flexible endoscopic evaluation of swallowing examination was inadequate non-nutritive sucking (45 %), inadequate postural tone (35 %), and inadequate nutritive sucking (65 %).</p></div><div><h3>Conclusion</h3><p>Dysphagia in preterm infants is mostly observed in those with mature post-menstrual age, longer length of stay, and the presence of gastroesophageal reflux disease with inadequate non-nutritive sucking and nutritive sucking abilities. Suck-swallow-breath incoordination is primarily observed in those with immature post-menstrual age, a higher prevalence of cardiopulmonary comorbidity, and a higher prevalence of upper airway pathologies (laryngomalacia, paradoxical vocal cord movement) with inadequate nutritive sucking ability.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001183/pdfft?md5=ba5a018686b629b3625bc7d4c762af92&pid=1-s2.0-S0021755723001183-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parameters of pubertal growth spurt in children and adolescents living at high altitude in Peru","authors":"Lucila Sanchez-Macedo ,&nbsp;Rubén Vidal-Espinoza ,&nbsp;Juan Minango-Negrete ,&nbsp;Enio Vaz Ronque ,&nbsp;Luis Felipe Castelli Correia de Campos ,&nbsp;José Fuentes-López ,&nbsp;Eliseny Vargas-Ramos ,&nbsp;Margot Rivera-Portugal ,&nbsp;Marco Cossio-Bolaños ,&nbsp;Rossana Gomez-Campos","doi":"10.1016/j.jped.2023.08.010","DOIUrl":"10.1016/j.jped.2023.08.010","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim was to estimate the pubertal growth height of children and adolescents living in a high-altitude region of Peru using the Preece-Baines model 1 (1 PB).</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted in schoolchildren from the department of Puno (Peru) between 3841 and 3874 masl. The age range was between 4 and 17 years. Standing height was evaluated. 1 PB was used to infer the mathematical and biological parameters of stature.</p></div><div><h3>Results</h3><p>Mathematical parameters estimated by the 1 PB model reflected small residual standard error (RSE) values in both sexes (0.25 in boys and 0.27 in girls). In boys, the age at which peak velocity was reached (APHV) was estimated at 13.21 ± 0.33years. While in girls it was 9.96 ± 0.26years (<em>p</em> &lt; 0.05). In general, girls reached APHV (y) 3.25 years earlier than boys. On the other hand, the growth velocity of maximum height [APHV (cm/y)] of boys was higher (6.33 ± 6.06 cm/y) relative to girls (6.06 ± 0.32 cm/y). Estimated final adult height (EFAH) in boys was reached at 166.020 ± 0.99 cm and height at maximum growth velocity (HPHV) was 153.07 ± 0.67 cm, while in girls they were significantly lower (EFAH; 153.74 ± 0.44 cm and HPHV: 139.73 ± 0.84 cm).</p></div><div><h3>Conclusions</h3><p>This study showed that girls living in Puno at a high altitude in Peru reached APHV 3 years earlier than boys and at the same time reflected slower PHV. These results suggest that pubertal growth at high altitudes is slower in both sexes and especially in girls. Thus, modeling physical growth may be an important step in understanding the onset of puberty at different latitudes.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S002175572300133X/pdfft?md5=0e4c45b86071582e508809d6e3d9cc46&pid=1-s2.0-S002175572300133X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}