Jornal de pediatria最新文献

{"title":"Elimination diet in food allergy: friend or foe?","authors":"Elaine Cristina de Almeida Kotchetkoff ,&nbsp;Lucila Camargo Lopes de Oliveira ,&nbsp;Roseli Oselka Saccardo Sarni","doi":"10.1016/j.jped.2023.09.012","DOIUrl":"10.1016/j.jped.2023.09.012","url":null,"abstract":"<div><h3>Objectives</h3><p>To review and discuss the role of an elimination diet in food-allergic children, emphasizing nutritional aspects for a better practical approach.</p></div><div><h3>Sources</h3><p>Non-systematic review of the literature<strong>.</strong></p></div><div><h3>Findings</h3><p>Under an elimination diet, food-allergic patients may suffer from growth impairment or obesity and compromised quality of life. Disease phenotype, age, type, number of foods excluded, comorbidities, eating difficulties, economic status, and food availability must be considered for an appropriate diet prescription. Diet quality encompasses diversity and degree of food processing, which may alter immune regulation.</p></div><div><h3>Conclusions</h3><p>A friendly food elimination diet prescription depends on a multidisciplinary approach beyond macro and micronutrients<strong>.</strong></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/S0021755723001304/pdfft?md5=e4307239eb90dcb6de534bcf3f8fb262&pid=1-s2.0-S0021755723001304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423825","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":"Replacing screen time, with physical activity and sleep time: influence on cardiovascular indicators and inflammatory markers in Brazilian children","authors":"Luiza N. Reis ,&nbsp;Cezane P. Reuter ,&nbsp;Anthony Okely ,&nbsp;Caroline Brand ,&nbsp;Camila F. Fochesatto ,&nbsp;Clarice M.L. Martins ,&nbsp;Jorge Mota ,&nbsp;Adroaldo C.A. Gaya ,&nbsp;Anelise R. Gaya","doi":"10.1016/j.jped.2023.10.007","DOIUrl":"10.1016/j.jped.2023.10.007","url":null,"abstract":"<div><h3>Objective</h3><p>To examine if the substitution of different screen time intervals with light physical activity (LPA), moderate to vigorous physical activity (MVPA) and sleep is associated with cardiovascular indicators and inflammatory markers in children.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study developed with 186 children aged between six and 11 years old from public schools in southern Brazil. CRF was measured with the 6-minute running and walking test, following the Brazil Sports Project procedures. The percentage of fat was evaluated through DXA. LPA and MVPA were measured using accelerometers. Sleep and screen time were assessed by questionnaires answered by parents. Leptin and C-reactive protein were measured by fasting blood collection. Systolic and diastolic blood pressure were determined through a digital sphygmomanometer. Isotemporal substitution models were used for statistical analysis.</p></div><div><h3>Results</h3><p>Replacing 1 h of screen time with MVPA was associated with lower BMI, systolic and diastolic blood pressure, fat percentage, leptin, and C-reactive protein. When screen time was substituted for sleep time, lower waist circumference was observed. Regarding the substitution of 1 h of screen time with LPA, significant values were found only for leptin.</p></div><div><h3>Conclusion</h3><p>The replacement of screen time with physical activities of different intensities and sleep time was associated with benefits in cardiovascular indicators and inflammatory markers in childhood.</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/S0021755723001419/pdfft?md5=d49a4f977665d7224ed04ca1b65ea142&pid=1-s2.0-S0021755723001419-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477705","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":"Hepcidin and inflammation associated with iron deficiency in childhood obesity - A systematic review","authors":"Pedro Ferro Berton,&nbsp;Alessandra Gambero","doi":"10.1016/j.jped.2023.06.002","DOIUrl":"10.1016/j.jped.2023.06.002","url":null,"abstract":"<div><h3>Objectives</h3><p>This paper aims to review data on the association of obesity and iron deficiency in children and adolescents, exposing the possible involvement of hepcidin and interleukin-6 (IL-6), obesity's inflammation biomarkers.</p></div><div><h3>Data source</h3><p>Articles from PUBMED and WEB OF SCIENCE database with no chronological limit were reviewed to write this systematic review. Keywords such as children, obesity, iron deficiency, and hepcidin were used. After deleting duplicated and review articles, 91 were screened, and 39 were selected as eligible. Sixteen articles were included because they involved serum hepcidin levels in obese children and adolescents as outcomes.</p></div><div><h3>Summary of findings</h3><p>Finally, those 16 articles were organized in two tables: one includes therapeutic interventions, and the other does not. As hepcidin was discovered in 2000, the first articles that presented serum hepcidin's quantification in obese children and adolescents, homeostasis iron markers, and their possible association with obesity's inflammatory environment began to be published in 2008.</p></div><div><h3>Conclusions</h3><p>Obesity's chronic inflammation state leads to the production of IL-6, which acts as a signaling molecule for hepcidin synthesis, resulting in iron deficiency, which is common in obese children and adolescents who respond inadequately to iron supplementation. On the other hand, that population responds adequately to therapeutic intervention programs that lead to weight loss, guaranteeing iron homeostasis improvement. Therefore, perhaps it is time to discuss serum hepcidin level quantification as part of evaluating children and adolescents with iron deficiency, which could guide clinical choices that might lead to better therapeutic outcomes.</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/S0021755723000840/pdfft?md5=fb3e41bdef9f74d0fdd7c6579f1d3e51&pid=1-s2.0-S0021755723000840-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940063","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 neutropenic diet in the nutritional care of pediatric cancer patients with neutropenia: a scoping review","authors":"Ana Paula Carvalho Arnhold ,&nbsp;Hana Gabriela Severino Araújo ,&nbsp;Ana Facury Cruz ,&nbsp;Mayla Cardoso Fernandes Toffolo ,&nbsp;Silvia Fernandes Mauricio","doi":"10.1016/j.jped.2023.07.009","DOIUrl":"10.1016/j.jped.2023.07.009","url":null,"abstract":"<div><h3>Objective</h3><p>to carry out a scoping review with the purpose of mapping the scientific evidence on the use of the neutropenic diet in neutropenic pediatric cancer patients.</p></div><div><h3>Source of data</h3><p>The scoping review protocol was prepared in accordance with the PRISMA-ScR and the checklist before the literature search was performed. Articles on nutritional management in adults or on the treatment of other diseases, and articles that were not in Portuguese or English and published before the year 2000, were excluded. Data were extracted based on the Cochrane Consumer and Communication Review Group form.</p></div><div><h3>Summary of the findings</h3><p>Three hundred and forty scientific articles were identified, with the final sample of this review consisting of nine studies. Although the neutropenic diet has been part of the nutritional management of pediatric cancer patients for more than 20 years, there is still great variation in the criteria for indicating use and starting and discontinuing it, as well as in the nutritional composition of the diet. Furthermore, there is no consensus on the impact of using a neutropenic diet on different clinical and nutritional outcomes.</p></div><div><h3>Conclusion</h3><p>In the absence of guidelines that standardize the use of a neutropenic diet in pediatric patients with neutropenia, there are heterogeneous approaches reported in the literature, even within the same institution. The available literature presents an absence of evidence on the use, viability, and effectiveness of the neutropenic diet in oncological children with neutropenia. More studies are needed to identify the real impact of the neutropenic diet on clinical and nutritional outcomes.</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/S0021755723001092/pdfft?md5=f8d2df825eca41fc2191138213a9bbc0&pid=1-s2.0-S0021755723001092-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182640","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":"Food packaging and endocrine disruptors","authors":"Leila Cristina Pedroso de Paula ,&nbsp;Crésio Alves","doi":"10.1016/j.jped.2023.09.010","DOIUrl":"10.1016/j.jped.2023.09.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Narrative review evaluating food contamination by endocrine disruptors present in food packaging.</p></div><div><h3>Data source</h3><p>The terms “endocrine disruptors” and “food packaging” were used in combination in the PubMed, MEDLINE and SciELO databases, evaluating studies, in humans, published in Portuguese, English, French and Spanish between 1990 and 2023.</p></div><div><h3>Data synthesis</h3><p>Packaging, especially those made from plastic or recycled material, is an important source of food contamination by endocrine disruptors. Bisphenols and phthalates are the endocrine disruptors most frequently associated with food contamination from packaging. However, many unknown substances and even those legally authorized can cause harm to health when exposure is prolonged or when substances with additive effects are mixed. Furthermore, the discarding of packaging can cause contamination to continue into the environment.</p></div><div><h3>Conclusion</h3><p>Although packaging materials are essential for the transport and storage of food, many of them are associated with chemical contamination. As it is not possible to exclude them from our routine, it is important to develop research aimed at identifying the endocrine disruptors present in them, including the effects of chronic exposure; and that regulatory agencies and industry come together to reduce or prevent this risk. Additionally, consumers must be instructed on how to purchase products, handle them and prepare them to reduce the migration of chemical substances into food.</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/S0021755723001262/pdfft?md5=414bf9fe8a28a6fd7b367cf298e96d93&pid=1-s2.0-S0021755723001262-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423826","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":"Carbohydrate counting and insulin analogs to treat type 1 diabetes mellitus. How to improve metabolic control?","authors":"Amanda Maria Barradas Monteiro de Santana,&nbsp;Nathália Azevedo,&nbsp;Raphael Del Roio Liberatore Junior","doi":"10.1016/j.jped.2023.10.003","DOIUrl":"10.1016/j.jped.2023.10.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Clinical-laboratory comparison of a population of children and adolescents with DM1 followed at a Brazilian outpatient university clinic, at two different periods (2014 and 2020), regarding changes made both to the insulin therapy scheme and to the nutritional approach to carbohydrate counting.</p></div><div><h3>Methods</h3><p>The data of patients with DM1 aged 0–19 years enrolled in the service in 2014 and 2020 were collected. Student's <em>t</em>-test was performed to compare the means of HbA1c and the variables of interest.</p></div><div><h3>Results</h3><p>NPH + regular insulin was predominantly used in 2014 (49.1%), while in 2020, the predominance shifted to insulin analogs (48.4%). Pump use tripled from 1.3% in 2014 to 4.4% in 2020, and the percentage of patients performing carbohydrate counting reduced from 28.3% to 17.8%. Regarding HbA1c, the 2014 group of patients had a mean of 9.8%, while the 2020 group had a mean of 9.6% (<em>p</em> = 0.49).</p></div><div><h3>Conclusion</h3><p>The change in treatments between 2014 and 2020 did not result in a significant improvement in HbA1c levels. However, it was identified the importance of carbohydrate counting and the use of insulin analogs to improve metabolic control in this population at both times.</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/S0021755723001328/pdfft?md5=bb3ccceffb7439185973cf1ae27e89ad&pid=1-s2.0-S0021755723001328-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014328","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":"Death, dying and palliative care in the NICU","authors":"A.A. Eduard Verhagen","doi":"10.1016/j.jped.2023.11.003","DOIUrl":"10.1016/j.jped.2023.11.003","url":null,"abstract":"","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/S0021755723001390/pdfft?md5=e60e50fb7053ef3f6fe667f1aa0aa583&pid=1-s2.0-S0021755723001390-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440642","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":"Correlation between nasal anatomical characteristics in newborns and short binasal prong dimensions","authors":"Débora F.C. Ribeiro ,&nbsp;Adriane M. Nakato ,&nbsp;Paula K. Hembecker ,&nbsp;Beatriz L. Fernandes ,&nbsp;Percy Nohama","doi":"10.1016/j.jped.2023.09.007","DOIUrl":"10.1016/j.jped.2023.09.007","url":null,"abstract":"<div><h3>Objective</h3><p>To correlate the nasal anatomical characteristics of newborns with the dimensions of short binasal prongs.</p></div><div><h3>Method</h3><p>Observational, cross-sectional study carried out in two hospitals in southern Brazil. The authors evaluated 1620 newborns with neonatal data and nasal dimensions. To measure the dimensions of the nasal region, the authors considered the width of the medial columella, the right nostril diameter, and the left nostril diameter. These data were correlated with the dimensions of two models of short binasal prongs.</p></div><div><h3>Results</h3><p>Of the total newborns evaluated, 807 were female (49.8%), and 813 were male (50.2%). The majority were white (96.2%). The mean gestational age was 37.4 ± 2.9 weeks, ranging from 22 to 42 weeks. The birth weight was 2946.8 ± 699.3 g, ranging from 490.0 to 4740.0 g. Most of the nasal measures were significantly larger than both prong model measurements.</p></div><div><h3>Conclusion</h3><p>The sizes of short binasal prongs available on the Brazilian market do not match the nasal anatomical characteristics of newborns.</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/S0021755723001249/pdfft?md5=008a63c458d0f01db021270665da989b&pid=1-s2.0-S0021755723001249-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160943","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":"Translation, cross-cultural adaptation and validation of the Short Screening Instrument for Psychological Problems in Enuresis for use in Brazil (SSIPPE-Br)","authors":"Gláucia Cristina Medeiros Dias ,&nbsp;Mônica Maria de Almeida Vasconcelos ,&nbsp;José Murillo Bastos Netto ,&nbsp;Débora Marques de Miranda ,&nbsp;Eleonora Moreira Lima ,&nbsp;Ana Cristina Simões e Silva ,&nbsp;Janaina Matos Moreira ,&nbsp;Flávia Cristina de Carvalho Mrad","doi":"10.1016/j.jped.2023.11.001","DOIUrl":"10.1016/j.jped.2023.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br).</p></div><div><h3>Methods</h3><p>Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used.</p></div><div><h3>Results</h3><p>Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test &lt; 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value &lt; 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains.</p></div><div><h3>Conclusion</h3><p>The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.</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/S0021755723001365/pdfft?md5=f5e1e376447d506218e47fb4e317736a&pid=1-s2.0-S0021755723001365-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444782","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":"Hidden hunger – a narrative review","authors":"Virgínia Resende Silva Weffort ,&nbsp;Joel Alves Lamounier","doi":"10.1016/j.jped.2023.08.009","DOIUrl":"10.1016/j.jped.2023.08.009","url":null,"abstract":"<div><h3>Objective</h3><p>Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil.</p></div><div><h3>Data source</h3><p>Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023.</p></div><div><h3>Data synthesis</h3><p>The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic.</p></div><div><h3>Conclusion</h3><p>Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.</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/S0021755723001286/pdfft?md5=688b88883daebd090ea8766de4b8218a&pid=1-s2.0-S0021755723001286-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423827","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}