Microcephaly in South Brazil: Are cases of Congenital Zika Syndrome increasing in recent years?

Northeast Brazil was the first region to detect a significant increase in babies born with microcephaly associated with prenatal zika virus infection in 2015. Rio Grande do Sul (RS) state was less impacted due to the temperate climate preventing the spread of the vector. This study investigated the prevalence and etiology of congenital microcephaly in RS in two different periods. This cross-sectional descriptive study included all live births with congenital microcephaly in RS from 2015 to 2022. Cases were divided into two groups: P1 "outbreak" (2015-16); and P2 "endemic" (2017-22). There were 58 cases of microcephaly (3.8/10,000) in P1 and 148 (1.97/10,000) in P2. Congenital Zika Virus infection was the etiology in 5.2% (n=3) in P1 and 6.7% (n=10) in P2. In conclusion, although the ZIKV outbreak in Brazil has receded, RS remains an area of concern, with a possible slight increase of live births with microcephaly secondary to ZIKV prenatal infection relative to the number of cases due to congenital infections. The broader distribution of the vector Aedes aegypti with warmer temperatures in our state might be linked to the increase in recent years. This study can be an alert to other regions of temperate or subtropical climates.

Mother-to-Child HIV Transmission among Pregnant Women in a City with the Highest Rates of HIV in Brazil.

OBJECTIVE: Most of the HIV pediatric infections are acquired through mother-to-child transmission (MTCT). Porto Alegre is a state capital of Brazil that had a HIV MTCT rate of 4.1% in 2013 and the highest rate of HIV-infected pregnant women in the country during 2018. Zidovudine and nevirapine have been used in Brazil for high-risk newborns since 2012. The aim of the study was to investigate HIV MTCT rate and the factors associated with HIV transmission at a hospital that is a reference center for HIV-infected mothers in Porto Alegre, after the introduction of this policy. STUDY DESIGN: This retrospective cohort study included all HIV-exposed infants born between February 2013 and December 2016 at the Hospital de Clínicas de Porto Alegre. Student's t-test or Fisher's exact test was used to compare variables between HIV-infected and uninfected groups of newborns. Poisson's regression with robust variance was used to determine the factors associated with HIV MTCT. RESULTS: A total of 375 newborns were exposed to HIV, with an outpatient loss of 14.4% (n = 54). The HIV MTCT rate was 2.18% (n = 7), with four infected during the intrauterine period. The risk factors for MTCT were no prenatal care (relative risk [RR] = 9.4; 95% confidence interval [CI]: 2.0-44.3), late maternal HIV diagnosis in the peripartum period (RR = 16.3; 95% CI: 3.6-73.0), syphilis infection during pregnancy (RR = 9.3; 95% CI: 2.1-40.3), maternal viral load >1,000 copies/mL in the third trimester or peripartum period (RR = 9.5; 95% CI: 1.7-50.5), and lack of or inappropriate antiretroviral therapy during pregnancy (RR = 8.2; 95% CI: 1.6-41.4). CONCLUSION: MTCT rate was 2.18%. With the institution of two-drug prophylaxis for high-risk newborns, persistent cases HIV MTCT were predominantly found among women with absence of antenatal care, late HIV diagnosis, syphilis coinfection, high viral load, and inadequate ARV therapy during pregnancy. Although zidovudine and nevirapine were administered postnatally to high-risk newborns, this regimen could not prevent transplacental transmission. KEY POINTS: · Most of the HIV pediatric infections are acquired through mother-to-child transmission.. · The study investigated HIV MTCT rate and the factors associated with HIV transmission in Brazil.. · HIV MTCT rate was 2.18% and most of them were infected during the intrauterine period..

The Impact of Maternal Syphilis and Associated Factors on HIV Vertical Transmission.

Maternal syphilis may increase HIV vertical transmission or it may be a marker of other risk factors. In a Brazilian historical series, HIV vertical transmission risk was higher in newborns exposed to maternal syphilis-HIV co-infection than in newborns exposed to maternal HIV infection alone. Maternal syphilis was a risk factor for HIV vertical transmission independent of education and prenatal visits but not independent of maternal elevated HIV viral loads or inadequate maternal antiretroviral treatment.

Neurological evaluation of microcephalic children with Zika syndrome and congenital cytomegalovirus infection.

Introduction: The association between the virus prenatal infection by Zika virus (ZIKV) and central nervous system disorders has been well established and it has been described as the Congenital Syndrome Associated to the Zika Virus (CSZ). However, the neurological development in those patients is still an object of study. The main differential diagnosis is the Cytomegalovirus (CMV). Objective: Describe the involvement of microcephalic patients affected by the congenital infection by the Zika Virus or CMV. Methodology: Data has been collected from microcephalic patients whose birth took place after 2016 and which also had the congenital infection confirmed or presumed. The researched data consists in: congenital infection, head circumference from birth, presence of epilepsy, treatment by mono or polytherapy, electroencephalographic patterns, neurological physical examination and evaluation of gross motor development. Results: 21 microcephalic children have been included showing the following congenital infectious syndromes: 9 were affected by cytomegalovirus (43%), 6 by the Zika virus (29%) and 6 ones by presumed infection due to the Zika virus (29%). From those ones, 13 (62%) presented epilepsy diagnosis including generalized crises and 9 (69%) were in current use of polytherapy. All of them also showed disorganized and asymmetrical base rhythms. Concerning the epileptiform activity, 5 presented multifocal activity and 3 ones hypsarrhythmia. All of the patients went under neuroimaging: 12 (57%) of them presented calcifications and 5 (24%) hydrocephalus. On the neurological exam, 17% presented a decreased axial tone and an enlarged appendicular. Smaller head circumference children had greater motor impairment and severity in the epilepsy. There was no difference in the frequency of epilepsy between children with CSZ and CMV. Conclusion: Epilepsy is confirmed as one of the most important complications of congenital infections by CSZ and CMV.

Prevalence and causes of congenital microcephaly in the absence of a Zika virus outbreak in southern Brazil.

OBJECTIVE: The aim of this study was to identify the causes of congenital microcephaly in Rio Grande do Sul, a state in southern Brazil, where no ZIKV outbreak was detected, from December 2015 to December 2016, which was the period when ZIKV infection was at its peak in northeast Brazil. METHODS: This was a cross-sectional study where all notifications of congenital microcephaly in the state of Rio Grande do Sul were included for analysis. Evaluation of cases followed the guidelines of the Brazilian Ministry of Health. Dysmorphological and neurological evaluations were performed by a specialized team, and genetic tests and neuroimaging were performed when clinically indicated. STORCH infections were diagnosed using standard tests. ZIKV infection was diagnosed through maternal serum RT-PCR and/or neuroimaging associated with clinical/epidemiological criteria. RESULTS: From 153744 registered live births in the study period, 148 cases were notified, but 90 (60.8%) of those were later excluded as "non-confirmed" microcephaly. In the 58 confirmed cases of microcephaly (prevalence = 3.8/10000 live births), congenital infections (syphilis, toxoplasmosis, cytomegalovirus, and ZIKV) constituted the predominant etiology (50.0%), followed by isolated CNS (15.5%), and genetic syndromes (10.3%). Congenital ZIKV syndrome (CZS) with typical phenotype was diagnosed in three cases (5.2% of all confirmed microcephaly cases or 10.4% of all congenital infections). CONCLUSION: In Rio Grande do Sul, where no outbreak of ZIKV infection was recorded, congenital infections were the leading cause of congenital microcephaly, and the attributable risk for CZS in the etiology of microcephaly was 5.2%.

Growth rate of lung function in healthy preterm infants.

RATIONALE: It remains unclear whether premature birth, in the absence of neonatal respiratory disease, results in abnormal growth and development of the lung. We previously reported that a group of healthy infants born at 32-34 weeks' gestation and without respiratory complications had decreased forced expiratory flows and normal forced vital capacities at 2 months of age. OBJECTIVES: Our current study evaluated whether these healthy infants born prematurely exhibited improvement or "catch-up" in their lung function during the second year of life. METHODS: Longitudinal measurements of forced expiratory flows by the raised volume rapid thoracic compression technique were obtained in the first and the second years of life for infants born prematurely at 32.7 (range, 30-34) weeks' gestation (n = 26) and infants born at full term (n = 24). MEASUREMENTS AND MAIN RESULTS: Healthy infants born prematurely demonstrate decreased forced expiratory flows and normal forced vital capacities in the first and second years of life. In addition, the increases in lung function with growth were similar to full-term infants. CONCLUSIONS: Persistently reduced flows in the presence of normal forced vital capacity and the absence of catch-up growth in airway function suggest that premature birth is associated with altered lung development.

Incidence of Symptomatic Congenital Toxoplasmosis During Ten Years in a Brazilian Hospital.

BACKGROUND: Population seroprevalence and rates of mother-to-child transmission are important in determining the incidence of congenital toxoplasmosis. (CT) Mother-to-child transmission depends on the timing of acute maternal infection and treatment during pregnancy. The incidence of CT varies widely across geographic regions, ranging from 1 to 10 cases per 10,000 live births. The incidence of symptomatic disease varies from 0.15 to 0.34 cases per 10,000. METHODS: This is a review of patients treated at a pediatric CT clinic at a university hospital in the south of Brazil, from 2004 to 2014. RESULTS: The annual incidence of CT varied from 0 to 14 cases per 10,000 live births, with a mean incidence of 6 cases per 10,000 during the 10 years studied (CI 95%: 3.02-8.91). The incidence of symptomatic CT varied from 0 to 9 cases per 10,000 live births, with a mean incidence of 5 per 10,000 (CI 95%: 2.44-6.94). There were 5 (14.3%) asymptomatic cases. The main findings were retinochoroiditis (54%), intracranial calcifications (37.5%) and altered cerebrospinal fluid (37.5%). CONCLUSIONS: The incidence of CT and the rate of symptomatic cases were in accordance with the previous data from other studies in Brazil, being significantly higher than in previous North American and European studies.

[Pulmonary prognosis in preterm infants]. / Prognóstico pulmonar em prematuros.

OBJECTIVE: The increased survival of preterm infants poses the challenge of dealing with a wide range of chronic pulmonary diseases, including bronchopulmonary dysplasia, Wilson-Mikity syndrome and recurrent wheezing. This article reviews the pulmonary clinical and functional prognosis of preterm newborns in infancy and adolescence. SOURCE OF DATA: MEDLINE search for articles published between 1970 and 2004 that focused on lung growth and function of preterm infants, besides a clinical follow-up of this group. SUMMARY OF THE FINDINGS: Prenatal and postnatal events, such as placental insufficiency, tobacco exposure, infections, oxygen and mechanical ventilation, have an important effect on lung development and can lead to chronic lung diseases, of which bronchopulmonary dysplasia is the most severe complication. However, significant loss of lung function occurs in preterm infants who do not fulfill the criteria for bronchopulmonary dysplasia, and even in those who did not have significant respiratory disease during the neonatal period. The impact of prematurity on the respiratory system of these patients is usually underestimated. Clinically, preterm infants have an increased incidence of pneumonia and bronchiolitis, hospital readmissions due to respiratory diseases, chronic cough and wheezing and bronchial hyperresponsiveness. In adolescence, there is a tendency for normalization of the lung function, but they persist with reduced flows, lower exercise tolerance and bronchial hyperresponsiveness. CONCLUSIONS: Prematurity, the events that cause it and the interventions that follow it permanently change the development of the respiratory system. Studies are necessary to clarify the effect of each of these perinatal insults on the development of the respiratory system.

O comportamento alimentar aos 30 dias de vida está associado à adequação do peso ao nascimento? / Is eating behavior at 30 days of age associated with adequate birth weight?

Introdução: O objetivo principal é avaliar o comportamento alimentar de recémnascidos (RN) pequenos (PIG) e grandes (GIG) para a idade gestacional através de questionário específico e comparar com RN adequados para a idade gestacional (AIG) com 1 mês de vida. Métodos: É um estudo de coorte, cuja primeira fase consistiu na realização de uma entrevista com mães que tiveram seus filhos a termo no Hospital de Clínicas de Porto Alegre. Dados perinatais foram coletados de prontuários eletrônicos. Na segunda fase do estudo, após 1 mês do nascimento, foi aplicado o Questionário sobre Comportamento Alimentar do Bebê (Baby Eating Behaviour Questionnaire, BEBQ) através de contato telefônico. Resultados: Foram avaliados 126 RN (43 AIG, 43 PIG e 41 GIG). Foi observada uma maior escolaridade em mães de RN PIG (p=0,004) e uma menor prevalência de aleitamento materno exclusivo até a alta hospitalar em RN GIG (p=0,002). A análise de variância não encontrou diferença significativa entre os grupos em relação aos domínios do BEBQ, mesmo quando corrigidos por sexo do RN. Conclusão: O estudo demonstrou que alterações do comportamento alimentar ainda não estão presentes com 1 mês de vida, sugerindo que não são inatas, e sim desenvolvidas com o passar do tempo. O estudo está limitado a avaliações de crescimento baseadas em registros de terceiros. (AU)

Introduction: The main purpose of this paper was to evaluate the feeding behavior of infants born small and large for gestational age (SGA and LGA, respectively) using a specific questionnaire and to compare them with infants born adequate for gestational age (AGA) at 1 month of age. Methods: The first phase of this cohort study consisted of an interview with mothers whose babies were born at term at Hospital de Clínicas de Porto Alegre. Perinatal data were collected from electronic medical records. In the second phase of the study, at 1 month of birth, the Baby Eating Behaviour Questionnaire (BEBQ) was administered through telephone interview. Results: A total of 126 infants (43 AGA, 43 SGA and 41 LGA) with a mean gestational age of 39.4 weeks were assessed. A higher level of education was observed in mothers of SGA infants (p = 0.004) and a lower prevalence of exclusive breastfeeding in the LGA group (p = 0.002). The analysis of variance found no significant difference between the groups in any of the BEBQ domains, even when corrected for sex of the baby. Conclusions: This study demonstrated that changes in feeding behavior are not yet present at 1 month of age, suggesting that they are not innate, but rather developed over time. The study is limited to growth assessments based on third-party records. (AU)

Epidemiological profile of 39 cases of microcephaly caused by congenital infections diagnosed in the state of Rio Grande do Sul between 2015-2017

Introduction: Microcephaly is a clinical finding that can arise from congenital anomalies or emerge after childbirth. Maternal infections acquired during pregnancy can result in characteristic brain damage in the newborn (NB), which may be visible even in the fetal stage. To describe the epidemiological profile of newborns with reported microcephaly and diagnosed with congenital infections in the state of Rio Grande do Sul between 2015 and 2017. Methods: A cross-sectional study was carried out on data collected from the Public Health Event Registry as well as from medical records. The investigation included serologies for toxoplasmosis and rubella; polymerase chain reaction (PCR) for Zika virus (ZIKV) in the blood and cytomegalovirus in the urine; non-treponemal tests for syphilis; and brain imaging tests. Results: Of the 257 reported cases of microcephaly, 39 were diagnosed with congenital infections. Severe microcephaly was identified in 13 patients (33.3%) and 51.3% of the cases showed alterations in brain imaging tests. In relation to the diagnosis of congenital infections, three patients (7.7%) were diagnosed with ZIKV, nine (23.1%) with cytomegalovirus, nine (23.1%) with toxoplasmosis, and 18 (46.1%) with congenital syphilis. The three cases of ZIKV showed calcification in brain imaging tests, signs of arthrogryposis, excess occipital skin and irritability, characterizing the typical phenotype of ZIKV infection. Conclusions: Most cases of congenital infection had severe neurological lesions, particularly the cases of ZIKV, which can cause neurodevelopmental delays and sequelae in these infants throughout early childhood.

Prevalence and causes of congenital microcephaly in the absence of a Zika virus outbreak in southern Brazil / Prevalência e causas da microcefalia congênita sem a presença do surto do vírus Zika no Sul do Brasil

Abstract Objective: The aim of this study was to identify the causes of congenital microcephaly in Rio Grande do Sul, a state in southern Brazil, where no ZIKV outbreak was detected, from December 2015 to December 2016, which was the period when ZIKV infection was at its peak in northeast Brazil. Methods: This was a cross-sectional study where all notifications of congenital microcephaly in the state of Rio Grande do Sul were included for analysis. Evaluation of cases followed the guidelines of the Brazilian Ministry of Health. Dysmorphological and neurological evaluations were performed by a specialized team, and genetic tests and neuroimaging were performed when clinically indicated. STORCH infections were diagnosed using standard tests. ZIKV infection was diagnosed through maternal serum RT-PCR and/or neuroimaging associated with clinical/epidemiological criteria. Results: From 153 744 registered live births in the study period, 148 cases were notified, but 90 (60.8%) of those were later excluded as "non-confirmed" microcephaly. In the 58 confirmed cases of microcephaly (prevalence = 3.8/10 000 live births), congenital infections (syphilis, toxoplasmosis, cytomegalovirus, and ZIKV) constituted the predominant etiology (50.0%), followed by isolated CNS (15.5%), and genetic syndromes (10.3%). Congenital ZIKV syndrome (CZS) with typical phenotype was diagnosed in three cases (5.2% of all confirmed microcephaly cases or 10.4% of all congenital infections). Conclusion: In Rio Grande do Sul, where no outbreak of ZIKV infection was recorded, congenital infections were the leading cause of congenital microcephaly, and the attributable risk for CZS in the etiology of microcephaly was 5.2%.

Resumo: Objetivo: Identificar as causas da microcefalia congênita no Rio Grande do Sul, Região Sul do Brasil, onde não foi detectado surto de ZIKV, de dezembro de 2015 a dezembro de 2016. Esse foi o período em que a infecção por ZIKV estava em seu auge no Nordeste do Brasil. Métodos: Este é um estudo transversal no qual todas as notificações de microcefalia congênita no estado do Rio Grande do Sul foram incluídas para análise. A avaliação dos casos seguiu as orientações do Ministério da Saúde. A avaliação dismorfológica e neurológica foi feita por uma equipe especializada e os testes genéticos e as neuroimagens foram feitos quando indicado clinicamente. As infecções STORCH (Sífilis, Toxoplasmose, Rubéola, Citomegalovírus e Herpes simples) foram diagnosticadas utilizando testes padrão. A infecção por ZIKV foi diagnosticada por meio da transcriptase reversa seguida de reação em cadeia da polimerase (RT-PCR) no soro materno e/ou neuroimagem associada a critérios clínicos/epidemiológicos. Resultados: De 153.744 nascidos vivos registrados no período do estudo, 148 bebês foram casos notificados, porém 90 (60,8%) casos foram excluídos posteriormente como microcefalia "não confirmada". Nos 58 casos confirmados de microcefalia (prevalência = 3,8/10.000 nascidos vivos), as infecções congênitas (sífilis, toxoplasmose, citomegalovírus e ZIKV) constituíram a etiologia predominante (50,0%), seguidas de doenças ligadas ao SNC isolado (15,5%) e síndromes genéticas (10,3%). A síndrome congênita do ZIKV (SCZ) com fenótipo típico foi diagnosticada em três casos (5,2% de todos os casos confirmados de microcefalia ou 10,4% de todas as infecções congênitas). Conclusão: No Rio Grande do Sul, Brasil, onde não foi registrado surto de infecção por ZIKV, a principal causa de microcefalia congênita foram infecções congênitas e o risco atribuível para SCZ na etiologia de microcefalia foi de 5,2%.

Chorioamnionitis and subsequent lung function in preterm infants.

OBJECTIVE: To explore the relationship between prematurity, gender and chorioamnionitis as determinants of early life lung function in premature infants. METHODS: Placenta and membranes were collected from preterm deliveries (<37 weeks gestational age) and evaluated for histological chorioamnionitis (HCA). Patients were followed and lung function was performed in the first year of life by Raised Volume-Rapid Thoracic Compression Technique. RESULTS: Ninety-five infants (43 males) born prematurely (median gestational age 34.2 weeks) were recruited. HCA was detected in 66 (69%) of the placentas, and of these 55(58%) were scored HCA Grade 1, and 11(12%) HCA Grade 2. Infants exposed to HCA Grade 1 and Grade 2, when compared to those not exposed, presented significantly lower gestational ages, higher prevalence of RDS, clinical early-onset sepsis, and the use of supplemental oxygen more than 28 days. Infants exposed to HCA also had significantly lower maximal flows. There was a significant negative trend for z-scores of lung function in relation to levels of HCA; infants had lower maximal expiratory flows with increasing level of HCA. (p = 0.012 for FEF50, p = 0.014 for FEF25-75 and p = 0.32 for FEV0.5). Two-way ANOVA adjusted for length and gestational age indicated a significant interaction between sex and HCA in determining expiratory flows (p<0.01 for FEF50, FEF25-75 and p<0.05 for FEV0.5). Post-hoc comparisons revealed that female preterm infants exposed to HCA Grade 1 and Grade 2 had significant lower lung function than those not exposed, and this effect was not observed among males. CONCLUSIONS: Our findings show a sex-specific negative effect of prenatal inflammation on lung function of female preterm infants. This study confirms and expands knowledge upon the known association between chorioamnionitis and early life chronic lung disease.

Reduced lung function in healthy preterm infants in the first months of life.

RATIONALE: Preterm delivery has been associated with a higher incidence of respiratory morbidity even in infants that do not have significant respiratory disease during the neonatal period. Reduced flows have been reported in children and adolescents born prematurely. OBJECTIVE: The aim of this study was to assess lung function in healthy preterm infants in the first months of life. METHODS: Preterm infants with less than 48 h of supplemental oxygen were recruited. Lung function was assessed by the raised-volume rapid thoracic compression in the first months of life. The control group consisted of full-term infants without a history of respiratory diseases. MEASUREMENTS AND MAIN RESULTS: Sixty-two preterm (29 male) and 27 full-term (10 male) infants were tested. Adjusting for length, age, and sex, we found a mean significant reduction of 92 ml/s (22%) in FEF(50), 73 ml/s (21%) in FEF(25-75), and 19 ml (28%) in FEV(0.5) in the preterm group. These differences in expiratory flows remained significant using another model that adjusts for lung volume (p < 0.01 for FEF(50), FEF(25-75), and FEV(0.5), and p < 0.05 for FEF(75)). In the preterm group, after adjusting for length, male sex, lower gestational age, and increased weight were significantly and independently associated with reduced flows. CONCLUSIONS: Our findings confirm that prematurity is independently associated with reduced lung function and that this is detectable in the first months of life. Male sex, lower gestational age, and weight are important predictors for reduced expiratory flows in this group.

Prognóstico pulmonar em prematuros / Pulmonary prognosis in preterm infants

OBJETIVO: O aumento da sobrevida de prematuros traz o desafio de lidar com um amplo espectro de doenças pulmonares crônicas, incluindo displasia broncopulmonar, síndrome de Wilson-Mikity e sibilância recorrente. Este artigo discute o prognóstico pulmonar clínico e funcional de prematuros na infância e na adolescência. FONTE DE DADOS: Foi realizada pesquisa no MEDLINE de publicações entre 1970 e 2004 que abordassem função e crescimento pulmonar de prematuros, bem como a evolução clínica dos mesmos. SíNTESE DOS DADOS: Eventos pré e pós-natais como insuficiência placentária, tabagismo, infecções, oxigênio e ventilação mecânica exercem efeitos importantes no desenvolvimento pulmonar, podendo conduzir a doenças pulmonares crônicas, sendo a displasia broncopulmonar a complicação clínica mais severa. No entanto, perdas significativas de função pulmonar também podem ocorrer em prematuros sem critérios de displasia broncopulmonar e que não apresentaram doença respiratória neonatal significativa. Nestes pacientes, o impacto da prematuridade sobre o sistema respiratório é freqüentemente subestimado. Clinicamente, observa-se incidência aumentada de pneumonias e bronquiolites, re-hospitalizações por doenças respiratórias, tosse e sibilância crônicas e hiper-reatividade brônquica. Posteriormente, percebe-se uma tendência à normalização da função pulmonar, mas persistem fluxos reduzidos, menor tolerância a exercícios e hiper-reatividade brônquica. CONCLUSÕES: A prematuridade, os eventos que a provocam e as intervenções que dela decorrem alteram de maneira permanente, em maior ou menor grau, o desenvolvimento do sistema respiratório. São necessários estudos adicionais para esclarecer o efeito de cada um desses insultos perinatais no desenvolvimento do sistema respiratório.

Cuidados com o recém-nascido normal / Care of the normal newborn

O nascimento, por ser um momento de transição, é cercado por uma série de cuidados dirigidos ao preparo de um ambiente favorável ao recém-nascido(RN). Acompanhar o comportamento do feto logo antes do nascimento, o comportamento do RN logo após o parto e o seguimento dos primeiros minutos de vida até a alta hospitalar constituem uma estratégia simples, adequada e eficaz na avaliação da trajetória do bebê na sua adaptação à vida extra-uterina. Neste módulo de ensino serão abordados os cuidados com o RN normal em vários aspectos, desde o período anteparto imediato até a alta hospitalar

Estudo de habitos alimentares em uma amostra de estudantes secundaristas de Porto Alegre / Food intake habits in a sample of Porto Alegre high schools students

O padräo alimentar adotado pelos adolescentes e de extrema importância, principalmente quando associado a seu crescimento e desenvolvimento. Com o objetivo de avaliar hábitos alimentares de adolescentes entre 14 e 18 anos em duas escolas secundaristas de classe media-alta de Porto Alegre, foi aplicado um questionário a 675 alunos, com questöes referentes a frequência de lanches e de refeiçöes nos principais horários de alimentaçäo (café da manha, almoço e jantar). Também foram avaliados o julgamento dos alunos quanto a qualidade do que ingerem e quanto a frequência com que se alimentam. Observou-se uma omissäo significativa de café da manha: 26 por cento tomavam café 2 ou menos vezes por semana. Sessenta e cinco por cento consideraram sua alimentaçäo boa ou muito boa, principalmente entre o sexo masculino...