Prevalence of iron-deficiency anaemia in Brazilian children under 5 years of age: a systematic review and meta-analysis.

Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.

Author Correction: Changes in Infant and Neonatal Mortality and Associated Factors in Eight Cohorts from Three Brazilian Cities.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Changes in Infant and Neonatal Mortality and Associated Factors in Eight Cohorts from Three Brazilian Cities.

Stillbirth (SBR), perinatal (PMR), neonatal (NMR) and infant mortality rates (IMR) are declining in Brazil and the factors associated with these falls are still being investigated. The objective of the present study was to assess changes in SBR, PMR, NMR and IMR over time and to determine the factors associated with changes in NMR and IMR in eight Brazilian cohorts. All cohorts are population-based (Ribeirão Preto in 1978/79, 1994 and 2010; Pelotas in 1982, 1993 and 2004; and São Luís in 1997/98 and 2010). Were included data on 41440 children. All indicators were decreased, except in the city of Pelotas, from 1993 to 2004, and except SBR in São Luís. Sociodemographic variables seem to be able to explain reductions of NMR and IMR in Ribeirão Preto, from 1978/79 to 1994, and in São Luís. In Ribeirão Preto, from 1994 to 2010 declines in NMR and IMR seem to be explained by reductions in intrauterine growth restriction (IUGR). Newborn's gestational age had diminished in all cohorts, preventing even greater reductions of NMR and IMR. Improved sociodemographic variables and reduction of IUGR, seem to be able to explain part of the decrease observed. NMR and IMR could have been reduced even more, were it not for the worsening in gestational age distribution.

The dietary inflammatory index and insulin resistance or metabolic syndrome in young adults.

OBJECTIVE: The aim of this study was to assess the association between the inflammatory potential of diet, as measured by the dietary inflammatory index (DII) and insulin resistance (IR) or metabolic syndrome (MetS). METHODS: A cross-sectional study (nested within a cohort) was conducted on 2017 adults 23 to 25 y of age in Ribeirão Preto, Brazil. Food consumption was assessed using a validated food frequency questionnaire. DII scores were calculated from 35 available food parameters. IR was determined from the classification of homeostatic model assessment (HOMA) values (≥2.7 uU mL-1). MetS was diagnosed based on the Joint Interim Statement (JIS) criterion. The association of DII score with IR or MetS was determined by Poisson regression analysis. The variables included in the multivariable model were selected from directed acyclic graphs. RESULTS: The diet of the young adults studied showed a high inflammatory potential, with a mean DII score of +1.10 (range: -4.69 to +5.28). The prevalence of MetS was 12.2% and IR 12.3%; both were higher in men than in women. The correlation between DII and HOMA-IR values was -0.038 (P = 0.09). The DII was not associated with IR or MetS in either sex. CONCLUSION: Although the association between DII and the outcomes was not detected in this sample, the study demonstrated that the diets of these young adult Brazilians had a high inflammatory potential when compared with other studies. Future studies, preferably using longitudinal designs, are recommended.

Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010.

OBJECTIVES: To estimate the baseline prevalence and risk factors for microcephaly at birth before the Zika virus epidemic in 2 Brazilian cities. METHODS: We used population-based data from the Brazilian Ribeirão Preto (RP) and São Luís (SL) birth cohort studies of 2010 that included hospital deliveries by resident mothers. The final sample was 7376 live births in RP and 4220 in SL. Gestational age was based on the date of the mother's last normal menstrual period or obstetric ultrasonography, if available. Microcephaly at birth was classified according to the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century and the Brazilian Ministry of Health. Risk factors for microcephaly, proportionate and disproportionate microcephaly, and severe microcephaly were estimated in a hierarchized logistic regression model. RESULTS: According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (>2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (>3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of ∼90%. CONCLUSIONS: The prevalence of severe microcephaly was much higher than expected in both cities. Our findings suggest that microcephaly was endemic in both municipalities before the circulation of the Zika virus.

Phonological working memory and reading in students with dyslexia.

PURPOSE: To investigate parameters related to fluency, reading comprehension and phonological processing (operational and short-term memory) and identify potential correlation between the variables in Dyslexia and in the absence of reading difficulties. METHOD: One hundred and fifteen students from the third to eighth grade of elementary school were grouped into a Control Group (CG) and Group with Dyslexia (GDys). Reading of words, pseudowords and text (decoding); listening and reading comprehension; phonological short-term and working memory (repetition of pseudowords and Digit Span) were evaluated. RESULTS: The comparison of the groups showed significant differences in decoding, phonological short-term memory (repetition of pseudowords) and answers to text-connecting questions (TC) on reading comprehension, with the worst performances identified for GDys. In this group there were negative correlations between pseudowords repetition and TC answers and total score, both on listening comprehension. No correlations were found between operational and short-term memory (Digit Span) and parameters of fluency and reading comprehension in dyslexia. For the sample without complaint, there were positive correlations between some parameters of reading fluency and repetition of pseudowords and also between answering literal questions in listening comprehension and repetition of digits on the direct and reverse order. There was no correlation with the parameters of reading comprehension. CONCLUSION: GDys and CG showed similar performance in listening comprehension and in understanding of explicit information and gap-filling inference on reading comprehension. Students of GDys showed worst performance in reading decoding, phonological short-term memory (pseudowords) and on inferences that depends on textual cohesion understanding in reading. There were negative correlations between pseudowords repetition and TC answers and total score, both in listening comprehension.

Perspectivas da atuação fonoaudiológica diante do diagnóstico e prognóstico da surdocegueira / Prospects of the speech therapy intervention in the diagnosis and prognostic of deafblindness

A audição e a visão tratam de duas entradas sensoriais importantes para o desenvolvimento e a conservação de uma plenitude na comunicação. Há enfermidades em que, além da observação clínica e aplicação de testes empíricos, a avaliação qualitativa é imprescindível, como nas síndromes ou doenças que acometem os sistemas auditivo e visual, simultaneamente. A surdocegueira na Síndrome de Cogan é caracterizada por disacusia neurossensorial, alterações vestibulares e oftalmológicas, além de complicações sistêmicas; é rara e de causa desconhecida, acometendo predominantemente indivíduos adultos jovens, da raça branca e sem preponderância de sexo. Neste estudo de caso, avaliamos de forma qualitativa um indivíduo com diagnóstico de Síndrome de Cogan, incluindo questões relativas aos aspectos de vida pessoal, social e profissional, nos períodos pré e pós-diagnóstico, enfatizando as dimensões da funcionalidade da sua comunicação. Discutimos critérios a serem estabelecidos pela equipe multidisciplinar para tais casos particulares, quanto às condutas na avaliação e orientação familiar, e apontamos diretrizes do processo de reabilitação, especialmente a terapia fonoaudiológica e a realização da cirurgia de implante coclear