[Relationship between the motor development of the body and the acquisition of oral skills]. / Relação entre desenvolvimento motor corporal e aquisição de habilidades orais.

BACKGROUND: the literature points to the influence of body posture on the oral skills of children which sensorimotor deficits. Only a few studies with normal children exist on this subject. AIM: to study the relationship between motor skills and oral motor skills in children, from the first day of life to 24 months of age. METHOD: 42 children were video recorded at the first day of life, and at 1, 2, 3, 4, 5, 6, 9, 12 and 24 months of age. Recordings were made in the following postures: supine, prone, seated, standing and during breast and bottle feeding (until 5 months), using spoon (purée: 3 - 12 months); cup (water or juice: 6 - 24 months) and eating solid food (6 -24 months). Quantitative scores for body motor development and oral skills were established; and for the statistical analysis the Pearson Correlation Coefficient Test was used with a significance level of 5%. RESULTS: the results of motor development point to similar data between supine, prone, seated and standing positions; for the oral motor skills (during feeding/ breastfeeding, using spoon, cup and chewing). A similarity was observed in the acquisition of motor abilities related to the lips, tongue and jaw in each of the feeding situations. There was an association between the motor and the oral motor skills; the results indicate that the motor development (motor skills) occurred prior to the development of the oral skills from the 5th to 24 months and that the skills related to the jaw when using a cup and spoon occurred prior to the development of the skills related to the lips and tongue. CONCLUSION: there was a growing increase in the acquisition of motor and oral skills along the ages, as well as a variability of skills in the ages between the 3rd and 24 months and a significant association between the motor and oral skills.

Reduction of podocytes number in late diabetic alloxan nephropathy: prevention by glycemic control.

PURPOSE: To determine podocyte number and GBM thickness in diabetic rats either under glycemic control or without glycemic control at 6 and 12 months after diabetes induction. METHODS: 100 Wistar rats weighing 200-300g were divided into 6 groups: Normal group (N6 and N12- 25 rats); Diabetic group (D6 and D12- 25 rats), diabetic treated group ( DT 6 and DT 12- 25 rats) on insulin 1,8- 3,0 IU/Kg associated with acarbose (50 mg to 100g of food) daily mixed in chow. Alloxan was injected intravenously in a dose of 42 mg/Kg of weight. Body weight, water intake, 24-h diuresis, glycemia and glucosuria were determined before induction, 7 and 14 days after induction and monthly thereafter. Treatment started at day 14. Three groups were sacrificed at 6 months (N6,D6, DT6) and 3 groups at 12 months (N12, D12, DT12) with the renal tissue being prepared for electron microscopy. RESULTS: Glycemia in DT6" and in DT12 was significantly different from that in D6 and D12 rats and similar to that in N6 and N12 animals. The number of podocytes in DT6 was not different from that in N6 and D6 (median = 11); the number of podocytes in DT12 (median = 11) differed from that in D12 (median = 8), but not from that in N12 (median = 11). GBM thickness in D6 (0.18 micrometers) was lower than in D12 (0.29 micrometers); while in DT6 (0.16 micrometers) it was lower than in D6 (0.18 micrometers). In DT12 (0.26 micrometers), it was lower than in D12 (0.29 micrometers). CONCLUSION: The control of hyperglycemia prevented GBM thickening in early and late (12 mo) alloxan diabetic nephropathy and podocyte number reduction.

Predictive factors of mortality in pediatric patients with acute renal injury associated with sepsis.

OBJECTIVE: To evaluate the prognosis factors of children with sepsis and acute kidney injury. METHODS: This was a retrospective study of children with sepsis and acute kidney injury that were admitted to the pediatric intensive care unit (PICU) of a tertiary hospital. A multivariate analysis was performed to compare risk factors for mortality. RESULTS: Seventy-seven children (47 males) were retrospectively studied, median age of 4 months. Mean length of hospital stay was 7.33±0.16 days, 68.9% of patients received mechanical ventilation, 25.9% had oligo-anuria, and peritoneal dialysis was performed in 42.8%. The pRIFLE criteria were: injury (5.2%) and failure (94.8%), and the staging system criteria were: stage 1 (14.3%), stage 2 (29.9%), and stage 3 (55.8%). The mortality rate was 33.7%. In the multivariate analysis, the risk factors for mortality were PICU length of stay (OR=0.615, SE=0.1377, 95% CI=0.469-0.805, p=0.0004); invasive mechanical ventilation (OR=14.599, SE=1.1178, 95% CI=1.673-133.7564, p=0.0155); need for dialysis (OR=9.714, SE=0.8088, 95% CI=1.990-47.410, p=0.0049), and hypoalbuminemia (OR=10.484, SE=1.1147, 95% CI=1.179-93.200, p=0.035). CONCLUSIONS: The risk factors for mortality in children with acute kidney injury were associated with sepsis severity.

Pancreas Transplantation Delays the Progression of Morphological, Morphometric and Ultrastructural Changes in Testes of Alloxan-Induced Diabetic Rats.

Aim: The aim of this study was to assess the effects of pancreas transplantation on the progression of testicular lesions in diabetic rats. Methods: Diabetic rats were subjected to pancreas transplantation and sacrificed after 6, 14, 26 and 50 weeks of follow-up, using non-diabetic and untreated diabetic rats as controls. Results: Successful pancreas transplantation corrected all of the metabolic changes observed in diabetic rats, including low levels of testosterone. The testicular mass was decreased, and the relative weight of the testes was high in diabetic rats. The seminiferous tubules of diabetic rats showed progressive atrophy of the germinal epithelium, with cytoplasmic vacuolization, detachment of germ cells to the tubular lumen and the appearance of giant cells. Leydig cells were abnormally distributed, and hyperplasia of Sertoli cells was observed. Sperm were not detectable within the tubular lumen in late follow-up. The diameter, total area, lumen area, and germinal epithelium area of the seminiferous tubules were low, and tubular density was high in diabetic rats. Ultrastructural changes were also observed in these rats, compromising the cytoplasm, organelles and cellular nuclei of the germ, Sertoli, and Leydig cells. The most frequent changes consisted of accumulation of lipid droplets and electron-dense dark material in the cell cytoplasm, cellular degeneration and apoptosis. Similar to non-diabetic rats, pancreas-transplanted rats showed progressive testicular lesions, but they were much less severe and occurred much later than in the untreated diabetic controls. Conclusion: Diabetes causes morphological and ultrastructural changes in rat testes, but the progression of lesions can be significantly delayed by successful pancreas transplantation, which may have a positive impact on male infertility due to diabetes.

The number of podocyte and slit diaphragm is decreased in experimental diabetic nephropathy.

PURPOSE: To determine the number of podocyte, slit diaphragms, slit diaphragm extensions and GBM thickness in diabetic nephropathy. METHODS: Sixty "Rattus Wistar"of both sexes weighing 200-300 g were divided in two experimental groups: normal group 10 animals, and alloxan diabetic rats--50 animals. Alloxan was administered in a single IV dose of 42 mg/kg body weight. Body weight, water and food intake, diuresis, and blood and urine glucose were determined in both groups before alloxan injection and two weeks, six and twelve months after alloxan injection. Proteinuria was measured at 12 months in both groups. After 12 months animals were sacrificed, and the right kidney processed for electron microscopy. RESULTS: Clear clinical and laboratory signs of severe diabetes were seen, in all alloxan-diabetic rats at all follow-up times. Glomerular basement membrane (GBM) thickening, podocyte number, and slit diaphragm number and extension were determined. GBM of all diabetic rats was significantly thicker (median=0.29 microm; semi-interquartile range=0.065 microm) than in the normal rats (0.23 microm; 0.035 microm). Diabetic rat podocyte number (8; 1), slit diaphragm number (4; 1), and slit diaphragm extension (0.021 microm; 0.00435 microm) were significantly lower than in normal rats (11; 1) and (7; 1.5), and (0.031 microm; 0.0058 microm). Diabetic rat proteinuria (0.060 mg/24 h; 0.037 mg/24 h) was higher than in normal rats (0.00185 mg/24 h; 0.00055 mg/24 h). CONCLUSION: Experimental diabetes is associated with significant (p<0.05) changes in podocyte foot process, slit number, slit diaphragm extension, and GBM thickness.

[Comparative study among five different treatments on the clinical and laboratory changes in rats with alloxan-induced diabetes]. / Estudo comparativo entre cinco diferentes tratamentos sobre as alterações clinicas e laboratoriais do rato diabético induzido pela aloxana.

PURPOSE: The long-term effects of five different treatments of diabetes were evaluated in alloxan-induced diabetic rats. METHODS: Seven experimental groups, with 50 rats each (GN--normal control; GD--untreated diabetic control; GI, GA, GIA--treated groups with insulin, acarbose, and insulin plus acarbose, respectively; GTIL, GTPD--treated groups with islet of Langerhans and pancreas transplantation) were studied. Clinical (body weight, water intake, food intake and urine output) and laboratory (blood and urinary glucose, and plasma insulin) parameters were analyzed at the beginning of the study, and after 1, 3, 6, 9 and 12 months of follow-up. RESULTS: Mortality was observed in all groups, except GN, during 12 months (GD = 50%; GI = 20%; GA = 26%; GIA = 18%; GTIL = 4%; GTPD = 20%). Rats from the GD, GI, and GIA groups died due to metabolic or hydrossaline disbalance, and/or pneumonia, diarrhoea, and cachexy. All deaths observed in GTIL and GTPD groups were in decorrence of technical failure at the immediate postoperative, until 72h. Animals from the GI, GA and GIA had significative improving of the clinical and laboratory parameters (p < 0,05) observed in diabetic rats, being the efficacy of theses treatments equal. However, rats from the GTIL and GTPD groups had better control of these parameters than GI, GA, and GIA groups. Transplanted rats had complete restoration, at the normal levels, of all analyzed variables (p < 0.01). CONCLUSIONS: Conventional treatments with insulin, acarbose, and insulin plus acarbose improved the severe diabetic state of the alloxan-diabetic rats, but pancreas and islet transplantation have a better performance for treatment of diabetes.

[Cognitive function evaluation in school-age children from economically impoverished community: results of enriched education program]. / Alterações cognitivas em escolares de classe socio-econômica desfavorecida: resultados de intervenção psicopedagógica.

Sixty-three school-age children of low socioeconomic status and exposed to adverse environmental factors (malnutrition, familiar distress and low familiar incomes) were submitted to neuropsychological tests to investigate possible cognitive impairments. Classical neuropsychological test battery was employed (Raven test, Bender Gestalt copy of complex figures, draw-a-man Goodenough test). Low intellectual level was found on 30% and 74% showed higher cognitive disorders (visuoperceptual skills and/or perseverations and/or global shapes perception and/or draw-a-man disturbances). These children attended to a school with semi-boarding regimen which receives children under personnel and social adverse factors. School program was enriched with learning activity program based on Piaget and psychomotor exercises based on Lambert for at least one year. They also had some other activities, as painting, singing, computer training, English and Spanish classes. Twenty children were newly accepted and 43 attended at school for one, two or three years. We found significant correlations (p < or =0.05) between superior intellectual performances, bigger periods of attendance at school and methods for cognitive development. There was no association between other brain cognitive functions examined, the attendance to the teaching programs and the years of permanence at school.

[Renal scars in children with primary vesicoureteral reflux]. / Cicatrizes renais em crianças com refluxo vesicoureteral primário.

OBJECTIVE: To determine the incidence of renal scars in children with primary vesicoureteral reflux taking into consideration the following variables: sex, age at diagnosis, febrile urinary infection, degree of reflux and bacteria specimen. METHOD: Retrospective study of 58 children with age ranging from 2 months to 11 years, presenting primary vesicoureteral reflux detected by voiding cystourethrogram after documented episode of urinary tract infection. The diagnosis of renal scarring was obtained by dimercaptosuccinic acid scan 5 months after the treatment of the urinary infection; in 40 children the dimercaptosuccinic acid scan was performed again from 6 months up to 6 years after the treatment. RESULTS: 45 children (77.6%) were girls and 13 (22.4%) were boys, 51.7% were 2 years old or younger. The incidence of renal scarring was 55.2%. There was significant higher proportion of renal scars in girls, when the patients presented fever and dilated vesicoureteral reflux (III, IV, V). Fever and female sex were risk factors for the development of renal scars (fever--ODDS ratio=6.19 and female sex--ODDS ratio=4.12). There was a prevalence of renal scars in children over 2 years old. The interval between the beginning of the symptoms and the first medical visit was longer in the children with renal scars. New renal scars were observed in 12.5%. CONCLUSIONS: Fever and female sex were risk factors for the presence of renal scars, mainly in the dilated vesicoureteral reflux. The high incidence of renal scars in this study may be related to delayed diagnosis of vesicoureteral reflux.

[Primary hyperoxaluria with endstage renal failure in an infant]. / Hiperoxalúria primária com insuficiência renal crônica terminal em lactente.

OBJECTIVE: To report a case of an infant with endstage renal failure caused by primary hyperoxaluria. METHODS: The review of the literature showed the rarity of the disease. In France, the prevalence is about 1.05/million and the incidence rate is 0.12/million/year. A survey, performed in international specialized centers in 1999, documented 78 cases in infants; in 14% of them the initial onset symptom was uremia. The rarity and severity of the disease justify the description of this case. RESULTS: A girl presenting vomiting and failure to thrive within the first months of life developed endstage renal failure at 6 months of age. She was being treated with dialysis. At 8 months of age, she was referred for investigation. She was undernourished and the laboratory examinations showed urea (69 mg/dl), creatinine (2.2 mg/dl) and creatinine clearance (12.5 ml/min/1.73 m2 SA). The routine urinalysis was normal, the renal ultrasound showed increased echogenicity in both kidneys; the dosage of urinary oxalate was 9.2 mg/kg/day or 0.55 mmol/1.73 m2 SA; the urinary oxalate/creatinine ratio was 0.42. Renal biopsy showed calcium oxalate crystals throughout the renal parenchyma. The radiograph of long bones showed osteopathy and the ophthalmic examination showed flecked retinopathy. The child was treated with continuous ambulatory peritoneal dialysis and administration of pyridoxine was initiated. CONCLUSIONS: Primary hyperoxaluria should be considered as a differential diagnosis for endstage renal failure in infants, especially if there are no symptoms of other diseases.

Long term evaluation of morphometric and ultrastructural changes of testes of alloxan-induced diabetic rats.

PURPOSE: To evaluate in a long term the morphometric and ultrastructural changes in seminiferous tubules (ST) of normal and diabetic rats, and to correlate any changes with animal age and diabetes duration. METHODS: Sixty male Wistar rats, three months-old, were randomly divided into two groups: 30 non-diabetic controls (N) and 30 alloxan untreated diabetic (D). After one, six and 12 months of follow-up or diabetes induction rats were sacrificed and the testes examined. Morphometric measures of the ST were performed by digital imaging analysis. ST ultrastructure was analyzed by transmission electron microscopy. RESULTS: Sustained hyperglycemic state was observed in all diabetic rats throughout the study. Serum testosterone was also significantly decreased in these animals. The diameter, total area, epithelium area and epithelium thickness of ST were lower and tubular density was higher in diabetic animals. Diabetic rats also showed ultrastructural changes compromising the whole testis including germ-, Sertoli-, and Leydig cells, and also the mithocondria and cellular nuclei. Most frequent of these consisted of vacuolization and/or accumulation of lipid droplets and electron dense dark material in cell cytoplasm and/or in membranes, cellular degeneration, and apoptosis. Non-diabetic control rats also showed testicular lesions that resemble to the diabetic lesions, although much less severe and with later onset in life of these animals. CONCLUSION: Histopathological changes observed in testes of normal and diabetic rats are closely related to the animal age and/or duration of the hyperglycemic state, being progressively more severe in animals sacrificed belatedly. These changes may play an important role in male infertility observed in diabetic subjects.

Predictive factors of mortality in pediatric patients with acute renal injury associated with sepsis / Fatores preditivos de mortalidade em pacientes pediátricos com lesão renal aguda associada com sepse

Abstract: Objective: To evaluate the prognosis factors of children with sepsis and acute kidney injury. Methods: This was a retrospective study of children with sepsis and acute kidney injury that were admitted to the pediatric intensive care unit (PICU) of a tertiary hospital. A multivariate analysis was performed to compare risk factors for mortality. Results: Seventy-seven children (47 males) were retrospectively studied, median age of 4 months. Mean length of hospital stay was 7.33 ± 0.16 days, 68.9% of patients received mechanical ventilation, 25.9% had oligo-anuria, and peritoneal dialysis was performed in 42.8%. The pRIFLE criteria were: injury (5.2%) and failure (94.8%), and the staging system criteria were: stage 1 (14.3%), stage 2 (29.9%), and stage 3 (55.8%). The mortality rate was 33.7%. In the multivariate analysis, the risk factors for mortality were PICU length of stay (OR = 0.615, SE = 0.1377, 95% CI = 0.469-0.805, p = 0.0004); invasive mechanical ventilation (OR = 14.599, SE = 1.1178, 95% CI = 1.673-133.7564, p = 0.0155); need for dialysis (OR = 9.714, SE = 0.8088, 95% CI = 1.990-47.410, p = 0.0049), and hypoalbuminemia (OR = 10.484, SE = 1.1147, 95% CI = 1.179-93.200, p = 0.035). Conclusions: The risk factors for mortality in children with acute kidney injury were associated with sepsis severity.

Resumo: Objetivo: Avaliar os fatores prognósticos de crianças com sepse e lesão renal aguda. Métodos: Estudo retrospectivo de crianças internadas com sepse e lesão renal aguda em unidade de terapia intensiva pediátrica de serviço terciário. Usou-se a análise multivariada na comparação dos fatores de risco para mortalidade. Resultados: Foram avaliados 77 pacientes (47 masculinos) com mediana de 4 meses de idade. A média do tempo de internação foi de 7,33 ± 0,16 dias, 68,9% de necessitaram ventilação mecânica, 25,9% eram oligoanúricos e 42,8% necessitaram de diálise. A classificação da lesão renal aguda foi pRIFLE (Pediatric Risk, Injury, Failure, Loss, and End-stage Renal Disease) I em 5,2% e F em 94,8%; e estágio 1 (14,3%), estágio 2 (29,9%) e estágio 3 (55,8%). A taxa de mortalidade foi de 33,7%. Na análise multivariada, os fatores de risco foram tempo de internação (OR = 0,615 erro padrão = 0,1377, 95% CI = 0,469-0,805, p = 0,0004), ventilação mecânica (OR = 14.599, erro padrão = 1,1178, 95% CI = 1,673-133,7564, p = 0,0155), necessidade de diálise (OR = 9.714, erro padrão = 0,8088, 95% CI = 1,990-47,410, p = 0,0049) e hipoalbuminemia (OR = 10.484, erro padrão = 1,1147, 95% CI = 1,179-93,200, p = 0,035). No modelo de Cox a sobrevida foi influenciada pela necessidade de diálise (HR = 2.952, erro padrão = 0,44862, 95% CI = 1,225-7,112, p = 0,016) e hipoalbuminemia (HR = 3.326, erro padrão = 0,59474, 95% CI = 1,037-10,670, p = 0,043). Conclusões: Os fatores de risco para mortalidade nas crianças com lesão renal aguda foram associados à gravidade da sepse.

Long term evaluation of morphometric and ultrastructural changes of testes of alloxan-induced diabetic rats

PURPOSE: To evaluate in a long term the morphometric and ultrastructural changes in seminiferous tubules (ST) of normal and diabetic rats, and to correlate any changes with animal age and diabetes duration. METHODS: Sixty male Wistar rats, three months-old, were randomly divided into two groups: 30 non-diabetic controls (N) and 30 alloxan untreated diabetic (D). After one, six and 12 months of follow-up or diabetes induction rats were sacrificed and the testes examined. Morphometric measures of the ST were performed by digital imaging analysis. ST ultrastructure was analyzed by transmission electron microscopy. RESULTS: Sustained hyperglycemic state was observed in all diabetic rats throughout the study. Serum testosterone was also significantly decreased in these animals. The diameter, total area, epithelium area and epithelium thickness of ST were lower and tubular density was higher in diabetic animals. Diabetic rats also showed ultrastructural changes compromising the whole testis including germ-, Sertoli-, and Leydig cells, and also the mithocondria and cellular nuclei. Most frequent of these consisted of vacuolization and/or accumulation of lipid droplets and electron dense dark material in cell cytoplasm and/or in membranes, cellular degeneration, and apoptosis. Non-diabetic control rats also showed testicular lesions that resemble to the diabetic lesions, although much less severe and with later onset in life of these animals. CONCLUSION: Histopathological changes observed in testes of normal and diabetic rats are closely related to the animal age and/or duration of the hyperglycemic state, being progressively more severe in animals sacrificed belatedly. These changes may play an important role in male infertility observed in diabetic subjects.

Prevalência de pressão arterial elevada em crianças e adolescentes do ensino fundamental / Prevalence of elevated blood pressure in children and adolescents attending highschool / Prevalencia de presión arterial elevada en niños y adolescentes de la enseñanza fundamental

Verificar a prevalência de pressão arterial elevada em crianças e adolescentes e sua associação com indicadores antropométricos. MÉTODOS: Estudo transversal de estudantes de três instituições de ensino em Botucatu (SP). As variáveis avaliadas foram: pressão arterial (PA) (obtida em três ocasiões diferentes), peso, estatura, índice de massa corporal (IMC), circunferência braquial, circunferência abdominal (CA), dobras cutâneas tricipital e subescapular. A PA foi aferida por método auscultatório e classificada em pré-hipertensão (PH) e hipertensão arterial (HAS), para os valores entre os percentis 90 e 95 e maior que o percentil 95, respectivamente. Os dados antropométricos foram comparados, segundo o sexo, pelo teste t de Student. A correlação de Pearson foi utilizada para verificar a variação das PA sistólica (PAS) e diastólica (PAD) segundo dados antropométricos. A variação do escore Z da PA segundo percentil de IMC foi avaliada pela análise de variância seguida do teste de Tukey. RESULTADOS: Foram avaliadas 903 crianças (51,7 por cento meninos), com idade de 9,3±2,5 anos para ambos os sexos. A prevalência de PH foi de 9,1 por cento e de HAS foi de 2,9 por cento. Houve correlação positiva significativa entre os níveis de PAS e PAD elevados e as variáveis antropométricas, com valores maiores para peso (r=0,53 e r=0,45, p<0,05, respectivamente) e CA (r=0,50 e r=0,38, p<0,05, respectivamente). CONCLUSÕES: A prevalência de níveis pressóricos elevados nesta casuística foi compatível com outros estudos brasileiros e internacionais, correlacionando-se positivamente com indicadores antropométricos elevados, o que sinaliza a influência do excesso de peso na PA já na infância.

To assess the prevalence of elevated blood pressure in schoolchildren and adolescents and the association of blood pressure with anthropometric measures. METHODS: This cross-sectional study, conducted in three schools in Botucatu, Brazil, collected blood pressure (BP) measurements taken at three different time points and anthropometric data: weight, height, body mass index (BMI), arm circumference, waist circumference, triceps and subscapular skinfolds. Blood pressure was measured using the auscultation method, and children were classified into two groups: pre-hypertension or hypertension for values between the 90th and 95th percentiles or above the 95th percentile. Data were compared according to sex using the Student's t test. The Pearson correlation coefficient was used to evaluate the association between blood pressure and anthropometric data. To evaluate blood pressure, the Z score according to BMI percentile categories, one-factor analysis of variance (ANOVA) and the Tukey post hoc test were used. RESULTS: This study evaluated 903 children and adolescents (51.7 percent boys) whose mean age was 9.3±2.5 years. The prevalence of pre-hypertension and hypertension was 9.1 percent and 2.9 percent. There was a positive correlation between both systolic and diastolic blood pressure and anthropometric variables, especially for weight (r=0.53 and r=0.45, p<0.05) and waist circumference (r=0.50 and r=0.38, p<0.05). CONCLUSIONS: The prevalence of elevated blood pressure in this study was similar to what has been reported in international and national studies. A positive correlation with abnormal anthropometric measures was found. These results suggest that overweight affects blood pressure already in childhood.

Verificar la prevalencia de presión arterial elevada en niños y adolescentes y su asociación con indicadores antropométricos. MÉTODOS: Estudio transversal incluyendo a estudiantes de tres instituciones de enseñanza de Botucatu (São Paulo, Brasil). Las variables evaluadas fueron: presión arterial (PA) (obtenida en tres ocasiones distintas), peso, estatura, índice de masa corporal (IMC), circunferencia braquial, circunferencia abdominal (CA), pliegues cutáneos tricipital y subescapular. La PA fue verificada por método auscultatorio, siendo posteriormente clasificada como pre-hipertensión (PH) e hipertensión arterial (HAS) para los valores entre los percentiles 90 y 95 y superior al percentil 95, respectivamente. Los datos antropométricos fueron comparados, conforme al sexo, por la prueba t de Student. La correlación de Pearson fue utilizada para verificar la variación de las PA sistólica (PAS) y diastólica (PAD) según datos antropométricos. La variación del escore Z de la PA según percentil de IMC fue evaluada por el análisis de variancia seguida por la prueba de Tukey. RESULTADOS: Se evaluaron 903 niños (51,7 por ciento niños), con edad de 9,3±2,5 años para ambos sexos. La prevalencia de PH fue de 9,1 por ciento y de HAS fue de 2,9 por ciento. Hubo correlación positiva significativa entre los niveles presóricos elevados (PAS/PAD > percentil 90) y las variables antropométricas, con valores mayores para peso (r=0,53 y r=0,45, p<0,05, respectivamente) y CA (r=0,50 y r=0,38, p<0,05, respectivamente). CONCLUSIONES: La prevalencia de niveles presóricos elevados en esta casuística fue compatible con otros estudios brasileños e internacionales, correlacionándose positivamente con indicadores antropométricos elevados, lo que señaliza la influencia del exceso de peso en la PA ya en la infancia.

Tolerance of arabica coffee cultivars for aluminum in nutritive solution

This work aimed to evaluate the Coffea arabica cultivars for aluminum toxicity tolerance, in modified Hoagland solution. A completely randomized design with five repetitions in a factorial 4 x 4 (cultivar x combinations of aluminum) was used. After 44 days of the sowing, were transferred ten seedlings each cultivar germinated in the absence of Al3+ to solution without Al3+, and ten for solution with Al3+; ten seedlings each cultivar germinated in presence of Al3+ to solution without Al3+, and ten for solution with Al3+. In the treatment with aluminum, the element was added to the nutritive solution in the concentration of 0.83 mmol L-1 as Al2(SO4)3.16H2O. The cultivars Catuaí Amarelo IAC 62 and Iapar 59 were tolerant to the aluminum; cultivar Oeiras presented intermediate tolerance, while cultivar Obatã IAC 1669-20 was sensitive. The tolerance of the coffee cultivars to the aluminum during the initial development of the seedlings did not depend on the presence of aluminum in the germination phase.

Relação entre desenvolvimento motor corporal e aquisição de habilidades orais / Relationship between the motor development of the body and the acquisition of oral skills

TEMA: a literatura aponta para a influência da postura corporal sobre as habilidades orais em crianças com desenvolvimento sensório-motor alterado. Em crianças normais existem poucos estudos sobre essa relação. OBJETIVO: estudar em crianças a termo a relação entre habilidades motoras e habilidades motoras orais, desde 1 dia de vida até 24 meses de idade. MÉTODO: 42 crianças foram filmadas com 1 dia, 1 mês, 2, 3, 4, 5, 6, 9,12 e 24 meses nas posições supino, prono, sentado e em pé e durante alimentação com amamentação / mamadeira (até 5 meses), uso de colher para alimentação pastosa (3 aos 12 meses), uso de copo para água ou suco (6 aos 24 meses) e alimento sólido (6 aos 24 meses). Estabeleceram-se escores de quantificação para o desenvolvimento corporal e habilidades orais e utilizou-se o coeficiente de correlação de Pearson para o estudo estatístico, adotando-se nível de significância de 5 por cento. RESULTADOS: os resultados do desenvolvimento motor apontaram para semelhança de dados entre supino e prono e sentado e em pé; para as habilidades orais (durante a alimentação com mamadeira/amamentação, colher, copo, mastigação) constatou-se em cada modalidade de alimentação, homogeneidade de aquisição de habilidades para lábios, língua e mandíbula. Houve associação entre habilidades motoras e orais; resultados apontam que o desenvolvimento motor (habilidades motoras) se deu antes das orais desde o 5° ao 24° mês e que as habilidades de mandíbula em copo e colher ocorreram antes das habilidades de lábios e língua. CONCLUSÃO: houve crescente aquisição de habilidades motoras e orais, variabilidade de habilidades em idades entre 3 e 24 meses e associação entre habilidades motoras e orais.

BACKGROUND: the literature points to the influence of body posture on the oral skills of children which sensorimotor deficits. Only a few studies with normal children exist on this subject. AIM: to study the relationship between motor skills and oral motor skills in children, from the first day of life to 24 months of age. METHOD: 42 children were video recorded at the first day of life, and at 1, 2, 3, 4, 5, 6, 9, 12 and 24 months of age. Recordings were made in the following postures: supine, prone, seated, standing and during breast and bottle feeding (until 5 months), using spoon (purée: 3 - 12 months); cup (water or juice: 6 - 24months) and eating solid food (6 -24 months). Quantitative scores for body motor development and oral skills were established; and for the statistical analysis the Pearson Correlation Coefficient Test was used with a significance level of 5 percent. RESULTS: the results of motor development point to similar data between supine, prone, seated and standing positions; for the oral motor skills (during feeding/ breastfeeding, using spoon, cup and chewing). A similarity was observed in the acquisition of motor abilities related to the lips, tongue and jaw in each of the feeding situations. There was an association between the motor and the oral motor skills; the results indicate that the motor development (motor skills) occurred prior to the development of the oral skills from the 5th to 24 months and that the skills related to the jaw when using a cup and spoon occurred prior to the development of the skills related to the lips and tongue. CONCLUSION: there was a growing increase in the acquisition of motor and oral skills along the ages, as well as a variability of skills in the ages between the 3rd and 24 months and a significant association between the motor and oral skills.

Contribuições das práticas alimentares e inatividade física para o excesso de peso infantil: [revisão] / Feeding practices and physical inactivity contributions to childhood overweight: [review]

OBJETIVO: Revisar estudos que abordam as práticas alimentares atuais e o padrão de atividade física como contribuintes do excesso de peso na infância. FONTES DE DADOS: Ovid Journals, Highwire e SciELO, com seleção de artigos originais e de revisão nos últimos dez anos (1997 a 2007), na língua portuguesa e inglesa. SÍNTESE DE DADOS: O acompanhamento do estado nutricional de crianças permite diagnosticar seu estado de saúde atual, bem como predizer parcialmente seu prognóstico na vida adulta. A prevalência de obesidade infantil, no Brasil, apresenta aumento progressivo em todas as classes sociais e sua freqüência varia entre cinco a 18 por cento, dependendo da região estudada. A associação da transição epidemiológica, demográfica e comportamental e a alteração do hábito alimentar são apontadas como fatores causais do aumento progressivo da obesidade infantil. Práticas alimentares caracterizadas por elevado teor de lipídios, sacarose e sódio e por reduzido consumo de cereais integrais, frutas e hortaliças associadas à inatividade física decorrente do uso de computadores, jogos eletrônicos e televisores influenciam parte considerável de crianças. Este estilo de vida reflete os hábitos familiares e pode ser influenciado pelo ambiente escolar no qual a criança está inserida. CONCLUSÕES: Os dados sugerem influência considerável dos fatores ambientais, principalmente hábitos alimentares e inatividade física, no crescente aumento da prevalência de excesso de peso na população pediátrica.

OBJECTIVE: To review the literature in order to show how current feeding and physical activity practices may contribute to childhood overweight. DATA SOURCE: Ovid Journals, Highwire and SciELO, selecting original and review articles from 1997 to 2007, published in English and Portuguese. DATA SYNTHESIS: The periodic assessment of children nutritional status is important to diagnose their current health status and to predict their adult life prognosis. In Brazil, the prevalence of childhood obesity is progressively increasing in all social classes and its frequency varies from five to 18 percent, according to the region assessed. The association between the health, demographic and behavioral transition and the change in feeding practices can explain the increasing prevalence of childhood overweight. The current food consumption with high fat, sugar and sodium intake and low intake of whole cereals, fruits and vegetables associated to physical inactivity due to the excessive use of computers, electronic games and television may play a role in childhood obesity. This life style can be explained by changing family habits and school environment. CONCLUSIONS: These data suggest considerable influence of environmental factors, mainly nutritional habits and physical inactivity, on the increasing prevalence of childhood overweight.

Brotação de mamoeiro tainung 1 submetido a diferentes alturas de corte do caule / Shooting of papaya tainung 1 (Carica papaya L. ) submitted the different heights of cut of the stem

Esse trabalho foi realizado em casa de vegetação, no CCA-UFES, Alegre-ES, e objetivou-se estudar o efeito de diferentes alturas de corte do caule na brotação de mamoeiro Tainung 01 (Carica papaya L.). O trabalho foi realizado em duas fases, utilizando plantas com idade de 190 dias, cultivadas em recipientes de polietileno de 1288 cm³. Na primeira fase, o delineamento experimental foi o inteiramente casualizado, com 14 repetições e três tratamentos: corte do caule com 20; 35 e 50 cm de altura, medidos a partir do colo da planta. Após 30 dias do corte do caule, avaliaram-se as seguintes características agronômicas: diâmetro do broto terminal, medido na sua base; tamanho do broto terminal, medido da base do broto à gema apical; número de folhas do broto terminal maiores que 1 cm, no seu maior comprimento e número de brotos por planta maiores que 1 cm. Cada planta representou uma parcela. Nessa primeira fase, o tamanho do broto terminal foi a característica que apresentou diferença significativa. Na segunda fase, foram retirados todos os brotos terminais das plantas utilizadas na fase anterior, para se dar continuidade ao ensaio. O delineamento experimental utilizado foi o inteiramente casualizado com 13 repetições, em parcela subdividida, onde os tratamentos primários foram os mesmos da fase anterior e na subparcela foi feita avaliação no primeiro e aos 15 e 30 dias. As características agronômicas avaliadas foram as mesmas da primeira fase. O corte do caule, feito a 20 cm de altura, proporcionou melhor desenvolvimento do broto terminal e aumento do número de folhas do broto terminal.

This work was carried out at greenhouse, in the CCA-UFES, Alegre-ES and had as an aim to study the effect of different heights of cut of stem in sproution of papaya plants Tainung 01 (Carica papaya L.). The work was carried out in two phases, utilizing plants with age of 190 days cultivated in polyethylene containers of 1288 cm³. In the first phase, the experimental design was in completely randomized design, with three treatments and 14 replications of one plant per plot: plants cutting with 20; 35 e 50 cm of height, measured from the plant lap. After 30 days of cut of the stem, they evaluated the next agronomical characteristic: last shoot diameter, last shoot size, last shoot leaf number larger one centimeter and shoot number for plant. In this first phase, the last shoot size was the characteristic that introduced significant difference. In the second phase, last shoots of plants utilized in the previous phase were removed. The experimental design was in completely randomized design with 13 repetitions in split plot, with the primary treatments of the previous phase and in split plot was made an evaluation in the first one and at 15 and 30 days. The agronomical characteristic evaluated was the same of the first phase. The cutting at 20 cm height provides better last shoot development and increase of the leaf number in the last shoot.

Fatores associados à recorrência da infecção do trato urinário em crianças / The factors associated to urinary tract infection recurrence in children

OBJETIVOS: verificar a freqüência de infecção urinária recorrente (ITU) e avaliar os fatores associados à recorrência da ITU em crianças. MÉTODOS: estudo retrospectivo de 95 pacientes com seguimento de um ano (68 meninas e 27 meninos, mediana de idade três anos). As variáveis estudadas foram: sexo, idade, febre, constipação, tipo de bactéria, refluxo vésico-ureteral (RVU), anormalidades na cintilografia renal com ácido dimercaptosuccínico (DMSA). RESULTADOS: infecção urinária recorrente ocorreu em 49,5 por cento crianças (19 com trato urinário normal, 19 com RVU e 9 com estenose da junção pielocalicial). Comparando o grupo com ITU recorrente com o grupo sem ITU recorrente não se encontrou diferença significativa entre sexos, presença de febre, constipação e anormalidades na cintilografia renal com DMSA. A ITU recorrente foi significativamente maior nas crianças com um ano ou menos, naquelas menores de dois anos com RVU, nas com bactéria diferente da Escherichia coli e sem profilaxia antibacteriana. Os fatores de risco significativos para a recorrência ITU foram idade < 2 anos (OR = 3,83) e refluxo vésico-ureteral (OR = 4,95). CONCLUSÕES: por causa da elevada freqüência de ITU recorrente é importante o seguimento regular de grupo de crianças com fatores de risco para ITU recorrente.

OBJECTIVES: to determine the frequency of recurrent urinary tract infection (UTI) and to evaluate the factors associated to UTI recurrence in children. METHODS: retrospective study of 95 patients with one year follow-up (68 girls and 27 boys, median of age three years old). The variables studied were: sex, age, fever, constipation, bacteria specimen, vesico-ureteral reflux (VUR), abnormalities of renal Dimercaptosuccinic acid (DMSA) scintigraphy. RESULTS: Recurrent UTI occurred in 49.5 percent children (19 with normal urinary tract, 19 with VUR and 9 with stenosis of the ureteropelvic junction ). Comparing data of the group with recurrent UTI and the group without recurrent UTI the following was determined: there were no significant differences between sexes, presence of fever, constipation and abnormalities in renal DMSA scintigraphy. Recurrent UTI was significantly higher in symptomatic children < 1 year old, of those with < 2 years old, with VUR, with bacteria other than Escherichia coli and the ones not receiving antibacterial prophylaxis. Risk factors for UTI recurrence were age < 2 years old (Odds ratio = 3.83) and vesicoureteral reflux-(Odds ratio = 4.95). CONCLUSIONS: due to the high recurrent UTI frequency the regular follow-up of children with risk factor for recurrent UTI is essential.

Estudo da excreção urinária de cálcio, potássio e sódio com o emprego de citrato de potássio na hipercalciúria idiopática na criança / Study of urinary excretion of calcium, potassium and sodium using potassium citrate in children with idiopathic hypercalciuria

OBJETIVO: Estudar as relações entre a excreção urinária de cálcio, sódio e potássio e a associação sódio/potássio urinários em crianças com hipercalciúria idiopática em dieta habitual, antes e depois da administração de citrato de potássio na dose de 1mEq/kg/dia. MÉTODOS: Foram estudadas prospectivamente 26 crianças: 19 (73 por cento) meninos e sete (27 por cento) meninas com idade entre dois e 13 anos, portadores de hipercalciúria idiopática recém-diagnosticada por dosagem de cálcio em urina de 24 horas >4mg/kg/dia. O citrato de potássio foi administrado na dose de 1mEq/kg/dia. Foram realizadas dosagens séricas e em urina de 24 horas de cálcio (Ca), potássio(K), sódio (Na) e creatinina (Cr), antes e 15 dias depois da administração diária do citrato de potássio. Para comparar os resultados de cálcio/creatinina (Ca/Cr), potássio/creatinina (K/Cr) e sódio/potássio (Na/K) urinários nos dois momentos, aplicou-se o teste não-paramétrico de Wilcoxon. Para a análise das associações entre Ca/Cr e K/Cr e entre Ca/Cr e Na/Cr foi utilizado o coeficiente de correlação de Pearson. Considerou-se significante p<0,05. RESULTADOS: Após o uso de citrato de potássio, ocorreu significativa redução da calciúria e da relação Na/K urinários, bem como elevação na caliúria. Não houve modificação da excreção urinária de sódio. CONCLUSÕES: Em dieta habitual, o citrato de potássio eleva a caliúria e diminui a calciúria em criança hipercalciúricas, sendo um eficaz recurso terapêutico.

OBJECTIVE: Evaluate the relationships among the urinary excretion of calcium (UCa), potassium (UK), sodium (UNa) and the ratio between UNa/UK in children with idiopathic hypercalciuria and a regular diet, before and after 1mEq/kg/day potassium citrate administration. METHODS: 26 children with idiopathic hypercalciuria (UCa>4mg/kg/day) were prospectively studied: 19 (73 percent) boys and seven (27 percent) girls between two and 13 years old. Potassium citrate was administered: 1mEq/Kg/day twice a day for 15 days. Blood and 24-hour urinary determinations of calcium, potassium, sodium and creatinine were done in two periods: before and after the 15-day administration of potassium citrate. The following urinary ratios were analyzed before and after potassium citrate use by Wilcoxon test: calcium/creatinine (UCa/UCr), potassium/creatinine (UK/UCr) and sodium/creatinine (UNa/UCr). The association between UCa/UCr, UK/UCr and Ca/Cr, UCa/UCr and UNa/UK were analyzed by Pearson's correlation. Significance was considered for p<0.05. RESULTS: After potassium citrate use, there were significant reductions of UCa and UNa/UK ratios, as well as a significant increase of UK. The UNa did not change. CONCLUSIONS: Children with idiopathic hypercalciuria and regular diet treated with daily potassium citrate increased their potassium urinary excretion and decreased their calciuria.

Reduction of podocytes number in late diabetic alloxan nephropathy: prevention by glycemic control

PURPOSE: To determine podocyte number and GBM thickness in diabetic rats either under glycemic control or without glycemic control at 6 and 12 months after diabetes induction. METHODS: 100 wistar rats weighing 200-300g were divided into 6 groups: Normal group (N6 and N12- 25 rats); Diabetic group (D6 and D12- 25 rats), diabetic treated group ( DT 6 and DT 12- 25 rats) on insulin 1,8- 3,0 IU/Kg associated with acarbose (50mg to 100g of food) daily mixed in chow. Alloxan was injected intravenously in a dose of 42 mg/Kg of weight. Body weight, waterintake, 24-h diuresis, glycemia and glucosuria were determined before induction, 7 and 14 days after induction and monthly thereafter. Treatment started at day 14. Three groups were sacrificed at 6 months (N6,D6, DT6) and 3 groups at 12 months (N12, D12, DT12) with the renal tissue being prepared for electron microscopy. RESULTS: Glycemia in DT6¨and in DT12 was significantly different from that in D6 and D12 rats and similar to that in N6 and N12 animals. The number of podocytes in DT6 was not different from that in N6 and D6 (median = 11); the number of podocytes in DT12 (median = 11) differed from that in D12 (median = 8), but not from that in N12 (median = 11). GBM thickness in D6 (0.18 micrometers) was lower than in D12 (0.29 micrometers); while in DT6 (0.16 micrometers) it was lower than in D6 (0.18 micrometers). In DT12 (0.26 micrometers), it was lower than in D12 (0.29 micrometers). CONCLUSION: The control of hyperglycemia prevented GBM thickening in early and late (12 mo) alloxan diabetic nephropathy and podocyte number reduction.

OBJETIVO: Avaliar o número de podócitos e espessamento da membrana basal glomerular (MBG) em ratos diabéticos com e sem controle glicêmico com 6 e 12 meses da indução. MÉTODOS: 100 ratos Wistar com 200-300g compuseram 6 grupos: Normal (N6, N12 - 25 animais) Diabético (D6,D12 - 25 animais) e diabético tratado com insulina 1,8 a 3,0 U/Kg e acarbose misturada a ração (50g para cada 100g de ração) (DT6 e DT12 - 25 animais). Aloxana foi ministrada via endovenosa na dose de 42mg/Kg. Peso, ingestão hídrica e diurese de 24 horas e glicemia e glicosúria foram determinados antes da inoculação, 7 e 14 dias após e mensalmente. No 14ª dia foi iniciado o tratamento. Três grupos de animais (N6, D6 e DT6) foram sacrificados no 6° mês e três grupos (N12, D12 e DT12), no 12ª mês sendo o tecido renal processado para estudo à microscopia eletrônica. RESULTADOS: A glicemia dos animais DT6 e DT12 diferiram significativamente, dos ratos D6 e D12, e não diferiram dos grupos N6 e N12. O número de podócitos do grupo DT6 não diferiu de N6 e D6 (mediana=11); o número de podócitos de DT12 (mediana=11) diferiu de D12 (mediana=8) e não diferiu de N12 (mediana=11). O espessamento da MBG de D6 (0,18 micrômetros) foi menor que D12 (0,29 micrômetros); de DT6 (0,16 micrômetros) foi menor que D6 (0,18 micrômetros) e de DT12 (0,26 micrômetros) foi menor que D12 (0,29 micrômetros). CONCLUSÃO: O controle da hiperglicemia preveniu o espessamento da MBG na nefropatia diabética aloxânica precoce (6 meses) e tardia (12 meses), e a diminuição do número de podócitos.