Medição da temperatura corporal em crianças: Estudo comparativo entre o método de medição axilar e timpânico / Child body thermometry: A comparative study of axillary and tympanic thermometry / Medición de la temperatura corporal en niños: Estudio comparativo entre el método de medición axilar y timpânico

Resumo Enquadramento: A temperatura corporal é um dos sinais vitais mais avaliados nos cuidados de saúde pediátricos para avaliação e orientação clínica. Objetivos: Avaliar a concordância entre a medição da temperatura por via axilar e timpânica em crianças dos 6 aos 36 meses. Metodologia: Estudo observacional e descritivo desenvolvido num hospital de nível II, em Portugal. O protocolo de medição da temperatura seguiu as orientações da Direção-Geral da Saúde. Resultados: Participaram no estudo 331 crianças. A diferença entre a temperatura timpânica e axilar variou entre os 0,00ºC e os 1,40ºC com uma média de 0,45ºC ± 0,30ºC e uma mediana de 0,50ºC, com uma concordância quase perfeita entre os dois métodos. Observou-se um efeito no valor da temperatura consoante o método utilizado em todas as variáveis estudadas. Conclusão: Existe uma concordância quase perfeita entre estes dois métodos de medição da temperatura, não influenciando a tomada de decisão clínica. Dado a maior facilidade de implementação e exequibilidade, as vantagens do método de avaliação via timpânica são superiores ao método tradicional via axilar, pelo que poderá ser implementado como rotina na avaliação da temperatura em crianças dos 6 aos 36 meses.

Abstract Background: Body temperature is one of the most evaluated vital signs in pediatric health care for clinical assessment and guidance. Objectives: To evaluate the agreement between axillary and tympanic thermometry in children aged 6 to 36 months. Methodology: An observational and descriptive study was carried out in a level II hospital in Portugal. The thermometry protocol followed the guidelines of the Portuguese Directorate-General of Health. Results: A total of 331 children participated in the study. The difference between tympanic and axillary temperatures ranged from 0.00ºC to 1.40ºC, with a mean of 0.45ºC ± 0.30ºC and a median of 0.50ºC, an almost perfect agreement between both methods. An effect on the temperature value was observed according to the technique used in all variables studied. Conclusion: There is an almost perfect agreement between these two thermometry methods, not influencing clinical decision-making. Advantages of the tympanic method over the traditional axillary method include easy implementation and feasibility. Therefore, it can be routinely implemented in assessing temperature in children aged 6 to 36 months.

Resumen Marco contextual: La temperatura corporal es una de las constantes vitales más valoradas en los cuidados de salud pediátricos para la evaluación y orientación clínica. Objetivos: Evaluar la concordancia entre la medición de la temperatura axilar y la timpánica en niños de 6 a 36 meses. Metodología: Estudio observacional y descriptivo desarrollado en un hospital de nivel II de Portugal. El protocolo de medición de la temperatura siguió las directrices de la Dirección General de Sanidad. Resultados: Un total de 331 niños participaron en el estudio. La diferencia entre la temperatura timpánica y la axilar varió entre 0,00ºC y 1,40ºC con una media de 0,45ºC ± 0,30ºC y una mediana de 0,50ºC, con una concordancia casi perfecta entre los dos métodos. En todas las variables estudiadas se observó un efecto sobre el valor de la temperatura según el método utilizado. Conclusión: Existe una concordancia casi perfecta entre estos dos métodos de medición de la temperatura, sin influencia en la toma de decisiones clínicas. Dada la mayor facilidad de aplicación y viabilidad, las ventajas del método de evaluación timpánica son superiores a las del método tradicional a través de la axila, por lo que puede aplicarse de forma rutinaria en la evaluación de la temperatura en niños de 6 a 36 meses.

Exposure to Gambling and Alcohol Marketing in Soccer Matchday Programmes.

The UK's Premier League and Championship are two of the most well attended soccer leagues worldwide; however, little is known regarding exposure to gambling marketing through the matchday experience. The current study sought to quantify exposure to gambling and alcohol marketing, and responsible gambling messages within matchday programmes. Programmes for each team in the English Premier League and Championship were analysed across consecutive matchday weekends, made available to 1,269,404 match-going fans. Direct adverts for, and incidental exposure to, gambling, alcohol, and responsible gambling marketing or messages were coded. Direct adverts were counted, as were absolute counts and percentage of pages with incidental exposure. Programmes averaged 2.3 direct gambling adverts and 37.8 instances of incidental gambling marketing exposure. Incidental gambling marketing was found on 22.2% of pages. There was more gambling marketing than either alcohol marketing or responsible gambling messages. This was observed across: number of direct adverts (p < .001), incidents of exposure (p < .001) and the percentage of pages with exposure (p < .001). Teams with gambling shirt sponsors had more incidental marketing exposure, in both absolute count (p < .001) and percentage of pages (p < .001) but did not have more direct gambling adverts (p = .63). Incidental exposure to gambling marketing was present in 59.0% of children's specific sections of programmes. There was greater exposure to gambling marketing in soccer matchday programmes. Gambling marketing was frequently evident in child specific sections of matchday programmes. Attending soccer matches and reading the matchday programme increases exposure to gambling.

First molecular identification of mosquito vectors of Dirofilaria immitis in continental Portugal.

BACKGROUND: Canine dirofilariasis due to Dirofilaria immitis is known to be endemic in continental Portugal. However, information about the transmitting mosquito species is still scarce, with only Culex theileri identified to date, albeit with L1-2, through dissection. This study was carried out to investigate the potential vectors of Dirofilaria spp. in continental Portugal. METHODS: Mosquitoes were collected in three distinct seasons (Summer, Autumn and Spring), 2011-2013, in three districts. CDC traps and indoor resting collections were carried out in the vicinity of kennels. Mosquitoes were kept under controlled conditions for 7 days to allow the development of larval stages of Dirofilaria spp.. DNA extraction was performed separately for both head+thorax and abdomen in order to differentiate infective and infected specimens, respectively, in pools, grouped according to the species and collection site (1-40 specimen parts/pool), and examined by PCR using pan-filarial specific primers. Mosquito densities were compared using non-parametric tests. Dirofilaria development units (DDU) were estimated. RESULTS: In total, 9156 female mosquitoes, from 11 different species, were captured. Mosquito densities varied among the 3 districts, according to capture method, and were generally higher in the second year of collections. From 5866 specimens screened by PCR, 23 head+thorax and 41 abdomens pools, corresponding to 54 mosquitoes were found positive for D. immitis DNA. These belonged to 5 species: Culex (Cux) theileri (estimated rate of infection (ERI)=0.71%), Cx. (Cux) pipiens f. pipiens and f. molestus (ERI=0.5%), Anopheles (Ano) maculipennis s.l. (ERI=3.12%), including An. (Ano) atroparvus, Aedes (Och) caspius (ERI=3.73%) and Ae. (Och) detritus s.l. (ERI=4.39%). All but Cx. pipiens, had at least one infective specimen. No D. repens infected specimens were found. Infection rates were: 3.21% in Coimbra, 1.22% in Setúbal and 0.54% in Santarém. DDU were at least 117/year in the study period. CONCLUSIONS: Culex theileri, Cx. pipiens, An. maculipennis s.l. An. atroparvus, Ae.caspius and Ae. detritus s.l. were identified as potential vectors of D. immitis in three districts of Portugal, from Spring to Autumn, in 5 of the 6 collection dates in 2011-2013. Implications for transmission, in the context of climate changes, and need for prophylactic measures, are discussed.