Clinical course and disease burden of patients with generalized pustular psoriasis in Portugal: a multicenter retrospective cohort study.

OBJECTIVES: Generalized pustular psoriasis (GPP) is a rare, life-threatening skin inflammatory disorder. This study aimed to describe the disease course, treatment strategies, and healthcare utilization among patients with GPP in Portugal. METHODS: This multicentric, observational, retrospective study included consecutive adult patients with GPP undergoing a dermatology evaluation in different reporting institutions by experienced dermatologists between 2002 and 2023. RESULTS: A total of 59 patients were assessed. Most of the cohort had a previous history of plaque psoriasis (71%) and 83% presented at least one comorbidity. At the initial encounter, 64% of the cohort needed hospitalization. Systemic involvement was common, including fever (37%), and elevated white blood cell count and erythrocyte sedimentation rate/C-reactive protein (49%). Nearly, 73% of patients initiated systemic drugs, and 70% had to discontinue the first treatment. During the study, 98% of patients experienced at least one flare. At the last visit, 3.4% of patients had died, and 71.2% exhibited signs of active disease despite undergoing treatment. CONCLUSIONS: Our study demonstrates that GPP is a chronic, debilitating condition associated with systemic involvement, frequent flares, and hospitalizations, despite receiving multiple systemic treatments. Improved disease awareness and new treatments are needed to improve patient care and decrease the burden of the disease.

Direct links between resource availability and activity budget better reveal ecological patterns of endangered Coimbra-Filho's titi monkey.

Many primatological studies do not assess direct indexes of food availability to make inferences about behavioral strategies. We related the diet and behavior of a group of Callicebus coimbrai in northeastern Brazil to fruit availability indexes and compared this pattern between seasons (direct and indirect assessment of food availability) to assess whether direct and indirect approaches detect similar ecological patterns. We monitored the study group for 33 months (5 days/month) via scan sampling. The monthly availability of fruits and new leaves was recorded in phenological transects. Fruit availability varied across years based on fruit prevalence, and timing and duration of the abundant seasons. We did not find evidence of a time-minimizing strategy, since C. coimbrai did not change its activity levels according to food availability. However, the negative relationship between foraging and fruit availability indicates that C. coimbrai can compensate for the lower fruit availability by increasing the search for alternative food sources. Monthly fruit consumption was positively correlated to fruit availability and negatively related to the consumption of other food items. However, the behavioral and feeding profiles did not vary between seasons and were not related to rainfall levels. Primate studies should directly relate behavioral and feeding profiles to fruit availability indices, thus avoiding using seasons as proxies of food availability.

Physical and Psychological Maltreatment of Deaf and Hard of Hearing Children: Frequency and Associated Factors in a Low Socioeconomic Setting.

Few studies have assessed frequency of maltreatment and other factors associated with maltreatment of deaf and hard of hearing children. The present study's objective was to verify the frequency of physical and psychological maltreatment and associated factors experienced by DHH children. DHH children from low-income families in Maceió, Brazil, were studied (N = 265). The Parent-Child Conflict Tactics Scales (Straus et al., 1998) were used to identify nonviolent discipline, psychological aggression, and physical assault (minor, severe, very severe). The study found that 221 children (83.4%) experienced physical assault; 238 (89.8%) experienced psychological aggression. Both physical and psychological aggression was reported for 94.3%. Most mothers (98.1%) reported using nonviolent discipline. Maltreatment was associated with male children, mothers' job dissatisfaction, religiously nonobservant families, and children born of unintended pregnancy. In conclusion, high frequencies of physical and psychological maltreatment of DHH children of low-income families were found.

Evaluation of Four Clinical Metrology Instruments for the Assessment of Osteoarthritis in Dogs.

Osteoarthritis (OA) is the most commonly diagnosed joint disease in companion animals, and proper tools are necessary to assess patients and response to treatment. We aimed to perform the psychometric evaluation of several clinical metrology instruments (CMI), developed to evaluate pain and assess outcome. Fifty police working dogs with bilateral hip OA were assessed in a prospective, randomised, double-blinded study. Patients were evaluated using a stance analyser in six different moments divided over a 180-day period. Pedometer step count, weight-bearing symmetry index and deviation from normal weight-bearing were calculated and used for criterion validity. In each evaluation moment, a copy of the Hudson Visual Analogue Scale (HVAS), Canine Brief Pain Inventory (CBPI), Liverpool Osteoarthritis in Dogs (LOAD) and Canine Orthopaedic Index (COI) were completed by the dogs' handlers. Correlations between CMIs were evaluated as construct validity. Further evaluation was performed with the Kaiser-Meyer-Olin measure of sampling adequacy, Eigenvalue and scree-plot analysis. Internal consistency was tested with Cronbach's α. Significant weak correlation was found between all CMIs and stance analysis symmetry index measure and deviation, indicating criterion validity. Significant weak correlation was also found between pedometer count and LOAD plus COI. Cronbach's α was 0.80 for HVAS, 0.98 for CBPI, 0.97 for LOAD and 0.98 for COI. Significant strong correlation was observed between CMIs, indicating construct validity. We present criterion and construct validity of these CMIs, which are able to capture various dimensions of OA. They can be used for the evaluation of osteoarthritis and response to treatment in dogs.

A survey on the orthopedic and functional assessment in a Portuguese population of police working dogs.

BACKGROUND: Working dogs are at an increased risk of developing an orthopedic disease compared to companion dogs. This study aimed to evaluate functional and orthopedic index fitness in a Portuguese population of police working dogs. In an observational, prospective study, information on 165 dogs was collected. The age, sex, breed, specific work, and history of previous diagnosis of orthopedic disease were recorded for each patient. A copy of the Canine Orthopedic Index (COI), Hudson Visual Analogue Scale (HVAS), and Functional Assessment (FA) was collected for all dogs. COI, HVAS, and FA scores between breeds, work, age, sex, and history of a previous diagnosis of orthopedic disease were compared. Multiple regression was run to predict COI, HVAS, and FA scores from breeds, work, age, sex, and history of orthopedic disease. Correlations between items were determined with Pearson's correlation. A p < 0.05 was set. RESULTS: The sample was composed of 92 males and 73 females, with a mean age of 5.2 ± 3.2 years. Four main dog breeds were represented, 60 Belgian Malinois Shepherd Dogs, 52 German Shepherd Dogs, 29 Labrador Retrievers, and 14 Dutch Shepherd Dog. A prevalence of diarrhea of 10.6% was determined, with 4% of dogs having liquid diarrhea. German Shepherd Dogs had significantly higher FA scores (p = 0.03). Dogs with a history of previous veterinary assistance due to orthopedic issues had significantly lower HVAS scores and higher scores with all remaining questionnaires (p < 0.01 for all). No differences were found between sexes or specific work. Age and a history of orthopedic disease contributed to the prediction of all scores. FA scores had a good correlation with COI and HVAS. CONCLUSION: This population of police working dogs has a good to excellent level of physical fitness. There was a relationship between increasing age, history of orthopedic disease, and worse scores with all questionnaires. All considered questionnaires could differentiate between animals with a previous history of orthopedic disease and sound dogs.

Percepção da comunidade sobre suas ações preventivas contra dengue, zika e chikungunya nas cinco regiões do Brasil / Community perception of its preventive actions against dengue, zika and chikungunya in five Brazilian regions

Resumo O controle ambiental do vetor no interior e ao redor dos domicílios, enquanto estratégia fundamental para a prevenção de arboviroses como dengue, zika e chikungunya, demanda um envolvimento ininterrupto da população. A pandemia de Covid-19 e, consequentemente, o isolamento social necessário ao seu controle, têm reduzido a vigilância profissional nos domicílios, tornando a atuação da população ainda mais necessária. Estudos que buscam compreender o envolvimento das comunidades na execução das ações preventivas têm sido quase exclusivamente locais. O artigo relata uma pesquisa-intervenção baseada em oficinas sobre práticas preventivas realizadas antes do isolamento social, em 16 municípios das 5 regiões brasileiras, as quais envolveram um total de 379 participantes. Os resultados apresentam as ações preventivas preconizadas por campanhas que são as mais comumente compreendidas e executadas pela população; as situações que dificultam a execução; as práticas preventivas de iniciativa própria dos cidadãos; e as práticas baseadas em saberes populares. Ficou evidente que as informações fornecidas às comunidades não podem estar restritas às campanhas de massa, e que se faz necessário investir em ações educativas mais efetivas e adequadas à variedade de contextos nacionais, com vistas a construções coletivas e intersetoriais de estratégias de enfrentamento às arboviroses.

Abstract The environmental control of the vector inside and around households, as a fundamental strategy for the prevention of arboviruses such as dengue, zika and chikungunya, demands an uninterrupted involvement of the population. The pandemic context of Covid-19, and consequently the social isolation has reduced professional surveillance in the households, making the performance of the population even more necessary. Studies that seek to understand the involvement of communities in the implementation of preventive actions have been almost exclusively local. This article reports an intervention research based on workshops on preventive practices carried out before social isolation, in 16 municipalities in the five Brazilian regions and involved 379 participants. Our results show the preventive actions recommended by campaigns that are the most commonly understood and performed by the population; situations that hinder execution; preventive practices of citizens' own initiative; and practices based on popular knowledge. It became evident that information to communities cannot be restricted to mass campaigns, and that it is necessary to invest in educational actions adequate to the variety of national contexts, seeking collective and intersectoral constructions of strategies to confront arboviruses.

The parental care partnership in the view of parents of children with special health needs. / A parceria de cuidados pelo olhar dos pais de crianças com necessidades especiais de saúde.

OBJECTIVE To understand how the care partnership was experienced by parents of children with special healthcare needs. METHOD Qualitative, descriptive and exploratory study, carried out from December 2013 to February 2014. The method used was the narrative. The population corresponded to parents of children admitted to a medical service of a Pediatric Hospital in Portugal. The sample consisted of 10 parents. The data collection included the sociodemographic characterization and the etnobiografic orientation interview. Once transcribed, the interviews yielded 10 narratives of partnership experiences between the parents and the nursing team. RESULTS It was noted, as partnership opportunities, the training of parents and the collaborative decision-making, established in a dynamic, unique and ongoing relational process. CONCLUSION The opportunities for partnership are key assumptions for the care delivery focusing on the child and on the parents as their resources.

A parceria de cuidados pelo olhar dos pais de crianças com necessidades especiais de saúde / La colaboración en cuidados según la mirada de padres de niños con necesidades especiales de salud / The parental care partnership in the view of parents of children with special health needs

Resumo OBJETIVO Compreender como foi experienciada a parceria de cuidados pelos pais de crianças com necessidades especiais de saúde. MÉTODO Estudo qualitativo, descritivo e exploratório, realizado no período de dezembro de 2013 a fevereiro de 2014. O método utilizado foi a narrativa. A população correspondeu aos pais de crianças internadas num serviço de medicina de um Hospital Pediátrico em Portugal. A amostra foi constituída por 10 pais. A coleta de dados contemplou a caracterização sociodemográfica e a entrevista de orientação etnobiográfica. Depois de transcritas, as entrevistas originaram 10 narrativas de experiências de parceria dos pais com a equipe de enfermagem. RESULTADOS Constatou-se, enquanto oportunidades de parceria, a capacitação dos pais e a tomada de decisão em parceria, estabelecidas num processo relacional dinâmico, singular e contínuo. CONCLUSÃO As oportunidades de parceria são pressupostos fundamentais para a prestação de cuidados com foco na criança e nos pais enquanto recursos da mesma.

Resumen OBJETIVO Comprender la percepción experimentada por padres de niños con necesidades especiales de salud sobre su colaboración en los cuidados de enfermería. MÉTODO Estudio cualitativo, descriptivo y exploratorio, realizado entre diciembre de 2013 y febrero de 2014. El método utilizado fué la narrativa. La muestra poblacional abarcó a padres de niños internados en servicio de medicina de un hospital pediátrico de Portugal. La muestra fue constituida por 10 padres. La recolección de datos incluyó la caracterización sociodemográfica y la entrevista de orientación etnobiográfica. Después de transcritas, las entrevistas se produjeron 10 historias de experiencias de colaboración de los padres con el equipo de enfermería. RESULTADOS Se confirmó la existencia de oportunidades de asociación, la capacitación de los padres y la toma de decisiones en conjunto, las cualesson establecidas en un proceso relacional dinámico, único y permanente. CONCLUSIÓN Las oportunidades de asociación son condiciones fundamentales para la prestación de cuidados de atención en los niños, siendo los padres los medios del niño para obtenerlos.

Abstract OBJECTIVE To understand how the care partnership was experienced by parents of children with special healthcare needs. METHOD Qualitative, descriptive and exploratory study, carried out from December 2013 to February 2014. The method used was the narrative. The population corresponded to parents of children admitted to a medical service of a Pediatric Hospital in Portugal. The sample consisted of 10 parents. The data collection included the sociodemographic characterization and the etnobiografic orientation interview. Once transcribed, the interviews yielded 10 narratives of partnership experiences between the parents and the nursing team. RESULTS It was noted, as partnership opportunities, the training of parents and the collaborative decision-making, established in a dynamic, unique and ongoing relational process. CONCLUSION The opportunities for partnership are key assumptions for the care delivery focusing on the child and on the parents as their resources.

Systematic review of endometriosis pain assessment: how to choose a scale?

BACKGROUND: Numerous studies concerning endometriosis and pain have been reported. However, there is no consensus on the best method to evaluate pain in endometriosis and many scales have been used. Moreover, there are only a few descriptions of minimal clinically important differences after treatment (MCID) to evaluate variations in pain. In our study, we aim to identify pain scales used in endometriosis pain treatment, to address their strong and weak points and to define which would be the ideal scale to help clinicians and researchers to evaluate endometriosis-related pain. METHODS: A search of the MEDLINE and EMBASE databases was carried out for publications in English, French or Portuguese from 1980 to December 2012, for the words: endometriosis, treatment, pain. Studies were selected if they studied an endometriosis treatment and a pain scale was specified. A quantitative and a qualitative analysis of each scale was performed to define strong and weak points of each scale (systematic registration number: CRD42013005336). RESULTS: A total of 736 publications were identified. After excluding duplications and applying inclusion criteria 258 studies remained. We found that the visual analog scale (VAS) is the most frequently used scale. Both VAS and the numerical rating scale (NRS) show a good balance between strong and weak points in comparison with others such as the Biberoglu and Behrman scale. Concerning MCID, only VAS, NRS and Brief Pain Inventory scales have reported MCID and, among these, only VAS MCID has been studied in endometriosis patients (VAS MCID = 10 mm). Adding the Clinical Global Impression score (CGI) to the pain scale allows calculation of the MCID. CONCLUSIONS: When using pain scales their strengths and weaknesses must be known and included in the analysis. VAS is the most frequently used pain scale and, together with NRS, seems the best adapted for endometriosis pain measurement. The use of VAS or NRS for each type of typical pain related to endometriosis (dysmenorrhea, deep dyspareunia and non-menstrual chronic pelvic pain), combined with the CGI and a quality-of-life scale will provide both clinicians and researchers with tools to evaluate treatment response.

[Intergenerational evolution of stature in Pernambuco State, Brazil (1945-2006): 2 - analytical aspects]. / Evolução intergeracional da estatura no Estado de Pernambuco, Brasil, entre 1945 e 2006: 2 - aspectos analíticos.

This study used multivariate regression models to identify factors associated with the height trend in residents of Pernambuco State, Brazil, in 2006, born from 1945 onward. The data were from two population-based statewide surveys. In the final model for each age bracket, year of birth, gender, schooling, and residence in urban areas were positively associated with stature in adults, as well as in children and adolescents 5 to 19 years of age. In children under five years, in addition to these variables, birth weight and prenatal care were also positively associated, while diarrhea in the two weeks prior to the interview showed a negative association. The findings show that stature was favored by settings with better socioeconomic and environmental conditions.

Evolução intergeracional da estatura no Estado de Pernambuco, Brasil, entre 1945 e 2006: 2 - aspectos analíticos / Intergenerational evolution of stature in Pernambuco State, Brazil (1945-2006): 2 - analytical aspects

Utilizando-se modelos de regressão multinível, foram identificados fatores relacionados à evolução estatural de pessoas residentes em Pernambuco, Brasil, em 2006 e nascidas a partir de 1945. Os dados provêm de dois inquéritos estaduais de base populacional. No modelo final de cada grupo etário, ano de nascimento, sexo, escolaridade, renda e residência em área urbana ficaram positivamente associadas ao crescimento estatural dos adultos, bem como de crianças e adolescentes de 5 a 19 anos. Nos menores de cinco anos, além dessas variáveis, também ficaram positivamente associados o peso ao nascer e a realização de pré-natal, enquanto a ocorrência de diarreia nas últimas duas semanas anteriores à entrevista mostrou associação negativa. Os resultados do estudo mostram que o crescimento estatural foi mais favorecido em ambientes nos quais predominaram melhores condições socioeconômicas e ambientais.

This study used multivariate regression models to identify factors associated with the height trend in residents of Pernambuco State, Brazil, in 2006, born from 1945 onward. The data were from two population-based statewide surveys. In the final model for each age bracket, year of birth, gender, schooling, and residence in urban areas were positively associated with stature in adults, as well as in children and adolescents 5 to 19 years of age. In children under five years, in addition to these variables, birth weight and prenatal care were also positively associated, while diarrhea in the two weeks prior to the interview showed a negative association. The findings show that stature was favored by settings with better socioeconomic and environmental conditions.

Prevalence and predictors of physical inactivity in a slum in Brazil.

The aim of this study was to ascertain the prevalence of physical inactivity and examine the role of potential predictors in a very low-income adult population in a slum located in Recife city, northeast of Brazil. A cross-sectional study was conducted with 1,176 subjects aged 20-60 years residing in a slum. Using the short version of the International Physical Activity Questionnaire, 307 (26.1%) study participants-97 (23.8%) men and 210 (27.3%) women-have a low physical activity score (MET-minutes per week). Increased age was associated with physical inactivity only in people without overweight/obesity. Low physical activity was less common (i.e., respondents were more active) than in other Brazilian population-based studies. These results suggest that the relationship between physical activity and socioeconomic level is more complex and depends on the internal characteristics of the community.

Condição socioeconômica e prevalência de más oclusões em crianças de 5 e 12 anos na USF Castelo Branco III: João Pessoa/Paraíba / Prevalence of malocclusions and social-economic conditions of children aged 5 and 12 years old in the Familiar Health Unit of Castelo Branco III, João Pessoa/PB

OBJETIVO: verificar a prevalência de más oclusões e condições socioeconômicas de crianças de 5 e 12 anos na Unidade de Saúde da Família Castelo Branco III, em João Pessoa/PB. METODOLOGIA: foram examinadas 49 crianças com idades de 5 e 12 anos. Os exames seguiram a metodologia da OMS (1997) e SB Brasil (2001), e utilizou-se o critério da OMS (1997) e o Dental Aesthetic Index (DAI). RESULTADOS: constatou-se que a maioria das crianças já tinha frequentado consultório odontológico (principalmente os da rede pública). A presença de más oclusões foi observada em 33,3 por cento das crianças de 5 anos de idade e 40,7 por cento das de 12 anos, no entanto, não houve associação com o gênero em ambas as faixas etárias (p > 0,05). A maioria das mães apresentou escolaridade acima de 8 anos (80,8 por cento para as crianças de 5 anos e 92,5 por cento para as de 12 anos), relatando renda abaixo de dois salários mínimos, em ambas as faixas etárias estudadas. Observou-se acesso a insumos de higiene bucal (97,9 por cento possuíam escovas) e uma boa frequência de escovação foi relatada (64,6 por cento escovavam 3 ou mais vezes ao dia). CONCLUSÕES: não houve concordância entre os critérios adotados para definição de má oclusão e autopercepção em relação à aparência, ao tratamento e à mastigação. Diante disso, faz-se necessária a implementação de políticas públicas para prevenção e tratamento ortodôntico nessas crianças.

AIM: To verify the prevalence of malocclusions and social-economic conditions of children aged 5 and 12 years old in the Familiar Health Unit of Castelo Branco III, João Pessoa/PB. METHODS: 49 children aged 5 and 12 years old were examined. The exams followed the methodology of the WHO (1997) and SB Brazil (2001), and was used the criterion of the WHO (1997) and the Dental Aesthetic Index (DAI). RESULTS: It was found that most of the children had already gone to the dental office (mainly of the ones of the public network). The presence of malocclusions was observed in 33.3 percent of the 5 years old children and 40.7 percent of the 12 years old, there was no association with the gender in both ages (p > 0.05). Most of the mothers presented education above 8 years (80.8 percent for the 5 years old children and 92.5 percent for the 12 years old), related income below two minimum salaries in both ages studied. It was observed the access to mouth health products (97.9 percent had toothbrush) and a good frequency of brushing was related (64.6 percent brushed 3 or more times a day). CONCLUSION: There was no agreement between the criterion adopted for definition of malocclusion and self perception towards the appearance, treatment and mastication. Facing this, it was necessary the implementation of public politics for prevention and orthodontic treatment in these children.

[Effect of physical exercise on bodyweight in overweight children: a randomized controlled trial in a Brazilian slum]. / Efeito do exercício físico sobre peso corporal em crianças com excesso de peso: ensaio clínico comunitário randomizado em uma favela no Brasil.

Given the increase in obesity in developed and developing countries and its concomitant morbidity, successful treatment approaches are needed. We examined the effect of a structured exercise intervention in overweight children in a slum in Recife, Pernambuco State, Brazil. This was a randomized, controlled efficacy trial. Seventy-eight children were randomized. Exercise was supervised, consisting of three 50' group aerobics sessions per week for six months. All participants maintained ad libitum diets. Based on intention-to-treat analyses, children in both groups had a significant increase in weight at follow-up (p-value for within-group increase < or = 0.01). The increase in weight was significantly lower in the exercise group (mean difference between groups; -1.37; 95%CI: -2.00; -0.74). A significant difference (p = 0.049) between the exercise and control groups at six-month follow-up was also found for BMI (mean difference between groups; -0.53; 95%CI: -1.06; -0.002). When we restricted the analyses to children who completed the trial (intervention = 30 and control = 38), the results were the same. An exercise program for children, sustained for six months, was effective for reducing weight gain in overweight children living in a very poor neighborhood.

Efeito do exercício físico sobre peso corporal em crianças com excesso de peso: ensaio clínico comunitário randomizado em uma favela no Brasil / Effect of physical exercise on bodyweight in overweight children: a randomized controlled trial in a Brazilian slum

Associação da obesidade com doenças crônicas tem se mostrado mais intensa nas áreas carentes. Examinamos o efeito de um programa de exercício físico para crianças com excesso de peso, em uma favela do Recife, Pernambuco, Brasil, por meio de um ensaio comunitário, randomizado, com 78 crianças. Um grupo (n = 39) recebeu três aulas semanais de exercícios físicos durante seis meses. Não foi realizada nenhuma intervenção em relação à alimentação. A análise por intenção de tratamento demonstrou que todas as crianças apresentaram aumento significativo de peso. Entretanto, esse aumento foi menor no grupo que sofreu a intervenção (diferença média entre os grupos; -1.37; IC95 por cento: -2,00; -0,74). Em relação ao índice de massa corporal (IMC), também foi verificada uma diferença significativa (p = 0,049) entre os dois grupos (diferença média entre os grupos; -0,53; IC95 por cento: -1,06; -0,002). Na análise restrita às crianças que completaram o estudo (intervenção = 30 e controle = 38), os resultados foram similares. Concluímos que um programa regular de exercícios físicos para crianças com excesso de peso em áreas carentes seja eficaz, sem a necessidade de intervenções dietéticas, na redução do ganho ponderal e do IMC.

Given the increase in obesity in developed and developing countries and its concomitant morbidity, successful treatment approaches are needed. We examined the effect of a structured exercise intervention in overweight children in a slum in Recife, Pernambuco State, Brazil. This was a randomized, controlled efficacy trial. Seventy-eight children were randomized. Exercise was supervised, consisting of three 50' group aerobics sessions per week for six months. All participants maintained ad libitum diets. Based on intention-to-treat analyses, children in both groups had a significant increase in weight at follow-up (p-value for within-group increase < 0.01). The increase in weight was significantly lower in the exercise group (mean difference between groups; -1.37; 95 percentCI: -2.00; -0.74). A significant difference (p = 0.049) between the exercise and control groups at six-month follow-up was also found for BMI (mean difference between groups; -0.53; 95 percentCI: -1.06; -0.002). When we restricted the analyses to children who completed the trial (intervention = 30 and control = 38), the results were the same. An exercise program for children, sustained for six months, was effective for reducing weight gain in overweight children living in a very poor neighborhood.

[Overweight, physical activity and foods habits in adolescents from different economic levels, Campina Grande (PB)]. / Excesso de peso, atividade física e hábitos alimentares entre adolescentes de diferentes classes econômicas em Campina Grande (PB).

OBJECTIVE: To compare overweight and obesity, eating habits and life style among adolescents from different economic levels. METHODS: A cross-sectional study was undertaken with 588 adolescents from a public and a private school in Campina Grande, PB. They belonged to economic levels A(1), A(2) and B(1)(292) and C, D and E (296), according to the Brazilian Criteria of Economic Classification of the Brazilian Association of Research Iistitutes. Height and body weight were measured and Body Mass Index (BMI) was calculated; >or= p85 = overweight and >or= p95 = obesity. A questionnaire for assessment of leisure time, physical activity, time spent watching TV and eating habits was administered. RESULTS: Overweight and obesity were more common in the higher economic level than in the lower economic one; 31.4% versus 18.1% ; p < 0.001. Leisure time for physical activity was more present in adolescents with A(1), A(2) e B(1) economic status. Watching TVdisclosed no difference between the two economic levels surveyed. Daily consumption of softs drinks, sweets and salty snacks were more common in the higher economic level but this was not associated with obesity. A low consumption of fruits was observed in all economic levels. CONCLUSION: Overweight and obesity are frequent among adolescents of Campina Grande, PB, as well as time spent watching TV and unhealthy eating habits, especially among those of the higher economic level.. The amount of time spent on leisure for physical activities was low, especially in the lower economic level.

Excesso de peso, atividade física e hábitos alimentares entre adolescentes de diferentes classes econômicas em Campina Grande (PB) / Overweight, physical activity and foods habits in adolescents from different economic levels, Campina Grande (PB)

OBJETIVO: Comparar a freqüência de sobrepeso e obesidade, hábitos alimentares e de estilo de vida, entre adolescentes de diferentes condições econômicas. MÉTODOS: Foi realizado um estudo transversal com 588 adolescentes, alunos de uma escola pública ou privada na cidade de Campina Grande/PB, pertencentes a classes econômicas diferentes, pelos critérios da Associação Brasileira de Empresas de Pesquisa. Foram calculados o índice de massa corpórea (IMC > p85 = excesso de peso e > p95 = obesidade), aplicado um questionário para avaliar atividade física de lazer, horas gastas assistindo a TV e hábitos alimentares. RESULTADOS: Foi observado um maior número de adolescentes com sobrepeso / obesidade nas classes econômicas A¹, A² e B¹ do que nas classes C, D e E; 93/292 (31,4 por cento) versus 53/296 (18,1 por cento); p<0,001. Atividade física de lazer foi mais freqüente entre os alunos das classes econômicas A¹, A² e B¹. Quanto às horas diárias gastas assistindo a TV, não foi observada diferença significativa entre os dois grupos estudados. Consumo diário de refrigerantes, doces e salgadinhos foi hábito alimentar mais comum nos adolescentes pertencentes às classes econômicas mais abastadas, embora não associado com excesso de peso / obesidade. Registrou-se um baixo consumo de frutas nos dois grupos estudados. CONCLUSÃO: São elevadas as freqüências de sobrepeso e obesidade entre adolescentes em Campina Grande/PB, assim como o tempo gasto assistindo a TV e os maus hábitos alimentares, especialmente naqueles pertencentes às classes econômicas mais favorecidas. É reduzido o tempo despendido com atividades físicas de lazer, principalmente nas classes econômicas desfavorecidas.

OBJECTIVE: To compare overweight and obesity, eating habits and life style among adolescents from different economic levels. METHODS: A cross-sectional study was undertaken with 588 adolescents from a public and a private school in Campina Grande, PB. They belonged to economic levels A¹, A² and B¹(292) and C, D and E (296), according to the Brazilian Criteria of Economic Classification of the Brazilian Association of Research Iistitutes. Height and body weight were measured and Body Mass Index (BMI) was calculated; > p85 = overweight and > p95 = obesity. A questionnaire for assessment of leisure time, physical activity, time spent watching TV and eating habits was administered. RESULTS: Overweight and obesity were more common in the higher economic level than in the lower economic one; 31.4 percent versus 18.1 percent ; p < 0.001. Leisure time for physical activity was more present in adolescents with A¹, A² e B¹ economic status. Watching TVdisclosed no difference between the two economic levels surveyed. Daily consumption of softs drinks, sweets and salty snacks were more common in the higher economic level but this was not associated with obesity. A low consumption of fruits was observed in all economic levels. CONCLUSION: Overweight and obesity are frequent among adolescents of Campina Grande, PB, as well as time spent watching TV and unhealthy eating habits, especially among those of the higher economic level.. The amount of time spent on leisure for physical activities was low, especially in the lower economic level.

Custos hospitalares com crianças e adolescentes vítimas de traumatismos no Estado de Pernambuco em 1999 / Hospital costs of trauma-related hospitalizations of children and adolescents in the State of the Pernambuco in 1999

Avaliou-se os gastos do Sistema Unico de Saúde (SUS) com internações hospitalares de crianças e adolescentes, vítimas de traumatismos no estado de Pernambuco, no ano de 1999. Utilizou-se o banco de dados do Sistema de Informações Hospitalares do DATASUS, construído a partir das informações contidas nas Autorizações de Internação Hospitalar (AIH). Foram registradas 9.220 internações por causas externas a um custo de R$ 3.659.558,62, sendo 7.807 por traumatismos (84,7 por cento). O custo médio no estado de Pernambuco nesse ano, para as internações por todos os diagnósticos na faixa etária de 0 a 19 anos, foi de R$ 306,49. Quando se computou apenas os traumatismos o custo médio passou para R$ 370,66. Os maiores gastos ocorreram com os traumatismos intracranianos e as fraturas de membros superiores e inferiores.

[Analysis of social and environmental risk for pleural involvement in severe pneumonia in children younger than 5 years of age]. / Análise de risco sócio-ambiental para comprometimento pleural na pneumonia grave em crianças menores de 5 anos.

OBJECTIVE: To determine social and environmental risk factors associated with pleural involvement among children from 3 to 59 months old who were hospitalized with severe pneumonia in northeastern Brazil. METHODS: This was an observational and descriptive cross-sectional study with an analytical component. We evaluated 154 patients hospitalized due to severe pneumonia, with or without pleural involvement. Pleural involvement was determined based on radiological findings. The following variables were analyzed: age, sex, place of residence, housing conditions, day care attendance, passive smoking, family income, presence of consumer goods in the home (e.g., television, radio, refrigerator, automobile), and schooling and occupation of the mother or other caregiver. The information was obtained by interviewing the mother or other caregiver or by consulting the inpatient medical chart. RESULTS: The frequency of pleural involvement among the 154 patients evaluated was 25.3%. The following factors were associated with pleural involvement: living in a rural area, being in a household with two or fewer rooms, family income below 170 U.S. dollars per month, and birthweight < 2 500 g. CONCLUSIONS: These findings indicate the need to improve the socioeconomic and living conditions of the less-privileged population, especially in rural areas. The health sector should emphasize primary care, focusing on a preventive approach beginning in the prenatal period.

Análise de risco sócio-ambiental para comprometimento pleural na pneumonia grave em crianças menores de 5 anos / Analysis of social and environmental risk for pleural involvement in severe pneumonia in children younger than 5 years of age

OBJETIVO: Determinar fatores de risco sócio-ambientais associados ao desenvolvimento de comprometimento pleural em crianças de 3 a 59 meses internadas com pneumonia grave em um hospital do Nordeste brasileiro. MÉTODOS: Estudo observacional, transversal, descritivo, com componente analítico. Foram avaliados 154 pacientes hospitalizados com pneumonia grave, com ou sem comprometimento pleural. O comprometimento pleural foi definido segundo achados radiológicos. As seguintes variáveis sócio-ambientais foram analisadas: faixa etária, sexo, local de residência, condições do domicílio, freqüência à creche, fumo passivo, renda familiar, presença de bens de consumo, escolaridade e trabalho extra-domiciliar da mãe ou responsável pela criança. As informações foram obtidas através de entrevistas com o responsável pelo paciente ou consulta ao prontuário médico durante a hospitalização. RESULTADOS: A freqüência de comprometimento pleural foi de 25,3 por cento. Os seguintes fatores foram associados à ocorrência de comprometimento pleural: residência em zona rural, dois cômodos ou menos no domicílio, renda familiar mensal inferior a 170 dólares e peso de nascimento <2 500 g. CONCLUSÕES: Os achados sugerem a necessidade de priorizar a melhoria das condições socioeconômicas e de moradia da população mais carente, principalmente aquela oriunda do meio rural. O setor saúde deve enfatizar a atenção primária, com enfoque preventivo desde o período pré-natal.

Objective. To determine social and environmental risk factors associated with pleural involvement among children from 3 to 59 months old who were hospitalized with severe pneumonia in northeastern Brazil. Methods. This was an observational and descriptive cross-sectional study with an analytical component. We evaluated 154 patients hospitalized due to severe pneumonia, with or without pleural involvement. Pleural involvement was determined based on radiological findings. The following variables were analyzed: age, sex, place of residence, housing conditions, day care attendance, passive smoking, family income, presence of consumer goods in the home (e.g., television, radio, refrigerator, automobile), and schooling and occupation of the mother or other caregiver. The information was obtained by interviewing the mother or other caregiver or by consulting the inpatient medical chart. Results. The frequency of pleural involvement among the 154 patients evaluated was 25.3%. The following factors were associated with pleural involvement: living in a rural area, being in a household with two or fewer rooms, family income below 170 U.S. dollars per month, and birthweight < 2 500 g. Conclusions. These findings indicate the need to improve the socioeconomic and living conditions of the less-privileged population, especially in rural areas. The health sector should emphasize primary care, focusing on a preventive approach beginning in the prenatal period.