ABSTRACT
Abstract Objective: The literature suggests that a fetus will adapt to surrounding adversities by optimizing its use of energy to improve survival, ultimately leading to the programming of the individual's energy intake and expenditure. While recent reviews focused on the fetal programming of energy intake and food preferences, there is also some evidence that fetal adversity is associated with diminished physical activity levels. Therefore, we aimed to review (a) the evidence for an association between being born with intrauterine growth restriction and sedentarism over the life-course and (b) the potential benefits of physical activity over cardiometabolic risk factors for this population. Sources: PubMed, Scielo, Scopus and Embase. Summary of findings: Most clinical studies that used objective measures found no association between intrauterine growth restriction and physical activity levels, while most studies that used self-reported questionnaires revealed such relationships, particularly leisure time physical activity. Experimental studies support the existence of fetal programming of physical activity, and show that exposure to exercise during IUGR individuals' life improves metabolic outcomes but less effect was seen on muscle architecture or function. Conclusions: Alterations in muscle strength and metabolism, as well as altered aerobic performance, may predispose IUGR individuals to be spontaneously less physically active, suggesting that this population may be an important target for preventive interventions. Although very heterogeneous, the different studies allow us to infer that physical activity may have beneficial effects especially for individuals that are more vulnerable to metabolic modifications such as those with IUGR.
Resumo Objetivo: A literatura sugere que um feto se adaptará às adversidades externas ao aprimorar seu gasto energético para melhorar a sobrevida, o que leva, em última instância, à programação do consumo e gasto energético do indivíduo. Apesar de análises recentes terem focado na programação fetal do consumo energético e preferências alimentares, ainda há alguma comprovação de que as adversidades fetais estão associadas aos baixos níveis de atividade física. Portanto, visamos a analisar: a) a comprovação de uma associação entre nascer com restrição de crescimento intrauterino (RCIU) e sedentarismo durante o curso de vida e b) os possíveis benefícios da atividade física sobre os fatores de risco cardiometabólico dessa população. Fontes: PubMed, Scielo, Scopus e Embase. Resumo dos achados: A maior parte dos estudos clínicos que usaram medidas objetivas não constatou associação entre RCIU e os níveis de atividade física, ao passo que a maior parte dos estudos que usaram questionários de autorrelato revelou essas relações, principalmente no que diz respeito à atividade física de lazer. Estudos experimentais corroboram a existência de programação fetal de atividade física e mostram que a exposição a exercícios durante a vida de indivíduos com RCIU melhora os resultados metabólicos, porém menos efeito foi visto sobre a arquitetura ou função muscular. Conclusões: Alterações na força muscular e no metabolismo, bem como o desempenho aeróbico alterado, podem predispor indivíduos com RCIU a serem espontaneamente menos ativos fisicamente, sugere que essa população pode ser um importante alvo de intervenções preventivas. Apesar de muito heterogêneos, os diferentes estudos nos possibilitam deduzir que a atividade física pode ter efeitos benéficos principalmente em indivíduos mais vulneráveis a modificações metabólicas, como aqueles com RCIU.
Subject(s)
Humans , Male , Female , Exercise/physiology , Fetal Development/physiology , Sedentary Behavior , Fetal Growth Retardation/metabolism , Time Factors , Birth Weight/physiology , Risk Factors , Energy Metabolism/physiology , Fetal Growth Retardation/physiopathology , Motivation/physiologyABSTRACT
Descrever as características demográficas e clínicas de pacientes pediátricos internados com reação em cadeia da polimerase (PCR) positivo para Bordetella pertussis. Métodos: Estudo retrospectivo, observacional incluindo todos os pacientes pediátricos entre zero e 2 anos, 11 meses e 29 dias de idade internados em um hospital universitário com diagnóstico de coqueluche confirmado por PCR, no período de julho de 2011 a dezembro de 2012. Resultados: Foram incluídos no estudo 155 pacientes com idade média de 7,8 meses. Apenas 22 casos tinham história de contato com tosse paroxística ou prolongada (>14 dias). O tempo médio de duração de sintomas antes da admissão hospitalar foi de 9,87±10,08 dias e o tempo de internação médio foi de 5,52±9,60 dias. Tosse foi o sintoma mais prevalente (99%), sendo paroxística em apenas 16,8%. Cianose esteve presente em 29,7% e apneia em 5,8%. Além disso, 52,2% dos pacientes necessitaram oxigênio suplementar, 6,5% necessitaram de ventilação mecânica, e 2,5% foram a óbito. Conclusão: O estudo corrobora o impacto da coqueluche epidêmica sobre as crianças, principalmente lactentes, evidenciando a necessidade da implementação de novas estratégias de prevenção e controle desta infecção...
To describe the demographic and clinical characteristics of pediatric patients admitted with positive polymerase chain reaction (PCR) for Bordetella pertussis. Methods: Retrospective, observational study including all pediatric patients between zero and 2 years, 11 months and 29 days of age admitted to a university hospital, diagnosed with pertussis confirmed by PCR from July 2011 to December 2012. Results: The study included 155 patients with a mean age of 7.8 months. Only 22 cases had history of contact with people with paroxysmal or prolonged cough (>14 days). The average duration of symptoms before hospital admission was 9.87±10.08 days and the average time of hospitalization was 5.52±9.60 days. Coughing was the most prevalent symptom (99%), with paroxysmal features in only 16.8%. Cyanosis was present in 29.5% and apnea was present in 5.8%. Additionally, 52.2% of patients required supplemental oxygen, 6.5% required mechanical ventilation, and 2.5% died. Conclusion: The study corroborates the impact of epidemic pertussis in children, particularly in infants, highlighting the need for new strategies to prevent and control this infection...
Subject(s)
Humans , Whooping Cough/epidemiology , Whooping Cough/prevention & controlABSTRACT
Pyroglutamic acid (also known as 5-oxoproline) is an organic acid intermediate of the gamma-glutamyl cycle. Accumulation of pyroglutamic acid is a rare cause of high anion gap metabolic acidosis. In the pediatric population, the congenital form of pyroglutamic acidemia has been extensively described. However, there are scarce reports of the acquired form of this condition in children. The urine test for organic acids confirms the diagnosis of pyroglutamic acidemia. We report the case of a 16-month-old girl who developed transient 5-oxoprolinemia associated with malnutrition and the use of acetaminophen and ampicillin for the treatment of acute otitis media and abdominal pain. The patient received 21-hour course of n-acetylcysteine with improvement of metabolic acidosis. This report highligts the need of considering pyroglutamic acidemia in the differencial diagnosis for high anion gap metabolic acidosis in pediatric patients with malnutrition and other risk factors...
Subject(s)
Humans , Glutathione Synthase/deficiency , Ketosis , Pyrrolidonecarboxylic AcidABSTRACT
Description of a case report of Gorlin-Goltz Syndrome diagnosed in a male newborn who presented increased head circumference and bifid ribs. Mother and grandmother presented typical physical findings of the syndrome, including palmar pits, odontogenic cysts, and history of multiple skin cancer resections. The diagnosis was based on clinical findings of three relatives. A literature review is also presented.
Subject(s)
Humans , Male , Infant, Newborn , Symptom Assessment , Basal Cell Nevus Syndrome/complications , Basal Cell Nevus Syndrome/diagnosis , Basal Cell Nevus Syndrome/etiology , Basal Cell Nevus Syndrome/physiopathology , Basal Cell Nevus Syndrome/pathology , Musculoskeletal Abnormalities/etiology , Neoplasms/etiologyABSTRACT
Description of two cases of pyogenic liver abscess. The first case: a 3-years-old immunocompetent girl with fever, abdominal pain, vomiting, and diarrhea. Abdominal ultrasound: multiloculated heterogeneous collection in the right hepatic lobe (figure 1A). The second case, a 1-year-old girl with congenital neutropenia, showed fever,malaise, anorexia, sweating and pallor. Abdominal computed tomography showed hypodense lesion with heterogeneous impregnation by contrast in the left hepatic lobe (figure 1B). Different clinical presentations, images and treatment are of special interest in pediatrics and are reviewed in this text.