RESUMEN
OBJECTIVE: To evaluate the secondary attack rate (SAR) in children and adolescents, contacts of essential activities workers who were infected by SARS-CoV-2; and to describe associated clinical and epidemiological data. METHODS: A cross-sectional study conducted in children and adolescents aged 5 to 19 years of age, that were household contacts of parents and other relatives who were infected by SARS-CoV-2 in the city of Goiânia, Central Brazil, from March to October 2020. Sociodemographic and clinical data were collected from all participants. Nasopharyngeal and oropharyngeal swabs were collected and tested for SARS-CoV-2 RNA using real-time reverse transcription polymerase chain reaction (RT-PCR). Factors associated with SARS-CoV-2 infection and SAR were analyzed using Poisson regression. RESULTS: A total of 267 children and adolescents were investigated. The prevalence of SARS-CoV-2 RNA by the real-time RT-PCR test and/or the presence of COVID-19 associated symptoms (anosmia/ageusia and flu syndrome) was 25.1% (95.0% Confidence Interval [95.0% CI] = 20.3-30.6). More than half (55.1%) of the participants had sygns and symptoms. The most prevalent signs and symptoms in positive individuals were nasal congestion (62.7%), headache (55.2%), cough (50.8%), myalgia (47.8%), runny nose (47.8%), and anosmia (47.8%). The Poisson model showed that the following signs or symptoms were associated with SARS-CoV-2 infection: fever, nasal congestion, decreased appetite, nausea, anosmia, and ageusia. Families that had more than one infected adult, in addition to the index case, presented greater transmissibility to children and adolescents. CONCLUSIONS: Our results contribute to the hypothesis that children and adolescents are not important sources of transmission of SARS-CoV-2 in the home environment during a period of social distancing and school closure; even though they are susceptible to infection in the household (around » of our study population).
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COVID-19 , SARS-CoV-2 , Adolescente , Adulto , Niño , Estudios Transversales , Ambiente en el Hogar , Humanos , ARN ViralRESUMEN
BACKGROUND: Dyslipidemia is a major risk factor in triggering cardiovascular events, which can lead to the death of millions of people around the world. Thus, several pharmacological and non-pharmacological therapeutic strategies have been developed in recent decades with the objective of improving lipid profiles, including the use of probiotics. Therefore, the purpose of this protocol is to describe the steps that will guide the construction of an overview to demonstrate the scientific evidence of the efficacy of probiotics in improving the lipid profile of dyslipidemic individuals and to propose specific recommendations regarding their use. METHODS: The search will be conducted in the following databases: MEDLINE/PubMed, EMBASE, PROSPERO, Cochrane Library, CINAHL, JBI Database of Systematic Reviews and Implementation Reports, Google Scholar, and CADTH. Reviewers will select systematic evaluations and data analyses from randomized clinical trials that evaluated the effects of probiotics on lipid profiles. The studies will be analyzed for methodology quality by the AMSTAR 2 tool and risk of bias by ROBIS. The data will be extracted by three independent reviewers based on a data extraction sheet, which will include the most relevant variables for the analysis and interpretation of the results. The variables will be categorized and described in narrative form or in tables. DISCUSSION: There are some systematic reviews about the use of probiotics to prevent and/or treat dyslipidemia; however, their outcomes related to the ability of probiotics to improve lipid profiles are conflicting. So, an overview on this topic is needed to clarify this important issue. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017080328.
Asunto(s)
Colesterol/sangre , Dislipidemias/sangre , Dislipidemias/terapia , Probióticos/uso terapéutico , Literatura de Revisión como Asunto , Triglicéridos/sangre , Humanos , Proyectos de Investigación , Revisiones Sistemáticas como AsuntoRESUMEN
OBJECTIVE: To identify the occurrence of anemia in pediatric patients on hemodialysis and the association between hemoglobin levels and anemia in CKD-related variables. METHODS: This was a retrospective study. Patients aged up to 18 years with chronic kidney disease undergoing hemodialysis at this service between January of 2009 and December of 2010 were selected. Clinical and laboratory data were obtained from medical records. Statistical analysis was performed with chi-squared test, Student's t-test and general estimating equations (GEE) using SPSS 20.0, assuming a significance level of 5%. RESULTS: A total of 357 medical records depicting the monthly evolution of 29 patients were analyzed. The most common etiology for chronic kidney disease was malformations of the genitourinary tract (28%). Hemoglobin showed a mean (standard deviation) value of 9.20 (1.8) g/dL, with the occurrence of anemia in 65.3% of cases. Anemia was associated with hospitalization; antibiotic use; transfusion; use of intravenous iron hydroxide; low values of creatinine, hematocrit, and albumin; and high values of ferritin, aluminum, and equilibrated Kt/V (p<0.05). The odds ratio for anemia with the use of intravenous iron hydroxide was 0.36 (95% CI: 0.25 to 0.89), i.e., a 2.78-fold higher chance of developing anemia without the use of this medication. CONCLUSIONS: Anemia predominated in children and adolescents with chronic kidney disease; intravenous iron hydroxide use was a protective factor.
Asunto(s)
Anemia/epidemiología , Compuestos Férricos/administración & dosificación , Hemoglobinas/análisis , Fallo Renal Crónico/terapia , Diálisis Renal/estadística & datos numéricos , Administración Intravenosa , Adolescente , Anemia/sangre , Anemia/etiología , Anemia/prevención & control , Ácido Ascórbico/sangre , Brasil/epidemiología , Niño , Femenino , Ferritinas/sangre , Estudios de Seguimiento , Humanos , Fallo Renal Crónico/sangre , Masculino , Oportunidad Relativa , Hormona Paratiroidea/sangre , Prevalencia , Estudios RetrospectivosRESUMEN
OBJECTIVE: To describe the process of integration and revision of a pediatric program curriculum which resulted in the creation of a competency-based framework recommended in the Brazilian National Curricular Guidelines. METHODS: Quali-quantitative analysis of an intervention evaluating the students and professors' perception of the pediatric program curriculum (focus groups and semi-structured interviews). Results were discussed during teaching development workshops. A competency-based framework was suggested for the pediatric program from the 3rd to the 6th year. The new curriculum was approved, implemented, and reevaluated six months later. RESULTS: Twelve students (12%) from the 3rd to the 6th year participated in the focus groups, and 11 professors (78.5%) answered the questionnaire. Most participants reported lack of integration among the courses, lack of knowledge about the learning goals of the internships, few opportunities of practice, and predominance of theoretical evaluation. In the training workshops, a competency-based curriculum was created after pediatrics and collective health professors reached an agreement. The new curriculum was focused on general competency, learning goals, opportunities available to learn these goals, and evaluation system. After six months, 93% (104/112) of students and 79% (11/14) of professors reported greater integration of the program and highlighted the inclusion of the clinical performance evaluation. CONCLUSION: The collective creation of a competency-based curriculum promoted higher satisfaction of students and professors. After being implemented, the new curriculum was considered to integrate the teaching practices and contents, improving the quality of the clinical performance evaluation.
Asunto(s)
Educación Basada en Competencias/normas , Conducta Cooperativa , Curriculum , Pediatría/educación , Desarrollo de Programa/métodos , Brasil , Humanos , Estudios Longitudinales , Evaluación de Programas y Proyectos de Salud , Investigación CualitativaRESUMEN
OBJECTIVE: To identify the occurrence of anemia in pediatric patients on hemodialysis and the association between hemoglobin levels and anemia in CKD-related variables. METHODS: This was a retrospective study. Patients aged up to 18 years with chronic kidney disease undergoing hemodialysis at this service between January of 2009 and December of 2010 were selected. Clinical and laboratory data were obtained from medical records. Statistical analysis was performed with chi-squared test, Student's t-test and general estimating equations (GEE) using SPSS 20.0, assuming a significance level of 5%. RESULTS: A total of 357 medical records depicting the monthly evolution of 29 patients were analyzed. The most common etiology for chronic kidney disease was malformations of the genitourinary tract (28%). Hemoglobin showed a mean (standard deviation) value of 9.20 (1.8) g/dL, with the occurrence of anemia in 65.3% of cases. Anemia was associated with hospitalization; antibiotic use; transfusion; use of intravenous iron hydroxide; low values of creatinine, hematocrit, and albumin; and high values of ferritin, aluminum, and equilibrated Kt/V (p < 0.05). The odds ratio for anemia with the use of intravenous iron hydroxide was 0.36 (95% CI: 0.25 to 0.89), i.e., a 2.78-fold higher chance of developing anemia without the use of this medication. CONCLUSIONS: Anemia predominated in children and adolescents with chronic kidney disease; intravenous iron hydroxide use was a protective factor. .
OBJETIVO: Identificar a ocorrência de anemia entre pacientes pediátricos em hemodiálise e a associação entre os valores de hemoglobina e variáveis relacionadas à anemia na DRC. MÉTODOS: Estudo retrospectivo. Selecionados pacientes até 18 anos com doença renal crônica em hemodiálise no serviço entre janeiro de 2009 e dezembro de 2010. Verificados prontuários para coleta de dados clínicos e laboratoriais. Análise estatística com testes de qui-quadrado, t de Student e General Estimating Equations (GEE) em programa Statistical Package for the Social Sciences 20.0, assumindo-se nível de significância de 5%. RESULTADOS: Analisadas 357 fichas de evolução médica mensal de 29 pacientes. A etiologia mais frequente para a doença renal crônica foram as malformações do trato genito-urinário (28%). Hemoglobina apresentou valor médio (desvio padrão) de 9,20 (1,8) g/dL, com ocorrência de anemia em 65,3% das consultas. Anemia associou-se a internação, uso de antibiótico, transfusão, uso de hidróxido de ferro endovenoso, valores baixos de creatinina, hematócrito e albumina e valores altos de ferritina, alumínio e Kt/V equilibrado (p < 0,05). A odds ratio para anemia com uso de hidróxido de ferro endovenoso foi 0,36 (95% IC 0,25-0,89), ou seja, uma chance 2,78 vezes maior de desenvolver anemia sem o uso dessa medicação. CONCLUSÕES: A anemia predominou em crianças e adolescentes com doença renal crônica, tendo como fator protetor o uso de hidróxido de ferro endovenoso. .
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Adolescente , Niño , Femenino , Humanos , Masculino , Anemia/epidemiología , Compuestos Férricos/administración & dosificación , Hemoglobinas/análisis , Fallo Renal Crónico/terapia , Diálisis Renal/estadística & datos numéricos , Administración Intravenosa , Anemia/sangre , Anemia/etiología , Anemia/prevención & control , Ácido Ascórbico/sangre , Brasil/epidemiología , Estudios de Seguimiento , Ferritinas/sangre , Fallo Renal Crónico/sangre , Oportunidad Relativa , Prevalencia , Hormona Paratiroidea/sangre , Estudios RetrospectivosRESUMEN
OBJETIVO: Descrever o processo de revisão e de integração curricular de um programa de pediatria por meio da criação de uma matriz de competências referenciada nas Diretrizes Curriculares Nacionais. MÉTODOS: Estudo quali-quantitativo de intervenção que avaliou a percepção de estudantes e docentes em relação ao currículo existente (grupos focais e entrevistas semiestruturadas). Discutiram-se os resultados em oficinas de desenvolvimento docente, o que propôs uma matriz baseada em competências para todo o programa de pediatria do 3º ao 6º ano. O novo currículo foi aprovado, implementado e reavaliado após 6 meses. RESULTADOS: Doze estudantes (12%) do 3º ao 6º ano participaram dos grupos focais, e 11 dos 14 professores (78,5%) responderam ao questionário. A maioria referiu falta de integração entre as disciplinas, desconhecimento dos objetivos de aprendizagem dos estágios, poucas oportunidades de práticas e avaliação predominantemente teórica. Nas oficinas de capacitação, foi criada uma matriz curricular integrada por competências após a pactuação entre professores da pediatria e da saúde coletiva. A matriz destacava a competência geral, os objetivos de aprendizagem, oportunidades disponíveis para aprendê-los e o sistema de avaliação. Após 6 meses, 93% (104/112) dos alunos e 79% (11/14) dos professores relataram que percebiam maior integração do programa e destacaram a incorporação da avaliação de desempenho clínico. CONCLUSÃO: A construção coletiva da matriz curricular por competências levou à maior satisfação de docentes e discentes com a nova proposta que, após a implementação, foi percebida como integradora de conteúdos e práticas de ensino da pediatria, tendo qualificado a avaliação de desempenho clínico.
OBJECTIVE: To describe the process of integration and revision of a pediatric program curriculum which resulted in the creation of a competency-based framework recommended in the Brazilian National Curricular Guidelines. METHODS: Quali-quantitative analysis of an intervention evaluating the students and professors' perception of the pediatric program curriculum (focus groups and semi-structured interviews). Results were discussed during teaching development workshops. A competency-based framework was suggested for the pediatric program from the 3rd to the 6th year. The new curriculum was approved, implemented, and reevaluated six months later. RESULTS: Twelve students (12%) from the 3rd to the 6th year participated in the focus groups, and 11 professors (78.5%) answered the questionnaire. Most participants reported lack of integration among the courses, lack of knowledge about the learning goals of the internships, few opportunities of practice, and predominance of theoretical evaluation. In the training workshops, a competency-based curriculum was created after pediatrics and collective health professors reached an agreement. The new curriculum was focused on general competency, learning goals, opportunities available to learn these goals, and evaluation system. After six months, 93% (104/112) of students and 79% (11/14) of professors reported greater integration of the program and highlighted the inclusion of the clinical performance evaluation. CONCLUSION: The collective creation of a competency-based curriculum promoted higher satisfaction of students and professors. After being implemented, the new curriculum was considered to integrate the teaching practices and contents, improving the quality of the clinical performance evaluation.
Asunto(s)
Humanos , Conducta Cooperativa , Curriculum , Educación Basada en Competencias/normas , Pediatría/educación , Desarrollo de Programa/métodos , Brasil , Estudios Longitudinales , Evaluación de Programas y Proyectos de Salud , Investigación CualitativaRESUMEN
Objetivo: Avaliar, a médio prazo, o efeito do uso de corticóides sobre o crescimento linear de crianças portadoras de síndrome nefrótica primária (SNP).Métodos: Análise retrospectiva de crianças entre 2 e 8 anos portadoras de SNP em tratamento no serviço de Nefrologia Pediátrica do HC-FM-UFGo, que estavam em uso de prednisona por um período mínimo de um ano. Estudaram-se as variações anuais da velocidade do crescimento durante cinco anos de acompanhamento, individualizando-se os períodos com e sem uso de corticóide. O teste t-Student foi utilizado para avaliar as correlações das variáveis com o uso do corticóide. Resultados: Foram avaliadas 29 crianças, com média de idade de 63,4 + 36,4 meses. A velocidade de crescimento anual no período do uso de corticóide variou de 2,5 -18,1 cm, com média de 7,0+ 3,2, e na ausência do uso de corticóide variou de 1,31 - 13,9 cm, com média de 6,8 + 2,8. A comparação dos grupos pelo teste T-student não demonstrou diferença estatisticamente significante (p=0,81). Conclusão: O uso da prednisona em doses terapêuticas não demonstrou alterações na velocidade de crescimento em médio prazo nesse grupo de crianças.