Inclusion of chia seeds (Salvia hispanica L.) and pumpkin seeds (Cucurbita moschata) in dairy sheep diets.

Chia (Salvia hispanica L.) seed (CS) and Pumpkin (Cucurbita moschata) seed (PS) are used in ruminant diets as energy sources. The current experiment studied the impact of dietary inclusion of CS and PS on nutrient intake and digestibility, milk yield, and milk composition of dairy sheep. Twelve primiparous Texel × Suffolk ewes [70 ± 5 days in milk (DIM); 0.320 ± 0.029 kg milk yield] were distributed in a 4 × 3 Latin square design and fed either a butter-based control diet [CON; 13 g/kg dry matter] or two diets with 61 g/kg DM of either CS or PS. Dietary inclusion of CS and PS did not alter live weight (p >0.1) and DM intake (p >0.1). However, compared to the CON, dietary inclusion of both CS and PS increased the digestibility of neutral detergent fiber (p <0.001) and acid detergent lignin (p < 0.001). Milk production (p = 0.001), fat-corrected milk (p < 0.001), and feed efficiency (p < 0.001) were enhanced with PS, while the highest milk protein yield (p < 0.05) and lactose yield (p < 0.001) were for CS-fed ewes. Compared to the CON diet, the ingestion of either CS and/or PS decreased (p < 0.001) the C16:0 in milk. Moreover, both CS and PS tended to enhance the content of C18:3n6 (p > 0.05) and C18:3n3 (p > 0.05). Overall short-term feeding of CS and/or PS (up to 6.1% DM of diet) not only maintains the production performance and digestibility of nutrients but also positively modifies the milk FA composition.

Epidemiological Overview of Overweight and Obesity Related to Eating Habits, Physical Activity and the Concurrent Presence of Depression and Anxiety in Adolescents from High Schools in Mexico City: A Cross-Sectional Study.

Overweight and obesity in adolescents has become a serious public health problem worldwide and Mexico City is no exception. Therefore, the objective of this study was to investigate the epidemiological panorama of overweight and obesity related to eating habits, physical activity and the concurrent presence of depression and anxiety in adolescents from high schools in Mexico City. Anthropometric measurements were taken from 2710 adolescents from 33 participating high schools. Likewise, a previously validated eating habit and physical activity questionnaire was administered, which consisted of four different sections, where each of the sections focused on key aspects of the participants' lifestyle: (1) eating habits, (2) intake of non-recommended foods, (3) food and company environment, and (4) physical activity. Moreover, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression was applied. In this study, a high prevalence of overweight and obesity (26.5% overweight and 20.0% obese) was found in adolescents from high schools in Mexico City. Only 13.14% of participants had adequate eating habits and 18.19% physical activity habits. An association was found between having inadequate eating habits and obesity in adolescent women (OR = 1.95; CI 1.009-3.76). Additionally, associations were observed between depression symptoms and obesity (OR = 5.68, CI 1.36-32.81; p = 0.01), while anxiety was associated with underweight and obesity adjusted by other dietary habits and psychological factors. Therefore, it is important to identify adolescents with overweight or obesity and establish prevention strategies for weight control in this age group, promoting healthy eating, physical activity and education in mental health.

Quality of life in Down syndrome in Brazil: a cross-sectional study.

BACKGROUND: Down syndrome is the most commonly genetic cause of developmental delay and intellectual disability, affecting 1:700 live births. It is associated with heart disease and recurrent infections, among other complications that greatly impair the patient's quality of life. OBJECTIVE: To evaluate the major factors associated with quality of life in a cohort of patients with Down syndrome. METHODS: We assessed 1,187 patients with Down syndrome, older than 4 years old, with an adaptation of the Personal Outcomes Scale validated for Portuguese language, interviewing patients, parents, and caregivers. RESULTS: A bad quality of life was reported in 56.4% of the sample. The main factors associated with better quality of life were female sex, first medical visit before 4 months old, higher parental education, a professionally active mother, and prenatal care. The main factors associated with worse quality of life were family history of alcohol abuse and psychiatric disorders and comorbidity with autism and epilepsy. CONCLUSION: Clinical comorbidities such as autism and epilepsy carry a heavy burden among patients with Down syndrome, while factors related to family support, such as employment status and educational background of the parents, enhance quality of life. The factors associated with quality of life among patients with Down syndrome should be adequately evaluated in medical consultation and targeted in public health policies.

ANTECEDENTES: A síndrome de Down é a mais comum causa identificável de atraso de desenvolvimento e deficiência intelectual, afetando 1 a cada 700 nascidos vivos. Está associada a cardiopatias, infecções recorrentes e outras complicações que impactam significativamente a qualidade de vida dos pacientes. OBJETIVO: Avaliar os principais fatores associados a qualidade de vida em uma coorte de pacientes com Síndrome de Down. MéTODOS: Avaliamos 1.187 pacientes com síndrome de Down com mais de 4 anos de idade utilizando uma adaptação da versão validada para o português da Escala Pessoal de Resultados, entrevistando pacientes, pais e cuidadores. RESULTADOS: Uma má qualidade de vida foi encontrada em 56.4% da amostra. Os principais fatores associados à melhor qualidade de vida foram sexo feminino, primeira consulta médica antes dos 4 meses de idade, maior nível educacional dos pais, mãe profissionalmente ativa e atenção pré-natal. Os principais fatores associados à pior qualidade de vida foram o histórico familiar de abuso de álcool e distúrbios psiquiátricos, além de comorbidade com autismo e epilepsia. CONCLUSãO: As comorbidades clínicas como autismo e epilepsia levam a um maior impacto entre os pacientes com síndrome de Down, enquanto fatores relacionados ao apoio familiar, como situação profissional e formação educacional dos pais, estão associados à melhor qualidade de vida. Os fatores associados à qualidade de vida de pacientes com síndrome de Down devem ser adequadamente avaliados em consulta médica e alvo de políticas públicas de saúde.

Quality of life in Down syndrome in Brazil: a cross-sectional study / Qualidade de vida na síndrome de Down no Brasil: um estudo transversal

Abstract Background Down syndrome is the most commonly genetic cause of developmental delay and intellectual disability, affecting 1:700 live births. It is associated with heart disease and recurrent infections, among other complications that greatly impair the patient's quality of life. Objective To evaluate the major factors associated with quality of life in a cohort of patients with Down syndrome. Methods We assessed 1,187 patients with Down syndrome, older than 4 years old, with an adaptation of the Personal Outcomes Scale validated for Portuguese language, interviewing patients, parents, and caregivers. Results A bad quality of life was reported in 56.4% of the sample. The main factors associated with better quality of life were female sex, first medical visit before 4 months old, higher parental education, a professionally active mother, and prenatal care. The main factors associated with worse quality of life were family history of alcohol abuse and psychiatric disorders and comorbidity with autism and epilepsy. Conclusion Clinical comorbidities such as autism and epilepsy carry a heavy burden among patients with Down syndrome, while factors related to family support, such as employment status and educational background of the parents, enhance quality of life. The factors associated with quality of life among patients with Down syndrome should be adequately evaluated in medical consultation and targeted in public health policies.

Resumo Antecedentes A síndrome de Down é a mais comum causa identificável de atraso de desenvolvimento e deficiência intelectual, afetando 1 a cada 700 nascidos vivos. Está associada a cardiopatias, infecções recorrentes e outras complicações que impactam significativamente a qualidade de vida dos pacientes. Objetivo Avaliar os principais fatores associados a qualidade de vida em uma coorte de pacientes com Síndrome de Down. Métodos Avaliamos 1.187 pacientes com síndrome de Down com mais de 4 anos de idade utilizando uma adaptação da versão validada para o português da Escala Pessoal de Resultados, entrevistando pacientes, pais e cuidadores. Resultados Uma má qualidade de vida foi encontrada em 56.4% da amostra. Os principais fatores associados à melhor qualidade de vida foram sexo feminino, primeira consulta médica antes dos 4 meses de idade, maior nível educacional dos pais, mãe profissionalmente ativa e atenção pré-natal. Os principais fatores associados à pior qualidade de vida foram o histórico familiar de abuso de álcool e distúrbios psiquiátricos, além de comorbidade com autismo e epilepsia. Conclusão As comorbidades clínicas como autismo e epilepsia levam a um maior impacto entre os pacientes com síndrome de Down, enquanto fatores relacionados ao apoio familiar, como situação profissional e formação educacional dos pais, estão associados à melhor qualidade de vida. Os fatores associados à qualidade de vida de pacientes com síndrome de Down devem ser adequadamente avaliados em consulta médica e alvo de políticas públicas de saúde.

A Retrospective Cohort Study of Combined Therapy in West Syndrome associated with Trisomy 21.

Background: West syndrome (WS) is a frequent epileptic encephalopathy associated with Down syndrome (DS). This study evaluated an outpatient protocol for WS in patients with DS who received vigabatrin (VGB) or VGB plus adrenocorticotrophic hormone. Methods: We analyzed infants treated in two neuropediatric centers from 2001-2021. We reviewed perinatal and familial history of epilepsy, spasm onset, treatment lag, electroencephalogram, neuroimaging, progression to epilepsy, and other neurological conditions. The outcomes were electroclinical resolution (ECR), relapses, and epilepsy progression. Results: Nineteen infants were included; 57.8% were male. The average spasm onset, follow-up, and treatment lag were 6.4 months, 8.15 years, and 2.33 months, respectively. Almost 74% had ECR after protocol intervention and minor epilepsy progression. Relapses occurred during combined therapy. Conclusions: The treatment protocol, especially combined therapy, was effective for WS in DS, impacting epilepsy progression and indicating the effectiveness of combined therapy to treat WS in patients with trisomy 21.

Índice de massa corporal, nutrição e atividade física em crianças e adolescentes com síndrome de Down / Body-mass index, nutrition and physical activity in children and adolescents with Down syndrome

Objetivo: Descrever e comparar hábito nutricional, prática de atividade física e índice de massa corporal (IMC) de crianças e adolescentes com síndrome de Down acompanhados em ambulatório especializado de um hospital terciário no sul do Brasil. Método: Estudo transversal realizado a partir da análise de prontuário de pacientes com síndrome de Down em idade escolar e adolescentes acompanhados em ambulatório especializado do Complexo Hospital de Clínicas da Universidade Federal do Paraná. A alimentação foi considerada adequada se consistisse em alimentos de todos os grupos nas três refeições principais e um ou dois lanches e água nos intervalos. Sedentarismo foi definido como tempo de atividade física inferior a 300 minutos por semana. O estado nutricional foi avaliado usando as curvas de IMC da Organização Mundial da Saúde, 2007.Resultados: O estudo incluiu 755 pacientes, sendo 236 (31,3%) crianças e 519 (68,7%) adolescentes. Sobrepeso e obesidade foram observados em 10,7% e 14,8% da população, respectivamente, sem diferença significativa entre os gêneros. Alimentação inadequada foi observada em 34,6% e sedentarismo em 23,7% dos pacientes. IMC elevado foi observado em 20,3% das crianças e 27,9% dos adolescentes (p=0,026). Observou-se sedentarismo em 29,5% dos adolescentes e 11% das crianças (p<0,001). Alimentação inadequada também foi mais prevalente em adolescentes, porém sem diferença estatística. Pacientes com IMC elevado, em comparação com eutróficos, tiveram maior prevalência de alimentação inadequada e sedentarismo, com significância estatística. Nesse subgrupo, o sedentarismo foi observado em 25% das crianças e 57,2% dos adolescentes (p<0,001). Conclusão: Adolescentes com síndrome de Down apresentam maiores taxas de IMC elevado e sedentarismo comparados com crianças. Estudos específicos em educação em saúde para essa população são necessários com o objetivo de promover hábitos de vida saudáveis e prevenir a obesidade com efetividade. [au]

Objective: To describe and compare the nutritional habits, physical activity, and body mass index (BMI) of children and adolescents with Down syndrome followed up in the specialized outpatient clinic of a tertiary hospital in southern Brazil. Method: Cross-sectional study conducted from the analysis of medical records of patients with Down syndrome at school age and adolescents followed up at the Complexo Hospital de Clínicas of the Universidade Federal do Paraná. The diet was considered adequate if it consisted of foods from all groups in the three main meals and one or two snacks and water in the intervals. A sedentary lifestyle was defined as physical activity time of fewer than 300 minutes per week. Nutritional status was assessed using BMI curves from the World Health Organization, 2007. Results: The study included 755 patients, of whom 236 (31.3%) were children and 519 (68.7%) were adolescents. Overweight and obesity were observed in 10.7% and 14.8% of the population, respectively, without significant gender differences. Inadequate diet was observed in 34.6% and sedentarism in 23.7% of the patients. High BMI was observed in 20.3% of children and 27.9% of adolescents (p=0.026). Sedentarism was observed in 29.5% of adolescents and 11% of children (p<0.001). Inadequate diet was also more prevalent in adolescents but without statistical difference. Patients with high BMI, compared to eutrophic patients, had a higher prevalence of inadequate diet and sedentarism, with statistical significance. In this subgroup, sedentarism was observed in 25% of children and 57.2% of adolescents (p<0.001). Conclusion: Adolescents with Down syndrome have higher rates of high BMI and sedentarism compared to children. Specific studies in health education for this population are necessary to promote healthy lifestyle habits and effectively prevent obesity. [au]

Triacylglycerides and Cholesterol in Organic Milk from Chiapas, Mexico.

The study of milk fat composition is a priority topic at the international level; however, there are few studies on the composition of triacylglycerides (TAG) and sterols in cow's milk produced in organic production systems. The objective of this study was to determine the profile of TAG, cholesterol, and other sterols in the fat of raw cow's milk produced under organic conditions in the municipality of Tecpatán, Chiapas. Every month for one year, milk samples were obtained from three production units (PU 1, 2 and 3) and from the collecting tank (CT) of the municipality (12 months × 4 = 48 samples), in accordance with Mexican regulations. Milk fat was extracted by detergent solution and TAG and sterol analyses were performed by gas chromatography with a flame ionization detector and capillary columns. Chromatographic analyses identified and quantified 15 TAG in all milk fats, from C26 to C54, with a bimodal behavior; the maximum value (% w/w) for the first mode was located at C38 (14.48) and, for the second mode, C50 and C52 were considered with values of 11.55 and 11.60, respectively. Analysis of variance (ANOVA) followed by Tukey's test only yielded significance (p < 0.05) for C26; most TAG values over time showed homogeneous variability. Cholesterol, brassicasterol, and campesterol were also determined; ANOVA did not show statistical significance (p ≥ 0.05) between them in the production units and collecting tank. Cholesterol had the highest percentage of the sterols with a mean value of 96.41%. The TAG and cholesterol profiles found in this study were similar to those reported in other countries.

Respiratory and otolaryngological disorders in Down syndrome from one center in Brazil.

Down syndrome (DS) is the most common chromosomal condition. Anatomical and functional variations in the upper and lower airways are component manifestations of the syndrome and increase the risk of various medical problems. The objective of this study was to determine the prevalence of otorhinolaryngological and respiratory diseases in a DS outpatient clinic over a 3-year period. Medical records data from 1207 patients were retrospectively reviewed. Newborn Hearing Screening was positive in 7.1% of patients. Brainstem auditory evoked potential was performed in 1101 children and showed a hearing loss of 19.8% in the first year. It was positive in 21% of 1021 exams. Audiometry was altered in 64 of 994 exams (6.4%), showing a conductive loss in 90%. Adenotonsillectomy was performed in 308 (25.5%) patients, and 169 (14.0%) required serous otitis ventilation tubes. Asthma was observed in 140 (11.6%) patients, and allergic rhinitis in 544 (56.6%). There were hospitalizations for invasive infection in 480 (39.8%) children, and two (0.2%) patients had severe septicemia from pulmonary focus. Five (0.4%) infants had laryngotracheomalacia, and one patient had anomalous right tracheal bronchus. Recognizing the prevalence of respiratory and otorhinolaryngological disorders in patients with DS allows the promotion of optimal follow-up and early treatment, preventing the development of sequelae.

Worldwide Traceability of Antibiotic Residues from Livestock in Wastewater and Soil: A Systematic Review.

The use of antibiotics in animal production are widely used for disease treatment, health protection, and as growth promoters. Common antibiotics used in veterinary medicine are excreted and eliminated through the sewage system, contaminating water and soil with negative effects on agricultural activities. This systematic review focuses on the trend of research works on antibiotic residues, evaluating antibiotics used in livestock production and their excretion in animal products and in environmental matrices such as water and soil. Our database was composed of 165 articles, reporting the concentration of antibiotic residues found in the environment, livestock (cow, sheep, pig, horse, chicken, rabbit, goat), aquatic and terrestrial animal tissues, animal products (milk and eggs), wastewater, and soil. The documents were obtained from Asia, Africa, North America, South America, Europe, and Oceania. A descriptive analysis of antibiotic residues found worldwide was analyzed according to each of the variables used such as antibiotic family, name, concentration (% and mg/kg or ppm), and country and continent where the residue was found. The descriptive analysis was carried out using the "describe" function of psych package and pirate plots were drawn. According to our study, the main antibiotics used worldwide in animal production are sulfonamides, tetracyclines, quinolones, penicillin, and cephalosporins. At present, despite the trends of increased regulations on the use of antibiotics worldwide, antibiotics are still utilized in food animal production, and are present in water and soil, then, there is still the misuse of antibiotics in many countries. We need to become aware that antibiotic contamination is a global problem, and we are challenged to reduce and improve their use.

Ophthalmological abnormalities in Down syndrome among Brazilian patients.

Down syndrome is the most common chromosomal disorder, affecting 1/700 live births. Among the clinical findings, one constant concern is the high prevalence of visual disorders that, if left untreated, can negatively affect child development. The aim of this study was to determine the prevalence of ophthalmological findings among patients who attended an outpatient clinic for patients with Down syndrome in southern Brazil between 2005 and 2016. A cross-sectional study including 1,207 patients medical records were done, which 492 (40.8%) had some ophthalmological disorder. These data were subjected to descriptive analysis using Statistica software. Among the 492 patients with any ophthalmological disease, the need for glasses was found in 434 (36%) patients, keratoconus in 254 (42.1%), congenital cataract in 27 (15.1%), nasolacrimal duct obstruction in 25 (2.0%), strabismus in 22 (1.9%), nystagmus in four (0.3%), and juvenile cataract in two (0.2%). Two young adults with keratoconus underwent corneal transplantation. Although the prevalence of an ophthalmological disease among the present sample (40.8%) was lower than described in the current literature, it still reinforced the importance of routine and early evaluations in infants. These should begin at 6 months of age and be repeated half-year until 2 years old, annually until 7 years old, biennial in adolescents, and triennial in adults and elderly. Our findings of a high frequency of keratoconus support a detailed corneal study in such patients for early detection and treatment.

Gastrointestinal disorders in Down syndrome.

Down syndrome is the most common human chromosomal disorder. Among clinical findings, one constant concern is the high prevalence of gastrointestinal system alterations. The aim of this study was to determine the prevalence of gastrointestinal disorders at a Down syndrome outpatient clinic during a 10-year follow-up period. Data from medical files were retrospectively reviewed from 1,207 patients. Gastrointestinal changes occurred in 612 (50.7%). The most prevalent disorder was chronic intestinal constipation. Intestinal parasite occurred in 22% (mainly giardiasis), gastroesophageal reflux disease in 14%, digestive tract malformations occurred in 5%: 13 cases of duodenal atresia, 8 of imperforate anus, 4 annular pancreases, 2 congenital megacolon, 2 esophageal atresias, 2 esophageal compression by anomalous subclavian and 1 case of duodenal membrane. We had 38/1,207 (3.1%) patients with difficulty in sucking and only three with dysphagia that resolved before the second year of life. Peptic ulcer disease, celiac disease, and biliary lithiasis were less prevalent with 3% each. Awareness of the high prevalence of gastrointestinal disorders promotes outstanding clinical follow-up as well as adequate development and greater quality of life for patients with Down syndrome and their families.

Down syndrome: Prevalence and distribution of congenital heart disease in Brazil.

CONTEXT AND OBJECTIVE: Down syndrome is the most common genetic disorder, affecting 1/700 live births. Among the clinical findings, one constant concern is the high prevalence of congenital heart disease. The objective of this study was to determine the prevalence and profile of congenital heart disease among patients attended at a Down syndrome outpatient clinic in southern Brazil between 2005 and 2013. DESIGN AND SETTING: Cross-sectional study conducted in a referral center. METHODS: Data were retrospectively gathered from the medical files of 1,207 patients with Down syndrome, among whom 604 (50.0%) had been diagnosed with congenital heart disease. These data were subjected to descriptive analysis using the Statistica software. RESULTS: Among the 604 patients with congenital heart disease, 338 (55.8%) were male and 269 (44.5%) were female. The most common heart diseases were atrial septal defect in 254 patients (42.1%); total atrioventricular septal defect in 91 (15.1%); atrial septal defect and ventricular septal defect in 88 (14.6%); ventricular septal defect in 77 (12.7%); patent ductus arteriosus in 40 (6.6%); patent foramen ovale in 34 (5.6%) patients; tetralogy of Fallot in 12 (2%); and other diseases in 8 (1.3%). Pulmonary hypertension was present in 57 (9.4%). Out of the total, 150 patients (24.8%) underwent cardiac surgery. CONCLUSION: The high prevalence of congenital heart disease among the patients at the Down syndrome outpatient clinic (50%) was similar to findings from other studies and justifies investigation during the neonatal period, so as to decrease mortality and morbidity.

Down syndrome: Prevalence and distribution of congenital heart disease in Brazil / Síndrome de Down: prevalência e distribuição de cardiopatia congênita no Brasil

ABSTRACT CONTEXT AND OBJECTIVE: Down syndrome is the most common genetic disorder, affecting 1/700 live births. Among the clinical findings, one constant concern is the high prevalence of congenital heart disease. The objective of this study was to determine the prevalence and profile of congenital heart disease among patients attended at a Down syndrome outpatient clinic in southern Brazil between 2005 and 2013. DESIGN AND SETTING : Cross-sectional study conducted in a referral center. METHODS : Data were retrospectively gathered from the medical files of 1,207 patients with Down syndrome, among whom 604 (50.0%) had been diagnosed with congenital heart disease. These data were subjected to descriptive analysis using the Statistica software. RESULTS : Among the 604 patients with congenital heart disease, 338 (55.8%) were male and 269 (44.5%) were female. The most common heart diseases were atrial septal defect in 254 patients (42.1%); total atrioventricular septal defect in 91 (15.1%); atrial septal defect and ventricular septal defect in 88 (14.6%); ventricular septal defect in 77 (12.7%); patent ductus arteriosus in 40 (6.6%); patent foramen ovale in 34 (5.6%) patients; tetralogy of Fallot in 12 (2%); and other diseases in 8 (1.3%). Pulmonary hypertension was present in 57 (9.4%). Out of the total, 150 patients (24.8%) underwent cardiac surgery. CONCLUSION : The high prevalence of congenital heart disease among the patients at the Down syndrome outpatient clinic (50%) was similar to findings from other studies and justifies investigation during the neonatal period, so as to decrease mortality and morbidity.

RESUMO CONTEXTO E OBJETIVO : A síndrome de Down é a anomalia genética mais comum e afeta 1/700 nascidos vivos. Entre os achados clínicos, uma preocupação constante é a alta prevalência de cardiopatia congênita e o objetivo do presente estudo é determinar a prevalência e o perfil de cardiopatia congênita em pacientes atendidos em um ambulatório de síndrome de Down no período de 2005 a 2013 no sul do Brasil. TIPO DE ESTUDO E LOCAL : Estudo transversal conduzido em um centro de referência. MÉTODOS : Foi realizada coleta retrospectiva de dados de 1.207 prontuários de pacientes com síndrome de Down, com 604 (50,0%) diagnosticados com cardiopatia congênita. Os dados foram submetidos a análise descritiva, utilizando-se o programa Statistica. RESULTADOS : Entre os 604 pacientes com cardiopatia congênita, 338 (55,8%) eram do sexo masculino e 269 (44,5%) do feminino. A cardiopatia mais comum foi comunicação interatrial, observada em 254 (42,1%) pacientes, defeito de septo atrioventricular total, em 91 (15,1%), comunicação interatrial em conjunto com comunicação interventricular, em 88 (14,6%), comunicação interventricular, em 77 (12,7%), persistência do canal arterial, em 40 (6,6%), forame oval patente, em 34 (5,6%), tetralogia de Fallot, em 12 (2%) e outras cardiopatias observadas em oito (1,3%) pacientes. Hipertensão pulmonar esteve presente em 57 (9,4%). Do total, 150 (24,8%) pacientes foram submetidos a cirurgia cardíaca. CONCLUSÃO : A elevada prevalência das cardiopatias congênitas nos pacientes do ambulatório da síndrome de Down, de 50%, semelhante à encontrada em outros estudos, justifica a investigação no período neonatal, com diminuição da mortalidade e morbidade.

Comparative study on sexual and reproductive health of adolescents with and without aids: is there a difference in knowledge between the two groups? / Estudo comparativo sobre a saúde sexual e reprodutiva dos adolescentes com e sem aids: há diferença de conhecimento entre os dois grupos?

Currently we are facing the challenge to deal with the first generation of adolescents HIV+, infected by vertical transmission. This is new, and creates the need to improve attention to self-care and knowledge on sexual and reproductive health. Issues like the exercise of sexuality, contraception, pregnancy, sexually transmitted diseases (STD), are not enough debated among professionals, families and adolescents, despite their importance, concerning the affective and sexual discoveries typical of that age. Objective: To assess and compare the knowledge among adolescents HIV+ and HIV-, the guidance received on sexual and reproductive health and their sexual behavior, in order to better assist an integral health attention. Methods: A prospective, quali-quantitative, observational, analytical and cross-sectional study that took place during one year at the public hospital of an university in Curitiba, interviewing 61 adolescents HIV+ and 61 adolescents HIV- after their outpatient attendance. A questionnaire with objective multi-choice questions, as well as open-ended questions thought to stimulate free narratives was the base of data acquisition. Statistical analysis have considered the adolescents HIV+ and HIV- matched by age, gender and education. To evaluate differences on continuous variables, Student'st-test for normal distribution and Mann-Whitney test for asymmetric distribution were the tools. For categorical variables: Fisher exact tests and chi-square of Pearson. The analysis of answers for the openended questions was based on categorization of semantic equivalence. Significance level of 5% for all tests. Main variables of study in the amount enough to allow comparisons have driven the sample estimation, with less than 5% of significance level and minimum test power of 95%. Results: The study showed that adolescents don't have good enough knowledge about reproductive health in both groups (p=0.01). They have initiated sexual activity at about 15 years old, they report using condoms, but not the habit of picking them up. The group of HIV + have expressed more opinions about the sexual and reproductive rights, they have received less guidance on emergency contraception (p<0.001); they "hook-up" and dated less than HIV- group. Conclusion: The lack of knowledge of adolescents on reproductive health is greater than about sexual health and both groups reported the habit of not getting condoms. The HIV+ group had more opinions about sexual and reproductive rights, received less guidance on emergency contraception, "hooked-up" and dated less than the HIV- group. The knowledge about sexual rights and sexuality, and the guidance provided to both groups of teenagers, didn't seem to be adequate to make protective sexual attitudes preventing STD.

A sociedade está enfrentando o desafio de lidar com a primeira geração de adolescentes HIV+, infectados por transmissão vertical. Isso cria a necessidade de melhorar a atenção ao autocuidado e o conhecimento sobre saúde sexual e reprodutiva. Questões como sexualidade, contracepção, gravidez e doenças sexualmente transmissíveis (DST) são pouco debatidas entre profissionais, famílias e adolescentes, apesar de sua importância diante das descobertas afetivas e sexuais típicas dessa idade. Objetivo: Avaliar e comparar o conhecimento de adolescentes HIV+ e HIV- e as orientações recebidas sobre saúde sexual e reprodutiva, seus comportamentos sexuais, visando auxiliar na Atenção Integral à Saúde. Métodos: Estudo prospectivo, quali-quantitativo, observacional, analítico e transversal, realizado por um ano em hospital público de uma universidade de Curitiba, entrevistando 61 adolescentes HIV+ e 61 adolescentes HIV-, após seu atendimento ambulatorial. Foi elaborado questionário com perguntas objetivas de múltipla escolha e perguntas abertas, para estimular a livre narrativa sobre as temáticas. Foram pareados por idade, gênero e escolaridade. Para avaliar as diferenças em variáveis contínuas, foram utilizados os testes t de Student, para distribuição normal, e de Mann-Whitney, para distribuição assimétrica; para variáveis categóricas, os testes exato de Fisher e do χ2 de Pearson. A análise das respostas para as perguntas abertas baseou-se na categorização de equivalência semântica. Para os testes, foi considerado um nível mínimo de significância de 5%. A amostra foi estimada considerando as principais variáveis do estudo, sendo suficiente para as comparações um nível de significância inferior a 5%, com poder de teste mínimo 95%. Resultados: O estudo mostrou que ambos os grupos de adolescentes não têm conhecimento suficiente sobre saúde reprodutiva (p=0,01), iniciaram atividade sexual com cerca de 15 anos, relataram uso de preservativos, mas não o hábito de buscá-los. O grupo HIV+ expressou mais opiniões sobre os direitos sexuais e reprodutivos, recebeu menos orientações sobre contracepção de emergência (p<0,001), "ficou" e namorou menos que o grupo HIV-. Conclusão: O desconhecimento dos adolescentes sobre a saúde reprodutiva é maior do que sobre a saúde sexual e ambos os grupos disseram não ter o hábito de adquirir preservativos. O grupo HIV+ expressou mais opiniões sobre os direitos sexuais e reprodutivos, recebeu menos orientações sobre contracepção de emergência, "ficou" e namorou menos que o grupo HIV-. O conhecimento sobre direitos sexuais e sexualidade e as orientações fornecidas, para ambos os grupos de adolescentes, não pareceram ser suficientes para atitudes sexuais protetivas diante das DST.

Association between congenital heart defects and severe infections in children with Down syndrome.

INTRODUCTION: There is a high prevalence of congenital heart disease (CHD) in Down syndrome (DS) patients. Children with DS and CHD also present greater susceptibility to pulmonary infections than those without CHD. AIM: To investigate the prevalence and types of CHD and their association with severe infections in children with DS in southern Brazil seen in a reference outpatient clinic. METHODS: Children aged between six and 48 months with a diagnosis of DS were included consecutively in the period May 2001 to May 2012, and the presence of CHD and severe infections (pneumonia and sepsis) was investigated, classified and analyzed. RESULTS: A total of 127 patients were included, of whom 89 (70.1%) had some type of CHD, 33 (37.7%) of them requiring surgical correction. Severe infections (pneumonia and sepsis) were seen in 23.6% and 5.5%, respectively. Of the cases of pneumonia, 70% had associated CHD (p=0.001) and of those with sepsis, 85% presented CHD (p=0.001). CONCLUSIONS: Our study showed a high prevalence of CHD and its association with severe infections in children with DS seen in southern Brazil.

Presence of polychlorinated biphenyls (PCBs) in bottled drinking water in Mexico City.

This paper describes the concentrations of seven polychlorinated biphenyls (PCBs) in bottled drinking water samples that were collected over 1 year from Mexico City in two sizes (1.5 and 19 L), using gas chromatography with an electron capture detector. PCBs 28 (0.018-0.042 µg/L), 52 (0.006-0.015 µg/L) and 101 (0.001-0.039 µg/L) were the most commonly found and were present in the majority of the samples. However, total concentrations of PCBs in bottled drinking water (0.035-0.039 µg/L) were below the maximum permissible level of 0.50 µg/L stated in Mexican regulations and probably do not represent a hazard to human health. PCBs were detectable in all samples and we recommend a monitoring program be established to better understand the quality of drinking bottled water over time; this may help in producing solutions for reducing the presence of organic contaminants.

Presence of polycyclic aromatic hydrocarbons (PAHs) in apple in rural terrains from Mexico City.

This paper describes PAH concentrations in apple crops that are growing in rural terrains in Mexico City. The concentrations of individual PAHs showed great variability, there being low and high molecular weight compounds in dry (high molecular weight for Tlahuac 7.06 microg/g and Milpa Alta 3.96 microg/g) and wet months (high molecular weight for Tlahuac 11.25 microg/g and Milpa Alta 12.05 microg/g). Some PAHs indicators and cross plot ratios Ant/(Ant + Phe) and Flu/(Flu + Pyr) define fossil fuels and vegetation combustion as the source of contamination over the cuticle of the apples. It is likely that deposition (dry and wet) is the principal source o f contamination over the apple surface. This study reveals the presence of PAHs in apples due to the high air contamination of Mexico City.