ABSTRACT
OBJECTIVE: To present current concepts about the diagnosis of recurrent abdominal pain and to review the basis of the therapeutic approach for this disease in children and adolescents. METHODS: References were obtained from the Medline, from recent review articles, and from personal files. Books and dissertations were also analyzed. Only the most important articles were included in this review. RESULTS: Recurrent abdominal pain is the main cause of recurrent pain in children between 4 and 16 years of age. It is defined as the occurrence of three or more abdominal pain attacks within 3 months or less. These attacks are severe enough to interrupt routine activities, making the child remain asymptomatic between the episodes of pain. The diagnosis is based on a detailed clinical history, on an improved physical examination, and on a few laboratory tests. It can be manifested with isolated paroxysms of umbilical pain, abdominal pain with dyspeptic symptoms, and abdominal pain with digestive tract dysfunction. The treatment must emphasize the cognitive-behavioral factors of the recurrent pain. CONCLUSIONS: The treatment of recurrent abdominal pain using the strategy presented here represents an equilibrium in which time is neither wasted nor insufficient during the investigative process required for treating children and their families with this problem.
Subject(s)
Carcinoma/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Medronate , Technetium Tc 99m Sestamibi , Thyroid Neoplasms/diagnostic imaging , Carcinoma/secondary , Female , Humans , Middle Aged , Radionuclide Imaging , Skull/diagnostic imaging , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/secondary , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47%) boys and 176 (53%) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3%), 218 were mulatto (65.7%), and 40 were black (12%). Mean hemoglobin level was 12.75 +/- 0.75 g/dl. Lower values were determined for black children (12.32 +/- 0.87g/dl) compared to white (12.76 +/- 0.99 g/dl) and mulatto (12.81 +/- 0.94 g/dl) children. The prevalence of anemia was 16.6% when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2% when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13% for the population in general and 20% for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.
Subject(s)
Anemia, Iron-Deficiency/epidemiology , Adolescent , Brazil/epidemiology , Child , Cross-Sectional Studies , Female , Humans , MaleABSTRACT
The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47 per cent) boys and 176 (53 per cent) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3 per cent), 218 were mulatto (65.7 per cent), and 40 were black (12 per cent). Mean hemoglobin level was 12.75 ñ 0.75 g/ dl. Lower values were determined for black children (12.32 + 0.87 g/dl) compared to white (l2.76 ñ 0.99 g/dl) and mulatto (12.81 ñ 0.94 g/dl) children. The prevalence of anemia was 16.6 per cent when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2 per cent when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13 per cent for the population in general and 20 per cent for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.
Subject(s)
Child , Humans , Male , Female , Adolescent , Anemia, Iron-Deficiency/epidemiology , Brazil , Cross-Sectional StudiesABSTRACT
There is concern that feeding full-strength animal milk to infants aged less than 6 months with diarrhoea may have adverse consequences. We assessed the effects on clinical course of two feeding regimens in 159 Guatemalan and Brazilian infants aged 2 weeks to 6 months who had had acute diarrhoea for 120 h or less, showed signs of mild to moderate dehydration, and had no complications. After correction of dehydration, infants were assigned randomly to receive continued full-strength milk feeding or initial feeding with diluted milk with regrading to full-strength milk over 48 h. There were no significant differences between feeding groups in rate of treatment failures (-1%, 95% Cl -14 to 12%) or mean (SD) total stool output (full-strength milk 335 [268] g/kg, diluted milk 338 [354] g/kg) and duration of diarrhoea (92 [50] vs 92 [44] h). A significant association was found between presence of reducing substances in stools and treatment failure (OR 4.3, 95% CI 1.1 to 16.8), but reducing substances in stools were common both in treatment successes (61%) and in failures (87%). Our study supports the conclusion that, for infants under 6 months of age with diarrhoea whose only food is animal milk or formula, the milk or formula normally given should be provided in full strength as soon as dehydration has been corrected.
Subject(s)
Diarrhea, Infantile/diet therapy , Infant Nutritional Physiological Phenomena , Milk/chemistry , Academies and Institutes , Animals , Body Weight , Brazil/epidemiology , Dehydration/epidemiology , Dehydration/etiology , Dehydration/therapy , Diarrhea, Infantile/complications , Diarrhea, Infantile/physiopathology , Energy Metabolism , Feces , Fluid Therapy , Guatemala/epidemiology , Hospitals, University , Humans , Infant , Milk/adverse effects , Nutritional Status , Osmolar Concentration , Recurrence , Severity of Illness Index , Treatment Failure , Treatment Outcome , Weight GainABSTRACT
1. A study of six patients with Chronic Calcifying Pancreatitis (CCP) occurring over a 10 year period, representing an incidence rate of approximately 1:1,000 of the inpatients in the children's ward of a general hospital in central Brazil, is reported. 2. Major clinical manifestations as well as therapeutic management are described. 3. The possible relationship between CCP and primary protein-calorie malnutrition is discussed and the importance of a CCP diagnosis when dealing with malnourished children who do not respond satisfactorily to common therapy is emphasized.
Subject(s)
Pancreatitis/etiology , Protein-Energy Malnutrition/complications , Calcinosis/diagnosis , Calcinosis/etiology , Child , Child, Preschool , Chronic Disease , Female , Humans , Male , Pancreatitis/diagnosis , Pancreatitis/therapyABSTRACT
1. Study of six patients with chronic calcifying pancreatitis (CCP) occurring over a 10 year period, representing an incidence rate of approximately 1:1,000 of the impatients in the children's ward of a general hospital in central Brazil, is reported. 2. Major clinical manifestations as well as therapeutic management are described. 3. The possible relationship between CCP and primary protein-calorie malnutrition is discussed and the importance of a CCP diagnosis when dealing malnourished children who do not respond satisfactorily to common therapy is emphasized
Subject(s)
Child, Preschool , Child , Humans , Male , Female , Calcinosis/etiology , Pancreatitis/etiology , Protein-Energy Malnutrition/complications , Chronic Disease , Nutritional StatusABSTRACT
Neste trabalho sao feitas consideracoes sobre a doenca celiaca. Uma casuistica e apresentada, e a necessidade de se estabelecer criterios bem definidos da doenca e discutida. Enfatiza-se o risco de complicacoes que correm os celiacos em uso de gluten. Manifestacoes clinicas pouco comuns e outras menos evidentes sao abordadas no trabalho o efeito protetor do leite humano e enfatizado
Subject(s)
Infant , Child, Preschool , Child , Humans , Celiac DiseaseABSTRACT
Os autores apresentam a sua experiencia com o uso de carne de peito de frango como fonte proteica no tratamento dietetico da diarreia protraida do lactente. Os bons resultados obtidos sao motivo de sugestao para o uso desta formula