Estado nutricional y anemia en niños de etnia shuar / Nutritional status and anemia in children of the Shuar ethnic group

Introducción: El estado nutricional se entiende como una condición de salud que valora patologías nutricionales como anemia y malnutrición en grupos de edades consideradas vulnerables. El objetivo del presente estudio fue determinar la relación entre estado nutricional y anemia en la población shuar de 6 meses a 5 años de edad, de la Comunidad Shimpis, Cantón Logroño, Morona Santiago-Ecuador desde agosto 2018-agosto 2019. Métodos: El presente estudio transversal. Universo de 235 y muestra de 163 tomada del Epi Info. Los datos se obtuvieron de historias clínicas y Sistema de Vigilancia Alimentaria Nutricional. El estado nutricional se analizó con software WHO Anthro. La anemia se basó en valores de referencia de hemoglobina establecidos por Organización Mundial y Ministerio de Salud Pública. Los datos fueron tabulados en el programa estadístico SPSS 25. Se realizaron tablas simples de frecuencia y porcentaje, tablas de asociación considerando valor P<0.05 estadísticamente significativo. Resultados: Se incluyeron 163 niños, 46.0% hombres, 54% mujeres, el grupo etario predominante fue de 2-5 años con porcentaje de 56.4%. Frecuencia de anemia fue 38%. Niños con anemia y desnutrición crónica fueron: 42, con desnutrición aguda: 10, con desnutrición global: 3, con sobrepeso: 2, en eutróficos 5. Al relacionar ambas variables se obtuvo valor p estadísticamente significativo (P< 0.001). Conclusiones: el grupo etario es un factor predisponente en la alteración del estado nutricional en niños. También se observó que el estado nutricional alterado tiene mayor predisposición a presentar anemia.

Introduction: Nutritional status is a health condition that assesses nutritional pathologies such as anemia and malnutrition in vulnerable age groups. The objective of this study was to determine the relationship between nutritional status and anemia in the Shuar population from 6 months to 5 years of age from the Shimpis Community, Logroño Canton, Morona Santiago-Ecuador, from August 2018-August 2019. Methods: The present cross-sectional study. A total of 235 samples and 163 samples were taken from Epi Info. The data were obtained from medical records and the Nutritional Food Surveillance System, and nutritional status was analyzed using WHO Anthro software. Anemia was based on hemoglobin reference values established by the World Organization and the Ministry of Public Health. The data were tabulated in the statistical program SPSS 25. Simple tables of frequency and percentage were made, and tables of association considering P value <0.05 were statistically significant. Results: A total of 163 children were included, 46.0% men and 54% women, and the predominant age group was 2-5 years, with a percentage of 56.4%. The anemia frequency was 38%. There were 42 children with anemia and chronic malnutrition, 10 with acute malnutrition, 3 with global malnutrition, 2 with overweight, and 5 with eutrophy. When relating both variables, a statistically significant p-value was obtained (P < 0.001). Conclusions: The age group is a predisposing factor in the alteration of nutritional status in children. It was also observed that altered nutritional status has a greater predisposition to anemia.

Uso da caderneta de saúde da criança no acompanhamento do crescimento ­ uma revisão de escopo / Use of the child health booklet in growth monitoring ­ a scoping review

O Ministério da Saúde prevê a disponibilização da Caderneta de Saúde da Criança (CSC) desde 2005 a todas as crianças nascidas no Brasil. Trata-se de uma ferramenta centralizadora para a atenção integral da saúde na infância e, portanto, de um instrumento valioso para o acompanhamento do crescimento das crianças. O registro correto e completo das informações é requisito básico para que a CSC cumpra seu papel estratégico. Elegemos a revisão de escopo com o objetivo de discutir os estudos primários que analisaram quantitativamente o preenchimento dos dados sobre crescimento na CSC. A pesquisa foi realizada nas bases de dados MEDLINE, LILACS, SciELO e na Biblioteca Virtual em Saúde usando os descritores "Saúde da criança"e "Registros de saúde pessoal" (em inglês, "Child Health" e "Health Records, Personal"). Além disso, foi usada a palavra-chave "Caderneta de Saúde da Criança. Foram identificados 191 trabalhos, sendo 15 artigos elegíveis para esta revisão. Os estudos observaram registro insatisfatório dos dados sobre o crescimento na CSC. O preenchimento dos gráficos de peso por idade variou entre 8,9% e 96,3%, por exemplo, revelando fragilidade no uso desse instrumento e necessidade de melhora dos registros no acompanhamento do crescimento das crianças.

The Ministry of Health has made the Caderneta de Saúde da Criança (CSC), a child health booklet, available to all children born in Brazil, since 2005. It is a strategic tool for comprehensive child health care, a valuable instrument for registering and monitoring growth. The correct and complete registration of this information is a basic requirement for the CSC to fulfill itsrole. We chose the scoping review in order to discuss primary studies that quantitatively analyze the filling in of data on growth in the CSC. The research was carried out in the databases MEDLINE, LILACS, SciELO, and in the Biblioteca Virtual em Saúde, using the descriptors in Portuguese: "Saúde da Criança" and "Registros de saúde pessoal"; in English: "Child Health" and "Health Records, Personal"; and, in addition, the keyword "Caderneta de Saúde da Criança" was also used. A total of 191 papers were identified, 15 of which were eligible for this review. The studies observed an unsatisfactory filling in of data on the growth of CSC. Completion of weight-for-age charts ranged between 8.9% and 96.3%, for example, revealing weaknesses in the use of this instrument and the need to improve records in monitoring the growth of children.

Influência da idade gestacional no termo sobre o peso: estudo de coorte / Influencia de la edad gestacional a término sobre el peso: estudio de cohorte / Influence of term gestational age on weight: cohort study

Resumo Objetivo: Identificar o efeito da idade gestacional no termo sobre o peso ao nascer e sua evolução no primeiro ano de vida da criança. Método: Coorte única, concorrente, com seguimento prospectivo de um ano, realizado em Botucatu/SP. A coleta de dados foi realizada em três momentos no primeiro ano de vida da criança. Análise do peso ao nascer, aos seis e doze meses, em função da idade gestacional, incluindo potenciais variáveis de confusão foi realizada, ajustando modelos de regressão com resposta normal, após identificação das associações bivariadas com p<0,20. Análises executadas com o software SPSS v22. Resultados: De maneira independente, crianças nascidas de termo precoce tinham, em média, 161 g a menos no peso ao nascer (β=-161,6; IC 95%= −236,1- −87,2; p<0,001), 350g a mais no peso aos seis meses (β=0,35; IC 95%= 0,16-0,53; p<0,001) e 290 g a mais no peso aos doze meses (β= 0,29; IC 95%= 0,04-0,50; p=0,019) que aquelas nascidas de termo completo. Achados secundários: mães com mais idade e número de consultas pré-natal tiveram bebês com maior peso ao nascer; crianças com maior comprimento ao nascer tiveram maior peso aos seis e doze meses e aquelas com maior tempo de aleitamento materno tiveram menor peso aos doze meses. Conclusão: Houve associação entre idade gestacional no termo e peso ao nascer, aos seis e doze meses. Crianças nascidas de termo precoce tiveram, de maneira independente, menor peso ao nascer e maior peso que as nascidas de termo completo aos seis e doze meses de vida.

Resumen Objetivo: Identificar el efecto de la edad gestacional a término sobre el peso al nacer y su evolución en el primer año de vida del niño. Método: Cohorte única, concurrente, con seguimiento prospectivo de un año, realizado en Botucatu, estado de São Paulo. La recolección de datos se realizó en tres momentos durante el primer año de vida del niño. El peso fue analizado al nacer, a los seis y a los doce meses, en función de la edad gestacional, que incluyó potenciales variables de confusión, con el ajuste de modelos de regresión con respuesta normal, luego de la identificación de las relaciones bivariadas con p<0,20. Los análisis se realizaron con el software SPSS v22. Resultados: De manera independiente, los niños nacidos antes de término tenían, en promedio, 161 g menos de peso al nacer (β=-161,6; IC 95 %= −236,1- −87,2; p<0,001), 350 g más de peso a los seis meses (β=0,35; IC 95 %= 0,16-0,53; p<0,001) y 290 g más de peso a los doce meses (β= 0,29; IC 95 %= 0,04-0,50; p=0,019) que los niños nacidos a término. Descubrimientos secundarios: madres con más edad y número de consultas de atención prenatal tuvieron bebés con más peso al nacer; niños con mayor longitud al nacer tuvieron más peso a los seis y doce meses, y los que tuvieron más tiempo de lactancia materna tuvieron un peso menor a los doce meses. Conclusión: Se encontró relación entre edad gestacional a término y peso al nacer, a los seis y a los doce meses. Niños nacidos antes de término tuvieron, de manera independiente, menos peso al nacer y más peso que los nacidos a término a los seis y doce meses de vida.

Abstract Objective: Identify the effect of term gestational age on birth weight and its evolution in the first year of the child's life. Method: Single cohort, concurrent, with prospective follow-up of one year, performed in Botucatu/SP. Data were collected at three moments in the child's first year of life. To analyze the weight at birth, at six and at twelve months, in function of the gestational age, including potential confounding variables, regression models with normal response were adjusted after identifying bivariate associations with p<0.20. The analyses were developed using SPSS V22. Results: Independently, early-term children were, on average, 161 g lighter at birth (β=-161.6; 95% CI= −236.1 - −87.2; p<0.001), 350 g heavier at six months (β=0.35; 95% CI= 0.16-0.53; p<0.001) and 290 g heavier at twelve months (β= 0.29; 95% CI= 0.04-0.50; p=0.019) than full-term children. Secondary findings: mothers of older age and who attended a larger number of antenatal consultations had heavier babies at birth; longer children at birth were heavier at six and twelve months and infants breastfed longer were lighter at twelve months. Conclusion: Full-term gestational age was associated with birth weight, at six and twelve months. Early-term children independently showed a lower birth weight and higher weight than full-term infants at six and twelve months of age.

Relative age effect on competitive performance in judo athletes / Efeito da idade relativa no desempenho competitivo em atletas de judô

ABSTRACT Differences in chronological age within an age group are known as Relative Age (RA), and their consequences to athletic performance are referred to as Relative Age Effect (RAE). The RAE among athletes is believed to affect their competitive success in several ways, even in adulthood. Thus, the objective of the present study was to investigate the RAE on all judo fighters competing nationally in 2013, by age category and competitive performance. A total of 862 male and 637 female athletes participated in this research. The chi-squared test was used for comparing observed and expected values among quartiles, adopting p < 0.05 as significance. A Bonferroni post hoc analysis was employed to identify where significant differences were (adjusted p < 0.00417). Results showed significant differences in the male under-15 category (Q2 in G1: OV = 17; EV = 9.7; p = 0.001) and male under-23 category (Q1 in G3: OV = 37; VE = 10.1; p < 0.0001). In conclusion, RAE was identified only in male athletes. However, there were major discrepancies between athletes born in the first semester and those born in the second semester.

RESUMO A diferença da idade cronológica em uma faixa etária é chamada de Idade Relativa (IR) e suas consequências no desempenho de atletas é chamada de Efeito da Idade Relativa (EIR). Acredita-se que o EIR entre atletas pode afetar o sucesso competitivo de diversas maneiras, até mesmo na idade adulta. Dessa forma, o objetivo do presente estudo foi investigar o EIR em todos os competidores de judô das competições nacionais do ano de 2013, fazendo-se a diferenciação por categorias etárias e o desempenho competitivo. Fizeram parte da presente investigação 862 atletas do sexo masculino e 637 do sexo feminino. O qui-quadrado foi empregado para comparar os valores observados e esperados entre quartis, adotando-se significância como p < 0,05. Uma análise post hoc de Bonferroni foi utilizada para identificar onde estavam as diferenças significativas (p ajustado < 0,00417). Os resultados mostraram diferença significativa nas categorias sub-15 masculino (Q2 em G1: VO = 17; VE = 9,7; p = 0,001) e sub-23 masculino (Q1 em G3: VO = 37; VE = 10,1; p < 0,0001). Em conclusão, o EIR foi identificado apenas em atletas do sexo masculino. Contudo, houve grande discrepância entre atletas nascidos no primeiro semestre e atletas nascidos no segundo semestre.

Estado nutricional de niños menores de cinco años en la parroquia de Pifo / Nutritional status of children under five years old in the parish of Pifo

OBJETIVO: Evaluar el estado nutricional, según indicadores antropométricos, de los niños menores de cinco años en la parroquia de Pifo. METODOLOGÍA: Estudio descriptivo de corte transversal en 609 niños de cero a cinco años que asisten regularmente al subcentro de salud de Pifo: el 50,7% niños y el 49,3% niñas. Para esto, se tomó como dimensión temporal un estudio comprendido entre el período de julio a noviembre de 2018. Se describieron las variables de promedio y desviación estándar, con un análisis comparativo por sexo. RESULTADOS: Entre los principales resultados, se determinó que existió una prevalencia de desnutrición crónica, global y aguda de 15,8%, 4,6% y 2,0% respectivamente, con un sobrepeso de 4,3% y obesidad de 1,2%. Estos datos fueron más críticos para los niños, con un 19,4% frente al 12,0% de desnutrición crónica, con un 6,0 % frente al 3,0% de desnutrición global, con un 2,6% frente al 1,3% de desnutrición aguda en las niñas, y con un sobrepeso y obesidad similar de 5,5% frente al 5,3% en las niñas. CONCLUSIÓN: Los resultados del estado nutricional muestran que el riesgo de desnutrición en la población infantil de Pifo estuvo por debajo de los promedios nacionales: 9,5% menor en desnutrición crónica (25,3%), 1,8% menor en desnutrición global (6,4%) y 0,4% menor en desnutrición aguda. En sobrepeso y obesidad, 3,1% menor que los datos de la Encuesta Nacional de Salud y Nutrición de 2012 (8,6%)

OBJECTIVE: to evaluate the nutritional conditions of children under five years old through anthropometric variables in the parish of Pifo. METHODOLOGY: Descriptive, transversal research cut in 609 children from zero to five-year-old that regularly come to the health center in Pifo; 50,7% male and 49,3% female. Research period: July through November 2018. Variables used: average, standard deviation and a comparative analysis by genre. RESULTS: Significant findings were a prevalence of chronic, global and severe malnutrition in 15,8%, 4,6%, and 2,0% respectively, overweight 4,3%, and obesity 1,2%, which were more severe in male, 19,4% versus 12,0% in chronic malnutrition, 6,0% versus 3% in global malnutrition, 2,6% versus 1,3% in severe malnutrition in female, overweight and obesity in 5,5% versus 5,3% in female. CONCLUSION: Children nutritional status of the parish of Pifo is under the average of the national indicators registered by the National Health and Nutrition survey, 2012: 9,5% less in chronic malnutrition (25,3%), 1,8% less in global malnutrition (6,4%), and 0,4% less in severe malnutrition. Overweight and obesity: 3,1% less compared to ENSANUT, 2012 (8,6%)

Mejora del conocimiento y conducta alimentaria de los adolescentes con una intervención educativa basada en orientación alimentaria / Improvement of knowledge and feeding behavior of adolescents with an educational intervention based on food orientation

Métodos: estudio cuasiexperimental, con 32 adolescentes entre 15 y 17 años. Se aplicó un cuestionario estructurado pretest y postest de un programa educativo de orientación alimentaria con base en la NOM-043-SSA2-2012. Los datos se analizaron con estadística descriptiva y t de Student no paramétrica para observar la diferencia (p ≤ 0.05). Resultados: el 56.2% de los adolescentes de ambos sexos se encuentran en Normopeso. El sobrepeso fue mayor en hombres (44.5%) que en mujeres (35.7%). Hubo incremento en el consumo de agua pura (20%) y disminución del consumo de refresco o agua de sabor (8%). También aumentó el consumo de frutas y verduras (18%), cereales y tubérculos (16%), y alimentos de origen animal (9%). La diferencia pretest y postest fue significativa (p ≤ 0.05). Conclusión: la intervención educativa basada en orientación alimentaria tiene un efecto positivo sobre el conocimiento reforzando la conducta alimentaria de los adolescentes.

Introduction: Adolescents are susceptible to unhealthy eating behaviors that trigger health problems such as obesity, malnutrition or eating disorders. Objective: To evaluate the effect of an educational intervention based on food orientation to improve knowledge and eating behavior of high school students. Methods: Quasi-Experimental study, with 32 adolescents between 15 and 17 years old. A structured pre-test and post-test questionnaire was applied to an educational food orientation program based on NOM-043-SSA2-2012. The data were analyzed with descriptive statistics and nonparametric Student t to observe the difference (p ≤ 0.05). Results: 56.2% of adolescents of both sexes are in Normopeso. Overweight was higher in men (44.5%) than in women (35.7%). There was an increase in the consumption of pure water (20%) and a decrease in the consumption of soft drink or water of flavor (8%). The consumption of fruits and vegetables (18%), cereals and tubers (16%) and foods of animal origin (9%) also increased. The pretest and posttest difference was significant (p ≤ 0.05). Conclusions: The educational intervention based on food orientation has a positive effect on knowledge by reinforcing the adolescents' eating behavior.

Índice cintura/estatura en niños de 7 a 11 años con alto peso al nacer y su relación con el sexo, la edad y la dieta / Waist-height ratio in children of 7 to 11 years with high weight at birth and its relationship with gender, age and diet

Introducción: La obesidad (OB), considerada como una de las enfermedades crónicas no trasmisibles, tiene como características fundamentales la de ser frecuente a nivel global, ser cada vez más creciente, afectar a países desarrollados y en vías de desarrollo, afectar a ambos sexos, y a todas las edades y grupos sociales. Objetivo: Identificar si el alto peso al nacer constituye un factor predictor (factor de riesgo) para la OB abdominal en niños de 7 a 11 años, y su relación con el sexo, la edad y la dieta. Método: Se realizó un estudio descriptivo con un diseño de tipo caso-control con los niños nacidos entre enero de 1992 y diciembre de 1995, con el fin de identificar de forma temprana factores de riesgo (aceleradores ateroscleróticos) como la OB abdominal en niños de 7 a 11 años, que tienen antecedentes de macrosomía o alto peso al nacer y su relación con el sexo, la edad y la dieta. Resultados: Observamos que en el grupo de estudio y en el grupo control el valor de cintura/estatura es normal, con un 60,80 y un 64,00%, respectivamente, estando alterado el 39,20% en el grupo de estudio y el 36,00% en el grupo de control, además de presentar una p = 0,6859, no siendo estadísticamente significativo, comportándose de igual manera en ambos grupos, ocurriendo lo mismo con el sexo y la edad. En cuanto a la dieta en el grupo de estudio (macrosómico), no existe asociación significativa entre el tipo de dieta y los valores de circunferencia cintura/estatura, con un χ2 = 0,2223 y una p = 0,6373 (no significativo). En el grupo control (con peso normal al nacer) encontramos que existe asociación estadística significativa entre el tipo de dieta y los valores de circunferencia cintura/estatura. Esto quiere decir que se puede afirmar con un 95% de confiabilidad que el tipo de dieta está asociado con los valores de cintura/estatura. Conclusiones: El alto peso al nacer no constituye un factor predictor (factor de riesgo) para la OB abdominal (aumento del índice cintura/estatura). El sexo y la edad es independiente para la OB abdominal (macrosómico y peso normal al nacer). La dieta en el alto peso al nacer no está relacionada con el índice cintura/estatura, no ocurriendo así con los nacidos con peso normal en iguales condiciones. Preocupante el marcado aumento de la OB abdominal (índice cintura/estatura) en niños entre 7 y 11 años en ambos grupos

Introduction: Obesity (OB), considered as one of the Non-Transmissible Chronic Diseases, has as its fundamental characteristics that of being prevalent at a global level, increasing in number, affecting developed and developing countries, affecting both genders, and all ages and social groups. Objective: To identify if high birth weight is a predictive factor (risk factor) for abdominal obesity in children 7 to 11 years old, and its relationship to gender, age and diet. Method: A case-control descriptive study was carried out with children born between January 1992 and December 1995, in order to identify early risk factors (atherosclerotic accelerators) such as abdominal obesity in children aged 7 to 11, and who have a history of macrosomia or high birth weight, as well as their relationship with gender, age and diet. Results: It was observed that the waist/height value was normal in 60.8% of the study group and in 64.00% in the control group. The difference between groups, gender, and age was not significant (P = .6859). As regards the diet in the study group (macrosomic), there was no significant association between the type of diet and waist circumference/height values, with an χ2 = 0.223 and P = .6373 (not significant). In the control group (with normal weight at birth), it was found that there is a significant statistical association between the type of diet and waist circumference/height values. This means that it can be stated, with 95% reliability, that the type of diet is associated with waist/height values. Conclusions: High birth weight is not a predictive factor (risk factor) for abdominal obesity (increased waist/height index). Gender and age are independent for abdominal obesity (macrosomic and normal weight at birth). The diet in high birth weight children is not related to the index waist-height index, which is not the case in those born with normal weight under the same conditions. The marked increase in abdominal obesity (Waist/height index) in children between 7 and 11 years old in both groups is worrying

Erupción dental relacionada con el indicador peso para la edad / Dental eruption related with weight indicator for age

El objetivo del presente estudio fue verificar la existencia de la relación entre la erupción dental con el indicador peso para la edad. Material y métodos: Fue realizado un estudio observacional, transversal, prospectivo. Siendo evaluados un total de 1644 niños con edades comprendidas entre los 5 y 16 años, nativos de la amazonia. Para ello, fue realizado un examen bucodental con el fin de determinar el estadio de erupción de la pieza dentaria. El estado nutricional fue evaluado mediante el programa Anthroplus(R) donde se realizó los cálculos antropométricos para los indicadores; peso para la edad entre los 0 y 10 años, estatura para la edad y el índice de masa corporal entre los 0 y 19 años. Se decide realizar los cálculos antropométricos en niños en edades comprendidas entre los 5 a 10 años. Resultados: Se asoció significativamente el bajo peso con el retardo en la erupción de los incisivos centrales, aunque en el mandibular se obtuvo un tamaño de efecto pequeño. Se encontró relación estadísticamente significativa entre el retardo de erupción del primer molar inferior e incisivo central inferior y la talla baja aunque se obtuvo un tamaño de efecto pequeño. Respecto al IMC no existen casos atípicos ya que todos los niños tienen las puntuaciones típicas entre -1 y 1. Conclusiones: El presente estudio encuentra una relación entre el retardo de la erupción de incisivos centrales y el bajo peso, expresado para el indicador peso para la edad

The objective of the present study was to verify the existence of the relationship between tooth eruption and the weight indicator for age. Material and methods: An observational, cross-sectional, prospective study was carried out. A total of 1644 children between the ages of 5 and 16, native of the Amazon were evaluated. A dental examination was performed in order to determine the stage of eruption of the tooth. The nutritional status was evaluated through the Anthroplus(R) program, where the anthropometric calculations were carried out for the indicators: weight for age between 0 and 10 years, height for age and body mass index between 0 and 19 years. It was decided to perform the anthropometric calculations in children between the ages of 5 and 10 years. Results: Low weight was significantly associated with the delay in the eruption of the central incisors, although a small effect size was obtained in the mandibular. A statistically significant relationship was found between the eruption delay of the first lower molar and the lower central incisor and the short height, although a small effect size was obtained. Regarding BMI, there are no atypical cases since all children have typical scores between -1 and 1. Conclusions: The present study finds a relationship between the delay of the eruption of central incisors and the low weight, expressed for the indicator weight for age

Evaluation of diagnostic criteria and cut-off points to predict underweight among adolescents from the Brazilian semiarid region / Avaliação de critérios diagnósticos e pontos de corte para predição de baixo peso em adolescentes do semiárido brasileiro

Abstract Objectives: to evaluate diagnostic criteria and to propose arm and calf circumference cutoff points to predict underweight in adolescents aged 13-19 years in two Brazilian municipalities of the semiarid region. Methods: underweight was defined as a Body Mass Index (BMI) of less than two z-scores, according to World Health Organization criteria (2007). Measurements of arm and calf circumferences were compared to BMI, and the diagnostic criteria for low-weight prediction were evaluated with the area under the Receiver Operating Characteristic (ROC) curve, coefficients of sensitivity, specificity, predictive values, kappa and diagnostic odds ratios. Results: the prevalence of underweight was 4.2% (CI95%= 3.3-5.0). The cutoff points for arm circumference were 22.1 cm (adolescents of both genders aged 13-15 years), and 25.1 cm and 24.0 cm, respectively, for males and females aged 16-19 years. The cutoff points for calf circumference were 30.0 cm in the first group and 31.8 cm and 31.0 cm, respectively, in the second age group. Conclusions: both anthropometric indicators analyzed evidenced a reasonable to excellent diagnostic capacity to predict underweight among adolescents.

Resumo Objetivos: avaliar critérios diagnósticos e propor pontos de corte para circunferência do braço e circunferência da panturrilha para predição de baixo peso em adolescentes de 13 a 19 anos de dois municípios do semiárido brasileiro. Métodos: o baixo peso foi definido como índice de massa corporal (IMC) menor que menos dois escores-zpelas curvas da Organização Mundial da Saúde (2007). As medidas das circunferências de braço e de panturrilha foram comparadas ao IMC, avaliando-se os critérios diagnósticos para predição de baixo peso pela área sob a curva ROC (receiver operating characteristic), coeficientes de sensibilidade, especificidade, valores preditivos, kappa e razão de odds diagnóstica. Resultados: a prevalência de baixo peso foi de 4,2% (IC95% 3,3-5,0). Os pontos de corte para circunferência do braço foram de 22,1 cm (adolescentes de 13 a 15 anos de ambos os sexos) e de 25,1 cm e 24,0 cm, respectivamente, para o sexo masculino e feminino, de 16 a 19 anos. Para circunferência da panturrilha, os pontos de corte foram de 30,0 cm no primeiro grupo e de 31,8 cm e 31,0 cm, respectivamente, no segundo grupo etário. Conclusão: os dois indicadores antropométricos analisados apresentaram capacidade diagnóstica de razoável à excelente para predizer baixo peso em adolescentes.

Nutrimetría de z-IMC vs z-peso en función al desarrollo lineal en edades de 0 a 30 meses / Nutrimetry of z-BMI vs z-weight in relation to lineal development from 0 to 30 agemonths

Fundamentos: Para favorecer la salud del individuo es necesario contar con indicadores que permitan valorar su estado nutricional a lo largo de todo su desarrollo. El IMC/edad podría permitir esto pero en menores de 2 años su uso no es habitual. Este trabajo compara IMC/edad vs peso/edad en función de longitud/edad por medio de la Nutrimetría, proponiendo ambas como herramientas de vigilancia nutricional para su uso clínico y epidemiológico.Métodos:5,186 niños divididos por edades (0-6, 7-12, 13-18, 19-24 y 25-30 meses) derivados de ENSANUT-2012, con Nutrimetría considerando puntuaciones Z según OMS, ponderando para longitud/edad: z≤-2=1, z≥2=5, o 3 al resto, y para IMC/edad o peso/edad: z≤-1=0, z≥1=6, o 3 al resto resultando dos nutricódigos (longitud-IMC y longitud-peso). Resultados: Diferencias en prevalencias de longitud-IMC menos longitud-peso en las 9 clasificaciones (1,3,5,4,6,8,7,9,11) por grupo de edad: (1)-5,19;0,37;1,94;1,91;-11,13;-0,47;3,29;10,76;-1,46; (2)-5,04;-1,10;1,70;-1,68;-10,00;-1,03;6,73;11,11;-0,67; (3)-8,82;-2,73;1,29;1,84;-18,64;-0,74;6,99;21,37;-0,55; (4)-8,69;-4,31;0,59;3,12;-11,91;-0,12;5,56;16,22;-0,46; (5)-7,04;-2,41;0,43;2,03;-12,95;0,13;5,01;15,35;-0,56. Correlación IMC/edad con longitud/edad (r=-0,19, p≤0,01) y peso/longitud (r=0,97, p≤0,01). Conclusiones: El Nutricódigo longitud-peso en niños altos, sobreestima la proporción de riesgo de sobrepeso/obesidad (R-Sp/Ob) y subestima la de desnutrición, y en longitud/edad baja sobreestima la desnutrición crónica y subestima el R-Sp/Ob, esto y las correlaciones muestran más adecuado usar en Nutrimetría el cruce longitud/edad con IMC/edad

Background: People's health should be enhanced since childhood, so indicators that allow assessing their nutrition status throughout their development are necessary. Body mass index for age (BMI/age) could allow this, but in children under 2 years of age its use is not usual. The present study compares BMI-for-age vs weight-for-age according to length-for-age through Nutrimetry, proposing both as nutritional surveillance tools for clinical and epidemiological use. Methods: We analyzed 5,186 children divided by age (0-6, 7-12, 13-18, 19-24 and 25-30 months) derived from ENSANUT-2012, with Nutrimetry according to WHO's Z scores, assigning for length-for-age: z≤-2=1, z≥2=5, or 3 for the rest, and for BMI-for-age or weight-for-age: z≤-1=0, z≥1=6, or 3 to the rest resulting in two nutricodes (length-BMI and length-weight). Results: Differences of prevalences of length-BMI minus length-weight in their 9 classifications (1,3,5,4,6,8,7,9,11) per age group: (1)-5.19;0.37;1.94;1.91;-11.13;-0.47;3.29;10.76;-1.46; (2)-5.04;-1.10;1.70;-1.68;-10.00;-1.03;6.73;11.11;-0.67; (3)-8.82;-2.73;1.29;1.84;-18.64;-0.74;6.99;21.37;-0.55; (4)-8.69;-4.31;0.59;3.12;-11.91;-0.12;5.56;16.22;-0.46; (5)-7.04;-2.41;0.43;2.03;-12.95;0.13;5.01;15.35;-0.56. Correlation BMI-for-age with length-for-age (r=-.19, p≤0.01) and weight-for-length (r=.97, p≤0.01). Conclusions: With length-weight nutriticode in tall children, proportion of overweight/obesity risk was overestimated and malnutrition underestimated, and in low length-for-age children, chronic malnutrition was overestimated and risk of overweight /obesity underestimated, thus and correlations shows more suitable the use of Nutrimetry crossing length with BMI-for-age

A partir de qual idade podemos doar sangue?

Série de vídeos onde Dr. Fabio Lino, hematologista, responde as dúvidas da população sobre Doação de Sangue.

Caracterización del crecimiento y desarrollo de los adolescentes del séptimo grado de la Secundaria Básica Dagoberto Sanfield / Growth and Development Characterization of the Seventh-Grade Adolescents from Dagoberto Sanfield Secondary School

Introducción: la adolescencia se caracteriza por un intenso crecimiento y desarrollo, hasta el punto que se llega a alcanzar, en un período relativamente corto de tiempo, el 50% del peso corporal definitivo.Objetivo: caracterizar el ritmo de crecimiento y desarrollo en los adolescentes del séptimo grado.Métodos: se realizó un estudio transversal; el universo estuvo constituido por 227 adolescentes de 11 y 12 años de edad que cursaban el séptimo grado en la Secundaria Básica Dagoberto Sanfield en el curso escolar 2012-2013. La muestra de 161 niños, se obtuvo por el método aleatorio simple. La información fue obtenida a través de métodos empíricos como la observación, la entrevista y examen físico. Los datos fueron llevados a una planilla de vaciamiento diseñada al efecto.Resultados: en relación al índice peso talla 101 niños estaban entre el 10 y el 90 percentil, que representaba el 62,7%, considerados eutróficos. Además 53 niños, que constituían el 32,92%, se encontraban valorados como talla alta y 43 (26,70%) como peso alto.Conclusiones: el mayor número de los adolescentes estudiados clasificaron dentro de los canales percentilares normales. Se encontraron cifras estadísticamente significativas de adolescentes con talla alta, con valores superiores en el sexo masculino. La talla estuvo influenciada por parámetros de alto peso como la talla de los padres.(AU)

Introduction: adolescence is characterized by intensive growth and development, 50% of the final body weight achieved in a relatively short period of time.Objective: to characterize the growth and development in adolescents in seventh grade.Methods: a cross-sectional study was conducted; the universe consisted of 227 adolescents aged 11 and 12 years from seventh grade of Dagoberto Sanfield Secondary school during 2012-2013 school year. The sample of 161 children was obtained by the simple random method. The information was obtained through empirical methods such as observation, interview and physical examination. Data were taken for the purpose of the study.Results: one hundred one children were between 10 and 90 percentile according to weight height index for 62.7%, they were considered eutrophic. In addition 53 children, which constituted 32.92% were rated as high stature and 43 (26.70%) and high weight.Conclusions: the largest number of teens surveyed classified within normal percentiles channels. Statistically significant numbers of adolescents with high-class, with higher values in males were found. The size was influenced by high weight parameters such as size of the parents.

Pseudohipoaldosteronismo y aparente exceso de mineralocorticoides: cara y ceca en dos pacientes pediátricos / Pseudohypoaldosteronism and apparent mineralocorticoid excess: two faces, two pediatric patients

Los síndromes endocrinológicos con hipofunción o hiperfunción con niveles paradójicos de dosajes hormonales han sido bien caracterizados en los últimos años del siglo XX, a partir del desarrollo de técnicas genéticas y moleculares. Presentamos dos pacientes con pseudohipoaldosteronismo y aparente exceso de mineralocorticoides como síndromes en espejo, con la intención de alertar al médico clínico respecto de su consideración como entidad diagnóstica en niños con alteraciones hidroelectrolíticas. (AU)

Endocrinological syndromes with underactive or overactive hormonal levels with paradoxical dosages have been well characterized over the years of the twentieth century, from the development of genetic and molecular techniques. We present two patients with pseudohypoaldosteronism and apparent mineralocorticoid excess as mirror syndromes, with the aim to alert the clinician regarding their consideration as a diagnostic entity in children with fluid and electrolyte disturbances. (AU)

The distribution of the indicator height for age of Mexican children and adolescents with Down syndrome according to different reference standards / La distribución del indicador talla para la edad de niños y adolescentes mexicanos con síndrome de Down de acuerdo a diferentes patrones de referencia

Objective: to compare the indicator height for age in Mexican children with Down Syndrome (DS) with two different reference patterns of growth (American and Spanish) that might be suitable for the Mexican population. Methods: a cross-sectional study was performed including 235 Mexican children and adolescents of both sexes with DS aged 45 days to 16 years enrolled in two specialized schools in the metropolitan area of Guadalajara. The dependent variables were weight/age; height/age; weight/ height and BMI. The data expressed was percentiles and the chi-square test was used to compare the distribution of the height/age index with American and Spanish reference patterns. In addition, a chi-square test was performed for the goodness of fit of the height/age index, with breakpoints lower and greater than the 50th percentile. Results: the percentage of participants who were below the 50th percentile in the height/age index was significantly higher with the Spanish vs. the American reference pattern. The chi-square test for goodness of fit showed that the frequency of cases located below the 50th percentile in the height/age index was significantly higher with the American pattern in the age groups of 0 to 36 months (p = 0.022) and 37 to 72 months (p< 0.001), but it was not significant (p = 0.225) in the older than 72 months age group. Conclusion: the American reference pattern is a better fit for the growth of Mexican children with DS compared with the Spanish reference pattern, and the distribution profile obtained with the standard growth and WHO reference was not suitable for the assessment of children with Down syndrome (AU)

Objetivo: comparar el índice talla/edad en niños con síndrome de Down (SD) con dos patrones de referencia (americano y español) que podrían ser adecuados en niños mexicanos. Métodos: en un estudio transversal se incluyeron 295 niños y adolescentes de ambos sexos con SD desde 45 días hasta 16 años de edad, inscritos en dos escuelas del área metropolitana de Guadalajara. Variables dependientes: peso/edad; talla/edad; peso/talla e IMC. Los datos fueron expresados en percentiles y se utilizó la prueba de chicuadrado para comparar la distribución del índice de talla/edad entre los patrones de referencia de EUA y de España. Se realizó una prueba de bondad de ajuste del índice talla/edad con puntos de corte menor y mayor al percentil 50. Resultados: el porcentaje de participantes por debajo del percentil 50 en el índice de talla/edad fue significativamente mayor con la referencia española vs. americana. La prueba de bondad de ajuste mostró que la frecuencia de casos debajo del percentil 50 en el índice talla/edad fue significativamente mayor con la referencia estadounidense en el grupo de edad de 0-36 meses (p = 0,022) y 37-72 meses (p< 0,001), pero no fue significativa en el grupo de edad mayor de 72 meses. Conclusión: la referencia estadounidense se ajustó más al crecimiento de los niños mexicanos con síndrome de Down que la referencia española. El perfil de distribución obtenido con el estándar de crecimiento y referencia de la OMS no fue adecuado para la evaluación de niños con síndrome de Down (AU)

Behaviour and growth performance of low-birth-weight piglets cross-fostered in multiparous sows with piglets of higher birth weights / Comportamento e desempenho de crescimento de leitões com baixo peso ao nascer uniformizados com leitões de maior peso em fêmeas suínas multíparas

The aim of the study was to evaluate the behaviour, pre-weaning survival rate and growth performance of low birth weight (BW) piglets cross-fostered with piglets of higher weights. Piglets were transferred to 60 foster sows, and divided in three groups (G; n=20): G1- 12 low BW piglets (0.80 - 1.25kg); G2- six low BW piglets and six intermediate BW piglets (1.40 - 1.60kg), and G3- six low BW piglets and six high BW piglets (>1.70kg). For the analysis, groups G2 and G3 were subdivided in LG2 (six G2 light piglets); IG2 (six G2 intermediate piglets), LG3 (six G3 light piglets), and HG3 (six G3 heavy piglets). Behavioural observations were carried out on days 1, 2, 4 and 6 (visual direct observation) and on days 3 and 5 (video recording) after birth. The percentage of missed nursings was higher in LG3 piglets than in LG1, IG2 and HG3 piglets, on days 1 and 2. On day 4, light piglets (LG1, LG2 and LG3) missed more nursings than IG2 and HG3 piglets. On day 3, video recording showed a higher percentage of missed nursings in LG1, LG2, and LG3 piglets as compared to HG3 piglets. On day 1, the number of fights during nursing was higher in IG2 than in LG1 and LG3 piglets. Also on day 1, number of fights and percentage of piglets engaged in fights, during 15min after nursing, were higher in LG1, LG3 and HG3 than in LG2 piglets. More playful behaviours were observed on day 2 in IG2 and HG3 piglets compared to LG1, LG2 and LG3 piglets. Light piglets (LG1, LG2, and LG3) presented similar body weight on days 4, 8, 12 and 16 after birth, regardless of being mixed with piglets of higher weights or not; however, the survival rate until day 16 was most compromised in LG3 piglets compared to the other groups. Despite the lack of influence of littermates' weight on the growth of low BW piglets, their survival rate indicates that they should not be mixed with high BW piglets...

O objetivo do estudo foi avaliar o comportamento, a taxa de sobrevivência pré-desmame e o desempenho de crescimento de leitões leves ao nascer uniformizados com leitões de maior peso ao nascer (PN). Os leitões foram transferidos para 60 fêmeas e divididos em três grupos (G; n=20): G1 - 12 leitões de baixo PN (0,80-1,25kg); G2 - seis leitões de baixo PN e seis com PN intermediário (1,40-1,60kg); e G3 - seis leitões de baixo PN e seis leitões pesados (>1,70kg). Para a análise, os grupos G2 e G3 foram subdivididos em LG2 (seis G2 leitões leves); IG2 (seis G2 leitões de peso intermediário); LG3 (seis G3 leitões leves) e HG3 (seis G3 leitões pesados). Observações de comportamento foram realizadas nos dias 1, 2, 4 e 6 (observações visuais diretas) e nos dias 3 e 5 (gravações) após o nascimento. A porcentagem de mamadas perdidas foi maior no grupo LG3 quando comparado aos grupos LG1, IG2 e HG3, nos dias 1 e 2. No dia 4, leitões leves (LG1, LG2 e LG3) perderam maior número de mamadas do que os grupos IG2 e HG3. No dia 3, a gravação mostrou maior porcentagem de perda de mamadas nos grupos LG1, LG2 e LG3 do que no grupo HG3. No dia 1, o número de brigas durante a mamada foi maior nos grupos IG2 do que nos grupos LG1 e LG3. Também no dia 1, o número de brigas e porcentagem de leitões envolvidos em brigas, durante 15 minutos após a mamada, foi maior nos grupos LG1, LG3 e HG3 do que no grupo LG2. Brincadeiras foram mais observadas no dia 2 nos grupos IG2 e HG3 quando comparado aos grupos LG1, LG2 e LG3. Leitões leves (LG1, LG2 e LG3) apresentaram peso semelhante nos dias 4, 8, 12 e 16 após o nascimento, independentemente de serem misturados ou não com leitões pesados. No entanto, a taxa de sobrevivência até o dia 16 foi mais comprometida nos leitões do grupo LG3 do que nos outros grupos. Apesar da falta de influência do peso das leitegadas no crescimento de leitões de baixo PN, a taxa de sobrevivência indicou que estes não devem ser misturados com leitões de maior PN...

Análise genética de características de fertilidade, de crescimento e de produtividade em vacas da raça Canchim / Genetic analysis of fertility, growth and productivity traits of Canchim cows

O objetivo deste trabalho foi estimar herdabilidades e correlações genéticas para idade (IPP), peso (PPP) e escore da condição corporal (EPP) ao primeiro parto, tempo de permanência no rebanho (TPR), número (ND10) e quilograma (QD10) de bezerros desmamados em até dez anos de idade, número (NDT) e quilograma (QDT) de bezerros desmamados durante a permanência no rebanho, quilograma de bezerros desmamados por ano de permanência no rebanho (QTPR), peso adulto (PAD) e parâmetros A e k da curva de crescimento de Bertalanffy de fêmeas de um rebanho da raça Canchim. As distribuições a posteriori dos componentes de (co)variância foram obtidas por inferência bayesiana, em análises bicaráter de IPP, PPP e EPP com as outras características. Os modelos estatísticos incluíram os efeitos aleatórios genético aditivo direto e residual e os efeitos fixos de ano e mês de nascimento ou do parto e idade da vaca ao parto, dependendo da característica. As médias a posteriori das herdabilidades foram 0,12 (IPP); 0,51 (PPP); 0,36 (EPP); 0,22 (TPR); 0,24 (ND10); 0,24 (QD10); 0,25 (NDT); 0,23 (QDT); 0,31 (QTPR); 0,56 (PAD); 0,60 (A) e 0,54 (k), indicando que as características possuem variação genética aditiva suficiente para apresentar boa resposta à seleção massal, com exceção de IPP. As correlações genéticas de TPR (-0,35; -0,23 e -0,02), ND10 (-0,33; -0,40 e -0,02), QD10 (-0,47; -0,29 e 0,00), NDT (-0,43; -0,41 e -0,02), QDT (-0,46; -0,28 e 0,00), QTPR (-0,52; -0,35 e 0,00), PAD (0,19; 0,86 e 0,40), A (0,07; 0,09 e -0,18) e k (-0,21; 0,08 e 0,04) com IPP, PPP e EPP, respectivamente, sugerem que a seleção para reduzir a IPP deve melhorar a longevidade e as características de produtividade das fêmeas; porém, o aumento do PPP poderá prejudicá-las...

The objective of this work was to estimate heritabilities and genetic correlations for age at first calving (AFC), weight at first calving (WFC), body condition score at first calving (SFC), culling age (DIH, days in herd), number (NW10) and kilograms (KW10) of calves weaned up to ten years of age, total number (TNW) and total kilograms (TQW) of calves weaned during herd life, kilograms of calves weaned per year in herd (KYH), adult body weight (ABW) and parameters A and k of the Bertalanffy growth curve of females of a Canchim (5/8 Charolais + 3/8 Zebu) beef cattle herd. The variance and covariance components were obtained by two-trait analyses of AFC, WFC and SFC with the other production traits, using the bayesian inference with statistical models that included the additive direct and residual random effects, and the fixed effects of year and month of birth or of calving and calving age, depending on the trait. The posteriori means of the heritability estimates were 0.12 (AFC), 0.51 (WFC), 0.36 (SFC), 0.22 (DIH), 0.24 (NW10), 0.24 (KW10), 0.25 (TNW), 0.23 (TKW), 0.31 (KYH), 0.56 (ABW), 0.60 (A) and 0.54 (k), indicating that these traits have enough additive genetic variation to show response to mass selection. The genetic correlations for DIH (-0.35, -0.23 and -0.02), NW10 (-0.33, -0.40 and -0.02), KW10 (-0.47, -0.29 and 0.00), TNW (-0.43, -0.41 and -0.02), TKW (-0.46, -0.28 and 0.00), KYH (-0.52, -0.35 and 0.00), ABW (0.19, 0.86 and 0.40), A (0.07, 0.09 and -0.18) and k (-0.21, 0.08 and 0.04) with AFC, WFC and SFC, suggest that selection to reduce age at first calving should improve longevity and productivity traits of females, but the increase in body weight at first calving should reduce these traits...

Tendencia secular del crecimiento durante la primera infancia en el norte de España / Growth secular trend during early childhood in northern Spain

Objective: To check whether secular changes exist in growth pattern of caucasic children from the North of Spain up to 2 years of age compared with 25-30 years ago population growth curves. Material and methods: Longitudinal study of a representative cohort of caucasic infants born a term in Aragon (n=1.099). Standard deviation scores (z-scores) for weight, length and body mass index (BMI) have been calculated by two available 25-30 years ago population growth curves (Sobradillo et al. and Ferrández et al.). Results: At all ages, weight, length and BMI mean z-scores significantly vary depending on the growth standard curve used (p≤0.001). At birth, weight z-score is -0.36 (95%CI:-0.42;-0.30) according to Sobradillo et al. and -0.26 (95%CI:-0.29;0.33) according to Ferrández et al. These differences decreased progressively becoming minimum at 2 years (mean weight z-score -0.08 and -0.05; respectively). At this age, length mean z-score is +0.54 (95%CI:0.48;0.61) according to Sobradillo et al. and +0.19 (95%CI:0.12;0.25) according to Ferrández et al. Mean BMI z-scores of our sample showed lower values than selected standards. Conclusions: Current birth weight of caucasic infants from Northern Spain is lower than in the previous generation. At 2 years of age there is a trend of increasing length, with a similar weight, resulting in lower BMI values (AU)

Objetivo: Comprobar si existen cambios seculares en el patrón de crecimiento de los niños caucásicos en el norte de España hasta los 2 años de edad, en comparación con los estándares poblacionales disponibles de hace 25-30 años. Material y métodos: Estudio longitudinal de una cohorte representativa de la población de niños aragoneses caucásicos nacidos a término (n=1.099). Se han calculado las puntuaciones típicas (Pt) para el peso, longitud e índice de masa corporal (IMC) según dos estándares disponibles de hace 25-30 años (Sobradillo et al. y Ferrández et al.). Resultados: Las Pt medias de peso, longitud e IMC de la muestra varían significativamente según el estándar empleado en todas las edades estudiadas (p≤0,001). Al nacimiento, la Pt media para el peso es -0,36 (IC95%:-0,42;-0,30) respecto a los estándares de Sobradillo et al. y -0,26 (IC95%:-0,29;0,33) respecto a los de Ferrández et al. Estas diferencias se atenúan paulatinamente haciéndose mínimas a los 2 años (Pt media para el peso -0,08 y -0,05; respectivamente). A los 2 años de edad, la Pt media para la longitud es +0,54 (IC95%:0,48;0,61) respecto a Sobradillo et al. y +0,19 (IC95%:0,12;0,25) respecto a Ferrández et al. El IMC de nuestra muestra presenta valores inferiores respecto a los estándares seleccionados. Conclusión: El peso al nacer de los niños caucásicos del norte de España en la actualidad es menor que en la generación anterior. A los 2 años de edad se comprueba una aceleración secular de la longitud pero con un peso similar, lo que conlleva valores inferiores de IMC (AU)

Tabaquismo y peso / Smoking and weight

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