[Tuberculosis in childhood and adolescence: prevalence and factors associated with treatment abandonment]. / Tuberculose na infância e adolescência: prevalência e fatores associados ao abandono do tratamento.

Tuberculosis (TB) is an infectious disease that remains a serious public health problem worldwide. In the pediatric population, the knowledge about the factors that lead to the abandonment of TB treatment is limited, especially in regions with a high prevalence of the disease. This study aimed to identify the prevalence and risk factors associated with TB treatment abandonment in children and adolescents. A cross-sectional study was carried out using data obtained from TB notifications from the São Paulo State Tuberculosis Patient Control System, Brazil, for individuals aged between 0 and 18 years, from January 2009 to December 2019. The crude and adjusted prevalence ratios were estimated with a 95% confidence interval, using the Poisson regression model to identify associations between the outcome of treatment abandonment and the sociodemographic, clinical-epidemiological, diagnostic and therapeutic factors of TB cases with complete information. Of the 12,256 cases analyzed, 941 individuals abandoned treatment. The highest prevalence rate of treatment abandonment occurs among Black or brown adolescents, those over 11 years of age and those deprived of their liberty. Other characteristics associated with treatment abandonment include: being a person living with HIV/AIDS, having a history of previous TB treatment, using illicit substances and using a self-administered TB treatment regimen. Knowing the profile of the patient most likely to abandon TB treatment makes it possible to devise more effective strategies focused on adherence to drug treatment.

A tuberculose (TB) é uma doença infectocontagiosa que ainda representa um grave problema de saúde pública no mundo. Na população pediátrica, os fatores que levam ao abandono do tratamento da TB, especialmente em regiões de elevada prevalência da doença, são pouco conhecidos. Portanto, este estudo objetivou identificar a prevalência e os fatores de risco associados ao abandono do tratamento da TB em crianças e adolescentes. Foi realizado um estudo transversal com dados obtidos das notificações de TB provenientes do Sistema de Controle de Pacientes com Tuberculose do Estado de São Paulo, Brasil, em indivíduos com idade entre 0 e 18 anos, no período de janeiro de 2009 a dezembro de 2019. Estimou-se a razão de prevalência bruta e ajustada com intervalo de 95% de confiança, utilizando-se o modelo de regressão de Poisson para identificar associações entre o desfecho abandono do tratamento com os fatores sociodemográficos, clínico-epidemiológicos, diagnósticos e terapêuticos dos casos de TB, contendo informações completas. Dos 12.256 casos analisados, 941 indivíduos abandonaram o tratamento. A maior taxa de prevalência de abandono do tratamento ocorre entre os adolescentes pretos ou pardos, acima de 11 anos e privados de liberdade. Outras características associadas ao abandono do tratamento incluem: serem pessoas vivendo com HIV/aids, ter histórico de tratamento anterior para TB, fazer uso de substâncias ilícitas e utilizar o regime de tratamento de TB autoadministrado. Concluiu-se que conhecer o perfil do paciente com maiores chances para abandonar o tratamento da TB permite elaborar estratégias focadas na adesão ao tratamento medicamentoso mais efetivas.

La tuberculosis (TB) es una enfermedad infectocontagiosa que sigue siendo un grave problema de salud pública mundial. Se sabe poco sobre los factores que conducen al abandono del tratamiento de la TB en la población pediátrica, especialmente en regiones con alta prevalencia de la enfermedad. Por lo tanto, este estudio tuvo como objetivo identificar la prevalencia y los factores de riesgo asociados con el abandono del tratamiento de la TB en niños y adolescentes. Se trató de un estudio transversal realizado a partir de los datos de notificaciones de TB del Sistema de Control de Pacientes con Tuberculosis del Estado de São Paulo, Brasil, recopilados de individuos con edades comprendidas entre 0 y 18 años, en el período de enero de 2009 a diciembre de 2019. La relación de prevalencia bruta y ajustada se estimó con un intervalo de 95% de confianza; y se utilizó el modelo de regresión de Poisson para identificar las asociaciones entre el resultado del abandono del tratamiento y los factores sociodemográficos, clínico-epidemiológicos, diagnósticos y terapéuticos de los casos de TB que contienen información completa. De los 12.256 casos analizados, 941 individuos habían abandonado el tratamiento. La mayor tasa de prevalencia de abandono del tratamiento se dio entre adolescentes negros o pardos, mayores de 11 años y los privados de libertad. Otras características asociadas con el abandono del tratamiento fueron personas que viven con VIH/sida, tener antecedentes de tratamiento previo de TB, usar sustancias ilícitas y utilizar el régimen de tratamiento de TB autoadministrado. Se concluyó que conocer el perfil de los pacientes con mayor tendencia a abandonar el tratamiento de la TB nos permite desarrollar estrategias efectivas enfocadas en una adherencia al tratamiento farmacológico.

Immune Evasion of SARS-CoV-2 Omicron Subvariants XBB.1.5, XBB.1.16 and EG.5.1 in a Cohort of Older Adults after ChAdOx1-S Vaccination and BA.4/5 Bivalent Booster.

The recently emerged SARS-CoV-2 Omicron sublineages, including the BA.2-derived XBB.1.5 (Kraken), XBB.1.16 (Arcturus), and EG.5.1 (Eris), have accumulated several spike mutations that may increase immune escape, affecting vaccine effectiveness. Older adults are an understudied group at significantly increased risk of severe COVID-19. Here we report the neutralizing activities of 177 sera samples from 59 older adults, aged 62-97 years, 1 and 4 months after vaccination with a 4th dose of ChAdOx1-S (Oxford/AstraZeneca) and 3 months after a 5th dose of Comirnaty Bivalent Original/Omicron BA.4/BA.5 vaccine (Pfizer-BioNTech). The ChAdOx1-S vaccination-induced antibodies neutralized efficiently the ancestral D614G and BA.4/5 variants, but to a much lesser extent the XBB.1.5, XBB.1.16, and EG.5.1 variants. The results showed similar neutralization titers between XBB.1.16 and EG.5.1 and were lower compared to XBB.1.5. Sera from the same individuals boosted with the bivalent mRNA vaccine contained higher neutralizing antibody titers, providing a better cross-protection against Omicron XBB.1.5, XBB.1.16 and EG.5.1 variants. Previous history of infection during the epidemiological waves of BA.1/BA.2 and BA.4/BA.5, poorly enhanced neutralization activity of serum samples against XBBs and EG.5.1 variants. Our data highlight the continued immune evasion of recent Omicron subvariants and support the booster administration of BA.4/5 bivalent vaccine, as a continuous strategy of updating future vaccine booster doses to match newly emerged SARS-CoV-2 variants.

Assessment of the Interferon-Lambda-3 Polymorphism in the Antibody Response to COVID-19 in Older Adults Seropositive for CMV.

BACKGROUND: Here, we investigated the impact of IFN-lambda-3 polymorphism on specific IgG responses for COVID-19 in older adults seropositive for CMV. METHODS: Blood samples of 25 older adults of both sexes were obtained at three different times: during a micro-outbreak (MO) of SARS-CoV-2 in 2020; eight months after (CURE); and 30 days after the administration of the second dose of ChadOx-1 vaccine (VAC). The specific IgG for both SARS-CoV-2 and CMV antigens, neutralizing antibodies against SARS-CoV-2, and also the polymorphism profile for IFN-lambda-3 (rs12979860 C > T) were assessed. RESULTS: Higher levels of specific IgG for SARS-CoV-2 antigens were found in the MO and VAC than in the CURE time-point. Volunteers with specific neutralizing antibodies against SARS-CoV-2 showed better specific IgG responses for SARS-CoV-2 and lower specific IgG levels for CMV than volunteers without specific neutralizing antibodies. Significant negative correlations between the specific IgG levels for SARS-CoV-2 and CMV were found at the MO time-point, as well as in the group of individuals homozygous for allele 1 (C/C) in the MO time-point and heterozygotes (C/T) in the CURE time-point. CONCLUSION: Our results suggested that both CMV seropositivity and the homozygosis for allele 1 (C/C) in IFN-lambda-3 gene can negatively impact the antibody response to COVID-19 infection and vaccination in older adults.

Older Adults Who Maintained a Regular Physical Exercise Routine before the Pandemic Show Better Immune Response to Vaccination for COVID-19.

BACKGROUND: In this study, we aimed to investigate the specific-antibody response to the COVID-19 vaccination and the immunophenotyping of T cells in older adults who were engaged or not in an exercise training program before the pandemic. METHODS: Ninety-three aged individuals (aged between 60 and 85 years) were separated into 3 groups: practitioners of physical exercise vaccinated with CoronaVac (PE-Co, n = 46), or vaccinated with ChadOx-1 (PE-Ch, n = 23), and non-practitioners vaccinated with ChadOx-1 (NPE-Ch, n = 24). Blood samples were collected before (pre) and 30 days after vaccination with the second vaccine dose. RESULTS: Higher IgG levels and immunogenicity were found in the PE-Ch and NPE-Ch groups, whereas increased IgA levels were found only in the PE-Ch group post-vaccination. The PE-Co group showed a positive correlation between the IgA and IgG values, and lower IgG levels post-vaccination were associated with age. Significant alterations in the percentage of naive (CD28+CD57-), double-positive (CD28+CD57+), and senescent (CD28-CD57+) CD4+ T and CD8+ T cells were found post-vaccination, particularly in the PE-Ch group. CONCLUSIONS: The volunteers vaccinated with the ChadOx-1 presented not only a better antibody response but also a significant modulation in the percentage of T cell profiles, mainly in the previously exercised group.

High Fatality Rates in Pediatric Multisystem Inflammatory Syndrome: A Multicenter Experience From the Epicenter of Brazil's Coronavirus Pandemic.

BACKGROUND: Brazil´s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children. METHODS: We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of São Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables. RESULTS: A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants. CONCLUSION: We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.

Development and validation of an enzyme-linked immunoassay kit for diagnosis and surveillance of COVID-19.

There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.

DEVELOPMENT AND VALIDATION OF AN ENZYME-LINKED IMMUNOASSAY KIT FOR DIAGNOSIS AND SURVEILLANCE OF COVID-19.

There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.

In Nasal Mucosal Secretions, Distinct IFN and IgA Responses Are Found in Severe and Mild SARS-CoV-2 Infection.

Likely as in other viral respiratory diseases, SARS-CoV-2 elicit a local immune response, which includes production and releasing of both cytokines and secretory immunoglobulin (SIgA). Therefore, in this study, we investigated the levels of specific-SIgA for SARS-CoV-2 and cytokines in the airways mucosa 37 patients who were suspected of COVID-19. According to the RT-PCR results, the patients were separated into three groups: negative for COVID-19 and other viruses (NEGS, n = 5); negative for COVID-19 but positive for the presence of other viruses (OTHERS, n = 5); and the positive for COVID-19 (COVID-19, n = 27). Higher specific-SIgA for SARS-CoV-2, IFN-ß, and IFN-γ were found in the COVID-19 group than in the other groups. Increased IL-12p70 levels were observed in OTHERS group as compared to COVID-19 group. When the COVID-19 group was sub stratified according to the illness severity, significant differences and correlations were found for the same parameters described above comparing severe COVID-19 to the mild COVID-19 group and other non-COVID-19 groups. For the first time, significant differences are shown in the airway's mucosa immune responses in different groups of patients with or without respiratory SARS-CoV-2 infection.

Lower cost alternatives for molecular diagnosis of COVID-19: conventional RT-PCR and SYBR Green-based RT-qPCR.

In March 2020, WHO declared a pandemic state due to SARS-CoV-2 having spread. TaqMan-based real-time RT-qPCR is currently the gold standard for COVID-19 diagnosis. However, it is a high-cost assay, inaccessible for the majority of laboratories around the world, making it difficult to diagnose on a large scale. The objective of this study was to standardize lower cost molecular methods for SARS-CoV-2 identification. E gene primers previously determined for TaqMan assays by Colman et al. (2020) were adapted in SYBR Green assay and RT-PCR conventional. The cross-reactivity test was performed with 17 positive samples for other respiratory viruses, and the sensibility test was performed with 8 dilutions (10 based) of SARS-CoV-2 isolated and 63 SARS-CoV-2-positive samples. The SYBR Green assays and conventional RT-PCR have not shown amplification of the 17 respiratory samples positives for other viruses. The SYBR Green-based assay was able to detect all 8 dilutions of the isolate. The conventional PCR detected until 107 dilution, both assays detected the majority of the 63 samples, 98.42% of positivity in SYBR Green, and 93% in conventional PCR. The average Ct variation between SYBR Green and TaqMan was 1.92 and the highest Ct detected by conventional PCR was 35.98. Both of the proposed assays are less sensitive than the current gold standard; however, our data shows a low sensibility variation, suggesting that these methods could be used by laboratories as a lower cost molecular method for SARS-CoV-2 diagnosis.

Violência por parceiro íntimo contra a mulher e insegurança alimentar: uma revisão narrativa da literatura / Violencia por parte de compañero íntimo contra la mujer e inseguridad alimentaria: una revisión narrativa de la literatura / Intimate partner violence against woman and food insecurity: a narrative review of the literature

O objetivo do presente artigo é revisar a literatura que aborda a relação entre violência por parceiro íntimo contra a mulher e insegurança alimentar. A busca por materiais foi realizada nas bases de dados Pubmed, SciELO, Lilacs e Medline. Foram incluídos estudos prospectivos, retrospectivos e transversais. O critério de inclusão foram estudos que relacionassem a violência por parceiro íntimo contra a mulher e insegurança alimentar, sendo selecionados16 artigos com esse tema. A avaliação da violência e da insegurança foi realizada com escalas e questionários próprios, que mediam, além da incidência, o nível de insegurança e os tipos de violência. Todos os estudos identificaram uma forte associação entre ambos os temas, identificando-se forte associação, bidirecional, entre violência por parceiro íntimo e insegurança alimentar, relação mediada principalmente por problemas psicológicos e econômicos.(AU)

El propósito de este artículo es revisar la literatura sobre la relación de la violencia por parte de compañero íntimo contra la mujer e inseguridad alimentaria. La búsqueda se realizó en las bases de datos Pubmed, SciELO, Lilacs y Medline. Se incluyeron estudios prospectivos, retrospectivos y transversales. Los criterios de inclusión comprendieron estudios que relacionaron la violencia por parte de compañero íntimo contra la mujer con la inseguridad alimentaria, siendo seleccionados 16 artículos con esa temática. La evaluación de la violencia y de la inseguridad se realizó con escalas y cuestionarios propios que medían, además de la incidencia, el nivel de inseguridad y los tipos de violencia. Todos los estudios identificaron una fuerte asociación entre ambos temas, identificando una fuerte asociación, bidireccional, entre violencia por parte de compañero íntimo e inseguridad alimentaria, relación mediada principalmente, por problemas psicológicos y económicos.(AU)

The purpose of this article is to review the literature on the relationship between intimate partner violence against woman and food insecurity. The search was carried out in the Pubmed, SciELO, Lilacs and Medline databases. Prospective, retrospective, and cross-sectional studies were included. The inclusion criteria included studies that related intimate partner violence against women with food insecurity, being selected 16 articles with this theme. The assessment of violence and insecurity was made using scales and questionnaires, measuring the incidence, as well as the level of insecurity and the types of violence. All studies identified a strong and robust association between both topics, identifying a strong association, in a bidirectional way, between intimate partner violence and food insecurity, a relationship was mediated mainly by psychological and economic problems.(AU)

The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers.

OBJECTIVE: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. CONCLUSION: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers

OBJECTIVE: We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. METHODS: In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. RESULTS: Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. CONCLUSION: The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

Evaluation of the anesthetic management of children and adolescents in a teaching hospital.

BACKGROUND AND OBJECTIVES: Anesthetic quality and patients' satisfaction has been increasingly praised. Our objective was to evaluate anesthetic management of children and adolescents in our Hospital, by interviewing parents and/or tutors. METHODS: 230 parents or tutors of children and adolescents submitted to anesthesia in the period April-December 2003 were interviewed during the postoperative visit through a four-item questionnaire: children and adolescents and their parents or tutors identification (item 1); explanations during preanesthetic evaluation (item 2) about anesthesia (item 3) and post-anesthetic recovery (PACU) (item 4). Person informing respondents was identified and the presence of post-anesthetic complications made known. Respondents have scored the Anesthesiology Department from 0 to 10. RESULTS: Survey was answered by mothers in 189 (82.2%) of cases. Most respondents (114, 75.6%) were aged 20 to 39 years, were married (148, 64.3%), and 140 (60.9%) had no job. Anesthesiologists have introduced themselves to 89%; for 37% and 77.4% they have explained the importance and duration the fasting period; 82% were informed about anemia; 90% were informed about allergy; 46.8% were informed about PACU importance; 42.2% were explained about length of stay; 72.9% were informed about the health status of their children. There have been no concerns for 49%, 58% and 58%, respectively about pre, intra and post-anesthetic period; 78.9% would like to have been with their children at PACU arrival. Pre, intra and post-anesthetic concerns were related to patients' age and gender - no concern whatsoever for most respondents - and to respondents' education - the better the education the lower the number and diversity of reported concerns. Scores to the Anesthesiology department were mostly between 7 and 10 (97.4%). CONCLUSIONS: The Anesthesiology Department provides satisfactory services, in spite of communication failures, which are easy to solve and depend more on Department's willingness than on scientific knowledge.

Avaliação do atendimento anestésico da criança e do adolescente em um hospital universitário / Evaluation of the anesthetic management of children and adolescents in a teaching hospital

JUSTIFICATIVA E OBJETIVOS: Qualidade em anestesia e na satisfação dos pacientes têm tido acentuado destaque. O objetivo foi avaliar o atendimento anestésico de crianças e adolescentes, entrevistando seus responsáveis. MÉTODO: Foram entrevistados 230 responsáveis por crianças e adolescentes submetidos à anestesia no período compreendido entre abril e dezembro de 2003. Realizou-se entrevista na visita pós-operatória através de questionário com quatro itens: identificação das crianças e de adolescentes e seus responsáveis (item 1); esclarecimentos na visita pré-anestésica (item 2), quanto à anestesia (item 3) e à recuperação pós-anestésica (SRPA) (item 4), determinando-se quem dera as informações aos entrevistados e se houvera complicação no pós-anestésico. O responsável atribuiu nota de 0 a 10 ao Serviço de Anestesiologia. RESULTADOS: A pesquisa foi respondida pela mãe em 189 (82,2 por cento) casos. A maioria dos entrevistados, 114 (75,6 por cento), tinha entre 20 e 39 anos, era casada (148 a 64,3 por cento) e 140 (60,9 por cento) não tinham ocupação. Para 89 por cento, o anestesiologista se identificou; para 37 por cento e 77,4 por cento, esclareceu sobre importância e tempo do jejum; 82 por cento, sobre anemia; 90 por cento, alergia; 46,8 por cento, importância da SRPA; 42,2 por cento, tempo de permanência; 72,9 por cento, estado de saúde de sua criança. Não houve apreensões para 49 por cento, 58 por cento e 58 por cento, respectivamente, no pré, intra e pós-anestésico. Gostariam de ter estado com sua criança/adolescente na chegada à SRPA 78,9 por cento. Foram relacionadas preocupações no período pré, intra e pós-anestésico com o sexo e a idade do paciente - não ter tido nenhuma preocupação - maioria dos entrevistados - e com a escolaridade do entrevistado - quanto mais completa, menor foi o número e a variedade das preocupações relatadas. As notas atribuídas ao Serviço de Anestesiologia tiveram maior freqüência entre 7 e 10 (97,4 por cento). CONCLUSÕES: Considera-se que o Serviço de Anestesiologia desenvolve bom trabalho, apesar de falhas na comunicação, que são de solução simples e dependem mais da vontade do serviço que de seu conhecimento científico.