Influence of intra- and extrauterine factors on infant sleep in the first 6 months of life

ABSTRACT Objective: Infant sleep problems can affect the child's health. Maternal characteristics have been associated with the quality of infant sleep, but few studies have investigated the impact of intrauterine conditions. The aim of the study was to evaluate the association between adverse intrauterine environments (maternal smoking, hypertension, diabetes, and intrauterine growth restriction) and extrauterine factors on infant sleep in the first 6 months of life. Methods: Prospective cohort study, including singleton and at-term infants. Mothers were interviewed after delivery and at 30 days, 3 months, and 6 months of life. Socioeconomic, breastfeeding, and sleep data were self-reported by mothers using semi-structured interviews. Maternal stress (Perceived Stress Scale) and postpartum depression symptoms (Edinburgh Postpartum Depression Scale) were assessed. Results: There was no statistically significant association between intrauterine environments and the sleep of infants of the 359 mother-child dyads investigated. Total infant sleep time decreased from approximately 13-11 h from 30 days to 6 months of age (p < 0.001) and the longest period of uninterrupted sleep increased from approximately 4-6 h during the same period (p < 0.001). Breastfed infants slept longer in 24-h periods in the first month, but they woke up more often throughout the night when compared to infants receiving formula. Mothers with depressive symptoms reported increased sleep latency time. Conclusions: Adverse intrauterine environments did not significantly affect sleep measures in the first 6 months of life. Maternal characteristics and practices, however, were associated with infant sleep, suggesting that environmental factors significantly contribute to sleep quality early in life.

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal / Prevalence of colorectal adenomas in patients with family history of colorectal cancer

O câncer colorretal (CCR) é uma doença comum e letal, influenciada por fatores genéticos e ambientais, e pela interação entre ambos. Seu risco está fortemente associado ao número e à idade dos parentes de primeiro grau com história de CCR. O objetivo foi estudar a prevalência de adenomas em pacientes com história familiar de câncer colorretal. Métodos: Realizou-se um estudo retrospectivo, tendo como alvo todos os pacientes submetidos à colonoscopia em um hospital de referência da cidade de Porto Alegre, entre 2003 e 2007. Resultados: Dos 2.462 pacientes estudados, 118 apresentaram história familiar para CCR e 2.344 não apresentaram. Nos dois grupos, houve predomínio do sexo feminino (P=0,001). Nos pacientes com adenomas e história familiar para CCR, houve predomínio do sexo feminino. Já nos pacientes com adenomas e sem história familiar, o sexo masculino foi mais frequente (P=0,032). O número de adenomas entre eles não foi estatisticamente significativo (P=0,187). Conclusão: O grupo com história familiar para CCR mostrou mais mulheres (P=0,001) e a idade também foi inferior (P=0,002). A comparação entre o grupo com adenomas e história familiar para CCR mostrou um número maior de mulheres que o grupo com adenomas sem história familiar para CCR (P=0,032).

Colorectal cancer is a common and lethal disease, influenced by genetic and environmental factors and the interaction between both. The risk of colorectal cancer is strongly associated with the number and age of first degree relatives with colorectal cancer. Methods: A retrospective study was performed having as its objective all the patients submitted to colonoscopy in a reference hospital in the city of Porto Alegre, between 2003 and 2007. The goal is to study the prevalence of adenomas in patients with family history of colorectal cancer. Results: From the 2,462 analyzed patients, 118 had family history for colorectal cancer and 2,344 did not have. In both groups there was predominance of females (P=0.001). In the patients with adenomas and family history of colorectal cancer, there was predominance of females. In the patients with no family history of colorectal cancer there was predominance of males (P=0.032). The number of adenomas between them was not statistically significant (P=0.187). Conclusion: The group with family history of colorectal cancer has shown more women (P=0.001) and the age was also lower (P=0.002). The comparison between the group with adenomas and family history for colorectal cancer has shown a bigger number of women than the group with adenomas with no family history for colorectal cancer (P=0.032).

Prevalência do uso de anti-hipertensivos em pacientes acompanhados em Unidade Básica de Saúde, Canoas, RS, Brasil / Prevalence of use of antihypertensive drugs in patients followedin a Basic Health Unit of Canoas, RS, Brazil

Introdução: Considerada uma doença crônico-degenerativa, a hipertensão arterial sistêmica (HAS) é um problema de saúde pública em países desenvolvidos, sendo responsável por um grande número de mortes. É uma das doenças mais prevalentes no mundo, afetando um em cada cinco brasileiros, segundo dados da Organização Mundial da Saúde (OMS). A investigação constante sobre informações epidemiológicas dessa doença é importante para os gestores públicos. O objetivo deste estudo foi investigar a prevalência de uso contínuo de medicamentos anti-hipertensivos entre os pacientes atendidos no serviço de Medicina de Família e Comunidade (MFC) da Universidade Luterana do Brasil (ULBRA), em uma Unidade Básica de Saúde (UBS) do município de Canoas (RS). Métodos: O estudo realizado é do tipo inquérito epidemiológico, em que a amostra foi composta por todos os pacientes maiores de 18 anos, que foram atendidos no serviço de MFC da ULBRA, em uma UBS do município de Canoas (RS), no período de janeiro a março de 2010, totalizando 371 pacientes. A coleta de dados foi feita através da revisão dos prontuários dos pacientes atendidos no referido período. Resultados: O uso de anti-hipertensivos estava presente em 48,5% (118 casos) da população estudada. A maioria (33,4%) já fazia uso de algum desses medicamentos há mais de 18 meses. Os mais utilizados foram captopril (66,1%) e hidroclorotiazida (61,7%). Conclusões: A prevalência do uso de anti-hipertensivos na população assistida por essa UBS é alta (48,5%). Captopril foi o medicamento mais prescrito, o que está em desacordo com a terapêutica recomendada atualmente.

Introduction: Considered as a chronic degenerative disease, hypertension (HBP) is a public health problem in developed countries, accounting for a large number of deaths. It is one of the most prevalent diseases worldwide, affecting one in every five Brazilians, according to the World Health Organization (WHO). The continual research on epidemiological information of this disease is important for policy makers. The aim of this study was to investigate the prevalence of the continuous use of antihypertensive medications among patients seen in the service of Family and Community Medicine (FCM) of the Lutheran University of Brazil (ULBRA) in a Basic Health Unit (BHU) in Canoas (RS). Methods: We conducted an epidemiological survey in which the sample consisted of all patients aged over 18 years who visited the FCM service of ULBRA in a BHU in Canoas (RS) from January to March 2010, with a total of 371 patients. Data collection was done by reviewing the medical records of patients seen in that period. Results: The use of antihypertensive drugs was present in 48.5% (118 cases) of the population studied. The majority (33.4%) had been using some of these drugs for more than 18 months. The most used drugs were Captopril (66.1%) and hydrochlorothiazide (61.7%). Conclusions: The prevalence of use of antihypertensive drugs in this population is high (48.5%). Captopril was the most prescribed drug, which is at odds with the currently recommended therapy.