Prospective effect of dietary intake of fat on menarche among girls / 中国学校卫生

Objective@#To explore the prospective effect of dietary intake of total fat and fatty acids on menarcheal timing among girls,and to provide a theoretical basis for preventing the early puberty development of Chinese children.@*Methods@#Using the data from 1997-2015 China Health and Nutrition Survey (CHNS), 1 240 girls aged 6-13 with menarche information, baseline dietary survey data and at least one follow up assessment were selected. Cox regression analysis was performed to examine the prospective effect of dietary intake of total fat and fatty acids before menarche on age at menarche.@*Results@#The mean baseline age of the participants was (8.3±1.8). After adjustment for year of birth, residence, household income, dietary energy intake and body mass index Z score at baseline, girls in the highest quartile of intake of total fat and polyunsaturated fatty acid (PUFA) had a 30% and 34% higher probability of experiencing menarche at an earlier age than those in the lowest quartile [ HR(HR 95%CI )=1.30 (1.01~1.68)，1.34(1.05~1.70)]. After adjusting for the confounders, there were no correlations between the intake of saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) and the onset of menarche [ HR(HR 95%CI )=1.24(0.98~1.58),1.25(0.97~ 1.62 )]( P >0.05).@*Conclusion@#Higher dietary intake of total fat and PUFA before menarche may lead to earlier age at menarche and no correlation between intake of SFA and MUFA before menarche with age at menarche is found among Chinese girls.

Sex differences in the growth and physical development of Beijing school aged children and adolescents / 中国学校卫生

Objective@#The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents.@*Methods@#Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individuallevel information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA).@*Results@#Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11 year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P<0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56，-47.46，3.22，P<0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty.@*Conclusion@#Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height.

A ludoterapia e a criança hospitalizada na perspectiva dos pais / The play therapy and child hospitalized in perspective of parents / La ludoterapia y el niño hospitalizado desde la perspectiva de los padres

A hospitalização traz transtornos que, na infância, tornam-se mais evidentes nas manifestações de insatisfação momentânea ou prejuízos, podendo permanecer mesmo após a alta hospitalar. Na Pediatria as crianças são submetidas a procedimentos dolorosos, além de depararem com situações variadas como a presença constante de pessoas estranhas ao seu convívio habitual, como profissionais de saúde de diversas áreas, outros pacientes internados e seus acompanhantes. Nesse cenário, a aplicação da ludoterapia no meio hospitalar transforma-se em um método benéfico no processo de adaptação da criança. Trata-se de pesquisa qualitativa, descritiva, que buscou analisar o uso do brincar na assistência à criança hospitalizada na perspectiva dos pais. O estudo foi realizado na Pediatria de um Hospital Municipal de Belo Horizonte-MG. Foram entrevistados 13 pais por meio de roteiro semiestruturado e realizada a análise de conteúdo, segundo Bardin, para interpretação dos dados. Os achados evidenciaram que o brincar é instrumento de grande valor para minimizar o estresse da internação e contribuir para melhor adaptação da criança ao ambiente hospitalar. Ademais, o mesmo traz benefícios referentes à promoção do bem-estar, diversão, redução da dor e socialização durante a hospitalização. Concluiu-se, dessa maneira, que a utilização do brincar pode ser muito benéfica na rotina da Pediatria, favorecendo um cuidado mais humanizado e integral, além da possibilidade de diminuir os prejuízos no desenvolvimento da criança, causados pela experiência da hospitalização.

Hospitalization brings disorders in childhood become more evident in the momentary manifestations of dissatisfaction or damage may remaineven after hospital discharge. In pediatrics children are subjected to painful procedures, and faced with different situations as the constant presenceof strangers to his usual conviviality, as health professionals from various fields, other hospitalized patients and their companions. In this scenario,the application of play therapy in hospitals becomes a beneficial method in the child’s adaptation process. This is a qualitative, descriptive, whichsought to analyze the use of play in the care of hospitalized children from the perspective of parents. The study was conducted in pediatrics of a Municipal Hospital of Belo Horizonte / MG. They interviewed 13 parents through semi-structured and conducted a content analysis script, accordingto Bardin interpretation of data. The findings showed that the play is valuable tool to minimize the stress of hospitalization and contribute to betteradaptation of the child to the hospital. Moreover, it brings benefits for the promotion of well-being, fun, pain reduction and socialization during hospitalization. The conclusion is thus that the use of the play can be very beneficial in the pediatric routine, favoring a more humanized andcomprehensive care and the possibility of reducing the losses in child development, caused by the experience of hospitalization.

La hospitalización trae trastornos que en la infancia se hacen más evidentes en manifestaciones de insatisfacción momentánea o en daños quepueden permanecer incluso después del alta hospitalaria. En pediatría los niños son sometidos a procedimientos dolorosos y deben también habituarse a situaciones desconocidas, entre ellas la presencia de extraños en el día a día tales como de distintos profesionales de la salud, de otrospacientes hospitalizados y de sus acompañantes. En este escenario, la ludoterapia en los hospitales es un método beneficioso en el proceso deadaptación del niño. Se trata de un estudio cualitativo descriptivo que buscó analizar el uso del juego en la atención del niño hospitalizado desde la perspectiva de los padres. El estudio se realizó en la pediatría de un hospital Municipal de Belo Horizonte / MG, con entrevistas semiestructuradas a13 padres. Los datos fueron analizados por el contenido de la escritura, según la interpretación de datos de Bardin. Los resultados mostraron que eljuego es una valiosa herramienta para minimizar el estrés de la hospitalización y contribuir a una mejor adaptación del niño al hospital. Además, promueve el bienestar, la diversión, la disminución del dolor y la socialización durante la internación. La ludoterapia puede ser muy benéfica en larutina pediátrica, favoreciendo la atención más humanizada e integral y la posibilidad de reducir los daños en el desarrollo infantil causados porla experiencia de la hospitalización.

Association between MPO gene polymorphism and clinical characteristics in children with Kawasaki disease / 临床儿科杂志

Objective To investigate the association between MPO gene single nucleotide polymorphisms (SNP) loci (rs2333227,-643G/A) and clinical characteristics in Kawasaki disease (KD) in Han population in central China. Methods A case-control study was performed. Two hundred and thirty-seven children with KD and 249 normal children were recruited. The polymorphism distribution of SNP was detected using PCR-RFLP. The clinical data of children with KD were collected. Results The frequency of SNP loci (rs2333227) genotypes (GG, GA, AA) was signiifcantly different between children with KD and normal children (P=0.039), the allele frequency was also signiifcantly different between two groups (P=0.012), and the G allele was the risk factor. Compared with other genotypes, KD children with GG genotype had higher frequency in hand-foot edema (P=0.029). The SNP polymorphism was also associated with peritoneal effusion (P=0.028), however this SNP polymorphism was not associated with conjunctival hyperemia, oral mucosa lesions, and coronary artery lesion (P>0.05), also was not associated to imaging characteristics of hepatomegaly, splenomegaly, and lobular pneumonia (P>0.05). Conclusion The SNP loci (rs2333227) in MPO gene was associated with KD susceptibility, the G allele was a risk factor, and the SNP polymorphisms is associated with some clinical characteristic.

Distribution of blood pressure in children aged 7 to 12 in Zhengzhou / 临床儿科杂志

ObjectiveTo understand the feature of blood pressure in children aged 7 to 12 years in Zhengzhou.Methods According to stratiifed cluster random sampling method, children aged 7 to 12 years in ifve schools from three urban and two suburban counties in Zhengzhou were analyzed. The height, weight, waist circumference, hip circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured and analyzed.Results The survey included total 6460 children aged 7 to 12 years, 3206 urban children (49.63%), 3254 suburban children (50.37%), 3525 boys (54.57%) and 2935 girls (45.43%). SBP in boys [(117.86±18.18) mmHg] was signiifcantly higher than that in girls [(113.82±13.11) mmHg (t=3.16;P=0.002). The incidence of hypertension in children in Zhengzhou was 7.52%. The blood pressure in boys was higher than that in girls (χ2=9.66,P=0.002). The blood pressure in urban boys and girls was higher than that in suburban boys and girls respectively (χ2=24.15, 14.39;P=0.000). The SBP and DBP had positive correlation with age, height, weight, BMI, waist circumference in boys (P<0.01). The SBP had positive correlation with age, height, weight, BMI, waist circumference in girls (P<0.01). Conclusions The blood pressure is higher in boys than in girls, which also is higher in urban children than in suburban children in Zhengzhou. The SBP is related to the age, height, weight, BMI, waist circumference.

Comunicação não verbal na unidade de terapia intensiva pediátrica: percepção da equipe multidisciplinar / Non-verbal communication in the pediatric intensive care unit: perception of the multidisciplinary team / Comunicación no verbal en unidad de cuidados intensivos pediátricos: una visión de equipo multidisciplinario

OBJETIVO: compreender o significado da comunicação não verbal na assistência ao paciente e à família, em uma unidade de terapia intensiva pediátrica (UTIP), pela equipe multiprofissional.METODOLOGIA: trata-se de um estudo de natureza qualitativa, baseado na fenomenologia, realizado junto à equipe multiprofissional que atua na UTIP de uma instituição filantrópica de Minas Gerais. A coleta de dados foi realizada a partir de entrevistas semiestruturadas, respeitando a Resolução 196/96.RESULTADOS: os resultados foram agrupados e descritos em cinco categorias, denominadas: trabalho em equipe - implicações do processo de comunicação na assistência; estratégias utilizadas pela equipe multidisciplinar na comunicação não verbal; comunicação verbal e não verbal: humanização do processo de cuidar; a família como elo no processo de comunicação não verbal; dificuldades encontradas pela equipe no processo da comunicação não verbal.CONCLUSÃO: é de extrema importância que surjam novas discussões acerca da comunicação nessas unidades, como forma de refletir sobre o cuidado prestado às crianças internadas em uma UTIP.

Objective: to understand the meaning of nonverbal communication in the assistance to patient and families in a pediatric intensive care unit(PICU) for the multidisciplinary team. Methodology: this is a qualitative study, based on phenomenology, carried out by the multidisciplinaryteam that operates in the PICU of a philanthropic institution in Minas Gerais. The data were collected using semi-structured interviews incompliance with the 196/96 resolution. Results: the results were grouped and described in five categories known as: teamwork – implications ofthe process of communication in assistance; strategies used by the multidisciplinary team in non-verbal communication; verbal and non-verbalcommunication: humanization of the process of care; the family as a link in the process of non-verbal communication; difficulties encounteredby the team in the process of non-verbal communication. Conclusion: the emergence of new discussions about the communication in theseunits is of extreme importance as a way to reflect on care provided to children admitted to a PICU.

Este trabajo tiene como objetivo comprender la importancia de la comunicación no verbal en la atención al paciente / familia en una Unidad de Cuidados Intensivos Pediátricos (UCIP), por el equipo multidisciplinario. Se llevó a cabo un estudio cualitativo en base a la fenomenología con un equipo multidisciplinario de la UCIP de una institución filantrópica de Minas Gerais. La recogida de datos se realizó a partir de entrevistas semi-estructuradas, respetando la Resolución 196/96. Los resultados se agruparon y se describen en las cinco categorías siguientes: Trabajo en equipo consecuencias del proceso de comunicación en la atención; estrategias utilizadas por el equipo multidisciplinario de comunicación no verbal; comunicación verbal y no verbal: la humanización del proceso de atención; la familia como comunica eslabón en el proceso de comunicación no verbal; dificultades encontradas por el personal en el proceso de comunicación no verbal. Es sumamente importante que se realicen más debates sobre la comunicación en estas unidades con miras a reflexionar sobre la atención brindada a los niños en la UCIP.

Analysis of related factors of chronic cough in children / 中国基层医药

Objective To analyze primary diseases and risk factors of chronic cough in children,and develop clinical thinking for the doctor,looking for the orderly diagnosis method.Methods The clinical data of 123 children with chronic cough(medical history,physical examination,routine chest X-ray,PPD test,mycoplasma,Chlamydia antibody,antibody of respiratory syncytial virus,adenovirus IgM determination of IgM determination,Coxsackie virus IgM determination,when necessary,be lung CT,CT of paranasal sinuses,gastrointestinal barium meal,bronchiectasis agent diagnostic treatment and surgery consultation) were retrospectively analyzed.The cause of chronic cough in children with primary disease and related factors were analyzed.Results 123 cases of chronic cough in children's primary diseases were asthma-related cough in 57 cases (46.3 %),upper airway cough syndrome (rhinitis,allergic rhinitis,sinusitis) in 41 cases (33.3 %),chronic pharyngitis and tonsillitis,bronchitis in 27 cases (22.0%) ; the main etiology for Mycoplasma Chlamydia(48.8%,60 cases adenovirus),19 cases(15.4%),12 cases of respiratory syncytial virus (9.8%).Conclusion The main primary disease cough,asthma associated upper airway cough syndrome,chronic pharyngitis and tonsillitis,bronchitis,chronic cough in children,the main pathogen Chlamydia,Mycoplasma-for adenovirus,respiratory syncytial virus infection,diagnosis should be based on detailed,comprehensive medical history and physical examination,from simple to complex,according to from low to high,from conventional to special,from noninvasive to invasive principles are examined.

Maloclusiones en niños y adolescentes de caseríos y comunidades nativas de la Amazonía de Ucayali, Perú / Malocclusions in children and adolescents from villages and native communities in the Ucayali amazon region in Peru

Se realizó un estudio descriptivo transversal para evaluar la prevalencia de maloclusiones en niños y adolescentes de 2 a 18 años de edad de caseríos y comunidades nativas de la selva de Ucayali, Perú. Se evaluó la presencia de maloclusiones usando la clasificación de Angle así como alteraciones ortodónticas. Se incluyeron 201 sujetos, 106 (52,7 por ciento) fueron mujeres, la mayoría (54,7 por ciento) tuvieron entre 6 y 12 años. Se encontró una prevalencia de maloclusiones del 85,6 por ciento; la más prevalente según la clasificación de Angle fue la clase I (59,6 por ciento). Se evidenciaron alteraciones ortodónticas en el 67,2 por ciento de casos. Las alteraciones ortodónticas encontradas más frecuentes fueron apiñamiento dentario (28,4 por ciento), mordida cruzada anterior (17,4 por ciento), sobresalte exagerado (8,5 por ciento), sobremordida exagerada (5,0 por ciento) y mordida abierta anterior (5,0 por ciento). Se evidencia una alta prevalencia de maloclusiones y alteraciones ortodónticas en las comunidades nativas evaluadas, por lo que es necesario implementar programas preventivos para mejorar la salud bucal de estas poblaciones marginadas.

We conducted a cross-sectional descriptive study to assess the prevalence of malocclusions in children and adolescents aged 2 to 18 years of villages and native communities of the Ucayali jungle of Peru. We assessed the presence of malocclusions using Angle’s classification and orthodontic changes. We evaluated 201 individuals, 106 (52.7 percent) were women, most of them (54.7 percent) had between 6 and 12 years. The prevalence of malocclusions was 85.6 percent, the most prevalent according to Angle’s classification was class I (59.6 percent). Orthodontic alterations were present in 67.2 percent of cases. The most frequent were dental crowding (28.4 percent), anterior crossbite (17.4 percent), exaggerated overjet (8.5 percent), excessive overbite (5.0 percent) and anterior open bite (5.0 percent). We found a high prevalence of malocclusion and orthodontic changes in the evaluated native communities, highlighting the need to implement preventive programs to improve the oral health of these negleted populations.

A associação entre a suspeita inicial de perda auditiva e a ausência de comunicação verbal em crianças com transtornos do espectro autístico / The association between an initial suspicion of hearing loss and the absence of verbal communication in children with autism spectrum disorders

OBJETIVO: Averiguar a associação entre a suspeita inicial de deficiência auditiva e a ausência de comunicação verbal em crianças com diagnóstico de transtornos do espectro autístico. MÉTODOS: Por meio de estudo retrospectivo, analisamos 54 anamneses de indivíduos com diagnóstico de transtornos do espectro autístico. Inicialmente, obtivemos o registro da suspeita inicial de perda auditiva, mencionada pela família. O grau de associação entre a presença de suspeita inicial de perda auditiva e o tipo de desempenho comunicativo (não verbal e verbal) foi verificado. Posteriormente, as avaliações audiológicas foram rastreadas para confirmarmos a pertinência da queixa auditiva mencionada. Para tratamento estatístico dos resultados utilizamos os Testes Qui-quadrado e Exato de Fisher. Estabeleceu-se nível de significância de 0,05. RESULTADOS: Verificamos que 62,96 por cento dos pais de crianças autistas (verbais ou não) apresentaram a suspeita inicial de perda auditiva como primeira etiologia. A avaliação audiológica mostrou que somente 11,11 por cento dos indivíduos com comunicação não verbal e nenhum com comunicação verbal apresentaram algum tipo de deficiência auditiva. CONCLUSÕES: O número de crianças com suspeita inicial de perda auditiva mostrou-se significativo, independente destas serem verbais ou não. Na análise da associação entre desempenho comunicativo e suspeita de prejuízos na audição, os resultados foram estatisticamente significante maiores em crianças não verbais. Esses dados nos fazem refletir sobre a importância da sensibilização dos profissionais que atuam em clínica infantil quanto à busca pelo diagnóstico diferencial entre a deficiência auditiva e os transtornos do espectro autístico.

PURPOSE: To determine the association between the initial suspicion of hearing loss and the absence of verbal communication in children with diagnosis of autistic spectrum disorders. METHODS: A retrospective study was carried out analyzing 54 anamneses of individuals with diagnosis of autistic spectrum disorders. From each case history, it was obtained the records of the initial suspicion of hearing loss, mentioned by family members. The degree of association between the initial suspicion of hearing loss and the type of communicative performance (verbal and non-verbal) was verified. After that, hearing assessments were tracked down to confirm the pertinence of the hearing complaint mentioned. The data were statistically analysed using Chi-Square Test and Fisher's Exact Test. A significance level of 0.05 was adopted. RESULTS: It was verified that 62.96 percent of the parents of children with autism (both verbal and non-verbal) exhibited an initial suspicion of hearing loss as the first etiology. The hearing assessment demonstrated that only 11.11 percent of the individuals with non-verbal communication and none of those with verbal communication actually had some type of hearing impairment. CONCLUSIONS: The number of children with initial suspicion of hearing loss was significant, regardless whether these individuals had verbal or non-verbal communication. However, in the association analysis between communicative performance and suspicion of hearing impairments, the results were significantly greater for non-verbal children. This fact leads to a reflection on the importance of sensitization of the professionals who act in childcare clinic regarding the search for a differential diagnosis between hearing impairment and autistic spectrum disorders.