Depresión materna como mediadora en el desarrollo de sobrepeso y obesidad infantil: una revisión integrativa / Maternal depression as a mediator in the development of childhood overweight and obesity: an integrative review

Introducción: la depresión materna interfiere en la crianza y la alimentación de los hijos a través de conductas de alimentación infantil. Objetivo: examinar cómo la depresión materna predispone al desarrollo de sobrepeso y obesidad infantil. Metodología: revisión integrativa empleando la metodología de Whittemore y Knafl, y la declaración PRISMA, en PubMed y CONRICyT, utilizando los descriptores "depression", "depressive symptoms","mothers" y "childhood obesity", e incluyendo artículos con metodología cuantitativa publicados entre 2013 y 2020 cuyos indicadores fueran peso y conductas en la población infantil. Resultados: en 22 artículos se identificaron vías conductuales, como conductas maternas de alimentación, estilos de alimentación, prácticas de alimentación infantil, inseguridad alimentaria y recurrencia de la depresión. Conclusión: seis vías conductuales poco aptas para la alimentación y el desarrollo se identificaron como mediadoras entre la depresión y el aumento de peso infantil.

Introduction: Maternal depression interferes with raising and feeding children through infant feeding behaviors. Objective: To examine how maternal depression predisposes to the development of childhood overweight and obesity. Methods: An integrative review with the Whittemore & Knafl methodology and the PRISMA background in PubMed and CONRICyT, using descriptors "depression","depressive symptomatology","mothers" and "childhood obesity". Articles with a quantitative methodology, from 2013 to 2020, with analysis of weight or behavior indicators in the child population were included. Results: In 22 articles, behavioral pathways were identified, such as: maternal eating behaviors, feeding styles, feeding practices, food insecurity and recurrence of depression. Conclusions: Six behavioral pathways unsuitable for eating and development were identified as mediators between depression and infant weight gain.

Prediction of bacterial meningitis based on cerebrospinal fluid pleocytosis in children

Children with cerebrospinal fluid pleocytosis are frequently treated with parenteral antibiotics, but only a few have bacterial meningitis. Although some clinical prediction rules, such as bacterial meningitis score, are of well-known value, the cerebrospinal fluid white blood cells count can be the initial available information. Our aim was to establish a cutoff point of cerebrospinal fluid white blood cell count that could distinguish bacterial from viral and aseptic meningitis. A retrospective study of children aged 29 days to 17 years who were admitted between January 1st and December 31th, 2009, with cerebrospinal fluid pleocytosis (white blood cell > 7 µL-1) was conducted. The cases of traumatic lumbar puncture and of antibiotic treatment before lumbar puncture were excluded. There were 295 patients with cerebrospinal fluid pleocytosis, 60.3% females, medium age 5.0 ± 4.3 years distributed as: 12.2% 1-3 months; 10.5% 3-12 months; 29.8% 12 months to 5 years; 47.5% >5 years. Thirty one children (10.5%) were diagnosed with bacterial meningitis, 156 (52.9%) viral meningitis and 108 (36.6%) aseptic meningitis. Bacterial meningitis was caused by Neisseria meningi tidis (48.4%), Streptococcus pneumoniae (32.3%), other Streptococcus species (9.7%), and other agents (9.7%). cerebrospinal fluid white blood cell count was significantly higher in patients with bacterial meningitis (mean, 4839 cells/µL) compared to patients with aseptic meningitis (mean, 159 cells/µL, p < 0.001), with those with aseptic meningitis (mean, 577 cells/µL, p < 0.001) and with all non-bacterial meningitis cases together (p < 0.001). A cutoff value of 321 white blood cell/µL showed the best combination of sensitivity (80.6%) and specificity (81.4%) for the diagnosis of bacterial meningitis (area under receiver operating characteristic curve 0.837). Therefore, the value of cerebrospinal fluid white blood cell count was found to be a useful and rapid diagnostic test to distinguish between bacterial and nonbacterial meningitis in children.

Saúde e nutrição de crianças de 0 a 60 meses de um assentamento de reforma agrária, Vale do Rio Doce, MG, Brasil / Health and nutrition of children, 0 to 60-month old, in an agrarian-reform settlement, Vale do Rio Doce, MG, Brazil

OBJETIVO: Este estudo avaliou as condiçöes gerais de saúde das crianças de um assentamento rural, localizado no Município de Tumiritinga, Vale do Rio Doce, MG, Brasil. MÉTODOS: Foram obtidos dados de 69 crianças de zero a 60 meses de idade, com relação ao estado nutricional (antropometria e nível de hemoglobina), parasitose intestinal, tempo de aleitamento materno, práticas alimentares e calendário de vacinação. RESULTADOS: Verificou-se que 7,6 por cento das crianças apresentavam déficits nos índices peso/idade e estatura/idade e 47,5 por cento, baixa concentração de hemoglobina. A infestação parasitária foi detectada em 96,1 por cento das 51 crianças que fizeram o exame e 34,0 por cento estavam com a vacinação atrasada. A mediana de tempo de aleitamento materno exclusivo foi de 30 dias e observou-se inadequada freqüência de consumo de alimentos-fontes de ferro. CONCLUSAO: Dado o aumento dos assentamentos rurais no Brasil e as precárias condiçöes de saúde e nutrição infantil encontradas neste estudo, tornam-se necessárias medidas urgentes e efetivas de intervenção preventiva, voltadas à promoção da saúde dessa população.