Perfil clínico de pacientes dermatológicos encaminhados para avaliação oftalmológica / Clinical profile of dermatological patients referred to ophthalmological evaluation

RESUMO Objetivo: Analisar o perfil clínico de pacientes em acompanhamento dermatológico encaminhados para avaliação oftalmológica. Métodos: A amostra foi composta de pacientes dermatológicos encaminhados para avaliação oftalmológica, nos anos de 2016 e de 2017. Estudou-se a concomitância de doenças dermatológicas com as afecções oftalmológicas por meio da coleta simultânea do histórico dermatológico (prontuários registrados com dados gerais e diagnóstico) e de dados da consulta oftalmológica após o encaminhamento. Resultados: Foram avaliados pela oftalmologia 224 pacientes, sendo 65% do sexo feminino, 80% caucasianos, com idade variando entre 1 mês e 85 anos. As situações cujo encaminhamento foi mais prevalente foram psoríase, lúpus, vitiligo e rosácea (18,3%, 13,8%, 12,9% e 10,7%, respectivamente). Fototerapia crônica e uso de hidroxicloroquina representaram 35,7% e 22,3% dos pacientes. Casos de neurofibromatose, micose fungoide, líquen plano, neoplasias de pele, atopias, pênfigo e esclerodermia também estiveram presentes. Cegueira legal foi detectada em 6%, e deficiências visuais ligadas a afecções dermatológicas foram verificadas em 16,5% dos casos. As alterações oculares mais prevalentes foram catarata (18,9%), blefarite (15,9%), pterígio (5,3%) e conjuntivite (5,3%). Conclusão: Encontrou-se elevada frequência de alterações oftalmológicas em uma população de pacientes com doenças dermatológicas. Assim, o estudo e a análise de manifestações oculares em pacientes dermatológicos podem auxiliar na detecção precoce e na prevenção de complicações.

ABSTRACT Objective: To analyze the clinical profile of patients under dermatological care and referred to ophthalmological evaluation. Methods: The sample comprised dermatology patients referred to ophthalmological evaluation in 2016 and 2017. The simultaneous occurrence of skin and ophthalmic diseases was studied, by collecting dermatological history (medical records containing general data and diagnosis) and ophthalmic consultation data following referral. Results: A total of 224 patients were assessed, 65% were female, 80% were white, and age varied between one month and 85 years. The conditions more often referred were psoriasis, lupus, vitiligo and rosacea (18.3%, 13.8%, 12.9% and 10.7%, respectively). Chronic phototherapy and use of hydroxychloroquine were observed in 35.7% and 22.3% of patients, respectively. Cases of neurofibromatosis, mycosis fungoides, lichen planus, skin cancer, atopic dermatitis, pemphigus and scleroderma were also reported. Legal blindness was detected in 6% and visual impairment related to skin conditions in 16.5% of patients. The most prevalent ocular changes were cataracts (18.9%), blepharitis (15.9%), pterygium (5.3%) and conjunctivitis (5.3%). Conclusion: A high frequency of ophthalmic changes in a population of dermatological patients was found. In this context, studying and analyzing ocular manifestations in dermatological patients could be useful in early detection and prevention of complications.

Recurrent aphthous stomatitis in 18-year-old adolescents - Prevalence and associated factors: a population-based study

Abstract: Background: Recurrent aphthous stomatitis is a painful disorder of unknown etiology. It is among the most common oral mucosal lesions with high prevalence among young adults. Objectives: To conduct a population-based study with 18-year-old army recruiters to assess its prevalence and associated factors in male adolescents. Methods: Interview during clinical examination in the army. Results: In this group (2,427 interviewed adolescents) there was a RAS prevalence of 24.9%. Smoking, herpes labialis and socioeconomic status correlated with the outcome. Study Limitations: only male adolescents were interviewed. Conclusions: Our results showed high prevalence of RAS; association with higher economic level and herpes simplex was found. Protective effect of smoking was confirmed.

Sampling: how to select participants in my research study?

Abstract: Background: In this paper, the basic elements related to the selection of participants for a health research are discussed. Sample representativeness, sample frame, types of sampling, as well as the impact that non-respondents may have on results of a study are described. The whole discussion is supported by practical examples to facilitate the reader's understanding. Objective: To introduce readers to issues related to sampling.

Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors

Abstract: Background: Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. Objectives: To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. Methods: A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. Results: A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. Conclusions: There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.

Test of association: which one is the most appropriate for my study?

AbstractBACKGROUND:Hypothesis tests are statistical tools widely used for assessing whether or not there is an association between two or more variables. These tests provide a probability of the type 1 error (p-value), which is used to accept or reject the null study hypothesis.OBJECTIVE:To provide a practical guide to help researchers carefully select the most appropriate procedure to answer the research question. We discuss the logic of hypothesis testing and present the prerequisites of each procedure based on practical examples.

Field work I: selecting the instrument for data collection

The selection of instruments that will be used to collect data is a crucial step in the research process. Validity and reliability of the collected data and, above all, their potential comparability with data from previous investigations must be prioritized during this phase. We present a decision tree, which is intended to guide the selection of the instruments employed in research projects. Studies conducted along these lines have greater potential to broaden the knowledge on the studied subject and contribute to addressing truly socially relevant needs.

Emotional impact of halitosis / O impacto emocional da halitose

Objective: To evaluate the emotional impact of halitosis on 18-year-old men using a self-reported questionnaire. Method: A total of 2,224 participants underwent dental and medical examinations in the army medical services in the city of Pelotas, southern Brazil, in July 2008. Results: In this sample, 12% of respondents expressed concern about their oral malodor, which had a strong emotional impact on their quality of life. Conclusions: The individuals reporting halitosis showed a higher degree of concern with their oral malodor. Low educational level and low income were associated with psychological impact and halitosis in this population (AU)

Objetivo: Avaliar o impacto da halitose em uma amostra de homens de 18 anos usando um questionário autoaplicável. Métodos: Um total de 2.224 indivíduos foram submetidos a exames dentários e médicos no serviço médico do Exército na cidade de Pelotas, no sul do Brasil, em julho de 2008. Resultados: Nessa amostra, 12% dos respondentes expressaram sua preocupação quanto ao mau hálito, com forte impacto emocional em sua qualidade de vida. Conclusões: Os indivíduos que relataram halitose apresentavam maior grau de preocupação com mau hálito. Nível educacional baixo e baixa renda estiveram associados ao impacto psicológico e à halitose nesta população (AU)

Dissatisfaction and acne vulgaris in male adolescents and associated factors

BACKGROUND: Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES: To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS: A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS: A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION: This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction. .

Sample size: how many participants do I need in my research?

The importance of estimating sample sizes is rarely understood by researchers, when planning a study. This paper aims to highlight the centrality of sample size estimations in health research. Examples that help in understanding the basic concepts involved in their calculation are presented. The scenarios covered are based more on the epidemiological reasoning and less on mathematical formulae. Proper calculation of the number of participants in a study diminishes the likelihood of errors, which are often associated with adverse consequences in terms of economic, ethical and health aspects.

Presenting data in tables and charts

The present paper aims to provide basic guidelines to present epidemiological data using tables and graphs in Dermatology. Although simple, the preparation of tables and graphs should follow basic recommendations, which make it much easier to understand the data under analysis and to promote accurate communication in science. Additionally, this paper deals with other basic concepts in epidemiology, such as variable, observation, and data, which are useful both in the exchange of information between researchers and in the planning and conception of a research project.

Transplante autólogo de células-tronco do sangue periférico no Hospital Universitário de Santa Maria / Autologous peripheral blood stem cells transplantation at the University Hospital of Santa Maria

Introdução: O principal objetivo deste estudo foi identificar as características clínicas dos pacientes transplantados na instituição e avaliar os resultados obtidos com a infusão autóloga de células-tronco hematopoiéticas do sangue periférico (CTHSP), a mortalidade relacionada ao transplante (MRT) e a sobrevida global (SG). Métodos: Através da revisão e avaliação retrospectiva dos prontuários dos 120 pacientes submetidos a transplante autólogo no período de dezembro de 1996 a dezembro de 2011. Resultados: Cento e vinte pacientes receberam quimioterapia mieloablativa e resgate com infusões de CTHSP, sendo 78,3% adultos, com mediana de idade de 47 anos e predomínio do sexo masculino. Os diagnósticos foram 32,5% para Mieloma Múltiplo (MM), 35,8% para Linfoma de Hodgkin (LH), 16,7% para Linfoma não Hodgkin (LNH) 4,2% para Leucemia Mieloide Aguda (LMA) e 10,8% para outras neoplasias como Tumor de Wilms, Câncer de Mama Neuroblastoma, Sarcoma de Ewing, Tumor de Testículo, Meduloblastoma, Macroglobulinemia, Amiloidose e Tumor de SNC. A mediana do número de células nucleadas totais infundidas foi de 6,46x108/kg e a de células CD34+ foi de 3,17x106/kg. A mediana de tempo para recuperação de neutrófilos foi de 10 dias e para plaquetas, de 12 dias. Foi encontrada uma correlação entre a quantidade de células CD34+ infundidas e a recuperação de neutrófilos e plaquetas. Para o grupo em geral, a MRT encontrada foi de 5%, e a probabilidade de SG em cinco anos de 55,1%. Conclusão: Os resultados obtidos com os transplantes autólogos em nossa instituição são semelhantes aos descritos na literatura internacional (AU)

Introduction: The aim of this study was to identify the clinical characteristics of patients transplanted in the institution and evaluate the results obtained with the autologous infusion of hematopoietic stem cells from peripheral blood (PBSC), transplant-related mortality (TRM) and overall survival (OS). Methods: A review and retrospective assessment of the charts of 120 patients who underwent autologous transplantation from December 1996 to December 2011. Results: One hundred and twenty patients received myeloablative chemotherapy and rescue with infusions PBSC, of whom 78.3% were adults, with a median age of 47 years and male predominance. The diagnoses were 32.5 % for Multiple Myeloma (MM), 35.8% for Hodgkin lymphoma (HL), 16.7 % for non-Hodgkin lymphoma (NHL), 4.2 % for Acute Myeloid Leukemia (AML ), and 10.8% for other cancers such as Wilms Tumor, breast cancer, neuroblastoma, Ewing's sarcoma, Testicular Tumor, medulloblastoma , macroglobulinemia , amyloidosis and CNS tumor. The median number of total nucleated cells infused was 6.46 x108/kg and of CD34+ cells was 3.17 x106/kg. The median time for neutrophil recovery was 10 days and for platelets 12 days. A correlation was found between number of CD34+ cells infused and recovery of neutrophils and platelets. For the overall group, the MRT was found to be 5% and the probability of OS at five years was 55.1 %. Conclusion: The results obtained with autologous transplantation at our institution are similar to those described in the international literature (AU)

Tattoos on 18-year-old male adolescents - Characteristics and associated factors / Tatuagens em Adolescentes Masculinos de 18 anos - Caracteristicas e fatores associados

BACKGROUND: Prevalence of tattoos is around 10-26% in men and 10-22% in women, and can involve negative effects such as: regret, removal attempts, physical and biological changes of the skin and association with some viral diseases. OBJECTIVE: to determine the prevalence, characteristics and factors associated with tattoos in recruiters joining the military. METHODS: the recruiters were examined by dermatologists that documented the presence or absence of tattoos, as well as their sizes, colors, designs and patterns, and whether they needed a parent's consent to get a tattoo. RESULTS: 1,968 recruiters were examined and the prevalence of tattoos was 10.82% (213), 141 (66.20%) had a single tattoo, 44 (20.66%) two tattoos, 15 (7.04%) three tattoos, 9 (4.23%) four tattoos, and 4 (1.88%) had more than four. Of the total sample, 168 (80.77%) reported getting the first tattoo before the age of 18. 158 (74.53%) were monochromatic. In relation to size, 108 (50.70%) had tattoos of up to 10 cm, 75 (35.21%) had tattoos measuring between 11-20cm, while 30 had ones over 21cm (14.09%). CONCLUSIONS: The population studied had a high prevalence of tattoos for their age, the percentage of complex (large and polychromatic) tattoos was also high. .

FUNDAMENTOS: Estima-se que a prevalência de tatuagens seja por volta de 10-26% em homens e 10-22% em mulheres, e estas trazem como consequência desdobramentos como: arrependimento, tentativas de remoção, alterações físicas e biológicas da pele e associação com soro positividade para doenças virais. OBJETIVOS: determinar a prevalência, características e fatores associados a tatuagens em alistandos do exército. MÉTODOS: Os alistandos foram entrevistados e examinados por dermatologistas, os quais anotaram a presença ou não de tatuagem , seus tamanhos, suas cores, padrões de desenhos e se havia permissão dos responsáveis para sua execução. RESULTADOS: Foram examinados 1.968 alistandos e a prevalência de tatuagens foi de 10,82% (213), 141 (66,20%) tinham tatuagem única, 44 (20,66%) tinham duas tatuagens, 15 (7,04%) tinham três tatuagens, 9 (4,23%) tinham quatro tatuagens e 4 (1,88%) tinham mais que quatro tatuagens; 168 (80.77%) informaram ter feito a primeira tatuagem antes de completar 18 anos de idade. 158 (74,53%) eram monocromáticas. Em relação ao tamanho no seu maior eixo temos que 108 (50,70%) tinham tatuagens com até 10 cm, 75 (35,21%) tinham entre 11 e 20 cm e com mais de 21 centimetros 30 (14,09%). CONCLUSÕES: a população estudada apresenta uma prevalência alta de tatuagens para a idade, e o percentual de tatuagens complexas (grandes e policromáticas) também é alto. .

Prevalence of sun exposure and its associated factors in southern Brazil: a population-based study / Prevalencia e fatores associados a exposicao solar no sul do Brasil: um estudo de base populacional

BACKGROUND: Sunlight exposure is responsible for a large number of dermatological diseases. OBJECTIVE: We estimated the prevalence of sunlight exposure and its associated factors in adults from southern Brazil in a cross-sectional, population-based study. METHODS: We investigated a representative sample of individuals aged ≥ 20 years (n=3,136). Sunlight exposure and its associated factors were evaluated in two distinct situations: at leisure time and at work. The time period investigated ranged from December 2004 to March 2005, comprising 120 days of the highest ultraviolet index in the urban area of the city of Pelotas, in southern Brazil. The participants were asked about sunlight exposure for at least 20 minutes between 10 A.M. and 4 P.M. The analysis was stratified by sex, and sunlight exposure was grouped into five categories. RESULTS: Among the 3,136 participants, prevalence of sunlight exposure at the beach was 32.8% (95% CI, 30.3 - 35.2) and 26.3% (95% CI, 24.2 28.3) among men and women, respectively. The prevalence at work was 39.8% (95% CI, 37.2 - 42.4) among men and 10.5% (95% CI, 9.1 - 12.0) among women. Age was inversely associated with sunlight exposure. Family income and achieved schooling were positively associated with sunlight exposure at leisure time and inversely associated with sunglight exposure at work. Self-reported skin color was not associated. Knowledge of any friend or relative who has been affected by skin cancer was positively ...

FUNDAMENTOS: A exposição solar é responsável por um grande número de doenças. OBJETIVOS: Nós estimamos a prevalência e fatores associados à exposição solar em adultos do sul do Brasil em um estudo transversal de base populacional. MÉTODOS: Uma amostra representativa de indivíduos com idade ≥ 20 anos (n=3,136). A exposição solar foi avaliada no lazer e durante o trabalho. O período de investigação foi de dezembro de 2004 a março de 2005, compreendendo os 120 dias de maior intensidade solar. Os participantes foram questionados sobre exposição solar por pelo menos 20 minutos entre as 10 as 16 hs. A análise foi estraificada por sexo e a exposição solar foi agrupada em 5 categorias. RESULTADOS: Entre os 3,136 participantes, a prevalência de exposição solar na praia foi de 32.8% (IC95% 30.3 - 35.2) e 26.3% (IC95% 24.2 - 28.3) entre homens e mulheres, respectivamente. A prevalência de exposição no trabalho foi de 39.8% (IC95% 37.2 - 42.4) entre homens e 10.5% (IC95% 9.1 - 12.0) entre mulheres. A idade esteve inversamente associada à exposição solar. Renda familiar e escolaridade estiveram positivamente associadas à exposição solar durante o lazer e inversamente associada durante o trabalho. A cor de pele auto referida não esteve associada. O conhecimento de qualquer amigo ou parente que tenha sido acometido por um câncer ...

Papilite lingual transitória ? relato de caso / Transient lingual papillitis ? case report

com essa afecção.Descrição do caso: Um homem de 34 anos apresentava desde a infância surtos de lesões papulosas dolorosas na língua. O exame anatomopatológico de uma das lesões demonstrou papilite crônica.Conclusões: Papilite lingual transitória é uma doença inflamatória dolorosa das papilas fungiformes, que tem seu início na infância e evolui em surtos, podendo ser acompanhada de dor ou desconforto. Embora seja frequente, é um distúrbio pouco estudado.

Aims: To describe a case of transient lingual papillitis in order to familiarize health professionals with this condition.Case description: A man of 34 years of age had since childhood bouts of painful papular lesions on the tongue. The anatomopathological examination of one lesion showed chronic papillitis.Conclusions: Transient lingual papillitis is a painful inflammatory disease of the fungiform papillae, which has its onset in childhood, progresses in spurts, and may be accompanied by pain or discomfort. Although it is common, is an understudied condition.

Facial miliary osteoma in HIV patient / Osteoma miliar da face em paciente portadora do HIV

Facial miliary osteoma is characterized by the presence of multiple normochromic papules, affecting mainly middle-aged women, with a previous history of acne. A 39-year-old HIV positive female patient presented hardened papules which had appeared 3 years before, located on the malar region, glabella and mentum. Optical microscopy showed spherical bone formations in the dermis. Computerized tomography of the face revealed small calcifications on the surface consistent with bone formation. Multiple facial osteomas are rare as well as its association with HIV virus infection.

Os osteomas miliares da face são caracterizados por múltiplas pápulas normocrômicas na face, afetando, geralmente, mulheres de meia idade, com história pregressa de acne. Uma paciente de 39 anos, portadora do HIV, apresentou pápulas endurecidas, com 3 anos de evolução, localizadas na região malar, glabela e mento. A microscopia óptica demonstrou formações ósseas esféricas na derme. A tomografia computadorizada da face observou pequenas calcificações na superfície, compatíveis com formação óssea. Os osteomas múltiplos da face são raros assim como sua associação com a infecção pelo HIV.

Análise clínica de 16 pacientes consecutivos tratados com LUX 1540® para rejuvenescimento / Skin rejuvenation with the Lux 1540® nm laser: a clinical analysis

Introdução: O tratamento do envelhecimento cutâneo com Lasers fracionados não ablativos tem sido muito divulgado nos últimos anos, embora o número de publicações, com aparelhos específicos, ainda seja pequeno. Objetivo: Descrever o grau de satisfação do paciente e de um dermatologista avaliador após o tratamento com o aparelho Lux 1540®.Métodos: Estudo retrospectivo com 16 pacientes que realizaram a terapia para rejuvenescimento facial com o Lux 1540®. Foi realizada análise fotográfica por dermatologista, não envolvido nos tratamentos, e os pacientes foram questionados quanto ao grau de satisfação antes e após três sessões.As variáveis avaliadas foram manchas, flacidez, rugas, poros dilatados, telangiectasias e satisfação geral. Resultados: Na avaliação do dermatologista ocorreu melhora considerada boa ou exce-lente na maioria dos pacientes, em todos os critérios estudados. Em relação à melhora do aspecto geral, 82% dos avaliados apresentaram melhora considerada boa ou excelente. Em relação à observação dos pacientes, 63% deles referiram satisfação geral boa a excelente.Conclusões: A terapia com Lux 1540® para rejuvenescimento da face pode ser alternativa com resultados satisfatórios, tornando-se boa opção para os pacientes que não desejam ou não podem submeter-se a tratamentos mais agressivos.

Caso para diagnóstico / Case for diagnosis

O eritema elevatum diutinum é vasculite cutânea rara. Caracteriza-se por pápulas e nódulos eritêmato-acastanhados, que podem coalescer formando placas. A região extensora dos membros é a mais acometida, e lesões antigas apresentam aspecto xantomatoso. O exame histopatológico apresenta infiltrado neutrofílico perivascular com depósito dérmico de fibrina, edema endotelial e leucocitoclasia. Apresenta-se um caso de eritema elevatum diutinum sem doença secundária associada.

Erythema elevatum diutinum is a rare presentation of cutaneous vasculitis. Typical lesions are papules, plaques, and nodules that may coalesce and later turn to yellow-brown color. The extensor surface of the extremities is the most involved area and older lesions may present xanthomatous appearance. Light microscopy of acute lesions shows neutrophilic, perivascular infiltrate with dermal fibrin deposits, endothelial expansion, and leukocytoclasis. We present a case of erythema elevatum diutinum without associated disease.

Padrões de sibilância respiratória do nascimento até o início da adolescência: coorte de Pelotas (RS) Brasil, 1993-2004 / Wheezing phenotypes from birth to adolescence: a cohort study in Pelotas, Brazil, 1993-2004

OBJETIVO: Estudar a prevalência dos padrões de sibilância respiratória e suas associações com variáveis independentes. MÉTODOS: Coorte de nascidos vivos, 1993, Pelotas (RS); subamostra sistemática de 20 por cento da coorte original acompanhada aos 6 e 12 meses e 4 anos; aos 10-12 anos localizou-se 87,5 por cento da coorte original. Definição dos padrões: transitório: chiado até 4 anos e ausência de chiado aos 10-12 anos; persistente: chiado em todos acompanhamentos; início tardio: chiado aos 10-12 anos. Variáveis independentes: gênero; cor da pele; renda familiar; fumo/asma na gravidez; amamentação; infecção respiratória/diarréia (1º ano); alergia e asma na família (4 e 10-12 anos); diagnóstico médico de rinite/eczema (10-12 anos). RESULTADOS: O total da subamostra foi de 897 adolescentes. Prevalência (IC95 por cento) dos padrões de sibilância: transitório 43,9 por cento (40,7-47,2);persistente 6,4 por cento (4,8-8,0); de início tardio 3,3 por cento (2,2-4,5). O transitório foi mais freqüente em crianças de famílias de baixa renda, com menor duração da amamentação, relato de infecções respiratórias (1º ano) e história familiar de asma (4 anos); o persistente foi quase duas vezes mais freqüente em meninos, em filhos de mulheres com asma na gravidez, com infecções respiratórias (1º ano) e história familiar de asma (4 e 10-12 anos); de início tardio mostrou maior prevalência naqueles com asma na família (10-12 anos) e diagnóstico médico de rinite (10-12 anos); menor prevalência em quem relatou infecções respiratórias (1º ano) e diagnóstico médico de eczema (10-12 anos). CONCLUSÕES: O conhecimento das associações dos padrões sibilantes permite a adoção de medidas preventivas e terapêuticas.

OBJECTIVE: To study the prevalence of wheezing patterns and their associations with independent variables. METHODS: Cohort study of live births in 1993 in Pelotas, Brazil. A systematic subsample (20 percent) of the original cohort was evaluated at 6 months, 12 months and 4 years. At 10-12 years, 87.5 percent of the original cohort was contacted. Wheezing was categorized: transient, wheezing at 4 years but not at 10-12; persistent, wheezing at all evaluations; late-onset, wheezing at 10-12 years. Independent variables were analyzed: gender; skin color; family income; smoking/asthma during pregnancy; breastfeeding; respiratory infection/diarrhea (during the 1st year); family members with asthma/allergy (at 4 years and at 10-12); physician-diagnosed rhinitis/eczema (at 10-12 years). RESULTS: The subsample comprised 897 adolescents. Wheezing patterns were expressed as prevalence (95 percent CI): transient, 43.9 percent (40.7-47.2); persistent, 6.4 percent (4.8-8.0); and late-onset, 3.3 percent (2.2-4.5). The transient pattern was more common in children from low-income families, children breastfed for less time, children with a history of respiratory infections (during the 1st year) and children with asthma in the family (at 4 years). The persistent pattern was almost twice as common in males, in children whose mothers had asthma during pregnancy, in children with respiratory infections (during the 1st year) and in children with asthma in the family (at 4 and 10-12 years). The late-onset pattern was more prevalent among those with asthma in the family (at 10-12 years) and those diagnosed with rhinitis (at 10-12 years), being less prevalent among those reporting respiratory infections (during the 1st year) and those diagnosed with eczema (at 10-12 years). CONCLUSIONS: Knowledge of the associations of wheezing patterns allows us to adopt preventive and therapeutic measures.

Epidemiologia das pregas cutâneas triciptal e subescapular elevadas em adolescentes / Epidemiology of elevated triciptal and subscapular skinfolds in adolescents

O objetivo deste estudo foi descrever e comparar as pregas cutâneas triciptal (PCT) e subescapular (PCS) de acordo com características demográficas, sócio-econômicas, comportamentais e biológicas em adolescentes de Pelotas, Rio Grande do Sul, Brasil. Realizou-se um estudo transversal aninhado a uma coorte de nascimentos (N = 4.452; média de idade = 11 anos). Os desfechos foram apresentar prega cutânea maior ou igual ao percentil 90 da curva de referência do National Center for Health Statistics. A prevalência de PCT e PCS elevada foi, respectivamente, de 20,2 por cento e 17,3 por cento nos meninos e de 14,2 por cento e 10,5 por cento nas meninas. O fator mais fortemente associado com adiposidade nos meninos foi o nível econômico (p < 0,001) e entre as meninas foi o índice de massa corporal materno (p < 0,001). Baixo nível de atividade física (< 300 minutos/semana) esteve associado com PCS elevadas somente entre as meninas, enquanto que escolaridade se associou à PCT e PCS elevada somente entre os meninos. Dieta, cor da pele e comportamento sedentário não se associaram com nenhum dos desfechos. Concluiu-se que os principais preditores de adiposidade foram características maternas e sócio-econômicas. Recomendam-se investigações utilizando-se outras técnicas de composição corporal para confirmação dos achados deste estudo.

The objective of this study was to describe and compare the tricipital (TSF) and subscapular skinfold (SSF) thickness according to demographic, socioeconomic, behavioral, and biological characteristics in adolescents from Pelotas, Rio Grande do Sul State, Brazil. A cross-sectional study nested in a birth cohort (n = 4,452; mean age = 11 years) was conducted. The outcomes were defined as skinfold thickness > 90th percentile of the National Center for Health Statistics reference curve. The prevalence rates for elevated TSF and SSF were 20.2 percent and 17.3 percent, respectively, in boys and 14.2 percent and 10.5 percent in girls. The strongest factor associated with adiposity in boys was socioeconomic status (p < 0.001), whereas among girls it was maternal body mass index (p < 0.001). Low physical activity (< 300 minutes/week) was associated with elevated SSF only among girls, while schooling was associated with increased TSF and SSF only among boys. Diet, skin color, and sedentary behavior were not associated with any of the outcomes. We concluded that the main predictors of adiposity were maternal and socioeconomic characteristics. We recommend that further studies on this issue apply other methods to estimate body composition in order to confirm our results.