The impact of the interpregnancy interval on birth weight and other pregnancy outcomes / O impacto do intervalo entre gestações no peso de recém-nascidos e outros desfechos da gravidez

To investigate the relationship between the interpregnancy interval and low birth weight and other pregnancy outcomes. METHODS: this case-control study was carried out in hospitals from January 2010 to April 2011. For cases, mothers of 1216 newborns with birth weight<2500 g were approached and 854 mothers participated (70.2 percent). For controls, mothers of 1158 newborns with >2500 g were approached and 854 mothers participated in this study (73.7 percent). Face-to-face interviews were conducted to complete the questionnaires. RESULTS: of the newborn babies with low birth weight, the risk was higher among mothers with a short interpregnancy interval (40.3 percent), whereas for infants with normal birth weight, the majority of the mothers had a longer interpregnancy interval of 24 months (44.7 percent). A short interpregnancy interval of 612 months was more common among women of <25years (49.4 percent; p<0.001) and those who were illiterate (13.1 percent; p=0.043) with a higher risk of low birth weight compared to the controls. Prenatal care during the 1st trimester was lower in women with low birth weight children (p<0.001). Normal delivery was observed less in women with a short birth interval among cases (58.7 percent) compared to controls (79 percent) (p=0.001). A J-shaped association was observed between low birth weight and the interpregnancy interval. CONCLUSIONS: a short interpregnancy interval is associated with an increased risk of low birth weight, especially in younger and illiterate women...

Investigar a relação entre o intervalo entre gestações e o baixo peso de recém-nascidos e outras conseqüências da gestação. MÉTODOS: este estudo caso-controle foi realizado em hospitais entre janeiro de 2010 e abril de 2011. Dentre as mães dos 1216 recém-nascidos com peso <2500 g, 854 (70,2 por cento) aceitaram participar do estudo de caso. No grupo controle, dentre as mães dos 1158 recém-nascidos com peso > 2500 g, participaram 854(73,7 por cento). Para completar os questionários, foram conduzidas entrevistas face a face. RESULTADOS: dos recém-nascidos com baixo peso, o fator de risco foi mais alto entre as mães com curto intervalo intergestacional (40,3 por cento), enquanto para recém-nascidos com peso normal a maioria das mães tinham uma boa margem de intervalo intergestacional de 24 meses (44,7 por cento). Curtos intervalo intergestacional (6 a 12 meses) foi mais comum entre mulheres de <25 anos (49,4 por cento; p<0,001) e analfabetas (13,1 por cento; p=0,043), com mais alto risco de baixo peso quando comparado aos controle. Cuidados pre-natais durante o primeiro trimestre foi menor nas mulheres com crianças de baixo peso (p<0,001). Menos partos normais foi observado em mulheres com curtos intervalos de nascimento para os casos (58,7 por cento) comparados aos controles (79 por cento) (p=0,001). Uma associação não monotônica tipo função J, foi observada entre o baixo peso e intervalo intergestacional. CONCLUSÕES: um curto intervalo entre gestações é associado a um risco maior de nascerem bebês de baixo peso, principalmente entre mulheres mais jovens e analfabetas...

Púrpura trombocitopênica idiopática na infância: estudo de base populacional no Catar / Idiopathic thrombocytopenic purpura in childhood: a population-based study in Qatar

OBJETIVO: Definir o padrão da púrpura trombocitopênica idiopática (PTI) (aguda/crônica), e descrever seus sintomas e características clínicas em crianças com menos de 14 anos de idade em uma sociedade árabe recentemente desenvolvida. MÉTODOS: Este estudo descritivo retrospectivo foi realizado no Departamento de Pediatria do Hospital Geral de Hamad, Hamad Medical Corporation, Catar. Foram incluídas neste estudo 50 crianças com idade inferior a 14 anos e diagnóstico de PTI durante o período de 2000 a 2005. RESULTADOS: Das crianças estudadas (50), 62 por cento foram diagnosticadas com PTI aguda e 38 por cento com PTI crônica. A PTI aguda foi mais prevalente em meninos (64,5 por cento) em comparação com meninas (35,5 por cento), enquanto que a PTI crônica apresentou uma distribuição quase igual em meninos (57,9 por cento) e meninas (42,1 por cento). História de infecção viral foi comum em casos de PTI tanto aguda (71 por cento) quanto crônica (63,2 por cento); 68 por cento das crianças com PTI apresentaram contagem de plaquetas abaixo de 20x10(9)/L ao diagnóstico. A maioria das crianças estudadas (74 por cento) foi tratada com imunoglobulina intravenosa. CONCLUSÕES: O estudo revelou uma alta incidência de PTI entre as crianças no Catar. As descobertas do estudo são semelhantes às de outros relatos internacionais.

OBJECTIVE: To find the pattern of idiopathic thrombocytopenic purpura (ITP) (acute/chronic) and to describe presenting features and clinical characteristics of the disease in children below 14 years of age in a newly developed Arabian society. METHODS: This retrospective, descriptive study was carried out at the Pediatric Department of the Hamad General Hospital, Hamad Medical Corporation, Qatar. A total of 50 children below 14 years of age who were diagnosed with ITP during the period 2000-2005 were included. RESULTS: Among the studied children (50), 62 percent were diagnosed with acute ITP and 38 percent with chronic ITP. Acute ITP was more prevalent in boys (64.5 percent) when compared with girls (35.5 percent), whereas for chronic ITP, nearly an equal distribution was found in boys (57.9 percent) and girls (42.1 percent). Preceding viral infection was common in both acute (71 percent) and chronic (63.2 percent) ITP cases; 68 percent of the children with ITP showed a platelet count below 20x10(9)/L at the time of presentation. Most of the studied children were treated with intravenous immunoglobulin (74 percent). CONCLUSIONS: The study revealed a high incidence of ITP among children in Qatar. The study findings are in line with other international reports.

Patterns of cancer incidence among the population of Qatar: a worldwide comparative study.

BACKGROUND: Cancer is a major public health problem all over the world. Monitoring the evolution of the cancer burden in the State of Qatar is of great value but has never been explored in depth. AIMS: The aim of the study was to determine the incidence patterns of cancer cases, assess trends during the period 1991 - 2006 and make comparisons with other countries. METHODS: This was a retrospective cohort study based on the Cancer disease registry of Al Amal Cancer hospital, State of Qatar, from 1991 - 2006. All Qataris and non-Qataris, males and females, who were diagnosed with any type of cancer were included in this study. The diagnostic classification of definite cancer cases was made according to the International Classification of Disease 10th revision (ICD-10). RESULTS: A total of 5,825 cancer cases were registered in Qatar during the period 1991 - 2006 with 56.7% in males and 43.3% in females, 35.6% in Qataris and 64.4% in non-Qataris. Incidence rates per 100,000 population showed that lung (5.9), lymph node (5.9), bone marrow (4.1) and connective tissue (3.9) were the top major cancers in men. In women, breast (30.1), genital organs (9), lymph node (6.8), rectum (6.1) and thyroid (5.7) cancers were the leading cancers. There was a sharp rise in the total number of cancer cases during the period 2002-2006 of 57.1% compared to the period 1991-1996. The incidence rate of cancer cases increased with increasing age in all cancer types except for breast cancer in women above 65 years old. During the study period, the five most common cancers among women were different from those in men. The incidence rate per 100,000 population of all cancer types in Qatar (63.1) was remarkably lower than the other Middle East countries and the UK. CONCLUSIONS: Cancer is an important public health problem in Qatar, with increase in incidence with age. Incidence rates of all cancers were higher across all age groups of women compared to men. Lung cancer was the most frequent cancer diagnosed in men and breast cancer in women. More epidemiological studies are now required to elucidate the patterns of cancer and related risk factors.

Does the circadian pattern for acute cardiac events presentation vary with fasting?

BACKGROUND: Over one billion Muslims fast worldwide during the month of Ramadan. The impact of fasting on circadian presentation with acute cardiac events is unknown. AIM: To determine if fasting has any effect on the circadian presentation of acute cardiac events. SETTING AND DESIGN: A prospective study in a general hospital. MATERIALS AND METHODS: Patients with acute coronary events were divided into two groups based on the history of fasting. Information about age, gender, cardiovascular risk factor profiles and outcome was collected. The relationship of time of presentation of initial symptoms with fasting was evaluated using Student's t-test, Mann-Whitney U-test and chi2 analysis. RESULTS: Of the 1019 patients hospitalized during the study period, 162 were fasting. Although, fasting patients were more likely to present to the emergency department in the time periods 5-6 AM (10.5% vs 6.3%) and 11 PM (11.1% vs 7.1%) and were less likely to present in the time periods 1-2 PM (3.7% vs 7.2%) and 5-6 PM (3.7% vs 7.0%); these differences were not statistically significant. Fasting patients were less likely to have their symptoms start between 5 and 8 AM (11.1% vs 19.4%) and more likely to have symptoms between 5 and 6 PM (11.1% vs 6.0%) and 3 and 4 AM (11.1% vs 6.9%). These differences for time of initial symptoms were statistically significant (P=0.002). CONCLUSION: Exogenous factors associated with fasting, namely, the changes in food intake and/or sleep timings, affect the circadian rhythm and influence the timing of presentation of acute coronary events.

Growth patterns of Qatari school children and adolescents aged 6-18 years.

The study was conducted to analyze the patterns of growth in height and weight and the prevalence of over-weight among Qatari school children aged 6-18 years. Weights and heights of a cross-sectional sample of Qatari school children were measured. These children were selected randomly, in equal proportions of age and gender, from different schools from urban and semi-urban districts. Appropriate statistical procedures were performed to produce smooth percentile curves for boys and girls using a two-stage approach. Initial curve smoothing for selected major percentiles was accomplished by various paramet-ric and non-parametric procedures. In the second stage, a normalization procedure was used for creating z-scores that closely matched the smooth percentile curves. The height and weight results were compared with the international reference values of National Center for Health Statistics/Centers for Disease Control and Prevention (NCHS/CDC). The prevalence of over-weight was calculated using the new International Obesity Task Force (IOTF) reference. Of 7442 Qatari children studied, 50.3% were male and 49.7%' female. The mean values for height, weight, and body mass index (BMI) increased with the age for both boys and girls until the age of 18 years, except BMI, which stabilized at the age of 16-18 years at around 22.6 for boys and at 21.6 for girls. The growth patterns of the Qatari children, aged 6-18 years, appeared to be comparable with those of the NCHS/CDC reference. The weight-for-age centile curves of the Qatari boys tended to be superior to those of the NCHS/CDC reference until the age of 15 years, less so those of the Qatari girls. In contrast, the height-for-age centile curves of the Qatari children tended to deviate in a negative sense from the NCHS/CDC reference curves, for boys and girls from age around 11 years and 13 years respectively. The deviation of the smoothed median height-for-age curves from the reference in adolescence could most likely be attributed to a later maturation among the Qatari children. The prevalence of under-weight, over-weight, and obesity for the Qatari children was quite below the CDC and IOTF rates, except for girls aged 6-9 years. More males than females were over-weight or obese according to either the local, the CDC, or the IOTF reference, and the prevalence increased with age. A good percentage of the Qatari children was at risk of being over-weight, which needs more attention because the development of obesity results in different types of diseases associated with changes in body composition.