14 resultados para Crianças Doenças - Teses

em Universidade Federal do Rio Grande do Norte(UFRN)


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Detectar os principais achados fundoscpicos em crianças portadoras de hemoglobinopatias falciformes. Mtodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Servio de Oftalmologia do Hospital Universitrio Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pr-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade mdia foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqncia da retinopatia por clulas falciformes foi maior aps os 10 anos de idade, sendo mais freqente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e black sunburst (7/26). Concluses: Observamos que a incidncia de retinopatia por clulas falciformes aumentou aps os 10 anos de idade e no evidenciamos achados da doena proliferativa. Portanto, enfatizamos a necessidade do exame oftalmolgico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicaes oculares

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Objetivou-se, neste estudo exploratrio/descritivo, identificar conhecimentos e necessidades dos cuidadores da criana com Infeco Respiratria Aguda (IRA) atravs de uma amostra de 129 crianças atendidas no servio de crescimento e desenvolvimento de uma unidade de sade. Foram aplicados formulrios junto aos cuidadores, em seu domiclio, nos meses de fevereiro e maro de 2002. Os cuidadores eram do sexo feminino, a maioria jovem, com ensino fundamental incompleto e com renda de 1 a 2 salrios. Em relao aos primeiros cuidados com a criana doente, 48,2% dos cuidadores procuram o mdico, 36,6% medicam por conta prpria e 13,2% utilizam fitoterpicos. Como medidas de preveno contra pneumonia em crianças com IRA leve, os cuidadores utilizam medidas de senso comum e sabem reconhecer sinais de gravidade das doenças, por experincias anteriores, revelando uma lacuna do conhecimento dos principais sinais e sintomas de doenças graves do trato respiratrio

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The human respiratory system was so designed that would allow efficient ventilation, regardless of variations in the external environment that may hinder the act of breathing, such an act involves dozens of variables, among them we find the respiratory depression, which is nothing more than respiratory muscle strength. The pressures are widely used in several cases: Neuro-muscular; evolution of pulmonary dysfunction and a predictor for discontinuation of mechanical ventilation. Therefore it was proposed to carry out evaluations of these respiratory pressures for children and adolescents aged 10 to 16 years and propose a predictive equation that involves the anthropometric variables age (A, years), body mass (BM, kilograms) and height (H, meters) with maximal respiratory pressures (maximum inspiratory and expiratory pressure). Evaluations were performed in this age group of students in public and private schools of the Grande Natal , measurements were performed using the analogue manometer, were children and adolescents and their parents gave informed consent. 517 samples were taken, and 250 for males (M), 255 for females (F) and 12 were excluded according to our exclusion criteria. The sample was subdivided into three age groups (10-11, 12-13 and 14 to 16 years old). It was found through the student s t test (p &#8804; 0.05) for all variables studied, children and male adolescents had higher means than females, except for the MC. For the correlation between the variables found significant correlation (p <0.05) among all the variables when analyzed as pairs except between MIP and height for females. The development of predictive equations (for p &#8804; 0.05) based on three types of strategies adopted were restricted to two association between anthropometric variables isolated, resulting in: for males: MIP = -32.29 + (-2.11*A) + (-0.52*BM), MIP = 9.99 + (-0.36*BM) + (-49.40*H); MEP = 18.54 + 3.53*A + 0, 42*BM, MEP = -33.37 + 2.78*A + 52.18* H, MEP = -17.39 + 0.33*BM + 55.04*H; and, for females we find: MEP = 24.32 + 2.59 * A + 0.24*BM

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Nas ltimas dcadas, houve grande aumento da prevalncia de obesidade, inclusive na faixa etria peditrica. Com isso, aumentou o nmero de crianças e adolescentes afetados por sndrome metablica (SM), diabetes tipo 2 (DM2) e doenças cardiovasculares (DCV), doenças anteriormente consideradas quase exclusivas de adultos. Os objetivos do estudo foram identificar e correlacionar marcadores antropomtricos (IMC- ndice de massa corprea, CA- circunferncia abdominal, RCQ- razo cintura/quadril, RCArazo cintura altura e PSE- prega subescapular), PAS e PAD- presso arterial sistlica e diastlica, respectivamente, e laboratoriais (CT- colesterol total, HDL, LDL, TGL- triglicrides, I/G- razo insulina glicose, HOMA- homeostatic model assessment for insulin resistance) de risco para o desenvolvimento de SM e observar a sua prevalncia em crianças e adolescentes com excesso de peso. Foi conduzido estudo transversal, em amostra aleatria, de convenincia, onde foram avaliadas 60 crianças e adolescentes com excesso de peso, atendidas no ambulatrio de endocrinologia peditrica do Hospital de Pediatria da Universidade Federal do Rio Grande do Norte (UFRN) com idade mnima e mxima de 7 e 15 anos, de maio de 2009 a abril de 2010. Foram admitidos os indivduos que apresentavam sobrepeso (IMC P > 85 e < 95) ou obesidade (IMC P > 95) (CDC, 2000) e histria familiar positiva para DM2 em parentes de primeiro ou segundo grau ou algum dos sinais de resistncia insulnica (acantose, hipertenso arterial, dislipidemia, sndrome de ovrios policsticos). 2 O componente individual para SM mais prevalente foi o percentil da CA &#8805; 90 (58,3%), seguido de HDL &#8804; 40 mg/dl (36,6%). Na regresso linear simples, observaram-se as variaes para mais nos parmetros laboratoriais e de PA para cada unidade de aumento de IMC, CA, RCA, RCQ e PSE, sendo significantes as seguintes correlaes: CA com TGL, HOMA IR, I/G, PAS e PAD; RCQ com TGL, HOMA, I/G, LDL e glicemia; RCA com TGL; PSE com TGL, HOMA-IR, I/G e PAS; e IMC com HOMA IR, I/G, PAS e PAD. De acordo com os critrios da IDF (Federao Internacional de Diabetes International Diabetes Federation) 2007, o diagnstico de SM foi encontrado em seis indivduos (10%). Do total, oito (13,3%), estavam em situao de sobrepeso e 52 (86,6%), obesos. As evidncias de correlao CA e RCQ, medidas de obesidade centrpeta, com vrios marcadores como TGL e HOMA, j sabidamente relacionados SM, chamam ateno para a necessidade de utilizao dessas medidas de forma mais rotineira na prtica peditrica, por serem de fcil obteno, baixo custo e mtodo no invasivo. Os valores de CA, RCQ, RCA e PSE, quando elevados devem justificar maior detalhamento na avaliao laboratorial de possvel resistncia insulnica. importante a identificao de crianças e adolescentes que preencham os requisitos para o diagnstico da SM, pois so indivduos de maior risco metablico e devem ser adequadamente acompanhados.

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Infections for intestinal parasites are one of the main morbidade causes in humans and, its relationships with socioeconomic levels and hygiene conditions in countries in development are already very established. Many works, even so, they are being accomplished to elucidate the complex interactions among nutrition, these infections and answer imunolgica, because it is seen that malnutrition commits the immunity increasing the susceptibilidade for infectious diseases and these for its time can harm the state human nutricional. It is known that sponge helmnticos they stimulate synthesis of IgE so much policlonal as specific for the same ones and that IgA secretora, main imunoglobulina of defense of the mucous ones, can act against protozoa as the Giardia lamblia and against helmintos as Trichuris tichiura and Strongyloides stercorales. Some studies show that the malnutrition energy protica influences in the production of these answers, but some authors show results divergentes. In this work it was evaluated the levels of total IgE, IgA srica and secretora, contagem of sanguine eosinfilos, levels of proteins sricas and state nutricional, in 103 children of low socioeconomic level, to discover a correlation between those and infection for enteroparasitas. They participated in the study children of both sexes, with age of 3 to 6 years, visitors of the same creche and residents in a neighborhood with precarious hygiene conditions and basic saneamento, in the city of Christmas. The obtained results showed that the faulty environmental and socioeconomic conditions favored to a high infection frequency for enteroparasitas, mainly Trichuris trichiura and Ascaris lumbricoides between the helmintos and Endolimax sleep and Girdia lamblia among the protozoa. Light malnutrition without deficit protico was observed in 30% of the children, which didn't also present significant deficiencies of IgA srica and secretora. The sponged children

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This dissertation focuses on the narratives of children hospitalized with chronic diseases. The overall goal is to deduce, from the look of the child health care, hospital class contributions to the process of school inclusion. The research is part of the qualitative ethnographical approach and is based on the principles and research methods (auto)biographical in education and schooling in hospital. Participated in the investigation 05(five) children, aged between 06 (six) and 12 (twelve) years of age, treated at the Center for Children s Onco-Hematology, Varela Santiago Children s Hospital in Natal-RN. The corpus used for the analysis comprises five (05) narrative interviews, 03 (three) drawings made by children as well as records in the researcher s field diary. The sources were collected during the months of August 2010 to February 2011. The analysis revealed that the inclusion of the hospital class, and ensure the right to education, contributes to the construction of strategies for coping with illness and hospitalization, as it promotes autonomy, comfort, playfulness and self-knowledge, the rand the world, easing the stress of hospitalization. The figure of the teacher took the class hospital in the voices of children, a reliever and minimizing the role of double exclusion that cause illness and hospitalization, showing the contributions to (re) construction of identity and subjectivity constitution strengthened. The children interviewed said that the hospital class leave the hospital more cheerful. The playfulness and learning experiences in the hospital are seen by children as actions that go beyond the physical treatment of the disease, since it provides them with acceptance and understanding of hospitalization and illness, to give them affective security and emotional. In conclusion, the narratives of children confirm that the service class hospital ensures continuity of schooling, but they reveal, namely, that this service provides them socialization among peers and with adults, strengthening the emotional, social and cognitive biopsychosocial perspective of attention

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Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte

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This study aimed to describe nurses' actions in the strategy of Integrated Management of Childhood Illness in the city of Natal, Rio Grande do Norte. This is a qualitative study with descriptive approach. The universe consisted of nurses from the Family Health Strategy, totaling 16 participants. For the research project was submitted for approval by the Ethics Committee of the Universidade Federal do Rio Grande do Norte, obtaining Opinion No. 187/2012. Data were obtained in two ways: a questionnaire survey to profile the training of nurses and an interview guided by a structured interview. Interviews were treated in the light of analysis of thematic category Bardin. The results showed the central thematic study "Integrated Management of Childhood Illness in the context of nursing activities" category and three analyzes: "Understanding the Integrated Management of Childhood Illness", "Difficulties invibializam use IMCI "and" Working conditions for nurses in the Integrated Management of Childhood Illness. " It is observed that nurses consider the Integrated Management of Childhood Illness useful, effective and important to keep sick children within the logic curative. However disregard the character of health promotion and disease prevention thereof. It was found that the participants still hold the attendance of crinaas within the biomedical model and that these same professionals are subjected to increasingly precarious working conditions and unhealthy due to lack of human and material resources. It was found that the interviewees do not follow the protocols of strategy because of barriers related to prescription medications by nurses, the medical, the lack of incentives, training and supervision by the municipal health and the Regional Nursing Council

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I ntroduction: The assessment of respiratory muscle strength is important in the diagnosis and monitoring of the respiratory muscles weakness of respiratory and neuromuscular diseases. However, there are still no studies that provide predictive equations and reference values for maximal respiratory pressures for children in our population. Aim: The purpose of this study was to propose predictive equations for maximal respiratory pressures in healthy school children. Method: This is an observational cross-sectional study. 144 healthy children were assessed. They were students from public and private schools in the city of Natal /RN (63 boys and 81 girls), subdivided in age groups of 7-8 and 9-11 years. The students presented the BMI, for age and sex, between 5 and 85 percentile. Maximal respiratory pressures were measured with the digital manometer MVD300 (Globalmed ). The maximal inspiratory pressure (MIP) and maximal expiratory pressures (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS Statistics 15.0 software (Statistical Package for Social Science) by assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'Student test was used for unpaired comparison of averages of the variables. The comparison of measurements obtained with the predicted values in previous studies was performed using the paired t'Student test. The Pearson correlation test was used to verify the correlation of MRP's with the independent variables (age, sex, weight and height). For the equations analysis the stepwise linear regression was used. Results: By analyzing the data, we observed that in the age range studied MIP was significantly higher in boys. The MEP did not differ between boys and girls aged 7 to 8 years, the reverse occurred in the age between 9 and 11 years. The boys had a significant increase in respiratory muscle strength with advancing age. Regardless sex and age, MEP was always higher than the MIP. The reference values found in this study are similar to a sample of Spanish and Canadian children. The two models proposed in previous studies with children from other countries were not able to consistently predict the values observed in this studied population. The variables sex, age and weight correlated with MIP, whereas the MEP was also correlated with height. However, in the regression models proposed in this study, only gender and age were kept exerting influence on the variability of maximal inspiratory and expiratory pressures. Conclusion: This study provides reference values, lower limits of normality and proposes two models that allow predicting, through the independent variables, sex and age, the value of maximal static respiratory pressures in healthy children aged between 7 and 11 years old

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The Commercial Sexual Exploitation of Children and Adolescents (ESCCA) is a phenomenon that has been given priority in public policy agenda of many democratic governments of Western countries and civil sectors of society, besides the object of studies in different fields of knowledge. Psychology is among these areas and is considered one of the references in the construction of knowledge and actions to confront the phenomenon. However, the epistemological foundations of psychological science are quite different, and so, several are his speeches, knowledge produced and ways of conceiving man and the world. This is evident in the publications of psychology on ESCCA. This work aims to achieve a state of the art of psychology publication in Brazil (in the post-graduation - through theses and dissertations - and journals) on the Commercial Sexual Exploitation of Children and Adolescents. More specifically try to evidence (a) what conceptions of commercial sexual exploitation of children and adolescents the authors lists, (b) what are aimed at research and publications, (c) how the research and issues are justified, and (d) that theoretical approaches the authors are affiliated and methodological possibilities are applied to range the aim proposed in their work. In order to do so, a survey was conducted in the major index sites (eg, BVS-Psi, Capes, theses and dissertations database of university libraries) of the material, covering the period 1990 to 2007. Through research on these sites, we built a database, including information relating to the work sought from specific descriptors for studies in the area of victimization of children and adolescents, with reference to a list provided by Faleiros (2000). After reading the summary of the work, the number of recovered 25 productions was reached - including theses, dissertations and articles. For analysis of the material used in the analysis of thematic content. Two axes themes were established in order to guide the analysis: conceptual elements of commercial sexual exploitation, and theoretical and methodological strategies employed. The axes have as reference for analysis a chapter built on the concept of commercial sexual exploitation, so that all analysis is anchored on it. The analysis points to the existence, still strong, conceptual and terminological confusion about ESCCA. Few studies have not demonstrated this confusion, maintaining a consistent theoretical approach. In relation to the theoretical and methodological strategies, there is a great diversity of approaches in psychology surrounding the phenomenon of ESCCA, enriching levels of understanding and action. This diversity reflects a constitutive heterogeneity of psychological science. We emphasize the perspective of socio-historical psychology, most frequently among the publications. It is hoped that this research will help advance the qualitative approach to ESCCA, especially in the field of psychology, as well as contribute to new research in the area and construction of new means of addressing this human rights violation

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Climate and air pollution, among others, are responsible factors for increase of health vulnerability of the populations that live in urban centers. Climate changes combined with high concentrations of atmospheric pollutants are usually associated with respiratory and cardiovascular diseases. In this sense, the main objective of this research is to model in different ways the climate and health relation, specifically for the children and elderly population which live in So Paulo. Therefore, data of meteorological variables, air pollutants, hospitalizations and deaths from respiratory and cardiovascular diseases a in 11-year period (2000-2010) were used. By using modeling via generalized estimating equations, the relative risk was obtained. By dynamic regression, it was possible to predict the number of deaths through the atmospheric variables and the betabinomial-poisson model was able to estimate the number of deaths and simulate scenarios. The results showed that the risk of hospitalizations due to asthma increases approximately twice for children exposed to high concentrations of particulate matter than children who are not exposed. The risk of death by acute myocardial infarction in elderly increase in 3%, 6%, 4% and 9% due to high concentrations CO, SO2, O3 and PM10, respectively. Regarding the dynamic regression modeling, the results showed that deaths by respiratory diseases can be predicted consistently. The beta-binomial-poisson model was able to reproduce an average number of deaths by heart insufficiency. In the region of Santo Amaro the observed number was 2.462 and the simulated was 2.508, in the S region 4.308 were observed and 4.426 simulated, which allowed for the generation of scenarios that may be used as a parameter for decision. Making with these results, it is possible to contribute for methodologies that can improve the understanding of the relation between climate and health and proved support to managers in environmental planning and public health policies.

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Child development is the result of the interaction of biological, psychological and social factors. Hostile environment, income, offered stimuli, as well as the presence of a chronic illness are issues that may interfere significantly. Considering the chronic diseases, we can identify congenital heart disease (CHD) is characterized by anatomical heart defects and functional and currently has presented an incidence of up to 1% of the population of live births. This research aimed to evaluate child development and verify an association with the commitment by biopsychosocial factors of children with and without CHD. Study participants were children from zero to six years, divided into three groups: Group1- 29 children pre-surgical congenital heart disease, Group2- 43 children post-surgical cardiac patients and Group3- 56 healthy children. The instruments used were a biopsychosocial questionnaire and the Screening Test Denver II. Of the total of 128 children evaluated, 66 (51.56%) are girls, and ages ranged from two months to six years (median 24.5 months). In G1 and G2 predominated acyanotic heart disease (55.2% and 58.1%). Regarding the Denver II reviews, children with heart disease had more development ratings "suspicious" and "suspect/abnormal", and 41.9% of children who have gone through surgery had characterized its development as "suspect/abnormal" . In the group of healthy children 53.6% were classified as developmental profile "normal" (p = 0,0001). On the areas of Denver II, among children with heart disease was greatest change in motor areas (p = 0.016, p = 0,001). The biopsychosocial variables that were related to a possible developmental delay were gender (p = 0.042), child's age (p = 0.0001) and income per capita (p = 0.019). There were no associations between the variables related to the treatment of disease, information, understanding of the disease and the way parents treat their children. In the group of healthy children showed that children who underwent hospitalization rates were more changes in development (p = 0.025) and the higher the number of admissions over these changes have intensified (p = 0.023). The results suggest that children with congenital heart disease have likely delayed development. It was also observed that there is a significant difference between the children who have gone through surgery, those who are still waiting for surgery only doing clinical follow-up. Changes in the development are more connected motor areas can be explained by the characteristic features of the disease and treatment, such as dyspnea, fatigue, care and limitations in daily activities. The gender and age appear to be decisive in the development as well as healthy children go through hospitalization experience. Already in children with heart disease, it was realized that social variables involved in the disease and the treatment did not affect the development. This question can be understood by means of protective factors and resiliency, as this population receives family and social support.

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Detectar os principais achados fundoscpicos em crianças portadoras de hemoglobinopatias falciformes. Mtodos: Foram estudados 26 pacientes com hemoglobinopatias falciformes, no Servio de Oftalmologia do Hospital Universitrio Onofre Lopes, Natal, RN, que foram submetidos a protocolo de pesquisa pr-estabelecido. Os resultados foram avaliados estatisticamente pelo teste qui-quadrado. Resultados: A idade mdia foi de 10,6 anos, com acuidade visual igual ou melhor que 20/25 na maioria, excetuando-se 3 olhos, que apresentavam outras doenças associadas. O tipo mais freqente foi o SS com 57,7% (15/26) dos casos, seguido pelos SC e SA com 15,4% (4/26) cada, e pelo S-Thal com 11,5% (3/26). A freqncia da retinopatia por clulas falciformes foi maior aps os 10 anos de idade, sendo mais freqente, em valores relativos, no tipo S-Thal (100% dos casos) e, em valores absolutos, no tipo SS (9 casos). Os dois achados mais comuns foram tortuosidade venosa (12/26) e black sunburst (7/26). Concluses: Observamos que a incidncia de retinopatia por clulas falciformes aumentou aps os 10 anos de idade e no evidenciamos achados da doena proliferativa. Portanto, enfatizamos a necessidade do exame oftalmolgico precoce nos portadores de anemia falciforme, como forma de prevenir futuras complicaes oculares

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Objetivou-se, neste estudo exploratrio/descritivo, identificar conhecimentos e necessidades dos cuidadores da criana com Infeco Respiratria Aguda (IRA) atravs de uma amostra de 129 crianças atendidas no servio de crescimento e desenvolvimento de uma unidade de sade. Foram aplicados formulrios junto aos cuidadores, em seu domiclio, nos meses de fevereiro e maro de 2002. Os cuidadores eram do sexo feminino, a maioria jovem, com ensino fundamental incompleto e com renda de 1 a 2 salrios. Em relao aos primeiros cuidados com a criana doente, 48,2% dos cuidadores procuram o mdico, 36,6% medicam por conta prpria e 13,2% utilizam fitoterpicos. Como medidas de preveno contra pneumonia em crianças com IRA leve, os cuidadores utilizam medidas de senso comum e sabem reconhecer sinais de gravidade das doenças, por experincias anteriores, revelando uma lacuna do conhecimento dos principais sinais e sintomas de doenças graves do trato respiratrio