Aleitamento e infecções por parasitas intestinais em gestantes adolescentes e seus filhos

The exclusive breastfeeding in the first six months of life practice is essential for the health and development of children. Studies show there is in human milk protective antibodies against intestinal parasites and a relationship between the absence of breastfeeding or weaning and parasitic infections. This work was a prospective cohort study involving 34 pregnant adolescents attended school in Maternity Januario Cicco / RN and their children, to assess the influence of breastfeeding on intestinal parasites in them. Thus, the parasitic infection was investigated by examination of feces parasitological and environmental factors by use of questionnaires. The average age of the mothers studied was 16.2 years. Of these 76.4% were infected and the most prevalent species of parasites were Entamoeba histolytica/dispar (76.9%), Giardia lamblia (19.2%) and Ascaris lumbricoides (11.5%). The infected children had an average age of 5.1 months and the frequency of parasites was 61.7%. The infection was earlier detecctada with 45 days of life. The most common parasites were Giardia lamblia (40%), Entamoeba histolytica/dispar (35%), Ascaris lumbricoides (5%) and Ancylostoma (5%). The average length of exclusive breastfeeding was 2.2 months. There was an association between increased duration of exclusive breastfeeding and increased time to detection of parasites in the feces of children. There was no statistically significant correlation between the socio-economic conditions and cultural and breastfeeding. The data reinforce the importance of breastfeeding to protect the children in its first year of life

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Um estudo sobre o perfil sexual e reprodutivo das adolescentes de um serviço de referência no município de Natal/RN

Adolescence is seen as a phase of life marked by a series of physical and behavioral changes, which leads to certain risk situations, such as early sexual activity, pregnancy and the occurrence of sexually transmitted diseases. Based on this statement, this research aimed generally: meet the sexual and reproductive adolescents of a reference service in Natal profile. Specifically describe the socioeconomic, sexual and reproductive individual and family characteristics of the population in question, but also verify possible association between pregnancy and age of onset of sexual activity with the socioeconomic aspects. The sectional study conducted in the database from the records of 463 adolescents seeking care in a referral center in Sexual and Reproductive Health in the period March 2011 to June 2012. The data collected were subjected to analysis by Excel 2007 and Statistical Package for Social Sciences (SPSS) 17.0. For data analysis, descriptive statistics, with absolute numbers and percentages was used, and its presentation by means of distribution and frequency tables. Results showed that the parents of these adolescents (65.7% - father; 57.8% - mother), had primary education; family income less than two minimum wages (66.2%); any type of chemical dependency in the family (33.5%) and presence of domestic violence (20.6%). A higher probability of pregnancy was verified when the mother had only primary education (26.3%), persons other than the father or mother contributed to family income (33.3%) and (26%) when there was substance abuse in the family early onset of sexual activity was observed when the mother had primary education (57.3%), persons other than the father or mother contributed to family income (63.1%) and the use of drugs / alcohol as a problem family (67.6%). It was concluded that such vulnerabilities appear as a reflection of the low social status of these young people, aggravated by emotional inheritance that is offered to every individual from birth. These findings may perhaps, support public health surveillance policies for adolescents in several areas

Cartografia da percepção de mês e profissionais sobre a atenção a saúde de crianças/adolescentes soropositivos no município de Natal

This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference

Avaliação do status antioxidante, expressão gênica e polimorfismos dos genes SOD1, SOD2 e GPx1 em crianças, adolescentes e adultos jovens com diabetes tipo 1

Studies report that the pathophysiological mechanism of diabetes complications is associated with increased production of Reactive Oxygen Species (ROS)-induced by hyperglycemia and changes in the capacity the antioxidant defense system. In this sense, the aim of this study was to evaluate changes in the capacity of antioxidant defense system, by evaluating antioxidant status, gene expression and polymorphisms in the genes of GPx1, SOD1 and SOD2 in children, adolescents and young adults with type 1 diabetes. We studied 101 individuals with type 1 diabetes (T1D) and 106 normoglycemic individuals (NG) aged between 6 and 20 years. Individuals with type 1 diabetes were evaluated as a whole group and subdivided according to glycemic control in DM1G good glycemic control and DM1P poor glycemic control. Glycemic and metabolic control was evaluate by serum glucose, glycated hemoglobin, triglycerides, total cholesterol and fractions (HDL and LDL). Renal function was assessed by measurement of serum urea and creatinine and albumin-to-creatinine ratio (ACR) in spot urine. Antioxidant status was evaluate by content of reduced glutathione (GSH) in whole blood and the activity of erythrocyte enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD). We also analyzed gene expression and gene polymorphisms of GPx1 (rs1050450), SOD1 (rs17881135) and SOD2 (rs4880) by the technique of real-time PCR (Taqman®). Most individuals with DM1 (70.3%) had poor glycemic control (glycated hemoglobin> 8%). Regarding the lipid profile, individuals with type 1 diabetes had significantly elevated total cholesterol (p <0.001) and LDL (p <0.000) compared to NG; for triglycerides only DM1NC group showed significant increase compared to NG. There was an increase in serum urea and RAC of individuals with DM1 compared to NG. Nine individuals with type 1 diabetes showed microalbuminuria (ACR> 30 mg / mg). There was a decrease in GSH content (p = 0.006) and increased erythrocyte GPx activity (p <0.001) and SOD (p <0.001) in DM1 group compared to NG. There was no significant difference in the expression of GPx1 (p = 0.305), SOD1 (.365) and SOD2 (0.385) between NG and DM1. The allele and genotype frequencies of the polymorphisms studied showed no statistically significant difference between the groups DM1 and NG. However, the GPx1 polymorphism showed the influence of erythrocyte enzyme activity. There was a decrease in GPx activity in individuals with type 1 diabetes who had a polymorphic variant T (p = 0.012). DM1 patients with the polymorphic variant G (AG + GG) for polymorphism of SOD2 (rs4880) showed an increase in the RAC (p <0.05). The combined data suggest that glucose control seems to be the predominant factor for the emergence of changes in lipid profile, renal function and antioxidant system, but the presence of the polymorphisms studied may partly contribute to the onset of complications

Repercussões sociais da violência contra crianças e adolescentes: deliqüência

This research is responsible for the investigation and problematization of the violence production process in children and teenagers through deviant behaviour, especially the drug s use and traffic, given that the deviant behaviour named juvenile criminality is something built and that can t be disassociated from the social and institutional relations that are ideological and violent, as well as the construction of, social and individual, positive identities can become important instruments for the process of democratization and the effective juvenile citizenship. In relation to the teorical referential, the work was developed from readings beyond the social science camp, without getting far from it, searching for support in other scientific camps and making your bases on Manuel Castells formulations about the power of the identity, and on Nancy Fraser and Axel Honneth in relation to the recognition struggle. In the empiric field, the discourses and graphic representations from twenty four children and teenagers that attend a social project were privileged, and compared to those shown at the documentary and the book Falcão Meninos do Tráfico produced by MV Bill, in relation to the social profile and life trajectory. From the study subjects' perspective, the data suggest that the children and the teenagers conceive violence as a natural thing, either as victims or persecutors. However, the research shows that, despite the subjects of the two studied groups reveled in your discourses the influence of the violent relations in their daily lives, the subjects got recognition during the process of identity construction by the groups with which they maintained the sense of belonging, either it being the family, the community or the school, they were positively influenced and established a positive representation of themselves and didn t show any deviant and violent tendency or behaviour. Therefore, we demonstrate the role of the school for an education for peace, as well as the participation of the family, the community and the stimulation of the juvenile protagonism as transforming practices, capable of awaking the citizenship and avoiding the construction of people that reproduce deviant and violent behaviour

Iniciação sexual e fatores associados: um estudo com adolescentes escolares

A iniciação sexual é um marco significativo na vida do indivíduo, ocorrendo geralmente na adolescência. Importantes transformações biopsicossociais ocorrem nesta fase, denotando vulnerabilidades à vida do adolescente, dentre elas, as decorrentes da iniciação sexual, sendo o risco de infecção pelo HIV/aids a mais grave. A infecção pelo HIV/aids constitui atualmente um importante problema de Saúde Pública, estando os jovens no centro da epidemia mundial. No Brasil, dados do último boletim epidemiológico, lançado em 2013, apontam para a tendência de aumento de sua prevalência na população jovem. Desta forma, o presente estudo teve por objetivo investigar a associação entre iniciação sexual e o perfil sociodemográfico, o indicador de conhecimento das formas de transmissão do HIV/aids e fatores biopsicossociais autoestima e habilidades sociais, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes do nível médio técnico integrado, do Instituto Federal de Educação, Ciências e Tecnologia do Rio Grande do Norte, Campus Natal. Trata-se de um estudo transversal, cuja amostra foi constituída aleatoriamente por 200 alunos que responderam de forma anônima a quatro instrumentos: perfil sociodemográfico, questionário da Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira (PCAP), Escala de Autoestima de Rosenberg e o Inventário de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A análise estatística dos dados foi realizada através do teste qui-quadrado de Pearson e do exato de Fisher (α <5%). A média de idade para a primeira relação sexual foi de 15,96 anos, com o início mais cedo para o sexo masculino. Verificou-se associações estatisticamente significativas entre iniciação sexual e as seguintes variáveis: idade, sexo, situação conjugal, religião, renda familiar, autoestima e o repertório de habilidades sociais. Observou-se ainda que apenas 11% dos adolescentes possuíam conhecimento correto acerca das formas de transmissão do HIV/aids. Conclui-se que os esforços para a prevenção das DST/aids precisam ser direcionados a campanhas e programas mais eficazes, que considerem não somente o caráter informativo, mas também os fatores psicossociais já que estes mostraram-se associados ao início da vida sexual

Adolescentes em conflito com a lei: a saga das punições na rota da exclusão social

This work deals with the problematic of the determinations that contribute to become the adolescents involved with law. Thus, in this research, the social exclusion is apprehended as one of the most important determining to understand this problematic, once we defend that it is part of the trajectory of this adolescent's life since its birth as a punishment that starts before they becoming envolved in act's that break the law. It is still questioned the discussion of the reduction of the penal age, viewed aa a proposal that will contribute to perpetuate the repression. The objectives of the research were: analyze the problematic of adolescents in conflict with law, where social exclusion is seen here as a main category. The research also aims to understand the situation towards social exclusion and that this public is undertaken in the state of Rio Grande do Norte, more specifically in Natal. This is dane through analysis of the profile of adolescents that are submitted to the treatment at Centro Integrate de Atendimento ao Adolescente Acusado de Ato Infracional - CIAD in 2005. This is dane on arder to identify of the State's and society's actions towards this issue, how it has prevailed in analyzing if there is punishing or social protection. The research also contributed with discussion towards the non penal reduction of for underage minors. The approach realized if of qualiquantitative nature. The research was realized with 190 male adolescent subjects, age ranging from 12 to 21 that were interns at CIAD in the year of 2005. The research shows that their fundamental rights (education, health, amongst others) are disrespected on a daily basis by the State. The State prioritizes economic issues, making social inequality more profound. The main argument is that this problematic has its main oring in the social exclusion and it is imposed to the adolescents as a punishment before thes have been involved with the law going on top of the social protection. When the adolescent goes from being the victim to executioner, the Statute of Children and Adolescents is questioned by many sectors that defend the reduction of penal minority as a solution to reduce the country's violence. Thus, it was aimed here to discuss arguments that point to non exclusion, discrimination and repression. It is proposed that the State should assume children and adolescents as a priority, implementing what the statute establishes as well as assures related to the fruition of denied rights as a way to prevent their future involvement with violence

Fatores de riscos cardiovasculares em adolescentes da cidade do Natal-RN

Estudos têm demonstrado elevada prevalência de fatores de risco cardiovascular em adolescentes a redor do mundo, entretanto, é possível que esses fatores de risco se comportem de modo diferente em diferentes localidades. Objetivos: Examinar a prevalência do sobrepeso/obesidade e sua associação com outros fatores de risco cardiovasculares, em adolescentes, da cidade do Natal-Brasil. Métodos: Estudo observacional de delineamento transversal, realizado em 626 adolescentes (10 a 19 anos) de ambos os sexos. Foram estudadas as variáveis: peso, idade, gênero, cor, escolaridade, renda familiar, hábitos de vida, história familiar, peso, estatura, índice de massa corporal, relação cintura/quadril, pressão arterial, perfil lipídico, Glicose e Insulina de jejum e pós Dextrosol. Resultados: Foram avaliados 273 (43,6%) adolescentes do sexo masculino e 353 (56,4%) feminino. 26,4% dos adolescentes apresentaram sobrepeso/obesidade. A presença de obesidade familiar foi relatada por mais de 30 % da nossa amostra. Na análise de regressão logística múltipla; Idade, renda familiar, percentil de pressão sistólica, história familiar de hipertensão e obesidade, triglicerídeos, HDL colesterol, e HOMA RI mostraram-se associados com sobrepeso/obesidade. A relação cintura quadril apresentou-se mais elevada nas mulheres, e encontramos 10,9 % dos adolescentes com percentil de pressão sistólica (PAS) 95, e 7,4 % com percentil de pressão diastólica (PAD) 95. As dosagens de triglicerídeos, colesterol HDL e HOMA-RI alterados foram mais prevalentes nos que apresentavam IMC aumentado. As alterações do xi colesterol total, triglicerídios, glicemia pós dextrosol e HOMA teste, tiveram maior prevalência no gênero feminino. Na regressão logística binária, foram observadas associações do sobrepeso / obesidade com idade; OR 0,85, IC de 95% (0,78-0,92); p<0,001, pressão arterial sistólica; OR 2,65, IC de 95% (1,18- 5,94); p< 0,020, renda familiar; OR 2,34, IC de 95% (1,53-3,58); p< 0,001, história familiar de hipertensão arterial; OR 1,76, IC de 95% (1,15-2,71); p< 0,009, história familiar de obesidade; OR 1,50, IC de 95% (1,09-2,27); p< 0,04, aumento dos trigliceridios; OR 2,74, IC de 95% (1,69-4,43); p< 0,001, redução do colesterol; HDL OR 0,58, IC de 95% (0,38-0,87); p< 0,009 e o aumento do HOMA OR 3,16, IC de 95% (1,64 - 6,02); p<0,001. Conclusão: A prevalência de fatores de risco cardiovascular em Natal – Brasil se constitui em grave problema de saúde pública, atingindo níveis que se igualam ou até superam os de outras cidades tanto no Brasil, como em outros países

Análise do perfil de encaminhamento da atenção primária para pré-natal de alto risco: desafios para o ensino de competências em saúde materno-infantil

OBJECTIVE: to identify a profile of the main causes of inappropriate referrals from primary care to specialized services, as strategy for the curriculum development of core competencies related to maternal health. METHODS: a cross-sectional study was performed using document analysis of all referrals of pregnant women from primary care to the high-risk pregnancy service, state of Rio Grande do Norte, Brazil. All pregnant women referred from June to December 2014 (n = 771) were included. According to their causes the referrals were categorized as adequate, inadequate or inconclusive. RESULTS: a total of 188 referrals were classified as inadequate (24.4%) and 93 inconclusive (12.1%) totalizing 36.5% of inappropriate referrals. The main causes identified in these inappropriate referrals were: low-risk pregnancy (12.8%), unconfirmed hypertension (12.1%), risk of abortion (8.9%), teenage pregnancy (7.1%) , toxoplasmosis (5.3%), Rh incompatibility (4.6%) and urinary tract infection (4.3%). These data contributed to the formulation of the following products: 1) a continuing education program for health professionals working in primary care, undergraduate students and residents; and 2) development of a virtual platform to support professionals who need to refer patients to high-risk pregnancy service. CONCLUSION: the results of this study are relevant in the current context of education of health professionals, with potential for positively impact not only in the development of skills related to maternal health in undergraduate and graduate education, as well as contributing for improvement of the health care of the population.