Analysis of the stimulated whole saliva in overweight and obese school children

OBJECTIVE: To determine if some stimulated whole saliva parameters are influenced by an increase of Body Mass Index. METHODS: Controlled cross-sectional study involving 90 school children of both genders between 7 and 10 years of age, from Bragança Paulista - SP. Three groups were formed: overweight, obese and control. Body Mass Index and diet intake by the Food Register method were evaluated. The salivary pH, flow rate, buffer capacity, protein, phosphate, calcium, fluoride, total and free sialic acid, and peroxidase activity were determined. RESULTS: The overweight and obese groups showed greater energy and lipid intake (P< 0.001) than the control group. There was no difference in the saliva flow rate between groups, however only the control group showed a mean value considered normal. In the overweight and obese groups a decrease in both the concentration of phosphate (P< 0.001) and peroxidase activity (P<0.001) was observed. In the obese group an increase in the concentrations of free sialic acid (P= 0.004) and protein (P= 0.003) occurred. CONCLUSION: Overweight and obese children show alterations in the concentrations of phosphate, free sialic acid and proteins, and in the peroxidase activity that are favorable conditions for dental caries.

A inclusão da criança com Síndrome de Down na rede regular de ensino: desafios e possibilidades

O estudo teve como objetivo buscar evidências na literatura acerca da inclusão de crianças com Síndrome de Down na rede regular de ensino. Elaboraram-se revisão da literatura e busca dos artigos nas bases de dados PubMed e PsycINFO, utilizando as palavras-chave Down syndrome, schools, mainstreaming (education), education, infant, newborn, adolescent, child e preschool, no período de 1994 a 2007. Selecionaram-se oito artigos e sua análise permitiu a identificação do tema: experiências e recomendações para a inclusão. Os dados desta revisão, em sua maioria provenientes de relatos de experiências, indicaram que os fatores que colaboraram ou dificultaram o processo de inclusão da criança com síndrome de Down na rede regular de ensino relacionaram-se à escola, aos pais e ao professor. Os resultados deste estudo oferecem possibilidades para melhorar o processo de inclusão, apresentam os desafios e ainda apontam a necessidade do desenvolvimento de novas pesquisas, cujos resultados possam ser aplicados na prática.

Timing and sequence of primary tooth eruption in children with cleft lip and palate

OBJECTIVE: To determine the timing and sequence of eruption of primary teeth in children with complete bilateral cleft lip and palate. MATERIAL AND METHODS: This cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, SP, Brazil, with a sample of 395 children (128 girls and 267 boys) aged 0 to 48 months, with complete bilateral cleft lip and palate. RESULTS: Children with complete bilateral clefts presented a higher mean age of eruption of all primary teeth for both arches and both genders, compared to children without clefts. This difference was statistically signifcant for all teeth, except for the maxillary first molar. Mean age of eruption of most teeth was lower for girls compared to boys. The greatest delay was found for the maxillary lateral incisor, which was the eighth tooth of children with clefts of both genders. Analyzing by gender, the maxillary lateral incisor was the eighth tooth to erupt in girls and the last in boys. CONCLUSION: The results suggest an interference of the cleft on the timing and sequence of eruption of primary teeth.

Photographic assessment of nasal morphology following rapid maxillary expansion in children

OBJECTIVE: The aim of the present study was to use facial analysis to determine the effects of rapid maxillary expansion (RME) on nasal morphology in children in the stages of primary and mixed dentition, with posterior cross-bite. MATERIAL AND METHODS: Facial photographs (front view and profile) of 60 patients in the pre-expansion period, immediate post-expansion period and one year following rapid maxillary expansion with a Haas appliance were evaluated on 2 occasions by 3 experienced orthodontists independently, with a 2-week interval between evaluations. The examiners were instructed to assess nasal morphology and had no knowledge regarding the content of the study. Intraexaminer and interexaminer agreement (assessed using the Kappa statistic) was acceptable. RESULTS: From the analysis of the mode of the examiners' findings, no alterations in nasal morphology occurred regarding the following aspects: dorsum of nose, alar base, nasal width of middle third and nasal base. Alterations were only detected in the nasolabial angle in 1.64% of the patients between the pre-expansion and immediate post-expansion photographs. In 4.92% of the patients between the immediate post-expansion period and 1 year following expansion; and in 6.56% of the patients between the pre-expansion period and one year following expansion. CONCLUSIONS: RME performed on children in stages of primary and mixed dentition did not have any impact on nasal morphology, as assessed using facial analysis.

Recalled and recorded bowel habits confirm early onset and high frequency of constipation in day-care nursery children

CONTEXT: Mothers recall early-onset constipation in children attending gastroenterology clinics. OBJECTIVES: To study the bowel habit of young children in the community to determine, first, whether early-onset constipation is confirmed in this setting and, second, the agreement between recalled and recorded bowel habit. METHODS:Defecation data of 57 children aged 6.0-40.7 mo were obtained by maternal recall (questionnaire on predominant stool characteristics) and by record (1,934 defecations registered prospectively at home and in the nursery). The bowel habit was classified according to stool frequency and proportion of stool characteristics (soft, hard and/or runny). Two criteria were used to classify recorded data, since the cutoff point for hard stools to identify constipation is undefined in children: predominant criterion and adult criterion, respectively with >50% and >25% of stools with altered consistency. Bowel habit categories were: adequate, constipation, functional diarrhea and "other bowel habit". Nonparametric statistics, and the Kappa index for agreement between recalled and recorded bowel habit, were used. RESULTS: Constipation occurred in 17.5%, 10.5%, 19.3% of the children by recall, the predominant and the adult criteria, respectively. Constipation was the main recalled alteration, vs 12.3% "other bowel habit". Only one child classified as having functional diarrhea (by the adult criterion). Agreement between recalled and recorded bowel habit was fair for constipation, by the predominant and the adult criteria (K = 0.28 and 0.24, respectively), but only slight (K <0.16) for other bowel habit categories. Individual data, however, pointed to a better relationship between recalled constipation and the adult rather than the predominant criterion. CONCLUSIONS: Frequent early-onset constipation was confirmed. Fair agreement between recalled and recorded constipation by the two used criteria indicates that recalled data are quite reliable to detect constipation.

Categorization skills and recall in brain damaged children: a multiple case study

During development, children become capable of categorically associating stimuli and of using these relationships for memory recall. Brain damage in childhood can interfere with this development. This study investigated categorical association of stimuli and recall in four children with brain damages. The etiology, topography and timing of the lesions were diverse. Tasks included naming and immediate recall of 30 perceptually and semantically related figures, free sorting, delayed recall, and cued recall of the same material. Traditional neuropsychological tests were also employed. Two children with brain damage sustained in middle childhood relied on perceptual rather than on categorical associations in making associations between figures and showed deficits in delayed or cued recall, in contrast to those with perinatal lesions. One child exhibited normal performance in recall despite categorical association deficits. The present results suggest that brain damaged children show deficits in categorization and recall that are not usually identified in traditional neuropsychological tests.

Reaction time assessment in children with ADHD

Attention deficit, impulsivity and hyperactivity are the cardinal features of attention deficit hyperactivity disorder (ADHD) but executive function (EF) disorders, as problems with inhibitory control, working memory and reaction time, besides others EFs, may underlie many of the disturbs associated with the disorder. OBJECTIVE: To examine the reaction time in a computerized test in children with ADHD and normal controls. METHOD: Twenty-three boys (aged 9 to 12) with ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 2000 (DSM-IV) criteria clinical, without comorbidities, Intelligence Quotient (IQ) >89, never treated with stimulant and fifteen normal controls, age matched were investigated during performance on a voluntary attention psychophysical test. RESULTS: Children with ADHD showed reaction time higher than normal controls. CONCLUSION: A slower reaction time occurred in our patients with ADHD. This findings may be related to problems with the attentional system, that could not maintain an adequate capacity of perceptual input processes and/or in motor output processes, to respond consistently during continuous or repetitive activity.

Health Related Quality of Life Assessment questionnaire for children aged 5 to 11 years with HIV/AIDS: cross-cultural adaptation for the Portuguese language

The objective of this study is to describe preliminary results from the cross-cultural adaptation of the Quality of Life Assessment Questionnaire, used to measure health related quality of life (HRQL) in Brazilian children aged between 5 and 11 with HIV/AIDS. The cross-cultural model evaluated the Concept, Item, Semantic and Measurement Equivalences (internal consistency and intra-observer reliability). Evaluation of the conceptual, item, semantic equivalences showed that the Portuguese version is pertinent for the Brazilian context. Four of seven domains showed internal consistency above 0.70 (α: 0.76-0.90) and five of seven revealed intra-observer reliability (ricc: 0.41-0.70). This first Portuguese version of the HRQL questionnaire can be understood as a valuable tool for assessing children's HRQL, but further studies with large samples and more robust analyses are recommended before use in the Brazilian context.

Magnetic fields and acute lymphoblastic leukemia in children: a systematic review of case-control studies

Leukemia incidence in children has increased worldwide in recent decades, particularly due to the rise in acute lymphoblastic leukemia. Studies have associated exposure to non-ionizing radiation generated by low frequency magnetic fields with childhood leukemia. The current article reviews the case-control studies published on this subject. Of 152 articles tracked in different databases, ten studies from North America, Asia, and Europe met the defined selection criteria, with patients diagnosed from 1960 to 2004. Methodological limitations were observed in these articles, including difficulties with the procedures for assessing exposure. An association may exist between exposure to low frequency magnetic fields and acute lymphoblastic leukemia in children, but this association is weak, preventing the observation of consistency in the findings. Future studies from a wider range of geographic regions should focus on the analysis of acute lymphoblastic leukemia, which is the subtype with the greatest impact on the increasing overall incidence of childhood leukemia.

Aleitamento materno, alimentação complementar, sobrepeso e obesidade em pré-escolares

OBJETIVO: Analisar a associação do sobrepeso e da obesidade com o aleitamento materno e a alimentação complementar em pré-escolares. MÉTODOS: Estudo transversal envolvendo 566 crianças matriculadas em escolas particulares no município de São Paulo, SP, 2004-2005. A variável dependente foi sobrepeso e obesidade. Para a classificação do estado nutricional das crianças foram utilizadas as curvas de percentis do Índice de Massa Corporal para idade, classificando como sobrepeso valores e"P85 e

Peso insuficiente ao nascer e crescimento alcançado na idade pré-escolar, por crianças atendidas em creches filantrópicas do município de Santo André, São Paulo, Brasil

OBJETIVOS: comparar o crescimento alcançado e a prevalência de baixa estatura na idade pré-escolar entre recém-nascidos de peso insuficiente (PNI) e de peso adequado (PNA). MÉTODOS: foram estudadas 323 crianças com PNI e 886 com PNA de famílias de baixa renda de quinze creches filantrópicas de Santo André, São Paulo, Brasil, em 2001 e 2002. As variáveis foram o escore Z de peso e de estatura para a idade, pelo referencial Center for Disease Control (CDC) and National Center for Health Statistics (NCHS) 2000, comparando-se as médias dos dois grupos. Calculou-se a razão de prevalência (RP) de baixa estatura na idade pré-escolar em decorrência do peso insuficiente ao nascer. RESULTADOS: o escore z médio de peso foi -0,09 e 0,39 e o escore z médio de estatura foi de -0,06 e de 0,24 para as crianças de PNI e de PNA, respectivamente. A prevalência de baixa estatura foi de 2,78% para as crianças com PNI e de 0,79% para aquelas com PNA. A RP de baixa estatura na idade pré-escolar para as crianças de PNI foi de 3,5 (IC95% 1,3-9,4). CONCLUSÕES: as crianças com PNI apresentaram crescimento inferior e maior risco de falhas de crescimento até a idade pré-escolar, sugerindo um efeito negativo do peso insuficiente ao nascer sobre o crescimento infantil.

Desenvolvimento de pré-escolares na educação infantil em Cuiabá, Mato Grosso, Brasil

O objetivo foi avaliar o desenvolvimento neuropsicomotor de pré-escolares na educação infantil. Estudo de corte transversal, utilizando 38 itens do teste de Denver II. Foram avaliados todos os pré-escolares com idade entre quatro e seis anos incompletos matriculados na Rede Pública Municipal de Ensino de Cuiabá, Mato Grosso, Brasil, no período de agosto 2002 a novembro 2003. Nesse período havia 960 pré-escolares matriculados em 27 creches e duas escolas públicas. Para a análise estatística foi aplicado o teste Ç2 com intervalo de 95% de confiança e ± = 5%. Para calcular os percentis da idade em que os pré-escolares passaram em cada prova foi realizada uma regressão logística. Dos 960 pré-escolares avaliados, 67% apresentaram desempenho normal, 30,2% questionável e 2,8% anormal. Em 27/38 itens avaliados, o percentual de acertos ultrapassou 90%. O desempenho alterado predominou no sexo masculino, no grupo de cinco a seis anos. O desempenho dessa população foi muito semelhante ao dos pré-escolares norte-americanos de Denver, Colorado. O melhor resultado segundo o gênero ocorreu no sexo feminino e segundo a idade no grupo de quatro anos.

Prevalência de sobrepeso e obesidade em crianças de dois a seis anos matriculadas em escolas particulares no município de São Paulo

OBJETIVO: verificar a prevalência de sobrepeso e obesidade segundo sexo e idade em crianças de 2 a 6 anos de idade, alunos de escolas particulares no município de São Paulo. MÉTODO: foram realizadas medidas de peso e de altura para verificação do estado nutricional de oitocentos e seis crianças de ambos os sexos. Para a classificação do estado nutricional das crianças foram utilizadas as curvas de percentis do Índice de Massa Corporal (IMC = Peso (kg) / Altura² (cm)) para idade, conforme padrão de referência do Multicentre Growth Study, recomendado pela Organização Mundial de Saúde que classifica como sobrepeso valores de percentis > 85 e < 97 e para a obesidade valores < 97. Para análise da relação entre sexo, idade da criança e estado nutricional utilizou-se modelo linear generalizado de regressão múltipla (glm) com ligação logarítmica e família binomial, que permite, diretamente, a estimação das razões de prevalências. A prevalência de sobrepeso+obesidade foi 37,2 por cento para o sexo masculino e 33,4 por cento para o sexo feminino. A razão de prevalência (RP) mostrou que não existe diferença significativa entre obesidade e sobrepeso+obesidade para sexo e idade. CONCLUSÃO: observaram-se prevalências de sobrepeso e de obesidade superiores às prevalências médias da população brasileira. Os resultados encontrados neste estudo reforçam a preocupação com a obesidade infantil que aparentemente vem crescendo, em idades mais precoces como dos pré-escolares

The influence of birthweight on arterial blood pressure of children

Background & aims.This study examined the relationship between birthweight and blood pressure in childhood. Methods.Prospective cohort study involving 472 Brazilian children ranging in age from 5 to 8 years. Birthweight, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), total cholesterol and fractions (LDL-c, HDL-c), and triglycerides were determined. Total cholesterol, LDL-c, HDL-c, and triglycerides were assessed by automated enzymatic methods. Blood pressure was measured with the HDI/Pulse Wave™ CR-2000 equipment. Multiple regression models were used to investigate the relationship between birthweight and SBP and DBP, controlling for the following variables: gender, age, BMI, total cholesterol, triglycerides, per capita income, and maternal education. Results.When adjusting for gender and BMI, we found a systolic blood pressure increase of 2.9 (95per cent CI = −5.33 to −0.56) mmHg per kilogram birthweight reduction. The unadjusted association was insignificant. Conclusion.Our data suggest that low birthweight is one of the factors contributing to blood pressure elevation at early ages. A way to prevent these diseases is by implementing public policies focused on good nutrition and adequate prenatal care for pregnant women