Growth velocity and weight gain in prepubertal asthmatic children

Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.National Counsel of Technological and Scientific Development (CNPq)Univ Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilFMABC, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilWeb of Scienc

Estado nutricional relativo ao selênio em pacientes com imunodeficiências primárias: associação com estresse oxidativo e risco de aterosclerose

Introduction: Ataxia Telangiectasia (AT) and Common Variable Immunodeficiency (ICV) are Inborn Immunity Errors (EII) that can be associated with endocrine changes, oxidative stress and inflammation. Studies suggest that selenium (Se) is a trace element related to protection, against the damage caused by oxidative stress; thus, it is postulated that adequate consumption reduces the risk of some chronic diseases. Objectives: To describe the concentrations of Se and glutathione peroxidase (GPx) in patients with TA and ICV and relate them to markers of the lipid profile, comparing them to the control group. Casuistry and methods: Cross-sectional controlled study, involving 54 patients, of both sexes, 22 with TA and 32 with ICV. Patients were matched for sex and age, with healthy individuals. The following were evaluated: nutritional status, food consumption, serum selenium, glutathione peroxidase (activity), biomarkers of lipid metabolism (lipid profile, apolipoproteins AI and B [Apo AI and Apo B] and oxidized LDL [LDLox]), inflammation (protein C ultrasensitive reactive [CRP] and adiponectin) and lipid peroxidation (malondialdehyde). Results: The median age in the TA group was 12.2 years, with a predominance of males; in the ICV the female gender predominated, with a mean age of 36.8 years. TA patients showed greater impairment of lean mass and lower abdominal circumference when compared to their controls. A more atherogenic lipoprotein profile was observed in the TA group, with higher concentrations of total cholesterol, non-HDL cholesterol, LDLox, ApoB, Apo B / Apo A-I ratio and LDL / HDL; while a lower value was observed in the Apo A-I / HDL ratio. ICV patients had lower serum concentrations of Se and GPx activity. On the other hand, in these same patients, the LDLox, CRP and non-HDL-c cholesterol values ​​were higher when compared to their controls. Dietary intake of energy, macronutrients, vitamins C and selenium were similar among patients and their respective controls, except in patients with TA, who had lower consumption of calories, carbohydrates, proteins, monounsaturated fats, trans and Se its controls Conclusion: the study showed a higher risk for CVD in patients with EII, such as ICV and TA. The presence of low selenium in ICVs and less GPx activity in TA points to the importance of assessing the nutritional status related to selenium in these patients. Patients with TA seem to have a potential risk for CVD due to impaired nutritional status, impaired liver function, dyslipidemia and inflammation.Introdução: Ataxia Telangiectasia (AT) e Imunodeficiência Comum Variável (ICV) são Erros Inatos da Imunidade (EII) que podem cursar com alterações endócrinas, estresse oxidativo e inflamação. Estudos sugerem que o selênio (Se) seja um oligoelemento relacionado à proteção, frente ao dano causado pelo estresse oxidativo; postula-se, assim, que o consumo adequado reduza o risco de algumas doenças crônicas. Objetivos: Descrever as concentrações de Se e glutationa peroxidase (GPx) em pacientes com AT e ICV e relacioná-las com marcadores do perfil lipídico, comparando-os ao grupo controle. Casuística e métodos: Estudo transversal controlado, envolvendo 54 pacientes, de ambos os sexos, sendo 22 com AT e 32 com ICV. Os pacientes foram pareados por sexo e idade, com indivíduos saudáveis. Foram avaliados: estado nutricional, consumo alimentar, selênio sérico, glutationa peroxidase (atividade), biomarcadores do metabolismo lipídico (perfil lipídico, apolipoproteínas A-I e B [Apo A-I e Apo B] e LDL oxidada [LDLox]), da inflamação (proteína C reativa ultrassensível [PCRus] e adiponectina) e da peroxidação lipídica (malondialdeído). Resultados: A mediana de idade no grupo dos AT foi de 12,2 anos, com predominância do sexo masculino; nos ICV predominou o sexo feminino, com média de idade de 36,8 anos. Os pacientes com AT apresentaram maior comprometimento de massa magra e menor circunferência abdominal, quando comparados aos seus controles. Observou-se perfil de lipoproteínas mais aterogênico no grupo dos AT, com maiores concentrações de colesterol total, colesterol não HDL, LDLox, ApoB, relação Apo B/ Apo A-I e LDL/HDL; ao passo que se observou menor valor na relação Apo A-I/HDL. Pacientes com ICV possuíram menores concentrações séricas de Se e de atividade da GPx. Por outro lado, nesses mesmos pacientes, os valores de LDLox, PCRus e colesterol não HDL-c foram maiores quando comparados aos seus controles. A ingestão dietética de energia, macronutrientes, de vitaminas C e selênio foram semelhantes entre os pacientes e seus respectivos controles, exceto nos pacientes com AT, que tiveram menores valores de consumo de calorias, carboidratos, proteínas, gorduras monoinsaturadas, trans e Se que os seus controles Conclusão: o estudo evidenciou maior risco para DCV em pacientes com EII, tais como ICV e AT. A presença de selênio baixo nos ICVs e de menor atividade de GPx nos AT apontam para a importância da avaliação do estado nutricional relativo ao selênio nestes pacientes. Os pacientes com AT parecem ter risco potencializado para DCV frente ao comprometimento do estado nutricional, acometimento da função hepática, quadro de dislipidemia e inflamação.Dados abertos - Sucupira - Teses e dissertações (2019

Comparison of oral amoxicillin given thrice or twice daily to children between 2 and 59 months old with non-severe pneumonia: a randomized controlled trial

Objectives: Oral amoxicillin (50 mg/kg/day) thrice daily is the first-line therapy for non-severe childhood pneumonia. Compliance could be enhanced if two daily doses are employed. We assessed the equivalence of oral amoxicillin (50 mg/kg/day) thrice or twice daily in those patients. Patients and methods: This randomized (1: 1), controlled, triple-blinded investigation conducted at one centre in Brazil included children aged 2–59 months with non-severe pneumonia diagnosed by trained paediatricians based on respiratory complaints and radiographic pulmonary infiltrate/consolidation. Participantswere randomly assigned to receive one bottle (Amoxicillin 1) at 6 am, 2 pm and 10 pm and the other bottle (Amoxicillin 2) at 8 am and 8 pm: one bottle contained amoxicillin and the other placebo and vice versa. Only the pharmacist knew patients’ allocation. Follow-up assessments were done at 2, 5 and 14 days after enrolment. Chest radiographs were read by three independent radiologists. Primary outcome was treatment failure (development of danger signs, persistence of fever, tachypnoea, development of serious adverse reactions, death and withdrawal from the trial) at 48 h. ClinicalTrials.gov: identifier NCT01200706. Results: Four hundred and twelve and 408 participants received amoxicillin thrice or twice daily, respectively. Treatment failure was detected in 94 (22.8%) and 94 (23.0%) patients in intention-to-treat analysis (risk difference 0.2%; 95% CI: 25.5%–6.0%) and in 80 (20.1%) and 85 (21.3%) patients in per-protocol analysis (risk difference 1.2%; 95% CI: 24.4%–6.8%). Pneumonia was radiologically confirmed by concordant reading in 277 (33.8%) cases, among whom treatment failure was registered in 25/133 (18.8%) and 27/144 (18.8%) participants from the thrice and twice daily doses subgroups, respectively (risk difference 20.05%; 95% CI: 29.3%– 9.2%). Conclusions: Oral amoxicillin (50 mg/kg/day) twice daily is as efficacious as thrice daily