Prevalence of Helicobacter pylori infection and associated factors among adults in Southern Brazil: a population-based cross-sectional study

BACKGROUND: Helicobacter pylori (Hp) infection is associated with several upper gastrointestinal disorders. Local data on the epidemiology of the infection are scarce in Brazil. The purpose of this study is to measure the prevalence rate and to explore the associated factors among the adult population living in Pelotas, a southern Brazilin city. METHODS: This was a population-based cross-sectional study. Through a multi-stage sampling method all individuals 20 years and over living at the selected households at the urban area of the city were interviewed regarding past and current socio-economic indicators; demographic characteristics; nutritional and behavioural habits; and history of upper gastrointestinal symptoms.Hp infection was ascertained through the (13)C-UBT. Due to the high prevalence, data were analysed through robust Poisson regression. All analyses took into account the family clustering of the data. RESULTS: Among 563 eligible individuals, 363 agreed to perform the (13)C-UBT (refusal rate of 35.5%). Refusals were associated with female sex, consumption of mate drinking, and presence of upper gastrointestinal symptoms. The prevalence rate of H. pylori infection was 63.4% (95%CI 59.3%–69.3%). In crude analyses, prevalence was associated with increasing age, non-white skin colour, lower current family income, lower education level, higher size of the family, low socio-economic conditions in childhood, higher number of siblings and attendance to day-care centres in childhood, and presence of dyspeptic symptoms. In adjusted analysis the level of education of the father was inversely associated with the infection, whereas number of siblings and attendance to day-care centre in childhood were directly associated with it. Non-white skin colour remained significantly associated with increased prevalence even after allowing for past and current socio-economic characteristics, age and sex. Compared to non-symptomatic individuals, those reporting dyspeptic symptoms presented a higher prevalence of the infection even after allowing for current and past socio-economic conditions, ethnicity, age, and sex. CONCLUSION: Hp infection is as common among adults in southern Brazil as it is in other developing countries. Socio-economic conditions in childhood besides ethnicity and presence of dyspeptic symptoms were the factors significantly associated with the infection

Associa??o entre restri??o de sono e sobrepeso/obesidade entre crian?as do sul do Brasil: estudo de uma coorte de nascimentos

Made available in DSpace on 2015-04-14T13:36:00Z (GMT). No. of bitstreams: 1 461279.pdf: 2459743 bytes, checksum: 9fa44daec31ee335a9623687951b34e0 (MD5) Previous issue date: 2014-07-14Introduction: Pediatric obesity has become a worldwide public health concern, with a perspective of an even greater increase over the next years, especially among developing countries. Overweight children are exposed from an early age to comorbidities and chronic pathologies that imply on an increase in morbimortality. Concomitantly, the general population, including children, has been sleeping gradatively less time. Studies have been searching for evidence linking sleep deprivation to overweight or obesity. Among pre-school children, this correlation is not well established. Objective: To evaluate the relation between sleep deprivation in the first years of life and overweight or obesity at 4 years of age. Materials and Methods: We used the data from the Pelotas, Brazil, 2004 birth Cohort, corresponding to perinatal, 12, 24 and 48 months follow-ups. On these moments, the child?s main caretaker responded to questions regarding sleep and feeding habits, as well as socioeconomic and demographic characteristics. Children who slept for less than 10 hours per night were considered sleep deprived. Children with a BMI Z-score 2 standard deviations above limits established by the World Health Organization were considered overweight, and those with a BMI Z-score above 3 standard deviations were considered obese. Results: Of the 4263 live births in Pelotas during the study year, 4231 were enrolled in the study. Of those, 94%, 93.5% and 92% were re-evaluated on the 12, 24 and 48-month follow-ups, respectively. On the analysis stratified by age, only at 24 months we found a positive association between sleep deprivation and overweight at 48 months (PR 1,731. CI95% 1,246; 2,406. P=0,001). Analyzing the relation between sleep deprivation at any moment during the study period, we found that sleep-deprived children had a 27% higher chance of overweight/obesity at the end of the study (RP 1,267. CI 95% 0,989;1,624). This association was maintained after adjusting for possible confounders. Conclusion: On the studied population, children with sleep deprivation between 12 and 48 months of age showed a higher chance of being overweight or obese at 4 years. These findings show the importance of sleep quality and sleep hygiene in prevention and management of overweight and obesity in childhood.Introdu??o: A obesidade infantil configura um problema de sa?de p?blica a n?vel mundial, com uma perspectiva de aumento ainda mais significativo nos pr?ximos anos, especialmente entre pa?ses em desenvolvimento. Crian?as com sobrepeso s?o expostas desde muito cedo a comorbidades e patologias cr?nicas que implicam em aumento da morbimortalidade. Concomitantemente, as horas de sono da popula??o em geral, inclusive crian?as, v?m diminuindo de maneira gradativa. Estudos v?m buscando evidencias que conectem a redu??o do n?mero de horas de sono noturno e obesidade. Entre crian?as em idade pr?-escolar, tal correla??o ainda n?o est? bem estabelecida. Objetivo: Avaliar e associa??o entre restri??o de sono nos primeiros anos de vida e sobrepeso/obesidade aos 4 anos. Materiais e M?todos: Foi utilizado o banco de dados da Coorte de Nascimentos de 2004 da cidade de Pelotas, Brasil, correspondentes aos acompanhamentos perinatal, de 12, 24 e 48 meses. Nesses momentos, o principal cuidador da crian?a respondeu perguntas a respeito de h?bitos de sono, alimentares e sobre caracter?sticas demogr?ficas e socioecon?micas. Consideraram-se restritas em sono as crian?as que dormiam em m?dia menos de 10 horas por noite. Consideraram-se com sobrepeso as crian?as com escore-Z para IMC a partir de 2 desvios-padr?es da m?dia estabelecida pela Organiza??o Mundial de Sa?de, e obesos os com a partir de 3 desvios-padr?o. Resultados: Dentre os 4.263 nascidos-vivos daquela cidade, 4.231 foram inscritos no estudo ainda no per?odo perinatal. Deste total, permaneceram em acompanhamento nos seguimentos de 12, 24 e 48 meses, respectivamente, 94%, 93,5% e 92%. Nas an?lises por faixa et?ria, somente aos 24 meses houve associa??o significativa entre restri??o de sono e sobrepeso/obesidade aos 48 meses (PR 1,731. CI95% 1,246; 2,406. P=0,001). Avaliando-se a associa??o entre restri??o de sono em algum momento durante o per?odo acompanhamento e sobrepeso/obesidade aos 48 meses, encontrou-se que os restritos em sono tiveram uma chance 27% maior (RP 1,267. CI 95% 0,989;1,624) de altera??es de peso ao final do acompanhamento. Essa associa??o se manteve ap?s ajuste para potenciais fatores de confus?o. Conclus?o: Na popula??o estudada, crian?as com restri??o de sono entre 12 e 48 meses apresentaram maior chance de sobrepeso/obesidade aos 48 meses. Estes achados chamam a aten??o para a import?ncia da qualidade do sono e da implanta??o de higiene do sono na preven??o e manejo de sobrepeso e obesidade na inf?ncia

Depress?o materna no per?odo perinatal e macroarquitetura do sono ao final do primeiro ano de vida

Submitted by PPG Medicina e Ci?ncias da Sa?de ([email protected]) on 2018-12-04T18:22:09Z No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5)Approved for entry into archive by Sheila Dias ([email protected]) on 2018-12-06T10:22:40Z (GMT) No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5)Made available in DSpace on 2018-12-06T10:35:35Z (GMT). No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5) Previous issue date: 2018-08-17Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESThe period extending from pregnancy to the months following delivery, although usually associated to positive feelings, represents a moment of great vulnerability to the development of major depressive disorders. Perinatal depression is a frequent pathology, and its consequences extend beyond the mother, potentially affecting the relationship with her partner and family functioning. Early exposure to maternal depression is associated to lower breastfeeding rates, impairment of mother-infant bonding, and consequences over child growth and development. Perinatal depression has been linked to infant sleep disturbances as early as in the neonatal period, with description of more night wakings, shorter sleep duration and more fragmented sleep. Sleep plays a fundamental role in child cognitive, social, and emotional development, and its disturbances, in a crucial moment of brain development, may facilitate significant and persistent dysfunctions. Studies associating maternal depression to child sleep disturbances show important heterogeneity in terms of design as in moment of sleep assessment. Sleep patterns go through important changes throughout the first twelve months of life, rendering impaired the association?s precise evaluation, as well as that of its potential long-term consequences. This study aimed to investigate the association between perinatal depression and altered infant sleep macrostructure at one year of life among participants in a birth cohort. In this population-based study, recruitment was carried out from pregnancy to soon after delivery, aiming to include all livebirths in the municipality of Pelotas throughout the year of 2015. Participants to one or both cohort-nested trials and those lacking information on maternal depression were excluded from these analyses. For the diagnosis of perinatal depression, the Edinburgh Postnatal Depression Scale (EPDS) was completed during pregnancy and 3 months after delivery, having been considered perinatally depressed mothers who scored ?13 points in one or both follow-ups. Infant sleep was assessed at 3 months through the Brief Infant Sleep Questionnaire (BISQ) and, at 12 months, through the same subjective questionnaire added to objective data derived from continuous 24-hour actigraphy. Main sleep outcomes were number of night time wakings, night vigil time and total sleep duration in 24 hours. The sample consisted of 2222 mothers/infants, in which prevalence of perinatal depression was of 22.3% (CI 95% 20.5-24). Adjusted analyses using Poisson?s regression from BISQ-derived data showed greater risk of >3 night time wakings at 12 months among infants of depressed mothers (RR 1.52; CI 95% 1.06-2.18; p=0.02). Actigraphic data did not, however, confirm those findings (adjusted RR=1.24; CI 95% 0.85-1.81; p=0.26). No association was found between perinatal depression and the other investigated sleep variables. This study suggests a potential defining role of dysfunctional cognition among mothers with a history of perinatal depression on infant sleep characteristics at the end of the first year of life.O per?odo que se estende da gesta??o at? os meses seguintes ao parto, apesar de normalmente associado a sentimentos positivos, representa um momento de grande vulnerabilidade ao desenvolvimento de quadros depressivos maiores. A depress?o perinatal ? um dist?rbio frequente, cujas consequ?ncias se estendem para al?m da mulher acometida, potencialmente exercendo efeito sobre a rela??o com o parceiro e o funcionamento familiar. Exposi??o precoce a depress?o materna associa-se a menores taxas de amamenta??o, preju?zo do v?nculo com o beb?, e consequentes efeitos sobre o crescimento e desenvolvimento infantis. Evid?ncias associam a depress?o perinatal a dist?rbios do sono da crian?a desde o per?odo neonatal, sob a forma de maior n?mero de despertares noturnos, menor dura??o de sono e maior fragmenta??o. O sono, por sua vez, exerce papel primordial no desenvolvimento cognitivo, social e emocional da crian?a, e seus dist?rbios, em um per?odo crucial do desenvolvimento cerebral, podem favorecer disfun??es significativas e permanentes. Existe uma importante heterogeneidade em rela??o tanto ao delineamento dos estudos que associam depress?o materna a dist?rbios do sono na crian?a, quanto ao momento de avalia??o do sono, que sofre mudan?as significativas no decorrer dos primeiros doze meses de vida. Com isso, a avalia??o dessa poss?vel associa??o fica prejudicada, assim como a mensura??o de suas consequ?ncias a longo prazo. Este estudo objetivou investigar a presen?a de associa??o entre depress?o perinatal e altera??es da macroarquitetura do sono de lactentes com um ano de vida, participantes de uma coorte de nascimentos. Neste estudo de base populacional, o recrutamento ocorreu desde a gesta??o at? logo ap?s o parto, visando incluir todos os nascidos vivos na cidade de Pelotas no transcorrer de 2015. Participantes de uma das interven??es aninhadas ? coorte e aqueles sem informa??es referentes ? depress?o materna foram exclu?dos desta an?lise. Para diagn?stico de depress?o perinatal, foi aplicada a Escala de Depress?o P?s-natal de Edimburgo (EPDS) na gesta??o e 3 meses ap?s o parto, tendo sido consideradas deprimidas as m?es com pontua??o ?13 em um ou ambos os acompanhamentos. O sono dos lactentes foi avaliado aos 3 meses atrav?s do Brief Infant Sleep Questionnaire (BISQ) e, aos 12 meses, a partir dos mesmos dados subjetivos somados a informa??es objetivas obtidas a partir de 24 horas cont?nuas de actigrafia. Os principais desfechos de sono analisados foram o n?mero de despertares noturnos, dura??o da vig?lia noturna, e tempo total de sono em 24 horas. A amostra constituiu-se de 2.222 m?es e lactentes, na qual a preval?ncia de depress?o perinatal foi de 22,3% (IC95% 20,5-24). Pelo BISQ, as an?lises ajustadas atrav?s de regress?o de Poisson mostraram maior risco para >3 despertares noturnos aos 12 meses entre filhos de m?es deprimidas (RR 1,52; IC95% 1,06-2,18; p=0,02). No entanto, a avalia??o dos dados actigr?ficos n?o confirmou este achado (RR ajustado=1,24; IC95% 0,85-1,81; p=0,26). N?o houve associa??o entre depress?o perinatal e as demais vari?veis do sono. Este estudo sugere um potencial papel definidor da impress?o disfuncional entre m?es com hist?ria de depress?o perinatal sobre as caracter?sticas do sono dos lactentes ao final do primeiro ano de vida

Associação entre restrição de sono e sobrepeso/obesidade entre crianças do sul do Brasil: estudo de uma coorte de nascimentos

Introdução: A obesidade infantil configura um problema de saúde pública a nível mundial, com uma perspectiva de aumento ainda mais significativo nos próximos anos, especialmente entre países em desenvolvimento. Crianças com sobrepeso são expostas desde muito cedo a comorbidades e patologias crônicas que implicam em aumento da morbimortalidade. Concomitantemente, as horas de sono da população em geral, inclusive crianças, vêm diminuindo de maneira gradativa. Estudos vêm buscando evidencias que conectem a redução do número de horas de sono noturno e obesidade. Entre crianças em idade pré-escolar, tal correlação ainda não está bem estabelecida.Objetivo: Avaliar e associação entre restrição de sono nos primeiros anos de vida e sobrepeso/obesidade aos 4 anos.Materiais e Métodos: Foi utilizado o banco de dados da Coorte de Nascimentos de 2004 da cidade de Pelotas, Brasil, correspondentes aos acompanhamentos perinatal, de 12, 24 e 48 meses. Nesses momentos, o principal cuidador da criança respondeu perguntas a respeito de hábitos de sono, alimentares e sobre características demográficas e socioeconômicas. Consideraram-se restritas em sono as crianças que dormiam em média menos de 10 horas por noite. Consideraram-se com sobrepeso as crianças com escore-Z para IMC a partir de 2 desvios-padrões da média estabelecida pela Organização Mundial de Saúde, e obesos os com a partir de 3 desvios-padrão.Resultados: Dentre os 4. 263 nascidos-vivos daquela cidade, 4. 231 foram inscritos no estudo ainda no período perinatal. Deste total, permaneceram em acompanhamento nos seguimentos de 12, 24 e 48 meses, respectivamente, 94%, 93,5% e 92%. Nas análises por faixa etária, somente aos 24 meses houve associação significativa entre restrição de sono e sobrepeso/obesidade aos 48 meses (PR 1,731. CI95% 1,246; 2,406. P=0,001). Avaliando-se a associação entre restrição de sono em algum momento durante o período acompanhamento e sobrepeso/obesidade aos 48 meses, encontrou-se que os restritos em sono tiveram uma chance 27% maior (RP 1,267. CI 95% 0,989;1,624) de alterações de peso ao final do acompanhamento. Essa associação se manteve após ajuste para potenciais fatores de confusão.Conclusão: Na população estudada, crianças com restrição de sono entre 12 e 48 meses apresentaram maior chance de sobrepeso/obesidade aos 48 meses. Estes achados chamam a atenção para a importância da qualidade do sono e da implantação de higiene do sono na prevenção e manejo de sobrepeso e obesidade na infância.Introduction: Pediatric obesity has become a worldwide public health concern, with a perspective of an even greater increase over the next years, especially among developing countries. Overweight children are exposed from an early age to comorbidities and chronic pathologies that imply on an increase in morbimortality. Concomitantly, the general population, including children, has been sleeping gradatively less time. Studies have been searching for evidence linking sleep deprivation to overweight or obesity. Among pre-school children, this correlation is not well established.Objective: To evaluate the relation between sleep deprivation in the first years of life and overweight or obesity at 4 years of age.Materials and Methods: We used the data from the Pelotas, Brazil, 2004 birth Cohort, corresponding to perinatal, 12, 24 and 48 months follow-ups. On these moments, the child´s main caretaker responded to questions regarding sleep and feeding habits, as well as socioeconomic and demographic characteristics. Children who slept for less than 10 hours per night were considered sleep deprived. Children with a BMI Z-score 2 standard deviations above limits established by the World Health Organization were considered overweight, and those with a BMI Z-score above 3 standard deviations were considered obese.Results: Of the 4263 live births in Pelotas during the study year, 4231 were enrolled in the study. Of those, 94%, 93. 5% and 92% were re-evaluated on the 12, 24 and 48-month follow-ups, respectively. On the analysis stratified by age, only at 24 months we found a positive association between sleep deprivation and overweight at 48 months (PR 1,731. CI95% 1,246; 2,406. P=0,001). Analyzing the relation between sleep deprivation at any moment during the study period, we found that sleep-deprived children had a 27% higher chance of overweight/obesity at the end of the study (RP 1,267. CI 95% 0,989;1,624). This association was maintained after adjusting for possible confounders.Conclusion: On the studied population, children with sleep deprivation between 12 and 48 months of age showed a higher chance of being overweight or obese at 4 years. These findings show the importance of sleep quality and sleep hygiene in prevention and management of overweight and obesity in childhood

Sleep and weight‐height development

Objective: To describe the association between sleep duration and weight–height development in children and adolescents. Source of data: A non‐systematic search in the MEDLINE database was performed using the terms anthropometry, body composition, overweight, obesity, body mass index, growth, length, short stature, sleep, children, and infants and adolescents, limited to the last 5 years. The references cited in the revised articles were also reviewed, when relevant. Synthesis of data: Sleep disorders are prevalent in the pediatric population. Among them, insomnia, which leads to a reduction in total sleep time, is the most prevalent disorder. Evidence found in the current literature allows the conclusion that sleep time reduction has a role in the current pandemic of overweight and obesity. Studies associating sleep deprivation and deficit in height growth are still insufficient. Conclusions: The association between shorter sleep duration and risk of overweight and obesity is well established for all pediatric age groups. However, more evidence is needed to establish an association between insufficient sleep duration and height growth deficit. Pediatricians should include the encouragement of healthy sleep habits in their routine guidelines as an adjuvant in the prevention and management of excess weight. Resumo: Objetivos: O objetivo deste artigo é descrever a associac¸ão entre a durac¸ão de sono e o desenvolvimento pondero‐estatural entre crianc¸as e adolescentes. Fontes de dados: Foi realizada uma busca não‐sistemática na base de dados MEDLINE utilizando os termos antropometria, composic¸ão corporal, sobrepeso, obesidade, índice de massa corporal, crescimento, comprimento, baixa estatura, sono, crianc¸as, lactentes e adolescentes, limitadas aos últimos cinco anos. As referências citadas nos artigos revisados também foram, conforme relevância, revisados. Síntese dos dados: Distúrbios do sono são prevalentes na população pediátrica. Dentre eles, a insônia, que cursa com redução do tempo total de sono, é a mais prevalente. Evidências presentes na literatura atual permitem apontar que a redução do tempo de sono tem um papel na pandemia atual de sobrepeso e obesidade. Os estudos que associam a privação de sono com déficit no crescimento estatural ainda são insuficientes. Conclusões: A associação entre menor duração de sono e risco para sobrepeso e obesidade está bem estabelecida para todas as faixas etárias da pediatria. Entretanto, maiores evidências são necessárias para que se possa estabelecer uma associação entre duração insuficiente de sono e déficit no crescimento estatural. O médico pediatra deve incluir nas suas orientações de rotina o estímulo a hábitos de sono saudáveis como coadjuvante na prevenção e manejo do excesso de peso. Keywords: Body composition, Body mass index, Growth, Sleep, Children, Adolescents, Palavras‐chave: Composição corporal, Índice de massa corporal, Crescimento, Sono, Crianças, Adolescente

Sleep and weight-height development

Objectives: To describe the association between sleep duration and weight–height development in children and adolescents. Source of data: A non-systematic search in the MEDLINE database was performed using the terms anthropometry, body composition, overweight, obesity, body mass index, growth, length, short stature, sleep, children, and infants and adolescents, limited to the last 5 years. The references cited in the revised articles were also reviewed, when relevant. Synthesis of data: Sleep disorders are prevalent in the pediatric population. Among them, insomnia, which leads to a reduction in total sleep time, is the most prevalent disorder. Evidence found in the current literature allows the conclusion that sleep time reduction has a role in the current pandemic of overweight and obesity. Studies associating sleep deprivation and deficit in height growth are still insufficient. Conclusions: The association between shorter sleep duration and risk of overweight and obesity is well established for all pediatric age groups. However, more evidence is needed to establish an association between insufficient sleep duration and height growth deficit. Pediatricians should include the encouragement of healthy sleep habits in their routine guidelines as an adjuvant in the prevention and management of excess weight. Resumo: Objetivos: O objetivo deste artigo é descrever a associação entre a duração de sono e o desenvolvimento pondero-estatural entre crianças e adolescentes. Fontes de dados: Foi realizada uma busca não-sistemática na base de dados MEDLINE utilizando os termos antropometria, composição corporal, sobrepeso, obesidade, índice de massa corporal, crescimento, comprimento, baixa estatura, sono, crianças, lactentes e adolescentes, limitadas aos últimos cinco anos. As referências citadas nos artigos revisados também foram, conforme relevância, revisados. Síntese dos dados: Distúrbios do sono são prevalentes na população pediátrica. Dentre eles, a insônia, que cursa com redução do tempo total de sono, é a mais prevalente. Evidências presentes na literatura atual permitem apontar que a redução do tempo de sono tem um papel na pandemia atual de sobrepeso e obesidade. Os estudos que associam a privação de sono com déficit no crescimento estatural ainda são insuficientes. Conclusões: A associação entre menor duração de sono e risco para sobrepeso e obesidade está bem estabelecida para todas as faixas etárias da pediatria. Entretanto, maiores evidências são necessárias para que se possa estabelecer uma associação entre duração insuficiente de sono e déficit no crescimento estatural. O médico pediatra deve incluir nas suas orientações de rotina o estímulo a hábitos de sono saudáveis como coadjuvante na prevenção e manejo do excesso de peso. Keywords: Body composition, Body mass index, Growth, Sleep, Children, Adolescents, Palavras-chave: Composição corporal, Índice de massa corporal, Crescimento, Sono, Crianças, Adolescente

Polysomnographic Aspects of Sleep Architecture on Self-limited Epilepsy with Centrotemporal Spikes: A Systematic Review and Meta-analysis

Self-limited epilepsy with centrotemporal spikes is the most common paediatric epileptic syndrome, with growing evidence linking it to various degrees and presentations of neuropsychological dysfunction. The objective of this study is to evaluate the possible sleep macro and microstructural alterations in children with this diagnosis. A systematic review of published manuscripts was carried out in Medline, LILACS and Scielo databases, using the MeSH terms epilepsy, sleep and polysomnography. From 753 retrieved references, 5 were selected, and data from macro and, when available, microstructure of sleep were extracted. Meta-analysis was performed with data from 4 studies using standardized mean difference. Findings were heterogeneous between studies, being the most frequent macrostructural findings a smaller proportion and greater latency of REM sleep in two studies and, in meta-analysis, a longer sleep latency was the most significant finding among epileptic patients. Only one study evaluated sleep microstructure, suggesting possible alterations in cyclic alternating pattern in diagnosed children. Studies evaluating macro and microstructure of sleep in children with self-limited epilepsy with centrotemporal spikes are necessary to a better understanding of mechanisms of the neuropsychologic disturbances that are frequently seen in children with this diagnosis

Translation and language validation of the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese

Objective: This study aimed to translate the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese. Material and Methods: The translation and language validation processes were carried out through translation, back translation, technical review, assessment of verbal comprehension/clarity of the scale by experts (four pediatric neurologists). After they have reached a final version of the ESS-HAD a sample of asymptomatic children and adolescents that were participants in another sleep project were invited to read and complete the questionnaire to evaluate comprehension by the aimed population. Results: Two independent researchers made the forward translation and it has around 90% of concordance. Minor disagreements were related to the position of adjectives in the sentence. No major difficulties were reported by the 3rd researcher that performed the back translation. After a consensus meeting with the four participants, we have reached a final version of the questionnaire. In the cognitive interviews, the scale was reportedly easy to understand to the 23 respondents. One adolescent suggested clarifying whether question 2 (likelihood of falling asleep watching TV or a video), referred to daytime or nighttime. The total ESS-CHAD score in this asymptomatic sample varied from 0-17, a mean score of 7.08±5.65. Discussion: The final version of the ESS-CHAD in Brazilian Portuguese was approved by the copyright owners and was well understandable by caregivers and adolescents. More studies are now necessary to use this questionnaire in a larger target population to verify its validity and internal consistency