Exploring de association between feeding habits, non-nutritive sucking habits, and malocclusions in the deciduous dentition

Background: This study aimed to explore the association between feeding habits, non-nutritive sucking habits, and malocclusions in deciduous dentition. Methods: A cross-sectional observational survey was carried out in 275 children aged 3 to 6 years and included clinical evaluations of malocclusions and structured interviews. Statistical significance for the association between feeding habits and the development of malocclusion was determined using chi-square and Fisher's exact tests. In addition, odds ratio (OR) calculations were used for intergroup comparisons. Controlling for confounders was adjusted by excluding children with non-nutritive sucking habits. Results: The results indicated that there were no significant relationships between exclusive breastfeeding or bottlefeeding and the presence of any type of malocclusion (p>0.05). There was also no significant association between breastfeeding or bottlefeeding duration and malocclusion (p>0.05). In addition, it was observed that exclusive breastfeeding had a protective effect and diminished the risk of acquiring non-nutritive sucking habits (p=0.001). Conclusions: There was no association between feeding habits and malocclusions in the deciduous dentition in this sample of children. Exclusive breastfeeding reduced the risk of acquiring non-nutritive sucking habits

Dermatite atópica pediátrica: fisiopatologia e manejo terapêutico / Pediatric atopic dermatitis: pathophysiology and therapeutic management

A dermatite atópica (DA), conhecida também como eczema atópico, é uma condição inflamatória crônica recidivante que acomete o tecido cutâneo. No que tange às estatísticas gerais, a incidência de DA aumentou de 2 a 3 vezes nos países industrializados, afetando aproximadamente 15% a 20% das crianças e 1% a 3% dos adultos em todo o mundo. A DA, em termos fisiopatológicos, é uma afecção inflamatória crônica recidivante da pele, multifacetada, comumente associada a outras manifestações atópicas, como alergia alimentar, rinite alérgica e asma. O início da doença é mais comum aos 5 anos de idade, sendo o diagnóstico e o tratamento precoces essenciais para evitar complicações da DA e melhorar a qualidade de vida. Há muitas condições de pele que podem mimetizar essa doença, sendo possível até mesmo coexistirem e/ou agravarem a DA, que devem ser excluídas ao diagnosticá-la, tais como: dermatite seborreica, sarna, dermatite de contato, psoríase, linfoma cutâneo de células T, dentre outras afecções cutâneas. O tratamento da DA objetiva condutas multifatoriais, das quais dependem da associação de medidas não farmacológicas e farmacológicas, sendo prescrita de acordo com o grau da doença. É imprescindível que os portadores de DA sejam esclarecidos e aderentes às medidas não farmacológicas para prevenção de crises agudas. Nesse sentido, cita-se a necessidade do uso de hidratantes neutros em toda a pele após banhos diários, evitando cremes e sabonetes com produtos alérgenos, além de não se submeterem a extremos de calor, frio ou umidade. Associado a essas medidas, o tratamento farmacológico tem se mostrado muito eficaz em casos mais graves e recidivantes

Exostoses múltiplas hereditárias com transformação maligna: Exostoses malignos hereditários com transformação

Introdução: Exostose múltipla hereditária (EMH) corresponde ao distúrbio hereditário musculoesquelético do crescimento ósseo intracondral. Caracteriza-se pela presença de saliências ósseas recobertas por cartilagem hialina em duas ou mais regiões metafisárias, formando, dessa forma, os osteocondromas. Estes ocorrem devido ao ativo crescimento e multiplicação celular no local. A EMH representa 40% dos tumores ósseos benignos e 10% de todos os tumores ósseos. Apresentação do caso: FAP, sexo masculino, 60 anos, com queixa de tumoração em joelho esquerdo, lateralmente à patela, há cerca de 10 anos. Relatou crescimento lento e indolor. Ao exame físico notou-se abaulamento de 8 cm longitudinal x 6 cm transversal x 3 cm anteroposterior, aderido ao plano ósseo patelar, endurecido, sem sinais flogísticos e que à movimentação acompanhava a patela em flexo-extensão do joelho esquerdo, ou seja, sem limitação de amplitude de movimento do membro em questão. Paciente apresentava-se estável e sem outras queixas. Realizou exames de imagem que evidenciaram tumoração óssea localizada no polo inferior da patela do joelho esquerdo, de caráter osteocartilaginoso, sugestivo de artrose nesta região. Foi orientada ressecção por abordagem cirúrgica, que sucedeu sem intercorrências, e o anatomopatológico confirmou diagnóstico de osteocondroma patelar sem sinais de malignidade. Discussão: As exostoses ou osteocondromas, nas proximidades das placas de crescimento ósseo, ocorrem mais comumente nas porções justa-epifisárias dos ossos longos, principalmente no fêmur distal, tíbia proximal, fíbula e úmero. A sintomatologia inclui dor persistente, causada pela pressão nos tecidos vizinhos, por distúrbios da circulação sanguínea ou raramente por compressão da medula espinhal. O diagnóstico é feito através do exame físico e exames de imagem. A EMH pode causar complicações, sendo que a mais grave é a malignização em condrossarcoma, que pode ocorrer em até 3,9% dos pacientes. Quanto ao tratamento, na presença de características clínicas ou radiológicas suspeitas, deve ser realizada a ressecção cirúrgica em bloco e a correlação histopatológica. Conclusão: Na EMH, a maioria das lesões são benignas, entretanto podem cursar com malignização e suscitar repercussões consideráveis na qualidade de vida dos indivíduos afetados. O diagnóstico é elementar, aprimorado no exame físico e radiológico, geralmente detectado na primeira década de vida e deve ser realizado precocemente a fim de evitar maiores complicações

Síndrome de Pickardt: Pickardt syndrome

Introdução: A síndrome de Pickardt-Fahlbusch, muito rara, encontra-se no grupo das síndromes endócrinas de interrupção da haste hipofisária, resultando no hipotireoidismo terciário. A fisiopatologia não está totalmente elucidada, sugerindo alterações de ordens cromossômicas. Apresentação do caso:  Paciente com 13 anos, sexo feminino, natural do Gama - DF, deu entrada no pronto socorro do Hospital Regional de Santa Maria (HRSM) com rebaixamento do nível de consciência associado a hipoglicemia grave, apresentando melhora após reversão da hipoglicemia. Discussão:  Observa-se uma maior prevalência da síndrome de Pickardt-Fahlbusch no sexo masculino, com sintomas de hipotireoidismo grave bem presentes, necessitando realizar exames complementares: laboratoriais e de imagens. Afastadas outras causas e realizado diagnóstico, deve iniciar precocemente as medidas terapêuticas, reduzindo os efeitos e complicações da ausência dos hormônios tireoidianos principalmente na faixa etária pediátrica. Outras características também podem vir acompanhadas, mascarando o diagnóstico, já que alteração ocorre a nível de haste hipofisária, o que induz outras sintomatologias. Conclusão: É imprescindível, diante das várias características apresentadas, entender e estudar mais sobre a síndrome de Pickardt. &nbsp

Antioxidant intake among Brazilian adults - The Brazilian Osteoporosis Study (BRAZOS): a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Antioxidant nutrient intake and the lesser formation of free radicals seem to contribute to chronic diseases. The aim of the present study was to evaluate the intake profile of the main dietary antioxidants in a representative sample of the adult Brazilian population and discuss the main consequences of a low intake of these micronutrients on overall health.</p> <p>Methods</p> <p>The sample comprised 2344 individuals aged 40 years or older from 150 cities and was based on a probabilistic sample from official data. The research was conducted through in-home interviews administered by a team trained for this purpose. Dietary intake information was obtained through 24-h recall. The Nutrition Data System for Research software program was used to analyze data on the intake of vitamins A, C and E, selenium and zinc, which was compared to Dietary Reference Intakes (DRIs). Differences in intake according to sex, anthropometrics, socioeconomic status and region were also evaluated. The SPSS statistical package (version 13) was used for the statistical analysis. P-values < 0.05 were considered significant.</p> <p>Results</p> <p>Higher proportions of low intake in relation to recommended values were found for vitamin E (99.7%), vitamin A (92.4%) and vitamin C (85.1%) in both genders. Intake variations were found between different regions, which may reflect cultural habits.</p> <p>Conclusion</p> <p>These results should lead to the development of public health policies that encourage educational strategies for improving the intake of micronutrients, which are essential to overall health and prevention of non-communicable diseases.</p

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

La relación entre los diferentes tipos de lactancia materna, los hábitos de succión no nutritiva y la oclusión en un grupo de niños de 3 a 6 años de edad

[spa] OBJETIVO: Explorar la asociación entre los hábitos alimenticios, hábitos de succión no nutritivos y la maloclusión en la dentición decidua y determinar la presencia de hábitos de succión no nutritivos y sus efectos en la oclusión de la dentición decidua en una población de niños españoles. MATERIALES Y MÉTODOS: El presente trabajo es un estudio de tipo transversal. Los exámenes clínicos fueron realizados en 275 niños con edades de 3 a 6 años de edad por un examinador con experiencia, el cual evaluó los tipos de maloclusión tales como: presencia de mordida abierta anterior (dimensión vertical), unilateral o bilateral posterior mordida (dimensiones transversales), desviación de línea media y las relaciones sagitales entre incisivos, molares y caninos. Asimismo, los padres o responsables de cada niño fueron invitados a responder cuestionarios relacionados a hábitos orales. Para el análisis estadístico en relación a la asociación entre los hábitos de succión y el desarrollo de la maloclusión fueron utilizados los Test de Chi-cuadrado y el Test exacto de Fisher. El análisis de los datos también incluyó la estadística descriptiva (distribución de frecuencias). El nivel de significancia fue del 5%. Se realizó el análisis de regresión logística múltiple ajustada a las variables de confusión (hábitos de succión no nutritivos) para determinar la significancia estadística. Los cálculos de odds ratio (OR) fueron realizados para las comparaciones entre los grupos. El control de los factores de confusión fue ajustado mediante la exclusión de los niños con hábitos de succión no nutritiva. RESULTADOS: La presencia de hábitos de succión no-nutritivos fue observado en 224 niños (81.5%) y la presencia de maloclusión fue observada en 152 niños (55.2%). Los resultados demostraron que existió una relación significativa entre el uso del chupete, alteraciones en la relación transversal (OR= 3.29; IC95%: 0.97-11.17, p=0.044) y desviación de la línea media (OR= 3.00, IC95%:1.22-7.38, p=0.013). Niños con antecedentes de succión digital tienen 4.25 veces mayor riesgo de desarrollar una maloclusión (95%IC: 0.92-19.58; p = 0.044). Existió relación significativa entre la succión digital y la mordida abierta anterior (dimensión vertical) (OR = 8.25, 95%IC: 2.50- 27.25; p = 0.001). Los niños con hábitos de succión no nutritivos tuvieron 2.55 veces mayor riesgo de desarrollar maloclusiones en comparación con los que no tienen hábitos de succión no nutritiva (p = 0.004). Los resultados también indicaron que no hubo relación significativa entre la lactancia materna exclusiva o el uso del biberón y la presencia de algún tipo de maloclusión (p > 0.05). Del mismo modo, no hubo asociación significativa entre la lactancia materna, duración del uso del biberón y las maloclusiones (p>0.05). Además, se observó que la lactancia materna exclusiva posee un efector protector disminuyendo el riesgo de adquirir hábitos de succión no-nutritivos (p = 0.001). CONCLUSIÓN: No hubo asociación entre los hábitos alimenticios y las maloclusiones en la dentición decidua de los niños que participaron de este estudio. La lactancia materna exclusiva disminuyó el riesgo de adquirir hábitos de succión no nutritivos. Los hábitos de succión no nutritivos y el desarrollo de maloclusiones tuvieron un impacto en los niños que participaron de este estudio. Los niños que usaban chupete presentaron alteraciones significativas en la dimensión transversal y la succión digital aumentó el riesgo de maloclusión vertical.[eng] AIM: To explore the association between feeding habits, non-nutritive sucking habits and malocclusions in deciduous dentition and to determine the presence of non-nutritive sucking habit and and their effects on the occlusion in the deciduos dentition in Spanish children. MATERIALS AND METHODS: Study design is cross-sectional survey. A clinical examination was performed by an examiner in 275 children aged 3 to 6 years and the collected included clinical evaluations of malocclusions. In addition, the parents of each child completed a structured interview about oral habits. Statistical significance for the association between feeding habits and development of maloclusion was determined using Chi-square and Fisher's exact tests. Data analysis included descriptive statistics (frequency distribution). Multiple logistic regression analysis was used. In addition, odds (OR) calculations were used for intergroup comparisons. RESULTS: Non-nutritive sucking habit was observed in 224 children (81.5%) and malocclusions were presented in 152 children (55.2%). There were significant relationships between pacifier sucking habit and transverse dimension alteration (OR= 3.29, CI: 0.97-11.17, p=0.044), midline deviation (OR= 3.00, CI: 1.22-7.38, p=0.013). Children with a history of finger sucking (or thumb sucking) had 4.25 an increased risk of malocclusion (CI: 0.92-19.58, p=0.044) and there was significant relationship between finger sucking and vertical relationship (OR= 8.25, CI: 2.50-27.25, p=0.001). Children with non-nutritive sucking habits had 2.55 an increased risk of malocclusion compared to those without non-nutritive sucking habits (p=0.004). The results also indicated that there were not significant relationships between exclusive breastfeeding or bottle feeding and the presence of any type of malocclusion (p>0.05). In addition, it was observed that exclusive breastfeeding had protective effect and diminished the risk of acquiring non-nutritive sucking habits (p=0.001). CONCLUSIONS: There was not association between feeding habits and malocclusions in the deciduous dentition in this sample of children. Exclusive breastfeeding reduced the risk of acquiring non-nutritive sucking habits. There was an impact of non-nutritive sucking habit and development of maloclusions in this sample of children. Children using pacifiers showed significant alterations in the transverse dimension and digital suction increased the risk of vertical malocclusion

Association between maternal breastfeeding and the development of non-nutritive sucking habits

<div><p>OBJECTIVE:</p><p> To analyze the association of maternal breastfeeding time with the introduction of non-nutritive sucking habits in children attending the Baby Clinic at the Araçatuba College of Dentistry, Universidade Estadual Paulista Júlio de Mesquita.</p>METHODS:<p> Interviews were conducted with the parents/legal guardians of 228 children, with the aim of obtaining information about the period of natural breastfeeding, the presence of non-nutritive sucking habits and the duration of the habit. A descriptive analysis of the results was performed.</p>RESULTS:<p> It was found that 42.5% of mothers nursed their children up to 6 months, and exclusive maternal breastfeeding was observed in just 13% of the sample. Amongst the children who were naturally breastfed for a period of more than 6 months, only 32.8% had non-nutritive sucking habits while 67.2% did not.</p>CONCLUSION:<p> There was an association between the length of natural breastfeeding and acquiring non-nutritive sucking habits. The habit of sucking on a pacifier was extremely prevalent in babies that only received maternal breastfeeding in the first six months of life. All of the children that were breastfed for only six months made use of a feeding bottle to complement their diet, showing that feeding bottles are still frequently used.</p><p></p></div

Exploring de association between feeding habits, non-nutritive sucking habits, and malocclusions in the deciduous dentition

Background: This study aimed to explore the association between feeding habits, non-nutritive sucking habits, and malocclusions in deciduous dentition. Methods: A cross-sectional observational survey was carried out in 275 children aged 3 to 6 years and included clinical evaluations of malocclusions and structured interviews. Statistical significance for the association between feeding habits and the development of malocclusion was determined using chi-square and Fisher's exact tests. In addition, odds ratio (OR) calculations were used for intergroup comparisons. Controlling for confounders was adjusted by excluding children with non-nutritive sucking habits. Results: The results indicated that there were no significant relationships between exclusive breastfeeding or bottlefeeding and the presence of any type of malocclusion (p>0.05). There was also no significant association between breastfeeding or bottlefeeding duration and malocclusion (p>0.05). In addition, it was observed that exclusive breastfeeding had a protective effect and diminished the risk of acquiring non-nutritive sucking habits (p=0.001). Conclusions: There was no association between feeding habits and malocclusions in the deciduous dentition in this sample of children. Exclusive breastfeeding reduced the risk of acquiring non-nutritive sucking habits