7 research outputs found

    Preterm children have unfavorable motor, cognitive, and functional performance when compared to term children of preschool age

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    OBJECTIVE: to compare the motor coordination, cognitive, and functional development of preterm and term children at the age of 4 years. METHODS: this was a cross-sectional study of 124 four-year-old children, distributed in two different groups, according to gestational age and birth weight, paired by gender, age, and socioeconomic level. All children were evaluated by the Movement Assessment Battery for Children - second edition (MABC-2), the Pediatric Evaluation of Disability Inventory (PEDI), and the Columbia Mental Maturity Scale (CMMS). RESULTS: preterm children had worse performance in all tests, and 29.1% of the preterm and 6.5% of term groups had scores on the MABC-2 indicative of motor coordination disorder (p = 0.002). In the CMMS (p = 0.034), the median of the standardized score for the preterm group was 99.0 (± 13.75) and 103.0 (± 12.25) for the term group; on the PEDI, preterm children showed more limited skill repertoire (p = 0.001) and required more assistance from the caregiver (p = 0.010) than term children. CONCLUSION: this study reinforced the evidence that preterm children from different socioeconomic backgrounds are more likely to have motor, cognitive, and functional development impairment, detectable before school age, than their term peers

    FrequĂȘncia de Escherichia coli e sua sensibilidade aos antimicrobianos em menores de cinco anos hospitalizados por diarreia aguda The frequency of Escherichia coli and its sensitivity to antimicrobials in children aged under five years admitted to hospital for treatment of acute diarrhea

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    OBJETIVOS: determinar a frequĂȘncia de Escherichia coli diarreiogĂȘnica e sua sensibilidade aos antimicrobianos em menores de cinco anos hospitalizados por diarreia aguda. MÉTODOS: estudo prospectivo tipo corte transversal realizado no Instituto de Medicina Integral Prof. Fernando Figueira, entre janeiro de 2010 e fevereiro de 2011. Foram excluĂ­das as crianças com diagnĂłstico de imunodeficiĂȘncia ou usando antimicrobianos. Para cada paciente foi feito uma Ășnica coleta de swab retal nas primeiras 24 horas de internação. Os patĂłgenos foram identificados na coprocultura e sorotipagem. Os antibiogramas foram obtidos por disco-difusĂŁo. RESULTADOS: 140 crianças foram arroladas, em sua maioria provinham de famĂ­lias de baixa renda da RegiĂŁo Metropolitana do Recife. Foram isolados 99 microorganismos: 9 (6,4%) E. coli enteropatogĂȘnica (EPEC) e 4 (2,9%) E. coli enteroinvasora (EIEC) e 80 (57,1%) outras E.coli nĂŁo EPEC, nĂŁo EIEC, 3 (2,1%) Shigella spp e 3 (2,1%) Salmonella spp. O perfil de sensibilidade aos antimicrobianos demonstrou nĂ­veis elevados de resistĂȘncia Ă  ampicilina e sulfametoxazol-trimetoprima. CONCLUSÕES: a baixa frequĂȘncia de EPEC observada pode estar associada Ă s condiçÔes de saneamento bĂĄsico favorĂĄveis apresentadas pelos pacientes do estudo. A anĂĄlise local do perfil da sensibilidade da E. coli aos antimicrobianos reforça a recomendação da Organização Mundial de SaĂșde para o uso racional dessas drogas visando prevenção da resistĂȘncia bacteriana.<br>OBJECTIVES: to determine the frequency of diarrheic Escherichia coli and its sensitivity to antimicrobials in children aged under five years admitted to hospital for treatment of acute diarrhea. METHODS: a prospective cross-sectional study was carried out at the Instituto de Medicina Integral Prof. Fernando Figueira, between January 2010 and February 2011. Children were excluded if they had been diagnosed as immunodeficient or were using antimicrobials. A single rectal swab was taken from each patient during the first 24 hours of hospitalization. The pathogens were identified in the coproculture and serotyping. Antibiograms were obtained using disc-diffusion. RESULTS: 140 children were recruited. Most were from low-income families in the Metropolitan Region of Recife. Ninety-nine micro-organisms were isolated: 9 (6.4%) enteropathogenic E. coli (EPEC) and 4 (2.9%) enteroinvasive E. coli (EIEC) and 80 (57.1%) other E.coli that are neither EPEC nor EIEC, 3 (2.1%) Shigella spp and 3 (2.1%) Salmonella spp. The profile of sensitivity to antimicrobials showed high levels to resistance to ampicillin and sulfametho-xazol-trimetropime. CONCLUSIONS: the low frequency of EPEC found may be associated with basic sanitary conditions among the patients in the study. The local analysis of the profile of sensitivity of E. coli to antimicrobials corroborates the World Health Organization recommendation that these drugs be used prudently to ensure prevention of resistance in bacteria

    Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

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    Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author
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