Search PubMed⌕ Search

Biomedical subjects

G A Silva

Publications and source records attributed to G A Silva.

27 records · Page 2Linked to original sources

[Overweight and obesity prevalence in children and adolescents from a private school in Recife]

OBJECTIVES: To determine the prevalence of overweight and obesity in students from a private school in Recife; compare the prevalence rates of overweight and obesity in boys and girls and in different age groups (children and adolescents) and verify the correlation between body mass index and triceps skinfold thickness in this population. METHODS: Cross-sectional study with 762 students (332 children and 430 adolescents) from a middle/upper class school in Recife, in 1999. Overweight was defined as body mass index equal or above the 85th percentile for age and gender. Obesity was defined as body mass index and triceps skinfold thickness equal or above the 85th percentile. RESULTS: The prevalence rates were 26.2% (95%CI = 23 to 29%) for overweight, and 8.5% (CI95% = 6.5 to 10.5%) for obesity. Overweight was more prevalent among children (34.3%) than among adolescents (20.0%) (P<0.001). Obesity was more frequent among children (14.2%) than among adolescents (4.2%) (P<0.001). The prevalence of overweight in boys (34.6%) was higher than in girls (20.6%) (P<0.001). The prevalence of obesity was also higher in boys (14.7%) than in girls (4.4%) (P<0.001). The correlation coefficient between body mass index and triceps skinfold thickness was equal to 0.64 (95%CI = 0.60 to 0.68). CONCLUSIONS: The prevalence of overweight in our study population was as high as that found in industrialized countries; obesity, however, was less frequent.

Journal Article↗

[Obesity and malnutrition in children: profile of a low-income community]

OBJECTIVE: To establish the nutritional diagnosis of children living in a low-income community through anthropometric evaluation, detecting insufficient nutrition (low weight-for-age, wasting and stunting) and excessive nutrition (overweight and obesity). METHODS: A community-based survey identified children below 11 years living in a low-income community. Their weight and height (or lengths) were measured. The National Center for Health Statistics growth curve was used as reference. The cut-off points used were: low-weight-for-age z score of < -2 (weight-for-age), wasting (weight-for-height) and stunting (height-for-age); respective overweight and obesity z scores of +1 to +2 and of > +2, according to weight-for-height. RESULTS: Prevalence rates were 3.8% for low weight for age, and 24% for low-weight-for-age risk factors; 1.2% for wasting, and 21.6% for wasting risk factors; 5% for stunting, and 14.3% for stunting risk factors; 10.1% for overweight, and 4.6% for obesity. CONCLUSIONS: Main nutritional issues were present in children from that community, with simultaneous occurrence of chronic malnutrition and obesity.

Journal Article↗

[Risk factors for neonatal death in Recife: a case-control study]

OBJECTIVE: Neonatal mortality is the main cause of infant mortality in the city of Recife. The objective of the present study was to determine the major risk factors for neonatal death in Recife in 1995. METHODS: This is a case control study. Information was obtained from the mortality and live birth databases after validation of the data set, between January and December 1995. A sample of 456 cases and 2,280 controls was obtained after using the linkage technique between the two data sets. The difference in proportion was analyzed by the chi square test. The odds ratio was calculated as a risk measure, with a 95% confidence interval. The logistic regression technique was used to adjust potential confounding factors. RESULTS: 212 deaths (46.6%) occurred in the first 24 hours of life. We found that 358 (79.7%) of the cases presented low birth weight, with a 46-fold higher risk of death (CI =33.8-59.0 P<0.001) than those weighing >/= 2,500g. The major risk factors observed in the logistic regression analyses of the measure, listed in descending order, were: birth weight < 1,500g (OR= 49.6 CI= 22.6-108.7 P<0.001), 5-minute Apgar score < 7 (OR = 44.1 CI= 25.1-77.2 P<0.001), birth weight between 1,500 and 2,500g (OR= 8.2 CI= 4.8-14.0 P<0.001), gestational age < 37 weeks (OR= 4.3 CI= 2.6-7.1 P<0.001). CONCLUSIONS: Among the studied variables, birth weight, gestational age, and Apgar score should be considered the main risk factors for the surveillance of neonatal death.

Journal Article↗

[Diarrheal disease in hospitalized children - importance of the persistent diarrhea]

OBJECTIVE: In this paper we aim at analyzing the epidemiological and clinical patterns of children with age below 24 months who were hospitalized with diarrhoea in order to determine the prevalence of persistent diarrhoea (PD). PATIENTS AND METHODS: 300 children with diarrhoea were studied at the General Hospital of Pediatrics - IMIP in Recife, Northeast Brazil, considering the period from July 1993 to March 1994. It was a cross-sectional study. The socio-demographic, clinical and evolutive characteristics of the sample were described. A bidimensional analysis was used to compare the groups with acute and persistent diarrhoea (PD) episodes. The proportion of deaths due to persistent diarrhoea was compared to the proportion of those due to acute diarrhoea. RESULTS: The majority of the children was younger than one year of age and come from low income families living in poor environmental and social conditions. At admission it was observed that the incidence of early weaning was high (44.2%); 71.1% of the children were below the third percentile for weight as compared with the NCHS curve. During the course of PD 33.2% of the children were hospitalized. Dysentery was detected in 52% of the cases. 106 children among the 246 observed (43.1%) recovered before the 14th day, while in 140 children (56.9%) diarrhoea persisted for two more weeks. PD contributed to extend the course of hospitalization and was associated with a higher proportion of fatal cases (72.9%). CONCLUSIONS: The majority of the children was younger than one year of age and come from low income families living in poor environmental and social conditions. PD frequency among the children who were hospitalized was high and accounted for a very high proportion of fatal cases. Inadequate management in the acute phase of diarrhoea was associated with the lengthening of the disease.

Journal Article↗

[Chronic functional constipation in children: diagnosis and prevalence in a low-income community]

OBJECTIVE: To investigate the prevalence of chronic functionalconstipation in children aged under 11 years of a low-incomecommunity in Recife, Northeast Brazil and to assess the validity ofcomplaints of bowel habits for the diagnosis of constipation. METHODS: A community-based survey identified 536 eligiblechildren. Data collection was home-based through a structuredquestionnaire applied to the mothers. The definition of chronicfunctional constipation was based on painful defecation or witheffort, with stools of hard consistency and/or frequency of defecationless than three times per week, during at least the last thirty days. RESULTS: The prevalence of chronic functional constipation was17.5%. Straining was the complaint which obtained the highestsensitivity for the diagnosis of constipation (96.8%) while pain todefecate obtained the highest specificity (99.5%). CONCLUSIONS: Chronic functional constipation was a prevalentsymptom in this community, pointing out to the need of an activesearch in paediatric consultation. Straining was identified as thesingle complaint which better diagnosed constipation.

Journal Article↗

[Study of lung involvement in patients with cystic fibrosis]

OBJECTIVE: To characterize the involvement of the respiratory apparatus of patients with cystic fibrosis in order to obtain a comprehensive view of their pulmonary picture.METHODS: Data were obtained retrospectively from the medical records of 16 patients with cystic fibrosis; arterial gas and spirometry data were obtained prospectively for the same patients, who were not in an acute pulmonary situation. The patients were subjects of both sexes aged 6 years or older who were followed up at the Pediatrics Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, USP.RESULTS: Median patient age was 114 months (9 years and 6 months) ranging between 72 - 360 months, and 68.75% were males. Productive cough was the most frequent symptom observed in 75% of the population studied. All patients had positive sputum culture obtained at least one year before, with Pseudomonas aeruginosa being detected in 81.25% of the cases. Arterial gases revealed some abnormalities in 81.25% of the patients and spirometry revealed abnormalities in 56.25%.CONCLUSION: All patients presented at least one type of pulmonary alteration. Measurement of arterial gases detected a larger number of patients with altered pulmonary function than did spirometry, but the two examinations complemented each other for a good evaluation of pulmonary function.

Journal Article↗

[Signs and symptoms associated with chronic constipation]

OBJECTIVE: To check whether signs and symptoms referred to by parents are associated with chronic constipation. METHODS: A comparative survey was carried out in a group of children with constipation and another group without constipation selected from a random sample. Data were collected from mothers using a structured questionnaire. Children with chronic constipation were expected to have undergone painful defecation or defecation with effort during at least thirty days with stools of hard consistency and/or bowel movements frequency below three times per week. RESULTS: An assessment was made of the variables: inappetence, abdominal distension, abdominal pain, fecal bleeding, soiling, urinary problems and vomit. Statistical differences were observed among children with and without constipation for inappetence, abdominal pain and faecal bleeding (p<0.05). CONCLUSIONS: An association was detected between the signs and symptoms analyzed and constipation. This study stresses the need to investigate accurately whether children have constipation and the extent of its relationship with those complications.

Journal Article↗