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Biomedical subjects

Joel A Lamounier

Publications and source records attributed to Joel A Lamounier.

13 recordsLinked to original sources
PubMed2006

[Additional cardiovascular risk factors associated with excess weight in children and adolescents: the Belo Horizonte heart study].

OBJECTIVE: To examine the association of overweight and obesity with physical activity, blood pressure (BP) and serum lipid profiles. METHODS: Epidemiologic investigation of 1,450 students, between the ages of 6 and 18, in the city of Belo Horizonte, MG. DATA: weight, height, BP, skinfold thickness, waist circumference, physical activity, total cholesterol (TC), LDL-c, HDL-c, and dietary habits. RESULTS: The prevalence rates for overweight and obesity were 8.4% and 3.1%, respectively. In relation to the students in the lower quartile (Q1) of the distribution of subscapular skinfold, the students in the upper quartile (Q4) presented a 3.7 times higher risk (odds ratio) of having elevated TC levels. Overweight and obese students had a 3.6 times higher risk of having elevated systolic blood pressure, and a 2.7 times higher risk of elevated diastolic blood pressure when compared to normal weight students. The less active students in the Q1 of distribution of MET presented a 3.8 times higher risk of having elevated TC levels compared to those who were more active (Q4). CONCLUSION: Students who were overweight, obese or in the upper quartiles for other adiposity variables, as well as students with low levels of physical activity or a sedentary lifestyle presented higher blood pressure levels and a lipid profile indicative of an increased risk of developing atherosclerosis.

Adolescent↗
PubMed2005

Effect of iron-fortified drinking water of daycare facilities on the hemoglobin status of young children.

BACKGROUND: Anemia is the most prevalent nutrition problem in young children. One possible strategy to prevent anemia is affordable fortification of drinking water. OBJECTIVE: The aim of this study was to evaluate the impact of iron-fortified drinking water of daycare facilities on the hemoglobin and anthropometric status of pre-school children. DESIGN: Hemoglobin (Hb) status, weight and height measurements were assessed in 160 pre-school children aged 6 to 59 m before and after 8 m consumption of iron- (12 mg/L) and vitamin C- (90 mg/L) fortified drinking water. RESULTS: Initially, 43.2% (69) of the children evaluated as being anemic decreased to 21% (37) at the end of study. At baseline, 42 (26.3%) children suffered from moderate anemia and 27 (16.9%) suffered severe anemia, but after iron fortification, total number of children suffering from moderate and severe anemia had decreased to 32 (20.7%) and 5 (3%), respectively. Weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) Z-scores increased significantly from -0.84 +/- 1.03 to 0.06 +/- 1.10, -0.84 +/- 1.11 to 0.54 +/- 1.10 and -0.39 +/- 0.94 to -0.18 +/- 1.14, respectively (p < 0.05). Daycare personnel reported increased appetite and food consumption and decreased absenteeism during intervention. CONCLUSION: Daily consumption of iron-fortified drinking water in daycare facilities is an effective, simple and inexpensive means of reducing and controlling for moderate and severe anemia in pre-school children.

Anemia, Iron-Deficiency↗
PubMed2004

[Breastfeeding and maternal medications].

OBJECTIVE: To contribute with information about the adequate administration of drugs during breastfeeding. SOURCES OF DATA: MEDLINE articles from 1993 to 2004, and Lilacs articles from 1995 to 2004 were selected in Portuguese, Spanish and English, by including the following keywords: breastfeeding, lactation, drugs and medicines. Other updated references found in articles and books were also included in this review, in order to provide additional information. SUMMARY OF THE FINDINGS: Most of the drugs are compatible with breastfeeding. Few were considered inadequate, such as antineoplastic drugs, radiopharmaceuticals and drugs of abuse. Some drugs require concern, as they may cause adverse effects in breastfed babies or reduce the mother's breast milk volume. However, further knowledge on some medicines during lactation is required. CONCLUSION: The fundamental principle in the prescription of medicines for lactating mothers is mostly based on the concept of risk and benefit. The option must be, as much as possible, for a drug that has already been studied, which is little released in the maternal milk or that does not mean an apparent risk for the infant's health. Medicines that reduce the mother's production of milk should be avoided during the lactation period. The use of galactogogos is reserved for particular situations. Therefore, only safety drugs should be administered during breastfeeding, which should rarely be discouraged or discontinued in such cases.

Breast Feeding↗
PubMed2004

[Recommendations for breastfeeding during maternal infections].

OBJECTIVE: To make a literature review on breastfeeding and maternal infectious diseases in order to contribute with knowledge and information that can aid the pediatrician to decide upon allowing infected mothers to breastfeed their babies or not. SOURCES OF DATA: Lilacs and MEDLINE databases were searched for books, technical rules and articles on the issue of breastfeeding and infected mothers. SUMMARY OF THE FINDINGS: Infected lactating mothers can transmit pathogenic agents to their infants. Although breastfeeding protects the child it can also be a dangerous source of infection. Maternal diseases caused by bacteria, virus, fungi and parasites may sometimes be transmitted via human milk. The literature points out that mothers infected with HIV and T-lymphotropic human viruses (type I) should not breastfeed. With other diseases a careful approach should be taken, but in general breastfeeding is maintained. CONCLUSION: The mother who is exposed to infectious diseases may transmit pathogenic agents through the human milk, attention should also be made to milk from milk banks. The healthcare provider must take his/her decision upon suspending breastfeeding -- or not, what can be distressful, once he/she has a fundamental role in promoting and stimulating breastfeeding.

Bacterial Infections↗
PubMedDate not supplied

[Emerging and reemerging rickettsiosis in an endemic area of Minas Gerais State, Brazil].

This article describes a serological survey for rickettsiosis in the county of Novo Cruzeiro, Minas Gerais State, Brazil, in 1998, testing schoolchildren and dogs. Sera included 331 samples from schoolchildren from an endemic area and 142 samples from schoolchildren from a non-endemic area in the county. All children examined were healthy and had not reported clinical symptoms of Brazilian spotted fever prior to the serological survey. Some 35 children in the endemic area were reactive to Rickettsia rickettsiiby indirect fluorescent antibody (IFA) with a titer of 1:64, corresponding to 10.6%. Sera from 73 dogs were tested, showing seroreactivity (IFA 1:64) to Rickettsia rickettsi, Ehrlichia chaffeensis, and Ehrlichia canisin 3 (4.11%), 11 (15.07%), and 13 (17.81%), respectively. The results in schoolchildren and the presence of canine seroreactivity to Ehrlichiaspecies that are potentially pathogenic to humans suggests the risk of transmission of other Rickettsiaein the study area.

Animals↗
PubMedDate not supplied

[Congenital generalized lipodystrophy].

OBJECTIVE: To present the major clinical and biochemical characteristics of congenital generalized lipodystrophy. DESCRIPTION: Eight infants with congenital generalized lipodystrophy were identified at the Endocrine and Nutritional Pediatric Disease Outpatient Clinics at Hospital de Clínicas, Universidade Federal de Minas Gerais (UFMG). Clinical manifestations common to all patients included muscle hypertrophy, generalized lipoatrophy, and acromegalic physical appearance. Acanthosis nigricans was identified in five patients, hepatosplenomegaly in six, hypertriglyceridemia and low levels of HDL cholesterol in seven, cardiac hypertrophy in one and diabetes mellitus in two patients. All patients are under dietetic and clinical control. COMMENTS: The phenotypic characteristics of congenital generalized lipodystrophy are well identified, which, in most cases, favors the clinical diagnosis. The congenital generalized lipodystrophy is a very unusual syndrome that illustrates the importance of the adipose tissue for the majority of metabolic processes. A better understanding of this syndrome may open new horizons in the research of more prevalent diseases such as diabetes mellitus and obesity.

Acromegaly↗
PubMedDate not supplied

[Overweight and obesity prevalence among children and adolescents from Northeast and Southeast regions of Brazil].

OBJECTIVE: To study the prevalence of obesity and overweight among children and adolescents from Northeast and Southeast regions of Brazil. METHODS: Data was collected form Life Pattern Research conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 1997. A sample of 3,317 children and 3,943 adolescents was studied according age groups. Overweight (adolescents) and obesity (adolescents and children) were defined according to World Health Organization recommendations. Z-test was used to compare prevalence among age groups, sex and geographic region. The cut-off point for statistical significance was 0.05. RESULTS: Overweight prevalence in adolescents was 1.7% in Northeast and 4.2% in Southeast. Obesity prevalence in adolescents was 6.6% and 8.4% in children and 8.2% and 11.9% in Northeast and Southeast, respectively. Considering both regions prevalence of obese female children was 10.3%, the rate of obese adolescents was 9.3% and overweight adolescents represented 3.0%. Among males prevalence was 9.2%, 7.3% and 2.6%, respectively. CONCLUSIONS: Obesity prevalence is lower in Northeast than Southeast among children with age from 2 to 17 years old. Overweight prevalence among adolescents was also lower in Northeast than in Southeast. The prevalence of obesity among younger than 2 and older than 18 years old was the same. Obesity prevalence is higher among breast-fed females. Among other age groups prevalence of obesity and overweight was the same for males and females. It is difficult to compare these results with other studies, since there are few populational studies and the criteria used to define overweight and obesity in children and adolescents varies in each study.

English Abstract↗
PubMedDate not supplied

[Does drug therapy in the postpartum period interfere with breastfeeding recommendations?]

OBJECTIVE: To study the frequency of medication use in the immediate postpartum period and to evaluate possible effects on breastfeeding. METHODS: A cross-sectional study was carried out with 2,173 women that gave birth in four hospitals in Belo Horizonte, a city in the southeast of Brazil, between July 1998 and July 1999. The sample was calculated by means of the data obtained from the Citýs Health Department according to the number of labors made in these four hospitals in 1995, which amounts to approximately 5% of the total number that usually occurs within a year. Women were randomized according to the calendar of epidemiological weeks. The interviews consisted of a questionnaire through which information about breastfeeding and sociodemographic data were obtained. In addition, the data were collected from motherś and newbornś medical records. The drugs were classified according to their compatibility and incompatibility with breastfeeding, and were monitored as to the possible adverse effects on newborn infants. RESULTS: 2,090 (96.2%) of 2,173 women received drug therapy in the immediate postpartum period. Among the drugs used, 2,054 (98.3%) were not contraindicated for breastfeeding; 338 (16.2%) did not contain safe information, and 3 (0.14%) were contraindicated. CONCLUSIONS: Although drug therapy was widespread among the mothers followed up at these four hospitals, there seems to be no influence on breastfeeding. Fortunately, most prescribed drugs did not interfere with motherś and infantś health.

Journal Article↗
PubMedDate not supplied

[Eating disorders in school children].

OBJECTIVE: To determine the prevalence of possible eating disorders and inappropriate eating behaviors in school children from six municipalities in the state of Minas Gerais, Brazil. METHODS: Cross-sectional study. The Bulimic Investigatory Test of Edinburgh (BITE), Eating Attitude Test (EAT), and Body Image Test were applied to 1,807 public school students with age ranging from 7 to 19 years. RESULTS: According to the EAT, 241 students (13.3%), mostly females, had inappropriate eating behaviors. Nineteen students (1.1%) had a BITE score indicating a possible diagnosis of bulimia nervosa. We found that 1,059 students (59%) were unhappy with their body image; 731 students (40%) were on a diet; and 1,014 (56%) exercised to loose weight. In addition, 218 students (12%) presented binge-eating and 175 students (10%) used purgative methods to control weight. CONCLUSIONS: We observed a high prevalence of possible eating disorders and inappropriate eating behaviors in the study population, especially among female adolescents. These results are similar to those reported for developed countries. The present findings are relevant for the clinical care of children and adolescents and can serve as the basis for future works aimed at increasing our understanding of the risk factors for these illnesses.

Adolescent↗
PubMedDate not supplied

[The impact of a breastfeeding promotion program at a health center].

OBJECTIVES: To determine the impact on breastfeeding sustained beyond two months of the "Seventeen Steps" breastfeeding maintenance program consisting of seventeen strategies used to promote, support and protect breastfeeding and implemented for ten months at a medical center. METHODS: Nonrandomized clinical trial, involving 147 children born between 01/01/99 and 31/12/2001, who had attended their first medical appointment before two months; 67 children who had passed through the traditional program were studied retrospectively and 80 that had the "17 steps" applied to them were studied prospectively. Maximum follow up period was ten months. The program's impact on breastfeeding was evaluated through survival analysis techniques. The survival curves were described by the Kaplan Meier method and compared with the log-rank test. The Cox regression model was used for covariate adjustment. The initial group comparison was done through the t, Kruskal-Wallis and Chi-squared tests. The significance level adopted was 5%. RESULTS: Adjusting for mother-child covariates, a significant difference was observed in breastfeeding duration between the two groups (p = 0.047). The relative risk of interrupting breastfeeding for the "17 steps" group was RR = 0.54 (95CI = 0.30-0.99), indicating that there was an 85% greater risk that children on the traditional program would be weaned before completing a year than there was that children on the "17 steps" program would be. CONCLUSION: The program had a positive impact on the duration of breastfeeding from two to twelve months of age.

Breast Feeding↗
PubMedDate not supplied

[Factors related to hospitalization due to injuries in children and adolescents].

OBJECTIVE: To analyze some factors related to injuries and children and adolescents' hospitalization. METHODS: This is a prospective, descriptive and observational research that took place at Marcio Cunha Hospital, Ipatinga, Minas Gerais, in the period of December 1st, 1999 to November 30th, 2000. The sample included 696 children and adolescents' hospitalized for injuries, age ranging from 0 to 19 years. The International Statistical Classification of Diseases and Related Health Problems (10th version) was used as a parameter to classify the types of injuries and sites where they happened. RESULTS: The injuries represented 9.9% of children and adolescents hospitalizations, of which, 69.7% were male patients. As for the informants opinion about causes of injuries, 57.2% attributed then to human failure, 18% believed they were due to fate and 12.7% did not know how to express their opinions. Only 23.1% of the informants had received previous orientation about prevention and the main sources were media, school and work place. A total of 31.9% of the events took place at home. Transportation injuries caused 34.5% of hospitalizations; falls, 33.2%; exposure to inanimate mechanical forces, 9%; contact with poisonous animals, 5.2%; aggression, 5%; burns, 4.9%; exposure to animated mechanical forces, 3.3%; intoxication, 2.3%; and other types, 2.6%. CONCLUSIONS: Males were more affected than females. Only a low percentage of the informants had received previous orientation about injury prevention. The most affected age group was between 15 and 19 years. Transportation accidents and falls were the most frequent causes of injuries.

Accidents↗
PubMedDate not supplied

[Pulmonary lesions and total parenteral nutrition in children admitted to a pediatric intensive care unit].

OBJECTIVE: To describe lung injuries in autopsied pediatric patients (neonates through 15 years old) subjected or not to total parenteral nutrition, in an intensive care unit. METHODS: Sections from six paraffin-embedded lung fragments, from 114 children were studied by routine staining. Demographic, clinical and therapeutic data were retrieved from the records. Statistical analysis was performed using Statistical Package for the Social Sciences. RESULTS: The 114 patients were divided in two groups: 50 who were treated with total parenteral nutrition with lipid emulsion and 64 who did not receive total parenteral nutrition. The two groups did not differ in gender (p = 0.654), age (p = 0.682) or body weight (p = 0.175), but duration of hospital stay (p = 0.000), prematurity (p = 0.008) and treatment with blood products (p = 0.009) were all higher in the group treated with total parenteral nutrition. All patients received mechanical ventilation during hospitalization. Chi-square comparisons showed that diffuse alveolar injury (p = 0.022), pulmonary fibrosis (p = 0.019), pneumocyte hyperplasia (p = 0.004), microthromboembolism (p = 0.047) and thrombophlebitis (0.033) all exhibited a significant relationship with total parenteral nutrition. However, a multivariate analysis by logistic regression, taking into account prematurity and duration of hospital stay, demonstrated that total parenteral nutrition was an independent factor only with respect of pulmonary fibrosis. CONCLUSION: Although lung injuries were significantly more frequent in children who had received total parenteral nutrition, it was impossible to conclude that the lipid infusion had a direct relationship with these injuries, because prematurity and duration of hospital stay were significant co-factors.

Adolescent↗