João Guilherme Bezerra Alves

Excesso de peso, atividade física e hábitos alimentares entre adolescentes de diferentes classes econômicas em Campina Grande (PB)

OBJECTIVE: To compare overweight and obesity, eating habits and life style among adolescents from different economic levels. METHODS: A cross-sectional study was undertaken with 588 adolescents from a public and a private school in Campina Grande, PB. They belonged to economic levels A1, A2 and B1(292) and C, D and E (296), according to the Brazilian Criteria of Economic Classification of the Brazilian Association of Research Iistitutes. Height and body weight were measured and Body Mass Index (BMI) was calculated; > p85 = overweight and > p95 = obesity. A questionnaire for assessment of leisure time, physical activity, time spent watching TV and eating habits was administered. RESULTS: Overweight and obesity were more common in the higher economic level than in the lower economic one; 31.4% versus 18.1% ; p < 0.001. Leisure time for physical activity was more present in adolescents with A1, A2 e B1 economic status. Watching TVdisclosed no difference between the two economic levels surveyed. Daily consumption of softs drinks, sweets and salty snacks were more common in the higher economic level but this was not associated with obesity. A low consumption of fruits was observed in all economic levels. CONCLUSION: Overweight and obesity are frequent among adolescents of Campina Grande, PB, as well as time spent watching TV and unhealthy eating habits, especially among those of the higher economic level.. The amount of time spent on leisure for physical activities was low, especially in the lower economic level.

Prevalence of high blood pressure and associated factors in students from public schools in Greater Metropolitan Recife, Pernambuco State, Brazil, 2006

The aim of this study was to identify the prevalence of systemic arterial hypertension (high blood pressure) and associated health factors in adolescents, using a cross-sectional, population-based, epidemiological design from April to September 2006, within a stratified sample according to school size and shift. Using the Portuguese version of the Global School-Based Student Health Survey questionnaire, 1,878 students from 29 public schools in Greater Metropolitan Recife, Pernambuco State, Brazil, were analyzed for: age, gender, body mass index, fruit, vegetable, alcohol, and tobacco consumption, as well as blood pressure, adopting the 1996 Task Force Report on High Blood Pressure in Children and Adolescents and Centers for Disease Control and Prevention parameters for nutritional status. Prevalence rates for high blood pressure, overweight, and obesity were 17.3%, 6.9%, and 3.7%, respectively. Factors associated with high blood pressure were: male gender, obesity, overweight, and lack of physical activity. Knowledge of factors associated with arterial hypertension in adolescents can help support health education campaigns.

Associação de fatores de risco para doenças cardiovasculares em adolescentes e seus pais

OBJECTIVES: to determine family risk factors aggregation for cardiovascular diseases focusing on overweight and obesity, sedentary lifestyle, smoking and arterial hypertension in adolescent groups and their parents. METHODS: cross sectional epidemiological study of 421 adolescents, students of the public school system in the city of Recife and their parents. Sample calculation based in the lower expected prevalence of the variables studied. Assessment protocol consisted of a structured questionnaire, anthropometry and arterial pressure reading. Variables association analysis performed by the chi-square method. RESULTS: 421 adolescents were assessed (173 males and 248 females; age median 16.0 ± 0.7 years old) overweight and obesity in 7.8% adolescents, 18.8% of fathers and 19.8% of mothers. Smoking habits were noted in 7.8% of adolescents, 14.7% of their fathers and 13.0% of their mothers. The presence of these risk factors in fathers and mothers have been associated with a higher frequency of these same factors in their children exception made related to arterial hypertension. CONCLUSIONS: a family correlation between obesity, smoking and sedentary lifestyle were determined, a finding consistent with other previous studies, confirming the significant influence of the family in the risk factors for cardiovascular disease.

Overweight and physical inactivity in children living in favelas in the metropolitan region of Recife, Brazil

OBJECTIVE To assess the prevalence of overweight and obesity and its association with physical activity levels in children living in favelas in the city of Recife, state of Pernambuco, Brazil. METHODS A cross-sectional study was performed with 973 children ranging from 7 to 10 years old, all from two favelas in Recife, Fragoso and Caranguejo (total population of 9,315); of the 973 children assessed, 733 were included in the study. Overweight was defined as body mass index (BMI) equal to or above the 85th percentile, and obesity as BMI equal to or above the 95th percentile, using Centers for Disease Control and Prevention growth charts. Physical activity level was assessed by the Physical Activity Questionnaire for Older Children (PAQ-C). Children with scores > or = 3 were considered active, while those with scores < 3 were considered inactive. RESULTS Of the 733 children studied, overweight and obesity were observed in 92 (12.6%). There was no statistical association between physical inactivity and sex, income, maternal schooling, number of siblings and hours of television. However, more children with physical inactivity were observed among overweight or obese children, 66/92 (71.6%) vs. 363/641 (56.7%) (p = 0.008). CONCLUSIONS The prevalence of overweight and obesity is high, and is associated with physical inactivity in children living in favelas in the city of Recife, Brazil.

Impact of immunization measures by the Family Health Program on infant mortality from preventable diseases in Olinda, Pernambuco State, Brazil.

This article analyzes the impact of the Family Health Program (FHP) on infant health in Olinda, Pernambuco State, Brazil, evaluating immunization and infant mortality from vaccine-preventable diseases. A time-series study was conducted with data from the principal health information systems, analyzing indicators before and after implementation of the FHP in 1995. The independent variable was year of birth, related to degree of population coverage by the FHP. Three periods were analyzed: 1990-1994 (prior), 1995-1996 (implementation phase: 0 to 30% coverage), and 1997-2002 (intervention: coverage of 38.6% to 54%). Trends in the indicators were analyzed by simple linear regression, testing significance with the t test. During the implementation period there was an increase in all the vaccination coverage rates (176% BCG, 223% polio, 52% DPT, 61% measures) and a decrease in infant mortality from preventable diseases (12.7 deaths/year), even without a decrease in absolute poverty in the municipality or an increase in either coverage by the public health care system or the sewage system. Improvement in the indicators demonstrates the effectiveness of FHP actions in the municipality.

Asma em escolares do Recife - comparação de prevalências: 1994-95 e 2002

OBJECTIVES: To describe the prevalence of asthma and asthma variants in schoolchildren from Recife in 2002, and to compare these data with data from 1994-95; to analyze the relationship between maternal schooling and the presence of asthma or worsening asthma; and to evaluate the diagnostic accuracy of the yearly prevalence of wheezing as an asthma indicator. METHODS: Cross-sectional study. A probabilistic sample of 3,086 and 2,774 13- and 14-year-old students answered a written questionnaire in 1994-95 and 2002, as part of the International Study of Asthma and Allergies in Childhood. RESULTS: The following prevalence rates were observed in 1994-95 and 2002, respectively: cumulative prevalence of referred asthma: 21 vs. 18.2%; cumulative prevalence of wheezing: 39 vs. 38%; yearly prevalence of wheezing: 19.7 vs. 19.4%; yearly prevalence of night cough: 31 vs. 38%; yearly prevalence of exercise-induced wheezing: 20.6 vs. 23.8%. The yearly prevalence of asthma attacks was 16.3% vs. 15.2% for 1 to 3 attacks; 2.7% vs. 1.2% for 4 to 12 attacks; and 1% vs. 0.4% for more than 12 attacks. The yearly prevalence of attacks that disturbed sleep was 13 and 10.3%. The yearly prevalence of attacks with compromised speech was 4.8 and 4.1%. Higher levels of maternal schooling were related to higher cumulative prevalence of referred asthma and to cumulative and yearly prevalence of wheezing. CONCLUSIONS: The prevalence of asthma and its severe forms is high in teenager students in Recife. It is also related to higher levels of maternal schooling.

Eventos adversos em Unidade de Terapia Intensiva Neonatal

This was a prospective, observational study conducted in a neonatal intensive care unit to determine the incidence of adverse events. A specific trigger tool instrument was used, based on the one from Vermont-Oxford Network. A total of 218 neonates were followed and AEs were detected in 183 (84%) of them, with a rate of 2,6 AE/patient. Thermoregulation disorders (29%), disorders of glycemic control (17,1%) and nosocomial infections (13,5%) were the most frequent. Some AE were associated with birth weight (p<0.05). The accidental extubations and nosocomial infections were associated with hospital days. The incidence of AEs is high, especially among neonates with very low birth weight. Best practices regarding preventive strategies are necessary to improve quality of health care for these infants.Estudio observacional, prospectivo para determinar la incidencia de eventos adversos (EAs) en la Unidad Neonatal de Cuidados Intensivos (UNCI). Fue utilizado un instrumento especifico adaptado del modelo americano Vermont-Oxford. De los 218 recien nacidos, el 84% presentaron EA, lo que corresponde a 2,6 EA / paciente. Trastornos de la termorregulacion (29%), trastornos de la glicemia (17,1%) e infeccion relacionada con el cuidado de la salud (IRCS) nosocomiales (13,5%) fueron los mas frecuentes. Algunos presentaron asociacion con el peso al nacer (p<0,05). El porcentaje de IRCS y la extubacion no programada fue directamente proporcional a la duracion de la estancia hospitalaria. La incidencia de EAs en la UNCI es alta entre los recien nacidos de muy bajo peso al nacer. La calidad de la asistencia es fundamental en el desarrollo de estrategias de prevencion.

Fetal Influences on Neonatal Blood Pressure

OBJECTIVE:To identify if there is a relationship between some newborn variables (baby’s sex, Apgar score, postnatal age, birth weight, birth length, and head circumference) and blood pressure (BP) in healthy term newborns.STUDY DESIGN:A cross-sectional hospital-based study was carried out to determine BP levels and a cutoff point for hypertension in healthy term newborns. Afterward, a comparative study was conducted to identify fetal factors that could influence BP in this specific group.RESULTS:According to the cutoff point (95th percentile), 34 infants were considered to be hypertensive. During the univariate analyses, infants with higher BP were heavier, longer, and had larger head circumference. After the multivariate analyses, birth weight was the only variable associated with higher BP in babies. Other newborn variables analyzed (baby’s sex, Apgar score, and postnatal age) showed no influence on the babies’ BP.CONCLUSION: There is a positive relationship between birth weight and BP in healthy term newborns.OBJECTIVE:To identify if there is a relationship between some newborn variables (baby’s sex, Apgar score, postnatal age, birth weight, birth length, and head circumference) and blood pressure (BP) in healthy term newborns.STUDY DESIGN:A cross-sectional hospital-based study was carried out to determine BP levels and a cutoff point for hypertension in healthy term newborns. Afterward, a comparative study was conducted to identify fetal factors that could influence BP in this specific group.RESULTS:According to the cutoff point (95th percentile), 34 infants were considered to be hypertensive. During the univariate analyses, infants with higher BP were heavier, longer, and had larger head circumference. After the multivariate analyses, birth weight was the only variable associated with higher BP in babies. Other newborn variables analyzed (baby’s sex, Apgar score, and postnatal age) showed no influence on the babies’ BP.CONCLUSION: There is a positive relationship between birth weight and BP in healthy term newborns.

Implementação do protocolo da Organização Mundial da Saúde para manejo da desnutrição grave em hospital no Nordeste do Brasil

To assess the implementation of WHO guidelines for managing severely malnourished hospitalized children, a case-series study was performed with 117 children from 1 to 60 months of age. A checklist was prepared according to steps in the guidelines and applied to each patient at discharge, thus assessing the procedures adopted during hospitalization. Daily spreadsheets on food and liquid intake, clinical data, prescribed treatment, and laboratory results were also used. 36 steps were evaluated, 24 of which were followed correctly in more than 80% of cases; the proportion was 50 to 80% for seven steps and less than 50% for five steps. Monitoring that required frequent physician and nursing staff bedside presence was associated with difficulties. With some minor adjustments, the guidelines can be followed without great difficulty and without compromising the more important objective of reducing case-fatality.

Consumo de álcool entre estudantes de escolas públicas da Região Metropolitana do Recife, Pernambuco, Brasil

This study analyzes alcohol consumption and health risk behaviors in adolescents, using a cross-sectional, population-based, epidemiological design from April to September 2006, within a sample stratified according to school size and shift. Using the Portuguese version of the Global School-Based Student Health Survey questionnaire, 1,878 students from 29 public schools in Greater Metropolitan Recife, Pernambuco State, Brazil, were analyzed by age, gender, alcohol consumption, lifetime history of intoxication, and negative consequences. Alcohol consumption in the previous 30 days was 29.8%. Adolescents reported easy acquisition of alcoholic beverages from commercial establishments and in social settings. Lifetime history of intoxication was reported by 30.5% of the students. Negative consequences were reported by 14.5%. Knowledge of risk behaviors for alcohol consumption by adolescents can provide backing for appropriate public polices in health education.