This study aimed to evaluate fluid intake and urinary osmolality in pediatric patients with funct... more This study aimed to evaluate fluid intake and urinary osmolality in pediatric patients with functional constipation. This was a cross-sectional, case–control study that prospectively included two groups: 36 pediatric patients older than 4 years with functional constipation (Rome III criteria) who were consecutively admitted in a public tertiary pediatric gastroenterology outpatient clinic and 93 controls with normal bowel habits. The control group was recruited from a public school and did not have any of the characteristics of the Rome III criteria. Fluid and food intakes were assessed using a daily diet inquiry and 24 h recording method. Hypohydration was defined as osmolality greater than 800 mOsm/kg H2O in a spot urine sample. The age of the functional constipation group (median, 8.9 years; range 7.3–10.0 years) and the control group (8.8 years) was similar (p = 0.51). The proportion of boys in the functional constipation group (76.6%; 25/36) was higher (p = 0.01) than that in the control group (45.2%; 41/93). The total water intake of the functional constipation group (median 1566 mL) was lower (p < 0.001) than that of the control group (median 2177 mL). Urinary osmolality was higher (p = 0.039) in the functional constipation group (median 859 mOsm/kg H2O) than in the control group (median 775 mOsm/kg H2O). The association between hypohydration and functional constipation did not reach statistical significance (Odds ratio 2.06; 95% confidence interval 0.93–4.55; p = 0.073). Compared to the control group, patients with functional constipation have lower fluid intake and higher urinary osmolality.
BACKGROUND It is possible that imbalances in the composition of the gut microbiota or the relatio... more BACKGROUND It is possible that imbalances in the composition of the gut microbiota or the relationship of the microbiota with the host may be implicated in the origin of allergy. Therefore, we studied the intestinal microbiota of children with atopic dermatitis (AD). METHODS Cross-sectional study with 81 children aged 5-11; 23 with AD and 58 controls. Surveys were conducted to obtain demographic, socioeconomic and neonatal data. Diagnosis of AD was made based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Eubacteria, Bacteroidetes, Firmicutes, B. fragilis, E. coli, Lactobacillus spp., S. aureus, E. faecalis, Salmonella spp., M. smithii, Bifidobacterium spp., C. difficile and C. perfringens were quantified using real-time PCR. RESULTS The analysis showed an association between presence of C. difficile (OR: 5.88; 95 % CI: 1.24; 27.98), greater abundance of bifidobacteria (OR: 11.09; 95 % CI: 2.14; 57.39) and a lower abundance of lactobacilli (OR: 0.07; 95 % CI: 0.01; 0.51) in the gut microbiota of children with AD. Counts of Eubacteria (0,05×103 and 8.49×103), B. fragilis (0.72×109 and 4.5×109), Lactobacillus spp. (0.02×108 and 0.38×108), E. coli (0.13×109 and 1.52×109) and M. smithii (0.02×108 and 0.31×108) were lower in children with AD (P<0.05). CONCLUSIONS This study confirmed that children living in the metropolitan area of São Paulo (Brazil) with AD have a different microbiota pattern with higher prevalence of C. difficile, lower abundance of Lactobacillus and greater abundance of bifidobacteria, regardless of socioeconomic status.
To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary schoo... more To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary school students from two public educational institutions in the metropolitan region of Sã o Paulo and evaluate whether there is a relationship between voluntary dehydration and nutritional status or socioeconomic status. METHODS: Analytical cross-sectional study with students from two public schools in the city of Osasco. The determination of urine osmolarity was performed using the freezing method of the Advanced s Osmometer Model 3W2. Urine osmolarity greater than 800 mOsm/kg H 2 O was considered voluntary dehydration. During data collection, the weights and heights of the students, environmental temperatures and air humidity levels were obtained. RESULTS: A total of 475 students aged six to 12 years were evaluated, of whom 188 were male. Voluntary dehydration occurred in 63.2% of the students and was more frequent in males than in females. The prevalence of voluntary dehydration was more frequent in males aged six to nine years than in females. However, no statistically significant difference was observed between males and females aged 10 to 12 years. No association was found between voluntary dehydration and nutritional status or socioeconomic status. CONCLUSION: The prevalence of voluntary dehydration was high in elementary school students and was more frequent in males. No association was found between voluntary dehydration and nutritional or socioeconomic status.
Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município ... more Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia.
This study evaluated the breath CH4excretion and concentration ofM. smithiiin intestinal microbio... more This study evaluated the breath CH4excretion and concentration ofM. smithiiin intestinal microbiota of schoolchildren from 2 slums. One hundred and eleven children from a slum near a sanitary landfill, 35 children of a slum located away from the sanitary landfill, and 32 children from a high socioeconomic level school were included in the study. Real-time PCR was performed to quantify theM. smithii nifHgene and it was present in the microbiota of all the participating children, with higherP<0.05concentrations in those who lived in the slum near the landfill (3.16×107 CFU/g of feces), comparing with the children from the slum away from the landfill (2.05×106 CFU/g of feces) and those from the high socioeconomic level group (3.93×105 CFU/g of feces). The prevalence of children who present breath methane was 53% in the slum near the landfill, 31% in the slum further away from the landfill and, 22% in the high socioeconomic level group. To live near a landfill is associated with high...
The original version of this article unfortunately contained a mistake in the row 'only boys' und... more The original version of this article unfortunately contained a mistake in the row 'only boys' under the heading 'Dietary fiber (g/day)' and in the row 'only girls' under the heading 'Carbohydrate' (g/day). The corrected Table 2 is given below.
Journal of Pediatric Gastroenterology and Nutrition, 2013
Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with s... more Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.
To study the evidence on the role of water and fluid intake in the prevention and treatment of fu... more To study the evidence on the role of water and fluid intake in the prevention and treatment of functional intestinal constipation in children and adolescents. A search was carried out in the Medline database (between 1966 and 2016) for all published articles containing the following words: constipation, water, and fluids, published in Portuguese, English, and Spanish. All original articles that assessed children and adolescents were selected by title and abstract. The references of these articles were also evaluated. A total of 1040 articles were retrieved. Of these, 24 were selected for reading. The study included 11 articles that assessed children and adolescents. The articles were divided into two categories, those that evaluated water and fluid intake as a risk factor for intestinal constipation and those that evaluated their role in the treatment of intestinal constipation. Five articles were included in the first category. The criteria for assessing fluid intake and bowel rhyt...
AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationshi... more AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests. METHODS: This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H2) and methane (CH4) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H2 ≥ 20 ppm or CH4 ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion. RESULTS: Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methaneproducing children (P = 0.017). CONCLUSION: Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.
To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with o... more To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with or without small intestinal bacterial overgrowth, and to investigate the occurrence of stunting and anemia. A total of 100 children were studied, aged 5-11 years, from the municipality of Osasco, São Paulo. Small intestinal bacterial overgrowth was screened through hydrogen and methane breath test with lactulose. Weight and height were measured, and the height-for-age and body mass-for-age anthropometric indexes were calculated. The occurrence of anemia was investigated by capillary hemoglobin. Analysis of bacterial phylum, genus, and species was performed by real-time polymerase chain reaction in fecal samples. Small intestinal bacterial overgrowth was identified in 61.0% of the children. A lower mean of height-for-age Z-score ([-0.48±0.90] vs. [-0.11±0.97]; p=0.027), as well as capillary hemoglobin ([12.61±1.03g/dL] vs. [13.44±1.19g/dL]; p<0.001) was demonstrated in children with SIB...
OBJETIVO: Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores soc... more OBJETIVO: Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores socioeconômicos e ambientais, peso, estatura e hemoglobina, em crianças de dois estratos socioeconômicos, no município de Osasco (SP). MÉTODOS: Estudo transversal, ...
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Purpose: The aim of this study was to investigate the presence of diarrheagenic Escherichia coli ... more Purpose: The aim of this study was to investigate the presence of diarrheagenic Escherichia coli and antibiotic resistance in asymptomatic school-age children living in an area with defective environmental sanitation, comparing with children registered at a private school, both in the city of Osasco, Brazil. Methods: Seventy-nine school-age children between 5 and 10 years living in a slum and 35 children who attended a private school of the same city were included in the study. Results: DEC was found in 58% of the children living in the slum and in 17% of the control group (P Z 0.001). Resistance to at least one antimicrobial drug was found in 65% of DEC strains; resistant to two or more antimicrobial drugs was found in 46% of strains. Conclusion: The high carriage status among the slum children point towards the widespread environment contamination in low socio-economic housing conditions, in conformance with the pediatric population at higher risk for developing DEC diarrhea.
To determine the number of lactobacillus and bifidobacterium colonies in the feces of schoolchild... more To determine the number of lactobacillus and bifidobacterium colonies in the feces of schoolchildren from two different socioeconomic levels.
OBJETIVO: Determinar o número de colônias de lactobacilos e bifidobactérias nas fezes de crianças... more OBJETIVO: Determinar o número de colônias de lactobacilos e bifidobactérias nas fezes de crianças escolares, pertencentes a dois estratos socioeconômicos. MÉTODOS: Foram analisadas amostras de fezes de crianças com idade entre 6 e 10 anos sem sintomas gastrointestinais ou uso recente de antimicrobianos. O primeiro grupo foi constituído por 86 crianças, moradoras em uma favela localizada no município de Osasco (SP). O segundo grupo foi constituído por 36 crianças matriculadas em uma escola particular da mesma cidade. O estado nutricional foi avaliado usando o índice de massa corporal (IMC) de acordo com os valores de referência do National Center for Health Statistics (NCHS). O isolamento das colônias foi realizado em meios de cultura específicos em anaerobiose, durante 48 e 72 horas a 37 °C. A determinação do número foi feita pelo método da contagem em placa. RESULTADOS: A mediana de lactobacilos (1,125 x 109 unidades formadoras de colônia, UFC/g) e bifidobactérias (1,675 x 109 UFC/g) na escola particular foi superior (p 9 e 0,350 x 109 UFC/g, respectivamente. No grupo da favela, crianças com escore z de IMC < -1,0 desvio padrão (n = 28) apresentaram menor mediana (p 9 UFC/g) e bifidobactérias (0,095 x 109 UFC/g) em relação às crianças com IMC > -1,0 desvio padrão (n = 57): 0,350 x 109 e 0,420 x 109 UFC/g, respectivamente. CONCLUSÃO: A microbiota de crianças escolares que moram em condições ambientais desfavoráveis apresenta menor número de colônias de lactobacilos e bifidobactérias nas fezes, especialmente naquelas com menores valores do IMC.
Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town o... more Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and Methods: This is a descriptive observational study with two different designs, the first using individuals as the unit of study, and the other ecological, using groups of individuals as units of observation and including time series analysis.
This study aimed to evaluate fluid intake and urinary osmolality in pediatric patients with funct... more This study aimed to evaluate fluid intake and urinary osmolality in pediatric patients with functional constipation. This was a cross-sectional, case–control study that prospectively included two groups: 36 pediatric patients older than 4 years with functional constipation (Rome III criteria) who were consecutively admitted in a public tertiary pediatric gastroenterology outpatient clinic and 93 controls with normal bowel habits. The control group was recruited from a public school and did not have any of the characteristics of the Rome III criteria. Fluid and food intakes were assessed using a daily diet inquiry and 24 h recording method. Hypohydration was defined as osmolality greater than 800 mOsm/kg H2O in a spot urine sample. The age of the functional constipation group (median, 8.9 years; range 7.3–10.0 years) and the control group (8.8 years) was similar (p = 0.51). The proportion of boys in the functional constipation group (76.6%; 25/36) was higher (p = 0.01) than that in the control group (45.2%; 41/93). The total water intake of the functional constipation group (median 1566 mL) was lower (p < 0.001) than that of the control group (median 2177 mL). Urinary osmolality was higher (p = 0.039) in the functional constipation group (median 859 mOsm/kg H2O) than in the control group (median 775 mOsm/kg H2O). The association between hypohydration and functional constipation did not reach statistical significance (Odds ratio 2.06; 95% confidence interval 0.93–4.55; p = 0.073). Compared to the control group, patients with functional constipation have lower fluid intake and higher urinary osmolality.
BACKGROUND It is possible that imbalances in the composition of the gut microbiota or the relatio... more BACKGROUND It is possible that imbalances in the composition of the gut microbiota or the relationship of the microbiota with the host may be implicated in the origin of allergy. Therefore, we studied the intestinal microbiota of children with atopic dermatitis (AD). METHODS Cross-sectional study with 81 children aged 5-11; 23 with AD and 58 controls. Surveys were conducted to obtain demographic, socioeconomic and neonatal data. Diagnosis of AD was made based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Eubacteria, Bacteroidetes, Firmicutes, B. fragilis, E. coli, Lactobacillus spp., S. aureus, E. faecalis, Salmonella spp., M. smithii, Bifidobacterium spp., C. difficile and C. perfringens were quantified using real-time PCR. RESULTS The analysis showed an association between presence of C. difficile (OR: 5.88; 95 % CI: 1.24; 27.98), greater abundance of bifidobacteria (OR: 11.09; 95 % CI: 2.14; 57.39) and a lower abundance of lactobacilli (OR: 0.07; 95 % CI: 0.01; 0.51) in the gut microbiota of children with AD. Counts of Eubacteria (0,05×103 and 8.49×103), B. fragilis (0.72×109 and 4.5×109), Lactobacillus spp. (0.02×108 and 0.38×108), E. coli (0.13×109 and 1.52×109) and M. smithii (0.02×108 and 0.31×108) were lower in children with AD (P<0.05). CONCLUSIONS This study confirmed that children living in the metropolitan area of São Paulo (Brazil) with AD have a different microbiota pattern with higher prevalence of C. difficile, lower abundance of Lactobacillus and greater abundance of bifidobacteria, regardless of socioeconomic status.
To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary schoo... more To evaluate the prevalence of voluntary dehydration based on urine osmolarity in elementary school students from two public educational institutions in the metropolitan region of Sã o Paulo and evaluate whether there is a relationship between voluntary dehydration and nutritional status or socioeconomic status. METHODS: Analytical cross-sectional study with students from two public schools in the city of Osasco. The determination of urine osmolarity was performed using the freezing method of the Advanced s Osmometer Model 3W2. Urine osmolarity greater than 800 mOsm/kg H 2 O was considered voluntary dehydration. During data collection, the weights and heights of the students, environmental temperatures and air humidity levels were obtained. RESULTS: A total of 475 students aged six to 12 years were evaluated, of whom 188 were male. Voluntary dehydration occurred in 63.2% of the students and was more frequent in males than in females. The prevalence of voluntary dehydration was more frequent in males aged six to nine years than in females. However, no statistically significant difference was observed between males and females aged 10 to 12 years. No association was found between voluntary dehydration and nutritional status or socioeconomic status. CONCLUSION: The prevalence of voluntary dehydration was high in elementary school students and was more frequent in males. No association was found between voluntary dehydration and nutritional or socioeconomic status.
Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município ... more Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia.
This study evaluated the breath CH4excretion and concentration ofM. smithiiin intestinal microbio... more This study evaluated the breath CH4excretion and concentration ofM. smithiiin intestinal microbiota of schoolchildren from 2 slums. One hundred and eleven children from a slum near a sanitary landfill, 35 children of a slum located away from the sanitary landfill, and 32 children from a high socioeconomic level school were included in the study. Real-time PCR was performed to quantify theM. smithii nifHgene and it was present in the microbiota of all the participating children, with higherP<0.05concentrations in those who lived in the slum near the landfill (3.16×107 CFU/g of feces), comparing with the children from the slum away from the landfill (2.05×106 CFU/g of feces) and those from the high socioeconomic level group (3.93×105 CFU/g of feces). The prevalence of children who present breath methane was 53% in the slum near the landfill, 31% in the slum further away from the landfill and, 22% in the high socioeconomic level group. To live near a landfill is associated with high...
The original version of this article unfortunately contained a mistake in the row 'only boys' und... more The original version of this article unfortunately contained a mistake in the row 'only boys' under the heading 'Dietary fiber (g/day)' and in the row 'only girls' under the heading 'Carbohydrate' (g/day). The corrected Table 2 is given below.
Journal of Pediatric Gastroenterology and Nutrition, 2013
Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with s... more Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.
To study the evidence on the role of water and fluid intake in the prevention and treatment of fu... more To study the evidence on the role of water and fluid intake in the prevention and treatment of functional intestinal constipation in children and adolescents. A search was carried out in the Medline database (between 1966 and 2016) for all published articles containing the following words: constipation, water, and fluids, published in Portuguese, English, and Spanish. All original articles that assessed children and adolescents were selected by title and abstract. The references of these articles were also evaluated. A total of 1040 articles were retrieved. Of these, 24 were selected for reading. The study included 11 articles that assessed children and adolescents. The articles were divided into two categories, those that evaluated water and fluid intake as a risk factor for intestinal constipation and those that evaluated their role in the treatment of intestinal constipation. Five articles were included in the first category. The criteria for assessing fluid intake and bowel rhyt...
AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationshi... more AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests. METHODS: This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H2) and methane (CH4) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H2 ≥ 20 ppm or CH4 ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion. RESULTS: Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methaneproducing children (P = 0.017). CONCLUSION: Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.
To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with o... more To analyze the fecal microbiota composition of children living in an urban slum in Brazil, with or without small intestinal bacterial overgrowth, and to investigate the occurrence of stunting and anemia. A total of 100 children were studied, aged 5-11 years, from the municipality of Osasco, São Paulo. Small intestinal bacterial overgrowth was screened through hydrogen and methane breath test with lactulose. Weight and height were measured, and the height-for-age and body mass-for-age anthropometric indexes were calculated. The occurrence of anemia was investigated by capillary hemoglobin. Analysis of bacterial phylum, genus, and species was performed by real-time polymerase chain reaction in fecal samples. Small intestinal bacterial overgrowth was identified in 61.0% of the children. A lower mean of height-for-age Z-score ([-0.48±0.90] vs. [-0.11±0.97]; p=0.027), as well as capillary hemoglobin ([12.61±1.03g/dL] vs. [13.44±1.19g/dL]; p<0.001) was demonstrated in children with SIB...
OBJETIVO: Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores soc... more OBJETIVO: Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores socioeconômicos e ambientais, peso, estatura e hemoglobina, em crianças de dois estratos socioeconômicos, no município de Osasco (SP). MÉTODOS: Estudo transversal, ...
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no mun... more Resumo Objetivo: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. Métodos: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. Resultados: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. Conclusão: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia. J Pediatr (Rio J). 2009;85(1):21-27: Diarreia, mortalidade na infância, séries temporais, indicadores sociais, indicadores econômicos. Abstract Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and 2000.
Purpose: The aim of this study was to investigate the presence of diarrheagenic Escherichia coli ... more Purpose: The aim of this study was to investigate the presence of diarrheagenic Escherichia coli and antibiotic resistance in asymptomatic school-age children living in an area with defective environmental sanitation, comparing with children registered at a private school, both in the city of Osasco, Brazil. Methods: Seventy-nine school-age children between 5 and 10 years living in a slum and 35 children who attended a private school of the same city were included in the study. Results: DEC was found in 58% of the children living in the slum and in 17% of the control group (P Z 0.001). Resistance to at least one antimicrobial drug was found in 65% of DEC strains; resistant to two or more antimicrobial drugs was found in 46% of strains. Conclusion: The high carriage status among the slum children point towards the widespread environment contamination in low socio-economic housing conditions, in conformance with the pediatric population at higher risk for developing DEC diarrhea.
To determine the number of lactobacillus and bifidobacterium colonies in the feces of schoolchild... more To determine the number of lactobacillus and bifidobacterium colonies in the feces of schoolchildren from two different socioeconomic levels.
OBJETIVO: Determinar o número de colônias de lactobacilos e bifidobactérias nas fezes de crianças... more OBJETIVO: Determinar o número de colônias de lactobacilos e bifidobactérias nas fezes de crianças escolares, pertencentes a dois estratos socioeconômicos. MÉTODOS: Foram analisadas amostras de fezes de crianças com idade entre 6 e 10 anos sem sintomas gastrointestinais ou uso recente de antimicrobianos. O primeiro grupo foi constituído por 86 crianças, moradoras em uma favela localizada no município de Osasco (SP). O segundo grupo foi constituído por 36 crianças matriculadas em uma escola particular da mesma cidade. O estado nutricional foi avaliado usando o índice de massa corporal (IMC) de acordo com os valores de referência do National Center for Health Statistics (NCHS). O isolamento das colônias foi realizado em meios de cultura específicos em anaerobiose, durante 48 e 72 horas a 37 °C. A determinação do número foi feita pelo método da contagem em placa. RESULTADOS: A mediana de lactobacilos (1,125 x 109 unidades formadoras de colônia, UFC/g) e bifidobactérias (1,675 x 109 UFC/g) na escola particular foi superior (p 9 e 0,350 x 109 UFC/g, respectivamente. No grupo da favela, crianças com escore z de IMC < -1,0 desvio padrão (n = 28) apresentaram menor mediana (p 9 UFC/g) e bifidobactérias (0,095 x 109 UFC/g) em relação às crianças com IMC > -1,0 desvio padrão (n = 57): 0,350 x 109 e 0,420 x 109 UFC/g, respectivamente. CONCLUSÃO: A microbiota de crianças escolares que moram em condições ambientais desfavoráveis apresenta menor número de colônias de lactobacilos e bifidobactérias nas fezes, especialmente naquelas com menores valores do IMC.
Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town o... more Objective: To analyze the trend in mortality due to diarrhea among children under 5 in the town of Osasco (SP), Brazil, between 1980 and Methods: This is a descriptive observational study with two different designs, the first using individuals as the unit of study, and the other ecological, using groups of individuals as units of observation and including time series analysis.
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