Search

OBJECTIVE: The purpose of this study was to analyze the factors that influence of the time between birth and the beginning of breastfeeding, especially at the moment of the rapid HIV test results at hospital admission for delivery.METHODS: Cohort study of 932 pregnant women who underwent rapid HIV test admitted in the hospital for delivery in Baby-Friendly Hospitals. The survival curves of time from birth to the first feeding were estimated by the Kaplan-Meier method and the joint effect of independent variables by the Cox model with a hierarchical analysis. As the survival curves were not homogeneous among the five hospitals, hindering the principle of proportionality of risks, the data were divided into two groups according to the median time of onset of breastfeeding at birth in women undergoing rapid HIV testing.RESULTS: Hospitals with median time to breastfeeding onset at birth of up to 60 min were considered as early breastfeeding onset and those with higher medians were considered as late breastfeeding onset at birth. Risk factors common to hospitals considered to be with early and late breastfeeding onset at birth were: cesarean section (RR = 1.75 [95% CI: 1.38-2.22]; RR = 3.83 [95% CI: 3.03-4.85]) and rapid test result after birth (RR = 1.45 [95% CI: 1.12-1.89]; RR = 1.65 [95% CI: 1.35-2.02]), respectively; and hospitals with late onset: starting prenatal care in the third trimester (RR = 1.86 [95% CI: 1.16-2.97]).CONCLUSIONS: The onset of breastfeeding is postponed, even in Baby-Friendly Hospitals, when the results of the rapid HIV test requested in the maternity are not available at the time of delivery.

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJETIVOS: Realizar análise de sobrevida e avaliar, através de análise multivariada, a influência de diversas variáveis na sobrevida, definindo fatores prognósticos de pacientes pediátricos com tumores do sistema nervoso central (SNC) tratados em um único centro. MÉTODOS: Analisamos, retrospectivamente, a sobrevida de 103 crianças portadoras de tumores cerebrais primários, diagnosticadas consecutivamente no período entre janeiro de 2000 e dezembro de 2006. Análise multivariada de fatores influenciando a sobrevida global por regressão de Cox foi usada para definir possíveis fatores prognósticos. RESULTADOS: A mediana e a média de idade foram de 7,2 e 7,6 anos. Houve predominância do sexo masculino (relação 1,22:1). A maioria dos pacientes tinha meduloblastoma ou tumores neuroectodérmicos primitivos (PNET, 38%) ou astrocitomas de baixo grau (18%). As topografias mais comuns foram cerebelar (49%) e tronco cerebral (21%). A sobrevida, 5 anos após o diagnóstico, foi de 84% para astrocitomas de baixo grau e 51% para meduloblastomas e PNET. Fatores prognósticos para a sobrevida global foram histopatológico (astrocitomas de alto grau e ependimomas, razão de risco entre 3,7 e 3,9), cirurgia (razão de risco 0,5 para tumores completamente ressecados) e radioterapia (razão de risco 0,5 para pacientes que receberam radioterapia). CONCLUSÕES: A sobrevida global de pacientes pediátricos com tumores cerebrais neste estudo é comparável àquela dos registros populacionais dos Estados Unidos e Europa. Os fatores de prognóstico definidos para sobrevida global também se assemelham àqueles previamente publicados.

OBJETIVOS: Avaliar a experiência dos primeiros 10 anos de transplante hepático em crianças e adolescentes do Serviço de Transplante Hepático do Instituto Alfa de Gastroenterologia do Hospital das Clínicas da Universidade Federal de Minas Gerais. MÉTODOS: Estudo descritivo de 84 pacientes menores de 18 anos inscritos em lista para transplante, no período de março de 1995 a janeiro de 2006, quanto às seguintes variáveis: idade, indicação do transplante, escores de gravidade (Child-Pugh, Malatack, PELD/MELD), tempo de espera em lista, complicações pós-operatórias e sobrevida. RESULTADOS: De 84 pacientes inscritos, 40 foram submetidos ao transplante, ocorrendo dois retransplantes. Vinte e seis faleceram na lista de espera. A atresia biliar foi a indicação mais freqüente. A mediana da idade no momento do transplante foi de 6,6 anos (variou de 1,9 a 16,8 anos). A mortalidade no pós-transplante foi de 32,5% (13 de 40 crianças). O tempo de espera em lista dos 40 pacientes transplantados apresentou mediana de 291 dias. As complicações relacionadas ao enxerto ocorreram em 24 dos 42 transplantes (57,1%), sendo que as vasculares representaram 30,8%, prevalecendo a trombose da artéria hepática (16,6%); episódio de rejeição aguda ocorreu em 16,6% dos casos. CONCLUSÃO: Os resultados encontrados são semelhantes ao que é observado na literatura em relação às indicações e sobrevida no pós-transplante. No entanto, houve elevada taxa de complicações não relacionadas ao enxerto e daquelas relacionadas à artéria hepática.OBJECTIVES: To evaluate the first 10 years' experience of the liver transplantation department at the Alfa Institute, Hospital das Clínicas da Universidade Federal de Minas Gerais, Brazil. METHODS: A descriptive study, based on a retrospective analysis of 84 children and adolescents enrolled on a liver transplantation waiting list, from March 1995 to January 2006, based on the following variables: age, etiology of underlying liver disease, Child-Pugh, Malatack, model for end-stage liver disease (MELD) and pediatric end-stage liver disease (PELD) scores, time on waiting list, complications and survival after the procedure. RESULTS: Forty children had 42 liver transplants. Twenty six died while on the waiting list. Biliary atresia was the most frequent indication for transplant. The median age was 6.6 years (ranging from 1.9 to 16.8 years). Post liver transplant mortality was 32.5% (13 of 40 children). The median time on the liver transplant waiting list was 291 days. Complications related to the graft occurred in 24 of 42 transplants (57.1%), including vascular complications (30.8%), with thrombosis of the hepatic artery being the most frequent (16.6%); acute rejection occurred in 16.6%. CONCLUSIONS: The overall results are similar to what can be found in the literature with relation to indications and post-transplant survival. However, there were elevated rates of complications unrelated to the graft and of complications involving the hepatic artery.

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Objective: To describe a historical series on the median duration of breastfeeding in a population of mothers whose children were born from the 1960s onwards, identifying factors associated with the interruption of breastfeeding in each decade. Methods: Data were analyzed from the Pró-Saúde Study, a longitudinal epidemiological investigation started in 1999 among technical and administrative employees of a university in the state of Rio de Janeiro. Breastfeeding duration was collected in two study phases: Phase 1 (1999), and phase 4 (2011-2012). Of these, those who had at least one child and reported the duration of breastfeeding for the first child were selected (n = 1539). To analyze the duration of breastfeeding, survival curves were constructed using the Kaplan-Meier method and the effect of covariates on the duration of breastfeeding was estimated by Cox regression model. Results: It was found that the median duration of breastfeeding was higher in the 1990s and 2000s and lower in the 1970s, compared to the 1960s. In addition, there was an association between higher income and maternal age with breastfeeding interruption, which was focused in the 1970s. Conclusion: There was shorter duration of breastfeeding in the 1970s compared to the 1960s. Increased duration and prevalence of breastfeeding from the 1970s onwards coincided with the national trend and the promotion of this practice since 1980.

Objective: To describe a historical series on the median duration of breastfeeding in a population of mothers whose children were born from the 1960s onwards, identifying factors associated with the interruption of breastfeeding in each decade., Methods: Data were analyzed from the Pró-Saúde Study, a longitudinal epidemiological investigation started in 1999 among technical and administrative employees of a university in the state of Rio de Janeiro. Breastfeeding duration was collected in two study phases: Phase 1 (1999), and phase 4 (2011-2012). Of these, those who had at least one child and reported the duration of breastfeeding for the first child were selected (n=1539). To analyze the duration of breastfeeding, survival curves were constructed using the Kaplan-Meier method and the effect of covariates on the duration of breastfeeding was estimated by Cox regression model., Results: It was found that the median duration of breastfeeding was higher in the 1990s and 2000s and lower in the 1970s, compared to the 1960s. In addition, there was an association between higher income and maternal age with breastfeeding interruption, which was focused in the 1970s., Conclusion: There was shorter duration of breastfeeding in the 1970s compared to the 1960s. Increased duration and prevalence of breastfeeding from the 1970s onwards coincided with the national trend and the promotion of this practice since 1980., (Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Objective: The purpose of this study was to analyze the factors that influence of the time between birth and the beginning of breastfeeding, especially at the moment of the rapid HIV test results at hospital admission for delivery., Methods: Cohort study of 932 pregnant women who underwent rapid HIV test admitted in the hospital for delivery in Baby-Friendly Hospitals. The survival curves of time from birth to the first feeding were estimated by the Kaplan-Meier method and the joint effect of independent variables by the Cox model with a hierarchical analysis. As the survival curves were not homogeneous among the five hospitals, hindering the principle of proportionality of risks, the data were divided into two groups according to the median time of onset of breastfeeding at birth in women undergoing rapid HIV testing., Results: Hospitals with median time to breastfeeding onset at birth of up to 60 min were considered as early breastfeeding onset and those with higher medians were considered as late breastfeeding onset at birth. Risk factors common to hospitals considered to be with early and late breastfeeding onset at birth were: cesarean section (RR=1.75 [95% CI: 1.38-2.22]; RR=3.83 [95% CI: 3.03-4.85]) and rapid test result after birth (RR=1.45 [95% CI: 1.12-1.89]; RR=1.65 [95% CI: 1.35-2.02]), respectively; and hospitals with late onset: starting prenatal care in the third trimester (RR=1.86 [95% CI: 1.16-2.97])., Conclusions: The onset of breastfeeding is postponed, even in Baby-Friendly Hospitals, when the results of the rapid HIV test requested in the maternity are not available at the time of delivery., (Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)