RESUMEN

OBJECTIVE: To review and discuss childhood and adolescence vulnerabilities, as well as Brazilian public policies of intervention. DATA SOURCES: A narrative review was performed, considering studies published between 1990 and 2012, found in the Virtual Health Library databases (Biblioteca Virtual em Saúde - BVS). A combination of the following descriptors was used in the search strategy: "Adolescent Health", "Child Health", "Health Public Politics" and "Vulnerability". In addition, Brazilian official documents, the Statute of the Child and the Adolescent, Guardianship Council, Bolsa Família and Saúde na Escola Programs were evaluated. DATA SYNTHESIS: The results were divided into five categories of analysis: Vulnerability of Children and Adolescents in Brazil, Public Politics of Intervention to Risk Factors in Childhood and Adolescence, the Statute of the Child and the Adolescent and Guardianship Council, Bolsa Família Program and Saúde na Escola Program. The studies show that children and adolescents are vulnerable to environmental and social situations. Vulnerabilities are exhibited in daily violence within families and schools, which results in the premature entrance of children and adolescents in the work environment and/or in the drug traffic. To deal with these problems, the Brazilian Government established the Statute of the Child and the Adolescent as well as social programs. CONCLUSIONS: Literature exposes the risks experienced by children and adolescents in Brazil. In the other hand, a Government endeavor was identified to eliminate or minimize the suffering of those in vulnerable situations through public policies targeted to this population group.

Asunto(s)

RESUMEN

OBJETIVO: Revisar e discutir as vulnerabilidades na infância e na adolescência, bem como as políticas públicas brasileiras de intervenção. FONTES DE DADOS: Realizou-se uma revisão narrativa, entre 1990 e 2012, em periódicos dos bancos de dados contidos na Biblioteca Virtual em Saúde (BVS). Aplicou-se a combinação dos seguintes descritores: "Saúde do Adolescente", "Saúde da Criança", "Políticas Públicas de Saúde" e "Vulnerabilidade". Além disso, documentos oficiais do Estado Brasileiro, Estatuto da Criança e do Adolescente, Criação dos Conselhos Tutelares, Programa Bolsa Família e o Programa Saúde na Escola foram avaliados. SÍNTESE DOS DADOS: Os resultados foram apresentados em cinco categorias de análise: As Vulnerabilidades das Crianças e Adolescentes no Brasil, Políticas Públicas de Intervenção aos Fatores de Risco na Infância e Adolescência, Estatuto da Criança e do Adolescente e o Conselho Tutelar, Programa Bolsa Família e Programa Saúde na Escola. As publicações revelaram que as crianças e adolescentes são vulneráveis às situações ambientais e sociais. As vulnerabilidades manifestam-se em violência cotidiana, no contexto familiar e escolar, obrigando crianças e adolescentes a se inserirem precocemente no mercado de trabalho e/ou no tráfico de drogas. Para o enfrentamento desses problemas, o Governo instituiu o Estatuto da Criança e do Adolescente, além de programas sociais. CONCLUSÕES: A literatura expõe os riscos vivenciados pelas crianças e adolescentes no Brasil. Em contrapartida, identificou-se o esforço do Governo para eliminar ou minimizar o sofrimento daqueles em situação de vulnerabilidade, por meio de políticas públicas direcionadas a esse contingente populacional.

OBJECTIVE: To review and discuss childhood and adolescence vulnerabilities, as well as Brazilian public policies of intervention. DATA SOURCES: A narrative review was performed, considering studies published between 1990 and 2012, found in the Virtual Health Library databases (Biblioteca Virtual em Saúde - BVS). A combination of the following descriptors was used in the search strategy: "Adolescent Health", "Child Health", "Health Public Politics" and "Vulnerability". In addition, Brazilian official documents, the Statute of the Child and the Adolescent, Guardianship Council, Bolsa Família and Saúde na Escola Programs were evaluated. DATA SYNTHESIS: The results were divided into five categories of analysis: Vulnerability of Children and Adolescents in Brazil, Public Politics of Intervention to Risk Factors in Childhood and Adolescence, the Statute of the Child and the Adolescent and Guardianship Council, Bolsa Família Program and Saúde na Escola Program. The studies show that children and adolescents are vulnerable to environmental and social situations. Vulnerabilities are exhibited in daily violence within families and schools, which results in the premature entrance of children and adolescents in the work environment and/or in the drug traffic. To deal with these problems, the Brazilian Government established the Statute of the Child and the Adolescent as well as social programs. CONCLUSIONS: Literature exposes the risks experienced by children and adolescents in Brazil. In the other hand, a Government endeavor was identified to eliminate or minimize the suffering of those in vulnerable situations through public policies targeted to this population group.

OBJETIVO: Revisar y discutir las vulnerabilidades en la infancia y adolescencia y las Políticas Públicas brasileñas de intervención. FUENTE DE DATOS: Se realizó una revisión narrativa, entre 1990 y 2012, en periódicos de las bases de datos contenidas en la Biblioteca Virtual de Salud (BVS). Se aplicó la combinación de los descriptores a continuación: Salud del Adolescente, Salud del Niño, Políticas Públicas de salud y vulnerabilidad. Además, documentos oficiales del Estado Brasileño, Estatuto del Niño y del Adolescente, Creación de los Consejos Tutelares, Programa de Auxilio a las Familias Carenciadas («Bolsa Família¼) y Programa de Salud en la Escuela fueron evaluados. SÍNTESIS DE LOS DATOS: Los resultados fueron presentados en cinco categorías de análisis: Las Vulnerabilidades de los Niños y Adolescentes en Brasil, Políticas Públicas de Intervención a los Factores de Riesgo en la Infancia y Adolescencia, Estatuto del Niño y del Adolescente y el Consejo Tutelar, Programa de Auxilio a las Familias Carenciadas («Bolsa Família¼) y Programa Salud en la Escuela. Las publicaciones revelaron que los niños y adolescentes son vulnerables a las situaciones ambientales y sociales. Las vulnerabilidades se manifiestan en violencia cotidiana, en el contexto familiar y escolar, obligando a los niños y adolescentes a insertarse tempranamente en el mercado laboral y/o en el tráfico de estupefacientes. Para el enfrentamiento de esos problemas el gobierno instituyó el Estatuto del Niño y del Adolescente, además de Programas Sociales. CONCLUSIONES: La literatura expone los riesgos vivenciados por niños y adolescentes en Brasil. Como contrapartida, se identificó un esfuerzo del Gobierno para eliminar o reducir el sufrimiento de aquellos en situación de vulnerabilidad mediante políticas públicas dirigidas a ese contingente de población.

Asunto(s)

RESUMEN

We describe a child who has central diabetes insipidus associated with congenital nasal pyriform aperture stenosis without any apparent anterior pituitary dysfunction. This association further strengthens the concept that congenital nasal pyriform aperture stenosis may be a microform of holoprosencephaly.

Asunto(s)

RESUMEN

OBJECTIVE: Premature infants have an ineffective epidermal barrier. The aim of this study was to investigate the cutaneous and systemic effects of preservative-free topical ointment therapy in premature infants. STUDY DESIGN: We conducted a prospective, randomized study of 60 infants less than 33 weeks' estimated gestational age. The treated infants received therapy for 2 weeks with twice-daily preservative-free topical ointment therapy while the control group received no topical treatment or as-needed therapy with a water-in-oil emollient. Data collection included transepidermal water loss (TEWL) measurement, skin condition evaluations, fungal and quantitative bacterial skin cultures, analysis of fluid requirements, patterns of weight low or gain, and the incidence of blood and cerebrospinal fluid cultures positive for microorganisms. RESULTS: We found that topical ointment therapy significantly decreased TEWL during the first 6 hours after the initial application. TEWL was decreased by 67% (p = 0.0001) when measured 30 minutes after application and 34% (p = 0.001) when measured 4 to 6 hours after application. We also observed significantly superior skin condition scores in the treated group on study days 7 and 14 (p = 0.001) and 0.0004, respectively). Quantitative bacterial cultures revealed significantly less colonization of the axilla on day 2, 3, or 4 and on day 14 (p = 0.008 and 0.04, respectively). The incidence of positive findings in blood and/or cerebrospinal fluid cultures was 3.3% in the treated group of infants versus 26.7% in the control group (p = 0.02). There was no statistical difference in the fluid requirements or patterns of weight gain or loss during the 2 weeks of the study. CONCLUSIONS: Preservative-free topical ointment therapy decreased TEWL for 6 hours after application, decreased the severity of dermatitis, and decreased bacterial colonization of axillary skin. Infants treated with ointment had fewer blood and cerebrospinal fluid cultures positive for microorganisms. These data support the use of topical ointment therapy in very premature infants during the first weeks after birth.

Asunto(s)

RESUMEN

It has been shown previously that individuals possessing the Gln353 allele of factor VII have significantly lower factor VIIc levels. In this population based study of Europeans, Afro-Caribbeans and Gujarati Indians, the Gln353 allele was associated with lower factor VIIc in all groups, carriers having factor VIIc levels 20-25% below the group mean. Although the Afro-Caribbeans had the lowest factor VIIc levels, the frequency of the Gln353 allele was not different from the European sample. However, in the Gujaratis, the frequency of the Gln353 allele was significantly higher than in the Europeans (0.25 compared to 0.09, P less than 0.001). Factor VIIc is known to be positively correlated with plasma triglyceride levels, although the Gujaratis, having the highest mean triglyceride levels, did not have the highest mean factor VIIc levels. On examination of the relationship between triglycerides and factor VIIc in the Gujaratis there was a correlation (r = 0.23, P = 0.13) in individuals homozygous for the factor VII Arg353 allele, but no correlation (r = 0.001, P = 0.5) among Gln353 carriers. This striking difference suggests that the effect of triglycerides on factor VIIc is genotype specific and thus provides an example of gene-environment interaction. The high frequency of the Gln353 allele, with its associated lack of relationship between triglyceride and factor VIIc levels, may explain the lower than expected factor VIIc levels in the Gujaratis.

Asunto(s)

RESUMEN

The 12-year-old Kung (""Bushman'') boy from South West Africa who has marked deficiency of red cell adenosine deaminase has been found to have 2 to 3% of enzyme activity in red blood cells, 10 to 12% in leukocytes, and 10 to 30% in cultured fibroblasts. The enzyme has ADA 1 electrophoretic mobility: SV40 transformation of cultured fibroblasts caused a decrease of ""tissue ADA'' and an increase in ""red cell ADA'' isozymes. A battery of investigations revealed that the child has normal humoral and cellular immunity. A family study showed that a sibling had the same level of red cell ADA and the parents had intermediate levels. Studies of the Kung population from which the child comes have shown that the allele responsible for the condition, and which we designate ADA8, is polymorphic.

Asunto(s)