RESUMEN
Objectives: The aim of this study was to evaluate neurodevelopmental outcomes (motor development, nonverbal intelligence, and attention) in children with cyanotic congenital heart disease (CHD) compared with healthy children from a public hospital in southern Brazil. Materials and Methods: This was a cross-sectional study with pediatric patients of both sexes: 37 children with cyanotic CHD and a control group with 38 healthy children. Parents/guardians undertook a questionnaire and the SNAP IV scale (to evaluate attention) was applied. Two instruments were applied to each child: the R-2 Non-Verbal Intelligence test and the motor development scale. To assess the factors associated with insufficient performance in the three fields of neurodevelopment, a Poisson regression analysis was performed with a robust estimate. Results: There were no significant differences between children with cyanotic CHD and the control group for any of the neurodevelopmental outcomes studied. Low socioeconomic class was a factor associated with worse performance on the intelligence test and inattention. Furthermore, age was a factor for performance on the intelligence test, while a greater number of siblings was a factor associated with worse performance on the attention test. Conclusions: Public policies regarding child health must involve prioritizing the improvement of families' social conditions.
Asunto(s)
Cardiopatías Congénitas , Masculino , Femenino , Humanos , Niño , Brasil/epidemiología , Estudios Transversales , Cardiopatías Congénitas/complicaciones , Cognición , PadresRESUMEN
Growing evidence suggests that early-life events can predispose the newborn to a variety of health problems in postnatal life, which can lead to the need for specialized care in the neonatal intensive care unit (NICU). These events may be caused by factors intrinsically related to the mother (i.e., lifestyle, socioeconomic conditions), and this interplay between maternal exposure factors and negative outcomes in the neonate can be efficiently monitored through effect biomarkers, such as DNA damage. Thus, the present study aimed to evaluate the DNA damage and the maternal and neonatal factors associated with the genotoxic outcome using newborns admitted to the NICUs of three hospitals located in the extreme south of Brazil. A total of 81 newborns were evaluated. DNA damage was assessed using the comet assay, and according to the result obtained for the evaluated parameters (tail length, % of tail DNA and tail moment). The investigation of associated factors was performed using the bivariate and multivariate Poisson regression analysis. As a result, we observed that the tail moment was the most sensitive parameter to detect differences between variables and genetic outcomes in newborns from NICU. Birthweight and the presence of respiratory diseases were associated with greater risks of DNA damage. Furthermore, the variables family income, sex, head circumference, preterm, birthweight and the presence of respiratory and/or infectious diseases showed a significant statistical difference regarding the groups with and without DNA damage (based on the median of the parameter). While the results of this study will serve as the basis for investigating genetic damage, we encourage that similar studies should be conducted elsewhere in order to confirm these and other outcomes as associated factors with DNA damage in newborns.
Asunto(s)
Daño del ADN , Unidades de Cuidado Intensivo Neonatal , Peso al Nacer , Brasil , Femenino , Humanos , Recién Nacido , Análisis de RegresiónRESUMEN
OBJECTIVE: The objective of this study is to investigate the association between anti-Toxocara IgG seropositivity and asthma in children. METHODS: This was a case-control study conducted in a university hospital in south Brazil between May 2012 and June 2013. Were recruited 208 children up to 12 years old of whom 156 had asthma (cases) and 52 did not have asthma (controls), with a case-control ratio of 3:1 matched by age. Children's parents or guardians were interviewed using a structured questionnaire with closed questions. Serology was performed using enzyme-linked immunosorbent assay (ELISA) with excretory-secretory antigen of Toxocara canis (TES). RESULTS: The seroprevalence of IgG anti-T. canis antibodies was 12.8% in the cases and 7.7% in the controls. There was no significant association between seropositivity to T. canis and risk of asthma (adjusted odds ratio [OR]: 1.89, 95% CI: 0.52 to 6.89, p = 0.33). Household income < 2 minimum salaries, paternal school years < 9, allergic rhinitis in children, a positive family history of asthma and rhinitis and contact with cats were significantly associated with asthma, with adjusted ORs (95% CIs) of 3.05 (1.21 to 7.73), 2.83 (1.11 to 7.18), 10.5 (4.32 to 25.6), 2.65 (1.14 to 6.17), 2.49 (1.07 to 5.78) and 2.73 (1.03 to 7.27), respectively. CONCLUSIONS: This study did not find a statistically significant association between seropositivity to Toxocara sp. and risk of asthma in children. Low family income, low paternal education level, concomitant allergic rhinitis, family history of asthma and allergic rhinitis and contact with cats were independent factors associated with childhood asthma.