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Abstract Objective To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. Data source Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. Data synthesis A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. Conclusions The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.

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Abstract Objective Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil. Data source Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023. Data synthesis The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic. Conclusion Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.

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OBJECTIVE: Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil. DATA SOURCE: Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023. DATA SYNTHESIS: The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic. CONCLUSION: Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.

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OBJECTIVE: To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. DATA SOURCE: Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. DATA SYNTHESIS: A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. CONCLUSIONS: The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.

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Recent studies have demonstrated that gut microbiota development is influenced by human biogeographic factors such as race, ethnicity, diet, lifestyle or culture-specific variations, and other environmental influences. However, biogeographic variation in gut microbiota assembly remains largely unexplored in Latin America. In this paper, we compared food recall information and microbiota composition of toddlers living in geographically separated urban populations within four states of Brazil. 16S RNA gene sequencing revealed that alpha diversity was similar between the four different populations. Gut microbiota compositions were dominated by members of the phyla Firmicutes and Bacteroidetes, resembling a more adult-like microbiota as compared with those of Western European toddlers of similar age. These findings suggest that inter-individual and nutrition-induced differences were apparent in the fecal microbiota. We conclude that urban dietary pattern plays a larger role in influencing the gut microbiota composition than do biogeographic factors.

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Objetivo:Revisar a literatura sobre a frequência da deficiência de vitamina D e suas consequências em crianças e adolescentes com anemia falciforme.Fontes de dados:O levantamento bibliográfico foi feito nas bases bibliográficas Medline, U.S. National Library of Medicine e National Institutes of Health (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Cochrane. Os descritores foram selecionados com o uso do Medical Heading Terms (MeSH): “Vitamin D” OU “Vitamin D deficiency” E “anemia, sickle cell” E “child” E “adolescent”. A busca limitou-se aos artigos em inglês, espanhol e português, com data de publicação até abril de 2014.Síntese dos dados:Foram selecionados 11 estudos, entre os 18 encontrados. A pesquisa revelou que os níveis séricos de vitamina D em crianças e/ou adolescentes com anemia falciforme encontram-se baixos em seis de 11 artigos analisados. Essa frequência de deficiência de vitamina D em pacientes com anemia falciforme excede a do grupo de comparação saudável. A baixa ingesta de vitamina D, a sazonalidade, a exposição solar, o metabolismo aumentado próprio da hemoglobinopatia e o aumento da idade são fatores associados à deficiência. Houve associação entre deficiência significativa de vitamina D e fraqueza óssea e crises dolorosas. Há correlação positiva entre aumento dos níveis de vitamina D por meio da suplementação e a capacidade funcional física.Conclusões:A deficiência de vitamina D em crianças e adolescentes com doença falciforme é prevalente e necessita de mais estudos para evidenciar a sua relação com comorbidades e possíveis benefícios da suplementação da vitamina D.

Objective:To review the literature about the prevalence of vitamin D deficiency and its consequences in children and adolescents with sickle-cell disease.Data sources:The literature survey was performed through the bibliographic databases MEDLINE; U.S. National Library of Medicine and National Institutes of Health (PubMed); Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), and the Cochrane Library. The keywords were selected using Medical Heading Terms (MeSH): “vitamin D” OR “vitamin D deficiency” AND “anemia, sickle cell” AND “child” AND “adolescent”. The search was limited to articles in English, Spanish and Portuguese, published until April 2014.Data synthesis:Eleven articles were selected among the 18 found. In 6 of the 11 studies, serum levels of vitamin D in children and/or adolescents with sickle-cell anemia were low. The prevalence of vitamin D deficiency in patients with sickle-cell anemia exceeded that of the comparison group. The low intake of vitamin D, seasonality, exposure to sun, increased metabolism associated with the hemoglobinopathy, and age increase were factors associated with the deficiency. There was an association between a significant vitamin D deficiency and bone weakness and painful crises. There was a positive correlation between increased levels of vitamin D by supplementation and functional, physical capacity.Conclusions:The vitamin D deficiency in children and adolescents with sickle-cell disease is prevalent and requires further studies to demonstrate its association with comorbidities and possible benefits of vitamin D supplementation.

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OBJECTIVE: To review the literature about the prevalence of vitamin D deficiency and its consequences in children and adolescents with sickle-cell disease. DATA SOURCES: The literature survey was performed through the bibliographic databases Medline; U.S. National Library of Medicine and National Institutes of Health (PubMed); Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), and the Cochrane Library. The keywords were selected using Medical Heading Terms (MeSH): "Vitamin D" OR "Vitamin D deficiency" AND "Anemia, Sickle Cell" AND "Child" AND "Adolescent". The search was limited to articles in English, Spanish and Portuguese, published until April 2014. DATA SYNTHESIS: Eleven articles were selected among the 18 found. In 6 of the 11 studies, serum levels of vitamin D in children and/or adolescents with sickle-cell anemia were low. The prevalence of vitamin D deficiency in patients with sickle-cell anemia exceeded that of the comparison group. The low intake of vitamin D, seasonality, exposure to sun, increased metabolism associated with the hemoglobinopathy, and age increase were factors associated with the deficiency. There was an association between a significant vitamin D deficiency and bone weakness and painful crises. There was a positive correlation between increased levels of vitamin D by supplementation and functional, physical capacity. CONCLUSIONS: The vitamin D deficiency in children and adolescents with sickle-cell disease is prevalent and requires further studies to demonstrate its association with comorbidities and possible benefits of vitamin D supplementation.

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Estima-se que cerca de 84% dos casos de Aids em indivíduos com até 13 anos de idade no Brasil ocorram devido à transmissão vertical. O impacto do HIV/Aids na vida dessas crianças pode afetar negativamente a qualidade de vida. O objetivo deste estudo foi avaliar a qualidade de vida de crianças e adolescentes infectados pelo HIV por transmissão vertical, segundo a visão da criança e a do cuidador. Trata-se de um estudo observacional, tipo inquérito transversal, analítico, desenvolvido na Universidade Federal do Triângulo Mineiro, com crianças e adolescentes infectados pelo vírus HIV. Participaram 24 crianças e adolescentes e seus responsáveis. A qualidade de vida foi mais afetada em relação ao domínio emocional, na percepção da criança ou do adolescente (61,88 pontos). Os cuidadores observaram maior impacto em relação ao domínio escolar (60,83 pontos). A evidência de menores escores nos domínios emocional e escolar, na visão dos participantes, indica uma influência negativa para a qualidade de vida dos participantes da pesquisa.(AU)

Estimates indicate that about 84% of Aids cases in individuals up to age 13 in Brazil occur due to vertical transmission. The HIV/Aids impact at these children can affect quality of life negatively. The objective of this study was to evaluate the quality of life in children and adolescents infected with HIV by vertical transmission; according to the vision of the wearer and caregiver. Observational study, transversal investigation, analytical, developed at Universidade Federal do Triângulo Mineiro (UFTM), with children and adolescents infected with HIV. 24 children and adolescents and their caregivers participated. The emotional domain of quality of life was the most affected in the child or adolescent perception (61.88 points). The caregivers reported a greater impact in relation to educational domain (60.83 points). The lower scores evidence in the patients and caregivers opinion indicates a negative influence on the research participants quality of life.(AU)

Se estima que alrededor del 84% de los casos de SIDA en personas menores de 13 años de edad en Brasil se producen debido a la transmisión vertical. El impacto del VIH / SIDA en las vidas de estos niños puede afectar negativamente la calidad de vida. El objetivo de este estudio fue evaluar la calidad de vida de los niños y adolescentes infectados con el VIH por transmisión vertical; de acuerdo con la visión del niño y el cuidador. Se trata de una investigación observacional, transversal, analítico, desarrollado en la Universidad Federal de Triangulo Mineiro, con niños y adolescentes infectados por el VIH. Un total de 24 niños, niñas y adolescentes y sus padres. La calidad de vida fue la zona más afectada en relación con la percepción emocional del niño o adolescente (61,88 puntos). Los cuidadores comunicaron un mayor impacto para la escuela de campo (60,83 puntos). La evidencia de las puntuaciones más bajas para emocional y académico en vista de los participantes, indicando una influencia negativa en la calidad de vida de los participantes en la investigación.(AU)

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Introdução: a doença hepática gordurosa não alcoólica (DHGNA) trata-se de uma comorbidade associada à obesidade frequente na faixa etária pediátrica, cujo impacto sobre o estado nutricional tem sido investigado. Objetivo: verificar se crianças e adolescentes obesos com DHGNA apresentam mais alterações antropométricas, bioquímicas e de exames que compõem o diagnóstico de síndrome metabólica (SM), em relação a obesos sem DHGNA. Métodos: estudo transversal desenvolvido em ambulatório de Pediatria. Os grupos com e sem DHGNA foram comparados quanto a variáveis antropométricas, bioquímicas e componentes da SM. Também foi verificado se SM ou alterações nos exames que são critério diagnóstico para SM estariam associados à DHGNA. Resultados: 59 indivíduos obesos foram avaliados, sendo 25,4% com DHGNA.Os grupos apresentaram entre si alterações significativas de peso, IMC, colesterol total, vitamina D, ácido fólico, ácido úrico, proteína C reativa, GGT, bilirrubina total e fosfatase alcalina (p<0,05). Na análise isolada dos exames que compõem o diagnóstico de SM, os valores elevados de circunferência abdominal e glicemia de jejum foram significativos entre os grupos (p<0,05). Entre os indivíduos com diagnóstico de SM, 44% possuíam DHGNA. Alterações de circunferência abdominal, triglicérides, glicemia de jejum, HDL colesterol e hipertensão arterial não estiveram associadas à DHGNA. Conclusão: crianças e adolescentes obesos com DHGNA têm mais alterações antropométricas, bioquímicas e de exames que compõem o diagnóstico de SM, em relação a obesos sem a doença. Porém, a SM ou alteração isolada de qualquer exame não demonstrouassociação significativa com o risco de desenvolver DHGNA

Introduction: the non-alcoholic fatty liver disease (DHGNA) is a comorbidity associated with common obesity in the pediatric age group, whose impact on the nutritional status has been investigated. Objective: to verify that obese children and adolescents with DHGNA have more anthropometric, biochemical, and related to tests alterations that determine the diagnosis of metabolic syndrome (SM) compared to those obese without DHGNA. Methods: this was a cross-sectional study conducted in the pediatric outpatient service. The groups with and without DHGNA were compared regarding anthropometric, biochemical, and metabolic syndrome components of SM. SM or test alterations that are diagnostic criteria for SM were evaluated for association with DHGNA. Results: 59 obesesubjects were evaluated; 25.4% presented DHGNA. The groups presented significant differences in alterations in weight, BMI, total cholesterol, vitamin D, folic acid, uric acid, C-reactive protein, GGT, total bilirubin, and alkaline phosphatase (p <0.05). The high values of waist circumference and fasting glucose were significant between groups (p <0.05) in the isolatedanalysis of tests that make up the diagnosis of SM. Among individuals diagnosed with SM, 44% presented DHGNA. Alterations in abdominal circumference, triglycerides, fasting glucose, HDL cholesterol, and high blood pressure were not associated with DHGNA. Conclusion:obese children and adolescents with DHGNA presentedmore anthropometric, biochemical, and tests that makethe diagnosis of SM alterations compared to those obesewithout the disease. However, SM or the isolated alterationof any examination showed no significant associationwith the risk of developing DHGNA.

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A autora enfatiza a importância da alimentação adequada da criança no primeiro ano de vida, com base nos achados do Nutriplanet, projeto científico, que investigou por meio de levantamento bibliográfico (Medline, Lilacs, Scielo, PubMed e publicações e posicionamentos em sites governamentais e de sociedades científicas brasileiras), a situação de saúde, alimentação e nutrição dos seguintes segmentos da população: gestantes, lactantes, lactentes e crianças de até três anos.

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A autora apresenta os principais achados do Nutriplanet, no que refere ao estado nutricional e o consumo alimentar de crianças até três anos, destacando as principais carências nutricionais (vitamina A, ferro e zinco) e o impacto do excesso de peso na incidência de doenças crônicas.

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Atualização dos requisitos e características da alimentação na infância, da neonatologia ao adolescente, com apresentação das condutas preconizadas pelos mais importantes órgãos de pesquisa e orientação nutricional, no Brasil e no exterior.

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O objetivo desse estudo foi descrever a avaliação dos profissionais de saúde sobre um protótipo de copo para administrar líquidos a recém-nascidos. Trata-se de estudo descritivo-exploratório, realizado na maternidade de um hospital universitário, em Uberaba, MG, Brasil. Questionários semiestruturados foram aplicados a 75 profissionais de saúde, após administrarem leite com o copo aos recém-nascidos, nos meses de julho e agosto de 2011. Os dados quantitativos foram analisados descritivamente e os qualitativos submetidos à análise de conteúdo, emergindo três categorias: aspectos positivos, com 269 unidades de registro; aspectos negativos, com 11 unidades e sugestões para melhoria do copo, com seis. A análise estatística evidenciou que conceitos ‘bom’ e ‘ótimo’, relacionados ao protótipo de copo, apresentaram índices acima de 90%. A percepção dos participantes demonstrou uma avaliação positiva acerca do protótipo de copo, que demonstrou ser um utensílio prático, de design e material seguros para a realização da ‘técnica do copinho’.

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A autora revê os princípios básicos da nutrição na primeira infância, destacando a importância da amamentação ao seio materno, complementação progressiva com outros alimentos, aporte de água e outras orientações visando tornar a nutrição mais adequada nessa faixa etária...

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OBJETIVOS: Verificar adequação do consumo de vitamina C em crianças e adolescentes infectados pelo vírus da imunodeficiência humana (HIV), avaliar níveis séricos da vitamina e indicadores de estresse oxidativo, comparar ao grupo não infectado, correlacionar a vitamina sérica ao estresse oxidativo e associá-los segundo os valores de referência. MÉTODOS: Estudo seccional transversal comparativo. Dois grupos com 27 crianças e adolescentes cada, de 3 a 19 anos, sendo G1 infectados pelo HIV por transmissão vertical atendidos em ambulatório regional e G2 indivíduos convidados sem histórico de infecção pelo HIV. Foram pareados por sexo, idade e condição socioeconômica. Avaliou-se: antropometria (índice de massa corporal para idade), ingestão e consumo do micronutriente, análise sérica da vitamina C, proteína C reativa e albumina. RESULTADOS: Idade média encontrada de 12 anos, prevalência do sexo feminino (17 - 63%) e da classe econômica C (27 - 50%). Diagnóstico nutricional prevalente foi eutrofia em 20 (74,1%) em G1 e 21 (77,8%) em G2. O consumo de vitamina C foi significativamente maior em G1 (p = 0,006; t = 2,987) pelo método recordatório 24 horas. Houve diferença significativa da dosagem sérica de vitamina C, sendo menor em G1 (p = 0,000; t = -7,309). Em relação ao estresse oxidativo, os valores da proteína C reativa em G1 foram significativamente maiores (p = 0,007; t = 2,958). Não houve relação entre deficiência da vitamina, proteína C reativa e albumina. CONCLUSÃO: Os resultados encontrados mostram que indivíduos infectados pelo HIV apresentam baixos valores da vitamina C, não relacionados à alimentação, uma vez que o consumo desse micronutriente foi superior ao grupo comparativo, que não apresentou essa depleção. Existem peculiaridades nos indivíduos infectados que aumentam o estresse oxidativo, evidenciado pelo aumento da proteína C reativa.

OBJECTIVES: To assess adequacy of vitamin C intake in HIV-infected children and adolescents; to evaluate serum levels of vitamin C and indicators of oxidative stress; to compare with the uninfected group; to correlate serum vitamin C with oxidative stress and associate them according to the reference values. METHODS: Comparative cross-sectional study. Two groups of 27 children and adolescents each, aged between 3 to 19 years. Group 1 (G1) comprised individuals vertically infected with HIV seen at a regional outpatient clinic. Group 2 (G2) comprised invited individuals without history of HIV infection. The groups were matched for age, sex, and socioeconomic status. The following variables were analyzed: body mass index for age; micronutrient intake and consumption; and serum vitamin C, C-reactive protein (CRP), and albumin. RESULTS: The mean age was 12 years old. Most subjects were female (17, 63%), and there was prevalence of the economic class C (27, 50%). The most prevalent nutritional status was normal weight in 20 individuals (74.1%) in G1 and 21 (77.8%) in G2. The intake of vitamin C was significantly higher in G1 (p = 0.006; t = 2.987) according to the 24-hour dietary recall method. There were significant differences in serum vitamin C concentration between the groups, with a lower level in G1 (p = 0.000; t = -7.309). In relation to oxidative stress, values of CRP in G1 were significantly higher (p = 0.007; t = 2.958). There was no association between deficiency of vitamin, CRP, and albumin. CONCLUSION: Our findings show that HIV-infected individuals have low levels of vitamin C; however, this deficiency is not related to eating habits, since the intake of this nutrient was higher in this group than in the control group. HIV-infected individuals have specific characteristics that increase their oxidative stress, which is evidenced by increased CRP.

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OBJECTIVES: To assess adequacy of vitamin C intake in HIV-infected children and adolescents; to evaluate serum levels of vitamin C and indicators of oxidative stress; to compare with the uninfected group; to correlate serum vitamin C with oxidative stress and associate them according to the reference values. METHODS: Comparative cross-sectional study. Two groups of 27 children and adolescents each, aged between 3 to 19 years. Group 1 (G1) comprised individuals vertically infected with HIV seen at a regional outpatient clinic. Group 2 (G2) comprised invited individuals without history of HIV infection. The groups were matched for age, sex, and socioeconomic status. The following variables were analyzed: body mass index for age; micronutrient intake and consumption; and serum vitamin C, C-reactive protein (CRP), and albumin. RESULTS: The mean age was 12 years old. Most subjects were female (17, 63%), and there was prevalence of the economic class C (27, 50%). The most prevalent nutritional status was normal weight in 20 individuals (74.1%) in G1 and 21 (77.8%) in G2. The intake of vitamin C was significantly higher in G1 (p = 0.006; t = 2.987) according to the 24-hour dietary recall method. There were significant differences in serum vitamin C concentration between the groups, with a lower level in G1 (p = 0.000; t = -7.309). In relation to oxidative stress, values of CRP in G1 were significantly higher (p = 0.007; t = 2.958). There was no association between deficiency of vitamin, CRP, and albumin. CONCLUSION: Our findings show that HIV-infected individuals have low levels of vitamin C; however, this deficiency is not related to eating habits, since the intake of this nutrient was higher in this group than in the control group. HIV-infected individuals have specific characteristics that increase their oxidative stress, which is evidenced by increased CRP.

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Este estudo, que avaliou a qualidade de vida de crianças portadoras de diabetes mellitus tipo 1 emacompanhamento ambulatorial, é de caráter observacional do tipo inquérito transversal e foi realizado com 22crianças de idade entre 8 e 12 anos, regularmente atendidas no Ambulatório de Endocrinologia Pediátrica doHospital de Clínicas da Universidade Federal do Triângulo Mineiro, bem como seus cuidadores. A qualidade devida foi medida pelo Questionário Genérico sobre Qualidade de Vida Pediátrica (PedsQL 4.0) e os dadossociodemográficos e clínicos foram identificados mediante consulta aos prontuários. Ao analisar os escores dequalidade de vida, foram observados maiores valores em todos os domínios do PedsQL 4.0 para o relato dos pacientes em relação ao relato dos cuidadores. As principais variáveis que influenciaram a qualidade de vidaforam acompanhamento nutricional e atividade física. Observou-se que, em sua maioria, as crianças tiveram dificuldades em realizar o controle domiciliar do diabetes por causa dos recursos financeiros disponíveis. Faz-se necessário o controle diário e consciência do paciente em relação à sua responsabilidade no tratamento, pois, mantendo-se os cuidados adequados se evitam complicações e hospitalizações repetidas, uma vez que adoença controlada possibilita ao sujeito um cotidiano normal.

This study described the quality of life of children with type 1 diabetes as an outpatient. This is an observationalstudy of cross-sectional survey carried out with 22 children from 8 to 12 years old, regularly treated at theAttendance of Pediatric Endocrinology, Hospital de Clinicas, of Universidade Federal do Triângulo Mineiro (HCUFTM)and their caregivers. Quality of life was evaluated by the generic questionnaire on pediatric quality of life(PedsQL 4.0) and the sociodemographic and clinical data were collected through medical records. By analyzingthe scores of quality of life, higher scores in all domains of PedsQL 4.0 for the report of patients related to thecaregivers were observed. The main factors which influenced the quality of life were: nutritional counseling andphysical activity. It was found that most children had difficulty performing home control of diabetes due to lack offinancial resources. Diabetes requires daily control and patient's consciousness regarding responsibility duringthe treatment in order to avoid hospitalization and complications, since the disease under control enables thepatient to have a normal daily life avoiding suffering on the part of the patient and the family as well.

Este estudio describió la calidad de vida de los niños portadores de Diabetes mellitas tipo 1 en acompañamientoen el ambulatorio. Se trata de un estudio de observación de tipo averiguación transversal realizado con 22 niños,de 8 a 12 años, atendidos regularmente en el Ambulatorio de Endocrinología Pediátrica del Hospital de Clínicas de la Universidad Federal del Triângulo Mineiro (HC-UFTM) así como sus cuidadores. La calidad de vida fuemedida por el Cuestionario Genérico sobre la Calidad de Vida Pediátrica (PedsQL 4.0) y los datos sociodemográficos y clínicos fueron identificados por la consulta a los registros. Al analizar los escores de calidadde vida, se observó mayores valores en todos los dominios del PedsQL 4.0 para el relato de los pacientes enrelación al relato de los cuidadores, siendo que las principales variables que influenciaron la calidad de vidafueron: acompañamiento nutricional y actividad física. Se observó que, en su mayoría, los niños tuvierondificultades en realizar el control domiciliario de la diabetes por causa de los recursos financieros disponibles. Esnecesario el control diario y conciencia del paciente en relación a su responsabilidad en el tratamiento, puesmanteniéndose los cuidados adecuados se evitan complicaciones y la hospitalizaciones repetidas, una vez quela enfermedad controlada posibilita al sujeto un cotidiano normal.

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Estudou-se a composiçäo quimica do Leite humano, analisando-se aliquotas de leite de 30 puérperas sadias, de baixo nivel (sócio-econômico, divididas em 3 grupos de acordo com a idade gestacional de seus recém-nascidos: 10 mäes de crianças a termo (grupo I), 10 mäes de recém-nascidos pré-termo maior que 32 semanas (grupo II) e 10 mäes de neonatos pré-termo menor que 32 semanas de gestaçäo (grupo III). As mäes foram selecionadas de fevereiro a outubro de 1986, no HC-FMRP-USP. Dosou-se os niveis de sódio, cloro, potássio, cálcio, fósforo, magnésio, cobre, zinco e nitrogênio total, de amostras colhidas as 48 ñ 12 horas, 15 ñ 2 e 30 ñ 2 dias após o parto, sempre pela manha e de ambas as mamas. Todo o material para colheita, estocagem e análise foi previamente lavado cocm ácido nitrico a 30% e água desionizada e feito avaliaçäo da eficiência da técnica de limpeza, buscando, com isso, eliminar eventuais contaminaçöes. O material colhido foi conservado a - 20-C e posteriormente analisado. Observou-se diminuiçäo na concentraçäo do sódio, cloro, cobre, zinco, e nirogênio total nos 3 grupos, do colostro para o leite maduro. Cálcio, fósforo e o potásio näo se alteraram. O magnésio apresentou diminuiçäo só no grupo II da fase de transiçäo para o leite maduro. Comparando-se os 3 grupos entre si observou-se que eles näo diferem quanto as concentraçöes de sódio, cloro, cálcio, fósforo e cobre. O potássio e o magnésio säo mais concentrados no leite maduro de mäes de recém-nascidos pré-termo menor que 32 semanas de gestaçäo, comparados com o grupo I. O zinco esteve em maior concentraçäo no colostro do leite de mäes do grupo I, comparando-as com o grupo II. O nitrogênio total apresentou-se em um nível mais elevado no leite de transiçäo do grupo III, comparando-o com o grupo I

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