Objective: To evaluate the growth of exclusively breastfed infants from birth to 6 months of life.Methods: This was a longitudinal study of 184 children who received primary care at a public institution (Exclusive Breastfeeding Stimulation Program, PROAME) in Belém, state of Pará, Brazil, between February 2000 and January 2001. A total of 102 children completed the study. All were born at full term with a birth weight greater than or equal to 2,500 g. No events were recorded during the neonatal period and the infants were exclusively breastfed, on demand, since their birth. The infants were followed up monthly, and the weight and length measured at birth and at the end of the first, fourth and sixth months of life were compared to the 50th percentile line of the NCHS growth charts and to other previous studies of Brazilian children who were exclusively breastfed.Results: Growth was adequate for all the children, who doubled their weight before the fourth month of life. Despite a slow-down in weight and height gain after the fourth month, the weight averages at 6 months were greater than the standards used for comparison. Conclusions:The average weight of these exclusively breastfed children was above the 50th percentile of the NCHS curve at 6 months, thus confirming the nutritional advantages of breast milk, especially when the mothers receive guidance regarding the appropriate techniques for breastfeeding.

O artigo apresenta as mais importantes medidas gerais nos cuidados do paciente com anemia falciforme, a qual apresenta elevada morbimortalidade. A prática de medidas preventivas, que incluem a triagem neonatal, a educação dos cuidadores e dos pacientes, o aconselhamento nutricional, a imunização e a profilaxia com penicilina na prevenção da infecção pelo pneumococo, contribuem para a redução da morbimortalidade bem como à melhora da qualidade de vida desses pacientes. Rev. bras. hematol. hemoter. 2007;29(3):233-238.Palavras-chave: Doença falciforme; imunização; antibioticoprofilaxia; infecção.

Objective:To evaluate the quality of life in children and adolescents with sickle cell disease attending a blood reference center, and to assess the quality of life of their relatives.Methods: Cross-sectional study that included 100 patients with sickle cell disease, which were divided into three subgroups according to age: 5 to 7 (n=18), 8 to 12 (n=32), and 13 to 18 years-old (n=50), and their parents. The Control Group included 50 healthy children and adolescents from a public local school, also divided into the same three age subgroups and their caregivers. The Pediatric Quality of life Inventory (PedsQL), version 4.0, was applied in both groups. The generic questionnaire Medical Outcomes Study 36 -Item Short-Form Health Survey (SF-36) was applied to the relatives. The answers were linearly transformed into a score and compared by nonparametric tests.Results: The PedsQL scores of patients were significantly lower than those obtained in the Control Group (p<0.0001) in all studied areas (physical, emotional, social skills, and school activities). Similarly, SF-36 scores applied to the patients' parents were lower than those obtained in the Control Group in all studied aspects (p<0.0001).Conclusions: Sickle cell disease affects the quality of life of children, adolescents, and their families. Patients sense restrictions in the emotional, social, family and physical aspects, among others.Key-words: quality of life; anemia, sickle cell; children; adolescents. RESUMOObjetivo: Avaliar a qualidade de vida relacionada à saúde de crianças e adolescentes com doença falciforme assistidas em um hemocentro de referência e mensurar a qualidade de vida relacionada à saúde dos respectivos familiares.Métodos: Estudo transversal e seccional com 100 pacientes portadores de doença falciforme, divididos em três subgrupos conforme a faixa etária: de 5 a 7 (n=18), de 8 a 12 (n=32) e de 13 a 18 anos (n=50) e com seus respectivos pais. O Grupo Controle foi composto por 50 crianças e adolescentes saudáveis de uma escola pública local, também divididos nos três subgrupos de idade e seus respectivos cuidadores. Resultados: Os escores dos pacientes no PedsQL foram inferiores àqueles do Grupo Controle (p<0,0001) nos aspectos estudados (capacidades física, emocional, social e atividade escolar). Da mesma forma, os escores do SF-36 aplicados aos pais dos pacientes foram mais baixos que os de pais do Grupo Controle em todos os aspectos estudados (p<0,0001).Conclusões: A doença falciforme compromete a qualidade de vida das crianças, dos adolescentes e de suas respectivas famílias. Os pacientes percebem restrições nos aspectos emocional, social, familiar e físico, dentre outros.Palavras-chave: qualidade de vida; anemia falciforme; crianças; adolescentes. RESUMENObjetivo: Evaluar la calidad de vida relacionada a la salud en niños y adolescentes con enfermedad falciforme asistidas en un servicio de hemoterapia de referencia y medir la calidad de vida relacionada a la salud de los respectivos familiares.Métodos: Estudio transversal y sec...

OBJECTIVESTo assess the food intake pattern and the nutritional status of children with cerebral palsy. METHODSCross-sectional study with 90 children from two to 12.8 years with cerebral palsy in the following forms: hemiplegia, diplegia, and tetraplegia. Nutritional status was assessed by weight, height, and age data. Food intake was verified by the 24-hour recall and food frequency questionnaire. The ability to chew and/or swallowing, intestinal habits, and physical activity were also evaluated. RESULTSFor 2-3 year-old age group, the mean energy intake followed the recommended range; in 4-6 year-old age group with hemiplegia and tetraplegia, energy intake was below the recommended limits. All children presented low intake of carbohydrates, adequate intake of proteins and high intake of lipids. The tetraplegia group had a higher prevalence of chewing (41%) and swallowing (12.8%) difficulties compared to 14.5 and 6.6% of children with hemiplegia, respectively. Most children of all groups had a daily intestinal habit. All children presented mild physical activity, while moderate activity was not practiced by any child of the tetraplegia group, which had a significantly lower height/age Z score than those with hemiplegia (-2.14 versus -1.05; p=0.003). CONCLUSIONSThe children with cerebral palsy presented inadequate dietary pattern and impaired nutritional status, with special compromise of height. Tetraplegia imposes difficulties regarding chewing/swallowing and moderate physical activity practice.

Helicobacter pylori and immune thrombocytopenic purpura (ITP) association is not well established in chronic ITP (cITP) in children, although the cure of thrombocytopenia in approximately half of H. pylori eradicated adult patients has been described. The aim of this study was to investigate the effect of H. pylori eradication on platelet (PLT) recovery in cITP children and adolescents through a randomized, controlled trial. A total of 85 children (mean age 11.4 years) with cITP were prospectively enrolled. Diagnosis of H. pylori was established by two locally validated tests, (13)C-urea breath test and monoclonal stool antigen test. Twenty-two infected patients were identified, and randomly allocated into two groups: H. pylori treatment group (n = 11) and the non-intervention control group (n = 11). The control group was offered treatment if the thrombocytopenia persisted after the follow-up. At baseline, there were no differences regarding age, sex, duration of disease, and PLT count between groups. Sixty three of 85 patients were uninfected. PLT response was classified as complete response: PLT > 150 × 10(9 )l(-1); partial response: PLT 50-150 × 10(9 )l(-1), or an increase of 20-30 × 10(9 )l(-1); no response: PLT < 50 × 10(9 )l(-1) or an increase of <20 × 10(9 )l(-1) after at least 6 months of follow-up. Complete response was observed in 60.0% (6/10, one excluded) H. pylori eradicated patients vs. 18.2% (2/11) in non-eradicated patients (p = 0.08; OR = 6.75) after 6-9 months of follow-up. Among uninfected patients, only 13.8% (8/58) presented complete response. Two non-treated controls were treated after 6-12 months of follow-up, and PLT response was observed in 61.5% (8/13) of H. pylori eradicated patients, and in 19.0% (11/58) of uninfected patients (p = 0.004). Cytotoxin associated gene A and vacuolating cytotoxin gene A IgG antibodies were present in almost all infected patients. Therefore, the study suggests that H. pylori eradication plays a role in the management of H. pylori infected cITP children and adolescents.