Background: Vitamin A deficiency (VAD) is endemic in Brazil and health professionals have difficulty in recognizing its subclinical form. In addition, serum retinol concentrations do not always represent vitamin A status in the organism. Objective: To identify VAD in preschool children by the serum 30-day dose-response test ( þ S30DR) and to examine its potential as a tool for the assessment of vitamin A status in the community. Design: A prospective transverse study in which blood samples were obtained from 188 preschool children for the determination of serum retinol concentrations and the children were submitted to ocular inspection and anthropometric measurements. Information about the presence of diarrhea and/or fever during the 15 days preceding the study was also obtained. The children received an oral dose of 200,000 IU vitamin A immediately after the first blood collection. A second blood sample was obtained 30-45 days after supplementation in order to determine the þ S30DR. Results: In all, 74.5% (140/188; 95% confidence interval: 68.3-80.7%) of the children presented þ S30DR values indicative of low hepatic reserves. The mean serum retinol concentration was significantly lower before supplementation (0.92 and 1.65 mmol/l, respectively; Po0.0001). No child presented xerophthalmia; 3.7% (7/188) of the children were malnourished. The presence of fever and/or diarrhea during the 15 days preceding the first blood collection did not affect the þ S30DR value. Conclusions: The prevalence of VAD in the study group was elevated. þ S30DR proved to be a good indicator of subclinical VAD in children from an underdeveloped country. Sponsorship: The study was supported

This paper suggests a proposal of Child Health Care, to children and adolescents, to be developed in the Family Health Care Programs.

ResumoObjetivo: Determinar, entre um grupo de crianças e adolescentes eutróficos, os valores de glicemia e insulinemia de jejum e de índice homeostasis model assessment (HOMA). Métodos: Estudo de corte transversal realizado em duas escolas públicas de Ribeirão Preto (SP). Foram obtidas medidasantropométricas, dados pessoais e colhida amostra de sangue venoso de 447 crianças e adolescentes eutróficos, de ambos os sexos, com idades entre 7 e 17,9 anos, maturadores médios. Mediram-se glicemia de jejum e insulinemia de jejum e calculou-se o HOMA. Utilizando o teste de Mann-Whitney, foram realizadas comparações entre os valores obtidos para meninos e meninas em cada faixa etária. Posteriormente, utilizando o teste de Kruskal-Wallis, foram comparados os valores em cada faixa etária para meninos e meninas.Resultados: Entre as meninas, os valores de glicemia apresentaram variação entre 7 a 8,9 anos (p = 0,0005). Para ambos os sexos, em relação à insulinemia, ocorreu variação de acordo com a idade (p < 0,001), com valores mais elevados na faixa de 13 a 14,9 anos. Os valores de HOMA apresentaram variação significativa de acordo com a idade (p < 0,001) para meninos e meninas, com valores crescentes até a faixa de 13 a 14,9 anos. Conclusões:Os dados apontam para a necessidade do estabelecimento de curvas de referência para os três indicadores.J Pediatr (Rio J). 2008;84(2):136-140: Obesidade, hiperinsulinismo, insulina, hiperglicemia, síndrome X metabólica. AbstractObjective: To determine fasting glycemia and insulinemia levels and the HOMA index in a group of children and adolescents with normal body mass index (BMI).Methods: This was a cross-sectional study conducted at two public schools in Ribeirão Preto, SP, Brazil. A total of 447 children and adolescents of both sexes, with normal BMI, aged 7 to 17.9 years and of average maturity for their age, underwent anthropometric measurements and provided personal data and a sample of venous blood so that glycemia, insulinemia and HOMA index could be determined. The results obtained for boys and girls were compared for each age range using the Mann-Whitney test. The results within each age band were then compared for boys and girls using the Kruskal-Wallis test. Results:Glycemia results varied from 7 to 8.9 years (p = 0.0005). Fasting insulinemia varied significantly with age in both sexes (p < 0.001), with the highest values observed among children aged 13 to 14.9 years. HOMA indices varied significantly with age in both boys and girls (p < 0.001), with values that increased progressively up to the age band of 13 and 14.9 years.Conclusions: These data demonstrate the necessity of establishing reference curves for these three indicators. J Pediatr (Rio J)

Estudou-se a incidência de casos de mordeduras caninas atendidas em uma unidade básica de saúde da cidade de Ribeirão Preto, SP, no período de 1993 a 1997, entre crianças com idades de 0 a 15 anos. Os dados encontrados mostraram a importância de se promover programas educativos sobre os riscos dessas ocorrências para evitar acidentes causados por contatos com cães.