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ntroduction: Atopic dermatitis is a chronic and recurrent condition, influenced byenvironmental factors, that requires frequent medical prescriptions. The aim of thisstudy was to investigate if children and adolescents with atopic dermatitis treated ata public clinic reported exacerbation of the disease or self-care problems during theCOVID-19 pandemic.Methods: We conducted a retrospective longitudinal study. Data were collectedfrom the medical records of patients aged < 18 years with atopic dermatitis treatedat a public outpatient clinic in Rio Grande do Sul, Brazil. The perception of diseaseexacerbation in children and adolescents was evaluated using the chi-square test orFisher’s exact test. Poisson regression was used to estimate the risk of worsening ofskin lesions according to the fear of COVID-19., Introdução: A dermatite atópica é uma doença crônica e recidivante, influenciada porfatores ambientais, que necessita prescrições médicas frequentes. O objetivo desteestudo foi investigar se crianças e adolescentes com dermatite atópica atendidos emum serviço público tiveram agravamento das lesões ou dificuldades no autocuidadodurante a pandemia COVID-19.Métodos: Estudo longitudinal retrospectivo. Os dados foram coletados do prontuáriode pacientes com dermatite atópica menores de 18 anos atendidos em um ambulatóriopúblico de referência do Rio Grande do Sul. A percepção sobre o agravamento daslesões foi avaliada pelos testes Qui-quadrado ou Exato de Fisher e regressão dePoisson foi utilizada para estimar o risco de agravamento das lesões conforme omedo da COVID-19.Resultados: Foram avaliados 33 pacientes, sendo 70% do sexo feminino e 57,6%residentes na capital. A média de idade foi de 9,6 ± 3,9 anos e o tempo médio deacompanhamento pelo serviço 4,6 ± 2,9 anos. A percepção de agravamento das lesõesdurante o período de suspensão dos atendimentos esteve presente em 81,8% dascrianças/adolescentes. As crianças relataram com frequência o aumento de coceira(78,3%) e descamação (60,9%), enquanto os adolescentes referiram maior aumentoda vermelhidão (60%). O medo de contrair o vírus foi associado a um risco oito vezesmaior de apresentar agravamento das lesões.Conclusões: O alto percentual de crianças/adolescentes com agravamento daslesões e a associação da piora da doença com o medo relacionado à pandemiareforçam a importância do acompanhamento destes por equipe multidisciplinar queobserve fatores fisiopatológicos e psicossociais.

The aim was to monitor the frequency of Breastfeeding (BF) and Exclusive Breastfeeding (EBF) in a Primary Healthcare Service, between the years of 2004 to 2015. This is a historical series is composed of eight cross-sectional surveys that were carried out during the annual vaccination campaigns. A total of 6027 children were evaluated, with a mean age of 6.2 months. There was a significant increase in the rates of BF (7.2%) and EBF (9.5%) in children less than four months old. In infants from four to five months old, a substantial decline was observed in the EBF rate between 2010 and 2015 (6.3%). The frequency of BF had a 10.1% increase in infants from six to nine months old and remained stable in children from 10 to 11 months of age. Among children less than six months old, monitoring by the health service had a positive impact on the frequency of BF ( p

To describe the profile of people who initiated HIV post-exposure prophylaxis (PEP) in a public health service, evaluating the use of this technology by key populations as recommended by the Brazilian Ministry of Health.This was a retrospective longitudinal study using secondary data on service users receiving care between 2015-2018. Absolute and relative frequencies were calculated and Pearson's chi-square test was used to compare behavioral characteristics.Of the 270 people evaluated, there was a higher frequency of young adults (45.4%), males (74.7%), people of white race/skin color (76.3%), with a high level of education (65.7%) and with multiple sex partners (40.7%). Among the key populations, there was a higher frequency of people who use alcohol and/or other drugs (49.6%) and men who have sex with men (38.1%), while transgender people (2.2%) and sex workers (4.8%) used PEP less.The use of PEP was not homogeneous among the vulnerable groups evaluated, with low frequency of transgender people and sex workers.Descrever o perfil de usuários que iniciaram a profilaxia pós-exposição ao HIV (PEP) em um serviço público, avaliando o uso dessa tecnologia pelas populações-chave recomendadas pelo Ministério da Saúde do Brasil.Estudo longitudinal retrospectivo, com uso de dados secundários de usuários atendidos entre 2015 e 2018. Foram calculadas frequências absolutas e relativas e o teste do qui-quadrado de Pearson foi utilizado para comparar características comportamentais.Dos 270 usuários, foram mais frequentes adultos jovens (45,4%), homens (74,7%), raça/cor da pele branca (76,3%), alta escolaridade (65,7%) e múltiplas parcerias sexuais (40,7%). Entre as populações-chave, observou-se maior frequência de usuários de álcool e/ou outras drogas (49,6%) e homens que fazem sexo com homens (38,1%), enquanto pessoas transgênero (2,2%) e profissionais do sexo (4,8%) fizeram menor uso da PEP.O uso de PEP não foi homogêneo entre os grupos vulneráveis avaliados, com baixa frequência de pessoas transgênero e profissionais do sexo.Describir el perfil de los usuarios que comenzaron la profilaxis post exposición al VIH (PEP) en un servicio público, evaluando el uso de esta tecnología por las poblaciones clave recomendadas por el Ministerio de Salud de Brasil.estudio longitudinal retrospectivo, con datos secundarios de usuarios atendidos entre 2015-2018. Se calcularon frecuencias absolutas y relativa y se utilizó chi-cuadrado de Pearson para comparar características de comportamiento.De los 270 usuarios estudiados, hubo mayor frecuencia de adultos jóvenes (45,4%), blancos (76,3%), hombres (74,7%), con educación superior (65,7%) y múltiples parejas sexuales (40,7%). Entre las poblaciones clave, hubo mayor frecuencia de usuarios de alcohol y/u otras drogas (49,6%) y hombres que tienen sexo con hombres (38,1%), mientras que personas transgénero (2,2%) y trabajadoras sexuales (4,8%) hizo menos uso de PEP.El uso de PEP no fue homogéneo entre los grupos vulnerables evaluados, con baja frecuencia de personas transgénero y trabajadoras sexuales.

Este artigo tem o objetivo de realizar uma revisão analítica de estudos observacionais que avaliaram a relação entre o excesso de peso materno e o tempo de início do aleitamento materno, com enfoque nos fatores que podem atuar como mediadores da associação. Extensa revisão foi realizada nas bases de dados PubMed/MEDLINE, Google Acadêmico e Bireme/Lilacs utilizando um conjunto de termos relacionados ao início do aleitamento materno e ao excesso de peso materno. As referências dos artigos incluídos foram manualmente revisadas para identificar artigos não revelados anteriormente. Os critérios de seleção foram: idioma português, inglês ou espanhol; estudos originais, e estudo realizado em humanos. Vinte e nove artigos, provenientes de 24 diferentes estudos foram incluídos nas análises. A avaliação desses estudos indica que o excesso de peso materno atua como fator de risco importante para o não início do aleitamento materno e que esse risco se acentua com o aumento no grau de excesso de peso materno. Fatores psicológicos, raça, formas corporais e complicações gestacionais/obstétricas são variáveis maternas que parecem interagir com o excesso de peso, influenciando o início da amamentação. This paper aims to propose an analytic review of observational studies that addressed the influence of maternal overweight on breastfeeding initiation, with emphasis on the factors that can act as mediators on this association. A search on PubMed/MEDLINE, Google Scholar and Bireme/Lilacs databases was conducted applying a number of descriptors related to breastfeeding and maternal body mass index. The reference lists of included articles were handsearched to identify further relevant studies. Selection criteria were: original articles, with human subjects, published in Portuguese, English or Spanish. A total of 29 papers from 24 different studies were included in the analysis. Maternal overweight was an important risk factor for failure to initiate breastfeeding. The risk was accentuated by the increase in maternal body mass index. Psychological factors, ethnicity, body shape and obstetric complications seem to interact with maternal overweight to interfere in breastfeeding initiation.

Background: Cesarean delivery (CD) perturbs the assembly of the neonatal gut microbiome and has been associated with child and adult obesity. However, it is still unknown whether CD is associated with metabolic risk factors in young adults. Objective: We investigated the association of CD and metabolic risk factors in young adults in a cohort study who were 23-25 y of age at follow-up. Design: We used data from a cohort study in Ribeirao Preto, Brazil. Baseline data on 6827 singleton pregnancies were collected in 1978-1979, and a sample of 2063 subjects were followed up 23-25 y later (2002-2004). Information on the type of delivery, birth weight, maternal age, parity, maternal schooling, and maternal smoking was obtained after birth. Anthropometric data, biochemical measure- ments, and information on participant schooling and smoking his- tory were collected at 23-25 y of age. A linear regression was performed to assess the association between CD and biochemical measurements in early adulthood, controlling for a minimum set of confounders that were identified in a directed acyclic graph. Results: The mean 6 SD age of the subjects was 23.9 6 0.71 y, and 51.8% of the sample were women. The CD rate was 32.0% and was more common in older (P , 0.001) and more educated mothers (P , 0.001). Compared with vaginal delivery, CD was associated with higher body mass index (BMI) after multivariable adjustment (P , 0.001) but not with glucose, homeostasis model assessment of insulin resistance, the quantitative insulin-sensitivity check index, total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides (all P. 0.05). Conclusion: In our sample of Brazilian adults, CD was associated with higher BMI but not with other metabolic risk factors. Am J Clin Nutr doi: 10.3945/ajcn.114.105205.

The hypertensive disorders of pregnancy complicate up to 10% of pregnancies worldwide and are a leading cause of maternal, foetal, and neonatal morbidity and mortality. The aim of this study was to present an overview of recent studies addressing offspring’s medium and long-term health outcomes after intrauterine exposure to maternal hypertension. A search on PubMed/MEDLINE and Bireme databases was conducted to identify observational studies that reported any offspring outcome measured after the 6th month of life. The search was limited to studies published after May 2008. Forty-five articles were included and categorized into four groups of outcomes: cardiovascular, immune, metabolic and behavioural/neurological effects. According to our findings, hypertensive disorders of pregnancy had an overall negative impact on offspring’s cardiovascular, immune and neurological health, although not all parameters analysed in each group had consistent results among studies. The most prominent and reliable associations were verified between gestational hypertension and higher offspring’s blood pressure and between preeclampsia and offspring’s lower cognitive functioning. In the metabolic outcomes, body composition had conflicting results among papers, while all studies that examined blood biomarkers showed no evidence that preeclampsia or gestational hypertension could be associated with an alteration of this metabolic outcomes. Most included studies were highly heterogeneous regarding the measure of outcomes and covariables used for adjustments. Future studies should consider using the same protocols and cut-off points already published so that results can be better compared and summarized.This review was registered in PROSPERO. Registration number: CRD42015020838

Introduction The hypertensive disorders of pregnancy are a leading cause of morbidity and mortality for mother and offspring, and complicate up to 10% of pregnancies over the world. Objectives The aim was to systematically review evidence of offspring’s medium and long term health outcomes after intrauterine exposure to maternal hypertension during pregnancy. Methods A research on PubMed/MEDLINE and Bireme databases were conducted to identify observational studies that reported evidence about any offspring outcome measured after the 6th month of life. Two authors independently and blindly reviewed the titles, abstracts and full papers, selecting those that meet all inclusion criteria. For each step, a third reviewer was requested to decide disagreements. Results A total of 45 were included in the review and the outcomes were categorized into four groups: cardiovascular, immune, metabolic and behavioral/neurological effects. According to our findings, hypertensive disorders of pregnancy had an overall negative effect on offspring’s cardiovascular, immune and neurological health. The most prominent and reliable associations were verified between preeclampsia and offspring’s lower cognitive functioning and between gestational hypertension and higher offspring’s blood pressure. Among the metabolic outcomes, body composition had conflicting results, while all studies that examined blood biomarkers showed no evidence of alteration after preeclampsia or gestational hypertension exposure. Most included studies were highly heterogeneous regarding the measure of outcomes and covariables used for adjustments. Conclusions Our findings suggest that further researches are necessary to overcome the heterogeneity of the studies about maternal hypertension disorders during pregnancy and to reveal the mechanisms involved in the observed associations. Future studies should consider using the same protocols and cut-off points already published so that results can be better compared and summarized.