Infant growth, development and tooth emergence patterns: A longitudinal study from birth to 6 years of age

OBJECTIVE: To test the association of child's growth/development status and socioeconomic variables with dental emergence patterns. DESIGN: A sample of 359 children belonging to a birth cohort of over 5000 children born in 1993 in Pelotas (Brazil) was studied in 1998-1999. Previously trained observers collected birthweight, head circumference at birth, birth height, gestational age, smoking during pregnancy, child's sex and skin colour, height by age at 6 months of age, caries experience in the deciduous teeth, number of emerged teeth at 6 and 12 months of age and emergence stages of the first permanent molars at 6 years of age. Family income, parental educational attainment and anthropometric measurements were collected at children's homes. Poisson regression models were applied in order to select best predictors of pairs of emerged teeth at 6 and 12 months of age and emerged (yes/no) first permanent molars at 6 years of age. RESULTS: Children shorter than 49cm had, on average, less pairs of emerged teeth at 6 months of age. Twelve-month-old children with birth height < or =49cm, presenting height-for-age deficit at 6 months of age and the females also presented less pairs of emerged teeth. Stunted children at 6 months of age were more likely to have non-emerged first upper left and lower right permanent molars at 6 years of age. CONCLUSIONS: Important developmental and nutritional variables at birth and throughout the early life may predict the numbers of emerged teeth children have in their oral cavity.     

Cardiac autonomic modulation evaluated by heart interval variability is unaltered but subtly widespread in the indeterminate Chagas' disease

BACKGROUND: Cardiac autonomic function in the indeterminate chronic form of Chagas' disease deserves better clearing-up and understanding, since the existing findings are scarce and controversial. This work analyzed the short-term heart interval variability in order to verify the cardiac autonomic modulation in indeterminate Chagas' disease subjects examined in a Brazilian endemic area. METHODS: Variability in time and frequency domain of 5-minute electrocardiogram (ECG) series of R-R intervals in supine and active standing positions were obtained from 18 age-, gender-, body mass index-, lifestyle-, and physical activity-matched chagasics and 18 control healthy subjects examined in Agua Comprida city, MG, Brazil. Mann-Whitney test was used for analysis of the data and spread of the individual indices in both groups. RESULTS: The median of the all variability indices in the chagasic group were statistically similar (P= 0.17-0.87) to that in the control group. A wide dispersion of the almost all individual indices values, ranging from normal to variably reduced or increased ones, was noted in the majority of the chagasics in relation to the control interquartile range, in both postural positions. CONCLUSION: As a group, indeterminate Chagas' disease subjects showed unaltered short-term heart interval variability. Individual somewhat widespread of majority of time- and frequency-domain indices, from depressed to exacerbated ones appears to exist. This conforms to a variable cardiac autonomic modulation in this form of disease, suggesting that the majority of chagasics has no lesions, and a minority has subtle lesions of the efferent innervation-sinus node complex.     

Catastrophic spending on health care in Brazil: private health insurance does not seem to be the solution

The objective of this study was to estimate catastrophic healthcare expenditure in Brazil, using different definitions, and to identify vulnerability indicators. Data from the 2002-2003 Brazilian Household Budget Survey were used to derive total household consumption, health expenditure and household income. Socioeconomic position was defined by quintiles of the National Economic Indicator using reference cut-off points for the country. Analysis was restricted to urban households. Catastrophic health expenditure was defined as expenditure in excess of 10% and 20% of total household consumption, and in excess of 40% of household capacity to pay. Catastrophic health expenditure varied from 2% to 16%, depending on the definition. For most definitions, it was highest among the poorer. The highest proportions of catastrophic health expenditure were found to be in the Central region of Brazil, while the South and the Southeast had the lowest. Presence of an elderly person, health insurance and socioeconomic position were associated with the outcome, and coverage by health insurance did not protect from catastrophic health expenditure.     

Inequities in maternal postnatal visits among public and private patients: 2004 Pelotas cohort study

Background  

The postnatal period is the ideal time to deliver interventions to improve the health of both the newborn and the mother. However, postnatal care shows low-level coverage in a large number of countries. The objectives of this study were to: 1) investigate inequities in maternal postnatal visits, 2) examine differences in postnatal care coverage between public and private providers and 3) explore the relationship between the absence of maternal postnatal visits and exclusive breastfeeding, use of contraceptive methods and maternal smoking three months after birth.     

Leisure time physical activity prevents accumulation of central fat in HIV/AIDS subjects on highly active antiretroviral therapy

The aim of this study was to verify the relationship between habitual physical activity and body fat in HIV/AIDS subjects on highly active antiretroviral therapy. This was a cross-sectional study covering 169 men and 51 women. It was conducted at the AIDS Clinic of the School of Medicine, University of S?o Paulo. The dependent variables analysed were central subcutaneous fat (CSF) and waist-to-hip-ratio (WHR). The independent variable was the score for leisure time physical activity (LTPA). The control variables were sex, age, education, energy intake, body mass index, smoking, diagnosis of AIDS, T-CD4+ lymphocyte levels and duration of use of protease inhibitors. Multiple linear regressions were used for statistical analysis. After controls, there was significant negative correlation for LTPA with CSF (beta=-2.849; Pvariable=0.013; r2(adjusted)=0.65; Pmodel<0.001), and LTPA was in the limit of the significance with WHR (beta=-0.005; Pvariable=0.073; r2(adjusted)=0.41; Pmodel<0.001). Physical activity contributed towards preventing fat accumulation in HIV/AIDS subjects.