Body composition of preschool children and relation to birth weight.

Objective: to evaluate the relationship between body composition of preschool children suffering from excess weight and birth weight (BW).

Methods: probabilistic sample, by conglomerates, with 17 daycare centers (of a total of 59) composing a final sample of 479 children. We used Z-score of Body Mass Index (zBMI) ≥ +1 and ≥ +2, respectively, to identify preschool children with risk of overweight and excess weight (overweight or obesity).

Longitudinal variations in fitting parameters for adult cochlear implant recipients.

In patients with a cochlear implant (CI), the first critical point in processing auditory information from sound stimuli that leads to comprehension is the interface between the electrode and the cochlear nerve, which is dependent on providing appropriate current input. The purpose of this work was to evaluate the longitudinal differences in psychoacoustic fitting parameters in CI users. We studied 26 profoundly deaf adults, aged between 18 and 58 years, who had been implanted in our department between 2009 and 2011.

Successful application of transoral robotic surgery in failures of traditional transoral laser microsurgery: critical considerations.

Aims: To assess the role of transoral robotic surgery (TORS) in managing failures of conventional transoral laser microsurgery (TLM) in cases with difficult laryngeal exposure.

Methods: Retrospective analysis of 3 patients with difficult laryngeal exposure treated with TORS. All 3 cases failed to be managed by conventional TLM after repeated attempts by experienced surgeons.

Analysis of cardiac autonomic modulation of children with attention deficit hyperactivity disorder.

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by decreased attention span, impulsiveness, and hyperactivity. Autonomic nervous system imbalance was previously described in this population. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV).

[Primary health care reform and implications for the organizational culture of Health Center Groups in Portugal].

The health sector's increasing complexity poses major challenges for administrators. There is considerable consensus on workforce quality as a key determinant of success for any health reform. This study aimed to explore the changes introduced by an action-training intervention in the organizational culture of the 73 executive directors of Health Center Groups (ACES) in Portugal during the primary health care reform.

[Masuda's Central Serous Chorioretinopathy (C.S.C.R.) and its somatic investment in Narcissism: our observations on new psychiatric nosography].

Case report. Co-morbidity between central serous chorioretinopathy (C.R.

Integrated disease management: a critical review of foreign and Portuguese experience.

Introduction: The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes.

Material And Methods: The literature review identified 1 251 articles, published from 2006 to 2011.

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial.

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects.

Clinical, neurophysiological, and skin biopsy findings in peripheral neuropathy associated with hepatitis C virus-related cryoglobulinemia.

Hepatitis C virus (HCV)-related cryoglobulinemia commonly causes disabling complications including peripheral neuropathy and neuropathic pain. In this prospective clinical, neurophysiological, and skin biopsy study we aimed at assessing clinical characteristics and risk factors of peripheral neuropathy and neuropathic pain in patients with HCV-related cryoglobulinemia. We enrolled 69 consecutive patients with HCV-related cryoglobulinemia.

Does the epidermal nerve fibre density measured by skin biopsy in patients with peripheral neuropathies correlate with neuropathic pain?

The different neuropathic pain types (e.g., ongoing burning pain and allodynia) are frequent and disabling complaints in patients with peripheral neuropathies.

Sweat conductivity: an accurate diagnostic test for cystic fibrosis?

Background: Sweat chloride test is the gold standard test for cystic fibrosis (CF) diagnosis. Sweat conductivity is widely used although still considered a screening test.

Methods: This was a prospective, cross-sectional, diagnostic research conducted at the laboratory of the Instituto da Criança of the Hospital das Clínicas, São Paulo, Brazil.

Development of a standardized process improvement protocol to address elevated health care-associated infection rates on an incented quality scorecard.

This practice forum report details a standardized improvement process that was created both to improve patient outcomes related to various hospital-acquired infections and to address leadership concerns related to incented quality metrics. A 3-year retrospective review identified common issues to guide future interventions and confirmed that this methodology reduced the rate of recurrent infections across the health care system. Process tool samples are provided.

Motivated reflection on attitude-inconsistent information: an exploration of the role of fear of invalidity in self-persuasion.

The mere thought effect is defined in part by the tendency of self-reflective thought to heighten the generation of and reflection on attitude-consistent thoughts. By focusing on individuals' fears of invalidity, we explored the possibility that the mere opportunity for thought sometimes motivates reflection on attitude-inconsistent thoughts. Across three experiments, dispositional and situational fear of invalidity was shown to heighten reflection on attitude-inconsistent thoughts.

Trends of cross-border mobility of physicians and nurses between Portugal and Spain.

Context: Health workforce cross-border mobility has an impact not only on individual health workers, but also on how health services are organized, planned, and delivered. This paper presents the results of a study of current mobility trends of health professionals along the borders between Portugal and Spain. The objective was to describe the profile of mobile physicians and nurses; to elicit the opinions of employers on mobility factors; to describe incentive policies to retain or attract health professionals; and to collect and analyse employers' opinions on the impact of this mobility on their health services.

Cognitive impairment and "invisible symptoms" are not associated with CCSVI in MS.

Background: We investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS). Moreover, we evaluated the association between CCSVI and other frequent self-reported MS symptoms.

Methods: We looked at the presence of CI in incident MS patients with CCVSI in a population-based cohort of Catania, Italy.

Health professionals moving to... and from Portugal.

The mobility of health professionals in the European Union is a phenomenon which policy-makers must take into account to provide the conditions to adjust for demand and supply of health services. This paper presents the case of Portugal, a country which at the same time imports and exports health workers. Since the early 1990s Portugal became a destination country receiving foreign health care professionals.

Vitamin D and periodontal health in older men.

Vitamin D, an anti-inflammatory mediator, has potential benefits for physical and oral health. Although it is produced endogenously, some individuals have a greater need for dietary and supplemental sources. This repeated-measures cross-sectional study assessed associations between total vitamin D intake and periodontal health in older men.

Is waist-to-height ratio a useful indicator of cardio-metabolic risk in 6-10-year-old children?

Background: Childhood obesity is a public health problem worldwide. Visceral obesity, particularly associated with cardio-metabolic risk, has been assessed by body mass index (BMI) and waist circumference, but both methods use sex-and age-specific percentile tables and are influenced by sexual maturity. Waist-to-height ratio (WHtR) is easier to obtain, does not involve tables and can be used to diagnose visceral obesity, even in normal-weight individuals.

Nutritional strategies of physically active subjects with muscle dysmorphia.

Background: The aim of this study was to identify dietary strategies for physically active individuals with muscle dysmorphia based on a systematic literature review.

Method: References were included if the study population consisted of adults over 18 years old who were physically active in fitness centers. We identified reports through an electronic search ofScielo, Lilacs and Medline using the following keywords: muscle dysmorphia, vigorexia, distorted body image, and exercise.

Acute bronchodilator responsiveness to tiotropium in postinfectious bronchiolitis obliterans in children.

Background: Patients with postinfectious bronchiolitis obliterans (PIBO) usually have severe airflow obstruction and respond poorly to β-adrenergic drugs. However, the bronchodilator response to an anticholinergic agent such as tiotropium bromide is not known. We studied the acute bronchodilator response to tiotropium for up to 24 h in children with PIBO using spirometric and plethysmographic criteria.

[Infant breastfeeding prevalence in the city of São Paulo, Brazil, 2008].

This cross-sectional epidemiological study based on AMAMUNIC aimed to evaluate infant breastfeeding (BF) prevalence and duration in São Paulo, Brazil. Sample size was based on a cluster calculation, selecting 35 primary care units and 35 infants (< 1 year of age) per unit. A total of 1,424 interviews with mothers were performed (56 items on feeding in the previous 24 hours) in August 2008, subsequently analyzed according to residential areas: Central West, East, North, Southeast, and South.

Fluid intake patterns: an epidemiological study among children and adolescents in Brazil.

Background: Energy from liquids is one of the most important factors that could impact on the high prevalence of children and adolescents obesity around the world. There are few data on the liquid consumption in Brazil. The aim of this study is to evaluate the volume and quality of liquids consumed by Brazilian children and adolescents and to determine the proportion of their daily energy intake composed of liquids.

Cementless total hip replacement for severe developmental dysplasia of the hip: our experience in Crowe's group IV.

Total hip replacement in developmental dysplasia of the hip grade IV of Crowe's classification presents some difficulties. In this study, we present our results of the treatment for this pathology, also describing the surgical techniques used and the complication we had. In this paper, 18 total hip replacements in developmental dysplasia of the hip Crowe IV were studied clinically and radiologically before and after surgery, with a mean follow-up of 4.