Microplastics: the hidden danger.

Objective: To assess the impact of microplastics/nanoplastics (MiP/NP) on human health.

Data Source: The authors conducted a narrative review of articles published in English, Portuguese, French and Spanish in the last decade in the following databases: PubMed, Google Scholar, EMBASE and SciELO. The keywords used in this search were: microplastics OR nanoplastics OR marine litter OR toxicology OR additives AND human health OR children OR adults.

IV Brazilian Consensus on Rhinitis - an update on allergic rhinitis.

Introduction: The guidelines on allergic rhinitis aim to update knowledge about the disease and care for affected patients. The initiative called "Allergic Rhinitis and its Impact on Asthma", initially published in 2001 and updated in 2008 and 2010, has been very successful in disseminating information and evidence, as well as providing a classification of severity and proposing a systemized treatment protocol. In order to include the participation of other medical professionals in the treatment of allergic rhinitis, it is important to develop algorithms that accurately indicate what should and can be done regionally.

Spatial distribution of tuberculosis from 2002 to 2012 in a midsize city in Brazil.

Background: Tuberculosis (TB) remains a major public health problem in many developing countries. Exploratory spatial analysis is a powerful instrument in spatial health research by virtue of its capacity to map disease distribution and associated risk factors at the population level. The aim of the present study was to describe the epidemiologic characteristics and spatial distribution of new cases of TB reported during the period 2002-2012 in Divinopolis, a midsized city located in the state of Minas Gerais, southeastern Brazil.

Serum levels of vancomycin: is there a prediction using doses in mg/kg/day or m(2)/day for neonates?

Coagulase-negative Staphylococcus has been identified as the main nosocomial agent of neonatal late-onset sepsis. However, based on the pharmacokinetics and erratic distribution of vancomycin, recommended empirical dose is not ideal, due to the inappropriate serum levels that have been measured in neonates. The aim of this study was to evaluate serum levels of vancomycin used in newborns and compare the prediction of adequate serum levels based on doses calculated according to mg/kg/day and m(2)/day.

Prevalence of self-reported smoking experimentation in adolescents with asthma or allergic rhinitis.

Objective: To determine the prevalence of smoking experimentation among adolescents with asthma or allergic rhinitis.

Methods: This was a cross-sectional study involving adolescent students (13-14 years of age) in the city of Belo Horizonte, Brazil. The participants completed the Centers for Disease Control and Prevention and International Study of Asthma and Allergies in Childhood questionnaires, both of which have been validated for use in Brazil.

Prediction equations for spirometry in four- to six-year-old children.

Objective: To generate prediction equations for spirometry in 4- to 6-year-old children.

Methods: Forced vital capacity, forced expiratory volume in 0.5s, forced expiratory volume in one second, peak expiratory flow, and forced expiratory flow at 25-75% of the forced vital capacity were assessed in 195 healthy children residing in the town of Sete Lagoas, state of Minas Gerais, Southeastern Brazil.

Increased risk of allergic rhinitis among children delivered by cesarean section: a cross-sectional study nested in a birth cohort.

Background: Few studies have evaluated the association between delivery by cesarean section (CS) and asthma, allergic rhinitis and chronic rhinitis and whether this association is different in children with and without a family history of asthma. This study aims to investigate whether children born by CS have a higher chance to develop asthma, allergic rhinitis and chronic rhinitis and to evaluate the influence of parental history of asthma on these associations.

Methods: This is a cross-sectional study of 672 children nested in a birth cohort evaluated at 6-years of age.

Are measurements of peak nasal flow useful for evaluating nasal obstruction in patients with allergic rhinitis?

Background: Nasal obstruction is one of the most bothering allergic rhinitis (AR) symptoms and there is a need for objective parameters to complement clinical evaluation due to blunted perception in many patients. In this study we compare measures of peak nasal inspiratory flow (PNIF) and peak nasal expiratory flow (PNEF) in patients with AR and in individuals without nasal symptoms and correlate them with the perception of nasal obstruction.

Methods: A comparative cross-sectional study was conducted in 64 AR patients and 67 individuals without nasal symptoms aged between 16 and 50 years.

Phenotypes of severe asthma among children and adolescents in Brazil: a prospective study.

Background: The morbidity associated with severe uncontrolled asthma is disproportionately higher in low- and middle-income countries than in high-income countries. The aim of this study was to describe the phenotypic characteristics of difficult-to-treat severe asthma and treatment-resistant severe asthma in a sample of children and adolescents in Brazil.

Methods: This was a prospective study, conducted between 2010 and 2014, following 61 patients (6-18 years of age) who had been diagnosed with severe uncontrolled asthma.

Diagnostic accuracy of respiratory diseases in primary health units.

Respiratory diseases are responsible for about a fifth of all deaths worldwide and its prevalence reaches 15% of the world population. Primary health care (PHC) is the gateway to the health system, and is expected to resolve up to 85% of health problems in general. Moreover, little is known about the diagnostic ability of general practitioners (GPs) in relation to respiratory diseases in PHC.

[Diagnosis of streptococcal pharyngotonsillitis in children and adolescents: clinical picture limitations].

Objective:: To assess the utility of clinical features for diagnosis of streptococcal pharyngotonsillitis in pediatrics.

Methods:: A total of 335 children aged 1-18 years old and presenting clinical manifestations of acute pharyngotonsillitis (APT) were subjected to clinical interviews, physical examinations, and throat swab specimen collection to perform cultures and latex particle agglutination tests (LPATs) for group A streptococcus (GAS) detection. Signs and symptoms of patients were compared to their throat cultures and LPATs results.

Exacerbation of asthma and airway infection: is the virus the villain?

Objective: To review the available literature on the association between acute viral respiratory tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses, detection methods, as well as preventive and therapeutic aspects.

Sources: A search was conducted in PubMed, Lilacs, and SciELO databases, between the years 2002 and 2013, using the following descriptors: asthma exacerbation, virus, child, and acute respiratory infection.

Summary Of The Findings: A total of 42 original articles addressing the identification of respiratory viruses during episodes of asthma exacerbation were selected, mostly cross-sectional studies.

Prevalence of rheumatic heart disease in a public school of Belo Horizonte.

Background: Previous studies indicate that compared with physical examination, Doppler echocardiography identifies a larger number of cases of rheumatic heart disease in apparently healthy individuals.

Objectives: To determine the prevalence of rheumatic heart disease among students in a public school of Belo Horizonte by clinical evaluation and Doppler echocardiography.

Methods: This was a cross-sectional study conducted with 267 randomly selected school students aged between 6 and 16 years.

Pulmonary radiographic findings in young children with cystic fibrosis.

Background: Pulmonary evaluation is one of the greatest challenges in children with cystic fibrosis who are younger than 6 years. Although chest CT can provide the most information for initial and progressive changes in cystic fibrosis, the radiation exposures can lead to significant cumulative exposure in children as they are followed with serial scanning to monitor early and progressive disease. Therefore the systematized study of chest radiographs using the Brasfield score has been used scientifically with the aim of evaluating the evolution of pulmonary abnormalities in children with cystic fibrosis.

Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012).

Objective: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3).

Methods: The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed.

Correlation between Bhalla score and spirometry in children and adolescents with cystic fibrosis.

Objective: To correlate the findings of high resolution computed tomography of the chest based on the Bhalla score with the clinical data and spirometry in children and adolescents with cystic fibrosis, and to study the concordance between two radiologists for the Bhalla score and its categories.

Methods: We evaluated the medical records of 23 patients from the outpatient clinic. The items evaluated included age, weight, height, height/age Z-score, weight/age Z-score, body mass index (BMI), O2 saturation, spirometry and Bhalla score.

Empyema and bacteremic pneumococcal pneumonia in children under five years of age.

We compared bacteremic pneumococcal pneumonia (BPP) and pneumococcal empyema (PE), in terms of clinical, radiological, and laboratory findings, in under-fives. A cross-sectional nested cohort study, involving under-fives (102 with PE and 128 with BPP), was conducted at 12 centers in Argentina, Brazil, and the Dominican Republic. Among those with PE, mean age was higher; disease duration was longer; and tachypnea, dyspnea, and high leukocyte counts were more common.

Pre and perinatal aspects of congenital cystic adenomatoid malformation of the lung.

Objective: To identify the incidence of congenital cystic adenomatoid malformation of the lung (CCAM) at birth; to evaluate prenatal and perinatal history, association with clinical and sociodemographic variables and concordance between CT scan results and anatomopathology studies.

Method: Descriptive study based on the registry of malformed newborns, deliveries and patients records between August 1990 and November 2010. Ultrasonic, clinical, imaging and anatomopathologic information were studied.

Incidence of infectious complications associated with central venous catheters in pediatric population.

Background: Central venous catheters (CVC) are essential in intensive pediatric care units (PICU). Preventive measures during insertion and maintenance reduce infection risks.

Methods: A prospective cohort study was conducted from January 2010 to December 2011 in a Brazilian university hospital PICU.

Feasibility and reproducibility of spirometry and inductance plethysmography in healthy Brazilian preschoolers.

Rationale: Preschoolers show peculiarities that reinforce the importance of assessing their pulmonary function. However, there are few data on the success rate and between-occasions reproducibility of pulmonary function tests in preschoolers, particularly in the Brazilian population.

Objective: To assess the success rate and between-occasions reproducibility of the variables obtained by spirometry and respiratory inductive plethysmography in healthy children aged 4-6 years.

Percutaneous central venous catheterization through the external jugular vein in children: is inserting the guide wire into the superior vena cava essential for successful catheterization?

Background/purpose: The external jugular vein (EJV) is an attractive alternative for percutaneous central venous catheterization (PCVC), with fewer complications. The inability to pass the guide wire into the superior vena cava (SVC) is, however, a major reason for the failure of this approach. The authors report a modification of the Seldinger technique to increase the effectiveness of this procedure in children.

Comparison of diagnostic methods for pancreatic insufficiency in infants with cystic fibrosis.

Objective: The objective of the present study is to compare daily weight gain and laboratory analysis (72-hour fecal fat and steatocrit) with fecal elastase-1 (EL-1) when diagnosing pancreatic insufficiency (PI) in infants with cystic fibrosis (CF).

Methods: A total of 39 infants with CF, diagnosed consecutively by newborn screening at 2 referral centers, were included in the study. Daily weight gain and results of laboratory analysis of stool samples were compared using the κ coefficient and the receiver operator characteristic (ROC) curve.

Prevalence of hyponatremia at diagnosis and factors associated with the longitudinal variation in serum sodium levels in infants with cystic fibrosis.

Objective: To determine the prevalence of hyponatremia at diagnosis in patients with cystic fibrosis and identify the factors associated with changes in serum sodium concentration over time.

Study Design: This longitudinal study investigated whether variations in serum sodium concentration were associated with age, diet, infection status, and climate/temperature. Multivariate analysis was performed using the random-effects model for longitudinal data.