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Compensate breaks by way of center-surround self-consciousness through anterior insula.
269; tri-ponderal mass index R2=0.289; p less then 0.001) and boys (body mass index Z scores R2=0.175; tri-ponderal mass index R2=0.210; p less then 0.001). CONCLUSIONS The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with insulin resistance. It is noteworthy that the use of tri-ponderal mass index is clearly advantageous, because it can be calculated with no concerns on adjustments for the age, a fact that makes it very applicable in the clinical practice.OBJECTIVE To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. METHODS Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child's food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). RESULTS The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). CONCLUSIONS Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.OBJECTIVE To identify the prevalence of insulin resistance in adolescents and its associations with metabolic factors and food intake. METHODS Cross-sectional study conducted with a stratified, complex, school-based sample. The subjects were adolescents (n=1,081) who participated in the Study of Cardiovascular Risk in Adolescents in the city of Recife (Pernambuco, Brazil). We analyzed demographic, socioeconomic, behavioral, anthropometric, biochemical, and dietary variables. Insulin resistance was defined as HOMA-IR>75th percentile. A Poisson multivariate regression model with robust variance adjustment was used, and variables with p≤0.05 in the final model were considered statistically associated with insulin resistance. RESULTS Median age was 14 years (interquartile range 13-16 years), and 25.3% of the sample showed insulin resistance. The variables associated with insulin resistance in the final model were age, body mass index-for-age (BMI/A), biochemical markers (triglycerides and high-density lipoprotein cholesterol) and saturated fat intake, with insulin resistance being more prevalent in individuals whose consumption of this type of fat was below the median of the sample distribution. CONCLUSIONS Insulin resistance was prevalent in the adolescents analyzed and was significantly associated with metabolic variables and saturated fat intake.OBJECTIVE To investigate the association between weight status and anthropometric indicators of adiposity with body esteem. METHODS Cross-sectional study including 305 adolescents from a public school in Rio de Janeiro, Brazil. Data were collected by a self-administered questionnaire and anthropometric measurements. The Body-Esteem Scale for Adolescents and Adults was used to evaluate total body esteem and the "appearance", "weight", and "attribution" domains. Body mass index (weight/stature2) was applied to assess weight status and waist circumference, the central body adiposity. The association between indicators of adiposity and body esteem was assessed using Student's t-test or Mann-Whitney's test and linear regression models, stratified by sex and age group. RESULTS Overweight/obesity was observed in 46% of younger adolescents (10 to 13 year-old girls, 10 to 14 year-old boys), 38% of older boys (15 to 18 year old), and 16% of older girls (14 to 18 year old). For both boys and girls in the younger age group, body mass index and waist circumference (as continuous variables) were inversely associated with total body esteem and weight domain. Overweight/obesity was associated with the appearance body esteem domain only among younger male adolescents; no association was found between either the body mass index or waist circumference and the attribution domain. CONCLUSIONS Indicators of adiposity were associated with low body esteem. These findings underscore the fact that considering adolescents' feelings concerning their body and appearance is important to promote a healthy control of weight.OBJECTIVE To report the case of a child who developed acute respiratory distress syndrome (ARDS) from a pulmonary infection by adenovirus. CASE DESCRIPTION A female patient aged 2 years and 6 months, weighting 10,295 grams developed fever, productive cough and vomiting, later on progressing to ARDS despite initial therapy in accordance with the institutional protocol for ARDS treatment. The child evolved to refractory hypoxemia and hypercapnia, requiring high parameters of mechanical pulmonary ventilation and use of vasoactive agents. In the treatment escalation, the patient received steroids, inhaled nitric oxide (iNO), was submitted to the prone position, started oscillatory high-frequency ventilation (HFOV) and extracorporeal membrane oxygenation (ECMO) was indicated due to severe refractory hypoxemia. During this time, the patient's clinical response was favorable to HFOV, improving oxygenation index and hypercapnia, allowing the reduction of vasoactive medications and mechanical ventilation parameters, and then the indication of ECMO was suspended. Staurosporine The patient was discharged after 26 days of hospital stay without respiratory or neurological sequelae. COMMENTS Adenovirus infections occur mainly in infants and children under 5 years of age and represent 2 to 5% of respiratory diseases among pediatric patients. Although most children with adenovirus develop a mild upper respiratory tract disease, more severe cases can occur. ARDS is a serious pulmonary inflammatory process with alveolar damage and hypoxemic respiratory failure; Adenovirus pneumonia in children may manifest as severe pulmonary morbidity and respiratory failure that may require prolonged mechanical ventilation. Exclusive pulmonary recruitment and HFOV are advantageous therapeutic options.OBJECTIVE To identify and analyze the scientific evidence of nutritional interventions performed in children and adolescents with Autism Spectrum Disorder. DATA SOURCES A systematic review was conducted in the MEDLINE, Cochrane Library, Embase, LILACS, Google Scholar, PubMed, PsycINFO and Periódicos CAPES databases, using a search strategy to identify studies published between January 2003 and March 2018, in Portuguese, English and Spanish. Were included studies that described nutritional interventions in children and adolescents with autism spectrum disorders and assessed autistic behavior and/or gastrointestinal symptoms. We excluded other review articles and studies that did not include a control group in the research design. The studies were reviewed for descriptive information, and the quality of evidence was assessed through the GRADE system. DATA SYNTHESIS 18 studies were included in the review, being 16 randomized clinical trials, 1 case-control study and 1 open-label trial. As a result, the implementation of a gluten-free and casein-free diet was the most used intervention among the studies. Of the total, 10 studies showed a positive association of intervention with the evaluated results, while 8 did not find of a significant association. CONCLUSIONS Although some authors report progress in the symptoms associated with autism in individuals with Autistic Spectrum Disorder undergoing nutritional interventions, there is little scientific evidence to support the use of nutritional supplements or dietary therapies in children and adolescents with autism.This study analyzed the first experience with vertical health consortia in Ceará State, Brazil, in order to shed light on their implementation. In the theoretical field, the article establishes a dialogue with studies on the state government's role in federalism and intergovernmental cooperation in health. A qualitative study was based on interviews with administrators associated with the consortia at the municipal, regional, and state levels, in addition to document analysis and a literature review. The results indicate that the implementation of consortia was designed by the state government and conducted initially in centralized fashion. A relationship of coordination was established with the definition of the arrangement's institutional design. We identified four factors that favor vertical cooperation in the state (i) the history of health policy in Ceará; (ii) action by the state government as the coordinating body in the regionalization process; (iii) the existence of policy leaders and cohesion in the bureaucracy; and (iv) juxtaposition between the consortia's institutional design and the decision-making structure of the Brazilian Unified National Health System (SUS). Vertical consortia represent a step forward in overcoming the negative effects of decentralization.This study reviewed articles originated in Brazil, in the United Kingdom, and in the United States from 1970 to September 2018 in the Web of Science database. Text mining techniques were used, and a predominantly qualitative analysis was performed, including correspondence analysis and sentiment analysis using the R Software (version 3.5.0) tools. Results show a repathologization of homosexuality in the gerontological knowledge production. This includes studies performed in 51 areas of knowledge in the three countries. That was followed by the depsychiatrization of homosexuality during the peak of deaths caused by AIDS, and its consequent recognition as an epidemiological threat. The article concludes reviewing the collected biomarkers, such as "sexual", "risk", "MSM", and "HIV/AIDS", which prove the progressive impact of sexual panic in gerontology studies and also associates AIDS with masculine homosexuality.Evidence has shown that urban environments that discourage walking contribute to functional incapacity in the elderly. Various indices have been proposed to describe an area's walkability, combining different aspects of the built environment that promote (or inhibit) walking. However, due to problems with the quality and availability of data in Brazil, there is no walkability index to date applies to all cities of the country and that has been properly tested in the population. The current study aimed to propose a walkability index based on geographic information systems for a medium-sized city, with open-access data, and to test its association with functional incapacity in the elderly. The study used data from the urban area of a medium-sized Brazilian city to select a parsimonious set of variables through factor analysis. The resulting index was tested for its association with the capacity to perform activities of daily living that require more movement, in 499 elderly, using generalized estimating equations.
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