There are few published studies on prevalence of allergic rhinitis in preschool children. The aims of this study were to verify the prevalence, clinical characteristics, and treatment of allergic rhinitis (AR) symptoms in the first year of life adding supplementary questions to the EISL instrument. A cross-sectional study used Phase III EISL written questionnaire in addition to modified allergic rhinitis ISAAC questions. One thousand and three parents of infants answered the questionnaire: 484 (48.3%) had at least one sneezing, or a runny or blocked nose episodes without cold or flu in the first year of life. A quarter of infants had recurrent wheezing (≥3 episodes) and more frequent in the presence of AR symptoms. Physician diagnosis of AR and the use of intranasal steroids and both antihistamines and intranasal steroids were more common among those infants with AR symptoms. The prevalence of AR symptoms was high and starting early in life.

BACKGROUNDPiercings are body embellishments commonly seen in young people, however their inherent risk of infection and scarring disorders are less divulged.OBJECTIVETo evaluate the prevalence of body piercings among medical students and their possible dermatologic consequences.METHODSCross-sectional study with 58 medical students, by means of a structured questionnaire covering socio-demographic characteristics, technical issues related to the piercing and characteristics of the dermatologic complications.RESULTSThe sample was predominantly female (86.2%), with mean age 24 ± 3 years. The placement of the first piercing occurred during adolescence (median age 15), without medical supervision (91.4%) or knowledge of parents/guardians (74%). Most piercings were made of metal alloy/stainless steel, in a dumbbell model (51.7%), inserted in the umbilical area (53.5%) or ear (41.4%), with frequent cutaneous reactions in the first six months post-piercing. Hypertrophic scarring, pain, swelling and infection (p<0.05) had significantly higher frequencies among those with navel piercings.CONCLUSIONPiercing insertion occurred during adolescence. Local inflammatory and infectious reactions were common. Scarring disorders and dermatitis appeared in the long term. There is need for preventive and educational activities, starting with those in the academic environment.

Objective: To determine epidemiological changes in recurrent wheezing among infants in Curitiba, Brazil. Results: Parents of 3,003 infants participated in phase I, and 22.6% of the infants had recurrent wheezing (≥ 3 episodes). After 5 years, 1,003 parents completed the same questionnaire during phase III, and 19.8% of the infants had recurrent wheezing (p = 0.1). There was a reduction in symptom severity (p = 0.001) and number of emergency department visits (p < 0.001), but not in number of hospitalizations (p = 0.12). Physician-diagnosed asthma was more frequent in phase III (p = 0.03). Conclusions:There were no changes in the prevalence of recurrent wheezing in infants, but there was an increase in physician-diagnosed asthma and a reduction in severity, which, however, did not affect the rate of hospitalizations.J Pediatr (Rio J). 2011;87(6):547-50: Asthma, infant, prevalence, wheezing. ResumoObjetivo: Verificar mudanças na epidemiologia da sibilância recorrente em lactentes de Curitiba (PR). Método: Estudo transversal com aplicação do questionário Estudio Conclusões:Não houve mudança na prevalência de sibilância recorrente em lactentes, mas ocorreu redução na gravidade, embora sem afetar o nível de internações e com aumento do diagnóstico de asma pelos clínicos.J Pediatr (Rio J). 2011;87(6):547-50: Asma, criança, prevalência, sibilo. Recurrent wheezing in infants: epidemiological changes IntroduçãoA prevalência de doenças alérgicas na população pediá-trica vem sendo amplamente estudada nos últimos anos. Na comparação das fases I e III do International Study of Asthma and Allergies in Childhood (ISAAC), realizada com intervalo de pelo menos 5 anos entre as fases, houve aumento na prevalência de asma em escolares e adolescentes na maioria dos centros participantes 1 . Apesar de o Brasil apresentar altas prevalências de asma e de sintomas relacionados, na fase III do ISAAC, a maioria dos centros evidenciou redução desses índices, tanto em escolares quanto nos adolescentes, e os ní-1. Pós-doutorando, Saúde da Criança e do Adolescente, Universidade Federal do Paraná (UFPR), Curitiba, PR. Pesquisador associado, Serviço

Introduction. Skin disorders can be the first manifestation of occult diseases. The recognition of typical paraneoplastic dermatoses may anticipate the cancer diagnosis and improve its prognosis. Although rarely observed, the sudden appearance and/or rapid increase in number and size of seborrheic keratoses can be associated with malignant neoplasms, known as the sign of Leser-Trélat. The aim of this report is to unveil a case of a patient whose recently erupted seborrheic keratoses led to investigation and consequent diagnosis of bladder cancer. Case Presentation. A 67-year-old man was admitted to the intensive care unit due to an exacerbation of chronic obstructive pulmonary disease (COPD). On physical examination, multiple seborrheic keratoses on the back of the hands, elbows, and trunk were observed; the patient had a 4-month history of these lesions yet was asymptomatic. The possibility of Leser-Trélat syndrome justified the investigation for neoplasia, and a bladder carcinoma was detected by CT-scan. The patient denied previous hematuria or any other related symptoms. Many of the lesions regressed during oncologic treatment. Conclusion. Despite the critics on the validity of the sign of Leser-Trélat, our patient fulfills the description of the disease, though urinary malignancy is a rare association. That corroborates the need of further investigation when there is a possibility of paraneoplastic manifestation.

BackgroundPrevalence of allergic diseases has increased in the last years. Data on recurrent wheezing (≥3 episodes) in infancy is scarce. The aim of this study was to verify changing in prevalence of recurrent wheezing infants in the south of Brazil.MethodsCross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) with questions: Has your baby had wheezing or whistling in the chest area or bronchitis in the first 12 months of life? Has your baby had 3 or more wheezing episodes in the first year of life? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between August 2005 to December 2006 (EISL Phase I) and September 2009 to September 2010 (EISL Phase III). Categorical variables are shown as proportion and differences verified by chi-square test, and continuous variables were expressed as mean ± SD and analyzed by Student t test.ResultsThree thousand three parents of infants answered questionnaire in the EISL Phase I, and 45.4% had had at least one wheezing episode; 50.7% were male, and 22.6% had recurrent wheezing episode starting at 5.5 ± 3.1 months. Five years later, in the EISL Phase III, 1003 parents participated in the survey: 40.6% had at least one wheezing episode (P = 0.46), 51.1% were male, and 19.8% had recurrent wheezing (P = 0.1) starting at 6.1 ± 3 months (P = 0.06).ConclusionsRecurrent wheezing in infancy is highly prevalent and starts early in life. In our population, recurrent wheezing rates did not modify in the time period of study.

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RESUMOApesar da hipertensão arterial sistêmica ser uma condição muito prevalente, a meta pressórica a ser atingida ainda permanece incerta. O estudo SPRINT comparou o controle pressórico mais intensivo (pressão sistólica menor que 120 mmHg) versus o controle habitual (pressão sistólica menor que 140 mmHg). Neste trabalho, houve redução significativa de eventos cerebro e cardiovasculares e também de mortalidade no grupo de tratamento intensivo. Entretanto, esta redução foi associada a maior incidência de eventos adversos.Descritores: Pressão arterial. Eventos cardiovasculares. Prevenção primária. ABSTRACTDespite the high prevalence of hypertension, the target blood-pressure levels to be achieved with therapy remains uncertain. The SPRINT trial compared more intensive blood pressure control (systolic blood pressure less than 120 mmHg) versus usual control (systolic blood pressure less than 140 mmHg). In this study, there was a significant reduction in cerebro-and cardiovascular events and also a reduced mortality in the intensive treated group. However, this reduction was associated with a higher incidence of adverse events.

BackgroundParacetamol (PCM) and antibiotic (ATB) use have been associated with risk for wheezing and asthma in children. The aim of this study was to verify the association of recurrent wheezing (≥3 episodes) in infancy and use of ATB or PCM in the first year of life.MethodsCross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) with questions: Has your baby had wheezing or whistling in the chest area or bronchitis in the first 12 months of life? Has your baby had 3 or more wheezing episodes in the first year of life? How often has your baby used antibiotics in the first year of life? How often has your baby used paracetamol in the first year of life? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between September 2009 to September 2010 (EISL Phase III). Risk was demonstrated using Odds ratio and 95% CI.ResultsOne thousand and 3 parents participated in the survey and 19.8% of infants had recurrent wheezing starting at 6.1 ± 3 months. The use of PCM was not related to the presence of recurrent wheezing [No PCM (OR = 0.91; 95% CI, 0.38-2.19; P = 0.83), PCM 1–3 times (OR = 1.21; 95% CI, 0.77-1.91; P = 0.4), PCM 4–6 times (OR = 1.21; 95% CI, 0.77-1.9; P = 0.41) and PCM ≥7 times (OR = 0.76; 95% CI, 0.51-1.13; P = 0.17)], while more frequent use of ATB reduced the risk of recurrent wheezing in the first year of life [No ATB (OR = 2.18; 95% CI, 1.35-3.51; P = 0.001), ATB 1–3 times (OR = 1.39; 95% CI, 0.93-2.07; P = 0.1), ATB 4–6 times (OR = 0.37; 95% CI, 0.22-0.62; P = 0.001) and PCM≥7 times (OR = 0.22; 95% CI, 0.07-0.66; P = 0.001)].ConclusionsThe frequent use of ATB reduced the risk of recurrent wheezing in the first year of life unlike PCM that was not associated with recurrent wheezing in this study population.