ObjectiveTo describe the mortality pattern among children enrolled in public day care centers.
MethodsThis was a descriptive study of the mortality pattern among children aged from 0 to 6 years and 11 months who were enrolled in all the public day care centers in the city of São Paulo, Brazil, from 1995 to 1999. The variables of interest were sex, age, u nderlying cause of death, duration of day care attendance and seasonality.
ResultsThe average mortality rate for the period was 36.4 per 100,000 children. Of the total number of deaths, 32.7% were among children under 1 year old and 78.4% under 3 years old. The deaths of 54.2% of these children occurred before completing six months in the day care center, with a concentration of 36.3% during the first three months. The majority of the deaths occurred during the winter and autumn seasons: 31.8% and 29.6%, respectively. The main underlying causes of death were infections: pneumonia (29.6%), meningococcal disease (13.0%), non-meningococcal meningitis (8.5%), gastroenteritis (7.6%) and chickenpox (5.4%). External causes were responsible for 13.5% of the deaths and included falls, being run over, drowning, burns and physical aggression.
ConclusionsThe study indicated that younger children (0-3 years) were the most vulnerable group and that the majority of deaths derived from avoidable causes, some of which pre ventable by vaccination nowadays.
KeywordsInfant mortality. Child day care centers. Underlying cause of death. Mortality rate. Seasonal variations.
To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.
ER. Reliability of information on varicella history in preschool children. Clinics. 2007;62(3):309-14.
OBJECTIVE:To verify how reliable is the information provided by parents about the history of varicella in their children. METHODS: 204 parents of previously healthy children attending two municipal day-care centers of São Paulo city were interviewed between August 2003 and September 2005. A standardized form was filled out with information regarding age, sex, history of varicella and other diseases, drug use and antecedent of immunization, After medical history, physical examination and checking of immunization records, 5 ml of blood were collected for ELISA (in house) varicella test. Exclusion criteria were: age less than 1 year or more than 60 months, previous immunization against chickenpox, presence of co-morbidities or recent use of immunosuppressive drugs. Data were filed in a data bank using the Excel 2003 Microsoft Office Program and stored in a PC computer. The exact Fisher test was employed to calculate sensibility, specificity, positive and negative predictive values of history of varicella informed by children's parents. RESULTS: The age of the children varied from 12 to 54 months (median, 26 months; 49 (24%) children had positive history of varicella, 155 (76%) a negative or doubtful history. The predictive positive and negative values of the information were 90% and 93%, respectively (p = 0.0001).
CONCLUSIONS:The degree of reliability of information about history of varicella informed by parents of children attending day care centers was high and useful to establish recommendations on varicella blocking immunization in day-care centers.
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