This study has demonstrated the lasting and greater effect of length and weight at birth on height in comparison to social factors, but social factors are still meaningful in their effects on height. Birth length has a marginal greater effect on final height than birth weight.

The association between early life factors and body mass index (BMI) in adulthood has been demonstrated in developed countries. The aim of the present study was to assess the influence of early life factors (birth weight, gestational age, maternal smoking, and social class) on BMI in young adulthood with adjustment for adult socioeconomic position. A cohort study was carried out in 1978/79 with 6827 motherchild pairs from Ribeirão Preto city, located in the most developed economic area of the country. Biological, economic and social variables and newborn anthropometric measurements were obtained shortly after delivery. In 1996, 1189 males from this cohort, 34.3% of the original male population, were submitted to anthropometric measurements and were asked about their current schooling on the occasion of army recruitment. A multiple linear regression model was applied to determine variables associated with BMI. Mean BMI was 22.7 (95%CI = 22.5-23.0). After adjustment, BMI was 1.22 kg/m 2 higher among infants born with high birth weight (≥4000 g), 1.21 kg/m 2 higher among individuals of low social class at birth and 0.69 kg/m 2 higher among individuals whose mothers smoked during pregnancy (P < 0.05). The association between social class at birth and BMI remained statistically significant (P < 0.05) even after adjustment for adult schooling. These findings suggest that early life social influences on BMI were more important and were not reversed by late socioeconomic position. Therefore, prevention of overweight and obesity should focus not only on changes in adult life styles but also on factors such as high birth weight.

Obesity is one of the rising public health problems characterized as a risk factor for many chronic diseases in adulthood. Early life events such as intrauterine growth restriction, as well as life style, are associated with an increased prevalence of this disease. The present study was performed to determine if intrauterine growth restriction interacts with overweight at primary school age to affect body mass index (BMI) in young adults. From June 1, 1978 to May 31, 1979, 6827 singleton liveborns from Ribeirão Preto, São Paulo State, Brazil, corresponding to 98% of all births at the 8 maternity hospitals, were examined and their mothers were interviewed. Samples from the initial cohort were examined again at primary school age (8 to 11 years of age) and at the time of military service (18 years of age). There were 519 male individuals with complete measurements taken in the three surveys. Intrauterine growth-restricted individuals had a BMI 0.68 kg/ m 2 lower than that of individuals who were not restricted (95%CI = -1.34 to -0.03) and overweight at primary school age showed a positive and strong effect on BMI at 18 years of age (coefficient 5.03, 95%CI = 4.27 to 5.79). However, the increase in BMI was much higher -6.90 kg/m 2 -when the conscript had been born with intrauterine growth restriction and presented overweight at primary school age (95%CI = 4.55 to 9.26). These findings indicate that the effect of intrauterine growth restriction on BMI at 18 years of age is modified by later weight gain during school age.

It was found that breastfeeding contributed to mature orofacial as it improved the ability of oral suction. Pacifier use was shown to affect the functioning of the stomatognathic system. This should be made clear to parents and the use of pacifiers during infancy should be avoided.

As escolas médicas brasileiras priorizam o ambiente hospitalar para o ensino e acabam formando profissionais carentes de compromisso social. O curso de Medicina da Universidade Federal de Santa Maria implantou, em 2004, um novo currículo que inclui o Internato Regional (IR), em que o interno permanece dois meses em município conveniado, atuando em atenção primária em saúde. Este estudo transversal e quanti-qualitativo teve por objetivo conhecer a percepção dos acadêmicos da primeira turma que realizou o IR sobre o impacto desse modelo de estágio em sua formação, mediante a aplicação de um questionário semiestruturado. Mais de 75% das respostas apontaram ter havido contribuição para maior conhecimento da realidade social e profissional, aprimoramento da relação médico-paciente e desenvolvimento de autoconfiança no exercício da profissão. O principal ponto negativo ressaltado foi o despreparo dos médicos-preceptores para atuar como docentes. No atual contexto de mudanças, o IR surge como uma proposta satisfatória de ampliação dos cenários de prática-ensino-aprendizagem e contribui com a formação humana e pessoal dos futuros médicos, apesar de ainda carecer de preceptoria qualificada.

The objective of the present study was to determine the oral motor capacity and the feeding performance of preterm newborn infants when they were permitted to start oral feeding. This was an observational and prospective study conducted on 43 preterm newborns admitted to the Neonatal Intensive Care Unit of UFSM, RS, Brazil. Exclusion criteria were the presence of head and neck malformations, genetic disease, neonatal asphyxia, intracranial hemorrhage, and kernicterus. When the infants were permitted to start oral feeding, non-nutritive sucking was evaluated by a speech therapist regarding force (strong vs weak), rhythm (rapid vs slow), presence of adaptive oral reflexes (searching, sucking and swallowing) and coordination between sucking, swallowing and respiration. Feeding performance was evaluated on the basis of competence (defined by rate of milk intake, mL/min) and overall transfer (percent ingested volume/total volume ordered). The speech therapist's evaluation showed that 33% of the newborns presented weak sucking, 23% slow rhythm, 30% absence of at least one adaptive oral reflex, and 14% with no coordination between sucking, swallowing and respiration. Mean feeding competence was greater in infants with strong sucking fast rhythm. The presence of sucking-swallowing-respiration coordination decreased the days for an overall transfer of 100%. Evaluation by a speech therapist proved to be a useful tool for the safe indication of the beginning of oral feeding for premature infants.

The purpose of this study was to determine the 3rd percentile (P3), 50th percentile (P50 = median age at menarche = MAM), and amplitude between the extremes (P97 and P3) of age at menarche among schoolgirls in the county of Barrinha, São Paulo, Brazil. Values were correlated with socioeconomic conditions such as social class, number of siblings, and father's employment status. This was a cross-sectional study based on the use of status quo adjusted by logit for calculation of percentiles. A questionnaire was applied to 1,602 schoolgirls aged 8 to 17 years (incomplete). MAM was 12 years (y) and 6 months (m), with a P97 of 10 y and 2 m and a P3 of 14 y and 10 m. Girls from lower-income families and those with unemployed fathers showed later MAM. No difference in MAM was observed with respect to number of siblings. Amplitude between P97 ad P3 was great in the overall sample. We conclude that Barrinha presented a MAM similar to and even lower than regional values for Brazil and for some developed countries. The study of the interval between extreme percentiles proved to be a better indicator of biological diversity and socioeconomic inequality than MAM alone.

OBJETIVO: verificar o desempenho da sucção nutritiva, na mamadeira, em recém-nascidos pré-termo submetidos à estimulação sensório-motora-oral. MÉTODOS: pesquisa do tipo ensaio clínico controlado de intervenção. 20 recém-nascidos pré-termo foram distribuídos em grupo estimulado e grupo controle. Estes grupos foram submetidos à avaliação fonoaudiológica em dois diferentes momentos: na liberação da alimentação por via oral; e quando atingiam alimentação plena por via oral num período de 24 horas. As avaliações foram filmadas, e os resultados foram analisados pela pesquisadora. Para análise dos dados utilizou-se o Teste exato de Fishe r e o Teste "T" de Studen t do software estatístico STATA 10.0. Considerou-se p < 0,05. RESULTADOS: recém-nascidos do grupo estimulado, na segunda avaliação, apresentaram resultados com diferença estatística significante quanto a força de sucção forte (p=0,003), presença dos três reflexos adaptativos (p=0,001), coordenação da sucção/deglutição/respiração (p=0,003), no tempo total de sucções (p=0,01) e na frequência de sucção (p<0,01). O número total de sucções apresentou diferença estatística significante (p<0,05) entre as avaliações do grupo controle. Quanto ao ritmo e a relação entre o volume de leite prescrito e ingerido não apresentou resultados com diferença estatística significante. CONCLUSÃO: a estimulação sensório-motora oral parece favorecer o desempenho nas funções de sucção nutritiva de recém-nascidos pré-termo.