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Comym V.C.,Federal University of Fluminense | Macedu Y.S.,Federal University of Fluminense | Neves E.K.P.B.,Federal University of Fluminense | Bueno A.C.,Federal University of Fluminense | And 3 more authors.
Jornal de Pediatria | Year: 2016

Objective: To verify if the connection of electrodes for heart and transcutaneous oxygen monitoring interfere with the measurement of electrical bioimpedance in preterm newborns. Methods: This was a prospective, blinded, controlled, cross-sectional, crossover study that assessed and compared paired measures of resistance (R) and reactance (Xc) by BIA, obtained with and without monitoring wires attached to the preterm newborn. The measurements were performed in immediate sequence, after randomization to the presence or absence of electrodes. The sample size calculated was 114 measurements or tests with monitoring wires and 114 without monitoring wires, considering for a difference between the averages of 0.1 ohms, with an alpha error of 10% and beta error of 20%, with significance <0.05. Results: No differences were observed between the R (677.37. ±. 196.07 vs. 677.46. ±. 194.86) and Xc (31.15. ±. 9.36 vs. 31.01. ±. 9.56) values obtained with and without monitoring wires, respectively, with good correlation between them (R: 0.997 and Xc: 0.968). Conclusion: The presence of heart and/or transcutaneous oxygen monitoring wires connected to the preterm newborn did not affect the values of R or Xc measured by BIA, allowing them to be carried out in this population without risks. © 2016. Source

Werner H.,Clinica de Diagnostico por Imagem CDPI | Werner H.,Federal University of Rio de Janeiro | Lopes Dos Santos J.R.,Brazilian National Institute of Technology | Lopes Dos Santos J.R.,Pontifical Catholic University of Rio de Janeiro | And 10 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2013

We report on four cases of fetal cervical tumor, comprising three lymphangiomas and one teratoma, evaluated by ultrasound and magnetic resonance imaging (MRI) between 26 and 37 weeks' gestation. The aim was to investigate the use of virtual bronchoscopy to evaluate fetal airway patency in each case. A three-dimensional (3D) model of the airway was created from overlapping image layers generated by MRI. The files obtained were manipulated using 3D modeling software, allowing the virtual positioning of observation cameras, adjustment of lighting parameters and creation of simulated 3D movies for analysis of a virtual path through the model. In all fetuses, fetal airway patency was clearly demonstrated by virtual bronchoscopy and this was confirmed postnatally. MRI with virtual bronchoscopy could become a useful tool for studying fetal airway patency in cases of cervical tumor. Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd. Source

Objective: To evaluate the use of the guidelines of the Centers of Disease Control (CDC, 2002) regarding the prophylaxes of group B Streptococcus (GBS) early onset neonatal sepsis. Methods: We conducted a retrospective study by chart review of 125 pregnant women colonized by GBS and 133 neonates born at a 3rd level maternity hospital, from January/2003 to December/2006. The intrapartum management was deemed correct when pregnant women were given prophylactic antibiotic at least four hours before delivery or when they did not receive medication but were submitted to elective cesarean section. The intrapartum management was considered incorrect when the pregnant woman was given antibiotic prophylaxis less than four hours before delivery, when the antibiotic prescription was inadequate or no prophylaxis had been prescribed. Results: The prevalence of maternal colonization by GBS was 4.7%. The time when the vaginal/rectal swab was collected ranged between 14-40 (mean 32) weeks of gestation. Among the colonized mothers, 54 (43%) received correct intrapartum management. Among 133 studied infants, 95 (71%) received a correct diagnosis; 17 (13%) developed clinical sepsis and one (0.75%) had proven bacterial sepsis. The incidence of sepsis was higher in infants whose mothers did not receive a correct intrapartum prophylaxis, but this difference was not significant (18 versus 7%, p>0.05). Conclusions: Although the guidelines to prevent perinatal GBS disease are in place, there are flaws in the intrapartum prophylaxis and in infants' evaluation. These flaws represent missed opportunities to prevent early onset GBS sepsis. Source

Context and Objective: Neonatal sepsis is associated with premature birth and maternal infection. Large-scale studies seek to define markers that identify neonates at risk of developing sepsis. Here, we examine whether the scientific evidence supports systematic use of polymorphism genotyping in cytokine and innate immunity genes, to identify neonates at increased risk of sepsis. Design and Setting: Narrative literature review conducted at Fernandes Figueira Institute, Brazil. Methods: The literature was searched in PubMed, Embase (Excerpta Medica Database), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Library Online) and Cochrane Library. From > 400,000 references, 548 were retrieved based on inclusion/exclusion criteria; 22 were selected for detailed analysis after quality assessment. Results: The studies retrieved addressed the impact of gene polymorphisms relating to immune mechanisms (most often TNF-a, LT-a, IL-6, IL-1β, IL-1ra, L-selectin, CD14 and MBL) or inflammatory mechanisms (ACE and angiotensin II receptors; secretory PLA2; and hemostatic factors). Despite initial reports suggesting positive associations between specific polymorphisms and increased risk of sepsis, the accumulated evidence has not confirmed that any of them have predictive power to justify systematic genotyping. Conclusions: Sepsis prediction through systematic genotyping needs to be reevaluated, based on studies that demonstrate the functional impact of gene polymorphisms and epidemiological differences among ethnically distinct populations. Source

Moreira M.C.N.,Instituto Fernandes Figueira IFF | Gomes R.,IFF | Sa M.R.C.,Fisioterapia Motora
Ciencia e Saude Coletiva | Year: 2014

The scope of this article is to analyze papers published between 2003 and 2011 that focus on discussions regarding chronic conditions or chronic diseases in children and adolescents. It combines a methodological review of the literature and thematic analysis of content in order to identify the elements that characterize chronic diseases in children and adolescents and the specificities generated by these chronic conditions. The review of the literature resulted in a description of the series of articles identified by year of publication, country of origin, type of study, population and the chronic condition addressed. Thematic content analysis generated two core themes: Definition of chronic disease and Ways of handling chronic disease in children and teenagers. The main conclusion reached is that the age transitions when a disease is diagnosed and treated since childhood involve transformations that include changes in health facilities, discharge processes, decision making and networking that include family, hospital, school and institutions that guarantee the child's rights. Source

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