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Denicol MM, Leotti VB, de Soares CRS, Hilgert JB. Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants. Rev Bras Epidemiol 2024; 27:e240013. [PMID: 38511823 PMCID: PMC10946291 DOI: 10.1590/1980-549720240013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/14/2023] [Accepted: 01/05/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE To assess early-onset sepsis as a risk factor of peri-intraventricular hemorrhage in premature infants born at less than or equal to 34 weeks' gestation and admitted to a neonatal intensive care unit (NICU). METHODS This retrospective cohort study included premature patients born at less than or equal to 34 weeks' gestation who were admitted to the NICU of a tertiary hospital in southern Brazil, and born from January 2017 to July 2021. Data were collected from patients' medical records. Early-onset sepsis was measured according to the presence or absence of diagnosis within the first 72 hours of life, whereas the outcome, peri-intraventricular hemorrhage, was described as the presence or absence of hemorrhage, regardless of its grade. RESULTS Hazard ratios were calculated using Cox regression models. A total of 487 patients were included in the study, of which 169 (34.7%) had some degree of peri-intraventricular hemorrhage. Early-onset sepsis was present in 41.6% of the cases of peri-intraventricular hemorrhage, which revealed a significant association between these variables, with increased risk of the outcome in the presence of sepsis. In the final multivariate model, the hazard ratio for early-onset sepsis was 1.52 (95% confidence interval 1.01-2.27). CONCLUSION Early-onset sepsis and the use of surfactants showed to increase the occurrence of the outcome in premature children born at less than or equal to 34 weeks' gestation. Meanwhile, factors such as antenatal corticosteroids and gestational age closer to 34 weeks' gestations were found to reduce the risk of peri-intraventricular hemorrhage.
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Affiliation(s)
- Mariana Martins Denicol
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
| | - Vanessa Bielefeldt Leotti
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
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de Oliveira SR, Machado ACCDP, Magalhães LDC, de Miranda DM, de Paula JJ, Bouzada MCF. Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors. Rev Paul Pediatr 2023; 42:e2022164. [PMID: 37646747 PMCID: PMC10503422 DOI: 10.1590/1984-0462/2024/42/2022164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/04/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. METHODS Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. RESULTS Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. CONCLUSIONS These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.
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Ciochetto CR, Bolzan GDP, Gonçalves DDS, da Silveira FPH, Weinmann ARM. Effects of Kangaroo Care on the development of oral skills and achievement of exclusive oral feeding in preterm infants. Codas 2023; 35:e20220070. [PMID: 37556686 PMCID: PMC10449087 DOI: 10.1590/2317-1782/20232022070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/22/2022] [Indexed: 08/11/2023] Open
Abstract
PURPOSE analyze the effects of hospitalization in the Kangaroo Neonatal Intermediate Care Unit (UCINCa), the second stage of the Kangaroo Care (KC), on the development of oral feeding skills in preterm neonates. METHODS an analytical observational study of the prospective longitudinal type, carried out in a public hospital in Southern Brazil, where infants were accompanied until hospital discharge. The sample consisted of 20 preterm neonates hospitalized at the UCINCa and 26 preterm neonates at the Conventional Neonatal Intermediate Care Unit (UCINCo), that were periodically evaluated through the levels of oral skill, in a bottle, according to the criteria of proficiency and milk transfer rate. The outcomes considered were a progression of the oral skill level, days of transition to obtain the full oral route, and days of hospital stay. RESULTS the duration of transition to exclusive oral feeding was shorter for preterm neonates at the UCINCa (4.5 vs. 10 days) relative to those at the UCINCo (p = 0.041). By the third assessment, all preterm neonates at the UCINCa had reached level 4, while participants at the UCINCo only achieved this level of performance on the fifth assessment. The average number of days of hospitalization was four days shorter in UCINCa participants (p=0.098). CONCLUSION the admission to the UCINCa had been a further acceleration in the maturation of oral skills, which allowed for a faster transition to exclusive oral feeding as compared to neonates admitted in UCINCo.
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Affiliation(s)
- Carla Ribeiro Ciochetto
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Faculdade de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | - Geovana de Paula Bolzan
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | - Daniela da Silva Gonçalves
- Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
| | | | - Angela Regina Maciel Weinmann
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Faculdade de Fonoaudiologia, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil.
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Vaccaro SM, Tofighi D, Moss N, Rieger R, Lowe JR, Phillips J, Erickson SJ. The association of infant temperament and maternal sensitivity in preterm and full-term infants. Infant Ment Health J 2021; 42:374-385. [PMID: 33836096 DOI: 10.1002/imhj.21915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/20/2020] [Accepted: 11/24/2020] [Indexed: 01/30/2023]
Abstract
Infants who experience sensitive caregiving are at lower risk for numerous adverse outcomes. This is especially true for infants born preterm, leading them to be more susceptible to risks associated with poorer quality caregiving. Some research suggests that preterm and full-term infants differ on temperament, which may contribute to these findings. This study aimed to investigate associations between infant temperament (negative emotionality, positive affectivity/surgency, and orienting/regulatory capacity) and maternal sensitivity among infants born preterm (M = 30.2 weeks) and full term. It was hypothesized that mothers of infants born preterm and mothers of infants with more difficult temperaments would display lower sensitivity, indicated by lower responsiveness to nondistress, lower positive regard, and higher intrusiveness. Videotaped play interactions and a measure of temperament (Infant Behavior Questionnaire) were coded for 18 preterm and 44 full-term infants at 9 months (corrected) age. Results suggest that mothers of preterm and full-term infants differed significantly in responding to their infants, but these results cannot be explained by infant temperament. Preterm status and sociodemographic risk emerged as correlates of maternal behavior, such that mothers of infants born preterm and mothers with greater sociodemographic risk displayed lower levels of maternal sensitivity.
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Affiliation(s)
- Suzanne M Vaccaro
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Davood Tofighi
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Natalia Moss
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Rebecca Rieger
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jean R Lowe
- Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA
| | - John Phillips
- The Mind Research Network, Albuquerque, New Mexico, 87106, USA
| | - Sarah J Erickson
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
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Bueno GGG, Barros MCDM, Guinsburg R. Preterm infants with peri/intraventricular hemorrhage have poorer habituation responses to external stimuli. J Pediatr (Rio J) 2019; 95:728-735. [PMID: 30059652 DOI: 10.1016/j.jped.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/17/2018] [Accepted: 06/18/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the association between intra-ventricular hemorrhage and habituation responses to external stimuli in preterm infants at 36-38 weeks post-conceptual age. METHODS Cross-sectional study of infants with gestational age <32 weeks. Intra-ventricular hemorrhage was identified by cranial ultrasonography and classified according to Papile et al. (1978). The luminous (flashlight), sound (rattle, bell), and tactile stimuli were presented, and the responses were scored according to Lester and Tronik (2004). Habituation response scores were compared between groups by Student's t-test. The association between IVH and habituation scores was evaluated by linear regression adjusted for GA, clinical severity score, post-conceptual age at habituation assessment, sepsis, and bronchopulmonary dysplasia. RESULTS Sixty-five infants were studied, 20 with intra-ventricular hemorrhage (16 grades I/II; four grades III/IV) and 45 without intra-ventricular hemorrhage. Infants with intra-ventricular hemorrhage had lower gestational age (28.2±2.2 vs. 29.7±1.7 weeks) and birth weight (990±305 vs. 1275±360g). Infants with intra-ventricular hemorrhage at 36-38 weeks post-conceptual age had lower habituation scores to light (4.21±2.23 vs. 6.09±2.44), rattle (3.84±2.12 vs. 6.18±2.27), and bell (3.58±1.74 vs. 5.20±2.47) after controlling for confounders. No differences were found for tactile stimulus. CONCLUSION Infants with gestational age <32 weeks and intra-ventricular hemorrhage had poorer habituation responses to external stimuli than those without intra-ventricular hemorrhage at 36-38 weeks post-conceptual age.
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Affiliation(s)
| | | | - Ruth Guinsburg
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, Divisão de Pediatria Neonatal, São Paulo, SP, Brazil
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Beleza LDO, Ribeiro LM, Paula RAP, Guarda LEDA, Vieira GB, Costa KSF. Profile of at-risk newborns attended by nurses in outpatient follow-up clinic: a retrospective cohort study. Rev Lat Am Enfermagem 2019; 27:e3113. [PMID: 30698216 PMCID: PMC6336357 DOI: 10.1590/1518-8345.2301.3113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 10/12/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE to analyze the cohort profile of at-risk newborns attended by nurses in a multidisciplinary follow-up clinic, with emphasis on the type of feeding and weight gain, after hospital discharge. METHOD retrospective cohort, whose population is composed of at-risk newborns attended in a 4-year period. Data came from medical records and attendance report, later exported to R Program. The outcome variables were number of the nursing consultation, type of feeding, daily weight gain and main guidelines. We used descriptive statistics, frequency distribution and applied Mann-Whitney, Chi-Square, Spearman correlation, Variance and Tukey analysis, with p <0.05 being significant. RESULTS a total of 882 consultations with 629 infants and families were analyzed. The frequencies of exclusive breastfeeding and weight gain increased as the consultations progressed. The infants who needed more consultations and with lower weight gain were those with lower gestational age (p = 0.001) and birth weight (p = 0.000), longer length of hospital stay (p <0.005), and diagnoses related to extreme prematurity (p <0.05), among others. CONCLUSION nurses verified the importance of outpatient follow-up of at-risk newborns, especially in promoting breastfeeding and healthy growth.
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Affiliation(s)
- Ludmylla de Oliviera Beleza
- Universidade de Brasília, Faculdade de Ciências da Saúde, Brasília, DF, Brazil
- Hospital Materno Infantil de Brasília, Brasília, DF, Brazil
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Pinho DFR, Real C, Ferreira L, Pina P. [Peribulbar block combined with general anesthesia in babies undergoing laser treatment for retinopathy of prematurity: a retrospective analysis]. Rev Bras Anestesiol 2018; 68:431-6. [PMID: 29544675 DOI: 10.1016/j.bjan.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 11/11/2017] [Accepted: 01/04/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. METHODS A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed. RESULTS During that period a total of six babies was submitted to laser treatment for retinopathy of prematurity, all under peribulbar block combined with general anesthesia. A single infratemporal injection of 0.15mL.kg-1 per eye ropivacaine 1% or 0.75% was performed. At the end of the procedure, all babies resumed spontaneous ventilation. No perioperative complications were reported. CONCLUSIONS Peribulbar block was a safe anesthetic technique in our sample considered.
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Dibley AL, Rydin-Orwin T, Stedmon J, Dallos R. THE FEASIBILITY OF USING "PREMIESTART," A MOTHER-PREMATURE INFANT INTERACTION PROGRAM, ON A NEONATAL UNIT IN ENGLAND. Infant Ment Health J 2016; 37:440-51. [PMID: 27348583 DOI: 10.1002/imhj.21572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/30/2016] [Accepted: 04/28/2016] [Indexed: 11/07/2022]
Abstract
This article explores the feasibility of running "PremieStart," a nine-individual-session maternal-premature infant interaction program, within a neonatal unit (NNU) in England. Four mothers of premature infants completed seven sessions on the NNU and two at home. Mothers and NNU staff provided feedback on PremieStart. Measures of maternal-infant relationship, maternal well-being, and maternal reflective functioning were completed before and after intervention. Thematic analysis of mothers' feedback highlighted the emotional, but cathartic, experience of engaging with PremieStart. NNU staff feedback indicated the need to include them more in PremieStart. Both mothers and staff were supportive of future implementation of PremieStart and highlighted the ongoing need for psychological support on the NNU. PremieStart was implemented with positive feedback from mothers and staff, with support shown for the continued use of PremieStart in the NNU. However, for future implementation, the self-report outcome measures need reviewing, and more involvement of fathers and NNU staff is needed. In addition, a larger sample with a control group should be utilized.
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Affiliation(s)
| | - Tracy Rydin-Orwin
- Virgin Care Limited, Integrated Children's Services, Exeter, Devon, United Kingdom
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de Mello RR, da Silva KS, Costa AM, Ramos JRDM. Longitudinal assessment of the lung mechanics of very low birth weight preterm infants with and without bronchopulmonary dysplasia. SAO PAULO MED J 2015; 133:401-7. [PMID: 26648428 PMCID: PMC10871802 DOI: 10.1590/1516-3180.2014.00101812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Prematurity has been correlated with altered lung mechanics. Some infants develop lung injury as a consequence of lung immaturity, invasive mechanical ventilation and exposure to oxygen, thus resulting in bronchopulmonary dysplasia. The aim here was to compare the lung mechanics of preterm infants with and without bronchopulmonary dysplasia during the first year of life. DESIGN AND SETTING Prospective cohort study in a tertiary-level hospital. METHODS This study included premature infants at a public hospital who underwent two pulmonary function tests: one at discharge and the other at the corrected age of 4 to 8 months. Tidal volume, lung compliance and lung resistance were measured. Statistical tests were used for comparisons between infants with and without bronchopulmonary dysplasia. RESULTS 102 children with mean gestational age of 29 ± 2.0 weeks were studied; 17 with bronchopulmonary dysplasia. Lung compliance (0.84 ± 0.29 versus 1.28 ± 0.46; P < 0.001) and tidal volume (6.1 ± 0.94 versus 7.2 ± 1.43; P < 0.01) at discharge were significant lower in children with bronchopulmonary dysplasia than in those without the disease, but no differences were observed at the second test (compliance: 1.53 ± 0.77 versus 1.94 ± 1.01; P = 0.12; and tidal volume: 6.9 ± 1.4 versus 7.3 ± 1.6; P = 0.42). CONCLUSION Differences in lung mechanics were observed between infants with and without bronchopulmonary dysplasia at hospital discharge but these differences were no longer detected at the final follow-up. The lung mechanics of all the infants improved over this period of time.
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Affiliation(s)
- Rosane Reis de Mello
- MD, PhD. Attending Physician, Department of Neonatology, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Rio de Janeiro (RJ), Brazil.
| | - Kátia Silveira da Silva
- MD, PhD. Epidemiologist, Clinical Research Unit, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Rio de Janeiro (RJ), Brazil.
| | - Anniele Medeiros Costa
- MSc. Physiotherapist, Department of Neonatology, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Rio de Janeiro (RJ), Brazil.
| | - José Roberto de Moraes Ramos
- MD, PhD. Head of Department of Neonatology, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Rio de Janeiro (RJ), Brazil.
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Hörner A, Hörner R, Salla A, Nunes MS, Garzon LR, Rampelotto RF, Martini R, dos Santos SO, Gindri L, Rodrigues MDA, Giacomolli C. Staphylococcal scalded skin syndrome in a premature newborn caused by methicillin-resistant Staphylococcus aureus: case report. SAO PAULO MED J 2015; 133:450-3. [PMID: 26648436 PMCID: PMC10871803 DOI: 10.1590/1516-3180.2013.79400715] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 06/13/2014] [Accepted: 07/15/2014] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Staphylococcal scalded skin syndrome is an exfoliative skin disease. Reports of this syndrome in newborns caused by methicillin-resistant Staphylococcus aureus are rare but, when present, rapid diagnosis and treatment is required in order to decrease morbidity and mortality. CASE REPORT A premature newly born girl weighing 1,520 g, born with a gestational age of 29 weeks and 4 days, developed staphylococcal scalded skin syndrome on the fifth day of life. Cultures on blood samples collected on the first and fourth days were negative, but Pseudomonas aeruginosa and Enterococcus sp. (vancomycin-sensitive) developed in blood cultures performed on the day of death (seventh day), and Pseudomonas aeruginosa and Serratia marcescens were identified in cultures on nasopharyngeal, buttock and abdominal secretions. In addition to these two Gram-negative bacilli, methicillin-resistant Staphylococcus aureus was isolated in a culture on the umbilical stump (seventh day). The diagnosis of staphylococcal scalded skin syndrome was based on clinical criteria.
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Affiliation(s)
- Andreas Hörner
- Undergraduate Student, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Rosmari Hörner
- PhD. Associate Professor, Department of Clinical and Toxicological Analyses, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Adenilde Salla
- BSc. Pharmacist, Bacteriology Laboratory, Hospital Universitário de Santa Maria (HUSM), Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Melise Silveira Nunes
- BSc. Master's Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Litiérri Razia Garzon
- BSc. Master's Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Roberta Filipini Rampelotto
- BSc. Master's Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Rosiéli Martini
- MSc. Doctoral Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Silvana Oliveira dos Santos
- BSc. Master's Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Lívia Gindri
- BSc. Master's Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Mônica de Abreu Rodrigues
- MSc. Doctoral Student, Postgraduate Pharmaceutical Sciences Program, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Cláudia Giacomolli
- MD. Pharmacist, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
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Abstract
CONTEXT AND OBJECTIVE The immaturity of preterm infants' organ systems may lead to difficulties in adapting to different environmental stimuli. The aim was to compare the psychomotor development of preterm infants (with corrected age) and term infants aged 6 to 12 months and to investigate associated factors. DESIGN AND SETTING Cross-sectional analytical study conducted at Hospital das Clínicas, Universidade Federal de Pernambuco. METHODS The sample consisted of 135 infants (45 preterm and 90 full-term) aged 6 to 12 months. Neuropsychomotor development was assessed using the Bayley III cognitive, language and motor subscales. Biological, socioeconomic and demographic data were gathered from medical records and through interviews with mothers. RESULTS The mean cognitive, language and motor indices were within the range of normality for the sample as a whole. No significant difference in the development of infants born preterm and full-term was observed, except for expressive communication, in which preterm infants presented a lower index. Motor development was influenced by biological factors, and the poorest performances were observed in male infants; birth weight birth weight < 1500 g; Apgar score at five minutes < 7; weight-, length- and head circumference-for-age < -1 Z-score; and exclusively breastfeeding for < two months. CONCLUSIONS Prematurity did not influence the psychomotor development of infants in this study population. Motor development was the most affected domain in the sample as a whole, especially due to biological factors. Investigations on child neuropsychomotor development should try to identify many determinant factors because of its multifactorial nature.
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Affiliation(s)
- Sophie Helena Eickmann
- Department of Maternal and Child Health, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
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Boechat MCB, Mello RRD, Silva KSD, Daltro P, Marchiori E, Ramos EG, Dutra MVP. A computed tomography scoring system to assess pulmonary disease among premature infants. SAO PAULO MED J 2010; 128:328-35. [PMID: 21308155 PMCID: PMC10948065 DOI: 10.1590/s1516-31802010000600004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 09/18/2010] [Accepted: 09/30/2010] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE High-resolution computed tomography (HRCT) is considered to be the best method for detailed pulmonary evaluation. The aim here was to describe a scoring system based on abnormalities identified on HRCT among premature infants, and measure the predictive validity of the score in relation to respiratory morbidity during the first year of life. DESIGN AND SETTING Prospective cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz. METHODS Scoring system based on HRCT abnormalities among premature newborns. The affected lung area was quantified according to the number of compromised lobes, in addition to bilateral pulmonary involvement. Two radiologists applied the score to 86 HRCT scans. Intraobserver and interobserver agreement were analyzed. The score properties were calculated in relation to predictions of respiratory morbidity during the first year of life. RESULTS Most of the patients (85%) presented abnormalities on HRCT, and among these, 56.2% presented respiratory morbidity during the first year of life. Scores ranged from zero to 12. There was good agreement between observers (intraclass correlation coefficient, ICC = 0.86, confidence interval, CI: 0.64-0.83). The predictive scores were as follows: positive predictive value 81.8%, negative predictive value 56.3%, sensitivity 39.1%, and specificity 90.0%. CONCLUSION The scoring system is reproducible, easy to apply and allows HRCT comparisons among premature infants, by identifying patients with greater likelihood of respiratory morbidity during the first year of life. Its use will enable HRCT comparisons among premature infants with different risk factors for respiratory morbidity.
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MESH Headings
- Epidemiologic Methods
- Humans
- Infant
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/diagnostic imaging
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/pathology
- Lung Diseases/diagnostic imaging
- Lung Diseases/mortality
- Lung Diseases/pathology
- Tomography, X-Ray Computed/methods
- Tomography, X-Ray Computed/standards
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Boëchat MCB, Mello RRD, Dutra MVP, Silva KSD, Daltro P, Marchiori E. Intra and interobserver reliability of the interpretation of high-resolution computed tomography on the lungs of premature infants. SAO PAULO MED J 2010; 128:130-6. [PMID: 20963364 PMCID: PMC10938957 DOI: 10.1590/s1516-31802010000300005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 04/04/2010] [Accepted: 04/04/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE High-resolution computed tomography (HRCT) of the lungs is more sensitive than radiographs for evaluating pulmonary disease, but little has been described about HRCT interpretation during the neonatal period or shortly afterwards. The aim here was to evaluate the reliability of the interpretation of HRCT among very low birth weight premature infants (VLBWPI; < 1500 g). DESIGN AND SETTING Cross-sectional study on intra and interobserver reliability of HRCT on VLBWPI. METHODS 86 VLBWPI underwent HRCT. Two pediatric radiologists analyzed the HRCT images. The reliability was measured by the proportion of agreement, kappa coefficient (KC) and positive and negative agreement indices. RESULTS For radiologist A, the intraobserver reliability KC was 0.79 (confidence interval, CI: 0.54-1.00) for normal/abnormal examinations; for each abnormality on CT, KC ranged from 0.05 to 1.00. For radiologist B, the intraobserver reliability KC was 0.79 (CI: 0.54-1.00) for normal/abnormal examinations; for each abnormality on CT, KC ranged from 0.37 to 0.83. The interobserver agreement was 88% for normal/abnormal examinations and KC was 0.71 (CI: 0.5- 0.93); for most abnormal findings, KC ranged from 0.51-0.67. CONCLUSION For normal/abnormal examinations, the intra and interobserver agreements were substantial. For most of the imaging findings, the intraobserver agreement ranged from moderate to substantial. Our data demonstrate that in clinical practice, there is no reason for more than one tomographic image evaluator, provided that this person is well trained in VLBWPI HRCT interpretation. Analysis by different observers should be reserved for research and for difficult cases in clinical contexts.
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Serpa ABM, Guinsburg R, Balda RDCX, dos Santos AMN, Areco KCN, Peres CA. Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life. SAO PAULO MED J 2007; 125:29-33. [PMID: 17505682 PMCID: PMC11014712 DOI: 10.1590/s1516-31802007000100006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 12/13/2005] [Accepted: 11/29/2006] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE It is challenge to assess and treat pain in premature infants. The objective of this study was to compare the multidimensional pain assessment of preterm neonates subjected to an acute pain stimulus at 24 hours, 72 hours and seven days of life. DESIGN AND SETTING Prospective cohort study, at Universidade Federal de São Paulo. METHODS Eleven neonates with gestational age less than 37 weeks that needed venepuncture for blood collection were studied. The exclusion criteria were Apgar score < 7 at five minutes, presence of any central nervous system abnormality, and discharge or death before seven days of life. Venepuncture was performed in the dorsum of the hand, and the heart rate, oxygen saturation and pain scales [Neonatal Facial Coding System (NFCS), Neonatal Infant Pain Scale (NIPS), and Premature Infant Pain Profile (PIPP)] were assessed at 24 hours, 72 hours and 7 days of life. NFCS and NIPS were evaluated prior to procedure (Tpre), during venepuncture (T0), and two (T2) and five (T5) minutes after needle withdrawal. Heart rate, O2 saturation and PIPP were measured at Tpre and T0. Mean values were compared by repeated-measurement analysis of variance. RESULTS The pain parameters did not differ at 24 hours, 72 hours and 7 days of life: heart rate (p = 0.22), oxygen saturation (p = 0.69), NFCS (p = 0.40), NIPS (p = 0.32) and PIPP (p = 0.56). CONCLUSION Homogeneous pain scores were observed following venepuncture in premature infants during their first week of life.
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Affiliation(s)
| | - Ruth Guinsburg
- Ruth Guinsburg Rua Vicente Félix, 77/09 São Paulo (SP) — Brasil — CEP 01410-020 Tel/Fax. (+55 11) 5579-4982 E-mail: E-mail:
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