Navegando por Palavras-chave "Pediatria."

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    Avaliação da terapia nutricional em uma unidade de terapia intensiva oncológica pediátrica
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-25) Teles, Nayara Dorascenzi Magri [UNIFESP]; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Silva, Dáfne Cardoso Bourguignon da [UNIFESP]; Maia-Lemos, Priscila dos Santos [UNIFESP]; http://lattes.cnpq.br/8598682271972840; http://lattes.cnpq.br/6694786767037804; http://lattes.cnpq.br/8148781454320955; http://lattes.cnpq.br/0732807232987497; Universidade Federal de São Paulo (UNIFESP)
    Objective: to evaluate the impact of nutritional status and other correlated variables on the mortality of critical pediatric oncology patients at the time of admission on Intensive Care Unit (ICU). Methods: retrospective observational study of patients admitted to the ICU of the Institute of Pediatric Oncology / Support Group to Children and Youth with Cancer (IOP/GRAACC - Instituto de Oncologia Pediátrica / Grupo de Apoio ao Adolescente e à Criança com Câncer) of the Federal University of São Paulo (UNIFESP - Universidade Federal de São Paulo), between August 2015 and February 2017. All patients in the pediatric age group, with malignant neoplasm and length of stay greater than 7 days were included. There were excluded patients admitted exclusively for palliative care. Clinical and nutritional parameters were evaluated. The prognostic score Pediatric Index of Mortality 2 (PIM 2) used to measure the clinical severity on multivariate logistic regression models were used to evaluate the performance of different markers of nutritional status (arm circumference, BMI-for-age z-score and height-for-age z-score) as predictors on risk for in-hospital death and death at ICU. The performance of the probability to estimate the occurrence of the event was evaluated using ROC curves. Results: The sample consisted of 155 admissions. The predicted death rate by PIM 2 and below-adequate BMI-for-age z-score were predictors of in-hospital death. Recurrence of oncological disease, hematopoietic stem cell transplantation (HSCT) and fasting time were predictors of death at ICU. The performance of the predictive PIM 2 score improved by adding the nutritional variables. Conclusion: Nutritional status and its deterioration by prolonged fasting affect the mortality of critically ill children with cancer.
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    Ensino de erros inatos do metabolismo na formação do pediatra geral
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-29) Almeida, Claudia Bezerra De [UNIFESP]; Batista, Nildo Alves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The aim of this research was to investigate the Inborn Errors of Metabolism (IEM) education in pediatrician training, during residency, in the city of São Paulo, from the perspective of the supervisors. As a qualitative research, with a descriptive and exploratory approach, the supervisors were questioned individually through semi structured and structured interviews intended to characterize IEM teaching in residency; to describe the competencies developed during residency; and to discuss challenges and suggestions to improve IEM teaching in Pediatric residency. The data produced was submitted to content and thematic analysis, thematic modality. All the supervisors recognized the relevance of IEM teaching and described specific situations in theoretical and practical teaching during residency, however, in most cases IEM was not included in the program. The supervisors were questioned about the resident’s capability to diagnose and initially approach patients with metabolic diseases, and most of them asserted that the residents could suspect and refer IEM cases. The interviewees raised six challenges for IEM teaching: unprepared preceptors; two-years is not enough time to teach IEM in residency; the resident's lack of fundamental knowledge; difficulty in experiencing IEM cases; difficulty in accessing specialized staff; and difficulty in accessing diagnostic tests and specific therapies. And the suggestions proposed were: insertion or emphasis of IEM theoretical teaching in the program; increasing the accessibility to Metabolic centers; promoting internship in IEM; training specialists or adding of specialized teams in the service; promoting IEM theoretical teaching to pediatricians and residency preceptors; a longer duration of residency; and evaluation of resident’s knowledge in IEM. From the results, we were able to determine IEM teaching difficulties to improve these aspects of education in Pediatrician training.