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- ItemAcesso aberto (Open Access)Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial(Associação Brasileira de Divulgação Científica, 2014-03-01) Goncalves-Ferri, W.a.; Martinez, Francisco Eulogio; Caldas, J.p.s.; Marba, S.t.m.; Fekete, S.; Rugolo, L.; Tanuri, C.; Leone, C.; Sancho, G.a.; Almeida, M.f.b.; Guinsburg, Ruth [UNIFESP]; Universidade de São Paulo (USP); Universidade Estadual de Campinas (UNICAMP); Universidade Estadual de São Paulo Departamento de Pediatria; Maternidade Hospital Cachoeirinha; Universidade Federal de São Paulo (UNIFESP)This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.
- ItemAcesso aberto (Open Access)Conteúdo mineral do esmalte de dentes decíduos de crianças nascidas pré-termo e a termo(Universidade Federal de São Paulo (UNIFESP), 2015-11-12) Takaoka, Liliana Aparecida Mendonca Vespoli [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Gonçalves, Alyne Simões; Mori, Matsuyoshi; http://lattes.cnpq.br/9166998633116091; http://lattes.cnpq.br/5926577659289987; http://lattes.cnpq.br/4138984911182645; http://lattes.cnpq.br/8960135211910066; Universidade Federal de São Paulo (UNIFESP)Objetivo: analisar e comparar a concentração de minerais no esmalte de dentes decíduos esfoliados naturalmente de crianças nascidas pré-termo e a termo aliar a correlação entre al uns dos minerais analisados no esmalte dos dentes decíduos de crianças nascidas pré-termo e a termo. Método: Foi feito um estudo transversal envolvendo crianças nascidas pré-termo e a termo, entre 6 e 8 anos de idade. Um grupo foi formado por 40 crianças prematuras nascidas nos hospitais afiliados à Escola Paulista de Medicina/Unifesp com peso ao nascer menor que 2.000g e acompanhadas no Ambulatório de Prematuros. O outro grupo foi constituído por 40 crianças nascidas a termo com peso ao nascer maior que 2.450g que frequentavam a Escola Paulistinha de Educação da Unifesp. Os 80 dentes coletados foram analisados pelo método PIXE (Proton Induced X Ray Emission), XRF (X Ray Fluorescence Spectroscopy) e ICP OES (inductively coupled plasma optical emission spectrometry). Resultados: Na análise pelo método PIXE os conteúdos de Sr e Cu foram maiores no grupo de prematuros (p<0,001 e p=0,009, respectivamente). Na análise pelo método XRF os conteúdos de Ca, P e Sr foram maiores nas crianças nascidas pré-termo (p=0,001, p=0,006 e p<0,001, respectivamente). Na análise pelo método ICP OES os conteúdos de Ca, Sr e Zn foram maiores no esmalte dos dentes dos prematuros (p<0,001, p<0,001 e p=0,001, respectivamente). Na análise pelo método XRF houve uma correlação positiva entre os conteúdos de Ca e Sr, Ca e P e P e Sr no grupo de prematuros e entre Ca e Sr e Ca e P no grupo de crianças nascidas a termo. Conclusão: Prematuros apresentaram maior quantidade de alguns minerais no esmalte dos dentes decíduos (Ca, P, Cu e Zn) quando comparados a crianças nascidas a termo, mas a principal diferença observada foi o maior conteúdo de estrôncio nos prematuros. Esses achados apontam novos caminhos para o entendimento da mineralização do esmalte da dentição decídua, bem como da doença metabólica óssea da prematuridade.
- ItemSomente MetadadadosCytokine Dosage in Fresh and Preserved Human Amniotic Membrane(Lippincott Williams & Wilkins, 2016) Bomfim Pereira, Mario Genilhu [UNIFESP]; Gomes, José Álvaro Pereira [UNIFESP]; Rizzo, Luiz Vicente; Cristovam, Priscila Cardoso [UNIFESP]; Silveira, Laila Christina; Universidade Federal de São Paulo (UNIFESP)
- ItemSomente MetadadadosCytokine Dosage in Fresh and Preserved Human Amniotic Membrane(Lippincott Williams & Wilkins, 2016) Bomfim Pereira, Mario Genilhu [UNIFESP]; Pereira Gomes, Jose Alvaro [UNIFESP]; Rizzo, Luiz Vicente; Cristovam, Priscila Cardoso [UNIFESP]; Silveira, Laila Christina
- ItemAcesso aberto (Open Access)Efeitos da betametasona sobre os fetos e placentas da rata albina(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2001-03-01) Souza, Eduardo de [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Camano, Luiz [UNIFESP]; Kulay Júnior, Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water) on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml) IM on the 11th, 12th, 18th and 19th day of pregnancy. Group III - the rats did not receive any drug or vehicle. The animals were weighed on days 0, 7, 14 and on the 20th of pregnancy, and on the last day of weighing, the animals were sacrificed. The number of implantations, resorptions, fetuses, placentas, malformations, maternal and fetal mortality as well as the weight of the fetuses and placentas were obtained and analyzed. Results: our results show that the rats treated with betamethasone gained significantly less weight. Their fetuses had an average weight of 3.2 g compared with 3.75 g in the control group. The results regarding placental weight were 0.36 g vs 0.48 g, respectively. All these differences were statistically significant. Conclusions: betamethasone had a negative effect on the gain of weight of matrices, fetuses and placentas when administered repeatedly and continuousy after the second half of pregnancy.
- ItemSomente MetadadadosFrequência Dos Defeitos Do Desenvolvimento Do Esmalte E Cárie Em Dentes Permanentes De Adolescentes Nascidos Pré Termo E Termo(Universidade Federal de São Paulo (UNIFESP), 2018-05-04) Alves, Stella Maria Coda Pinto [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The Enamel Developmental Defects On Permanent Dentition Have A Negative Impact On Oral Health, Esthetics And Tooth Sensitivity. Objective: To Evaluate Frequency And Distribution Of Enamel Developmental Defects (Dde), Hypomineralization Molar Incisor (Hmi) And Carie Experience (Dmft) In Permanent Teeth Of Adolescents Pre Term And Term. To Evaluate The Association Between Dde, Hmi And Pos Natal And Peri Natal Morbidity In Adolescents Born Pre Term And Term. Methods: Cross Sectional Study Was Conducted With 255 Adolescents (10 -19 Years) Followed Up By Two Ambulatories Services Of Federal University Of São Paul, Brazil. Dde And Mih Was Described Using Dde Index And European Academy Of Paediatric Dentistry (Eapd) Criteria. The Carie Experience Was Analysed Using Dmft Index. Results And Conclusions: 141 (55,7%) Of The Subject Were Born Pre Term And 114 (44,7%) Were Born Term. Prematury Was Associated With Dde And Hmi. Overwall Available Adolescents, There Were 29% With Low Probability, 38% With Mediu
- ItemAcesso aberto (Open Access)Intervalo entre o Nascimento de Gêmeos: Morbidade e Mortalidade do Segundo Gemelar(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2001-08-01) Fava, Jair Luiz; Souza, Eduardo de [UNIFESP]; Camano, Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to evaluate the impact of birth time interval between twins in relation to the morbidity and mortality of the second newborn twin. Methods: this is a retrospective study of 50 women with twin pregnancy at the `Maternidade Pró-Matre de Vitória' who gave birth to 100 alive newborns through the vaginal canal, weighing each over 500 g and not having any major malformations. The newborns were separated into two groups: G1 (first twin) and G2 (second twin). The following criteria were considered to be indicative of newborn morbidity: asphyxia at birth, characterized by Apgar index lower than 7 in the first minute of life; respiratory distress syndrome detected by clinical and radiological findings, and hospitalization period longer than 4 days. In-hospital mortality was analyzed as well. Cut off was at every 5 minutes, up to 35 minutes, to study the time interval between the twin (deltat) delivery. A time-span (deltat) analysis was also carried out up to 5 minutes: 6-10, 11-15, 16-20, and 21-150 minutes. Results: there were no statistically significant differences between the second twin's morbidity/mortality in relation to the first, considering the aforesaid cutoff and time-span levels. Conclusion: delivery time interval between G1 and G2 did not influence the second twin's morbidity and mortality; however, in the assistance of the second twin's delivery, it is absolutely necessary to individualize the characteristics of each case, not allowing any anxiety to set in through untimely and potentially damaging procedures.
- ItemSomente MetadadadosA predictive score for retinopathy of prematurity in very low birth weight preterm infants(Nature Publishing Group, 2012-03-01) Eckert, Gabriela Unchalo; Fortes Filho, Joao Borges; Maia, Mauricio [UNIFESP]; Procianoy, Renato Soibelmann; Hosp Clin Porto Alegre; Univ Fed Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP)Aims This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP.Methods A prospective cohort of preterm infants with BWp1500 g and/or GAp32 weeks was studied. the score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. the score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions.Results the sample included 474 patients. the area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately.Conclusions ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. the scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP. Eye (2012) 26, 400-406; doi: 10.1038/eye. 2011.334; published online 23 December 2011
- ItemSomente MetadadadosProspective evaluation of cytokine in saliva of preterm and fullterm neonates(Elsevier B.V., 2014-11-01) Talarico Sesso, Maria Lucia; Loureiro Borges, Mariana Castro; Leme Ferriani, Virginia Paes; Geraldo-Martins, Vinicius Range; Rocha Rodrigues, Denise Bertulucci; Nogueira, Ruchele Dias; Universidade Federal de São Paulo (UNIFESP); Univ UberabaLittle is known about the ontogeny of the cytokines in saliva of newborn. Previous studies showed that levels of immunoglobulin A (IgA) in saliva could be influenced by prematurity. So, the aim of this study was to analyze the levels of interleukin 6 (IL-6), interleukin 10 (IL-10), interleukin 12 (IL-12), and interferon gamma (IFN-gamma) in sample saliva of fullterm (FT) and preterm (PT) neonates at birth (TO) and after 3 months of age (T3). Saliva from 50 infants (25 FT and 25 PT) were collected at TO and T3 and analyzed by Luminex Corporation (Austin, Texas, United States) multiplex assay. Clinical characteristics and social-economic data were assessed through questionnaires. All cytokines could be detected at birth in levels higher than found in T3. the mean levels and frequency of detection of cytokines were significantly higher in PT than FT at TO (P < 0.05). There were a positive association between IL-10 and infection (P < 0.05) and IL-6 and stress (P < 0.005). Salivary cytokines were detected within the first hours after birth and their levels decreased after 3. months. the cytokine levels were different between PT and FT children and appear to be influenced by stress situation and/or antigenic microbial challenge. the results confirm the necessity for further studies about the mucosal immune system by using of saliva as a source of diagnostic by identification of biomarkers of the status of the immune. (C) 2014 Elsevier GmbH. All rights reserved.
- ItemAcesso aberto (Open Access)Resultados de um programa de prevenção da cegueira pela retinopatia da prematuridade na Região Sul do Brasil(Sociedade Brasileira de Pediatria, 2007-06-01) Fortes Filho, João Borges [UNIFESP]; Barros, Cristiano Koch; Costa, Marlene Coelho da; Procianoy, Renato Soibelmann; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio Grande do Sul; Hospital de Clínicas de Porto Alegre Setor de Retinopatia da Prematuridade; HCPA Centro de Neonatologia; HCPA Serviço de NeonatologiaOBJECTIVE: To describe the results of a program for the prevention of blindness caused by retinopathy of prematurity implemented in 2002 at a tertiary-care hospital, according to screening criteria adopted in Brazil, and to compare some aspects with the criteria adopted by other countries. METHODS: Descriptive observational study including all preterm infants born at this hospital weighing < 1,500 g at birth and/or gestational age < 32 weeks who survived up to the sixth week after birth, between October 2002 and June 2006. Ophthalmic examinations were performed from the sixth week of life and repeated as necessary until remission of the disease. RESULTS: A total of 300 newborns were included and there were 18 cases of treatable threshold disease (18/300, 6%) according to the Brazilian criteria. One patient was not treated because s/he developed the disease after hospital discharge and did not turn up for examination in order to initiate treatment. According to the criteria suggested by industrialized countries, the total number of exams would be reduced under the same circumstances, but 11.76% of the cases of threshold disease would not be detected. CONCLUSIONS: The Brazilian criteria for neonatal screening were efficient in detecting treatable cases. Blindness was averted in 17 preterm infants in the study period. The universal use of such program at teaching hospitals or in the public and private health networks could help prevent one of the main causes of preventable and treatable blindness among infants in developing countries. Currently, a change in these criteria in Brazil may compromise the diagnosis of some treatable patients.
- ItemAcesso aberto (Open Access)Salivary IgA antibody responses to Streptococcus mitis and Streptococcus mutans in preterm and fullterm newborn children(Elsevier B.V., 2012-06-01) Nogueira, Ruchele Dias; Talarico Sesso, Maria Lucia; Loureiro Borges, Mariana Castro; Mattos-Graner, Renata O.; Smith, Daniel James; Ferriani, Virginia Paes Leme [UNIFESP]; Univ Uberaba; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP); Forsyth InstObjectives: the intensities and specificities of salivary IgA antibody responses to antigens of Streptococcus mutans, the main pathogen of dental caries, may influence colonization by these organisms during the first 1.5 year of life. Thus, the ontogeny of salivary IgA responses to oral colonizers continues to warrant investigation, especially with regard to the influence of birth conditions, e.g. prematurity, on the ability of children to efficiently respond to oral microorganisms. in this study, we characterised the salivary antibody responses to two bacterial species which are prototypes of pioneer and pathogenic microorganisms of the oral cavity (Streptococcus mitis and Streptococcus mutans, respectively) in fullterm (FT) and preterm (PT) newborn children.Methods: Salivas from 123 infants (70 FT and 53 PT) were collected during the first 10 h after birth and levels of IgA and IgM antibodies and the presence of S. mutans and S. mitis were analysed respectively by ELISA and by chequerboard DNA-DNA hybridization. Two subgroups of 24 FT and 24 PT children were compared with respect to patterns of antibody specificities against S. mutans and S. mitis antigens, using Western blot assays. Cross-adsorption of 10 infant's saliva was tested to S. mitis, S. mutans and Enterococcus faecalis antigens.Results: Salivary levels of IgA at birth were 2.5-fold higher in FT than in PT children (Mann-Whitney; P < 0.05). Salivary IgA antibodies reactive with several antigens of S. mitis and S. mutans were detected at birth in children with undetectable levels of those bacteria. Adsorption of infant saliva with cells of S. mutans produced a reduction of antibodies recognizing S. mitis antigens in half of the neonates. the diversity and intensity of IgA responses were lower in PT compared to FT children, although those differences were not significant.Conclusion: These data provide evidence that children have salivary IgA antibodies shortly after birth, which might influence the establishment of the oral microbiota, and that the levels of salivary antibody might be related to prematurity. (C) 2011 Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Ser pequeno para a idade gestacional é um fator de risco para a retinopatia da prematuridade? Estudo com 345 pré-termos de muito baixo peso(Sociedade Brasileira de Pediatria, 2009-02-01) Fortes Filho, João Borges [UNIFESP]; Valiatti, Fabiana Borba; Eckert, Gabriela Unchalo [UNIFESP]; Costa, Marlene Coelho da; Silveira, Rita C.; Procianoy, Renato Soibelmann; Universidade Federal do Rio Grande do Sul Faculdade de Medicina; Hospital de Clínicas de Porto Alegre Setor de Retinopatia da Prematuridade; UFRGS; HCPA; Universidade Federal de São Paulo (UNIFESP); HCPA Unidade de Terapia Intensiva Neonatal; UFRGS Faculdade de Medicina; HCPA Serviço de NeonatologiaOBJECTIVE: To analyze prevalence and risk factors for retinopathy of prematurity (ROP) among preterm infants born small for gestational age (SGA) and appropriate for gestational age (AGA). METHODS: A prospective cohort study included preterm infants with birth weight (BW) ≤ 1,500 grams and gestational age (GA) ≤ 32 weeks, divided into two groups: AGA or SGA. Prevalences and risk factors for ROP were determined in both groups. Logistic regression was used for the significant variables after univariate analysis. RESULTS: A total of 345 patients were examined: 199 included in the AGA group and 146 in the SGA. Mean BW and GA in the whole cohort (345 patients) were 1,128.12 grams (±239.9) and 29.7 weeks (±1.9), respectively. The prevalence of any stage ROP and severe ROP (needing treatment) was 29.6 and 7.0%, respectively. ROP in any evolutive stage developed in 66 AGA (33.2%) and in 36 SGA (24.7%) (p = 0.111). Severe ROP occurred in 15 AGA (7.5%) and in nine SGA (6.2%) (p = 0.779). After adjusted logistic regression, weight gain from birth to sixth week of life and need for blood transfusions were found to be significant risk factors for ROP in both groups. CONCLUSIONS: This study has shown that being SGA was not a significant risk factor for any stage ROP or for severe ROP in this cohort and, also, that the risk factors for ROP were similar among SGA and AGA very-low-birth-weight preterm babies.
- ItemAcesso aberto (Open Access)Teratoma congênito de orofaringe: relato de caso(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2005-02-01) Chaves, Yuri Seguchi [UNIFESP]; Sousa, Jânio Serafim de [UNIFESP]; Feldner Junior, Paulo Cezar [UNIFESP]; Cruz, Reisson Serafim [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Chaves, Hiromi Seguchi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Oropharyngeal teratoma is the most rare type of teratoma, with only 2% of fetal teratomas. The diagnosis must be established as early as possible, preferably during the prenatal period. The prognosis will depend on the size and location of the lesion, growth rate of the lesion, degree of intracranial spread, its resectability, and immediate care at birth by a multisciplinary team. We report aparticular case of congenital oropharyngeal teratoma (epignathus). The diagnosis was made during the prenatal period by ultrasound, and the fetus evolved to intrauterine death at the 29th week. The anatomopathological examination revealed a female fetus, compatible with 27-28 weeks, oropharyngeal teratoma and congenital malformations.