Navegando por Palavras-chave "premature"
Agora exibindo 1 - 10 de 10
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Avaliação do processamento auditivo em crianças nascidas pré-termo(Sociedade Brasileira de Fonoaudiologia, 2011-01-01) Gallo, Julia [UNIFESP]; Dias, Karin Ziliotto [UNIFESP]; Pereira, Liliane Desgualdo [UNIFESP]; Azevedo, Marisa Frasson de [UNIFESP]; Sousa, Elaine Colombo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To verify the performance of children born preterm on auditory processing evaluation, and to correlate the data with behavioral hearing assessment carried out at 12 months of age, comparing the results to those of auditory processing evaluation of children born full-term. METHODS: Participants were 30 children with ages between 4 and 7 years, who were divided into two groups: Group 1 (children born preterm), and Group 2 (children born full-term). The auditory processing results of Group 1 were correlated to data obtained from the behavioral auditory evaluation carried out at 12 months of age. The results were compared between groups. RESULTS: Subjects in Group 1 presented at least one risk indicator for hearing loss at birth. In the behavioral auditory assessment carried out at 12 months of age, 38% of the children in Group 1 were at risk for central auditory processing deficits, and 93.75% presented auditory processing deficits on the evaluation. Significant differences were found between the groups for the temporal order test, the PSI test with ipsilateral competitive message, and the speech-in-noise test. The delay in sound localization ability was associated to temporal processing deficits. CONCLUSION: Children born preterm have worse performance in auditory processing evaluation than children born full-term. Delay in sound localization at 12 months is associated to deficits on the physiological mechanism of temporal processing in the auditory processing evaluation carried out between 4 and 7 years.
- ItemAcesso aberto (Open Access)Características da sucção não-nutritiva em RN a termo e pré-termo tardio(Sociedade Brasileira de Fonoaudiologia, 2011-09-01) Kao, Ana Paula D'oliveira Gheti [UNIFESP]; Guedes, Zelita Caldeira Ferreira [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To compare non-nutritive sucking parameters between late preterm and full-term infants. METHODS: Infants were divided into two groups, full-term and late preterm, and were submitted to non-nutritive sucking assessment using a protocol adapted from the Oral Motor Assessment Scale. Statistical analysis was conducted for comparison between the groups. RESULTS: The seeking and sucking reflexes were less frequent in late preterm than in full-term newborns, as well as palmar grip and hands in the midline. Most late preterm infants presented light sleep or drowsiness before the assessment. Late preterm subjects predominantly presented sporadic sucking or blocks of sucking with long pauses and mandibular locking and/or tremors. Tongue retraction and protrusion were mostly present in late preterm infants, and tongue central groove formation, in full-term infants. CONCLUSION: Readiness for feeding, behavioral state, axial tonus, sucking pattern and strength, and tongue movements were the less frequent parameters in late preterm infants, in comparison to full-term infants.
- ItemAcesso aberto (Open Access)Complacência pulmonar com uma hora de vida e displasia broncopulmonar em recém-nascidos prematuros(Instituto de Medicina Integral Prof. Fernando Figueira, 2007-12-01) Barros, Lídia Mayrink de [UNIFESP]; Guinsburg, Ruth [UNIFESP]; Miyoshi, Milton Harumi [UNIFESP]; Peluzzo, Adriana V. [UNIFESP]; Figueira, Simone Na [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: to evaluate whether early pulmonary compliance could be a predictor of the presence of bronchopulmonary dysplasia at 28 days of life in preterm infants. METHODS: a cohort study was carried out involving neonates with gestational age <32 weeks and a birth weight of 500-1250 g receiving prophylactic surfactant at 30 minutes of life. The lung mechanics was evaluated using a pneumotachograph connected to the ventilator circuit 60 minutes after birth. Flow signals and volume were measured using WinTracer® in order to determine the dynamic pulmonary compliance and the airway resistance. Variables associated with the need for oxygen or assisted ventilation at 28 days were assessed using logistic regression. RESULTS: 32 neonates were enrolled in the study and 25 survived until the 28th day, at which point 17 (68%) needed assisted ventilation and/or oxygen (Group 1), and 8 did not (Group 2). The Group 1 infants were younger, had higher clinical risk index scores and frequency of patent ductus arteriosus. The lung mechanics in the 1st hour of life was similar in Groups 1 and 2. Regression analysis showed that bronchopulmonary dysplasia was associated with the presence of patent ductus arteriosus and lower gestational age. CONCLUSIONS: pulmonary compliance figures in the 1st hour of life did not predict the presence of bronchopulmonary dysplasia in the 28th day of life of the studied population.
- ItemSomente MetadadadosDoppler velocimetry of the uterine, umbilical and fetal middle cerebral arteries in pregnant women undergoing tocolysis with oral nifedipine(Wiley-Blackwell, 2009-09-01) Lima, Marcelo Marques de Souza [UNIFESP]; Souza, A. S. R.; Diniz, Carolina Prado [UNIFESP]; Porto, A. M. F.; Amorim, M. M. R.; Moron, Antonio Fernandes [UNIFESP]; Inst Med Integral Prof Fernando Figueira; Hosp IMIP Dom Malan; Universidade Federal de São Paulo (UNIFESP)Objectives To evaluate Doppler velocimetry (resistance index (RI) and peak systolic velocity (PSV)) in the maternal-fetal circulation before and 5 and 24 h after tocolysis with oral nifedipine.Methods This was a prospective, observational, analytic cohort study performed in 47 pregnant women undergoing nifedipine tocolysis, each subject acting as her own control. Doppler assessment of uterine, umbilical and fetal middle cerebral (MCA) arteries was performed before and 5 and 24 h after an initial 20-mg sublingual dose, which was repeated twice at 20-min intervals if contractions failed to diminish. the maintenance dose consisted of 20 mg orally every 6 h for 24 h up to a total of 100-120 mg nifedipine. We analyzed whether there was a time effect and compared values at the different time-points.Results the MCA-RI bad decreased significantly after 24 h of tocolysis (0 h = 0.85; 5 h = 0.85; 24 h = 0.81; P = 0.001), with no differences in uterine or umbilical arteries or in the MCA to umbilical artery ratio. the MCA-PSV bad reduced significantly after 5 h (0 h = 41.5 cm/s; 5 h = 34.7 cm/s; P = 0.001), returning close to baseline levels between 5 and 24 h. the PSV increased significantly between 5 and 24 h in the right uterine artery (5 h = 55.1 cm/s; 24 h 65.0 cm/s; P = 0.037) and in the umbilical artery (5 h 28.4 cm/s; 24 h = 33.1 cm/s; P = 0.038).Conclusions Nifedipine tocolysis is associated with a reduction in RI in the MCA but not in the uterine or umbilical arteries, a reduction in PSV in the MCA after 5 h but returning to baseline within 24 h, and an increase in PSV between 5 and 24 h in the umbilical and right uterine arteries. Copyright (C) 2009 ISUOG. Published by John Wiley & Sons, Ltd.
- ItemAcesso aberto (Open Access)Efeito do uso de protetores auriculares no sono de recém-nascidos prematuros na unidade neonatal: estudo clínico, randômico, controlado e cruzado(Universidade Federal de São Paulo (UNIFESP), 2015-11-26) Sato, Monica Hiromi [UNIFESP]; Pinheiro, Eliana Moreira Pinheiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To compare the effect of using earmuffs on the sleep of preterm newborns during ?quiet time? in two neonatal intermediate care units. Method: This is a randomized controlled crossover clinical study conducted at two neonatal intermediate care units from different hospitals in São Paulo - SP. Sample comprised 24 clinically stable preterm newborns, whose weight ranged from 1,200 g to 2,000g, who were in an incubator and met the inclusion and exclusion criteria established for the study. We used a Polysomnography Alice 5 (Respironics®) and unstructured observation for data collection. The intervention consisted in the use of earmuffs during Quiet time, with a total of 96 periods analyzed: 48 in the experimental group, and the remainder 48 in the control group. Results: Of the total sample, half were male. The average gestational, corrected and chronological ages were 33.2 weeks, 34.9 weeks and 11 days, respectively. Current average weight of preterm newborns was 1,747g. There was no significant difference in total sleep time between the experimental and control groups, and their averages were 83.7 minutes and 87.1 minutes, respectively (p = 0.540). Comparisons of quiet and indeterminate sleep time showed a marginally significant difference between the two groups (p = 0.071). Younger preterm newborns and with lower weights had significantly reduced total sleep time and quiet sleep with the use of earmuffs (p <0.05). The increase of one week in gestational age resulted in a 3% increase in preterm newborn's total sleep time when variables such as ambient light, handling the newborn and current weight were controlled. Quiet sleep was the predominant sleep stage in most analyses. Ambient light and handling the preterm newborn did not influence total sleep time in both groups. Conclusion: We concluded that there was no significant difference in total sleep time of preterm newborns between the experimental and control groups during naptime in the units studied. Significant reductions in total sleep time of smaller preterm newborns in relation to the average gestational and corrected ages and current weight may be related to a possible discomfort they experience due to the use of earmuffs.
- ItemSomente MetadadadosLate-Onset Sepsis in very Low Birth Weight Infants: A Brazilian Neonatal Research Network Study(Oxford Univ Press, 2014-12-01) Suppo de Souza Rugolo, Ligia Maria; Bentlin, Maria Regina; Mussi-Pinhata, Marisa; Branco de Almeida, Maria Fernanda [UNIFESP]; Andrade Lopes, Jose Maria de; Martins Marba, Sergio Tadeu; Fiori, Humberto Holmer; Procianoy, Renato Soibelmann; Leone, Clea Rodrigues; Brazilian Network Neonatal Res; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Fundacao Oswaldo Cruz; Pontificia Univ Catolica Rio Grande do Sul; Univ Fed Rio Grande do SulBackground: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.Aim: To determine the incidence, risk factors and etiology of LOS.Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.Results: of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. the majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.Conclusion: LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.
- ItemSomente MetadadadosNon-nutritive sucking scoring system for preterm newborns(Wiley-Blackwell, 2008-10-01) Neiva, F. C. B.; Leone, C.; Leone, C. R.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Aim: To validate a non-nutritive sucking (NNS) scoring system for oral feeding in preterm newborns (PTNB).Methods: A cohort study was carried out in two phases. in phase one of the study, 22 mastered speech-language pathologists received the protocol and procedure for a NNS scoring system to evaluate the content and presentation of the form and to define the grading scale. in phase two, six speech-language pathologists evaluated 51 PTNBs weekly, using the defined scoring system.Setting: This study was carried out in the Nursery Annex to the Maternity at the Intensive and Neonatal Pediatrics Service, Instituto da Crianca, Hospital das Clinicas, School of Medicine, University of São Paulo (FMUSP) during the period from May 2004 to May 2006.Participants: A total of 28 speech-language pathologist experts and 51 PTNBs.Results: in the first phase of the study, 22 speech-language pathologists selected the criteria, utilized in the NNS evaluation with 80% agreement. in the second phase of the study, the NNS evaluation was carried out on 51 PTNB, and a scoring system of 50 points was proposed, which corresponds to the smallest number of false positive and negative results regarding oral feeding ability.Conclusion: An NNS evaluation system was validated that was able to indicate when oral feeding could safely begin in PTNBs with a high level of agreement among the speech-language pathologists who have participated.
- ItemAcesso aberto (Open Access)Prevalence and factors associated with thoracic alterations in infants born prematurely(Associação Médica Brasileira, 2012-12-01) Davidson, Josy [UNIFESP]; Garcia, Kessey Maria Bini [UNIFESP]; Yi, Liu Chiao [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To determine the prevalence of thoracic musculoskeletal alterations and associated factors in infants born prematurely. METHODS: This was a cross sectional study with infants in the first year of age, born prematurely with birth weight < 2,000 g, who were followed up at the Premature Clinic from February, 2007 to December, 2008. Exclusion criteria were: maj or congenital malformations as defined by the Centers for Disease Control and Prevention (CDC), grade III/IV intraventricular hemorrhage, or periventricular leucomalacia. Physical examinations performed independently by two physiotherapists were used to assess shoulder elevation and thoracic retractions. Comparisons between groups were performed using the chi-squared test or Fisher's exact test for categorical variables, and Mann-Whitney's test or Student's t-test were used for continuous variables. Interobserver reliability between the two physiotherapists was assessed by the kappa coefficient. Variables associated with these thoracic musculoskeletal alterations were studied by univariate and multiple logistic analyses. Statistical differences were considered significant when p < 0.05. This study was approved by the ethical committee of the institution, and parents/guardians signed an informed consent. RESULTS: 121 infants with a gestational age of 31.1 ± 2.8 weeks and birth weight of 1,400 ± 338 g were included. Thoracic alterations were detected by Physiotherapist 1 in 81 (66.9%) infants, and in 83 (68.6%) by Physiotherapist 2 (kappa coefficient = 0.77). By multivariate logistic regression analysis, factors associated with thoracic musculoskeletal alterations were: respiratory distress syndrome (odds ratio [OR] = 3.246, 95% confidence interval [CI]: 1.237-8.732), bronchopulmonary dysplasia (OR = 11.138, 95% CI: 1.339-92.621), and low length/age ratio (OR = 4.571, 95% CI: 1.371-15.242). CONCLUSION: The prevalence of thoracic alterations was high in infants born prematurely, and was associated with pulmonary disease and low length/age ratio.
- ItemSomente MetadadadosThe urinary activity of angiotensin-converting enzyme in preterm, full-term newborns, and children(Springer, 2006-08-01) Del Ben, Graziela Lopes; Redublo Quinto, Beata Marie; Casarini, Dulce Elena; Bueno Ferreira, Luiz Carlos; Ayres, Sergio Sousa; Abreu Carvalhaes, Joao Tomas de; Universidade Federal de São Paulo (UNIFESP); Sao Luiz Hosp & MaternThe urinary activity of the angiotensin-converting enzyme (U-ACE) is not yet completely documented in human neonates. We measured the UACE in 36 premature neonates on the 1st day and in the 1st, 2nd, 3rd, and 4th weeks of life, in 22 full-term neonates between the 1st and 2nd days, and in 30 nursing and preschool children between 1 month and 6 years of age. the urinary excretion of sodium (U-Na/U-Cr) and the potassium/sodium index (U-K/U-Na) were analyzed in the neonates. U-ACE was greater in premature than in fullterm neonates and greater in both than in older children (p < 0.001). in the premature neonates, U-ACE peaked at the 2nd week, the U-Na/U-Cr index decreased, and the U-K/U-Na index increased between the 1st day and the 2nd week (p < 0.001). the U-Na/U-Cr index on the 1st day and in the 1st and 2nd weeks was greater in premature than in full-term neonates (p < 0.001). There was no significant correlation between the U-ACE and the U-Na/U-Cr index. in conclusion, the U-ACE profile was shown to be age dependent and related to the postnatal renal development. the increase in U-ACE activity may reflect the high activity of the neonatal intrarenal renin-angiotensin system (RAS).
- ItemSomente MetadadadosA very strict guideline reduces the number of erythrocyte transfusions in preterm infants(Wiley-Blackwell, 2008-01-01) Mimica, A. F. M. A. [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Cunha, Deise Helena Fernandes da [UNIFESP]; Guinsburg, Ruth [UNIFESP]; Bordin, J. O. [UNIFESP]; Chiba, A. [UNIFESP]; Barros, M. M. O. [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background and Objectives Benefits of adopting restrictive guidelines for erythrocyte transfusions are still controversial. the objective of this study was to verify if a very strict guideline could reduce erythrocyte transfusions in preterm infants without adverse outcomes.Materials and Methods Two prospective cohorts of neonates with gestational age < 37 weeks and birth weight < 1500 g were studied. Neonates born in Period 1 were submitted to a strict guideline for erythrocyte transfusions. in Period 2, a new stricter protocol was introduced. Infants of both periods were compared regarding number of transfusions and clinical outcome.Results the median number of transfusions decreased from 2 (1 to 14) in Period 1 to 1 (1-9), P = 0.001, in Period 2. the linear regression multivariate analysis showed that the implementation of the stricter guideline was associated with a reduction in the number of transfusions received by patients by 0.55 (95% confidence interval: -0.08; -1.02) units/patients. Number of apnea episodes, weight at 28 days of life and days of hospital stay were similar in both periods. Intra-hospital death was lower in Period 2.Conclusion A very strict guideline reduced the number of erythrocyte transfusions in preterm infants, without threatening their clinical course.