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Avaliação nutricional do recém-nascido: limitações dos métodos atuais e novas perspectivas; Nutritional assessment of newborn infants: current method limitations and new perspectives

BROCK, Romy Schmidt; FALCÃO, Mário Cícero
Fonte: Sociedade de Pediatria de São Paulo Publicador: Sociedade de Pediatria de São Paulo
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
46.49%
OBJETIVO: Revisar a literatura sobre as abordagens na avaliação nutricional do recém-nascido. FONTES DE DADOS: Levantamento das publicações sobre avaliação nutricional de recém-nascidos indexadas no Medline, SciELO e Lilacs nos últimos dez anos, utilizando os descritores "antropometria" e "avaliação nutricional". SÍNTESE DOS DADOS: A avaliação nutricional do recém-nascido é importante tanto para classificação e diagnóstico de alterações do crescimento intra-uterino, quanto para posterior acompanhamento nutricional e de crescimento. Esta avaliação compreende parâmetros antropométricos, bioquímicos e de composição corpórea. Devido à limitação de métodos laboratoriais e de composição corpórea, a avaliação nutricional do recém-nascido continua sendo baseada em parâmetros antropométricos, como peso, comprimento, perímetros cefálico e braquial e dobras cutâneas. Além dos parâmetros antropométricos, as relações antropométricas são úteis para descrever proporcionalidades corpóreas. Dentre tais relações, destacam-se: razão entre perímetros braquial e cefálico e índice ponderal. O índice de massa corpórea (IMC), bastante utilizado em crianças e adultos como indicador de proporcionalidade do crescimento...

Transferência transplacentária de anticorpos anti-Streptococcus B nos recém-nascidos de termo e pré-termo; Placental transfer of anti-Streptococcus B antibodies in term and preterm newborn babies

Brasil, Tatiana Braga
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 25/06/2008 Português
Relevância na Pesquisa
46.4%
O Streptococcus do Grupo B (EGB) é um dos principais agentes de infecção no período neonatal, sendo responsável por altos índices de morbimortalidade materno-fetal. Este estudo tem por objetivo avaliar a passagem transplacentária de anticorpos anti-Streptococcus B e imunoglobulina G em recém-nascidos de termo e pré-termo, bem como comparar seus níveis séricos. Foi realizado estudo transversal incluindo 44 recém-nascidos (18 pré-termo e 26 de termo) do Berçário Anexo à Maternidade do Hospital das Clínicas da FMUSP no período de dezembro de 2006 a julho de 2007. Após consentimento esclarecido, foram obtidas amostras de sangue das mães e do cordão umbilical de seus respectivos recém-nascidos, realizadas dosagens de IgG total por nefelometria e de anticorpos anti-EGB através do ensaio imunoenzimático (ELISA). Observou-se que nos dois grupos de mães da casuística, compostos por 16 mães de RN pré-termo e 26 mães de RN de termo, não houve diferença significativa em relação aos níveis séricos de anticorpos anti-EGB. O nível sérico médio de anticorpos maternos anti-EGB foi de 1697,98, com variação de 456 a 5200 (em títulos). O nível sérico médio de anticorpos anti-EGB das mães de RNPT foi de 1570...

Antenatal corticosteroid use and clinical evolution of preterm newborn infants

Martinez, Francisco E.; Linhares, Nelson J.; Ferlin, Maria L. S.; Marba, Sérgio; Netto, Abimael A.; Procianoy, Renato S.; Uchoa, Natacha T.; Lopes, José Maria A.; Bomfim, Olga; Guinsburg, Ruth; Almeida, Maria Fernanda B.; Miyoshi, Milton; Meneguel, Joic
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 277-284
Português
Relevância na Pesquisa
46.51%
Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Results: Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time...

The frequency of pharmacological pain relief in university neonatal intensive care units

Prestes, Ana Claudia Yoshikumi; Guinsburg, Ruth; Balda, Rita C. X.; Marba, Sergio T. M.; Rugolo, Ligia M. S. S.; Pachi, Paulo R.; Bentlin, Maria Regina
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 405-410
Português
Relevância na Pesquisa
46.57%
Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU. Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0. Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion: It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Prediction of hyperglycemia in preterm newborn infants

Falcão,Mário Cícero; Ramos,José Lauro Araújo
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/1999 Português
Relevância na Pesquisa
56.39%
Many conditions are associated with hyperglycemia in preterm neonates because they are very susceptible to changes in carbohydrate homeostasis. The purpose of this study was to evaluate the occurrence of hyperglycemia in preterm infants undergoing glucose infusion during the first week of life, and to enumerate the main variables predictive of hyperglycemia. This prospective study (during 1994) included 40 preterm neonates (gestational age <37 weeks); 511 determinations of glycemic status were made in these infants (average 12.8/infant), classified by gestational age, birth weight, glucose infusion rate and clinical status at the time of determination (based on clinical and laboratory parameters). The clinical status was classified as stable or unstable, as an indication of the stability or instability of the mechanisms governing glucose homeostasis at the time of determination of blood glucose; 59 episodes of hyperglycemia (11.5%) were identified. A case-control study was used (case = hyperglycemia; control = normoglycemia) to derive a model for predicting glycemia. The risk factors considered were gestational age (<=31 vs. >31 weeks), birth weight (<=1500 vs. >1500 g), glucose infusion rate (<=6 vs. >6 mg/kg/min) and clinical status (stable vs. unstable). Multivariate analysis by logistic regression gave the following mathematical model for predicting the probability of hyperglycemia: 1/exp{-3.1437 + 0.5819(GA) + 0.9234(GIR) + 1.0978(Clinical status)} The main predictive variables in our study...

Necrotizing fasciitis in a newborn infant: a case report

Krebs,Vera Lúcia Jornada; Koga,Karen Mayumi; Diniz,Edna Maria de Albuquerque; Ceccon,Maria Esther Jurfest; Vaz,Flávio Adolfo Costa
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2001 Português
Relevância na Pesquisa
56.36%
We report the case of a one-day-old newborn infant, female, birth weight 1900 g, gestational age 36 weeks presenting with necrotizing fasciitis caused by E. coli and Morganella morganii. The newborn was allowed to fall into the toilet bowl during a domestic delivery. The initial lesion was observed at 24 hours of life on the left leg at the site of the venipuncture for the administration of hypertonic glucose solution. Despite early treatment, a rapid progression occurred resulting in a fatal outcome. We call attention to the risk presented by this serious complication in newborns with a contaminated delivery, and highlight the site of the lesion and causal agents.

Differences between uni-and multidimensional scales for assessing pain in term newborn infants at the bedside

Arias,Maria Carmenza Cuenca; Guinsburg,Ruth
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2012 Português
Relevância na Pesquisa
46.61%
OBJECTIVES: This study sought to determine the level of agreement between behavioral and multidimensional pain assessment scales in term newborn infants submitted to an acute nociceptive stimulus. METHODS: This cross-sectional study was performed on 400 healthy term newborns who received an intramuscular injection of vitamin K during the first 6 hours of life. Two behavioral pain scales (the Neonatal Facial Coding System and the Behavioral Indicators of Infant Pain) and one multidimensional tool (the Premature Infant Pain Profile) were applied by a single observer before the procedure, during cleansing, during injection and two minutes after injection. The Cochran Q, McNemar and kappa tests were used to compare the presence and degree of agreement between the three scales. The Hotelling T2 test was used to compare the groups of newborns for which the scales showed agreement or disagreement. A generalized linear regression was used to compare the results of the Neonatal Facial Coding System and the Behavioral Indicators of Infant Pain across the four study time points. RESULTS: The neonates studied had a gestational age of 39±1 weeks, a birth weight of 3169±316 g and and postnatal age of 67±45 minutes. During the stimulus procedure...

Torsade de pointes ventricular tachycardia in a newborn infant.

Finley, J P; Radford, D J; Freedom, R M
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/1978 Português
Relevância na Pesquisa
46.39%
A case of paroxysmal ventricular tachycardia of torsade de pointes variety occurring in a newborn infant is described. A rare problem in the newborn, ventricular tachycardia has been associated with congenital heart disease, electrolyte abnormality, and cardiac tumour. In this case, the association was with myocarditis. The arrhythmia was refractory to treatment, and the infant died.

Pharmacology of some oral penicillins in the newborn infant.

Cohen, M D; Raeburn, J A; Devine, J; Kirkwood, J; Elliott, B; Cockburn, F; Forfar, J O
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1975 Português
Relevância na Pesquisa
46.4%
Serum and urine concentrations of ampicillin, amoxycillin, and flucloxacillin achieved after oral administration have been measured in 27 newborn infants. Compared with adults and children, newborn infants show a delay in achieving adequate blood concentrations, presumably due to delayed absorption. However most infants achieve therapeutic concentrations in the serum. Infected newborn infants should be given these antibiotics by intramuscular injection for the first dose, but thereafter oral therapy (25 mg/lg every 6 hours begun concomitantly) should be satisfactory. The better absorption of amoxycillin compared with ampicillin reported in adults has not been confirmed in the newborn infant.

Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant.

Williams, L. A.; Evans, S. F.; Newnham, J. P.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 28/06/1997 Português
Relevância na Pesquisa
46.39%
OBJECTIVES: To determine the demographic, environmental, and medical factors that influence the relative weights of the newborn infant and the placenta and compare this ratio with other factors known to predispose to adult ill health. DESIGN: Prospective cohort study. SETTING: The tertiary referral centre for perinatal care in Perth, Western Australia. SUBJECTS: 2507 pregnant women who delivered a single live infant at term. MAIN OUTCOME MEASURES: Placental weight, birth weight, and the ratio of placental weight to birth weight. RESULTS: By multiple regression analysis the placental weight to birthweight ratio was significantly and positively associated with gestational age, female sex, Asian parentage, increasing maternal body mass index, increased maternal weight at booking, lower socioeconomic status, maternal anaemia, and increasing number of cigarettes smoked daily. There were no consistent relations between the placental weight to birthweight ratio and measures of newborn size. CONCLUSIONS: The ratio of placental weight to birth weight is not an accurate marker of fetal growth. In its role as a predictor of adult disease the ratio may be acting as a surrogate for other factors which are already known to influence health and may act before or after birth. Determining the role that relative growth rates of the fetus and placenta have in predisposing to adult disease requires prospective study to account for the many confounding variables which complicate this hypothesis.

Aproximación a la intervención en el niño recién nacido: percepción de padres y profesionales de las unidades de neonatología

Martínez Varela, Raquel
Fonte: Universidade da Corunha Publicador: Universidade da Corunha
Tipo: Trabalho de Conclusão de Curso
Português
Relevância na Pesquisa
46.6%
Traballo fin de grao (UDC.FCS). Terapia ocupacional. Curso 2013/2014; Introducción: El aumento del número de recién nacidos prematuros y los avances en los cuidados que reciben a nivel obstétrico y neonatológico han aumentado su supervivencia. Este hecho puede suponer un incremento del número de niños que presentan secuelas en su desarrollo, e implica la necesidad de que haya profesionales formados específicamente para atender a sus requerimientos en el contexto neonatológico. Objetivos: El objetivo general del presente estudio es explorar la percepción de los profesionales que trabajan en la unidad de neonatología y de los padres de los recién nacidos prematuros, acerca de la intervención y cuidados que reciben los neonatos en dicha unidad. Entre los objetivos específicos se pretende indagar las posibles aportaciones del terapeuta ocupacional como miembro del equipo de intervención con los recién nacidos prematuros. Metodología: Se empleará una metodología cualitativa, enmarcada en un paradigma fenomenológico. La selección de participantes se realizará siguiendo un muestreo teórico intencionado en el que se establecerán tres perfiles de informantes. La principal técnica de recogida de información que se utilizará será la entrevista semiestructurada. La aplicabilidad del proyecto reside en la demostración de la posible inclusión del terapeuta ocupacional como parte del equipo de profesionales que realiza una intervención con los recién nacidos prematuros en las unidades de neonatología de los complejos hospitalarios del SERGAS.; Introdución: O aumento do número de recen nados prematuros e os avances nos coidados que reciben a nivel obstétrico e neonatolóxico aumentaron a súa supervivencia. Este feito pode supoñer un incremento no número de nenos que presentan secuelas no seu desenvolvemento...

A life worth giving? The threshold for permissible withdrawl of life support from disabled newborn infants

Wilkinson, D.
Fonte: Routledge Publicador: Routledge
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
Relevância na Pesquisa
56.39%
When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view.; Dominic James Wilkinson

Respostas fisiológicas e comportamentais de recém-nascidos pré-termos submetidos a duas técnicas de banho de imersão: ensaio clínico cruzado; Physiological and behavioral responses of preterm newborn underwent to two immersion baths techniques: cross-over clinical trial

Freitas, Patricia de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 28/05/2015 Português
Relevância na Pesquisa
46.47%
Introdução: a revisão de literatura aponta que os recém-nascidos submetidos ao banho de imersão produzem menor variação térmica pós-banho comparado aos submetidos ao banho com esponja. No Brasil, o Ministério da Saúde vem capacitando profissionais que atuam em unidades de internação neonatal para implementar o Método Mãe Canguru e, entre outras práticas, recomenda que o recém-nascido pré-termo (RNPT) e com baixo peso seja submetido ao banho de imersão envolto em cueiro ou lençol, sugerindo mudança da prática hegemônica do banho com esponja ou banho de imersão convencional. No entanto, a técnica de banho de imersão recomendada carece de evidências científicas quanto a sua segurança em relação às repercussões na estabilidade da temperatura corporal (T), frequência cardíaca (FC), cortisol salivar (CS) e comportamental em RNPT. Hipótese: os RNPT submetidos ao banho de imersão envoltos em lençol (BIE) apresentam respostas fisiológicas e comportamentais similares aos submetidos à técnica de banho de imersão convencional (BIC), nos primeiros 20 minutos pós-banho. Objetivo: avaliar os parâmetros fisiológicos e comportamentais de RNPT submetidos ao banho de imersão envolto em lençol (BIE) e banho de imersão convencional (BIC). Método: ensaio clínico randomizado cruzado com amostra composta por 43 RNPT...

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

Falcão,Mário Cícero; Leone,Cléa Rodrigues; D'Andrea,Renata A. P.; Berardi,Roberta; Ono,Nilce A.; Vaz,Flávio Adolfo Costa
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/1999 Português
Relevância na Pesquisa
56.43%
OBJETIVE: to evaluate the efficacy of urine culture by bag specimen for the detection of neonatal urinary tract infection in full-term newborn infants. Retrospective study (1997) including full-term newborn infants having a positive urine culture (>100,000 CFU/ml) by bag specimen collection. The urinary tract infection diagnosis was confirmed by positive urine culture (suprapubic bladder aspiration method). The select cases were divided into three groups, according to newborn infant age at the bag specimen collection: GI (< 48 h, n = 17), GII (48 h to 7 d, n = 35) and GIII (> 7 d, n = 9). Sixty one full-term newborn infants were studied (5.1 % of total infants). The diagnosis was confirmed on 19/61 (31.1 %) of full-term infants born alive. Distribution among the groups was: GI = 2/17 (11.8 %), GII = 10//35 (28.6 %), and GIII = 7/9 (77.7 %). The most relevant clinical symptoms were: fever (GI - 100 %, GII - 91.4 %) and weight loss (GI - 35.3 %, GII - 45.7 %). Urine culture results for specimens collected by suprapubic aspiration were: E. coli GI (100 %), GII (40 %) and GIII (28.6 %), E. faecalis GI (30%), Staphylococcus coagulase-negative GII (20 %) and GIII (42.8 %), and Staphylococcus aureus GII (10 %). Correlation between positive urine culture collection (bag specimen method) and urinary tract infection diagnosis...

Desempenho motor em recém-nascidos pré-termo de alto risco; Motor performance in premature newborn of high risk

Nicolau, Carla Marques; Costa, Anna Paula Bastos Marques; Hazime, Haline Omar; Krebs, Vera Lúcia Jornada
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/08/2011 Português
Relevância na Pesquisa
56.45%
OBJETIVO: avaliar o desempenho motor em recém-nascidos pré-termo (RNPT) com risco para o desenvolvimento motor. MÉTODO: estudo prospectivo entre junho 2007 e dezembro 2008 com RN estáveis, respiração espontânea em ar ambiente e idade corrigida até 120 dias de vida. O estudo consistiu na avaliação do desempenho motor através do Test of Infant Motor Performance (TIMP), sendo aplicado por fisioterapeuta treinado, na alta hospitalar. A análise dos resultados foi realizada através de medidas descritivas e medidas de sensibilidade, especificidade e valores preditivos positivo e negativo. RESULTADOS: Foram estudados 69 RNs com idade gestacional (IG) média 32,61 ± 2,69 semanas e peso médio 1207,00 ± 380,14 gramas, com predomínio do sexo masculino (62%) e dos adequados para a idade gestacional (66,6%). Da população estudada 56 RN apresentaram pontuação na média, 7 apresentaram pontuação abaixo da média e 6 apresentaram escores muito abaixo da média. Os RN com pontuação dentro da média apresentaram IG média 34,44 ± 0,59 sem, peso médio de nascimento 1355,50 ± 294,26 gramas e permaneceram em média 11,22 ± 7,07 dias em oxigênio inalatório. Os RN que obtiveram desempenho abaixo da média apresentaram IG média 32...

Differences between uni-and multidimensional scales for assessing pain in term newborn infants at the bedside

Arias, Maria Carmenza Cuenca; Guinsburg, Ruth
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/10/2012 Português
Relevância na Pesquisa
46.51%
OBJECTIVES: This study sought to determine the level of agreement between behavioral and multidimensional pain assessment scales in term newborn infants submitted to an acute nociceptive stimulus. METHODS: This cross-sectional study was performed on 400 healthy term newborns who received an intramuscular injection of vitamin K during the first 6 hours of life. Two behavioral pain scales (the Neonatal Facial Coding System and the Behavioral Indicators of Infant Pain) and one multidimensional tool (the Premature Infant Pain Profile) were applied by a single observer before the procedure, during cleansing, during injection and two minutes after injection. The Cochran Q, McNemar and kappa tests were used to compare the presence and degree of agreement between the three scales. The Hotelling T2 test was used to compare the groups of newborns for which the scales showed agreement or disagreement. A generalized linear regression was used to compare the results of the Neonatal Facial Coding System and the Behavioral Indicators of Infant Pain across the four study time points. RESULTS: The neonates studied had a gestational age of 39±1 weeks, a birth weight of 3169±316 g and and postnatal age of 67±45 minutes. During the stimulus procedure...

Fasciíte necrosante em neonato: relato de caso; Necrotizing fasciitis in a newborn infant: a case report

Krebs, Vera Lúcia Jornada; Koga, Karen Mayumi; Diniz, Edna Maria de Albuquerque; Ceccon, Maria Esther Jurfest; Vaz, Flávio Adolfo Costa
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/04/2001 Português
Relevância na Pesquisa
56.36%
Os autores relatam o caso de um recém-nascido com um dia de vida, sexo feminino, com peso de nascimento de 1900g e idade gestacional de 36 semanas que apresentou fasciíte necrosante causada por E. coli e Morganella morganii. O parto foi domiciliar, com queda acidental no vaso sanitário durante o nascimento. A lesão inicial foi observada com 24 horas de vida, na perna esquerda em local de venopunção para a administração de solução de glicose hipertônica. Apesar do tratamento precoce, houve progressão rápida, com evolução fatal. Os autores chamam a atenção para o risco desta complicação grave em recém-nascido de parto contaminado, destacando o local da lesão e os agentes etiológicos.; We report the case of a one-day-old newborn infant, female, birth weight 1900 g, gestational age 36 weeks presenting with necrotizing fasciitis caused by E. coli and Morganella morganii. The newborn was allowed to fall into the toilet bowl during a domestic delivery. The initial lesion was observed at 24 hours of life on the left leg at the site of the venipuncture for the administration of hypertonic glucose solution. Despite early treatment, a rapid progression occurred resulting in a fatal outcome. We call attention to the risk presented by this serious complication in newborns with a contaminated delivery...

Propedêutica neurológica do recém-nascido e sua evolução; Neurological evaluation and follow-up of the newborn infant

Gherpelli, José Luiz Dias
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 29/12/2003 Português
Relevância na Pesquisa
66.45%
O autor descreve a propedêutica neurológica do recém-nascido a termo e pré-termo, tecendo considerações sobre as técnicas de exame mais freqüentemente empregadas na prática clínica e as síndromes neurológicas observadas no período neonatal. Posteriormente, descreve os padrões de desenvolvimentoobservados em crianças normais nos primeiros anos de vida, nas áreas motora, de linguagem, coordenação motora e adaptativa, descrevendo os testes mais comuns utilizados na avaliação das crianças pré-escolares.; The author describes the clinical neurological evaluation of the newborn infant at term and pre-term, with special remarks on the most frequently used techniques in clinical practice, and theneurological syndromes observed in the neonatal period. The developmental patterns found in normal children in the first years of life are described according to the major areas of development: motor, language, motor coordination and adaptative, along with the tests most frequently used for the evaluation of pre-school children.

Medication error in an extremely low birth weight infant: paracetamol overdose

Brener,Pablo; Ballardo,Mónica; Mariani,Gonzalo; Ceriani Cernadas,José M.
Fonte: Archivos argentinos de pediatría Publicador: Archivos argentinos de pediatría
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 Português
Relevância na Pesquisa
46.45%
Errors are part of human nature and are usually present in our actions. Medical errors occur quite often and can be serious. Medication errors are among the most frequent, especially in newborn infants because of the multiple steps that occur during the process of prescribing and administering drugs and because most drugs are not licensed for being used in newborn infants (off-label). The aim of this report is to describe a medication error in prescribing paracetamol for closing a patent ductus arteriosus in a preterm infant and to analyze its causes. A preterm female infant born at 27 weeks of gestational age with a birth weight of 750 g received paracetamol at 9 days old at a dose 20 times greater than required. The initial plasma level was 480 µg/mL. N-acetylcysteine was administered and her clinical outcome was satisfactory. Parents were notified of the event, which was recorded in the medical record and in the electronic error reporting system of the Hospital Italiano de Buenos Aires. We consider this report as an example that we are exposed to making mistakes and should maximize precautions to improve patient safety in neonatal units.

Time to focus child survival programmes on the newborn: assessment of levels and causes of infant mortality in rural Pakistan

Fikree,Fariyal F.; Azam,Syed Iqbal; Berendes,Heinz W.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2002 Português
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OBJECTIVE: Population-based surveys were conducted in selected clusters of Pakistan's least developed provinces, Balochistan and North-West Frontier Province (NWFP), including the Federally Administered Tribal Areas (FATA), to assess levels and causes of neonatal and postneonatal mortality. METHODS: Interviews were conducted in a total of 54 834 households: Balochistan, 20 486; NWFP, 26 175; and FATA, 8173. Trained interviewers administered questionnaires after obtaining verbal informed consent from the respondents. Verbal autopsy interviews were conducted for infant deaths reported for the previous year. FINDINGS: The infant mortality rate based on combined data from the different sites was 99.7 per 1000 live births (range 129.0-70.1). The contribution of neonatal deaths to all infant deaths was much higher for NWFP (67.2%), where the overall rate was lowest, than for Balochistan (50.8%) and FATA (56.8%). Around 70% of all neonatal deaths occurred in the early neonatal period. The three main clinical causes of infant deaths were diarrhoea syndrome (21.6%), tetanus (11.7%) and acute respiratory infections (11.6%). In the neonatal period, however, tetanus (18.3%), small size for gestational age or low birth weight (15.3%), and birth injury (12.0%) accounted for nearly half (45.6%) of all deaths...