ABSTRACT
O Ministério da Saúde prevê a disponibilização da Caderneta de Saúde da Criança (CSC) desde 2005 a todas as crianças nascidas no Brasil. Trata-se de uma ferramenta centralizadora para a atenção integral da saúde na infância e, portanto, de um instrumento valioso para o acompanhamento do crescimento das crianças. O registro correto e completo das informações é requisito básico para que a CSC cumpra seu papel estratégico. Elegemos a revisão de escopo com o objetivo de discutir os estudos primários que analisaram quantitativamente o preenchimento dos dados sobre crescimento na CSC. A pesquisa foi realizada nas bases de dados MEDLINE, LILACS, SciELO e na Biblioteca Virtual em Saúde usando os descritores "Saúde da criança"e "Registros de saúde pessoal" (em inglês, "Child Health" e "Health Records, Personal"). Além disso, foi usada a palavra-chave "Caderneta de Saúde da Criança. Foram identificados 191 trabalhos, sendo 15 artigos elegíveis para esta revisão. Os estudos observaram registro insatisfatório dos dados sobre o crescimento na CSC. O preenchimento dos gráficos de peso por idade variou entre 8,9% e 96,3%, por exemplo, revelando fragilidade no uso desse instrumento e necessidade de melhora dos registros no acompanhamento do crescimento das crianças.
The Ministry of Health has made the Caderneta de Saúde da Criança (CSC), a child health booklet, available to all children born in Brazil, since 2005. It is a strategic tool for comprehensive child health care, a valuable instrument for registering and monitoring growth. The correct and complete registration of this information is a basic requirement for the CSC to fulfill itsrole. We chose the scoping review in order to discuss primary studies that quantitatively analyze the filling in of data on growth in the CSC. The research was carried out in the databases MEDLINE, LILACS, SciELO, and in the Biblioteca Virtual em Saúde, using the descriptors in Portuguese: "Saúde da Criança" and "Registros de saúde pessoal"; in English: "Child Health" and "Health Records, Personal"; and, in addition, the keyword "Caderneta de Saúde da Criança" was also used. A total of 191 papers were identified, 15 of which were eligible for this review. The studies observed an unsatisfactory filling in of data on the growth of CSC. Completion of weight-for-age charts ranged between 8.9% and 96.3%, for example, revealing weaknesses in the use of this instrument and the need to improve records in monitoring the growth of children.
Subject(s)
Health Records, Personal , Primary Health Care , Weight by Age , Child Health , Integrality in Health , GrowthABSTRACT
BACKGROUND: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. METHODS: Seventeen patients (mean age, 9.6 ± 2.9 years) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. RESULTS: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. CONCLUSION: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.