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Food Chem ; 369: 130998, 2022 Feb 01.
Article En | MEDLINE | ID: mdl-34507088

High Temperature-Short Time (HTST) pasteurization was proposed as an alternative to Holder pasteurization (HOP) to increase the retention of specific human milk (HM) bioactive proteins. The present study explored whether HTST and HOP differently affect peptide release during simulated preterm infant gastrointestinal digestion. Raw (RHM), HOP- and HTST- pasteurized HM were digested using an in vitro dynamic system, and the identified peptides were analyzed by mass spectrometry and multivariate statistics. Before digestion, 158 peptides were identified in either RHM, HTST- or HOP- HM, mostly (84.4%) originating from ß-casein (CASB). During gastric digestion, HOP-HM presented a greater number and more abundant specific CASB peptides. A delayed release of peptides was observed in RHM during the intestinal phase, with respect to both pasteurized HM. Although limited to gastric digestion, the HM peptidomic profile differed according to the pasteurization type, and the pattern of the HTST peptides showed a greater similarity with RHM.

Milk, Human , Pasteurization , Animals , Digestion , Humans , Infant , Infant, Newborn , Infant, Premature , Milk , Peptides , Temperature
J Exp Child Psychol ; 213: 105270, 2022 01.
Article En | MEDLINE | ID: mdl-34487976

Developmental studies have shown that infants exploit ordinal information to extract and generalize repetition-based rules from a sequence of items. Within the visual modality, this ability is constrained by the spatial layout within which items are delivered given that a left-to-right orientation boosts infants' rule learning, whereas a right-to-left orientation hinders this ability. Infants' rule learning operates across different domains and can also be transferred across modalities when learning is triggered by speech. However, no studies have investigated whether the transfer of rule learning occurs across different domains when language is not involved. Using a visual habituation procedure, we tested 7-month-old infants' ability to extract rule-like patterns from numerical sequences and generalize them to non-numerical sequences of visual shapes and whether this ability is affected by the spatial orientation. Infants were first habituated to left-to-right or right-to-left oriented numerical sequences instantiating an ABB rule and were then tested with the familiar rule instantiated across sequences of single geometrical shapes and a novel (ABA) rule. Results showed a transfer of learning from number to visual shapes for left-to-right oriented sequences but not for right-to-left oriented ones (Experiment 1) even when the direction of the numerical change (increasing vs. decreasing) within the habituation sequences violated a small-left/large-right number-space association (Experiment 2). These results provide the first demonstration that visual rule learning mechanisms in infancy operate at a high level of abstraction and confirm earlier findings that left-to-right oriented directional cues facilitate infants' representation of order.

Child Development , Speech , Humans , Infant , Language , Space Perception
Neurosurg Clin N Am ; 33(1): 105-112, 2022 Jan.
Article En | MEDLINE | ID: mdl-34801135

Craniosynostosis involves the premature fusion of 1 or more cranial sutures and commonly presents as an isolated, nonsyndromic diagnosis. A subset of patients have syndromic craniosynostosis. Several unique considerations must be taken into account when managing patients with syndromic craniosynostosis. A multidisciplinary craniofacial team with a central coordinator is particularly useful for coordinating care among various specialists, and close monitoring is mandatory owing to the increased risk of intracranial hypertension. Surgical management varies among centers, but core options include fronto-orbital advancement with cranial vault remodeling, posterior vault expansion, endoscopic-assisted suturectomy with postoperative orthotic therapy, and midface advancement.

Craniosynostoses , Intracranial Hypertension , Craniosynostoses/diagnostic imaging , Craniosynostoses/surgery , Humans , Infant , Skull , Syndrome
Neurosurg Clin N Am ; 33(1): 17-23, 2022 Jan.
Article En | MEDLINE | ID: mdl-34801138

Achondroplasia is the most common of skeletal dysplasias and is caused by a defect in endochondral bone formation. In addition to skeletal deformities, patients with achondroplasia possess significant abnormalities of the axial skeleton, including small skull base with a narrowed foramen magnum and small vertebral bodies with shortened pedicles. Consequently, patients with achondroplasia are at risk of several severe neurologic conditions, such as cervicomedullary compression, spinal stenosis, and hydrocephalus, which frequently require the attention of a neurosurgeon. This article provides an updated review on the neurosurgical evaluation and care of children with Achondroplasia.

Achondroplasia , Hydrocephalus , Spinal Stenosis , Achondroplasia/surgery , Child , Constriction, Pathologic , Foramen Magnum , Humans , Hydrocephalus/surgery , Infant
Neurosurg Clin N Am ; 33(1): 25-35, 2022 Jan.
Article En | MEDLINE | ID: mdl-34801139

Much of the current medical discussion for within centers for skeletal dysplasia and specifically patients with achondroplasia focuses on infancy and early childhood. Most neurosurgical concerns arise due to a defect in the endochondral ossification, resulting on early fusion of the synchondrosis. As patients age, the neurosurgical focus shifts from primarily cranial to spinal concerns. Often pediatric neurosurgeons may continue to follow their patients with skeletal dysplasia. However, general adult neurosurgeons and orthopedic surgeons may see these graduated adults in their practice. This article provides a review of the common neurosurgical concerns for patients with achondroplasia.

Achondroplasia , Foramen Magnum , Achondroplasia/surgery , Adult , Child , Child, Preschool , Constriction, Pathologic , Humans , Infant
J Med Virol ; 94(1): 366-371, 2022 01.
Article En | MEDLINE | ID: mdl-34546584

Co-epidemics happening simultaneously can generate a burden on healthcare systems. The co-occurrence of SARS-CoV-2 with vector-borne diseases (VBD), such as malaria and dengue in resource-limited settings represents an additional challenge to the healthcare systems. Herein, we assessed the coinfection rate between SARS-CoV-2 and VBD to highlight the need to carry out an accurate diagnosis and promote timely measures for these infections in Luanda, the capital city of Angola. This was a cross-sectional study conducted with 105 subjects tested for the SARS-CoV-2 and VBD with a rapid detection test in April 2021. The participants tested positive for SARS-CoV-2 (3.80%), malaria (13.3%), and dengue (27.6%). Low odds related to testing positivity to SARS-CoV-2 or VBD were observed in participants above or equal to 40 years (odds ratio [OR]: 0.60, p = 0.536), while higher odds were observed in male (OR: 1.44, p = 0.392) and urbanized areas (OR: 3.78, p = 0.223). The overall co-infection rate between SARS-CoV-2 and VBD was 11.4%. Our findings showed a coinfection between SARS-CoV-2 with malaria and dengue, which could indicate the need to integrate the screening for VBD in the SARS-CoV-2 testing algorithm and the adjustment of treatment protocols. Further studies are warranted to better elucidate the relationship between COVID-19 and VBD in Angola.

COVID-19/epidemiology , Coinfection/epidemiology , Dengue/epidemiology , Malaria/epidemiology , Vector Borne Diseases/epidemiology , Adolescent , Adult , Age Factors , Angola/epidemiology , Antibodies, Protozoan/blood , Antibodies, Viral/blood , COVID-19 Testing , Chikungunya Fever/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Mass Screening , Middle Aged , RNA, Viral/blood , SARS-CoV-2/isolation & purification , Sex Factors , Young Adult , Zika Virus Infection/epidemiology
Handb Exp Pharmacol ; 268: 437-448, 2022.
Article En | MEDLINE | ID: mdl-34196812

Since allergic diseases are of great public health relevance, effective primary prevention strategies are urgently needed. This chapter gives an overview of existing primary prevention programs on environmental exposures and dietary strategies based on epidemiological studies which have defined risk- and protective factors for the development of allergic diseases.The allergy protective effect mediated by growing up on a traditional farm environment is well studied. But the exact underlying mechanisms have still not been fully clarified and have not yet led to concrete prevention strategies. The beneficial effect of avoiding cigarette smoke exposure, indoor moisture and molds in pregnancy and childhood on the development of asthma is well documented. Whereas the avoidance of house dust mite exposure is not recommended to prevent eczema or allergy. Dietary supplementation with vitamins, pre- and probiotics in pregnant woman and their offspring is not harmful but evidence for the prevention of allergic diseases is still lacking. Fish oil consumption was shown to be asthma protective. The early introduction of peanuts and egg protein to prevent peanut and egg allergy in children with atopic dermatitis is promising. Further studies are needed to increase the overall evidence in allergy prevention. Most studies lack methodological standards such as randomization and blinding. More evidence is in demand on the potential beneficial impact of multifaceted interventional studies. The future of allergy prevention strategies might be based on individual risk assessment. Therefore, research in the immunological and molecular basis of allergic diseases needs to be promoted.

Asthma , Dermatitis, Atopic , Eczema , Hypersensitivity , Child , Diet , Female , Humans , Hypersensitivity/prevention & control , Infant , Pregnancy
J Med Virol ; 94(1): 380-383, 2022 01.
Article En | MEDLINE | ID: mdl-34403142

The durability of infection-induced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity has crucial implications for reinfection and vaccine effectiveness. However, the relationship between coronavirus disease 2019 (COVID-19) severity and long-term anti-SARS-CoV-2 immunoglobulin G (IgG) antibody level is poorly understood. Here, we measured the longevity of SARS-CoV-2-specific IgG antibodies in survivors who had recovered from COVID-19 1 year previously. In a cohort of 473 survivors with varying disease severity (asymptomatic, mild, moderate, or severe), we observed a positive correlation between virus-specific IgG antibody titers and COVID-19 severity. In particular, the highest virus-specific IgG antibody titers were observed in patients with severe COVID-19. By contrast, 74.4% of recovered asymptomatic carriers had negative anti-SARS-CoV-2 IgG test results, while many others had very low virus-specific IgG antibody titers. Our results demonstrate that SARS-CoV-2-specific IgG persistence and titer depend on COVID-19 severity.

Antibodies, Viral/blood , COVID-19/pathology , Immunoglobulin G/blood , SARS-CoV-2/immunology , Severity of Illness Index , Adolescent , Adult , Aged , Aged, 80 and over , Asymptomatic Infections , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Time Factors , Young Adult
J Exp Child Psychol ; 213: 105260, 2022 01.
Article En | MEDLINE | ID: mdl-34390926

From infancy, neural processes for perceiving others' actions and producing one's own actions overlap (neural mirroring). Adults and children show enhanced mirroring in social interactions. Yet, whether social context affects mirroring in infancy, a time when processing others' actions is crucial for action learning, remains unclear. We examined whether turn-taking, an early form of social interaction, enhanced 9-month-olds' neural mirroring. We recorded electroencephalography while 9-month-olds were grasping (execution) and observing live grasps (observation). In this design, half of the infants observed and acted in alternation (turn-taking condition), whereas the other half observed several times in a row before acting (blocked condition). Replicating previous findings, infants showed significant 6- to 9-Hz mu suppression (indicating motor activation) during execution and observation (n = 24). In addition, a condition (turn-taking or blocked) by time (action start or end) interaction indicated that infants engaged in turn-taking (n = 9), but not in the blocked context (n = 15), showed more mirroring when observing the action start compared with the action end. Exploratory analyses further suggest that (a) there is higher visual-motor functional connectivity in turn-taking toward the action's end, (b) mirroring relates to later visual-motor connectivity, and (c) visual attention as indexed by occipital alpha is enhanced in turn-taking compared with the blocked context. Together, this suggests that the neural processing of others' actions is modulated by the social context in infancy and that turn-taking may be particularly effective in engaging infants' action perception system.

Electroencephalography , Infant Behavior , Adult , Child , Hand Strength , Humans , Infant , Social Environment
Addict Behav ; 124: 107120, 2022 01.
Article En | MEDLINE | ID: mdl-34560423

BACKGROUND: Pre-gaming, or drinking before going out, is common among young adults and associated with heavier drinking and negative consequences. However, findings have been mixed as to whether a unique, day-level association between pre-gaming and negative consequences exists independent of alcohol intake. It is also unknown whether young adults experience more positive consequences of alcohol use on days they engage in pre-gaming. This study tested day-level associations between pre-gaming and positive and negative consequences, controlling for same-day alcohol intake, as well as whether these associations were moderated by person- and day-level variables. METHODS: Participants were 148 young adult heavy drinkers (Mage = 20.30, SDage = 1.45, 57.4% female) who reported past-month simultaneous alcohol and marijuana use. For up to 14 consecutive days, participants completed electronic surveys asking about their drinking behaviors and consequences the previous day. RESULTS: Prior to adjusting for alcohol intake, Poisson multilevel models showed that participants reported more negative and positive consequences on days they pre-gamed and those who reported pre-gaming more often throughout the study also experienced more negative and positive consequences overall. After controlling for alcohol intake, a positive, day-level association between pre-gaming and positive consequences remained. There was no evidence of moderation of study associations by person- or day-level variables. CONCLUSION: The unique association between pre-gaming and positive consequences may help explain why pre-gaming is linked with heavy drinking and other risky behaviors as positive consequences have been shown to reinforce such behaviors. Findings suggest pre-gaming may be a useful intervention point for alcohol reduction programs.

Alcoholic Intoxication , Marijuana Smoking , Marijuana Use , Adult , Alcohol Drinking/epidemiology , Ethanol , Female , Humans , Infant , Male , Marijuana Use/epidemiology , Young Adult
Appl Ergon ; 98: 103553, 2022 Jan.
Article En | MEDLINE | ID: mdl-34428619

This study assessed the influence of different types of flooring on infants' crawling motion patterns and performance. Each participating infant (range: 8.7-12.4 months) was encouraged to crawl on a tatami mat made of woven straw as well as other flooring types such as hardwood, carpet, and joint mat. Material tests were conducted to quantify the friction and shock absorption of the flooring. A three-dimensional motion capture system was used to measure spatiotemporal and kinematic variables during hands-and-knees crawling. An increased crawling rate was associated with a faster cadence of cyclic arm movements, but not with crawling stride length. Hardwood flooring had a significantly lower crawling rate and longer duration of hand-floor contact than tatami, while the crawling stride length and range of motion of joint movements were hardly affected by flooring type. The results of this study suggest a drawback of hardwood flooring in terms of infants' effective quadrupedal locomotion.

Floors and Floorcoverings , Hand , Biomechanical Phenomena , Humans , Infant , Knee , Locomotion , Movement
Chemosphere ; 286(Pt 2): 131821, 2022 Jan.
Article En | MEDLINE | ID: mdl-34388869

Acute exposure to trace metals (TMs) in water is hazardous to human health. The average concentrations (Cavg.) and carcinogenic (CAR) and non-carcinogenic (non-CAR) risks of eight TMs to World Health Organization's (WHO) guidelines and national standard limits (NSLs)were determined. The Cavg. and (the range) of As, Hg, Cd, Pb, Co, Cr, Ni, and Zn were measured as 4.29 ± 0.57 µg L-1 (1.12-10.27 µg L-1), 0.22 ± 0.10 µg L-1 (ND-1.05 µg L-1), 0.31 ± 0.18 µg L-1 (ND-1.80 µg L-1), 4.66 ± 0.32 µg L-1 (0.10-14.22 µg L-1), 24.61 ± 4.65 µg L-1 (3.11-67.25 µg L-1), 16.86 ± 5.54 µg L-1 (5.12-34.61 µg L-1), 14.07 ± 4.37 µg L-1 (3.79-31.39 µg L-1), and 268.42 ± 75.82 (87.29-561.22 µg L-1), respectively. The Cavg. of Co and Hg exceeded the WHO and NSLs. The non-CAR risk assessment was used to order the TMs according to the total target hazard quotient (TTHQ) As > Pb > Cr > Co > Zn > Hg > Ni > Cd. None of the investigated age groups are at risk As there is a low Cavg of all trace metals (i.e., the THQ is > 1). The age groups were ranked based on THQ and incremental lifetime cancer risk (ILCR) As < 1 year, >1-10 years, > 11-19 years, and > + 20 years. The ILCR of As for all the age groups was >10-4, whereas for Pb it was <10-6. Cumulative carcinogenic risk (CCR) for As and Pb was at a safe threshold risk (>10-4) for all the age groups.

Drinking Water , Mercury , Metals, Heavy , Trace Elements , Environmental Monitoring , Heavy Metal Poisoning , Humans , Infant , Metals, Heavy/analysis , Metals, Heavy/toxicity , Risk Assessment , Trace Elements/analysis , Trace Elements/toxicity
Biol Trace Elem Res ; 200(1): 1-12, 2022 Jan.
Article En | MEDLINE | ID: mdl-33625659

Trace elements are essential nutrients for the optimal growth, development, and health of infants, and the reference intervals (RIs) from these trace elements in the blood are very important for an accurate assessment of the status of the elements. In this study, blood samples from a total of 13,446 infants (7206 boys and 6240 girls) were used, and the copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), and iron (Fe) in their blood were determined using atomic absorption spectrometry. After clearing the data and removing any outliers, the gender- and age-specific RIs obtained from the Cu, Zn, Ca, Mg, and Fe in the infants' blood were established according to the principles of the Clinical and Laboratory Standards Institute (CLSI) C28-A3. In the multivariable analysis, after making the relevant adjustments for the confounding factors, the age of the infants showed a significant positive correlation with the concentrations of Zn, Ca, Mg, and Fe found in the blood (p<0.01). Furthermore, there were obvious differences in the Cu, Zn, and Ca levels in the blood according to the gender of the infants (p<0.01). As infants are in the critical period of their growth and development, the gender- and age-specific RIs may provide helpful guidance for the nutritional status of the Cu, Zn, Ca, Mg, and Fe elements in the infants' blood.

Magnesium , Trace Elements , Calcium , Copper , Female , Humans , Infant , Iron , Male , Zinc
J Med Virol ; 94(1): 161-172, 2022 01.
Article En | MEDLINE | ID: mdl-34415583

Detailed information on intrahost viral evolution in SARS-CoV-2 with and without treatment is limited. Sequential viral loads and deep sequencing of SARS-CoV-2 from the upper respiratory tract of nine hospitalized children, three of whom were treated with remdesivir, revealed that remdesivir treatment suppressed viral load in one patient but not in a second infected with an identical strain without any evidence of drug resistance found. Reduced levels of subgenomic RNA during treatment of the second patient, suggest an additional effect of remdesivir on viral replication. Haplotype reconstruction uncovered persistent SARS-CoV-2 variant genotypes in four patients. These likely arose from within-host evolution, although superinfection cannot be excluded in one case. Although our dataset is small, observed sample-to-sample heterogeneity in variant frequencies across four of nine patients suggests the presence of discrete viral populations in the lung with incomplete population sampling in diagnostic swabs. Such compartmentalization could compromise the penetration of remdesivir into the lung, limiting the drugs in vivo efficacy, as has been observed in other lung infections.

Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/virology , Evolution, Molecular , SARS-CoV-2/genetics , Adenosine Monophosphate/therapeutic use , Adolescent , Alanine/therapeutic use , Child , Child, Preschool , Drug Resistance, Viral , Female , Haplotypes , Humans , Infant , Lung/virology , Male , Phylogeny , RNA, Viral/analysis , RNA, Viral/genetics , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Viral Load , Virus Replication/drug effects
J Med Virol ; 94(1): 240-245, 2022 01.
Article En | MEDLINE | ID: mdl-34460115

Many countries in the world are experiencing a recent surge in COVID-19 cases. This is mainly attributed to the emergence of new SARS-CoV-2 variants. Genome sequencing is the only means to detect the evolving virus mutants and emerging variants. Cycle threshold values have an inverse relationship with viral load and lower Ct values are also found to be associated with increased infectivity. In this study, we propose to use Ct values as an early indicator for upcoming COVID-19 waves. A retrospective cross-sectional study was carried out to analyze the Ct values of positive samples reported during the first wave and second wave (April 2020-May 2021). Median Ct values of confirmatory genes were taken into consideration for comparison. Ct values below 25, >25-30, and >30 were categorized as high, moderate, and low viral load respectively. Our study found a significantly higher proportion of positive samples with a low Ct value (<25) across age groups and gender during the second wave of the COVID-19 pandemic. A higher proportion of positive samples with a low Ct value (high viral load) may act as an early indicator of an upcoming surge.

COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , COVID-19/epidemiology , Adolescent , Adult , Asymptomatic Infections/epidemiology , COVID-19/virology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/physiology , Viral Load , Young Adult
Esc. Anna Nery Rev. Enferm ; 26: e20210088, 2022. tab
Article Pt | LILACS, BDENF | ID: biblio-1339881

Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do "eu", favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do "eu", revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.

Resumen Objeto: Comprender por medio del juego terapéutico dramático el significado, para el hermano, de la visita al niño hospitalizado en Terapia Intensiva Pediátrica. Método: Investigación cualitativa, modalidad fenomenológica, que utilizó el juego terapéutico dramático para comprender la experiencia del hermano. Se realizó en Unidad de Terapia Intensiva Pediátrica del interior del Estado de São Paulo, Brasil. Participaron de las sesiones de juego terapéutico 11 hermanos con menos de 10 años, quienes fueron analizados a la luz de la Teoría de la Maduración. Resultados: Los hermanos, al tener un lugar para jugar, dramatizaron situaciones anteriormente vividas, de su cotidiano y de la visita al niño hospitalizado. Al vivir de forma creativa, revelaron que jugar es permitir la integración de las experiencias del "yo", lo que favorece el concepto de seguir siendo, ante la situación vivida. Conclusiones e implicaciones para la práctica: El Juego Terapéutico Dramático comprendido a la luz de un referencial teórico hizo posible que el hermano entendiera la visita como una experiencia de integración del "yo", revelando emociones, deseos y preferencias cotidianas. En este sentido, el cuidado del hermano del niño hospitalizado se define por la oferta de juego libre, para que pueda demostrar su sentimiento de seguir siendo en sus interacciones con el mundo, en el que el contexto hospitalario se ha convertido en parte de la realidad.

Abstract Objective: to understand, by means of dramatic therapeutic play, the meaning, for the sibling, of visiting the child hospitalized in intensive care. Method: a qualitative research, phenomenological modality, which used the dramatic therapeutic play to access the siblings' experiences. It was carried out in a Pediatric Intensive Care Unit in the countryside of the State of São Paulo, Brazil. Eleven siblings under ten years of age participated in the therapeutic play sessions, which were analyzed in the light of the Theory of Maturation. Results: the siblings, having a place to play, dramatized previously lived situations, from their daily life and from the visit to the hospitalized child. By living creatively, they revealed that playing is to integrate the experiences of the "I", favoring the continuity of being in the face of the situation lived. Conclusions and implications for practice: the Dramatic Therapeutic Play understood in the light of a theoretical framework allowed the sibling to mean the visit as an experience of integration of the "I", revealing emotions, desires and preferences of daily life. In this sense, the care for the brother of the hospitalized child is defined by the offer of free play, so that he demonstrates the feeling of continuing to be in his interactions with the world, in which the hospital context has become part of reality.

Humans , Male , Female , Infant , Child, Preschool , Child , Play and Playthings/psychology , Visitors to Patients/psychology , Intensive Care Units, Pediatric , Child, Hospitalized , Siblings/psychology , Sibling Relations , Child Health , Creativity , Qualitative Research
Esc. Anna Nery Rev. Enferm ; 26(spe): e20210179, 2022. ilus
Article Pt | LILACS, BDENF | ID: biblio-1292850

Objetivo: O estudo objetivou compreender as repercussões da pandemia da Covid-19 no cuidado de lactentes prematuros, na perspectiva de mães e profissionais de saúde. Método: Foram realizadas entrevistas semiestruturadas nos meses de junho e julho de 2020, por meio de ligação telefônica, com 14 mães e quatro profissionais de saúde do serviço de follow-up de uma maternidade pública da Paraíba, Brasil. Resultados: A partir da análise temática indutiva, os impactos da pandemia no cuidado ao lactente nascido prematuro, foram: sobrecarga e afastamento dos profissionais dos serviços de saúde, desativação temporária da unidade mãe canguru, descontinuidade da assistência ao prematuro, medo materno de expor a criança à Covid-19 e baixa condição socioeconômica. Foram elencadas estratégias de enfrentamento para o cuidado dos lactentes durante a pandemia, como: maior espaçamento das consultas, acompanhamento por meio telefônico e cumprimento das medidas de biossegurança. Conclusão e implicações para a prática: A pandemia exigi adaptações na assistência, tornando necessárias novas formas de cuidado a essas crianças, como exemplo, as consultas de acompanhamento remotas, a fim de garantir o seu direito à vida e saúde

Objective: The study aimed at understanding the repercussions of the Covid-19 pandemic in the care of premature infants, from the perspective of mothers and health professionals. Method: Semi-structured interviews were conducted in the months of June and July 2020, over the telephone, with 14 mothers and four health professionals from the follow-up service of a public maternity hospital in Paraíba, Brazil. Results: From the inductive thematic analysis, the impacts of the pandemic on the care of premature infants were as follows: overload and distancing of health service professionals, temporary deactivation of the Kangaroo mother unit, discontinuity of care for the premature infant, maternal fear of exposing the child to Covid-19 and low socioeconomic status. Coping strategies for the care of infants during the pandemic were listed, such as: greater spacing between consultations, phone follow-up and compliance with biosafety measures. Conclusion and implications for the practice: The pandemic required adaptations in care, which make new forms of care necessary for these children, such as remote follow-up consultations, in order to guarantee their right to life and health

Objetivo: El estudio tuvo como objetivo comprender las repercusiones de la pandemia de Covid-19 en la atención de bebés prematuros, desde la perspectiva de las madres y los profesionales de la salud. Método: Se realizaron entrevistas semiestructuradas en los meses de junio y julio de 2020, por medio de llamadas telefónicas, a 14 madres y cuatro profesionales de la salud del servicio de seguimiento de una maternidad pública en Paraíba, Brasil. Resultados: A partir del análisis temático inductivo, los efectos de la pandemia en la atención de bebés prematuros fueron los siguientes: sobrecarga y distanciamiento de profesionales de los servicios de salud, inhabilitación temporal de la unidad Madre Canguro, discontinuidad de la atención al bebé prematuro, miedo materno a exponer al niño al Covid-19 y nivel socioeconómico bajo. Se enumeraron estrategias de afrontamiento para la atención infantil durante la pandemia, tales como: mayor intervalo entre consultas, seguimiento telefónico y cumplimiento de medidas de bioseguridad. Conclusión e implicaciones para la práctica: La pandemia requirió adaptaciones en la atención, que hacen necesarias nuevas formas de atención para estos niños, como las consultas de monitoreo remoto, para garantizar su derecho a la vida y a la salud

Humans , Female , Infant , Adult , Middle Aged , Infant, Premature/growth & development , Health Personnel , Maternal-Child Health Services , COVID-19 , Infant Care , Mothers , Workload/psychology , Remote Consultation , Qualitative Research , Vaccination Coverage , Fear , Kangaroo-Mother Care Method , Hand Hygiene , Physical Distancing , COVID-19/prevention & control
Arch. pediatr. Urug ; 92(2): e209, dic. 2021. tab
Article Es | LILACS, BNUY, UY-BNMED | ID: biblio-1278302

Introducción: el estreptococo del grupo B (EGB) es una causa frecuente de sepsis neonatal. La enfermedad precoz disminuyó su incidencia por la profilaxis antibiótica, a diferencia de la sepsis tardía, que aumentó su incidencia en los últimos años. Objetivo: conocer la incidencia de la sepsis tardía en el período 2016-2017 en el Centro Hospitalario Pereira Rossell (CHPR). El secundario, describir las características epidemiológicas y clínicas de sepsis tardía por EGB en niños ingresados a la Unidad de Cuidados Intensivos de Niños (UCIN) del CHPR en el período 2007-2017. Resultados: la incidencia calculada de sepsis tardía por EGB fue de 0,53 casos/1000 recién nacidos (RN) vivos. Entre los años 2007 y 2017 ingresaron cinco niños por sepsis tardía por EGB a la UCIN del CHPR. La presentación clínica más frecuentes fue fiebre sin foco y meningitis. Se obtuvieron tres aislamientos en sangre de EBG y tres en líquido cefalorraquídeo (dos en cultivo y otro por detección de ADN). Ninguno falleció. Los casos con meningitis presentaron alteraciones en la tomografía de cráneo. Un niño fue pretérmino. Conclusiones: la sepsis tardía se vincula a importante morbimortalidad en pediatría. No se ha establecido cuáles son los principales factores de riesgo asociados a una enfermedad grave ni las políticas para disminuir su incidencia.

Background: group B streptococcus (GBS) is a common cause of neonatal sepsis. Early disease decreased its incidence due to antibiotic prophylaxis. Late sepsis increased its incidence in recent years. Objectives: to know the incidence of late onset EGB sepsis in the period 2016-2017 at the Pereira Rossell Hospital Center (CHPR), and secondly, to describe the epidemiological characteristics and the clinical presentation of late onset sepsis due to GBS in children admitted to the Children's Intensive Care Unit (UCIN) of the CHPR in the period 2007-2017. Results: the calculated incidence of late sepsis due to GBS was 0.53 cases/1000 live newborns. Between 2007-2017, 5 children were admitted due to GBS late sepsis at the UCIN. The most frequent clinical presentation was fever without focus and meningitis. 3 isolates were obtained in EBG blood cultures and 3 in cerebrospinal fluid (2 in culture and another by DNA detection). None of them died. Cases with meningitis showed abnormalities in the brain tomography. 1 of the 5 was preterm. Conclusions: late sepsis is associated with significant morbidity and mortality in pediatric patients. The main risk factors associated with serious disease and the policies needed to reduce its incidence have not been established.

Introdução: o estreptococo do grupo B (SGB) é uma causa frequente de sepse neonatal. A doença precoce diminuiu sua incidência devido à profilaxia antibiótica, ao contrário da sepse tardia, que aumentou sua incidência nos últimos anos. Objetivo: conhecer a incidência de sepse tardia no período 2016-2017 no Centro Hospitalar Pereira Rossell (CHPR) e descrever as características epidemiológicas e clínicas da sepse tardia por SGB em crianças internadas na Unidade de Terapia Intensiva Infantil (UTIN) do CHPR no período de 2007-2017. Resultados: a incidência calculada de sepse tardia por SGB foi de 0,53 casos/1000 recém-nascidos vivos (RNs). Entre 2007-2017, 5 crianças foram internadas na UTIN do CHPR por sepse tardia devido a GBS. A apresentação clínica mais frequente foi febre sem causa e meningite. 3 isolados de EBG foram obtidos no sangue e 3 no líquido cefalorraquidiano (2 em cultura e outro por detecção de DNA). Nenhum dos pacientes morreu. Os casos com meningite apresentaram alterações na tomografia de crânio. Uma criança era pré-termo. Conclusões: a sepse tardia está associada a significativa morbimortalidade em pediatria. Os principais fatores de risco associados a uma doença grave e as políticas para reduzir sua incidência ainda não foram estabelecidas.

Humans , Male , Female , Infant, Newborn , Infant , Streptococcal Infections/epidemiology , Neonatal Sepsis/etiology , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Uruguay/epidemiology , Catastrophic Illness , Epidemiology, Descriptive , Incidence , Retrospective Studies
Arch. pediatr. Urug ; 92(2): e211, dic. 2021. tab
Article Es | LILACS, BNUY, UY-BNMED | ID: biblio-1278304

Introducción: las cardiopatías congénitas (CC) son patologías frecuentes en pediatría. Son causa de importante morbimortalidad en la infancia. Son pacientes complejos, que requieren abordaje integral, en equipo interdisciplinario. Objetivos: describir las características epidemiológicas, clínicas y evolutivas de niños portadores de CC asistidos en la Unidad de Cardiología del HP-CHPR durante el año 2015, así como su estado nutricional y los factores que pudieran influir en este. Material y método: estudio descriptivo, retrospectivo, a través de la revisión de historias clínicas de pacientes portadores de CC, hospitalizados en la Unidad de Cardiología del HP-CHPR en 2015. Se describieron características epidemiológicas y clínicas de los pacientes. Resultados: en el período evaluado egresaron 63 pacientes, que representaron una tasa de 6,58/1.000 egresos hospitalarios. Tenían un promedio de edad de 23,8 meses. Un total de 8 pacientes fueron diagnosticados en el período prenatal, 54 presentaban CC no cianóticas. Habían sido sometidos a tratamiento quirúrgico 24 niños, 13 con cirugía correctiva. Se diagnosticó desnutrición en 43%. Esta fue más prevalente en portadores de CC cianótica, de defectos complejos, y de cromosomopatías u otras malformaciones. Conclusión: los niños con CC representaron un pequeño porcentaje de quienes requirieron hospitalización en el HP-CHPR. El porcentaje de desnutrición fue elevado. Este estudio confirma la importante morbimortalidad de los niños pequeños portadores de CC. Es importante reconocer el mayor riesgo de estos pacientes y actuar en forma individualizada y oportuna.

Introduction: congenital heart disease (CHD) is a frequent pathology among children. It may cause significant morbidity and mortality during childhood. These are complex patients, who require a comprehensive approach and an interdisciplinary team. Objective: to describe the epidemiological, clinical and evolutionary characteristics of children with CHD assisted in the Cardiology Department of the Children Hospital-CHPR in 2015. Material and Methods: descriptive, retrospective study, review of clinical records of patients with CHD, hospitalized in the Cardiology Department of the Children's Hospital PRHC in 2015. Epidemiological and clinical characteristics of patients were described. Results: 63 patients were hospitalized during the evaluated period, a total rate of 6.58/1.000 discharges. They had an average age of 23.8 months. Eight patients were diagnosed in the prenatal period, 54 presented non-cyanotic CHD. Twenty-four children had undergone surgical treatment, 13 had had corrective surgery. Malnutrition was diagnosed in 43% and it was more prevalent in cyanotic CHD carriers, complex defects, and chromosomopathies or other malformations. Conclusion: CHD represented a small percentage of the children who required hospitalization at the PH-PRHC. The percentage of malnutrition was high. The study confirmed the significant morbidity and mortality of these patients. It is important to recognize the highest risk of these patients and act in a customized and timely fashion.

Introdução: as cardiopatias congênitas (CC) são patologias comuns em pediatria. Elas são uma causa significativa de morbidade e mortalidade na infância. Os pacientes são complexos e requerem uma abordagem integral e uma equipe interdisciplinar. Objetivos: descrever as características epidemiológicas, clínicas e evolutivas de crianças com CC atendidas na Unidade de Cardiologia do Hospital Pediátrico PHPR durante o ano de 2015, descrever seu estado nutricional e os fatores que poderiam influenciá-lo. Material e métodos: estudo descritivo, retrospectivo, feito por meio da revisão de prontuários de pacientes com CC, internados na Unidade de Cardiologia do HP-CHPR em 2015. Foram descritas as características epidemiológicas e clínicas dos pacientes. Resultados: no período avaliado, 63 pacientes receberam alta hospitalar, representando uma taxa de 6,5/1.000 altas hospitalares. Eles tinham uma idade média de 23,8 meses. Oito pacientes foram diagnosticados no período pré-natal, 54 apresentavam CC não cianótica. 24 crianças tinham sido submetidas a tratamento cirúrgico, 13 tinham recebido cirurgia corretiva. 43% foram diagnosticadas com desnutrição, a qual foi mais prevalente em portadores de CC cianótica, defeitos complexos e malformações cromossômicas ou outras. Conclusão: os CCs representaram um pequeno percentual de crianças que necessitaram de internação no HP-CHPR. O percentual de desnutrição foi alto. Este estudo confirma a morbidade e mortalidade significativas de crianças pequenas com CC. É importante reconhecer o risco aumentado desses pacientes e agir de forma individualizada e oportuna.

Humans , Male , Female , Pregnancy , Infant , Child, Preschool , Child , Adolescent , Malnutrition/complications , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/epidemiology , Hospitalization , Prenatal Diagnosis , Epidemiology, Descriptive , Retrospective Studies , Malnutrition/diagnosis , Malnutrition/epidemiology , Heart Defects, Congenital/surgery , Heart Defects, Congenital/classification
Arch. pediatr. Urug ; 92(2): e214, dic. 2021. tab
Article Es | LILACS, BNUY, UY-BNMED | ID: biblio-1339134

Las enfermedades neuromusculares (ENM) afectan los distintos componentes de la unidad motora. Desde el diagnóstico deben ser seguidos por un equipo interdisciplinario, donde el neumólogo pediátrico desempeña un papel importante en la valoración de la pérdida de fuerza muscular cuando afecta a la musculatura respiratoria o de la vía aérea superior. Objetivos: conocer las diferentes enfermedades neuromusculares atendidas en el Centro Hospitalario Pereira Rossell, analizar las características de la población y describir los resultados de los principales estudios solicitados por la policlínica de neumológica pediátrica. Metodología: estudio descriptivo, analítico y retrospectivo de los pacientes con enfermedad neuromuscular atendidos en el Centro Hospitalario Pereira Rossell entre el 1/6/2006 y el 31/12/2019. Resultados: las patologías neuromusculares más frecuentemente encontradas fueron distrofias musculares, miopatías, distrofia miotónica de Steinert y atrofia muscular espinal. No tienen diagnóstico definitivo 21/73 pacientes. La espirometría mostró una alteración restrictiva en la mayoría de los pacientes. Para descartar trastornos respiratorios del sueño se realizó oximetría nocturna con gasometría al despertar. La hipoventilación nocturna y las apneas obstructivas fueron las alteraciones encontradas. En 12/73 se inició ventilación no invasiva. Conclusiones: los pacientes con ENM experimentan un deterioro progresivo de la función respiratoria que contribuye a una elevada tasa de morbimortalidad. La evaluación y seguimiento regular de la función respiratoria junto con estudios de sueño, son fundamentales para el inicio oportuno de ventilación no invasiva.

Neuromuscular diseases (NMD) affect the different components of the motor system. As of diagnosis, they should be followed by an interdisciplinary team, in which pediatric pulmonologists play an important role in assessing the loss of muscle strength when NMD affects the respiratory or upper airway muscles. Objectives: to learn about the different neuromuscular diseases treated at the Pereira Rossell Hospital Center, to analyze the characteristics of this population and to describe the results of the main studies requested by the pediatric pulmonology clinic. Methodology: descriptive, analytical and retrospective study of patients with neuromuscular disease treated at the Pereira Rossell Hospital Center between 6/1/2006 and 12/31/2019. Results: the most frequent neuromuscular pathologies were muscular dystrophies, myopathies, Steinert's myotonic dystrophy and spinal muscular atrophy. 21/73 patients did not have a definitive diagnosis. Spirometry showed a restrictive alteration in most of the patients. To rule out respiratory sleep disorders, nocturnal oximetry with blood gas was performed upon awakening, with nocturnal hypoventilation and obstructive apneas being the alterations found. In 12/73 non-invasive ventilation was applied. Conclusions: patients with NMD experience a progressive deterioration of respiratory function that contributes to a high rate of morbidity and mortality. Regular evaluation and monitoring of respiratory function, along with sleep studies, are essential for the timely initiation of non-invasive ventilation.

As doenças neuromusculares (DNM) afetam os diferentes componentes da unidade motora. Desde o diagnóstico, os pacientes devem ser acompanhados por uma equipe interdisciplinar, onde o pneumologista pediátrico desempenha um papel importante na avaliação da perda de força muscular quando atinge a musculatura respiratória ou das vias aéreas superiores. Objetivos: conhecer as diferentes doenças neuromusculares tratadas no Centro Hospitalar Pereira Rossell, analisar as características desta população e descrever os resultados dos principais estudos solicitados à policlínica de pneumologia pediátrica. Metodologia: estudo descritivo, analítico e retrospectivo de pacientes com doenças neuromusculares atendidos no Centro Hospitalar Pereira Rossell entre 01/06/2006 e 31/12/2019. Resultados: as patologias neuromusculares mais encontradas foram distrofias musculares, miopatias, distrofia miotônica de Steinert e atrofia muscular espinhal. 21/73 pacientes não tiveram um diagnóstico definitivo. A espirometria mostrou alteração restritiva na maioria dos pacientes. Para afastar distúrbios respiratórios do sono, foi realizada oximetria noturna com gasometria ao despertar, sendo a hipoventilação noturna e as apneias obstrutivas as alterações encontradas. Em 12/73 foi iniciada ventilação não invasiva. Conclusões: os pacientes com DNM experimentam uma deterioração progressiva da função respiratória que contribui para uma alta taxa de morbidade e mortalidade. A avaliação regular e o monitoramento da função respiratória, juntamente com os estudos do sono, são essenciais para o início oportuno da ventilação não invasiva.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Neuromuscular Diseases/classification , Neuromuscular Diseases/epidemiology , Respiration Disorders/etiology , Respiration Disorders/therapy , Uruguay/epidemiology , Cross-Sectional Studies , Retrospective Studies , Noninvasive Ventilation , Neuromuscular Diseases/complications , Neuromuscular Diseases/diagnosis