This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the ...calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length
Z
-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week.
Conclusion
: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge.
What is Known:
• The importance of preterm newborn nutrition is well known.
• Early nutritional support may avoid severe BPD.
What is New:
• Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns’ growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.
Methylmercury (MeHg
) is a mercury species that is very toxic for humans, and its monitoring and sorption from environmental samples of water are a public health concern. In this work, a combination ...of theory and experiment was used to rationally synthesize an ion-imprinted polymer (IIP) with the aim of the extraction of MeHg
from samples of water. Interactions among MeHg
and possible reaction components in the pre-polymerization stage were studied by computational simulation using density functional theory. Accordingly, 2-mercaptobenzimidazole (MBI) and 2-mercaptobenzothiazole (MBT), acrylic acid (AA) and ethanol were predicted as excellent sulfhydryl ligands, a functional monomer and porogenic solvent, respectively. Characterization studies by scanning electron microscopy (SEM) and Brunauer-Emmett-Teller (BET) revealed the obtention of porous materials with specific surface areas of 11 m
g
(IIP-MBI-AA) and 5.3 m
g
(IIP-MBT-AA). Under optimized conditions, the maximum adsorption capacities were 157 µg g
(for IIP-MBI-AA) and 457 µg g
(for IIP-MBT-AA). The IIP-MBT-AA was selected for further experiments and application, and the selectivity coefficients were MeHg
/Hg
(0.86), MeHg
/Cd
(260), MeHg
/Pb
(288) and MeHg
/Zn
(1510), highlighting the material's high affinity for MeHg
. The IIP was successfully applied to the sorption of MeHg
in river and tap water samples at environmentally relevant concentrations.
Introduction
This study aimed to assess visual acuity (VA) in Congenital Zika Syndrome (CZS)-children to evaluate visual loss. To that end we evaluated 41 CZS - children, from Rio de Janeiro using ...Teller Acuity Cards.
Methods
To asses VA, we evaluated 41 CZS - children, from Rio de Janeiro using Teller Acuity Cards. The children had Zika virus-infection confirmed by reverse transcription–polymerase chain reaction (RT-PCR) or clinical evaluation.
Results
In 39 out of 41 (95%) children, the VA scores were below normative values, while in 10 cases, VA was only marginally below normal; in the remaining 29 cases, VA was more than 0.15 logMAR below the lower limit. There was no correlation between VA and the cognitive domain tasks, although there was a correlation between VA and motor domain tasks. Thirty-seven children performed at least one task in the cognitive set, while fourteen children did not perform any task in the motor set. Children with VA above the lower limit performed better in the cognitive and motor tasks.
Discussion
We concluded that ZIKV- infected children with CZS were highly VA impaired which correlated with motor performance, but not with cognitive performance. Part of the children had VA within the normal limits and displayed better performance in the cognitive and motor sets. Therefore, even if heavily impaired, most children had some degree of VA and visual function.
To verify if the connection of electrodes for heart and transcutaneous oxygen monitoring interfere with the measurement of electrical bioimpedance in preterm newborns.
This was a prospective, ...blinded, controlled, cross-sectional, crossover study that assessed and compared paired measures of resistance (R) and reactance (Xc) by BIA, obtained with and without monitoring wires attached to the preterm newborn. The measurements were performed in immediate sequence, after randomization to the presence or absence of electrodes. The sample size calculated was 114 measurements or tests with monitoring wires and 114 without monitoring wires, considering for a difference between the averages of 0.1 ohms, with an alpha error of 10% and beta error of 20%, with significance <0.05.
No differences were observed between the R (677.37±196.07 vs. 677.46±194.86) and Xc (31.15±9.36 vs. 31.01±9.56) values obtained with and without monitoring wires, respectively, with good correlation between them (R: 0.997 and Xc: 0.968).
The presence of heart and/or transcutaneous oxygen monitoring wires connected to the preterm newborn did not affect the values of R or Xc measured by BIA, allowing them to be carried out in this population without risks.
Verificar se a conexão de eletrodos e fios de monitoração cardíaca e transcutânea de oxigênio interferem na aferição da bioimpedância elétrica em recém-nascidos pré-termo (RNPT).
Estudo prospectivo, cego, randomizado, transversal, crossover, em que foram mensuradas e comparadas medidas pareadas de resistência (R) e reatância (Xc) por meio da BIA, obtidas com e sem os fios de monitoração acoplados aos RNPT. As medidas foram feitas em sequência imediata, após aleatorização para a presença ou ausência dos eletrodos. O tamanho amostral calculado foi de 114 aferições ou exames com fios de monitoração e 114 sem fios de monitoração, considerando para uma diferença entre as médias de 0,1 ohms, com erro alfa de 10% e erro beta de 20%, com significância<0,05.
Não foram observadas diferenças entre os valores de resistência (677,37±196,07 vs 677,46±194,86) e reatância (31,15±9,36 vs 31,01±9,56) obtidos com e sem fios de monitoração respectivamente, com boa correlação entre ambos (resistência:0,997 e reatância:0,968).
A presença de fios de monitoração cardíaca e/ou transcutânea de oxigênio não interferiu nos valores da resistência ou da reatância aferidos pela BIA em RNPT. Recomenda-se, então, esse exame, sem riscos, para essa população.
Background
Prematurity is considered to be the leading cause of death in children under 5 years of age, with one child dying every 2 s. Smoking is known to be one of the factors associated with ...prematurity, with both immediate and late consequences. However, it is difficult to obtain concrete data on the relationship between smoking and spontaneous preterm birth.
Objective
The aim of this study was to evaluate the influence of active and passive smoking on spontaneous preterm birth.
Methods
This was a multicenter, cross‐sectional complementary study that included data on preterm births in 20 maternity hospitals in Brazil between 2011 and 2012. The relationship between smoking category (people who smoke PWS; people who smoke indirectly PWSI; and people who do not smoke PWDNS) and sociodemographic characteristics, birth, and neonatal data was assessed. Statistical analysis was performed using frequencies, percentages, the χ2 test, and stepwise comparisons, with a significance level of 5%.
Results
The original study included 5295 pregnant participants and their preterm infants. There were 1491 spontaneous preterm births (SPBs); 1191 preterm rupture of membranes; 1468 therapeutic preterm births; and 1146 term births. The proportion of women who were PWS during pregnancy was 13.5%, and 31.6% were PWSI. Pregnant individuals who smoked and who smoked indirectly had a higher incidence of SPBs (61.2%) compared with PWDNS (48.4%; P < 0.0001); however, multivariate analysis did not confirm causality.
Conclusions
This study did not confirm that smoking during pregnancy increases the risk of SPB. PWSI also did not have an increased incidence of spontaneous preterm birth or adverse neonatal outcomes.
Synopsis
Active and passive smoking during pregnancy are associated with, but do not directly cause, spontaneous preterm birth..
Polymorphisms in MSTN have previously been associated with equine performance. Therefore, the aim of this study was to identify variants in MSTN intron 1 in 16 Brazilian Sport Horses selected for ...competition in eventing and their possible effects of selection on performance. Among the nine variants identified, eight had already been reported in previous studies or genomic databases, although they showed differences in frequencies when compared with other horse breeds. Moreover, a new mutation was identified in two horses, both in heterozygous form. Considering the absence of molecular studies in this valuable Brazilian breed, these findings represent an important contribution to the characterization of its genetic profile and may possibly aid in further genotype-phenotype association studies.
Piperaceae species can be found worldwide in tropical and subtropical areas and many of them have been used for centuries in traditional folk medicine and in culinary. In Brazil, species of ...Piperaceae are commonly used in some communities as local anesthetic and analgesic. Countrified communities have known some species of the genus Ottonia as "anestesia" and it is a common habit of chewing leaves and roots of Ottonia species to relief toothache. The purpose of this study is to report our findings on new molecules entities obtained from the roots of Ottonia anisum Spreng, in which local anesthetic activity (sensory blockage) is demonstrated for the first time in vivo guinea pig model. Phytochemical investigation led to the isolation of three amides (pipercallosidine, piperine and valeramide) and in an enriched mixture of seven amides (valeramide, 4,5-dihydropiperlonguminine, N-isobutil-6-piperonil-2-hexenamide, piperovatine, dihydropipercallosidine, pipercallosidine and pipercallpsine). Our findings demonstrated the anesthetic potential for the methanolic extract from roots, its n-hexane partition and amides from O. anisum and it is in agreement with ethnobotanical survey.
Objective
To identify cases of severe maternal morbidity (SMM) during pregnancy and childbirth, their characteristics, and to test the feasibility of scaling up World Health Organization criteria for ...identifying women at risk of a worse outcome.
Design
Multicentre cross‐sectional study.
Setting
Twenty‐seven referral maternity hospitals from all regions of Brazil.
Population
Cases of SMM identified among 82 388 delivering women over a 1‐year period.
Methods
Prospective surveillance using the World Health Organization's criteria for potentially life‐threatening conditions (PLTC) and maternal near‐miss (MNM) identified and assessed cases with severe morbidity or death.
Main outcome measures
Indicators of maternal morbidity and mortality; sociodemographic, clinical and obstetric characteristics; gestational and perinatal outcomes; main causes of morbidity and delays in care.
Results
Among 9555 cases of SMM, there were 140 deaths and 770 cases of MNM. The main determining cause of maternal complication was hypertensive disease. Criteria for MNM conditions were more frequent as the severity of the outcome increased, all combined in over 75% of maternal deaths.
Conclusions
This study identified around 9.5% of MNM or death among all cases developing any severe maternal complication. Multicentre studies on surveillance of SMM, with organised collaboration and adequate study protocols can be successfully implemented, even in low‐income and middle‐income settings, generating important information on maternal health and care to be used to implement appropriate health policies and interventions.
Tweetable
Surveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.
Tweetable
Surveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.
To assess the additional cost of incorporating the detection and treatment of retinopathy of prematurity (ROP) into neonatal care services of Brazil's Unified Health System (SUS).
A deterministic ...decision-tree simulation model was built to estimate the direct costs of screening for and treating ROP in neonatal intensive-care units (NICUs), based on data for 869 preterm infants with birth weight less than 1 500 g examined in six governmental NICUs in the capital city of Rio de Janeiro, where coverage was 52% and 8% of infants were treated. All of the parameters from this study were extrapolated to Brazilian newborn estimates in 2010. Costs of screening and treatment were estimated considering staff, equipment and maintenance, and training based on published data and expert opinion. A budget impact analysis was performed considering the population of preterm newborns, screening coverage, and the incidence of treatable ROP. One- and two-way sensitivity analyses were performed.
In Rio de Janeiro, unit costs per newborn were US$ 18 for each examination, US$ 398 per treatment, and US$ 29 for training. The estimated cost of ROP diagnosis and treatment for all at-risk infants NICUs was US$ 80 per infant. The additional cost to the SUS for one year would be US$ 556 640 for a ROP program with 52% coverage, increasing to US$ 856 320 for 80% coverage, and US$ 1.07 million or 100% coverage.
The results of this study indicate that providing ROP care is affordable within the framework of the SUS in Brazil, and might be feasible elsewhere in Latin America, considering the evidence of the effectiveness of ROP treatment and the social benefits achieved.
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