Jornal de Pediatria (Vers?o em Português)最新文献

{"title":"Transferrin isoelectric focusing for the investigation of congenital disorders of glycosylation: analysis of a ten‐year experience in a Brazilian center","authors":"Ana Paula Pereira Scholz de Magalhães ,&nbsp;Maira Graeff Burin ,&nbsp;Carolina Fischinger Moura de Souza ,&nbsp;Fernanda Hendges de Bitencourt ,&nbsp;Fernanda Medeiros Sebastião ,&nbsp;Thiago Oliveira Silva ,&nbsp;Filippo Pinto e Vairo ,&nbsp;Ida Vanessa Doederlein Schwartz","doi":"10.1016/j.jpedp.2019.11.001","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.11.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To characterize cases of suspected congenital disorders of glycosylation (CDG) investigated in a laboratory in southern Brazil using the transferrin isoelectric focusing TfIEF test from 2008 to 2017.</p></div><div><h3>Method</h3><p>Observational, cross‐sectional, retrospective study. The laboratory records of 1,546 individuals (median age = 36 months, 25‐75 IQR = 10‐108; males = 810) submitted to the TfIEF test during the period were reviewed.</p></div><div><h3>Results</h3><p>Fifty‐one individuals (3%) had an altered TfIEF pattern (5 ± 2.8 cases/year; median age = 24 months, 25‐75 IQR = 11‐57 months; males = 27, 53%). For 14 of them, data on diagnosis conclusion were available (classic galactosemia = 4; hereditary fructose intolerance = 4; peroxisomal diseases = 2; PMM2‐CDG = 2; MPDU1‐CDG = 1; SLC35A2‐CDG = 1).Comparing the cases with the normal and altered TfIEF patterns, there was a higher prevalence of altered cases in the age group from 11 months to 3 years. There was an increase in the likelihood of change in TfIEF, especially in the presence of inverted nipples or liver disease.</p></div><div><h3>Conclusions</h3><p>The data suggest that the investigation of a case with suspected CDG is a complex problem, being aggravated by the existence of other IEMs (inborn errors of metabolism) associated with altered TfIEF pattern and lack of access to confirmatory tests. The presence of inverted nipples and liver disease, especially in individuals aged 11 months to 3 years, should suggest the need for TfIEF investigation.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 710-716"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with bullying: differences between the roles of bullies and victims of bullying","authors":"Georgia Rodrigues Reis e Silva ,&nbsp;Maria Luiza Carvalho de Lima ,&nbsp;Raquel Moura Lins Acioli ,&nbsp;Alice Kelly Barreira","doi":"10.1016/j.jpedp.2019.09.005","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.09.005","url":null,"abstract":"<div><h3>Objective</h3><p>To identify the differences between the prevalence and factors associated with involvement in bullying among schoolchildren from Recife, in the role of victim and perpetrator.</p></div><div><h3>Method</h3><p>This is an epidemiological, cross‐sectional, analytical study, with a probabilistic cluster sample of 1,402 students enrolled in high schools in Recife. Data analysis consisted of a descriptive analysis, followed by the application of Pearson's chi‐squared test with statistical significance of 0.05 and 95% confidence interval. For the association analysis, multilevel modeling was used to control the cluster effect.</p></div><div><h3>Results</h3><p>It was observed that adolescents who feel different from other peers were associated with bullying, regardless of the role played. Being a victim was associated with being female, having low self‐esteem, and using tranquilizers; being a transgressor was a protective factor. As for the role of perpetrator, being male, excessive alcohol consumption, having poor school performance, being a transgressor, and accepting peer violence were the associated variables; in turn, not defending their ideas when among friends showed to be a protective factor for bullying.</p></div><div><h3>Conclusion</h3><p>The differences between the adolescents, whether in the role of victim or perpetrator, indicate that the advocacy and prevention actions should focus on these aspects, mainly in the school environment.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 693-701"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic prophylaxis and factors associated with bleeding in children with extrahepatic portal vein obstruction","authors":"Ana Paula Pereira de Oliveira,&nbsp;Alexandre Rodrigues Ferreira,&nbsp;Eleonora Druve Tavares Fagundes,&nbsp;Thaís Costa Nascentes Queiroz,&nbsp;Simone Diniz Carvalho,&nbsp;José Andrade Franco Neto,&nbsp;Paulo Fernando Souto Bittencourt","doi":"10.1016/j.jpedp.2019.08.011","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.08.011","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to evaluate factors associated with upper digestive hemorrhage and primary and secondary endoscopic prophylaxis outcomes in children with extrahepatic portal vein obstruction.</p></div><div><h3>Methods</h3><p>This observational and prospective study included 72 children with extrahepatic portal vein obstruction who were followed from 2005 to 2017. Risk factors associated with upper digestive hemorrhage and the results of primary and secondary prophylaxis of these patients were evaluated.</p></div><div><h3>Results</h3><p>Fifty patients (69.4%) had one or more episodes of bleeding during follow‐up, with a median age at first hemorrhage of 4.81 years. The multivariate analysis showed that medium‐ to large‐caliber esophageal varices were associated with an 18‐fold risk of upper digestive hemorrhage (95% CI: 4.33–74.76; p &lt; 0.0001). Primary prophylaxis was administered to 14 patients, with eradication in 85.7%; however, 14.3% of these patients had hemorrhages during the follow‐up period and 41.7% had a relapse of varices. Secondary prophylaxis was administered to 41 patients. Esophageal varices were eradicated in 90.2% of patients. There were relapse and re‐bleeding of esophageal varices in 45.9% and 34.1% of the children, respectively.</p></div><div><h3>Conclusion</h3><p>Primary and secondary endoscopic prophylaxes showed high rates of esophageal varix eradication, but with significant relapses. Eradication of esophageal varices cannot definitively prevent recurrent upper digestive hemorrhage, since bleeding from alternate sites can occur. Medium‐ and large‐caliber esophageal varices were associated with upper digestive hemorrhage in patients with extrahepatic portal vein obstruction. To the best of the authors’ knowledge, this study is the first to evaluate bleeding risk factors in children with extrahepatic portal vein obstruction.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 755-762"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.08.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an instrument for monitoring child development indicators","authors":"Sonia I. Venancio ,&nbsp;Maritsa C. Bortoli ,&nbsp;Paulo G. Frias ,&nbsp;Elsa R.J. Giugliani ,&nbsp;Cláudia R.L. Alves ,&nbsp;Miriam O. Santos","doi":"10.1016/j.jpedp.2019.10.008","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.10.008","url":null,"abstract":"<div><h3>Objective</h3><p>To create and validate an instrument for child development monitoring.</p></div><div><h3>Methods</h3><p>Methodological study, based on the World Bank's proposition to monitor child development indicators in low‐ and middle‐income countries. The stages of the study included the following: development of an inventory of items for child development evaluation, based on open access instruments; content validation by a group of experts on the topic, using consensus techniques; selection of questions to describe children and their families; pre‐test of the instrument during the vaccination campaign in 2016 in three municipalities, and conducting cognitive interviews.</p></div><div><h3>Results</h3><p>A total of 431 items were sent for the evaluation of the specialists; 77 were initially excluded and the others were evaluated in‐person by the group, with 162 items covering the motor, cognitive, language, and socio‐emotional domains, distributed in ten age ranges. Questions about health, nutrition, early learning, protection and safety, and responsive care were also included. The instrument was applied by volunteer undergraduate students to 367 mothers of children under 5 years, showing good adherence of the caregivers. The time of application of the questionnaire was, on average, 20<!--> <!-->minutes. The cognitive interviews allowed the final adjustment of 19 items of the instrument for better understanding by the caregivers.</p></div><div><h3>Conclusions</h3><p>The instrument created and validated by experts fills a gap, as it allows a comprehensive evaluation of the development of children under 5 years at the population level, using a fast and inexpensive tool, and can be useful for monitoring indicators of development in Brazilian children in vaccination campaigns.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 778-789"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.10.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of varicella vaccine effectiveness as public health tool for increasing scientific evidence and improving vaccination programs","authors":"Francesco Vitale,&nbsp;Emanuele Amodio","doi":"10.1016/j.jpedp.2020.07.001","DOIUrl":"https://doi.org/10.1016/j.jpedp.2020.07.001","url":null,"abstract":"","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 670-672"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2020.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health","authors":"Thiago Paulo Frascareli Bento ,&nbsp;Guilherme Porfirio Cornelio ,&nbsp;Priscila de Oliveira Perrucini ,&nbsp;Sandra Fiorelli Almeida Penteado Simeão ,&nbsp;Marta Helena Souza de Conti ,&nbsp;Alberto de Vitta","doi":"10.1016/j.jpedp.2019.07.006","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.07.006","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the prevalence of low back pain and to analyze the association with the individual, sociodemographic variables, electronic devices, habitual practice of physical activity, and mental health problems.</p></div><div><h3>Methods</h3><p>Cross‐sectional study with 1,628 students in public schools in the city of Bauru, SP, Brazil. The following data were collected: 1. demographic and socioeconomic aspects; 2. Use of electronic devices; 3. habitual physical activity level (Baecke); 3. mental health (SDQ). 4. low back pain (Nordic Questionnaire). Descriptive analyzes and bivariate and multivariate logistic regression were used.</p></div><div><h3>Results</h3><p>The overall prevalence of low back pain was 46.7% (95% CI: 44.27 to 49.11); men showed a prevalence of 42.0% (95% CI: 36.63 to 43.41) and women 58.0% (95% CI: 49.73 to 56.51), a statistically significant difference. The variables associated with pain in the low back region were: female gender (PR = 1.70), daily TV use for more than 3<!--> <!-->hours (PR = 1.17), use of laptop computer (PR = 1.40), use of the cell phone in the supine position (PR = 1.23), use of the cell phone in semi‐supine position (PR = 1.49), daily cell phone use for more than 3<!--> <!-->hours (PR = 1.36), use of tablet (PR = 1.67), daily tablet use for more than above 3<!--> <!-->hours (PR = 1.46), and clinically important mental health problems (PR = 2.62).</p></div><div><h3>Conclusion</h3><p>There is a high prevalence of low back pain in high school students and striking association with female sex, electronic devices, and mental health problems.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 6","pages":"Pages 717-724"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136818378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the measurement properties of the Brazilian version of two quality‐of‐life questionnaires in food allergy – for children and their parents","authors":"Raquel Bicudo Mendonça ,&nbsp;Dirceu Solé ,&nbsp;Audrey DunnGalvin ,&nbsp;Claudio Arnaldo Len ,&nbsp;Roseli Oselka Saccardo Sarni","doi":"10.1016/j.jpedp.2019.04.013","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.04.013","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the psychometric properties of the Brazilian version of health‐related quality‐of‐life questionnaires of children with food allergy and their parents.</p></div><div><h3>Methods</h3><p>The translation and cultural adaptation processes were previously performed, according to the method proposed by the World Health Organization. After this stage, the questionnaires were applied to 201 parents of children under 6 years of age with food allergy. The assessment of the psychometric properties included: evaluation of the internal consistency by Cronbach's alpha coefficient; of the reproducibility by the intraclass correlation coefficient between test and retest; and of the construct, using Spearman's correlation coefficient, comparing the obtained scores with those of generic questionnaires that evaluate health‐related quality of life.</p></div><div><h3>Results</h3><p>The means of the obtained scores were 2.44 and 3.35, for the children and their parents, respectively. Cronbach's alpha coefficients were 0.85 and 0.91, respectively, which showed good internal consistency of the tools. The intraclass correlation coefficients between test and retest were 0.87 and 0.84 for children and their parents, respectively, showing good reproducibility for both questionnaires. The correlation between the specific and the generic questionnaires was significant (−0.27 for the children, −0.64 for their parents, <em>p</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>The specific questionnaires to evaluate the health‐related quality of life of children with food allergy and of their parents were satisfactorily validated to be used in Brazil.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 5","pages":"Pages 600-606"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.04.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92060553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID‐19 and obesity in childhood and adolescence: a clinical review","authors":"Carlos Alberto Nogueira‐de‐Almeida ,&nbsp;Luiz A. Del Ciampo ,&nbsp;Ivan S. Ferraz ,&nbsp;Ieda R.L. Del Ciampo ,&nbsp;Andrea A. Contini ,&nbsp;Fábio da V. Ued","doi":"10.1016/j.jpedp.2020.07.003","DOIUrl":"10.1016/j.jpedp.2020.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>To identify factors that contribute to the increased susceptibility and severity of COVID‐19 in obese children and adolescents, and its health consequences.</p></div><div><h3>Sources</h3><p>Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases.</p></div><div><h3>Summary of findings</h3><p>Obesity is a highly prevalent comorbidity in severe cases of COVID‐19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response.</p></div><div><h3>Conclusions</h3><p>The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID‐19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 5","pages":"Pages 546-558"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2020.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130021429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why pediatricians need to know the disorders of sex development: experience of 709 cases in a specialized service","authors":"Mayra de Souza El Beck,&nbsp;Carlos W. Germano,&nbsp;Beatriz A. Barros,&nbsp;Juliana G.R. Andrade,&nbsp;Guilherme Guaragna‐Filho,&nbsp;Georgette B. Paula,&nbsp;Márcio L. Miranda,&nbsp;Mara S. Guaragna,&nbsp;Helena Fabbri‐Scallet,&nbsp;Tais N. Mazzola,&nbsp;Nilma L. Viguetti‐Campos,&nbsp;Társis A.P. Vieira,&nbsp;Sofia H.V. Lemos‐Marini,&nbsp;Antonia P. Marques‐de‐Faria,&nbsp;Roberto B. Paiva e Silva,&nbsp;Maricilda P. Mello,&nbsp;Andréa T. Maciel‐Guerra,&nbsp;Gil Guerra‐Júnior","doi":"10.1016/j.jpedp.2019.04.015","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.04.015","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate, in a sample of patients with disorders of sex development (DSD), data related to the age at referral and their correlation with the initial complaints, gender at referral, defined gender after diagnosis and etiological diagnosis.</p></div><div><h3>Methods</h3><p>Retrospective review of the age at the first consultation and the reason for it, initial social gender and gender after the diagnosis, karyotype and etiological diagnosis of all cases treated at a DSD outpatient clinic between 1989 and 2016. Cases that did not involve DSD and DSD diagnoses that do not usually involve ambiguous genitalia, thus not requiring specialized monitoring, were excluded.</p></div><div><h3>Results</h3><p>Of the 1793 treated cases, 1139 were diagnosed with some type of DSD. This study excluded 430 cases (272 with Turner's syndrome, 66 with Klinefelter syndrome, and 92 with pure gonadal dysgenesis), thus a total 709 individuals were included. Of these, 82.9% were referred due to ambiguous genitalia; only one‐quarter were still in the first month of life, and 6.6% were referred due to pubertal delay, with most of them aged 10 years or older. Of these patients, 68.6% had a diagnosis of XY DSD, 22.4% of XX DSD, and 9% of sex chromosome abnormalities.</p></div><div><h3>Conclusions</h3><p>This study presents the largest series in the literature of patients with DSD treated in a single center. The time of referral of the majority of patients with ambiguous genitalia fell short of the ideal, and milder cases of ambiguous genitalia and many with pubertal manifestations were referred even later. The results reinforce the importance of continuing education for professionals who will have the first contact with these patients, mainly pediatricians and neonatologists.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 5","pages":"Pages 607-613"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.04.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137091398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors of death in children during the first year of life due to congenital diaphragmatic hernia: analysis of a hospital cohort from 2005 to 2015","authors":"Roberta Ivanira Silva do Carmo ,&nbsp;Fernando Maia Peixoto‐Filho ,&nbsp;Arnaldo Bueno ,&nbsp;Marlon Fonseca ,&nbsp;Saint Clair dos Santos Gomes Junior","doi":"10.1016/j.jpedp.2019.05.018","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.018","url":null,"abstract":"<div><h3>Objective</h3><p>To describe and analyze the prognosis of children during the first year of life with a diagnosis of congenital diaphragmatic hernia admitted between the years 2005 and 2015 in the Neonatal Intensive Care Unit.</p></div><div><h3>Method</h3><p>In a retrospective cohort, 129 children with a diagnosis of congenital diaphragmatic hernia were studied. The prognostic factors were analyzed, whereupon prenatal, delivery, and postnatal exposure variables were associated with death during the first year of life. The odds ratio and the confidence interval (95% CI) were calculated for all the studied variables, using the chi‐squared test and Student's <em>t</em>‐test.</p></div><div><h3>Results</h3><p>The study included 129 children hospitalized from January of 2005 to December of 2015. Seventy‐nine (61%) patients died, 50 survived, and 33 had other associated malformations. Among the prognostic factors, the following were significant and increased the chance of death: polyhydramnios (<em>p</em> <!-->=<!--> <!-->0.001), gestational age of the earliest diagnosis (<em>p</em> <!-->=<!--> <!-->0.004), associated congenital abnormalities (OR: 3.013, <em>p</em> <!-->=<!--> <!-->0.022), pO₂ of the first gasometry (<em>p</em> <!-->=<!--> <!-->0.000), pCO₂ of the first gasometry (<em>p</em> <!-->=<!--> <!-->0.000), presence of pulmonary hypoplasia (OR: 3.074, <em>p</em> <!-->=<!--> <!-->0.000), use of preoperative vasoactive drugs (OR: 2.881, <em>p</em> <!-->=<!--> <!-->0.000), and use of nitric oxide (OR: 1.739, <em>p</em> <!-->=<!--> <!-->0.000). The presence of only intestines in the hernia content was a protective factor (OR: 0.615, <em>p</em> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>The mortality in the first year of life in patients with congenital diaphragmatic hernia in this study was 61% in the years 2005–2015. Among the prognostic factors that demonstrated a significant effect, pulmonary hypoplasia had the greatest impact.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 5","pages":"Pages 569-575"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91984342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}