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

{"title":"Influence of nutritional factors and the PON1 C(‐107)T polymorphism on paraoxonase‐1 activity in childhood","authors":"Tainá S. Sigales ,&nbsp;Gabriela Uliano ,&nbsp;Ludmila Muniz ,&nbsp;Carlos Barros ,&nbsp;Augusto Schneider ,&nbsp;Sandra C. Valle","doi":"10.1016/j.jpedp.2019.05.012","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.012","url":null,"abstract":"<div><h3>Objective</h3><p>The cardioprotective enzyme paraoxonase‐1 (PON1) suffers an important influence from genetic polymorphisms and nutritional factors. The aim of this study was to investigate the influence of diet, nutritional status, and the <em>C(‐107)T</em> polymorphism on PON1 arylesterase activity in children.</p></div><div><h3>Methods</h3><p>This was a cross‐sectional study with 97 children, aged between 5 and 8 years, of both genders, from a pediatric outpatient clinic in southern Brazil. A sociodemographic, behavioral, and food consumption questionnaire was applied, and anthropometric measurements and laboratory blood samples were taken. PON1 arylesterase activity was measured by phenol extinction (U/mL), and DNA extraction and analysis of the <em>PON1 C(‐107)T</em> polymorphism were performed. The Hardy–Weinberg equilibrium was tested with the chi‐squared test and linear regression was used to estimate PON1 activity according to four adjustment models, with an acceptable error of 5%.</p></div><div><h3>Results</h3><p>In the sample, the male gender accounted for 50.5%, 39.2% were 6 years of age, 54.5% had normal weight, and 51.5% had PON1 activity below the median (90.0, 15–30<!--> <!-->U/mL). Genotype frequency was 54.6% (53/97), 31.0% (30/97), and 14.4% (14/97), respectively, for CT, CC, and TT, consistent with the Hardy–Weinberg equilibrium (<em>p</em> <!--> <!-->=<!--> <!--> <!-->0.22). In the regression analysis, the model that included sociodemographic variables as well as frequency of consumption of fruits, vegetables, legumes, dairy products, and beans estimated a variability of 14.8% in PON1 activity combined with the <em>PON1 C(‐107)T</em> polymorphism.</p></div><div><h3>Conclusions</h3><p>During childhood, a good‐quality diet with greater inclusion of healthy foods was important to predict the activity of the cardioprotective enzyme PON1 combined with the <em>C(‐107)T</em> polymorphism of the PON1 gene.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 495-502"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905262","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":"Sarcopenia in children and adolescents with chronic liver disease","authors":"Ionar Figueredo Bonfim Rezende ,&nbsp;Maria Ester P. Conceição‐Machado ,&nbsp;Viviane Sahade Souza ,&nbsp;Elisana M. dos Santos ,&nbsp;Luciana R. Silva","doi":"10.1016/j.jpedp.2019.05.011","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.011","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the occurrence of sarcopenia in children and adolescents with chronic liver disease.</p></div><div><h3>Methods</h3><p>A series of cases, with patients aged 6‐19 years of both genders, who were treated in Liver Outpatient Clinics. Weight, height, muscle strength (assessed by manual grip strength), and muscle mass (estimated through dual‐energy X‐ray absorptiometry) were measured. Sarcopenia was diagnosed based on the simultaneous presence of muscle mass and muscle strength déficits, defined as the values below the mean for muscle mass and strength of the studied population, according to gender. A descriptive analysis (mean and standard deviation) was performed, and the difference of means was calculated by Student's <em>t‐</em>test.</p></div><div><h3>Results</h3><p>A total of 85 patients were studied, mostly females (64.7%), with a mean age of 11.7 (SD<!--> <!-->=<!--> <!-->3.4) years. Sarcopenia was identified in 40% of the patients. Muscle strength déficit was found in 54.1% of the subjects, and 50.6% showed muscle mass déficit. The mean muscle mass for males was higher than that for females (6.07; SD<!--> <!-->=<!--> <!-->1.22<!--> <!-->kg/m² <em>vs.</em> 5.42; SD<!--> <!-->=<!--> <!-->1.10<!--> <!-->kg/m²; p<!--> <!-->=<!--> <!-->0.016). However, there was no significant difference in sex‐related muscle strength (male<!--> <!-->=<!--> <!-->0.85; SD<!--> <!-->=<!--> <!-->0.52 kgf/kgm² and female<!--> <!-->=<!--> <!-->0.68; SD<!--> <!-->=<!--> <!-->0.30 kgf/kgm²; p<!--> <!-->=<!--> <!-->0.113).</p></div><div><h3>Conclusion</h3><p>The research findings identified that sarcopenia is a condition found in pediatric patients treated at a public referral institution for chronic liver disease.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 439-446"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905142","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":"Neonatal screening tests in Brazil: prevalence rates and regional and socioeconomic inequalities","authors":"Mariana B. Mallmann ,&nbsp;Yaná T. Tomasi ,&nbsp;Antonio Fernando Boing","doi":"10.1016/j.jpedp.2019.05.007","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>To identify the prevalence and associated factors with the performance of the Guthrie test, hearing, and red reflex screening tests in Brazil.</p></div><div><h3>Methods</h3><p>This was a population‐based, cross‐sectional study that analyzed data on 5,231 children under 2 years of age participating in the National Health Survey of 2013. The study described the prevalence and Confidence Intervals (95% CI) of the three neonatal screening tests performed, in any period, and their association with the country's regions, skin color/ethnicity, private health insurance, and per capita household income. Logistic regression models were used, and odds ratios were calculated by incorporating sample weights.</p></div><div><h3>Results</h3><p>The prevalence of Guthrie test screening in Brazil at any time of life was 96.5%, that of the newborn hearing screening was 65.8% and that of the red reflex screening test was 60.4%. The performance of the three screening tests was significantly higher among children whose mothers/guardians reported higher per capita household income, who lived in the South and Southeast regions, and who had private health insurance (p &lt;<!--> <!-->0.001). There was no statistically significant difference regarding the performance of the tests according to skin color/ethnicity (p<!--> <!-->&gt; 0.05). The same inequalities were verified when the tests were performed during the recommended periods, with a strong socioeconomic gradient.</p></div><div><h3>Conclusions</h3><p>There are inequalities in the performance of neonatal screening tests in the country, and also in the performance of these tests during the periods established in the governmental guidelines. The guarantee of the performance of these tests in a universal and public health system, as in Brazil, should promote equity and access to the entire population.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 487-494"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905259","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":"Pediatric sarcopenia: exploring a new concept in children with chronic liver disease","authors":"Manuela Merli","doi":"10.1016/j.jpedp.2019.09.002","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.09.002","url":null,"abstract":"","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 406-408"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905133","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":"Asthma mortality in children and adolescents of Brazil over a 20‐year period","authors":"Raquel Reis Pitchon ,&nbsp;Cristina Gonçalves Alvim ,&nbsp;Cláudia Ribeiro de Andrade ,&nbsp;Laura Maria de Lima Belizário Facury Lasmar ,&nbsp;Álvaro Augusto Cruz ,&nbsp;Adriana Pitchon dos Reis","doi":"10.1016/j.jpedp.2019.05.014","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.014","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the number of asthma deaths and the temporal trend of the asthma‐specific mortality rate in children and adolescents up to 19 years of age in Brazil.</p></div><div><h3>Methods</h3><p>This is an ecological time‐series study of asthma deaths reported in Brazil, in the population up to 19 years of age, between 1996 and 2015. The specific asthma mortality rate and its temporal trend were analyzed.</p></div><div><h3>Results</h3><p>There were 5014 deaths during the 20 years evaluated, with the majority, 68.1%, being recorded in children under 5 years of age. The specific asthma mortality rate ranged from 0.57/100,000 in 1997 to 0.21/100,000 in 2014, with a significant reduction of 59.8%. Regarding the place of death, 79.4% occurred in a hospital setting. In this sample, the adolescents had a 1.5‐fold higher chance of death out‐of‐hospital than children up to nine years of age. There was no significant difference in the temporal trend between the genders and no significant decrease in out‐of‐hospital deaths.</p></div><div><h3>Conclusions</h3><p>This study found a temporal trend for a reduction in asthma deaths over 20 years in children and adolescents in Brazil. Mortality rates varied across the geographic regions of the country and were higher in the Northeast. The prevalence of deaths under 5 years of age may be associated with the greater vulnerability of this age group in low‐income countries. In adolescence, deaths outside the hospital environment are noteworthy. Asthma deaths are rare but unacceptable events, considering the treatable nature of the disease and the presence of avoidable factors in most of fatal outcomes.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 432-438"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905135","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":"Can simple and low-cost motor function assessments help in the diagnostic suspicion of Duchenne muscular dystrophy?","authors":"Aline Chacon Pereira ,&nbsp;Alexandra Prufer de Queiroz Campos Araújo ,&nbsp;Márcia Gonçalves Ribeiro","doi":"10.1016/j.jpedp.2019.05.013","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.013","url":null,"abstract":"<div><h3>Objective</h3><p>Duchenne muscular dystrophy, an X-linked genetic disease, leads to progressive muscle weakness mainly in the lower limbs. Motor function tests help to monitor disease progression. Can low-cost, simple assessments help in the diagnostic suspicion of Duchenne muscular dystrophy? The authors aim to define the sensitivity of time to rise from the floor, time to walk 10<!--> <!-->meters, and time to run 10<!--> <!-->meters, evaluating them as eventual diagnostic screening tools.</p></div><div><h3>Methods</h3><p>This is an analytical, observational, retrospective (1998–2015), and prospective study (2015–2018). Cases were recruited from the database of the pediatric neurology department and the healthy, from child care consultations, with normal gait development (up to 15 months) and without other comorbidities (neuromuscular, pulmonary, heart diseases) from the same university hospital.</p></div><div><h3>Results</h3><p>128 Duchenne muscular dystrophy patients and 344 healthy children were analyzed, equally distributed in age groups. In Duchenne muscular dystrophy, there is a progressive increase in the means of the times to perform the motor tests according to the age group, which accelerates very abruptly after 7 years of age. Healthy children acquire maximum motor capacity at 6 years and stabilize their times. The time to rise showed a <em>p</em>-value &lt;0.05 and a strong association (effect size [ES] &gt;0.8) in all age groups (except at 12 years), with time to walk 10 meters from 9 years, and with time to run 10 meters, from 5 years. The 100% sensitivity points were defined as follows: time to rise, at 2<!--> <!-->s; time to walk 10 meters, 5<!--> <!-->s; time to walk 10 meters, 4<!--> <!-->s.</p></div><div><h3>Conclusions</h3><p>Time to rise is a useful and simple tool in the screening of neuromuscular disorders such as Duchenne muscular dystrophy, a previously incurable disease with new perspectives for treatment.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 503-510"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905260","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":"Bladder and bowel symptoms experienced by children with osteogenesis imperfecta","authors":"Gisele Martins ,&nbsp;Maia Siedlikowski ,&nbsp;Anna Kristina Silva Coelho ,&nbsp;Frank Rauch ,&nbsp;Argerie Tsimicalis","doi":"10.1016/j.jpedp.2018.12.002","DOIUrl":"https://doi.org/10.1016/j.jpedp.2018.12.002","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms experienced by children with osteogenesis imperfecta and to describe the socio‐demographic and clinical profile of these children.</p></div><div><h3>Method</h3><p>A descriptive study was conducted with a convenience sample of parent‐child pairs of toilet‐trained children aged from 3 to 18 years. Pairs were interviewed using three tools: (1) Socio‐Demographic and Clinical Questionnaire; (2) Dysfunctional Voiding Scoring System; (3) Rome III Criteria along with the Bristol Stool Scale. Data were stratified by socio‐demographic and clinical variables and analyzed using descriptive statistics.</p></div><div><h3>Results</h3><p>Thirty‐one parent‐child pairs participated in the study; 38.7% (<em>n</em> <!-->=<!--> <!-->12) children reported bowel symptoms, 19.4% (<em>n</em> <!-->=<!--> <!-->6) reported a combination of bladder issues (such as holding maneuvers and urgency) and bowel symptoms (such as hard or painful bowel movements and large diameter stools). There were no reports of isolated bladder issues. Among the child participants, 16 (51.7%) identified as female and 20 (64.5%) were 5–14 years old. The most prevalent type of osteogenesis imperfecta was type III (<em>n</em> <!-->=<!--> <!-->12; 38.7%) and eight (25.8%) children reported using a wheelchair.</p></div><div><h3>Conclusion</h3><p>This is the first study to examine the prevalence and presentation of bladder, bowel, and combined bladder and bowel symptoms in children with osteogenesis imperfecta, offering a preliminary socio‐demographic and clinical profile of these children. This research is an important step toward effective screening, detection, and access to care and treatment, especially for clinicians working with this group of very fragile patients.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 472-478"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2018.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905494","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":"Factors associated with current tobacco use among adolescents and young students","authors":"Samara Barreto Cunha ,&nbsp;Rodrigo Cappato de Araújo ,&nbsp;Jéssica Vanessa Barros de Oliveira ,&nbsp;Rachel Mola ,&nbsp;Ana Carolina Rodarti Pitangui","doi":"10.1016/j.jpedp.2019.01.001","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.01.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the prevalence of current tobacco use and its association with sociodemographic factors and risk behaviors among adolescents and young students, according to gender.</p></div><div><h3>Methods</h3><p>The sample consisted of students from the state public school network aged between 12 and 24 years, who answered the Brazilian version of the Youth Risk Behavior Survey questionnaire. The data were analyzed in SPSS software (v. 20.0), using Poisson regression to evaluate the prevalence ratio (PR) of the independent variables in relation to the outcome. <em>p</em> <!-->&lt;<!--> <!-->0.05 was established as the significance level.</p></div><div><h3>Results</h3><p>The final analysis consisted of 1275 adolescents, of whom 716 (56.2%) were girls and 559 (43.8%) were boys. The prevalence of current tobacco use was 6.6% among girls and 9.7% among boys. In females, consuming alcohol in the last 30 days (3.91 [1.54–9.94]) and being 14 years old or younger (0.50 [0.26–0.96]) influenced current tobacco use. In the male gender, tobacco use in the last 30 days was influenced by current alcohol consumption (2.92 [1.21–7.08]) and involvement in physical fighting in the last 12 months (2.32 [1.32–4.09]).</p></div><div><h3>Conclusion</h3><p>Although the prevalence of current tobacco use was low in both genders, the assessed population still presents a risk, since male involvement in physical fighting and current consumption of alcohol in both genders increased the probability of this population becoming regular tobacco users.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 447-455"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136904987","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":"Comparison of birth weight, length, and head circumference between the BRISA-RP and Intergrowth‐21st cohorts","authors":"João Roberto R. Pimenta ,&nbsp;Carlos Grandi ,&nbsp;Davi C. Aragon ,&nbsp;Viviane Cunha Cardoso","doi":"10.1016/j.jpedp.2019.05.022","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.05.022","url":null,"abstract":"<div><h3>Objectives</h3><p>(a) To determine the 3rd, 50th, and 97th percentiles of weight, length, and head circumference of newborns from the Ribeirão Preto BRISA cohort, according to gender and gestational age, and compare them with the Intergrowth‐21st standard; (b) To estimate the small for gestational age (<!--> <!-->&lt;<!--> <!-->3rd percentile), large for gestational age (<!--> <!-->&gt;<!--> <!-->97th percentile), stunting (length<!--> <!-->&lt;<!--> <!-->3rd percentile), and wasting (body mass index<!--> <!-->&lt;<!--> <!-->3rd percentile).</p></div><div><h3>Methods</h3><p>Observational study of a cohort of 7702 newborns between 01/01/2010 and 12/31/2010 in the city of Ribeirão Preto, SP, Brazil. The 3rd, 50th, and 97th percentiles were determined for the anthropometric measurements using fractional polynomial regression.</p></div><div><h3>Results</h3><p>The weight difference between Ribeirão Preto and Intergrowth-21st was small, being more pronounced in preterm infants (mean difference between the two populations of +266<!--> <!-->g); for full‐term newborns, there was a mean difference of +66<!--> <!-->g, and for post‐term infants, of −113<!--> <!-->g. For length, the mean variation was always &lt;1<!--> <!-->cm; whereas for head circumference, preterm newborns showed a variation &gt;1<!--> <!-->cm, and full‐term and post‐term newborns showed a variation of &lt;1<!--> <!-->cm. The small and large for gestational age detection rates were 2.9% and 4.3%, respectively. Stunting affected 6.5% of all newborns and wasting, 1.5%, with a predominance in girls and in full‐term pregnancies; both conditions were present in 0.4% of the sample.</p></div><div><h3>Conclusions</h3><p>Newborns from Ribeirão Preto, when compared to the Intergrowth‐21 standard, are heavier, longer, and have a larger head circumference until they reach full‐term.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 511-519"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.05.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905261","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":"High‐flow nasal cannula as a post‐extubation respiratory support strategy in preterm infants: a systematic review and meta‐analysis","authors":"José Colleti Junior ,&nbsp;Rafael de Azevedo ,&nbsp;Orlei Araujo ,&nbsp;Werther Brunow de Carvalho","doi":"10.1016/j.jpedp.2019.10.009","DOIUrl":"https://doi.org/10.1016/j.jpedp.2019.10.009","url":null,"abstract":"<div><h3>Objective</h3><p>Perform a systematic review and meta‐analysis to assess the effectiveness and complications caused by the use of the high‐flow nasal cannula in relation to the post‐extubation continuous positive airway pressure system in preterm newborns.</p></div><div><h3>Data Sources</h3><p>The searches were performed from January 2013 to December 2018 in the PubMed and Embase databases, as well as a manual search on the internet.</p></div><div><h3>Data Synthesis</h3><p>Two reviewers independently conducted the search, and a third reviewer resolved questions that arose. Ninety‐eight articles from the chosen sources were evaluated, and 66 were discarded because they did not meet the inclusion criteria (inadequate topic, age range, or design, in addition to the duplicates). Fifteen articles were read in full, and five more were discarded due to inadequacy to the topic or design. There were ten articles left for systematic review and four for meta‐analysis. The study showed non‐inferiority in terms of therapeutic failure of the high‐flow nasal cannula in relation to continuous positive airway pressure after extubation of preterm newborns. In the meta‐analysis, nasal trauma was significantly lower in patients submitted to the high‐flow nasal cannula compared to those using continuous positive airway pressure (p &lt; 0.00001).</p></div><div><h3>Conclusion</h3><p>The high‐flow nasal cannula is not inferior to continuous positive airway pressure for post‐extubation respiratory support in preterm newborns with a gestational age of 32 weeks or less and greater than 28 weeks, in addition to resulting in less nasal trauma.</p></div>","PeriodicalId":100742,"journal":{"name":"Jornal de Pediatria (Vers?o em Português)","volume":"96 4","pages":"Pages 422-431"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jpedp.2019.10.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136905136","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}