Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis

INTRODUCTION: Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease. MATERIAL AND METHODS: Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012. RESULTS: There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality. DISCUSSION: Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease. CONCLUSION: prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease were not diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.

Implementação da escovagem no ensino pré-escolar : projeto sr. Dente

Este projeto tem como objetivo identificar e realizar um levantamento dos hábitos de higiene oral das crianças do ensino pré-escolar, bem como, promover, motivar e sensibilizar as crianças acerca desta, ao verificar se a instrução de higiene oral, nomeadamente a escovagem, tem efeito positivo na redução da placa bacteriana medida através do índice de Greene & Vermillion Simplificado (IGV) e, cnsequentemente a aquisição de novos conhecimentos de higiene oral.Após realização de uma consulta de livros relacionados com o tema e pesquisa bibliográfica de artigos científicos, foram selecionados 23 artigos, tendo um limite temporal compreendido entre 2001 e 2013, designadamente 12 anos. Os artigos evidenciam que a maioria dos estudos são referentes aos hábitos de higiene oral e a necessidade da literacia desta em conhecimentos de prevenção das doenças orais. (...)