125 resultados para Extremely low birth weight infants


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This was a prospective study of 43 septic neonates at the NICU of the School of Medicine of Botucatu, São Paulo State University. Clinical and laboratory data of sepsis were analyzed based on outcome divided into two groups, survival and death. We calculated the discriminatory power of the relevant variables for the diagnosis of sepsis in each group, and using software for Discriminant Analysis, a function was proposed. There were 43 septic cases with 31 survivals and 12 deaths. The variables that had the highest discriminatory power were: n(o) of compromised systems, the SNAP, FiO2, and (A-a)O2. The study of these and others variables, such as birth weight, n(o) of risk factors, and pH using a Linear Discriminant Function(LDF) allowed us to identify the high-risk neonates for death with a low error rate (8.33%). The LDF was: F = 0.00043 (birth weight) + 0.30367 (n(o) of risk factors) - 0.1171 (n(o) of compromised systems) + 0.33223 (SNAP) + 2.27972 (pH) - 14.96511 (FiO2) + 0.01814 ((A-a)O2). If F > 22.77 there was high risk of death. This study suggests that the LDF at the onset of sepsis is useful for the early identification of the high-risk neonates that need special clinical and laboratory surveillance.

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Natural polymers, such as chitosan, obtained from chitin, are been widely studied for use in the tissue regeneration field. This study established a protocol to attain membranes made from this biopolymer, consisting of high or low molecular weight chitosan. The biocompatibility of these membranes was histologically evaluated, comparing them to collagen membrane surgically implanted in rat subcutaneous tissue. Fifteen Holtzmann rats were divided in three experimental groups: High and Low Molecular Weight Chitosan membranes (HMWC and LMWC) and Collagen membranes (C-control group); each of them with three experimental periods: 7, 15 and 30 days. As a result, after the seven days evaluation, the membranes were present and associated with a variable degree of inflammation, and after the 15 and 30 days evaluations, the membranes were absent in all groups. It is concluded that the chitosan-based membranes were successfully attained and presented comparable resorption times to collagen membranes.

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OBJETIVO: Avaliar a sobrevida e complicações associadas à prematuridade em recém-nascidos com menos de 32 semanas. MÉTODOS: Estudo prospectivo do tipo coorte. Foram incluídos os nascidos vivos, com idade gestacional entre 25 semanas e 31 semanas e 6 dias, sem anomalias congênitas admitidos em UTI Neonatal, entre 1º de agosto de 2009 e 31 de outubro de 2010. Os recém-nascidos foram estratificados em três grupos: G25, 25 a 27 semanas e 6 dias; G28, 28 a 29 semanas e 6 dias; G30, 30 a 31 semanas e 6 dias, e acompanhados até 28 dias. Foram avaliadas a sobrevida aos 28 dias e a morbidade associadas à prematuridade. Para análise dos resultados, utilizou-se o teste do c², análise de variância, teste de Kruskal-Wallis, razão de risco com intervalo de confiança (IC) e regressão logística múltipla, com significância em 5%. RESULTADOS: A coorte compreendeu 198 prematuros, sendo G25=59, G28=43 e G30=96. O risco de óbito foi significativamente maior em G25 e G28, em relação ao G30 (RR=4,1; IC95% 2,2-7,6 e RR=2,8; IC95% 1,4-5,7). A sobrevida encontrada foi, respectivamente, 52,5, 67,4 e 88,5%. A partir da 26ª semana e peso >700 g, a sobrevida foi superior a 50%. A morbidade foi inversamente proporcional à idade gestacional, exceto para enterocolite necrosante e leucomalácia, que não diferiram entre os grupos. A análise de regressão logística mostrou que a hemorragia pulmonar (OR=3,3; IC95% 1,4-7,9) e a síndrome do desconforto respiratório (OR=2,5; IC95% 1,1-6,1) foram fatores independentes de risco para óbito. Houve predomínio das lesões cerebrais hemorrágicas graves em G25. CONCLUSÕES: Sobrevivência superior a 50% ocorreu a partir da 26ª semana de gravidez e peso >700 g. A hemorragia pulmonar e a síndrome do desconforto respiratório foram preditores independentes de óbito. Há necessidade de identificar e instituir práticas para melhorar a sobrevida de prematuros extremos.

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OBJETIVO: Avaliar as características antropométricas, a morbidade e mortalidade de recém-nascidos (RN) prematuros nascidos vivos de mães hipertensas em função da presença ou não de diástole zero (DZ) ou reversa (DR) na doplervelocimetria arterial umbilical. MÉTODOS: Estudo prospectivo, envolvendo RN prematuros nascidos vivos de gestantes hipertensas, com idade gestacional entre 25 e 33 semanas, submetidas à doplervelocimetria da artéria umbilical nos 5 dias que antecederam o parto, realizado no Hospital do Distrito Federal, entre 1º de novembro de 2009 e 31 de outubro de 2010. Os RN foram estratificados em dois grupos, conforme o resultado da doplervelocimetria da artéria umbilical: Gdz/dr=presença de diástole zero (DZ) ou diástole reversa (DR) e Gn=doplervelocimetria normal. Medidas antropométricas ao nascimento, morbidades e mortalidade neonatal foram comparadas entre os dois grupos. RESULTADOS: Foram incluídos 92 RN, assim distribuídos: Gdz/dr=52 RN e Gn=40 RN. No Gdz/dr a incidência de RN pequenos para idade gestacional foi significativamente maior, com risco relativo de 2,5 (IC95% 1,7‒3,7). No grupo Gdz/dr os RN permaneceram mais tempo em ventilação mecânica mediana 2 (0‒28) e no Gn mediana 0,5 (0‒25), p=0,03. A necessidade de oxigênio aos 28 dias de vida foi maior no Gdz/dr do que no Gn (33 versus10%; p=0,01). A mortalidade neonatal foi maior em Gdz/dr do que em Gn (36 versus 10%; p=0,03; com risco relativo de 1,6; IC95% 1,2 - 2,2). Nessa amostra a regressão logística mostrou que a cada 100 gramas a menos de peso ao nascer no Gdz/dr a chance de óbito aumentou 6,7 vezes (IC95% 2,0 - 11,3; p<0,01). CONCLUSÃO: em RN prematuros de mães hipertensas com alteração na doplervelocimetria da artéria umbilical a restrição do crescimento intrauterino é frequente e o prognóstico neonatal pior, sendo elevado o risco de óbito relacionado ao peso ao nascimento.

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The polysaccharide (VSP) from the gum exudate of quaruba (Vochysia lehmannii) had two components of almost identical M. centred at 24,800, as shown by HSPEC-MALLS. The presence of aggregates was shown since carboxy-reduction gave VSP-RED, which contained low molecular weight components with M-w 19,000 > 5800 and polydispersity ratios dn/dc 0.160 and 0.149, respectively. VSP formed low viscosity aqueous solutions and acid hydrolysis gave Man (30%), Ara (16%), Gal (10%), and Glc (14%). The latter arose partly from GlcA (30%). Methylation analysis revealed mainly neutral units of 2-O- (60%) and 2,3-di-O-substituted Manp (5%), and those of nomeducing ends (8%), 2-O- (3%), and 4-O-substituted Arap and/or 5-O-substituted Araf units (6%). VSP-RED contained Glc (45%), Man (35%), and Ara (13%) and methylation analysis indicated mainly 4-O-substituted Glcp (31%) and 2-O- (51%) and 2,3-di-O-substituted Manp units (5%). A predominant alternating structure for VSP was shown by its C-13 NMR spectrum, which contained 10 main signals and a small one of C-6 of GlcpA. This was confirmed by formation, on partial hydrolysis of VSP, of a tetrasaccharide, which was characterised by NMR spectroscopy and ESI-MS as beta-GlcpA-(1 --> 2)-alpha-Manp-(1 --> 4)-beta-GlcpA-(1 --> 2)-Man, which arose from the main chain, thus confirming VSP to be a glycoglucuronomannan. (C) 2004 Elsevier Ltd. All rights reserved.

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Marketable chrysanthemums were produced in several different peat types. Only the plants in one of the dredged frozen black peats and one of the milled white peats had a significant lower shoot dry weight than those in one of the sod and milled white peats, respectively. As the N-contents of the fertilized peats show neither deficiency nor excess in nutrient supply, possibly they are not the reason for the differences in shoot dry weight. The air capacity, which is extremely low in both dredged frozen black peats and dropped further during the cultivation period due to decomposition, also cannot explain the differences in shoot dry weight sufficiently (R-2=0.44*; n=12). A close linear negative correlation (R-2=0.77**; n=12) was found between the CAT (VDLUFA) soluble Fe and the shoot dry weight. Therefore, the Fe-contents might be a quality factor of peat to be used as a growing medium.

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Birth weight and placental weight of 566 newborns were determined. The newborns were classified by birth weight and gestational age in seven groups: term, preterm and postterm newborns with weight appropriate for gestational age; term and postterm newborns small for gestational age; term and preterm newborns large for gestational age. The differences in the mean placental weight in the preterm, term and postterm newborns with weight appropriate for gestational age were not significant. After 34 weeks of gestation there was little increase in placental weight. The mean placental weight of newborns large for gestational age was significantly different from that of term newborns appropriate for gestational age. In the term and postterm newborns small for gestational age the mean placental weight was significantly different from term and postterm newborns appropriate for gestational age. These findings suggest that newborns with an appropriate intrauterine growth have little increase in placental weight in the gestational period. Gestational age is not an important factor in determining placental weight in this period. Nutrition is important for placental growth-retarded infants have small placentas and large-for-date infants have large placental weight.

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Objective. To assess factors determining growth in a group of children between 3 months and 6 years old enrolled in a public municipal (i.e., government-supported, not private) day-care center, in comparison to a group of children with similar characteristics but who were not enrolled in the center. Methods. A quasi-experimental study was designed to observe 444 children aged 3 to 72 months from a low-income neighborhood in the city of Sorocaba, in the state of São Paulo, Brazil. Two groups were studied: 164 children enrolled in a local municipal day-care center (intervention group) and 280 not receiving care at the center (nonintervention, comparison group) but instead being cared for at home. Both groups were seen four times over a period of 16 months. At each observation session, the children's weight and height were measured. Information was also collected on the mother's sociodemographic characteristics and the illnesses she had suffered as well as the child's weight and other health characteristics at birth, the child's illnesses in the 15 days before each observation, and any hospitalizations. Results. The children in both groups were from low-income families, with 65% of the families having an average monthly income below US$ 100; 80% of the mothers had received 8 years of schooling or less. Multivariate linear regression analysis showed that at the first observation (just before enrollment in the day-care center), birth weight was the only factor that explained the nutritional differences between the two groups. Subsequent analyses showed that being in day care was the factor that best explained the differences between the groups, especially in terms of the adequacy of weight for age, after controlling for birthweight, sex, age at the beginning of the study, and illnesses in the 15 days before an observation session. The nutritional impact of the intervention was significant as early as 3 months after being enrolled in day care. Conclusions. The nutritional benefits of the care provided at the center outweighed the negative effects sometimes seen in such centers, such as the greater morbidity that children in day-care centers often experience in comparison to children receiving care at home.

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The effect of nitrate concentration on giant river prawn, Macrobrachium rosenbergii, larvae was investigated. Survival rate, weight gain, and larval development were evaluated for different concentrations of nitrate in three experiments. The experiments were divided i n to two phases. In the first phase, larvae from stages I through VIII were analysed, while in the second phase larvae from stage VIII through post-larvae metamorphosis were analysed. Oxygen consumption was also determined for zoea I, II, and VIII exposed to 0, 700, and 1,000 mg/L of nitrate-N. No effect was observed for concentrations up to 180 mg/L NO3-N (experiments I and II), and nitrate levels as 1,000 mg/L NO3-N did not affect survival in the first phase of the third experiment. On the other hand, larval stage index (LSI) and weight gain decreased as nitrate-N concentration increased from 0 to 1,000 mg/L. In the second phase, survival and metamorphosis rate decreased as nitrate concentration increased, according to a linear model. The effect of nitrate levels on weight gain followed a curvilinear pattern. Larval respiration decreased in the water where nitrate was added, but only during stage II. The results demonstrated that nitrate presents extremely low toxicity for giant river prawn larvae, and data were related to the levels of nitrate that usually occur in larviculture systems also discussed. Therefore, nitrate is not a limiting factor for giant river prawn larviculture. © 2003 by The Haworth Press, Inc. All rights reserved.

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Marketable chrysanthemums were produced in several different peat types. Only the plants in one of the dredged frozen black peats and one of the milled white peats had a significant lower shoot dry weight than those in one of the sod and milled white peats, respectively. As the N-contents of the fertilized peats show neither deficiency nor excess in nutrient supply, possibly they are not the reason for the differences in shoot dry weight. The air capacity, which is extremely low in both dredged frozen black peats and dropped further during the cultivation period due to decomposition, also cannot explain the differences in shoot dry weight sufficiently (R2=0.44*; n=12). A close linear negative correlation (R2=0.77** n=12) was found between the CAT (VDLUFA) soluble Fe and the shoot dry weight. Therefore, the Fecontents might be a quality factor of peat to be used as a growing medium.

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The objective of the present study was to determine the presence of genotype by environment interaction (G × E) and to characterize the phenotypic plasticity of birth weight (BW), weaning weight (WW), postweaning weight gain (PWG) and yearling scrotal circumference (SC) in composite beef cattle using the reaction norms model with unknown covariate. The animals were born between 1995 and 2008 on 33 farms located throughout all Brazilian biomes between latitude -7 and -31, longitude -40 and -63. The contemporary group was chosen as the environmental descriptor, that is, the environmental covariate of the reaction norms. In general, higher estimates of direct heritability were observed in extreme favorable environments. The mean of direct heritability across the environmental gradient ranged from 0.05 to 0.51, 0.09 to 0.43, 0.01 to 0.43 and from 0.12 to 0.26 for BW, WW, PWG and SC, respectively. The variation in direct heritability observed indicates a different response to selection according to the environment in which the animals of the population are evaluated. The correlation between the level and slope of the reaction norm for BW and PWG was high, indicating that animals with higher average breeding values responded better to improvement in environmental conditions, a fact characterizing a scale of G × E. Low correlation between the intercept and slope was obtained for WW and SC, implying re-ranking of animals in different environments. Genetic variation exists in the sensitivity of animals to the environment, a fact that permits the selection of more plastic or robust genotypes in the population studied. Thus, the G × E is an important factor that should be considered in the genetic evaluation of the present population of composite beef cattle. © The Animal Consortium 2012.

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A total of 61,528 weight records from 22,246 Nellore animals born between 1984 and 2002 were used to compare different multiple-trait analysis methods for birth to mature weights. The following models were used: standard multivarite model (MV), five reduced-rank models fitting the first 1, 2, 3, 4 and 5 genetic principal components, and five models using factor analysis with 1, 2, 3, 4 and 5 factors. Direct additive genetic random effects and residual effects were included in all models. In addition, maternal genetic and maternal permanent environmental effects were included as random effects for birth and weaning weight. The models included contemporary group as fixed effect and age of animal at recording (except for birth weight) and age of dam at calving as linear and quadratic effects (for birth weight and weaning weight). The maternal genetic, maternal permanent environmental and residual (co)variance matrices were assumed to be full rank. According to model selection criteria, the model fitting the three first principal components (PC3) provided the best fit, without the need for factor analysis models. Similar estimates of phenotypic, direct additive and maternal genetic, maternal permanent environmental and residual (co)variances were obtained with models MV and PC3. Direct heritability ranged from 0.21 (birth weight) to 0.45 (weight at 6 years of age). The genetic and phenotypic correlations obtained with model PC3 were slightly higher than those estimated with model MV. In general, the reduced-rank model substantially decreased the number of parameters in the analyses without reducing the goodness-of-fit. © 2013 Elsevier B.V.