Survival prognosis of newborns from an intensive care unit through the SNAP-PE II risk score

OBJECTIVES: Although child mortality has declined significantly in recent decades, the reduction of neonatal mortality remains a major challenge as neonatal mortality represents 2/3 of the mortality rate in this population. The objective of this study was to evaluate the utility of the Score for Neonatal Acute Physiology Perinatal Extension II (SNAP-PE II) score for evaluating the survival prognosis of newborns admitted to a neonatal intensive care unit (NICU). METHODS: The study design involved an observational cross-sectional retrospective collection, as well as a prospective component. The sample included all newborns admitted to the NICU validated by the SNAP-PE II tool from January 1 to December 31, 2014. RESULTS: A predominance of young mothers (25.4 years), underwent prenatal care (86.2%), however a considerable percentage (49.4%) of mothers received insufficient medical consultation (less than six consults during their pregnancy). A prevalence of male admissions (62.4%) were noted in the NICU. Premature (61.7%) and underweight (weight <2,500 grams) newborns were also prevalent. The SNAP-PE II score showed an association between the infants who were discharged from the neonatal unit and the non-survivors. An increased prevalence of low birth weight and hypothermia was noted in the group of non-survivors. The mean arterial pressure appears to be a significant risk factor in the newborn group that progressed to death. Hypothermia, mean arterial pressure, and birth weight were the most significant variables associated with death. CONCLUSION: The SNAP-PE II was a beneficial indicator of neonatal mortality. The prevention of prematurity and hypothermia by improving maternity care and newborn care can decisively influence neonatal mortality.

Accidents involving motorcyclists and cyclists in the municipality of São Paulo: characterization and trends / Acidentes que envolvem motociclistas e ciclistas no município de São Paulo: caracterização e tendências

Objective: To describe the characteristics of motorcycle and bicycle accident victims, according to notifications of suspected and confirmed accidents that have occurred in the municipality of São Paulo. Method: This was a descriptive epidemiological study. It covered all accidents (12,924) that occurred involving motorcycles (11,366) and bicycles (1558) between January 2011 and October 2013. Data in the Health Department's information system for surveillance of violence and accidents (SIVVA) was surveyed. Results: Motorcycle accidents accounted for 52.1% of the cases notified and bicycles, 7.1%. Males predominated in both types of accidents: 81.6% and 80.6%, respectively. In the motorcycle accidents, the predominant age group among the victims was from 20 to 24 years. Both types of accidents occurred during the daytime (7:00-18:00 h): 37.4% and 27.0% respectively. Among the motorcycle accidents, the driver had been using alcohol in 3% and it was not possible to identify whether this had occurred in 67%. Conclusions: Public policies prioritizing financial and human resources applied toward reducing these types of accidents need to be brought in...

Objetivo: Descrever as características de vítimas de acidentes de motocicleta e bicicleta, segundo notificacões de acidentes, suspeitos e confirmados, ocorridos no município de São Paulo. Método: Estudo epidemiológico transversal, descritivo. Abrangeu todos os acidentes (12.924) ocorridos com motocicleta (11.366) e bicicleta (1.558) de janeiro de 2011 a outubro de 2013. Fez-se um levantamento dos dados do Sistema de Informação de Vigilância e Violência e Acidentes (SIVVA) da Secretaria de Saúde. Resultados: Os acidentes de motocicleta corresponderam a 52,1% dos casos notificados; os de bicicleta, a 7,1%. O sexo masculino foi predominante em ambos: 81,6% e 80,6%, respectivamente. Nos acidentes de motocicleta, a faixa predominante das vítimas foi entre 20 e 24 anos. Ambos os acidentes ocorreram durante o dia (7 às 18 horas): 37,4% e 27,0% respectivamente. Entre os acidentes de motocicleta, em 3% os pilotos fizeram uso de álcool e em 67% não foi possível identificar se isso ocorrera. Conclusões: Faz-se necessária a adoção de políticas públicas que priorizem a aplicação de recursos financeiros e humanos na redução desses tipos de acidente...

Desnutrição em escolares em região urbano-rural do extremo sul do município de São Paulo / Malnutrition in school children in an urban-rural region of the extreme South of São Paulo city

Objective: To evaluate the persistence of nutritional deficit in a sample of schoolchildren. Methods: A cross-sectional study of 1,761 schoolchildren between 6 and 10 years from 3 schools. They were assessed by Z scores of weight for height and height for age, according to the World Health Organization. The variables studied were gender, age, grade and school year. The X² test was used to relate the nutritional deficit with the variables. Results: Of all children 8.5% were malnourished according to the weight for height Z score, 21.6%, according to height for age. The analysis of the weight for height Z score revealed that 59.7% were male and 40.3% female. The mean age was 8.9 years. As to the Z score of height for age, 53.9% were males and 46.1% females. The risk of malnutrition was higher among boys: 59.7% for the weight for height index and 53.9% for height for age. There was no statistical difference between schools, gender and school year. As to nutritional status, school period (p < 0.0001) and students' grade (p = 0.0105), we observed statistical significance. Conclusion: Malnutrition still persists among the low-income population and males had a higher percentage of malnutrition. Nutritional evaluation of students is an extremely important tool for understanding the dynamics of child nutrition and development.

Objetivo: Verificar a persistência do déficit nutricional em amostra de escolares. Métodos: Estudo transversal com 1.761 escolares de 6 a 10 anos provenientes de 3 escolas de ensino fundamental. Foram avaliados pelos escores Z de peso/estatura e estatura/idade, segundo a Organização Mundial da Saúde. As variáveis estudadas foram: gênero, idade, série e período escolar. O teste do X² relacionou o déficit nutricional com as variáveis. Resultados: Segundo o escore Z de peso/estatura 8,5% eram desnutridas; 21,6% de acordo com estatura/idade. A análise do escore Z de peso/estatura revelou que 59,7% eram meninos e 40,3% meninas. A média de idade foi de 8,9 anos. Quanto ao escore Z de estatura/idade 53,9% eram do gênero masculino e 46,1% do gênero feminino. O risco de desnutrição foi maior entre os meninos: 59,7% para o índice peso/estatura e 53,9% para o estatura/idade. Não houve diferença estatística na comparação entre as escolas, o gênero e o período escolar. Já entre estado nutricional, período (p < 0,0001) e série dos escolares (p = 0,0105), observamos significância. Conclusão: A desnutrição ainda é persistente entre a população de baixa renda e o gênero masculino apresentou maior prevalência. Pode-se considerar que a avaliação nutricional é uma ferramenta de extrema importância para compreensão da dinâmica nutricional de crianças e seu desenvolvimento.

Efeito da frequência à creche nas condiçöes de saúde e nutriçäo de pré-escolares residentes em favelas da periferia de Säo Paulo, 1996 / Effects of the exposition to a day care center on the health and nutrition of pre-school children living in slums in Sao Paulo, 1996

Com o propósito de avaliar o efeito da frequência a uma creche na saúde e nutriçäo de pré-escolares residentes em favelas, estudaram-se, de março a novembro de 1996, 145 crianças de 4,9 a 54,7 meses de idade, sendo 92 do sexo masculino e 53 do feminino, que frequentaram a creche Padre Juan Carlos Castro Guardiola, situada na periferia de Sao Paulo, por pelo menos 9 meses...