ABSTRACT
INTRODUCTION: The guidelines to prophylaxis of infectious endocarditis changed, but many congenital heart diseases continue to be considered as high risk for the development of the disease. OBJECTIVE: To evaluate the knowledge of parents or guardians of children and adolescents with congenital heart disease seen at a referral center in Rio Grande do Sul, Brazil on infective endocarditis and its prevention. METHODS: Cross-sectional study with 90 patients with congenital heart defects in regular outpatient treatment. The parents' knowledge was assessed using a specific questionnaire and other data were obtained through medical records. RESULTS: The median age of patients was 5.6 years (3 months -14 years), being 57,7% males. The median follow-up time in service was 3.49 years (1.20-7.38). The years of formal schooling of the parents had a mean of 7.67 ± 3.25 years. According to the score previously established, the knowledge of the interviewed parents was considered satisfactory in 37.7%, regular in 33.3% and unsatisfying in 28,8%. There was significant correlation between the index of parents' knowledge and monitoring of children at service (r=0.584; P=0.796). There was no correlation between parents' education and knowledge of them (r=0.028; P=0.796). CONCLUSION: The parents' knowledge about endocarditis and its prevention was inadequate, requiring greater attention to the orientations passed in consultations.
Subject(s)
Endocarditis, Bacterial/prevention & control , Health Knowledge, Attitudes, Practice , Heart Defects, Congenital/complications , Parents , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Infant , MaleABSTRACT
INTRODUÇÃO: As diretrizes para profilaxia de endocardite infecciosa mudaram, mas muitas cardiopatias congênitas seguem sendo consideradas de alto risco para o desenvolvimento da doença. OBJETIVO: Avaliar o conhecimento dos pais ou responsáveis pelas crianças e adolescentes portadores de cardiopatias atendidos em um serviço de referência no estado do Rio Grande do Sul, Brasil, sobre endocardite infecciosa e sua profilaxia. MÉTODOS: Estudo transversal com 90 pacientes portadores de cardiopatias congênitas em acompanhamento ambulatorial regular. O conhecimento dos pais foi avaliado com o uso de questionário específico e os demais dados foram obtidos por meio da revisão de prontuários. RESULTADOS: A mediana da idade dos pacientes foi de 5,6 anos (3 meses - 14 anos e 7 meses), sendo 57,7% do sexo masculino. A mediana de tempo de acompanhamento no serviço foi de 3,49 anos (1,20-7,38 anos). Os anos de estudo formal dos pais apresentaram média de 7,67 ± 3,25 anos. De acordo com o escore previamente estabelecido, o conhecimento dos pais entrevistados foi considerado satisfatório em 37,7% dos casos, regular, em 33,3% e insatisfatório, em 28,8%. Houve correlação significativa entre o índice de conhecimento dos pais e tempo de acompanhamento das crianças no serviço (r=0,584; P<0,001). Não houve correlação entre a escolaridade dos pais e o conhecimento dos mesmos (r=0,028; P=0,796). CONCLUSÃO: O conhecimento dos pais sobre endocardite e sua profilaxia mostrou-se inadequado, requerendo maior atenção nas orientações transmitidas nas consultas.
INTRODUCTION: The guidelines to prophylaxis of infectious endocarditis changed, but many congenital heart diseases continue to be considered as high risk for the development of the disease. OBJECTIVE: To evaluate the knowledge of parents or guardians of children and adolescents with congenital heart disease seen at a referral center in Rio Grande do Sul, Brazil on infective endocarditis and its prevention. METHODS: Cross-sectional study with 90 patients with congenital heart defects in regular outpatient treatment. The parents' knowledge was assessed using a specific questionnaire and other data were obtained through medical records. RESULTS: The median age of patients was 5.6 years (3 months -14 years), being 57,7% males. The median follow-up time in service was 3.49 years (1.20-7.38). The years of formal schooling of the parents had a mean of 7.67 ± 3.25 years. According to the score previously established, the knowledge of the interviewed parents was considered satisfactory in 37.7%, regular in 33.3% and unsatisfying in 28,8%. There was significant correlation between the index of parents' knowledge and monitoring of children at service (r=0.584; P=0.796). There was no correlation between parents' education and knowledge of them (r=0.028; P=0.796). CONCLUSION: The parents' knowledge about endocarditis and its prevention was inadequate, requiring greater attention to the orientations passed in consultations.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Endocarditis, Bacterial/prevention & control , Health Knowledge, Attitudes, Practice , Heart Defects, Congenital/complications , Parents , Cross-Sectional Studies , Follow-Up StudiesABSTRACT
OBJECTIVES: To access the frequency of abnormal echocardiographic findings in patients with diagnosis of innocent murmur. METHODS: A transversal study of 166 consecutive patients was carried out with diagnosis of innocent murmur evaluated in the pediatric cardiology outpatient clinic of "Instituto de Cardiologia/Fundação Universitária de Cardiologia", a tertiary reference center, between December 3, 2001 and December 2, 2002. History, clinical examination and echocardiogram were performed in all patients. Post-test probabilities of disease with positive and negative clinical examination were estimated, considering the echocardiogram as gold standard. RESULTS: Of the 166 patients evaluated, 11 showed some alteration in the echocardiogram: pulmonary stenosis (4), patent foramen ovale (2), atrial septal defect (1), bicuspid aortic valve (2), minimum aortic regurgitation (1) and ventricular septal defect (1). Negative post-test probability (probability of disease with diagnosis of innocent murmur) was of 6.6%. CONCLUSION: In a referral outpatient clinic the proportion of minor lesions is high in patients with diagnosis of innocent murmur. These injuries may not be related to the heart murmur, as in the patent foramen ovale and bicuspid aortic valve. However, they raise the question of the indication of echocardiogram taking into account the low risk of detected lesions and, on the other hand, the resolutive character of a daycare reference center.
Subject(s)
Heart Injuries/pathology , Heart Murmurs/diagnostic imaging , Child , Child, Preschool , Cross-Sectional Studies , Echocardiography , Female , Heart Auscultation , Heart Injuries/diagnostic imaging , Heart Septal Defects, Ventricular/diagnostic imaging , Heart Septal Defects, Ventricular/pathology , Heart Ventricles/pathology , Humans , Infant , Infant, Newborn , Male , ProbabilityABSTRACT
OBJETIVOS: Avaliar a freqüência de alterações ecocardiográficas em pacientes com diagnóstico de sopro "inocente". Métodos. Estudo transversal de uma amostra de 166 pacientes com diagnóstico de sopro "inocente" avaliados no ambulatório de Cardiologia Pediátrica do Instituto de Cardiologia/Fundação Universitária de Cardiologia, um serviço terciário de referência, durante o período de 3/12/2001 a 2/12/2002. Todos os pacientes realizaram anamnese, exame físico, eletrocardiograma e ecocardiograma. Foram estimadas as probabilidades pós-teste de exame clínico considerando o ecocardiograma como padrão ouro. Resultados. Dos 166 pacientes estudados, 11 apresentaram alguma alteração ao ecocardiograma: estenose pulmonar leve (4), forame oval patente (2), aorta bicúspide (2), comunicação interatrial (1), insuficiência aórtica mínima (1), comunicação interventricular mínima (1). A probabilidade pós-teste negativo, ou seja, a probabilidade de lesão cardíaca com diagnóstico de sopro "inocente" foi de 6,6 por cento. Conclusão. Em ambulatório especializado, é alta a proporção de alterações ecocardiográficas em pacientes com diagnóstico de sopro "inocente". Estes achados podem não estar relacionados à presença de sopro, como o forame oval patente e a aorta bicúspide. No entanto, levantam a questão da indicação de ecocardiograma considerando, por um lado, o baixo risco das lesões detectadas e, por outro, o caráter resolutivo de um ambulatório de referência.
