ABSTRACT
INTRODUCTION: Due to growing evidence suggesting COVID-19 may have a benign course in the newborn, a number of guidelines supporting rooming-in and breastfeeding were developed. The main aim of the study was to assess the safety of this approach, through the risk of developing severe neonatal infection. MATERIAL AND METHODS: Prospective observational study from April 2020 to February 2021 on the approach and neonatal follow-up of infants born to mothers with COVID-19 at the time of delivery in a hospital with advanced neonatal care, where rooming in and breastfeeding were promoted whenever possible. We collected data during hospital admission and over the phone during the neonatal period. RESULTS: We included 77 infants born to mothers with COVID-19 (3.8% of newborns born during the time of study), median gestational age 39 weeks + 5 days and median birth weight 3270 g; 9% were born premature (versus 12% born premature among newborns born during the time of study). Rooming-in took place in all of them although 4% were briefly admitted to the Neonatal Intensive Care Unit; 88% were discharged home up to day three, 97% were breastfed at the time of discharge and 90% were still breastfed by the end of the neonatal period. We completed neonatal follow-up of 63 newborns, eight of them developed COVID-associated symptoms, three with need of medical evaluation; 40% had no medical assessment after being discharged. Out of 77, 5% of infants were infected with SARS-CoV-2 (total of four, one mild, three asymptomatic), with no significant differences during hospital stay or follow-up. DISCUSSION: Neonatal infection was uncommon and mild, and there was no increase in prematurity. Rooming-in and breastfeeding were safe and should be promoted whenever clinically possible. Follow-up care after hospital discharge needs improvement. CONCLUSION: Infants born to mothers with COVID-19 were safely roomed in with their mothers and exclusively breastfed.
Introdução: Dada a evidência crescente de maior benignidade da COVID-19 no recém-nascido, surgiram recomendações de promoção do alojamento conjunto e da amamentação. O principal objetivo do estudo foi avaliar a segurança dessa abordagem, através do risco de infeção neonatal grave.Material e Métodos: Estudo observacional prospetivo de abril 2020 a fevereiro 2021 da abordagem hospitalar e seguimento após a alta dos recém-nascidos de mãe com COVID-19 num hospital com apoio perinatal diferenciado, onde foram advogados o alojamento conjunto e amamentação, sempre que possível. Recolhemos os dados no internamento e em seguimento telefónico durante o período neonatal.Resultados: Incluímos 77 recém-nascidos de mãe com COVID-19 (3,8% do total de recém-nascidos), com medianas de idade gestacional 39 semanas e 5 dias e 2370 g de peso à nascença; destes, 9% nasceram pré-termos (versus 12% pré-termos no total de recém-nascidos). Todos estiveram em alojamento conjunto e 4% foram admitidos transitoriamente na Unidade de Cuidados Intensivos Neonatais; um total de 88% recém-nascidos tiveram alta até ao terceiro dia de vida, 97% tiveram alta sob aleitamento materno e 90% mantinham-no no fim do período neonatal. Dos 63 recém-nascidos com seguimento telefónico completo, oito tiveram sintomas compatíveis com COVID-19, três dos quais com observação médica. Em 40% dos casos não houve consulta médica de vigilância após a alta. Houve 5% recém-nascidos com COVID-19 (num total de quatro, registámos um quadro ligeiro e três assintomáticos), sem particularidades no internamento ou seguimento.Discussão: A infeção neonatal foi incomum, não houve quadros graves nem maior incidência de prematuridade. O alojamento conjunto e a amamentação foram práticas seguras, devendo ser promovidas desde que clinicamente possível. Destacamos que a vigilância de saúde após a alta necessita de ser melhorada.Conclusão: Os recém-nascidos de mãe com COVID-19 podem ser mantidos em alojamento conjunto e sob aleitamento materno exclusivo.
Subject(s)
Breast Feeding , COVID-19 , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Mothers , SARS-CoV-2ABSTRACT
Objective A novel technique is described for transpalatal hypophysectomy as an option for sellar region surgery using a microscope and/or endoscope. Technique A straight submucosal tunnel (approximately 20 mm in diameter; 40-50 mm long-half the length required by conventional transsphenoidal hypophysectomy) is dissected in favorable alignment with the main tumor axis, providing a direct view that allows the surgeon to operate on large suprasellar tumors, even in cases of extra-axial expansion. Results In a 25-year period, over 50 patients benefited from this surgery. Macroadenomas devoid of extra-axial expansions were totally excised (76.5%), otherwise, partially (23.5%). Forty-nine patients (98%) were extubated soon after surgery. Mean surgery duration was 3 hour 32 minute, with 2 days 6 hour before free feeding was restored. Postoperative hospitalization under neurosurgical care averaged 6 days 6 hour. Currently, patients undergoing the procedure do not require nasal tampons and can eat soft foods soon after recovery from anesthesia. Although two patients (3.9%) presented with oronasal fistulae postoperatively, no episodes of severe hemorrhage occurred during surgery and there were no cases of liquoric fistulae, visual impairment, panhypopituitarism, or severe syndrome of inappropriate antidiuretic hormone secretion. Conclusion The new surgical approach is safe, effective, and well accepted by patients, who reported low levels of discomfort. Postsurgical complications or sequela are currently rare, but further operations should be performed using more appropriate materials, instruments, and equipment to allow comparisons with other techniques.
ABSTRACT
OBJECTIVES: To detect the actual prevalence of systemic hypertension in the city of Campo Grande, MS, Brazil, and frequent factors. METHODS: Cross-sectional study with a randomized sample of the adult population of the city of Campo Grande, MS, in a total of 892 individuals. A questionnaire on age, gender, level of education, smoking, alcohol consumption, and aspects of the treatment was applied. Anthropometric data (weight and height) were collected. According to the WHO, a BMI<25 kg/m2 was considered normal weight; 25>BMI<30 overweight; and BMI> 30 obesity. Criteria for hypertension were based on the JNC VII report, with blood pressure cut-off values of 140 x 90 mmHg. RESULTS: The prevalence of hypertension was 41.4%, varying with age (up to 29 years: 11.8%; 30-39: 24.8%; 40-49: 43.3%; 50-59: 42.4%; 60-69: 48.6% and > 70: 62.3%). A higher prevalence was observed among men (51.8%), whereas among women the prevalence was 33.1%. Individuals with basic level of education tended to present higher rates. Among overweight and obese individuals, a higher prevalence of hypertension was observed: normal BMI (27.9%), overweight (45.6%) and obesity (58.6%). Above 60 years of age, a higher percentage of isolated systolic hypertension was observed, with 16.4% (60-69 years) and 24.6% (>70 years). Daily or weekly alcohol consumption was also related to a higher incidence, of 63.2% and 47.2%, respectively. Only 59.7% were known to be hypertensive. Of the hypertensive individuals, 57.3% were undergoing some type of treatment. Of those undergoing regular treatment, 60.5% presented hypertension. CONCLUSION: The prevalence of hypertension was 41.4%, therefore higher than the average verified in some studies. This calls the attention for worsened epidemiologic conditions and cardiovascular repercussions, thus showing the need for higher public investment on education and orientation of these population groups as regards prevention.
Subject(s)
Hypertension/epidemiology , Adult , Aged , Brazil/epidemiology , Epidemiologic Methods , Female , Humans , Male , Middle AgedABSTRACT
OBJETIVOS: Detectar a real prevalência de hipertensão arterial sistêmica em Campo Grande, MS, e fatores freqüentes. MÉTODOS: Estudo transversal com amostra randomizada da população adulta da cidade de Campo Grande, MS, num total de 892 pessoas. Foi aplicado questionário sobre idade, sexo, escolaridade, tabagismo, etilismo, aspectos sobre o tratamento. Foram colhidos dados antropométricos (peso e altura). Segundo a OMS, foi considerado peso normal: IMC<25 kg/m²; sobrepeso: 25>IMC<30; obeso: IMC> 30. Os critérios para hipertensão foram baseados no VII Joint, com valores de corte de Pressão Arterial de 140 x 90 mmHg. RESULTADOS: A prevalência de hipertensão foi de 41,4 por cento, variando conforme idade (até 29 anos: 11,8 por cento; 30-39: 24,8 por cento; 40-49: 43,3 por cento; 50-59: 42,4 por cento; 60-69: 48,6 por cento e > 70: 62,3 por cento). Houve maior prevalência nos homens (51,8 por cento), enquanto nas mulheres foi de 33,1 por cento. As pessoas com formação escolar de 1° grau primário tendem a apresentar maiores índices pressóricos. Nos indivíduos com sobrepeso e obesidade, observou-se maior prevalência de pressão elevada: IMC normal (27,9 por cento), sobrepeso (45,6 por cento) e obesidade (58,6 por cento). A partir dos 60 anos existe um maior porcentual de hipertensão sistólica isolada, representado por 16,4 por cento (60-69 anos) e de 24,6 por cento (>70 anos). Etilismo diário ou semanal também está relacionado a maior incidência, respectivamente, de 63,2 por cento e 47,2 por cento. Apenas 59,7 por cento eram sabidamente hipertensos. Das pessoas que apresentaram hipertensão, 57,3 por cento fazem algum tratamento. Dos que fazem tratamento regularmente, 60,5 por cento apresentaram hipertensão. CONCLUSÃO: A prevalência de hipertensão foi de 41,4 por cento, ultrapassando a média detectada em alguns trabalhos, alertando para piora epidemiológica e repercussões cardiovasculares, o que evidencia necessidade de maior investimento...
OBJECTIVES: To detect the actual prevalence of systemic hypertension in the city of Campo Grande, MS, Brazil, and frequent factors. METHODS: Cross-sectional study with a randomized sample of the adult population of the city of Campo Grande, MS, in a total of 892 individuals. A questionnaire on age, gender, level of education, smoking, alcohol consumption, and aspects of the treatment was applied. Anthropometric data (weight and height) were collected. According to the WHO, a BMI<25 kg/m² was considered normal weight; 25>BMI<30 overweight; and BMI> 30 obesity. Criteria for hypertension were based on the JNC VII report, with blood pressure cut-off values of 140 x 90 mmHg. RESULTS: The prevalence of hypertension was 41.4 percent, varying with age (up to 29 years: 11.8 percent; 30-39: 24.8 percent; 40-49: 43.3 percent; 50-59: 42.4 percent; 60-69: 48.6 percent and > 70: 62.3 percent). A higher prevalence was observed among men (51.8 percent), whereas among women the prevalence was 33.1 percent.Individuals with basic level of education tended to present higher rates. Among overweight and obese individuals, a higher prevalence of hypertension was observed: normal BMI (27.9 percent), overweight (45.6 percent) and obesity (58.6 percent). Above 60 years of age, a higher percentage of isolated systolic hypertension was observed, with 16.4 percent (60-69 years) and 24.6 percent (>70 years). Daily or weekly alcohol consumption was also related to a higher incidence, of 63.2 percent and 47.2 percent, respectively. Only 59.7 percent were known to be hypertensive. Of the hypertensive individuals, 57.3 percent were undergoing some type of treatment. Of those undergoing regular treatment, 60.5 percent presented hypertension. CONCLUSION: The prevalence of hypertension was 41.4 percent, therefore higher than the average verified in some studies. This calls the attention for worsened epidemiologic conditions and cardiovascular repercussions, thus showing...
