ABSTRACT
To determine the effectiveness and safety of prophylactic phototherapy compared with conventional phototherapy for the prevention of neonatal jaundice. We included clinical trials comparing prophylactic phototherapy to conventional phototherapy to prevent jaundice in premature newborns. We searched Embase, MEDLINE, LILACS, Central, and others. The statistical analysis was performed in RevMan (Review Manager 5.3). Outcomes were analyzed according to the type of variable: risk difference (RD) and mean difference (MD). A random effects model was used due to heterogeneity. We reported results in forest plots. Risk of bias was evaluated, and a sensitivity analysis was made. 1127 articles were found, and six studies (2332 patients) were included in the meta-analysis. Five studies evaluated the need for exchange transfusion as the primary outcome RD -0.01, 95% CI [-0.05 to 0.03]. One study evaluated bilirubin encephalopathy RD -0.04, 95% CI [-0.09 to 0.00]. Five studies evaluated the duration of phototherapy, MD 38.47, 95% CI [1.28 to 55.67]. Four studies evaluated levels of bilirubin (MD -1.23, 95% CI [-2.25 to -0.21]. Two studies evaluated mortality, RD 0.01, 95% CI [-0.03 to 0.04]. As a conclusion, compared to conventional phototherapy, prophylactic phototherapy decreases the last measured level of bilirubin, as well as the probability of neurodevelopmental disturbances. However, it increases phototherapy duration.
ABSTRACT
Introducción: El paso del adolescente con trasplante renal del servicio de pediatría al de adulto se relaciona con aumento en el rechazo y pérdida del injerto renal. Identificar las características de esta población podría ayudar a la hora de poder implementar un proceso de transición adecuado.Objetivo: Identificar las principales características sociodemográficas de los adolescentes con trasplante renal o en protocolo pre-trasplante renal previo a la implementación del programa de transición (STARx).Material y Método: Estudio cuantitativo, descriptivo de corte transversal. Se incluyeron los pacientes entre 11-19 años del servicio de nefrología pediátrica de la Fundación Valle del Lili, obteniendo 31 participantes con trasplante renal y 4 en protocolo pre-trasplante. Una prueba piloto de la encuesta sociodemográfica se aplicó a otro grupo con salud similar. La encuesta fue diseñada específicamente para este estudio. Tras la obtención del consentimiento informado la encuesta fue ajustada y aplicada a la población objeto del estudio.Resultados: El 54% de los adolescentes eran de sexo masculino, el promedio de edad fue 14,3±2,3 años, 23% afrodescendientes, el 65% provenían del Valle del Cauca y el 35% de otros departamentos del suroccidente colombiano. El 65% pertenecían a un nivel socioeconómico. El 44% cursó primaria, 47% secundaria y 9% cursaba educación superior. La madre fue el cuidador principal en el 85% y el 63% de los cuidadores cursó algún grado de secundaria. La enfermedad renal de base fueron las malformaciones congénitas 57%, y el 89% calificó su estado de salud como bueno.Conclusiones: El conocimiento de las características de esta población resulta de gran utilidad para poder llevar a cabo un proceso de transición al pasar del seguimiento en consulta pediátrica a la de adulto. (AU)
Introduction: The transference of the adolescent with a renal transplant from pediatric healthcare to adult healthcare has been related to an increased risk of graft rejection and graft loss. The evidence supports that an adequate transition program reduces the risk of graft rejection and improves clinical outcomes.Objective: Sociodemographic characterization of adolescents with a renal transplant or in pre-transplantation protocol previous to the implementation of a transition program (STARx).Material and Method: Quantitative, descriptive, and cross-sectional study. Patients aged 11 to 19 and registered in the service of pediatric nephrology were enrolled, obtaining 31 participants with a renal transplant and 4 participants in a pre-transplantation protocol. A pilot test of the sociodemographic survey was applied to a different group with a similar health condition. The survey was designed specifically for the study. Then, consent form was acquired and the survey was adjusted and applied to the target population.Results: 54% were male, the average age was 14.3 ±2.3 years, 23% were Afro-descendants, 65% came from the department of Valle del Cauca and 35% from other departments in the southwest of Colombia. The socioeconomic level was low in 65%. Regarding to schooling, 44% attended primary, 47% secondary and 9% attended higher education. The mother was the main caregiver in 85% and 63% of the caregivers attended some grade of secondary education. The underlying kidney disease was congenital anomalies of the kidney and urinary tract (CAKUT) in 57% and 89% rated their health as good.Conclusions: This study generated an appropriation of knowledge and compliance with treatment in adolescents, leading to the second phase of evaluation of the program in an oncoming study. (AU)
