[Congenital immature teratomas. Two case reports]. / Vrozhdennye nezrelye teratomy. Opisanie dvukh nablyudenii.

Teratomas belong to a group of germ cell tumors and consist of tissues that are derived from 3 germ layers. The localization of teratomas is extremely diverse. The main task of a morphological study is to diagnose the type of teratoma. According to the WHO classification, there are mature and immature teratomas (ICD-O codes 9080/0 and 9080/3, respectively). It is deemed that the disease prognosis does not depend on the composition of mature tissue components. This paper describes two sectional observations of congenital immature teratomas in a premature live birth infant and a stillborn one. One teratoma, such as epignathus, is a very rare tumor in localization. Emphasis is laid on the need for a thorough teratoma morphological study that defines the tactics of patient management. The described observations demonstrate the importance of timely prenatal diagnosis and an interdisciplinary approach, as well as the need for clear routing of patients with diagnosed fetal space-occupying lesions.

Using heated humidified high-flow nasal cannulas for premature infants may result in an underestimated amount of water reaching the airways.

AIM: Condensation often occurs when providing humidified respiratory support. We examined conditions conducive to excess water formation in heated humified high-flow nasal cannula (HHHFNC). METHODS: An HHHFNC device, at 35 or 37°C, was attached with a nasal cannula to a reservoir and tested in five ambient conditions and flows. For Group A, tubing and collection bottle remained at room temperature (23°C). Group B, tubing and reservoir remained inside an incubator (31°C). Group C, tubing and reservoir remained at 33°C. In Group D, the HHHFNC was set to 35°C, the reservoir remained at 33°C, and the nasal cannula and tubing remained at 23°C. Group E, same as D, with HHHFNC at 37°C. RESULTS: The largest amounts of collected water were in groups A and E. Both had highest temperature differences. Median (range) was 4.9°C (4.1-6.9) and 4.0°C, collecting 38.4 (26.4-50.4) and 26.4 (19.2-50.4) ml/24 h, respectively. Smallest amounts of water were seen with lower temperature differences as in groups B, C, and D with 2.7 (1.9-4.7), 1.6 (1.2-2.1), and 2.0°C with 8.4 (0.0-33.6), 2.4 (0.0-14.4), and 9.6 (4.8-16.8) ml/24 h, respectively. CONCLUSION: HHHFNC devices may produce clinically significant amounts of water reaching the upper airways. This may be prevented with appropriate device set-up.

Vivências paternas em UTI neonatal / Paternal experiences in a neonatal intensive core unit

Considerando-se a escassez de estudos sobre o papel do pai em situações do âmbito da saúde, investigou-se a experiência paterna durante o período de internação de recém-nascido prematuro na Unidade de Terapia Intensiva Neonatal (UTIN), entrevistando-se 5 pais com filhos internados em UTIN de hospital público. Os relatos foram submetidos a análise de conteúdo. Ficaram evidentes manifestações de interesse e envolvimento dos pais em relação à situação de seus recém-nascidos. Ter o filho internado em UTIN pela primeira vez traz sofrimento para os pais que buscam se adaptar à nova situação, reorganizando ativamente suas atividades cotidianas. Os dados indicaram ser necessário considerar transformações nos papéis parentais, admitindo a eqüidade de gênero nos setores de saúde reprodutiva e neonatologia/pediatria. Estudos adicionais sobre o pai em tal contexto e em contextos similares poderão respaldar novas práticas, acrescentando inovações à tradição de enfatizar apenas relações mães-bebês, atribuindo cuidados e responsabilidades exclusivamente às mães.(AU)

Considering few studies on the role of the father in healthcare situations, the paternal experience during the period of treatment of a premature, newborn child in a Neonatal Intensive Care Unit (NICU) was investigated. Five fathers with children undergoing treatment in a NICU of a public hospital were interviewed. The reports were submitted to content analysis. Manifestation of interest and paternal involvement in relation to the situation of their newborn infants were evident. Having the child treated in a NICU for the first time brings suffering for the fathers who are trying to adapt to the new situation, actively reorganizing their daily activities. The data indicated the need to consider transformations in the parental roles, admitting the gender equity in reproductive health and neonatology/pediatrics. Additional studies of fathers in such a contexts might reinforce new practices and bring innovations to the tradition of emphasizing only mother-baby relationships and of attributing care and responsibility exclusively to mothers.(AU)