[Normal neonatal cerebral ultrasonography in preterm infants - Is it possible to calm down the parents?] / Ultra-sonografia cerebral neonatal normal no prematuro - é possível tranqüilizar os pais?

OBJECTIVE: To verify the predictive values of neonatal cerebral ultrasonography for motor and cognitive development of very low birth weight preterm babies after twelve months correct age. METHODS: The population studied was a cohort of preterm babies with birth weight less than 1,500g, who had been admitted in the Neonatal Intensive Care Unit of Instituto Fernandes Figueira, and were followed to 12-30 months corrected age for prematurity. A cerebral ultrasonography was performed before discharge. The results were classified as normal and abnormal (parenchymal hemorrhage, porencephaly, periventricular leucomalacia, ventricular dilatation). The babies were followed in the Follow-up Clinic and between 12-30 months correct age they underwent a neurological assessment with observation of the acquisition of motor milestones and submitted to Bayley Scales of Development. RESULTS: We studied 83 babies. Cerebral ultrasonography was normal in 68 babies (81.9%) and abnormal in 15 (18.8%). With a mean age of 21 months, 63 children (75.9%) had normal motor development and 20 (24.0%) had motor abnormalities. The cognitive development was normal in 68 children (81.9%). The negative predictive value of the cerebral ultrasonography for motor development was 85.3%, and for cognitive development, 86.8%. The positive predictive value of the cerebral ultrasonography for motor development was 66.7% and for cognitive development, 42.9%. CONCLUSIONS: The negative predictive values were greater than the positive predictive values in both areas of development. The probability for children with normal neonatal ultrasonography to have normal motor and cognitive development is greater than 85%.

[The predictive value of neonatal neurological assessment and neonatal cranial ultrasonography with respect to the development of very low birth weight premature infants]. / Valores de predição da avaliação neurológica e ultra-sonográfica cerebral neonatal em relação ao desenvolvimento de prematuros de muito baixo peso.

OBJECTIVE: To verify the predictive value of two tests (neurological assessment and ultrasonography) performed at the time of discharge, with respect to the neuromotor and cognitive development of premature infants. METHODS: Seventy very low birth weight premature infants (below 1,500 g), admitted to the Neonatal Department between 1992 and 1994 were studied. The average birth weight and gestation age were, respectively, 1,185 g (SD: 180 g) and 32.2 weeks (SD: 1.4). At the term correct age, neurological assessment by the Dubowitz & Dubowitz method and cerebral ultrasonography were carried out. After discharge, the development was monitored at the follow up clinic. RESULTS: At 21 months correct age (SD: 4.9), neuromotor and cognitive abnormalities were observed, respectively, in 25.7% and 20.3% of the infants evaluated. The neonatal neurological assessment was found to be more sensitive than those specific for neuromotor (sensibility: 77.7%, specificity: 57.6%) and cognitive (sensibility: 78.5%, specificity: 56.4%) abnormalities, and exhibited low predictive value for both neuromotor and cognitive abnormality. Ultrasonography exhibited high specificity with respect to both neuromotor and cognitive development. The cerebral ultrasonography has also a reasonable predictive value for neuromotor abnormality. CONCLUSION: The combination of both tests yielded higher predictive values.

Desempenho de um laser do CO2 nacional para uso em cirurgias otorrinolaringologicas. / Performance of a national CO2 laser for use in otorhinolaryngologic surgery

No presente trabalho, apresentamos os resultados de cirurgias experimentais em mucosa oral de cobaias, realizadas com um laser de CO2 inteiramente construido no Instituto de Fisica da UNICAMP. Mostramos que o efeito da radiacao laser sobre o tecido e fundamentalmente dependente da densidade de energia da radiacao, a qual e inversamente proporcional ao quadrado da distancia focal da lente utilizada para concentracao do feixe laser. No caso, utilizamos lentes de 60 mm e 260 mm e para cada uma utilizamos potencias de 9, 6 e 3 Watt com tempo de exposicao de 1, 0,5 e 0,2 segundos