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1.
Braz J Med Biol Res ; 40(6): 779-86, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17581675

RESUMO

Polymorphisms and mutations in the surfactant protein B (SP-B) gene have been associated with the pathogenesis of respiratory distress syndrome (RDS). The objective of the present study was to compare the frequencies of SP-B gene polymorphisms between preterm babies with RDS and healthy term newborns. We studied 50 preterm babies with RDS (inclusion criteria - newborns with RDS and gestational age between 28 and 33 weeks and 6 days), and 100 healthy term newborns. Four SP-B gene polymorphisms were analyzed: A/C at nucleotide -18, C/T at nucleotide 1580, A/G at nucleotide 9306, and G/C at nucleotide 8714, by PCR amplification of genomic DNA and genotyping by cRFLP. The healthy newborns comprised 42 female and 58 male neonates; 39 were white and 61 non-white. The RDS group comprised 21 female and 29 male preterm neonates; 28 were white and 22 non-white. Weight ranged from 640 to 2080 g (mean: 1273 g); mean gestational age was 31 weeks and 2 days (range: 28-33 weeks and 6 days). When white children were analyzed separately, a statistically significant difference in the G/C polymorphism at 8714 was observed between groups (P = 0.028). All other genotype frequencies were similar for both groups when sex and race were analyzed together. Analysis of the SP-B polymorphism G/C at nucleotide 8714 showed that among white neonates the GG genotype was found only in the RDS group at a frequency of 17% and the GC genotype was more frequently found in healthy term newborns. These data demonstrate an association of GG genotype with RDS.


Assuntos
Genótipo , Polimorfismo Genético , Proteína B Associada a Surfactante Pulmonar/genética , Síndrome do Desconforto Respiratório do Recém-Nascido/genética , Estudos de Casos e Controles , Estudos Transversais , Feminino , Frequência do Gene/genética , Marcadores Genéticos/genética , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Estudos Prospectivos
2.
Braz. j. med. biol. res ; 40(6): 779-786, June 2007. graf
Artigo em Inglês | LILACS | ID: lil-452684

RESUMO

Polymorphisms and mutations in the surfactant protein B (SP-B) gene have been associated with the pathogenesis of respiratory distress syndrome (RDS). The objective of the present study was to compare the frequencies of SP-B gene polymorphisms between preterm babies with RDS and healthy term newborns. We studied 50 preterm babies with RDS (inclusion criteria - newborns with RDS and gestational age between 28 and 33 weeks and 6 days), and 100 healthy term newborns. Four SP-B gene polymorphisms were analyzed: A/C at nucleotide -18, C/T at nucleotide 1580, A/G at nucleotide 9306, and G/C at nucleotide 8714, by PCR amplification of genomic DNA and genotyping by cRFLP. The healthy newborns comprised 42 female and 58 male neonates; 39 were white and 61 non-white. The RDS group comprised 21 female and 29 male preterm neonates; 28 were white and 22 non-white. Weight ranged from 640 to 2080 g (mean: 1273 g); mean gestational age was 31 weeks and 2 days (range: 28-33 weeks and 6 days). When white children were analyzed separately, a statistically significant difference in the G/C polymorphism at 8714 was observed between groups (P = 0.028). All other genotype frequencies were similar for both groups when sex and race were analyzed together. Analysis of the SP-B polymorphism G/C at nucleotide 8714 showed that among white neonates the GG genotype was found only in the RDS group at a frequency of 17 percent and the GC genotype was more frequently found in healthy term newborns. These data demonstrate an association of GG genotype with RDS.


Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Genótipo , Polimorfismo Genético , Proteína B Associada a Surfactante Pulmonar/genética , Síndrome do Desconforto Respiratório do Recém-Nascido/genética , Estudos de Casos e Controles , Estudos Transversais , Frequência do Gene/genética , Marcadores Genéticos/genética , Recém-Nascido Prematuro , Estudos Prospectivos
4.
J Hum Hypertens ; 20(9): 679-83, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16710286

RESUMO

An increase in the survival of neonates with antenatal diagnosis of malformations was achieved by the recent technical advances in neonatal intensive care units. The aim of this article is to describe the experience with neonatal arterial hypertension, in newborns with nephro-urological malformations, in a tertiary care referral Nursery, in a period of 4 years. Newborn medical records from the Nursery Annex to the Maternity of Hospital das Clinicas, School of Medicine, University of Sao Paulo, with the diagnosis of nephro-urological malformations and systemic arterial hypertension (SAH) at hospital discharge, in a period from January 1999 to January 2003, were retrospectively analysed. Among 10.278 live newborns in the studied period, 15 (0.15%) newborns were compatible with our inclusion criteria. Of these 15 newborns, 12 (80%) were male and three were premature (20%). In relation to aetiology, 13 (87%) showed urological malformations, 1 (6%) chronic renal insufficiency secondary to kidney dysplasia and one (6%) autosomal recessive polycystic kidney disease. SAH control was achieved with monotherapy in eight patients (53%), five patients (33%) needed an association of two drugs (calcium-channel blocker and angiotensin converting enzyme (ACE) inhibitor), one child used three types of antihypertensive drugs (calcium-channel blocker, ACE inhibitor and hydrochlorothiazide) for pressoric control and one child's blood pressure (BP) was controlled exclusively by peritoneal dialysis. The incidence of nephro-urological malformations in our service during the studied period was 0.89%. SAH incidence among these newborns was 19%. Our data reinforce previous studies pointing to the necessity to consider children with nephro-urological malformations as a risk group for SAH, who should have the BP evaluated since the neonatal period.


Assuntos
Hipertensão/complicações , Sistema Urinário/anormalidades , Sistema Urinário/irrigação sanguínea , Feminino , Hospitais , Humanos , Hipertensão/sangue , Hipertensão/congênito , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Sistema Urinário/metabolismo
5.
J Matern Fetal Neonatal Med ; 17(1): 55-8, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15804788

RESUMO

OBJECTIVE: The aim of this study was to determine pharmacokinetic parameters after subcutaneous administration of a single dose (400 IU/kg) of lyophilized recombinant human erythropoietin-alpha (rhEPOalpha) to preterm newborns. The parameters determined were: maximum concentration (C(max)), time to reach maximum concentration (T(max)), absorption half-life (t(l/2abs)), volume of distribution (Vd), elimination half-life (t(l/2el)), clearance (C(L)), constant of elimination (k(el)) and area under the 0-72 h curve (AUC(0-72). METHODS: The study group comprised 20 premature newborns (eight males and 12 females) delivered in the Teaching Hospital, University of São Paulo. The inclusion criteria were birth weight < 1500 g or gestational age < or = 34 weeks, and clinical and hemodynamic stability. Serum erythropoietin (EPO) concentration was determined before and 1, 4, 6, 12, 24,48 and 72 h after subcutaneous administration of 400 IU/kg rhEPOalpha, and the pharmacokinetic parameters were calculated. RESULTS: There was a significant difference in serum EPO concentration between t72 and t0 (p = 0.001). Mean values (range) of the pharmacokinetic parameters were as follows: C(max), 739.8 (188.0-1390.0) mIU/ml; T(max), 7.7 (4.0-12.0) h; t(l/2abs), 2.9 (0.8-4.8) h, V(d), 0.705 (0.23-1.73) 1/kg; t(l/2e1), 14.9 (8.7-36.1) h; C(L), 0.032 (0.014-0.066) 1/h; k(el), 0.0475 (0.0200-0.0700); and AUC(0-72), 19058.2 (7648.0-34701.5) mIU/ml per h. The Spearman test showed no correlation between the pharmacokinetic parameters analyzed and the characteristics of the population studied. CONCLUSIONS: Studies evaluating the effectiveness of therapy with recombinant human erythropoietin in premature newborns have used various doses, administered at intervals between 24 and 48 h. The kinetics of absorption measured in our study supports the use of 400 IU/kg within an interval of no less than 72 h, together with therapeutic control of the drug and evaluation of the erythropoietic response.


Assuntos
Eritropoetina/administração & dosagem , Eritropoetina/farmacocinética , Recém-Nascido/metabolismo , Recém-Nascido Prematuro/metabolismo , Absorção , Área Sob a Curva , Relação Dose-Resposta a Droga , Eritropoetina/sangue , Feminino , Liofilização , Meia-Vida , Humanos , Injeções Subcutâneas , Masculino , Concentração Osmolar , Proteínas Recombinantes , Fatores de Tempo
6.
Int J Clin Pract ; 58(5): 536-8, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15206516

RESUMO

A 13-year-old girl with cirrhosis and cyanotic heart disease was admitted with a three-day history of pneumonia. The chest roentgenogram revealed left-sided pleural effusion and cultures from the pleural fluid yielded Listeria monocytogenes. The authors discuss the epidemiologic, clinical, and pathophysiological aspects of L. monocytogenes pneumonia and its association with cirrhosis.


Assuntos
Listeriose/complicações , Cirrose Hepática/complicações , Derrame Pleural/microbiologia , Pneumonia Bacteriana/complicações , Adolescente , Amicacina/uso terapêutico , Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Feminino , Humanos , Listeria monocytogenes , Listeriose/tratamento farmacológico , Pneumonia Bacteriana/tratamento farmacológico
7.
J Matern Fetal Neonatal Med ; 14(3): 187-96, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-14694974

RESUMO

OBJECTIVES: The aim of this study was to perform a comparative analysis of the clinical outcome, gasometric course and ventilatory indices of premature infants with a gestational age of < or = 34 weeks who were intubated in the delivery room, owing to respiratory insufficiency, according to whether or not they were submitted to porcine-derived lung surfactant therapy within the first hour of life. METHODS: The study was randomized and controlled. A total of 75 premature infants were classified into two groups: group A, comprising 35 neonates who were submitted to surfactant within the first hour of life; and group B, comprising 40 neonates who were not submitted to surfactant within the first hour of life. RESULTS: Exogenous surfactant therapy after establishment of respiratory distress syndrome (RDS) was necessary in eight neonates of group A (22.9%) and 31 neonates of group B (77.5%) (p < 0.001). The neonates in group A presented higher levels in relation to group B for the variables: partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) and PaO2/partial pressure of alveolar oxygen (PAO2), while neonates in group B presented higher levels for FiO2, PAO2 and difference D(A - a)O2 in relation to group A. Weight affected the oxygenation index (OI) parameter, in that neonates with lower weight presented greater values of the OI. CONCLUSIONS: In premature infants with established RDS, the need for exogenous surfactant was lower in the group that received surfactant within the first hour of life. Furthermore, the gasometric parameters and ventilatory indexes presented a better course in the first 24 h of life among premature infants who received exogenous surfactant within the first hour of life, in relation to those who did not.


Assuntos
Produtos Biológicos/uso terapêutico , Salas de Parto , Recém-Nascido Prematuro , Intubação Intratraqueal , Fosfolipídeos/uso terapêutico , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Feminino , Humanos , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Masculino , Troca Gasosa Pulmonar/efeitos dos fármacos , Troca Gasosa Pulmonar/fisiologia , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
8.
J Matern Fetal Neonatal Med ; 13(5): 341-50, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12916686

RESUMO

OBJECTIVES: To determine the prevalence of lower respiratory tract infection due to respiratory viruses in the neonatal period at admission to the neonatal intensive care unit and to compare the clinical, laboratory and radiological aspects of the clinical course, according to the etiological agent, in the neonatal period. METHODS: Ninety newborns were studied, from January 1999 to January 2001, with bronchiolitis and/or pneumonia. The newborns were classified into three groups, according to the etiological agent identified initially: viral infection (group A), mixed viral-bacterial infection (group B), and bacterial infection (group C). RESULTS: The virus was identified in 72 newborns (80.0%); the most prevalent was respiratory syncytial virus (RSV) (44.4%), followed by influenza A virus (22.2%). Coughing, wheezing and an interstitial infiltrate were significantly more frequent in newborns with viral infection. Mixed infection was more associated with sepsis. There was a correlation between viral infection and low values of initial and subsequent white blood cell count and C-reactive protein. RSV was the most important virus in these patients. CONCLUSIONS: It was observed that, although the majority of viral respiratory infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial infection.


Assuntos
Bronquiolite/virologia , Pneumonia/virologia , Vírus/isolamento & purificação , Peso ao Nascer , Bronquiolite/epidemiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Masculino , Orthomyxoviridae/isolamento & purificação , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/virologia , Pneumonia/epidemiologia , Pneumonia/microbiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prevalência , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/isolamento & purificação
9.
Rev Hosp Clin Fac Med Sao Paulo ; 56(2): 59-62, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11460206

RESUMO

We report the case of a one-day-old newborn infant, female, birth weight 1900 g, gestational age 36 weeks presenting with necrotizing fasciitis caused by E. coli and Morganella morganii. The newborn was allowed to fall into the toilet bowl during a domestic delivery. The initial lesion was observed at 24 hours of life on the left leg at the site of the venipuncture for the administration of hypertonic glucose solution. Despite early treatment, a rapid progression occurred resulting in a fatal outcome. We call attention to the risk presented by this serious complication in newborns with a contaminated delivery, and highlight the site of the lesion and causal agents.


Assuntos
Fasciite Necrosante/microbiologia , Parto Domiciliar , Dermatoses da Perna/microbiologia , Escherichia coli , Fasciite Necrosante/patologia , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Dermatoses da Perna/patologia , Morganella morganii
10.
Rev Assoc Med Bras (1992) ; 47(1): 52-8, 2001.
Artigo em Francês | MEDLINE | ID: mdl-11340451

RESUMO

UNLABELLED: PURPOSES AND METHODS: The aims of this study were: to detect moderate to profound hearing loss in high risk infants for deafness, to follow up their auditory development (localization of the sound source- Hear Kit - Downs, 1984); and their neuropsychomotor development during the two first years of life. All subjects were submitted to cerebral ultra sound assessment. RESULTS: An infant with a suspected hearing loss was identified and nine infants presented neuropsychomotor development delay. In a transversal analysis of the hearing assessment data it was verified that infants in this study presented different response than the referred in the American literature. CONCLUSIONS: It was concluded that 5% of the infants were delayed in localizing the sound source. Medical peech and hearing follow up during the two first years of life of high risk infants for deafness is important and advisable.


Assuntos
Transtornos da Percepção Auditiva/diagnóstico , Transtornos da Audição/diagnóstico , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido Prematuro , Transtornos Psicomotores/diagnóstico , Transtornos da Percepção Auditiva/etiologia , Feminino , Seguimentos , Transtornos da Audição/etiologia , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos , Transtornos Psicomotores/etiologia , Fatores de Risco , Crânio/diagnóstico por imagem , Ultrassonografia
11.
Rev Hosp Clin Fac Med Sao Paulo ; 56(1): 17-24, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11378679

RESUMO

UNLABELLED: A prospective study was conducted to determine if standardized vancomycin doses could produce adequate serum concentrations in 25 term newborn infants with sepsis. PURPOSE: The therapeutic response of neonatal sepsis by Staphylococcus sp. treated with vancomycin was evaluated through serum concentrations of vancomycin, serum bactericidal titers (SBT), and minimum inhibitory concentration (MIC). METHOD: Vancomycin serum concentrations were determined by the fluorescence polarization immunoassay technique, SBT by the macro-broth dilution method, and MIC by diffusion test in agar. RESULTS: Thirteen newborn infants (59.1%) had adequate peak vancomycin serum concentrations (20 - 40 mg/mL) and one had peak concentration with potential ototoxicity risk (>40 microg/mL). Only 48% had adequate trough concentrations (5 - 10 mg/mL), and seven (28%) had a potential nephrotoxicity risk (>10 microg/mL). There was no significant agreement regarding normality for peak and trough vancomycin method (McNemar test : p = 0.7905). Peak serum vancomycin concentrations were compared with the clinical evaluation (good or bad clinical evolution) of the infants, with no significant difference found (U=51.5; p=0.1947). There was also no significant difference between the patients' trough concentrations and good or bad clinical evolution (U = 77.0; p=0.1710). All Staphylococcus isolates were sensitive to vancomycin according to the MIC. Half of the patients with adequate trough SBT (1/8), also had adequate trough vancomycin concentrations and satisfactory clinical evolution. CONCLUSIONS: Recommended vancomycin schedules for term newborn infants with neonatal sepsis should be based on the weight and postconceptual age only to start antimicrobial therapy. There is no ideal pattern of vancomycin dosing; vancomycin dosages must be individualized. SBT interpretation should be made in conjunction with the patient's clinical presentation and vancomycin serum concentrations. Those laboratory and clinical data favor elucidation of the probable cause of patient's bad evolution, which would facilitate drug adjustment and reduce the risk of toxicity or failing to achieve therapeutic doses.


Assuntos
Antibacterianos/administração & dosagem , Sepse/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Vancomicina/administração & dosagem , Esquema de Medicação , Humanos , Recém-Nascido , Testes de Sensibilidade Microbiana , Estudos Prospectivos , Teste Bactericida do Soro , Estatísticas não Paramétricas
12.
Rev. Assoc. Med. Bras. (1992) ; 47(1): 52-58, jan.-mar. 2001. ilus, graf, tab
Artigo em Português | LILACS | ID: lil-298630

RESUMO

OBJETIVOS E MéTODOS: Este estudo teve como objetivos detectar a presença de deficiência auditiva (DA) de moderada a profunda em 60 lactentes de baixo peso ao nascimento, e na ausência desta, acompanhar o desenvolvimento da funçäo auditiva (localizaçäo da fonte sonora), e acompanhar o desenvolvimento neuropsicomotor destas crianças durante os dois primeiros anos de vida, através da avaliaçäo comportamental da audiçäo (Hear Kit, Downs - 1984), avaliaçäo clínica do desenvolvimento neuropsicomotor e ultra-sonografia de crânio. RESULTADOS: Os resultados obtidos mostraram que dos 60 lactentes, em um caso foi levantada a hipótese de DA e em nove crianças foi verificado atraso no desenvolvimento neuropsicomotor. Na análise transversal dos dados obtidos da avaliaçäo auditiva, verificou-se que o comportamento auditivo dos lactentes apresentou respostas diferentes do que aquelas citadas na literatura americana. CONCLUSAO: Concluiu-se que 5 por cento dos lactentes apresentaram atraso na localizaçäo auditiva da fonte sonora e que os atendimentos médico e fonoaudiológico precoces, no berçário e ambulatório, nos dois primeiros anos de vida destas crianças de alto - risco säo necessários


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Transtornos da Percepção Auditiva/diagnóstico , Transtornos da Audição/diagnóstico , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Transtornos Psicomotores/diagnóstico , Transtornos da Percepção Auditiva/etiologia , Seguimentos , Transtornos da Audição/etiologia , Estudos Prospectivos , Transtornos Psicomotores/etiologia , Fatores de Risco , Crânio
13.
J Pediatr (Rio J) ; 77(3): 243-8, 2001.
Artigo em Português | MEDLINE | ID: mdl-14647590

RESUMO

OBJECTIVES: To present the clinical outcome of a newborn with severe respiratory distress secondary to meconium aspiration syndrome and treated by extracorporeal membrane oxygenation (ECMO); and to present the effect of the use of exogenous surfactant in this case and the cost of the procedure. METHODS: Case report of a newborn with meconium aspiration syndrome and treated at the neonatal ICU of the Instituto da Criança Prof. Pedro de Alcantara, Hospital das Clínicas of the Universidade de São Paulo. RRESULTS: ECMO was carried out for 5 days with no clinical or mechanical complications. On the 4th day of ECMO, we administered porcine exogenous surfactant; a significant improvement in lung compliance was observed and the newborn was decannulated shortly after that. Treatment costs were compatible with the situation of healthcare in Brazil for treatment of critically ill newborn patients. CONCLUSIONS: ECMO is indicated in cases of neonatal respiratory distress not responding to other treatments. The technique should be made available in neonatal Intensive Care Units (ICUs) of tertiary hospitals according to well-established protocols. The use of exogenous surfactant apparently allowed for earlier decannulation of the patient and should be considered in similar cases. The treatment costs do justify the organizing of ECMO teams in this type of ICUs.

15.
J Pediatr (Rio J) ; 77 Suppl 1: S104-14, 2001 Jul.
Artigo em Português | MEDLINE | ID: mdl-14676898

RESUMO

OBJECTIVE: To describe the current rationale for the transfusion of blood, blood components, and plasma derivatives in term and preterm infants. SOURCES: Selection of relevant medical articles published within the last ten years. SUMMARY OF THE FINDINGS: Peculiar characteristics and special care concerning exchange transfusion, transfusion of red blood cells, platelets, granulocytes, and fresh frozen plasma were described. The recommendations for the use of hematopoietic growth factors, and plasma derivatives such as fibronectin, immunoglobulins, and albumin were also evaluated. CONCLUSIONS: The authors comment on the recommendations and contraindication of blood transfusions, and warn against the limitations and hazards involved.

16.
Arq Neuropsiquiatr ; 58(3A): 736-40, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10973119

RESUMO

Citrobacter diversus is closely related to brain abscess in newborn infants. We describe a case of brain abscess by this bacteria in a newborn infant and his clinical and cranial computed tomographic evaluation until the fourth month of life and discuss therapeutic management of this patient.


Assuntos
Abscesso Encefálico/microbiologia , Citrobacter , Infecções por Enterobacteriaceae/complicações , Meningites Bacterianas/microbiologia , Seguimentos , Humanos , Lactente , Masculino , Tomografia Computadorizada por Raios X
17.
Artigo em Inglês | MEDLINE | ID: mdl-10881073

RESUMO

OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997) including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability), or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration. RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9%) and Group II, n = 19 (31.1%). The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter) were more frequent in Group II (p<0.05). Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.


Assuntos
Infecções Urinárias/etiologia , Cateterismo/efeitos adversos , Feminino , Humanos , Recém-Nascido , Masculino , Nutrição Parenteral/efeitos adversos , Teste de Radioimunoadsorção , Estudos Retrospectivos , Fatores de Risco
19.
Rev. Assoc. Med. Bras. (1992) ; 45(4): 303-11, out.-dez. 1999. ilus, tab, graf
Artigo em Português | LILACS | ID: lil-247422

RESUMO

A infecção por C. trachomatis é adquirida pelo recém-nascido (RN) principalmente durante sua passagem pelo canal parto; 25 por cento a 50 por cento destes deverão desenvolver conjuntivite e 10 por cento a 20 por cento pneumonia. Objetivos. Verificar a incidência de infecção ocular por C. trachomatis nos RN internados com diagnóstico de conjuntivite, num período de 10 anos. - Observar a associação entre infecção ocular é pneumonia intersticial - Estudar os aspectos epidemiológicos e os métodos utilizados para o diagnóstico laboratorial. Casuística e Metodologia. Foram analisados os RN internados com diagnóstico de conjuntivite e/ ou pneumonia interticial internados na UCINE no período de 1987-1998. Os métodos de diagnóstico utilizados foram: a pesquisa direta do agente etiológico em raspado de conjuntiva, radiografia de tórax, sorologia para C. trachomatis no sangue pelo método de imunofluorescência para anticorpos IgG e IgM. Resultados. Estudamos as características de 20 RN que apresentaram infecção por C. trachomatis: 15 eram de termo (75 por cento) e cinco, pré-termos (25 por cento); houve predominância da infecção no sexo feminino (60 por cento); a pneumonia esteve presente em 15 dos 20 RN (75 por cento) e 12 apresentaram associação de conjuntivite e pneumonia. Não houve relação significante entre tipo de parto, idade materna, número de parceiros e a infecção, sendo que o antecedente materno de leucorreia esteve presente em 50 por cento dos casos. O diagnóstico sorológico esteve relacionado com a presença de pneumonia e a pesquisa direita com a conjuntivite. A incidência de conjuntivite por C. trachomatis entre os RN internados com esse diagnóstico durante o período de estudo foi de 17/100 (17 por cento). Conclusões. A. C. trachomatis é um importante agente patogênico e sua pesquisa é muito importante em RN com conjuntivite e/ou pneumonia intersticial mesmo na ausência de fatores de risco para doença sexualmente transmissível. A pesquisa direta em raspado de conjuntiva e o exame sorológico se mostraram importantes como métodos auxiliares do diagnóstico.


Assuntos
Feminino , Humanos , Recém-Nascido , Chlamydia trachomatis/isolamento & purificação , Conjuntivite de Inclusão/epidemiologia , Conjuntivite de Inclusão/transmissão , Doenças Pulmonares Intersticiais/epidemiologia , Infecções por Chlamydia/diagnóstico , Conjuntivite de Inclusão/complicações , Conjuntivite de Inclusão/diagnóstico , Incidência , Transmissão Vertical de Doenças Infecciosas , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/diagnóstico , Estudos Retrospectivos , Fatores de Risco
20.
Early Hum Dev ; 56(1): 1-15, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10530902

RESUMO

The authors report a prospective study of correlation between histopathological alterations of the placenta, risk factors and early-onset bacterial infections in 224 premature newborns. They used a mathematical model for evaluation and prediction of neonatal bacterial infection according to the localization in chorioamniotic tissues (chorioamniotic plate, amniotic membranes and umbilical cord) invaded by leukocytes. Septicemia, pneumonia or omphalitis were documented in 45 (20%) infected premature newborns and inflammatory lesions in the placenta were observed in all of them. In order of statistical significance, the most important variables for early-onset bacterial neonatal infection were invasion of the chorioamniotic plate, amniotic membranes and umbilical cord tissues by PMNL (P < 0.0000), premature rupture of membranes (P < 0.0000), birthweight lower than 1500 g (P < 0.0000), gestational age under 34 weeks (P < 0.0001), foul smell (P < 0.0038), no antibiotics before delivery (P < 0.0066) and intrapartum fever (P < 0.0087). By logistic stepwise multiple regression analysis, invasion of fetal chorioamniotic plate and of amniotic membranes by leukocytes were the only statistically significant variables. The probability of neonatal infection in premature newborns, when polymorphonuclear neutrophils were present in chorioamniotic plate and in amniotic membranes, was 62.5%, while the probability was 0.5% when these tissues were normal. These data suggest that histological chorioamnionitis has to be considered as an important risk factor for early-onset infection in premature newborns.


Assuntos
Infecções Bacterianas/patologia , Corioamnionite/patologia , Doenças do Prematuro/patologia , Recém-Nascido Prematuro , Neutrófilos/patologia , Idade de Início , Âmnio/microbiologia , Âmnio/patologia , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Bacteriemia/patologia , Bactérias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Corioamnionite/epidemiologia , Corioamnionite/microbiologia , Córion/microbiologia , Córion/patologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/microbiologia , Masculino , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/microbiologia , Pneumonia Bacteriana/patologia , Gravidez , Estudos Prospectivos , Fatores de Risco , Umbigo/microbiologia , Umbigo/patologia
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