Factors associated with packed red blood cell transfusions in premature infants in an intensive care unit

This study analyzed the factors that are associated with the need for packed red blood cell transfusions in premature infants in a neonatal intensive care unit. This study is a cross-sectional study of secondary data from premature infants who were admitted to a neonatal intensive care unit between 2008 and 2010. Premature infants with low birth weight were included. Packed red blood cell transfusion was the dependent variable. Pearson's Chi-square or Fisher's exact tests were used for data analysis, and the median, minimum, and maximum values were calculated. Prevalence ratios were calculated using the Poisson regression and Pearson correlation coefficient. Linear regression analyses were performed. P 32 weeks of gestation, and 191% more prevalent in infants who exhibited late-onset neonatal sepsis. The number of transfusions per patient was negatively correlated with gestational age and positively correlated with late-onset neonatal sepsis. A gestational age <32 weeks and late-onset neonatal sepsis explained 45% of the transfusions (p<0.0001). Premature infants with a gestational age <32 weeks and who developed late-onset neonatal sepsis exhibited a greater need for packed red blood cell transfusions

Factors associated with drug use among adolescents

The study aimed to identify factors associated to drug use in adolescents. For this purpose, it has been observed 133 adolescents registred in ninth grade in two municipal schools in Viçosa, who answered an individual questionnaire validated by PAHO / WHO, applied by members of the Uncensored Extension Project of the Federal University of Viçosa (UFV). Substance use and family structure were evaluated. Statistical tools were: Epi-Info 7.0 StatCalc, Pearson's chi-square test, Poisson regression and SPSS version 23.0 and Stata 9.0 programs. The sample had an average of 15 years old, that 26.3% reported drug use, thus, 65,4% related family history of drug use and low education. Other aspects of family structure included: good family perception, absence of violence and family mental disorder by 78.2%, 82.7% and 75.9% of adolescents, respectively. Only males persisted as a factor associated with drug use, with 2.4 times higher use (PR 2.39; 95% IC 1.19-4.78; p = 0.014). Therefore, only the male gender showed a higher risk for drug use, and further studies are needed to evaluate factors associated with drug use, aiming to promote public health

Hospitalizations and deaths of children and adolescents with Severe Acute Respiratory Infection due to COVID-19 during the epidemiological year of 2020

This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of children and adolescents with severe acute respiratory infection (SARI) caused by SARS-CoV-2 nationwide. The study comprised 6,843 children and adolescents hospitalized in 2020 who tested positive for COVID-19, based on data from the Influenza Epidemiological Surveillance Information System. Sociodemographic and clinical profiles, hospitalization frequency, lethality and recovery rates were analyzed. The outcome was recovery or death. The 6,843 children and adolescents comprised 1.9% of SARI hospitalized cases (n = 563,051). Of these, 57.7% developed critical SARI and 90% survived. Comorbidities were present in 40.8%, especially asthma, immunodepression, and neurological and cardiovascular diseases. The main symptoms were fever, cough, dyspnea, respiratory distress, and low oxygen saturation. Among those with critical SARI, 91.4% died. There was a higher frequency of children, especially those under five years of age and of mixed ethnicity. The highest hospitalization frequency occurred in the Southeastern and Northeastern regions, the highest recovery rates in the Southeastern and Southern regions, and the highest lethality rates in the Northern and Northeastern regions. Deaths were associated with ages ranging from 12 to 19 and being under one year of age, living in the Northern and Northeastern regions, progression to critical SARI, and having immunosuppression and cardiovascular disease. In contrast, asthma was associated with lower death rates. The frequency of complications and mortality rates caused by SARS-Cov-2 in the pediatric population are relevant, as well as the severity of the epidemic in the social inequality context and the health services’ frailty

INTERNAÇÕES HOSPITALARES E MORTALIDADE POR SÍNDROME RESPIRATÓRIA AGUDA GRAVE: COMPARAÇÃO ENTRE OS PERÍODOS PRÉ-PANDÊMICO E PANDÊMICO

Objective: To analyze the characteristics and the factors associated with mortality of cases hospitalized for Severe Acute Respiratory Syndrome in a health region, in pre-pandemic and pandemic periods. Methods: A retrospective documentary study of epidemiological surveillance carried out with secondary data from the Influenza Epidemiological Surveillance Information System, regarding the cases of patients belonging to a health region of Minas Gerais, Brazil. Results: During the pandemic period, there was an increase in the number of hospitalizations and deaths due to Severe Acute Respiratory Syndrome, in addition to diferences between socioemographic and clinical-epidemiological characteristics. In both periods, the age and the use of invasive ventilatory support were the predictors of hospital mortality. The mortality in the pandemic period was also associated with male gender, presence of risk factors, admission to an intensive care unit, use of non-invasive ventilatory support and infection by COVID-19. Conclusions: In 2020, the detection rate of Severe Acute Respiratory Syndrome was 21 times higher than in 2019 and new symptoms, such as anosmia and ageusia, were included in their investigation. In both periods evaluated, elderly patients and patients on invasive mechanical ventilation had a higher risk of mortality. With the pandemic, there was a greater number of hospitalizations and factors associated with mortality.Objetivo: Analisar as características e os fatores associados à mortalidade dos casos hospitalizados por Síndrome Respiratória Aguda Grave em uma regional de saúde, nos períodos pré-pandêmico e pandêmico. Métodos: Estudo retrospectivo documental de vigilância epidemiológica realizado com dados secundários provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe, referentes aos casos de pacientes pertencentes a uma regional de saúde de Minas Gerais, Brasil. Resultados: Observou-se, no período pandêmico, aumento do número de hospitalizações e óbitos por Síndrome Respiratória Aguda Grave, além de diferenças entre as características sociodemográficas e clínico-epidemiológicas. Em ambos os períodos, comportaram-se como preditores da mortalidade hospitalar, a idade e o uso de suporte ventilatório invasivo. A mortalidade no período pandêmico se associou também ao sexo masculino, presença de fatores de risco, internação em unidade de terapia intensiva, uso de suporte ventilatório não invasivo e infecção por COVID-19. Conclusões: Em 2020, a taxa detecção de Síndrome Respiratória Aguda Grave foi 21 vezes maior do que em 2019 e novos sintomas, como a anosmia e ageusia, foram incluídos em sua investigação. Nos dois períodos avaliados, pacientes idosos e em ventilação mecânica invasiva apresentaram maior risco de mortalidade. Com a pandemia, houve maior número de hospitalizações e fatores associados à mortalidade

Breastfeeding practices, consumption of ultra-processed foods in complementary feeding and associated factors in premature children

Breastfeeding and a suitable eating plan in the first years of life are crucial for the development of premature children. Early exposure to ultra-processed foods (UPF) can lead to an increased risk of chronic diseases. To analyze premature infants for breastfeeding practices, intake of ultra-processed foods, their health risks and other associated factors. Data on diet and sociodemographic variables were investigated using questionnaires. We used anthropometric assessment according to WHO growth curves and laboratory tests to analyze the lipid profile. From the whole sample, 51% never received exclusive breastfeeding, or received it for less than a single month; 29% received between four and six months; in 84% another food was introduced before six months. After the stratification of consumption between “none/one type” and “more than one type” of UPF, the variables “child's age” and “family history of overweight/obesity” were positively associated. After bivariate and multivariate analyzes, a greater diversity of UPF intake was associated with family income &lt;2 minimum wages and employed mothers. Premature infants are at risk of early weaning and use of AUP before even six months of corrected age

Cooperação entre a universidade pública e a gestão municipal no combate a COVID-19: experiências do serviço de teleatendimento em Viçosa, Minas Gerais

Diante do cenário da COVID-19, representantes da Universidade Federal de Viçosa, Prefeitura Municipal de Viçosa-MG, e outros serviços de saúde do município implementaram o serviço “Telessaúde Covid”. O objetivo é oferecer atendimento e monitoramento por telefone a pacientes residentes em Viçosa-MG. Até 31 de dezembro de 2020, dos 21.286 casos notificados no município, 85,5% foram testados. Após oito meses de funcionamento, o Telessaúde realizou 3.426 novos atendimentos e 2.407 notificações, perfazendo 11,3% do total de notificações do município, e um total de 17.071 atendimentos. O serviço realizado pelo Telessaúde COVID vem contribuindo nesse cenário epidêmico, destacando-se como grande facilitador aos pacientes nesse cenário atual, fazendo com que o paciente se sinta seguro, acolhido e cuidado pelo nosso serviço. Diante da vivência atual, esse serviço permanecerá como facilitador e integrador das ações em saúde como principal missão de colaborar no controle e combate a essa epidemia. Palavras-chave: Coronavírus. Telemedicina. Saúde

Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months

OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age

Análise comparativa entre ecofuncional por pediatra e ecocardiografia compreensiva por cardiologista em unidade de terapia intensiva pediátrica e neonatal

Introduction: Bedside ultrasound performed by a non-imaging specialist has proven to be a useful tool in the diagnostic evaluation and performance of invasive procedures. Several clinical situations favor manifestations of hemodynamic instability, especially in intensive care units. Nowadays, several pediatric units have used functional echocardiography (fECHO) and, often, before the examination by echocardiography performed by a cardiologista (cECHO). Objective: Compare the accuracy of echocardiography performed by a pediatrician (fECHO) and a cardiologist (cECHO) on neonatal and pediatric patients in an intensive care unit. Material and Methods: Retrospective analysis of the medical records of pediatric patients from zero days to 14 years, admitted to the intensive care unit, with a clinical indication for evaluation by comprehensive echocardiography of anatomical cardiac alterations were also evaluated through ecofunctional by a pediatrician. Results: Eight nine patients were admitted from zero days to 14 years, 55 of whom were male, and 34 were female. The respective sensitivity and specificity of fECHO and cECHO were 80% and 96.2% for the persistence of the ductus arteriosus; 88.4% and 98.4% for congenital acyanotic heart disease; 77.7% and 98.7% for congenital cyanotic heart disease; 83.3% and 98.8% for ventricular hypertrophy; 100% and 100% for pericardial effusion; 76.2% and 96.2% for persistent neonatal pulmonary hypertension. Conclusions: The results demonstrate a good accuracy of the pediatrician performing fECHO compared with a examination performed by the cardiologist, which does not reduce the importance and obligation of expert assessment. The incorporation of fECHO in the routine pediatric evaluation allows for the expansion and improvement of the pediatrician's physical examination.Introdução: A ultrassonografia à beira do leito realizada por não especialista em imagem tem mostrado ser uma ferramenta útil na avaliação diagnóstica e realização de procedimentos invasivos. Diversas situações clínicas favorecem manifestações de instabilidade hemodinâmica, principalmente, nas unidades de terapia intensiva. Neste sentido, unidades pediátricas têm utilizado ecocardiografia funcional, muitas vezes, antes do exame realizado por um ecocardiografista. Objetivo: Avaliar a acurácia da ecocardiografia realizada por pediatra comparativamente à realizada por ecocardiografista em pacientes de uma unidade neonatal e pediátrica de tratamento intensivo. Material e Métodos: Análise retrospectiva dos prontuários de pacientes pediátricos de zero dia a 14 anos, internados na unidade de terapia intensiva, com indicação clínica para avaliação da existência de alterações anatômicas por ecocardiografia compreensiva e que também foram avaliados através da ecocardiografia funcional por pediatra. Resultados: Um total de 89 casos foram analisados com admissão variando de zero dia a 14 anos, sendo 55 do sexo masculino e 34 do sexo feminino. A sensibilidade e especificidade, respectivamente, da ecocardiografia funcional pelo pediatra comparado à ecocardiografia compreensiva feita pelo cardiologista relativamente às alterações encontradas foram: 80% e 96,2% para persistência do canal arterial; 88,4% e 98,4% para cardiopatia congênita acianótica; 77,7% e 98,7% para cardiopatia congênita cianótica e/ou críticas; 83,3% e 98,8% para miocardiopatia hipertrófica; 100% e 100% para derrame pericárdico; e 76,2% e 96,2% para hipertensão pulmonar persistente neonatal. Conclusões: Os resultados demonstram boa acurácia do pediatra realizando a ecocardiografia funcional quando comparado com exame realizado pelo cardiologista (ecocardiografia compreensiva), o que não reduz a importância e obrigatoriedade da análise do especialista. A incorporação da ecocardiografia funcional na avaliação rotineira pediátrica permite expandir e melhorar o exame físico pelo pediatra

Telessaúde Covid: caracterização sociodemográfica, clínico-epidemiológica e indicadores do telemonitoramento em Viçosa-MG

Em 2020, a Universidade Federal de Viçosa e a Gestão Municipal implementaram o projeto de extensão Telessaúde Covid para o enfrentamento da pandemia. O objetivo é fazer uma análise descritiva dos quatorze meses de atuação do projeto. Realizou-se análise descritiva da caracterização sociodemográfica, clínico-epidemiológica e indicadores do serviço. Foram atendidos 6.898 pacientes, predominando o gênero feminino e adultos jovens. Os sinais e sintomas mais frequentes foram cefaleia, tosse, coriza, dor de garganta, dor muscular e febre. O RT-PCR foi o teste realizado pela maioria e 31,6% dos pacientes foram positivos. O serviço concluiu o encerramento de 91,5% dos atendimentos. O Telessaúde Covid foi relevante para o contingenciamento da Covid-19, com número expressivo de atendimentos, e contemplou a missão social da universidade pública, transformando o modelo assistencial e reorientando o processo de formação e ação profissional de estudantes e profissionais de saúde