PERCEPÇÃO DOS PAIS DE CRIANÇAS COM IMPLANTE COCLEAR USUÁRIAS DA LÍNGUA BRASILEIRA DE SINAIS

O objetivo do estudo foi conhecer a percepção dos pais em relação ao implante coclear utilizado por seus filhos e o processo de aquisição da Língua Brasileira de Sinais (LIBRAS). Os participantes foram familiares de crianças usuárias de implante coclear atendidas em Instituição pública do Estado de São Paulo. Pesquisa do tipo transversal, análise qualitativa. Aplicou-se um roteiro de entrevista semiestruturado, sendo as entrevistas gravadas e transcritas para categorização e análise dos dados, por meio da análise conteúdo. Os familiares relataram que estão satisfeitos com a escolha pelo implante coclear; o processo de aprendizagem da LIBRAS foi natural e benéfico e relataram expectativas positivas sobre o futuro das crianças. Concluiu-se que os pais veem a escolha pelo implante coclear como algo positivo, devido ao desenvolvimento da comunicação das crianças e que a LIBRAS contribuiu para o processo de desenvolvimento de linguagem das crianças.Descritores: Implante Coclear; Linguagem de Sinais; Criança; Surdez; Perda Auditiva

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Analysis Of Neonatal Hearing Screening Program Performed On An Outpatient Basis: Analysis Of An Outpatient Hearing Screening Program

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective: The aims of the present study were to analyze the coverage of an outpatient hearing screening program in a public hospital for healthy newborns, to describe the social and demographic profile of the mothers and to identify the prevalence of infants with severe or profound hearing losses. Methods: The method was descriptive and retrospective. In 2002 and 2003, the newborn hearing screening program was initiated in the maternity ward. Due to many logistic problems, in 2004, we implemented screening on an outpatient basis. Thus, upon discharge from the hospital, the mothers received a printed schedule referring the baby to an outpatient clinic. A two-stage screening protocol was implemented. The screening results were presented from 2004 to 2013. Results: The program was initiated on an outpatient basis in 2004. From 2004 to 2013, 14,882 infants were screened but the complete data for 14,205 cases were obtained. The adherence of the families was 32% in 2004 and increased to 85% in 2013. The mean age of the screened newborns was 48.66 days in 2005 and 24.53 days in 2013. The number of newborns who failed the test and were referred for diagnosis decreased from 12.3% in 2004 to 3% in 2013. The majority of the mothers were young, 69.77% of them aged up to 29 years old and 74.86% had completed basic education. Seventy infants showed hearing loss, totaling 0.49% or approximately 5 cases in 1000, with eight individuals diagnosed with severe or profound sensorineural hearing loss, totaling 0.06% or approximately six cases in 10,000. Conclusions: The newborn hearing screening program offered by a public hospital in Brazil, over the years, has increased the coverage from 32% to 85%, and so, can be performed on an outpatient basis as an alternative to overcome the operating limitations that might occur in hospital hearing screening. The mothers of the newborns were young and had complete basic education; the prevalence was similar to international studies as hearing loss is concerned. (C) 2015 Elsevier Ireland Ltd. All rights reserved.791222272233Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Home environment of infants with risk indicators for hearing loss tends to be less stimulating

Objective: To verify the home opportunities to the motor development offered to infants with and without risk indicators for hearing loss (RIHL). Methods: Observational transversal study was done with infants between 8 and 10 months, being 77 with RIHL (Study Group-SG) and 77 without RIHL (Control Group-CG) The instrument used to characterize the sample and obtain information about the home affordances was the questionnaire Affordances in the Home Environment for the Motor Development - Infant Scale (AHEMD-IS). The results of the AHEMD-IS between the groups were compared using the Mann-Whitney and Chi-Squared tests. The significance test adopted for the study was 5%. Results: Absolute values in the frequency of homes considered "moderately adequate" and "less than adequate" were greater in the SG in the most part of the categories, except the item Toys for Fine Motricity. It was possible to observe a statistically significant difference in the Total Score of the groups (p-value = 0.01346). Even with better results when compared with the SG, the number of homes of the CG group with affordances below expected is more than half of the sample. Conclusions: It was possible to verify that home of infants with risk indicators for hearing loss have statistically less affordances when compared to the homes of infants without the indicators. The results alert us to the need of orientation to the infant's responsible/caretakers regarding to the importance of a favorable environment with stimulation of the infant motor development.12014615

Audiological And Genetics Studies In High-risk Infants.

Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society. The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening. Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient Evoked Otoacoustic Emission and otorhinolaryngological evaluation. DNA extraction from the oral mucosa was performed for genetic studies using the protocol method adapted from the Human Genetics Lab of the CBMEG/UNICAMP. Regarding gender and presence of risk factors, significant statistically differences were not found in normal hearing infants and in those with hearing loss. Concerning gestational age, term infants were more affected by hearing loss. Hearing loss was identified in 58% of the sample, conduction hearing loss represented 31.5% (12/38) and neurossensory 28.9% of cases. There were none of the genetic mutations most commonly seen in cases with a genetic etiology. Hearing loss was identified in the majority of High-risk infants.77784-9

Estudo audiológico e genético de lactentes de alto risco Audiological and genetics studies in high-risk infants

A audição é um dos principais meios de contato do indivíduo com o mundo externo, desempenhando papel fundamental na integração com a sociedade. OBJETIVO: Analisar os resultados obtidos na avaliação audiológica, otorrinolaringológica e genética de lactentes de alto risco que falharam na triagem auditiva neonatal. MATERIAL E MÉTODO: Estudo clínico e experimental. Foram avaliados 38 lactentes, entre 1 e 6 meses de idade cronológica. Os procedimentos utilizados foram: anamnese, imitanciometria, Potencial Evocado Auditivo de Tronco Encefálico, Emissões Otoacústicas por Transiente e avaliação otorrinolaringológica. O estudo genético foi realizado a partir da extração de DNA da mucosa bucal utilizando o método de protocolo adaptado no Laboratório de Genética Humana do CBMEG/UNICAMP. RESULTADO: Não houve diferença estatisticamente significante entre neonatos com audição normal e perda auditiva e as variáveis gênero e número de indicadores de risco. Quanto à idade gestacional, neonatos a termo foram mais afetados. A perda auditiva esteve presente em 58% da amostra, sendo do tipo condutiva em 31,5%, e neurossensorial em 28,9% dos casos. Não foram encontradas as mutações genéticas mais comumente observadas em casos com etiologia genética. CONCLUSÃO: A perda auditiva foi diagnosticada na maioria dos lactentes de risco com provável etiologia ambiental.Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society. AIM: The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening. MATERIALS AND METHODS: Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient Evoked Otoacoustic Emission and otorhinolaryngological evaluation. DNA extraction from the oral mucosa was performed for genetic studies using the protocol method adapted from the Human Genetics Lab of the CBMEG/UNICAMP. RESULTS: Regarding gender and presence of risk factors, significant statistically differences were not found in normal hearing infants and in those with hearing loss. Concerning gestational age, term infants were more affected by hearing loss. Hearing loss was identified in 58% of the sample, conduction hearing loss represented 31.5% (12/38) and neurossensory 28.9% of cases. There were none of the genetic mutations most commonly seen in cases with a genetic etiology. CONCLUSION: Hearing loss was identified in the majority of High-risk infants

Audiological and genetics studies in high-risk infants

Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society. AIM: The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening. MATERIALS AND METHODS: Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient Evoked Otoacoustic Emission and otorhinolaryngological evaluation. DNA extraction from the oral mucosa was performed for genetic studies using the protocol method adapted from the Human Genetics Lab of the CBMEG/UNICAMP. RESULTS: Regarding gender and presence of risk factors, significant statistically differences were not found in normal hearing infants and in those with hearing loss. Concerning gestational age, term infants were more affected by hearing loss. Hearing loss was identified in 58% of the sample, conduction hearing loss represented 31.5% (12/38) and neurossensory 28.9% of cases. There were none of the genetic mutations most commonly seen in cases with a genetic etiology. CONCLUSION: Hearing loss was identified in the majority of High-risk infants.A audição é um dos principais meios de contato do indivíduo com o mundo externo, desempenhando papel fundamental na integração com a sociedade. OBJETIVO: Analisar os resultados obtidos na avaliação audiológica, otorrinolaringológica e genética de lactentes de alto risco que falharam na triagem auditiva neonatal. MATERIAL E MÉTODO: Estudo clínico e experimental. Foram avaliados 38 lactentes, entre 1 e 6 meses de idade cronológica. Os procedimentos utilizados foram: anamnese, imitanciometria, Potencial Evocado Auditivo de Tronco Encefálico, Emissões Otoacústicas por Transiente e avaliação otorrinolaringológica. O estudo genético foi realizado a partir da extração de DNA da mucosa bucal utilizando o método de protocolo adaptado no Laboratório de Genética Humana do CBMEG/UNICAMP. RESULTADO: Não houve diferença estatisticamente significante entre neonatos com audição normal e perda auditiva e as variáveis gênero e número de indicadores de risco. Quanto à idade gestacional, neonatos a termo foram mais afetados. A perda auditiva esteve presente em 58% da amostra, sendo do tipo condutiva em 31,5%, e neurossensorial em 28,9% dos casos. Não foram encontradas as mutações genéticas mais comumente observadas em casos com etiologia genética. CONCLUSÃO: A perda auditiva foi diagnosticada na maioria dos lactentes de risco com provável etiologia ambiental.78479