USE OF SINGLE- AND DOUBLE-LUMEN PERIPHERALLY INSERTED CENTRAL CATHETERS IN EXTREMELY PREMATURE NEWBORNS: A RANDOMIZED CLINICAL TRIAL

Objetivo: comparar as taxas de complicações, infecção e obstrução do cateter central de inserção periférica mono lúmen com o duplo lúmen em prematuros extremos.Método: ensaio clínico randomizado, com 30 recém-nascidos de idade gestacional entre 24 e 32 semanas. As variáveis coletadas foram tempo de duração, complicações, manipulação dos cateteres e obtenção de acessos venosos periféricos. A análise foi realizada por estatística descritiva.Resultados: houve diferença nas taxas de manipulação do cateter (p=0,001) e obtenção de acessos venosos concomitantes (p=0,01). Contudo, não houve diferença nas taxas de complicações (p=0,14), obstrução (p=0,55) e infecção (p=0,47). O cateter duplo lúmen não eleva os riscos de complicações, porém é mais manipulado. Entretanto, reduz a obtenção de novos acessos periféricos, e consequentemente a dor dos prematuros.Conclusão: a utilização do cateter central de inserção periférica duplo lúmen é benéfica para os recém-nascidos que necessitam de terapia infusional múltipla.Objective: compare the rates of complications, infections and obstruction of single-lumenperipherally-inserted central catheters to those of double-lumen catheters in extremelypremature infants.Method: randomized clinical trial with 30 newborns with gestational age between 24 and 32weeks. The variables collected were period of use, complications, handling of catheters andobtaining peripheral venous accesses. Analysis was performed using descriptive statistics.Results: there were differences in rates regarding handling catheters (p=0.001) and obtainingconcomitant venous accesses (p=0.01). However, there was no difference in complication(p=0.14), obstruction (p=0.55) and infection rates (p=0.47). Despite being more frequentlyhandled, double-lumen catheters do not increase the risk of complications. They reduce theneed for obtaining new peripheral accesses and, consequently, the pain of premature infants.Conclusion: the use of double-lumen peripherally-inserted central catheters is beneficial fornewborns that need multi-infusion therapy.Objetivo: comparar las tasas de complicaciones, infección y obstrucción del catéter centralde inserción periférica mono lumen con las del doble lumen en bebés prematuros extremos.Método: ensayo clínico aleatorizado con 30 recién nacidos en edad gestacional entre 24 y 32semanas. Las variables recogidas fueron la duración, las complicaciones, la manipulación delcatéter y la obtención del acceso venoso periférico. El análisis fue realizado por estadísticasdescriptivas.Resultados: una diferencia fue observada en las tasas de manipulación del catéter (p=0,001) yobtención de accesos venosos concomitantes (p=0,01). Sin embargo, no se observó diferenciaen las tasas de complicaciones (p=0,14), obstrucción (p=0,55) e infección (p=0,47). El catéterdoble lumen no aumenta el riesgo de complicaciones, pero es más manipulado. Tambiénreduce la obtención de nuevos accesos periféricos y, en consecuencia, el dolor de los bebésprematuros.Conclusión: el uso del catéter central de inserción periférica doble lumen es beneficioso paralos recién nacidos que requieren terapia de infusión múltiple

Condutividade e teste quantitativo coulométrico na triagem neonatal para fibrose cística

Resumo Objetivo Comparar os resultados obtidos no teste do suor pelo método da condutividade e a dosagem coulométrica de cloreto no suor em recém0nascidos (RN) suspeitos da triagem neonatal para fibrose cística (FC). Métodos O teste do suor foi feito simultaneamente pelos dois métodos em crianças com e sem FC. Os valores de corte para confirmar FC foram na condutividade > 50 mmol/L e no teste coulométrico > 60 mmol/L. Resultados Fizeram o teste do suor por condutividade e dosagem coulométrica simultaneamente 444 RN sem FC (185 do sexo masculino, 234 do feminino e 24 não informado) e obtiveram resultado mediano de 32 mmol/L e 12 mmol/L respectivamente. Para os noventa RN com FC os valores medianos de condutividade e dosagem coulométrica foram 108 mmol/L e 97 mmol/L respectivamente. O índice de falso positivo para condutividade foi de 16,7% e em todos os pacientes FC foi superior a 50 mmol/L, o que confere ao método 100% de sensibilidade (IC 95% = 93,8 a 97,8), especificidade de 96,2% (IC 95% = 93,8 a 97,8), valor preditivo positivo 83,3 (IC 95% = 74,4 a 91,1), valor preditivo negativo 100% (IC 95% = 90,5 a 109,4) e acurácia 9,8%. A correlação entre os métodos foi de r = 0,97 (p > 0,001).O melhor valor de corte sugerido foi de 69,0 mmol/L, coeficiente de kappa = 0,89. Conclusão O teste da condutividade apresentou excelente correlação com o quantitativo coulométrico, alta sensibilidade e especificidade e pode ser usado no diagnóstico da FC em crianças detectadas pela triagem neonatal

Sweat conductivity and coulometric quantitative test in neonatal cystic fibrosis screening

Objective: To compare the results obtained with the sweat test using the conductivity method and coulometric measurement of sweat chloride in newborns (NBs) with suspected cystic fibrosis (CF) in the neonatal screening program. Methods: The sweat test was performed simultaneously by both methods in children with and without CF. The cutoff values to confirm CF were > 50 mmol/L in the conductivity and > 60 mmol/L in the coulometric test. Results: There were 444 infants without CF (185 males, 234 females, and 24 unreported) submitted to the sweat test through conductivity and coulometric measurement simultaneously, obtaining median results of 32 mmol/L and 12 mmol/L, respectively. For 90 infants with CF, the median values of conductivity and coulometric measurement were 108 mmol/L and 97 mmol/L, respectively. The false positive rate for conductivity was 16.7%, and was higher than 50 mmol/L in all patients with CF, which gives this method a sensitivity of 100% (95% CI: 93.8 to 97.8), specificity of 96.2% (95% CI: 93.8 to 97.8), positive predictive value of 83.3% (95% CI: 74.4 to 91.1), negative predictive value of 100% (95% CI: 90.5 to 109.4), and 9.8% accuracy. The correlation between the methods was r = 0.97 (p > 0.001). The best suggested cutoff value was 69.0 mmol/L, with a kappa coefficient = 0.89. Conclusion: The conductivity test showed excellent correlation with the quantitative coulometric test, high sensitivity and specificity, and can be used in the diagnosis of CF in children detected through newborn screening

Internet addiction and its correlation with behavioral problems and functional impairments – A cross-sectional study

ABSTRACT Objective Evaluate the prevalence of internet addiction (IA) among adolescents, as well as characterize behaviors that are considered to be a risk in this population regarding the use and addiction of the Internet. Methods In this cross-sectional study conducted in one public and one private school 91 adolescents, aged 12 to 16 years old, responded the Internet Addiction Test – Brazilian version (IAT) and Child Behavior Checklist (CBCL). Results The prevalence of internet addiction found was 21%, with no difference between private and public schools. On the group dependent on the Internet, there was a statistically significant correlation with Anxiety/Depression, Withdrawn/Depression, Rule Breaking Behavior and Aggressive Behavior, as well as the syndrome scales Social Problems, Thought Problems and Attention Problems. Conclusion Our study provides evidence of a relationship between internet addiction and behavioral problems among adolescents. As this is a cross-sectional study, we consider that future research is necessary to corroborate our results

Internet addiction and its correlation with behavioral problems and functional impairments – A cross-sectional study

<div><p>ABSTRACT Objective Evaluate the prevalence of internet addiction (IA) among adolescents, as well as characterize behaviors that are considered to be a risk in this population regarding the use and addiction of the Internet. Methods In this cross-sectional study conducted in one public and one private school 91 adolescents, aged 12 to 16 years old, responded the Internet Addiction Test – Brazilian version (IAT) and Child Behavior Checklist (CBCL). Results The prevalence of internet addiction found was 21%, with no difference between private and public schools. On the group dependent on the Internet, there was a statistically significant correlation with Anxiety/Depression, Withdrawn/Depression, Rule Breaking Behavior and Aggressive Behavior, as well as the syndrome scales Social Problems, Thought Problems and Attention Problems. Conclusion Our study provides evidence of a relationship between internet addiction and behavioral problems among adolescents. As this is a cross-sectional study, we consider that future research is necessary to corroborate our results.</p></div