[Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique].

Objective:: To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns.

Methods:: This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded.

Painful procedures and analgesia in the NICU: what has changed in the medical perception and practice in a ten-year period?

Objective: To compare the use of analgesia versus neonatologists' perception regarding analgesic use in painful procedures in the years 2001, 2006, and 2011.

Methods: This was a prospective cohort study of all newborns admitted to four university neonatal intensive care units during one month in 2001, 2006, and 2011. The frequency of analgesic prescription for painful procedures was evaluated.

Factors associated with red blood cell transfusions in very-low-birth-weight preterm infants in Brazilian neonatal units.

Background: Preterm infants in neonatal intensive care units frequently receive red blood cells (RBC) transfusions due to the anemia of prematurity. A number of variables related to gestational age, severity of illness and transfusion practices adopted in the neonatal unit where the neonate was born may contribute to the prescription of RBC transfusions. This study aimed to analyse the frequency and factors associated with RBC transfusions in very-low-birth-weight preterm infants.

Peri-intraventricular hemorrhage and oxidative and inflammatory stress markers in very-low birth weight newborns.

Objectives: To evaluate the association between oxidative and inflammatory stress markers with peri-intraventricular hemorrhage (PIVH) in very-low birth weight newborns.

Methods: This was a prospective study conducted in a level III neonatal unit. Basal and stimulated reactive oxygen intermediates (ROIs), reduced glutathione (GSH), and interleukin-6 (IL-6) levels were measured in umbilical cord blood.

Late-onset sepsis in very low birth weight infants: a Brazilian Neonatal Research Network Study.

Background: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.

Aim: To determine the incidence, risk factors and etiology of LOS.

Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs).

Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus.

Objective: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD.

Methods: This was a multicentric, cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded.

An auditory health program for neonates in ICU and/or intermediate care settings.

Unlabelled: Auditory screening and early identification and management of patients with hearing loss improve the development prospects of infants.

Objective: To analyze the outcomes produced by an Auditory Health Program in neonates managed in an intensive care unit.

Method: This prospective cross-sectional study enrolled neonates referred to the neonatal care unit at hospital CAISM/Unicamp with stays lasting for 48 hours and more within a period of 13 months.

[Breastfeeding among children of women workers].

Objective: To analyze employment benefits and factors associated with the maintenance of breastfeeding indexes among working mothers.

Methods: The sample was constituted by 200 formal women workers who returned to work before the child had reached six months of life, in the city of Piracicaba (Southeastern Brazil). Among the participants, 100 mother-infant dyads received guidance and support for the practice of breastfeeding within an oral health prevention program, and the other 100 dyads were addressed in a child vaccination campaign.

Antenatal maternal corticosteroid administration and markers of oxidative stress and inflammation in umbilical cord blood from very low birth weight preterm newborn infants.

Objective: To investigate the association between antenatal maternal corticosteroid administration and blood levels of reactive oxygen intermediates (ROI), reduced glutathione (GR) and interleukin-6 (IL-6) in preterm, very low birth weight infants.

Methods: This was a cohort study in which cord blood samples were used for the following tests: baseline and stimulated granulocyte ROI were measured by flow cytometry; GR was assayed by spectrophotometry; and IL-6 by enzyme-linked immunosorbent assay. Two different comparative analyses of antenatal corticosteroid (betamethasone) were conducted: the first compared administration against no administration and the second compared mothers who received the complete cycle with those given only a partial antenatal corticosteroid cycle.

Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study.

Objective: To assess the incidence of periventricular/intraventricular hemorrhage (PIVH) in very low birth rate neonates.

Methods: This was a prospective cohort study conducted on a sample of very low birth weight infants over a 15-year period. Neonates who did not undergo cerebral ultrasonography, had malformations affecting the central nervous system, or died within the first 24 hours of life were excluded.

Does staged closure have a worse prognosis in gastroschisis?

Introduction: Correction of gastroschisis can be accomplished by primary or staged closure. There is, however, no consensus regarding the best approach or criteria to favor one method over the other has been established.

Objective: To compare the outcome of primary and staged closure in newborns with gastroschisis using intravesical pressure (IVP) as the decision criterion.

Red blood cell transfusions are independently associated with intra-hospital mortality in very low birth weight preterm infants.

Objective: To test the hypothesis that red blood cell (RBC) transfusions in preterm infants are associated with increased intra-hospital mortality.

Study Design: Variables associated with death were studied with Cox regression analysis in a prospective cohort of preterm infants with birth weight <1500 g in the Brazilian Network on Neonatal Research. Intra-hospital death and death after 28 days of life were analyzed as dependent variables.

Brazilian multicenter study on prevalence of preterm birth and associated factors.

Background: The occurrence of preterm birth remains a complex public health condition. It is considered the main cause of neonatal morbidity and mortality, resulting in a high likelihood of sequelae in surviving children. With variable incidence in several countries, it has grown markedly in the last decades.

[Brain-sparing effect: comparison of diagnostic indices].

Purpose: to describe adverse perinatal outcomes in patients with fetal blood flow centralization, using the relationship between the pulsatility indexes of the middle cerebral and umbilical arteries (MCAPI/UAPI), and between the resistance indexes of the middle cerebral and umbilical arteries (MCARI/UARI), as well as to compare both diagnostic indexes.

Methods: 151 pregnant women with diagnosis of blood flow centralization, attended to at the maternity hospital of Universidade Estadual de Campinas, whose delivery occurred up to 15 days after the ultrasonographic diagnosis, were included. It was considered as adverse perinatal outcomes: Apgar index lower than 7 at the fifth minute, permanence in neonatal ICU, small fetus for the gestational age, severe fetal suffering, perinatal death, hypoglycemia, polycythemia, necrotizing enterocolitis, brain hemorrhage, lung hemorrhage, anemia, septicemia, hyaline membrane disease, convulsive syndromes, hyperreflexia syndrome and kidney insufficiency.

Secular trend in length of hospital stay for healthy newborns: 1951-2000.

Objective: To assess the secular trend in length of hospital stay for healthy newborns with birth weight >or= 2,500 g in a large maternity hospital of Campinas, state of São Paulo, Brazil.

Methods: In this descriptive, analytical, retrospective study, data were collected from 5,001 live births from 1951 to 2000. Studied variables were length of hospital stay, birth weight, maternal age, type of delivery, and category of admission.

Accuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis.

Objective: To evaluate the diagnostic value for late neonatal sepsis of white blood cell count (WBC) and assays for C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), in isolation and in conjunction.

Methods: This was a diagnostic test validation study. Chemiluminescence was used to assay CRP, IL-6 and TNF-alpha at the time of clinical suspicion and again after 24 and 48 hours, whereas the WBC was performed only once, at the time of suspicion.

Oral conditions in very low and extremely low birth weight children.

Purpose: The purpose of this study was to evaluate the oral conditions in very low birth weight (VLBW) and extremely low birth weight (ELBW) children.

Methods: Fifty-two VLBW and ELBW 2- to 4-year-old children (V/ELBW group) were evaluated and compared with 52 normal birth weight children (NBW group). The oral examination was performed in accordance with World Health Organization criteria.

Babies with brain damage who can not swallow: surgical management.

Background: Neonates with severe neurological impairment are often unable to swallow, necessitating gastrostomy for feeding. Because of the risk of developing severe reflux, this procedure is often associated with fundoplication.

Objective: To assess the safety and efficacy of gastrostomy and Nissen fundoplication in 22 neonates with swallowing difficulties due to serious neurological impairment.

Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers.

Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.

Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life.

Follow-up of neonatal jaundice in term and late premature newborns.

Objectives: To report on the results of a project following term and near term newborn infants who were jaundiced during the neonatal period.

Methods: Neonates were referred to the follow-up clinic with weight >/= 2,000 g and/or gestational age >/= 35 weeks, and jaundice at discharge was initially assessed with an Ingram icterometer or Bilicheck and, if indicated, with a Unistat bilirubinometer (Leica). These newborn infants had bilirubinemia at or above the 40th percentile on the nomogram developed by Bhutani.

Comparison of transcutaneous and plasma bilirubin measurement.

Objectives: To compare transcutaneous bilirubin measurements made using Bilicheck equipment with assays of capillary plasma using the Unistat bilirubinometer (Leica).

Methods: Two hundred concomitant assays were performed (transcutaneous and in plasma), and the correlation and level of agreement between them was calculated. An assessment was also made of the influence of birth weight, skin color, gestational age, postnatal age and phototherapy.

A prospective study on the prevalence and risk factors for neonatal thrombocytopenia and platelet alloimmunization among 9332 unselected Brazilian newborns.

Background: Neonatal thrombocytopenia (NT) occurs in 0.5 to 0.9% of unselected Caucasian newborns.

Hearing screening in a neonatal intensive care unit.

Objective: Investigate the prevalence of hearing impairment in newborns hospitalized at the Intensive and Intermediate Care Unit at the Women's Comprehensive Health Center Neonatology Service (UNICAMP) and associated risk factors.

Methods: 979 newborn babies were assessed between January 2000 and January 2003, through automated auditory brainstem response (AABR) (ALGO 2e color screener). The result was considered normal when the newborn showed response to a 35dBNA signal bilaterally.

[The frequency of pharmacological pain relief in university neonatal intensive care units].

Objective: To evaluate the use of drugs to relieve procedural pain of newborn infants hospitalized in Neonatal Intensive Care Units (NICU) of university hospitals.

Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of patients; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration.

The Gly972Arg polymorphism in insulin receptor substrate-1 is associated with decreased birth weight in a population-based sample of Brazilian newborns.

Objective: We studied the association between the Gly972Arg polymorphism in insulin receptor substrate-1 (IRS-1) and birth weight in a population-based sample of Brazilian newborns.

Research Design And Methods: We studied 194 newborn children with adequate gestational age to identify the association between the Gly972Arg polymorphism and birth weight using PCR-restriction fragment length polymorphism analysis.

Results: The data showed that the birth weight was lower in the newborns with the Gly972Arg polymorphism in IRS-1 compared with control subjects (3,141 +/- 31.