Pediatric Research and Reviews

  • Maternal obesity and first trimester iodine levels are associated with the risk of congenital malformations in Assam, Northeast India

    Purpose of the study: To assess body mass index (BMI) and trimester specific iodine status among pregnant women of Assam and study their association with congenital malformations (CM). Methods: Anthropometric, obstetric and socioeconomic data was obtained from pregnant women and apparently healthy women attending Assam Medical College and Hospital, Dibrugarh. Urinary iodine (UI) level was estimated in each trimester. BMI was classified based on Asian criteria suggested by WHO and the iodine intake was classified using WHO reference medians. Student’s t-test and univariate logistic regression analysis were used to determine the risk factors. Results: 156 pregnant women (age 18-35 years) and 160 controls were enrolled in the study. 55.8% pregnant women were underweight and 3.8% were overweight. Malformations were observed in 16 babies. The median urinary iodine concentration (MUIC) of pregnant women in their 1st trimester was 170 µg/l (IQR 100 µg/l) which increased to 275 µg/l (IQR 166 µg/l) during the 2nd trimester and decreased to 265 µg/l (IQR 160 µg/l) at the 3rd trimester. In the univariate analysis, maternal BMI > 23 kg/m2 (OR 3.67, 95% CI 0.20-67.65) and MUIC

  • Nutritional Disorders: Infant Protein-Energy Malnutrition

    Malnutrition is characterized as a deficiency of food and nutrients, mainly affecting children of preschool age (up to 5 years). Responsible for 30% of the world’s child deaths, malnutrition can compromise the child’s physical and mental development. The objective of this study was to present, through a literature review, information on energy-protective malnutrition; to expose the effects of malnutrition on the development and growth of the child and the immune system. Consequently, to discuss ways of diagnosis and treatment in order to reduce the high rates of child morbidity caused by malnutrition.

  • EVALUATION OF MEDIMENTAL INTOXICATIONS IN CHILDREN

    Introduction: Drug poisonings arise due to complex mechanisms and the high rate of these events in our country is multifactorial, among them a wide variety of formulations, the proliferation of drugstores, prescription errors and pharmaceutical dispensing, allied to a weakness in the ability to supervise. Objective: To evaluate the occurrence of drug poisoning in children, identifying the main classes and factors involved. Methodology: This was a descriptive study, such as literature review. The following search descriptors “intoxication”, “medicines” and “children” were searched, integrated in the SCIELO and MEDLINE databases. Results: Cases of drug poisoning in children aged 0 to 9 years represent 33% of the total cases. Although the main cause is attempted suicide in the child population, the highest incidence was due to accidents, or after a medical prescription, with errors in administration. The main drugs involved were nasal decongestants, bronchodilators, analgesics and anti-inflammatories. Conclusion: The occurrence of drug intoxications is frequently recorded in health systems, and the percentages are higher in children, so it is of utmost importance that the teaching about the use of medicines is carried out from the earliest years of life.

  • ROLE AND DYSFUNCTION OF THE EMBRYONIC DEVELOPMENT PATHS AND POST-NATAL PERSISTENCE. WNT / BETA-CATENINE SIGNALING ROAD INVOLVEMENT

    Introduction: Gene signaling is an essential input for successful embryonic events. Through gene transport pathways, such as the Wnt / β-catenin pathway, embryonic developments are orchestrated harmoniously with the other physiological functions. Objective: This is an integrative literature review in order to analyze the scientific evidence the participation of the Wnt family in embryonic events. Methodology: An extensive review was performed on the Lilacs, PubMed and SciELO databases with full articles published in Portuguese, English and Spanish. Results and Discussion: Wingless (Wnt) belongs to the group of molecular flags, from a family of genes that act in various embryonic processes. The phenotypes of mutant embryos revealed that these genes act on the morphogenesis of numerous tissues and organs. Wnts are part of a family of signaling proteins and participate in autocrine and paracrine mechanisms, determination of gonads, cancer, glioblastoma, as well as the pathway involved in cellular communication, environmental micro-modulation and immune response. Conclusion: Cellular and molecular events depend on signaling pathways that are controlled by the Wnt family of genes, which participate in prenatal and postnatal embryonic events.

  • PREVALENCE OF EPSTEIN’S PEARLS AND BOHN’S NODULES AMONG CONGENITAL ORAL ABNORMALITIES

    INTRODUCTION: Epstein’s pearls and Bohn’s nodules are characterized as inclusion cysts of the newborn, resulting from epithelial remnants that were trapped during the fusion of palatal processes. They are asymptomatic and transient cystic lesions and, therefore, do not require treatment by means of drugs or surgical intervention. This issue is problematic, since dental or pediatric professionals find it difficult to accurately identify and diagnose the cyst, failing to inform parents who are often distressed to realize the pathology. OBJECTIVE: The purpose of this paper is to develop an integrative literature review to analyze whether, in fact, Bohn’s nodules and Epstein pearls are the most common congenital oral lesions in newborns. METHODOLOGY: Articles indexed in SciELO, PubMed / Medline and Lilacs. The keywords used were: Epstein’s pearls, Bohn’s nodules, newborn, prevalence, palatine cysts, gingival cysts. As inclusion criteria, complete articles published in the last 10 years, in the Portuguese and English languages and that answered the research question. We found 23 articles and after applying the inclusion criteria, we selected 17 articles, 9 of which formed the present abstract, using them to explore the content. RESULTS AND DISCUSSION: Epstein’s pearls and Bohn’s nodules appeared in the literature as high frequency oral abnormalities among newborns. The data obtained in the base articles took age, location and gender as criteria, with differences between their percentages. Despite this dissonance, research has always resulted in about 50% more cases, compared to other congenital oral abnormalities. Thus, there is a comparative table between the studies that shows the results more easily in order to make explicit the prevalence of these cystic oral lesions. No evidence was found on causes related to these pathologies, only embryological origin, and further research is needed. CONCLUSION: Based on the findings, it is noticeable the prevalence of Epstein Pearls and Bohn’s…

  • PEDIATRICAL STORY CONTAINING: THE CONTRIBUTION OF EXTENSION PROJECT FOR TRAINING OF MEDICINE STUDENTS

    Background: Child hospitalization has a direct impact on the life of children who move away from a school, leisure and social routine, experiencing biopsychosocial repercussions. University extension projects in the hospital context can contribute to humanization and mental health prevention actions, as well as to develop professional skills of undergraduate health extension students. Objective: To develop reflections on the contribution of the Storytelling Project in pediatrics in a Recife hospital to train medical students. Methodology: Experience report. Results and discussion: In the project in question, medical students interact with students from pharmacy, psychology, nursing from the training activity and in the experience exchange meetings. In the child’s approach to storytelling in the ward and pediatric emergency room, they experienced welcoming each other, dedicating their time to the patient, making choices when selecting books and narrating them, the ability to communicate and interact. inserting the child in the plot read. This was an activity that required calmness, availability for the other, adjusting their time to the rhythm, physical conditions and illness of the patient. Thinking of a professional future as doctors, it was reflected that it will be necessary to welcome and tell “stories” to patients, whether as surgeries happened, or as a treatment, or what is a disease. This experience posed the students facing the challenge of dealing with the other’s cognitive and emotional reaction, dealing with resistance to participate, facing competition from the technological world, which makes it difficult to perform calmly in the hospital, as people are always in a hurry and involved in our world of chores and social networking. Final Considerations: Thus, it is believed that in the future, this project will impact the formation of students from various areas of higher health courses, highlighting the need to devote attention, welcome and fully care for the…

  • ANALYSIS OF THE INCIDENCE OF HAEMOGLOBIN S IN NEWBORNS IN PERNAMBUCO, BRAZIL

    Objective: To analyse the frequency of haemoglobin variants detected in the neonatal screening program in the state of Pernambuco from January / 2015 to July / 2016. Methodology: Descriptive study based on data provided by the health secretary of the state of Pernambuco referring to newborns submitted to the Guthrie’s test between 01/01/2015 to 07/31/2016. Results: During the period included in the study, 162,236 children participated in the neonatal screening program to evaluate haemoglobinopathies through the health department. From these, 5,997 (3.69%) presented some haemoglobin variant, being 5.019 (3.09%) carrying HbS in hetero or homozygous. Conclusions: It was possible to observe a high incidence of children diagnosed as having haemoglobin variants, especially HbS, showing the importance of performing this test so that all children can be assisted from the beginning of their lives.

  • To assess depressive symptoms in children

    Depression is a disorder that interferes in lives of human beings in a broad and comprehensive manner in several respects. Objectives: To assess the presence of depressive symptoms in children and make a comparison between two different groups. The research is a pilot study, who is results of a Masters dissertation who is in development. It counted on two types of samples totaling 36 children. Was realized analyzes mean comparison between samples using the Student t test for independent samples. After accomplish the analyzes between the groups previously discriminated against in the survey, it was found that there was no statistically significant difference in the total score for the instrument of depressive symptoms between the clinical and the school group. However, when the analysis was redone and the groups were outlined by a median, it was found that there was statistically significant difference in the total score for the instrument of depressive symptoms between the upper and lower group. At the end of the study it was concluded that their main objective was successfully achieved. Nevertheless, this is still an early study, which needs to be given continuity and enhanced in order to obtain even more scathing informations.

  • THE IMPORTANCE AND BENEFITS OF CHILD VACCINATION AND THE FACTORS THAT TAKE VACCINE DELAY: A REPORT OF EXPERIENCE

    Introduction: Vaccination is the most effective means of combating and preventing immunoprevolutionary diseases. This is only possible through vaccination, actions that represent one of the most important public health interventions in the control of pathologies generated by immunizable agents. which strengthens the effectiveness of vaccines. Objective: To report the experiences of nursing students in a supervised activity of the discipline Child Health on the importance and benefits of childhood vaccination and the factors that lead to vaccine delay. Methodology: Descriptive study of the type of experience report, carried out in a Basic Health Unit in the city of Maceió from March to June 2018. Outcome: During the period of the Child Health discipline, it was possible to observe the importance of childhood and the benefits that the vaccine brings, because the child who has the vaccination card in the daytime hardly gets sick by immunoprevolution. Having all the benefits of vaccination can still have a child who is not up to date with the passbook due to some factors such as: lack of information from parents about the importance of updated vaccination, logistical problems, among others. Thus, leaving children vulnerable to disease that can be prevented through the practice of vaccination. Conclusion: In the face of everything it is perceived that vaccination is a form of public health intervention in the fight against disease that can be avoided through the vaccine and also a way to reduce the costs of hospitalizations in hospitals.

  • PALLIATIVE CARE IN NEONATOLOGY: A PARADIGM CHANGE

    Introduction. Palliative care in neonatology involves a vision centered on the baby and his family. Assistance is not only focused on healing, but also on management of discomfort, support for family members, and parental involvement in decision making. Objective. Provide interdisciplinary care centered on the neonate and his / her family, supporting the physical, psychosocial and spiritual symptoms, helping in the decision process after the diagnosis of severe fetal disease. Methods. The interdisciplinary group “Caring for Life” was created in June 2017, which meets fortnightly for discussion of cases, scientific study and pipeline planning. Results. In the period from June 2017 to October 2018, 27 interdisciplinary team meetings were held, and 29 patients were attended, 5 of them being followed from the gestation period. There was sharing of information, providing explanations about procedures and welcoming feelings. In addition, unnecessary invasive procedures, skin-to-skin contact between the parents and the baby, avoidance of visiting hours, religious ceremonies, and farewell rituals in cases of death were avoided. Conclusion. The integral support to the family of a baby with diagnosis of serious illness can contribute to the understanding and elaboration of the situation, making possible the strengthening of the confrontation of this family. The practice in a palliative care team has provided professionals with the widening and sensitization of the gaze regarding the process of care, illness and death, qualifying care.