Navegando por Assunto "Pediatria"

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Acesso aberto (Open Access)
Acompanhamento farmacoterapêutico de pacientes pediátricos submetidos à sedoanalgesia em um hospital de alta complexidade em Belém-Pa
(Universidade Federal do Pará, 2022-12-06) ELMESCANY, Sâmella Benoliel; RIBEIRO, Carolina Heitmann Mares Azevedo; http://lattes.cnpq.br/3848996822163999; https://orcid.org/0000-0002-9457-2733; FONTES JÚNIOR, Enéas de Andrade; http://lattes.cnpq.br/7056265073849866; https://orcid.org/0000-0002-6186-9581
Introduction: The Intensive Care Unit (ICU) is a hospitalization unit for critically ill patients, whomostly use sedatives and analgesics. Seeking tominimize undesirable events, clinical follow-up of patients, especially pediatric patients, is necessary. Objective: To propose an instrument for pharmacotherapeutic monitoring of patients undergoing sedoanalgesia in the pediatric ICU. Method: Retrospective study, with data collected from medical records of patients aged 0 to 14 years, admitted to the pediatric ICU during the study period, who used sedoanalgesics. Results and discussion: In 326 prescriptions in the 90-day period involving 96 children, the age group of07-09 years predominated, with 49.2% underweight and predominantly male. Among the drugs prescribed were antimicrobials, sedoanalgesics, antipyretics and proton pump inhibitors. The average length of hospital stay was 18.5 days and approximately 32.7% of the patients had Withdrawal Syndrome (AS), corroborating the literature, where it is postulated that the longer thetime of use of these drugs, the greater the risk of SA. In 25% of the patients, 42.5% used antidotesother than those recommended by the Pediatrics and Pediatric & Neonatal Dosage Handbook. Asa product, a Manual for the Use of Sedoanalgesics was prepared to guide the multidisciplinary team in the care of patients during therapy. Conclusion: The data from this research indicated anunderweight public, the occurrence of medication errors and withdrawal syndrome, among otherfactors that reinforce the need for the elaboration of an institutionalized protocol for the administration of sedoanalgesics, aiming to guarantee patient safety, prevent the occurrence of adverse events related to its use and direct the multidisciplinary team on the care to be adopted.
Acesso aberto (Open Access)
Aspectos clínicos, epidemiológicos, microbiológicos e terapêuticos da candidemia nosocomial em unidades neonatal e pediátrica em um hospital geral em Belém/ Pará
(Universidade Federal do Pará, 2006-06-13) PAES, Andréa Luzia Vaz; LEÃO, Raimundo Nonato Queiroz de; http://lattes.cnpq.br/2956764853618778; SOUZA, Rita Catarina Medeiros de
The fungals infections have been emerging as responsible for nosocomial infections, particularly when associates with morbities as prematureness, blood diseases, hospitable stay for more than 15 days, come in another. With the purpose of evaluating candidemia occurrence in patients of neonates and of the pediatrics put into hospital in public hospital in Belém / Pará, Fundação Santa Casa of Misericórdia from Pará (FSCMP), was accomplished a retrospective study having as investigation base all the cultures accomplished in hospital from January 1999 to December 2004. Of a total of 2.622 cultures, just five with C. albicans isolation of pediatrics and neonates patients. It is worth stress that it was not identified no other species of Candida. The children had between 0 until 9 months, and all of them were submitted for surgical procedures. Occurring other concomitant hospitable infections to candidemias. Among signals and symptoms introduced at the moment of the isolation of Candida note that respiratory disfunction and fever were the most frequent. Anemia and leukocytoses were the laboratories alterations predominant. Some risk factors for candidemia development were identified as antibiotics therapy, surgeries, blood transfusion, and use of blocking of H2, central veined catheter, probe pray-gastric. Among antibiotics used note that antibiotic of wide spectrum, like ceftazidime, imipenem, vancomycin, were used in most cases (4/5). The average time of hospitable stay belonged to 55 days, and three patient remained put into hospital in ICU. This work reflects a Candida's low isolation in children put into hospital in FSCMP, suggesting an improvement in the tests employees for mushrooms cultures.
Acesso aberto (Open Access)
A criança e o adolescente com problemas do desenvolvimento no ambulatório de pediatria
(2003-06) MIRANDA, Luci Pfeiffer; RESEGUE, Rosa Miranda; FIGUEIRAS, Amira Consuêlo de Melo
OBJECTIVE: to review the literature on outpatient care of children and adolescents with developmental disabilities, focusing on prevention, early diagnosis, treatment, outcomes and rehabilitation. SOURCES OF DATA: search of Medline and Lilacs databases; publications of scientific committees of institutions for children with special needs; and outpatient care reports of reference centers for the treatment of children and adolescents with mental and developmental disabilities. SUMMARY OF THE FINDINGS: this population presents health problems associated with the basic pathology and its consequences in addition to the usual problems of the specific age group. The etiology of developmental disorders and the main characteristics of each type of disability are discussed. Special attention is given to outpatient pediatric care. CONCLUSIONS: the most recent study of the Brazilian population, performed in 2000, showed that 14.5% of this population presented some type of developmental deficiency. Therefore, developmental problems are one of the most prevalent health problems among children and adolescents. Consequently, pediatricians need to be prepared to evaluate and identify factors that may influence normal children development. Pediatricians are responsible for prevention, early diagnosis and coordination of the multidisciplinary treatment of these patients in addition to basic medical assistance, which is essential to guarantee the patients' good quality of life.
Acesso aberto (Open Access)
Frequency of acute myeloid leukemia in children attended in Belém, Pará from August 2005 to May 2009
(2015-04) BRITO JUNIOR, Lacy Cardoso de; LEVY, Ian Eliezer; FRANCÊS, Larissa Tatiane Martins; WANDERLEY, Alayde Vieira; CARNEIRO, Rita de Cassia Matos; BENTES, Alessandra Quinto
Introduction: Acute myeloid leukemia (AML) has variable incidence in different regions of Brazil. Objective: To determine the frequency of AML subtypes in children aged 0-17 years attended at Belém, Pará, from August 2005 to May 2009. Patients and methods: A retrospective study was performed with 278 patients diagnosed with acute or chronic leukemia based on clinical and morphological criteria (French-American-British [FAB]/World Health Organization classification [WHO]) and immunophenotyping profile by flow cytometry, to determine the frequency of the subtypes in AML. Results: We found 70 (25.18%) cases of AML, 37 of these (52.9%) were children aged 0-17 years (median age of 7 years and 8 months). There was no statistical difference in relation to gender. We observed a higher frequency of AML subtype M2 (18/37 - 48.6%) and M0/M1 (10/37 - 27%), especially in the first decade of life (16/28 [57.1%] AML M2 and 9/28 [32.1%] AML M0/M1). Conclusion: In the pediatric population, the types of AML M2, M0/M1 and M3 were respectively the most frequent.
Acesso aberto (Open Access)
O que os pediatras conhecem sobre avaliação e tratamento da dor no recém-nascido?
(2003-06) CHERMONT, Aurimery Gomes; GUINSBURG, Ruth; BALDA, Rita de Cássia Xavier; KOPELMAN, Benjamin Israel
OBJECTIVE: to analyze the knowledge of pediatricians who work with neonatal patients regarding the evaluation and treatment of pain in newborn infants. METHODS: cross-sectional study of 104 pediatricians (out of 110) who were working during 1999 to 2001 in seven intensive care units and 14 nurseries in the city of Belém (Pará). The pediatricians answered a questionnaire about their demographic profile and their knowledge of pain evaluation and pain relief methods during the neonatal period. RESULTS: 100% of the pediatricians believed that newborns feel pain, but only one-third of them declared to know any scale for the evaluation of pain for this age group. The majority of the interviewees perceived the presence of pain in newborns by means of behavioral parameters. Crying was the preferential parameter to evaluate pain in full-term newborns; facial activity was the parameter chosen for premature infants; and heart rate for mechanically ventilated neonates. Less than 10% of the pediatricians reported using analgesia for venous and capillary puncture, while 30 to 40% said that they used analgesia for lumbar puncture, venous dissection, chest tube placement and mechanical ventilation. Less than half of those interviewed reported applying postoperative pain relief measures following abdominal surgery. Opioid was the most frequent medication for analgesia (60%), followed by midazolam (30%). CONCLUSION: these results demonstrate that it is necessary to refresh and update pediatricians' knowledge about pain assessment and relief.
Acesso aberto (Open Access)
Severe visceral leishmaniasis in children: the relationship between cytokine patterns and clinical features
(Universidade Federal do Pará, 2013-12) GAMA, Mônica Elinor Alves; GOMES, Claudia Maria de Castro; SILVEIRA, Fernando Tobias; AURENTI, Márcia Dalastra; GONÇALVES, Eloisa da Graça do Rosario; SILVA, Antônio Rafael da; CORBETT, Carlos Eduardo Pereira
Introduction: The relationship between severe clinical manifestations of visceral leishmaniasis (VL) and immune response profi les has not yet been clarifi ed, despite numerous studies on the subject. This study aimed to investigate the relationship between cytokine profi les and the presence of immunological markers associated with clinical manifestations and, particularly, signs of severity, as defi ned in a protocol drafted by the Ministry of Health (Brazil). Methods: We conducted a prospective, descriptive study between May 2008 and December 2009. This study was based on an assessment of all pediatric patients with VL who were observed in a reference hospital in Maranhão. Results: Among 27 children, 55.5% presented with more than one sign of severity or warning sign. Patients without signs of severity or warning signs and patients with only one warning sign had the highest interferon-gamma (IFN-γ) levels, although their interleukin 10 (IL-10) levels were also elevated. In contrast, patients with the features of severe disease had the lowest IFN-γ levels. Three patients who presented with more than two signs of severe disease died; these patients had undetectable interleukin 2 (IL-2) and IFN-γ levels and low IL-10 levels, which varied between 0 and 36.8pg/mL. Conclusions: Our results showed that disease severity was associated with low IFN-γ levels and elevated IL-10 levels. However, further studies with larger samples are needed to better characterize the relationship between disease severity and cytokine levels, with the aim of identifying immunological markers of active-disease severity.