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  • ISSN: 2373-9312
    Volume 8, Issue 3
    Short Communication
    Yvanna L. D. C. Oliveira, Djane A. Oliveira, Lúcio H. S. Pinhero, Nathanielly L. Silva, Flávia O. Costa, Rosana Cipolotti, and Dulce M. Schimieguel*
    This study aimed to evaluate the interferents in a quantitative technique for glucose-6-phosphate dehydrogenase (G6PD), deficiency diagnosis. Newborn blood samples were collected in filter paper from May 2016 to January 2017 in Sergipe state, Brazil. Samples were divided into three groups with different pre-analytical and analytical conditions: in the pilot group was evaluated sample quality and time between collection and examination; in the standard group was analyzed the samples under regular conditions of newborn screening; and in the control group samples were transported with low temperature. We evaluated 11,677 samples, of which 8,213 (70.33%), were considered valid: 2,347 from Pilot Group, 5,766 from Standard Group, and 100 from Control Group. The prevalence obtained was 9.35% from the Standard Group. There was significant statistical difference among positive results of most groups. Prevalence decreased from 13.66% in Pilot Group to 1% in Standard Group, and the mean enzyme activity of samples from Pilot Group, Standard Group, and Control Group was 4.4, 4.3 and 7.5 U/g Hb, respectively. The optimal technical conditions observed were: completely filled filter paper (Pilot Group), three weeks between collection and examination (Standard Group), and refrigerated transport (Control Group). The confirmatory test was performed in 50 newborns from Standard Group, and the deficiency was confirmed in 20 patients. Among the established criteria, refrigerated transportation had the greatest impact in reducing prevalence. We suggest that quantitative measures of enzyme activity technique cannot be used to diagnose G6PD deficiency in regions with high temperature without refrigeration during transportation.
    Research Article
    Ian Munro Rogers*
    Background: There has been no shortage of published articles about pyloric stenosis of infancy(PS). Curiously, few have opined a cause despite a galaxy of potentially informative clues. The earliest speculative suggestion was that hyperacidity was involved. More recently the notion that there is a deficit of a relaxing agent-nitric oxide(NO) in the sphincter. Others have proposed that there is an abnormal accumulation of growth factors which leads to sphincter hypertrophy. Neither the NO nor the growth factor theories have attempted to link with the classical clinical features.
    Materials and methods: The accepted physiological facts and the classical clinical features are linked in a comprehensive theory of cause. An inherited greater than average acid secretory ability is key. An important support is provided by two other normal developmental phenomena- a peak acidity in the early weeks and a temporary insensitivity of the negative feed-back between neonatal gastrin and gastric acidity soon after birth. Inappropriate overfeeding is an important stimulus for sphincter contraction. The evidence for its contribution to pathogenesis is also examined.
    Results and conclusion: The Primary Hyperacidity theory has been found to expain all the clinical features.In outlining a conflict between stenosing forces and relaxing forces, it also provides and explanation for the way in which symptoms and signs may come and go.The theory is critically examined and is proposed as the cause.
    Wanélia V. Afonso, Wilza A. F. Peres, Nivaldo B. de Pinho, Renata B. Martucci, Tatiana P. de Paula and Patricia de C. Padilha
    Aim: This study aims to evaluate the influence of nutritional status on admission, according to the anthropometric indicator, serum C-reactive protein (CRP) and albumin on length of hospital stay (LHS) and time of mechanical ventilation (MV) in the Pediatric Intensive Care Unit (PICU) in a Oncological Treatment Center.
    Methods: It is a longitudinal, observational, retrospective study with all children admitted to the PICU in 2013. The comparison of medians related to LHS and VM was assessed using the nonparametric Mann-Whitney and Kruskal Wallis test. The Kaplan-Meier curve evaluated the influence of body mass index (BMI), CRP and albumin on LHS and VM. The significance value was p <0.05.
    Results: A total of 54 patients were selected, median age of 8.02 (2.35-12.79) years. Solid tumors were the most common (92.6%; n = 50), and the most frequent causes of hospitalization in the PICU were respiratory failure (26.4%; n = 14) and sepsis (24.5%; n = 13). The median LHS was 11 (6-18) days and MV median was 11 (6-16.86) days. The frequency of BMI above and below the adequate level was 23.5% (n = 12) and 29.4% (n = 15), respectively.
    Conclusion: The criteria used for nutritional assessment were not associated with clinical outcomes LHS and MV.
    Review Article
    Joao Victor Batista Cabral, Maria Mariana Barros Melo da Silveira, Ester Morais Reis, Henrique Lacet Cordeiro, Dario Celestino Sobral Filho, and Ana Celia Oliveira dos Santos
    Nutritional deficiency compromises the adequate immune and metabolic functions, and may cause repercussions during the postoperative period of pediatric patients submitted to cardiac surgery, thereby causing or aggravating clinical problems. Our aim was to investigate the association of operative complications with the nutritional deficiency of pediatric patients with congenital heart disease submitted to surgical correction. This was a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocol. Of the total number of studies, 16 were related to complications in pediatric cardiac surgery associated with malnutrition, and presented significantly statistical association measures. However, due to the heterogeneity of nutritional assessment methods, it was not possible to define a standard for clinical direction with variables to manage the preoperative period. PROSPERO Registration: CRD 42018111409.
    Joao Victor Batista Cabral, Maria Mariana Barros Melo da Silveira, Ester Morais Reis, Henrique Lacet Cordeiro, Dario Celestino Sobral Filho, and Ana Celia Oliveira dos Santos
    Inflammatory changes compromise the adequate immune and metabolic functions in the postoperative period of pediatric patients submitted to surgery and may cause and/or aggravate clinical problems. Our aim was to investigate the association between intra and postoperative complications with laboratory markers in pediatric patients with congenital heart disease submitted to surgical correction. This was a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocol. The studies demonstrated an association between parameters such as glycemia, lactate, interleukins 6, 8 and 10, and surgical complications, all of which presented results with a statistical significance. There was evidence that associated inflammatory parameters as predictors of postoperative complications in children submitted to cardiac surgery. PROSPERO Registration: CRD 42018111409.
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