Navegando por Palavras-chave "congenital"
Agora exibindo 1 - 7 de 7
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Anestesia congênita de córnea: relatos de casos(Conselho Brasileiro de Oftalmologia, 2012-06-01) Lana, Flávia Pelinsari [UNIFESP]; Oliveira, Renato Correa Souza De [UNIFESP]; Vieira, Ana Carolina Cabreira [UNIFESP]; Araújo, Maria Emília Xavier Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Case series of nine patients with congenital corneal anesthesia, six of them showed systemic changes in association with the ocular status. Three patients were submitted to electromyography, two showed isolated bilateral ophthalmic ramus alteration. Two patients had initial visual acuity better than 20/60 and six had final best corrected visual acuity better than 20/60 at the last visit. All of them were treated surgically and developed cornea opacities of variable sizes. Treatment of corneal congenital anesthesia must be performed as soon as possible to avoid corneal opacification. Systemic investigation, close follow-up and preparing the family for longterm and multidisciplinary approach are crucial to maintain the ocular health.
- ItemAcesso aberto (Open Access)Anestesia para tratamento intraparto extraútero (EXIT) em fetos com diagnóstico pré-natal de malformações cervical e oral: relato de casos(Sociedade Brasileira de Anestesiologia, 2012-06-01) Helfer, Daniel Corrêa [UNIFESP]; Clivatti, Jefferson [UNIFESP]; Yamashita, Américo Massafuni [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND AND OBJECTIVES: Fetus prenatally diagnosed with neck tumors, or with any other disease that obstructs the airways, should not be treated conventionally, as the assistant physician has to face two challenges right after the infant's delivery: the limited time to establish the access to the potentially difficult airways and the lack of anesthesia of the neonate in case of instrumentation of the airways. The ex utero intrapartum treatment, i.e., the EXIT procedure consists of maintaining the fetoplacental circulation during the cesarean section, until the airways of the fetus be secured. CASE REPORTS: Female patient, 37 years old, G3P2, 38 weeks pregnant, having polyhydramnios and fetus diagnosed with large cervical masses by prenatal ultrasound. A cesarean section was performed using the EXIT procedure to enable safe access to the infant's airways. After hysterotomy, the fetus was intubated by direct laryngoscopy. The neonate was immediately transferred to another operating room, where cervical tumor resection of the neck tumor and tracheostomy were successfully performed. Female patient, 27 years old, G3P1A1, 32 weeks pregnant, whose fetus was prenatally diagnosed with a large oral tumor. As the tumor obstructed the fetus' airways, a tracheostomy was performed when the fetus underwent EXIT procedure. It was then possible to use direct laryngoscopy for neonate intubation. The fetus underwent tumor resection and was sent to the Neonatal Intensive Care Unit. CONCLUSIONS: Reports describe the successful use of general anesthesia with isoflurane for cesarean delivery followed by the EXIT procedure in fetus diagnosed with tumors obstructing the airways.
- ItemAcesso aberto (Open Access)Avaliação do sopro cardíaco na infância(Sociedade Brasileira de Pediatria, 2003-06-01) Kobinger, Maria Elisabeth B.a. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: to discuss clinical and laboratorial evaluation of heart murmurs in children, an important problem faced by pediatricians in their practice. SOURCES OF DATA: this review was based on a critical analysis of the current literature, as well as pediatrics and pediatric cardiology textbooks, which were found to be an important source of information on the subject. SUMMARY OS THE FINDINGS: it is important for pediatricians to know how to obtain precise information regarding the patient's medical history and to perform extensive physical examination of a child with heart murmur. The diagnosis of innocent heart murmur is essentially clinical and it can help the pediatrician to identify situations which are associated with cardiovascular diseases. CONCLUSIONS: in our series, short-term video-EEG monitoring established a reliable diagnosis in most patients due to correlation between clinical and EEG data. This procedure was well tolerated by children, including infants and those with psychiatric disorders.
- ItemSomente MetadadadosCongenital duodenal obstruction: does prenatal diagnosis improve the outcome?(Springer, 2004-08-01) Bittencourt, D. G.; Barini, R.; Marba, S.; Sbragia, L.; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)Prenatal diagnosis of congenital duodenal obstruction (CDO) provides information about associated anomalies; helps plan the delivery, resuscitation, and neonatal surgery; and allows for appropriate family counseling. This report compares the outcomes of two groups of newborns: one with prenatal diagnosis of CDO (group I) and the other without (group II). Charts of the 23 newborns with CDO admitted to the Hospital of UNICAMP between 1993 and 2001 were retrospectively reviewed. Ten (44%) newborns had prenatal diagnosis of CDO. Among group I patients, the postnatal diagnosis was confirmed on the 1st day of life, whereas patients without prenatal diagnosis (group II) had the diagnosis of CDO confirmed at a mean age of 5.7 days (p=0.004). the mean ages at surgery, at total oral feeding, and at hospital discharge were also statistically lower among infants with prenatal diagnosis, and more complications occurred in group II patients. the earlier care could explain the statistically lower morbidity for patients with prenatal diagnosis, since they were able to undergo further investigation and surgical repair before any impairment to their clinical status could take place. We believe that prenatal diagnosis of CDO, associated with earlier surgery and adequate postoperative support, can provide lower morbidity, decrease the hospitalization period, and, therefore, decrease its costs to the state and to society.
- ItemSomente MetadadadosEtiology-specific outcomes of intracytoplasmic sperm injection in azoospermic patients(Elsevier B.V., 2005-03-01) Pasqualotto, Fábio F.; Rossi, Lia Mara; Guilherme, Patricia; Ortiz, Valdemar [UNIFESP]; Iaconelli, Assumpto; Borges Junior, Edson; Fertil Ctr Assisted Reprod; Jundiai Med Sch; Universidade Federal de São Paulo (UNIFESP)Objective: To assess fertilization, pregnancy, and miscarriage rates after intracytoplasmic sperm injection (ICSI) with epididymal or testicular spermatozoa from different types of azoospermia.Design: Retrospective study.Setting: Academic medical center and private fertility center.Patient(s): Two hundred twelve patients underwent 257 ICSI cycles.Intervention(s): Cycles of ICSI were divided into four groups according to the etiology of azoospermia: A (nonobstruction), B (postvasectomy), C (congenital obstruction), and D (obstruction due to infection). Testicular sperm aspiration and percutaneous epididymal sperm aspiration were the sperm retrieval methods used for ICSI.Main Outcome Measure(s): Fertilization, pregnancy, and miscarriage rates.Result(s): Normal fertilization rates were higher in groups C (67.7%) and B (64.1%) compared with groups A (47.3%) and D (58.9%). Although lower pregnancy rates were seen in group A, no statistical differences were detected among groups. However, the miscarriage rate was higher in group A (45.6%) compared with groups B (25.25%), C (24%), and D (22.58%).Conclusion(s): Although no differences were detected in the pregnancy rates across groups, fertilization and implantation rates were higher in patients with congenital obstruction of the seminal path. the pregnancy rate was higher and the miscarriage rate lower when epididymal sperm was used compared with testicular sperm. (c) 2005 by American Society for Reproductive Medicine.
- ItemSomente MetadadadosImplantação de observatório para sífilis gestacional e congênita(Universidade Federal de São Paulo (UNIFESP), 2016-04-29) Lazarini, Flaviane Mello [UNIFESP]; Barbosa, Dulce Aparecida Barbosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The emergence of syphilis in the Brazilian population and their aspects who include maternal and child health as well as the difficulties encountered by epidemiological surveillance in using health policies instituted by the Ministry of Health-Brazil, was necessary establish an Observatory for syphilis who originated from the partnership between the Municipal Health of Londrina, Paraná and the State University of Londrina. This study was based on the importance of educational and interventional role of epidemiological surveillance with introduce of measures needed to prevent and / or control the occurrence of syphilis epidemic. Purpose: the aim of this study was to describe the effectiveness of the implanted Observatory and monitoring the pregnancy and congenital syphilis and possible changes in the epidemiological profile of this disease. Methods: The epidemiological design used was quasi-experimental, before and after, conducted during the period from October 2013 to December 2015, approved by ethic committee of UNIFESP with the need of written consent signed from health professionals participating. The study material were all reported forms of individuals with gestational syphilis and congenital syphilis between 2007 and 2013 (before the intervention) and period 2014-2015, after the intervention. The population were 102 health professionals from Primary Health Care Unit, responsible for compulsory notification of infectious diseases. We performed situational diagnosis in the pre-intervention, intervention (professional training) with self-applied questionnaire to measure knowledge before and after the intervention. Data were tabulated and categorized by Excel for Windows and SPSS (Statistical Package for Social Sciences) ® 2.1. The analysis was descriptive and inferential (McNemar test). Results: about 92.6% of the professionals take part to local intervention workshops and have been improved their knowledge of antenatal on diagnosis and management of syphilis after the intervention, which reached a pre success rate of 53% and 74.3%, post-intervention (p<0.01). Syphilis detection rate in pregnant women increased by 7.3/1000 from 2013 to 2015. The incidence of congenital syphilis decreased from 7.1/1000 in 2013 to 4.8/1000 in 2014 but began to grow again in 2015 (6.7 /1000). After the intervention, there was no registration of infant deaths from syphilis, however, there was an increased detection fetal deaths investigated and confirmed. Conclusion: the educational intervention and the establishment of the Observatory for Syphilis expanded the development of epidemiological monitoring actions and brought positive impact with proper use of tool. We managed expand early case detection in pregnancy and we achieved the vertical transmission reduction of syphilis besides detection of fetal deaths who increased. There was elimination of specific infant mortality by this grievance in 2014 and 2015.
- ItemAcesso aberto (Open Access)Perfil das crianças submetidas à correção de cardiopatia congênita e análise das complicações respiratórias(Sociedade de Pediatria de São Paulo, 2012-01-01) Oliveira, Priscila Mara N. [UNIFESP]; Held, Priscila Antonichelli de; Grande, Rosângela Aparecida A.; Ribeiro, Maria Ângela Gonçalves de Oliveira; Bobbio, Tatiana Godoy; Schivinski, Camila Isabel S.; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica de Campinas Hospital Celso Pierro; Universidade Estadual de Campinas (UNICAMP); Universidade do Estado de Santa Catarina; UdescOBJECTIVE: To describe the profile of children that undergo surgical correction of congenital heart disease (CHD) in a university hospital and to compare patients with and without postoperative respiratory complications. METHOD: This observational analytical study reviewed the records of children that underwent corrective surgery for CHD a Brazilian University Hospital during 11 months. The following demographic variables were collected: age, sex, body mass index, comorbidities, and CHD types. Demographic variables and data about the intra- and postoperative care were compared for patients with and without postoperative respiratory complications. The Mann-Whitney and the Fisher exact tests were used, and the level of significance was set at p<0.05. RESULTS: The sample consisted of 55 children (49% boys) whose median age was 37.5 months. Three or more CHD were found in 29.1%, and 53% of all cases had comorbidities. The analysis of postoperative respiratory complications revealed that 31% of the patients had atelectasis and pleural effusion and 5.5% had laryngitis, pneumomediastinum or lung injury. Non-respiratory complications were identified in 24% of the patients. Survival was 89%. Children with postoperative respiratory complications received mechanical ventilation for a longer time and had a prolonged hospital stay (p<0.001). CONCLUSION: The association between respiratory complications, longer mechanical ventilation and longer hospital stay reinforced the need to avoid such complications to reduce costs of a prolonged hospital stay.