Manoel A. S. Ribeiro

[Breastfeeding and early childhood caries: a critical review].

OBJETIVO: Buscar evidencias cientificas que comprovem ou refutem a afirmacao de que o aleitamento materno noturno e em livre demanda esta associado com carie do lactente e do pre-escolar. FONTES DOS DADOS: Foi realizada busca de artigos cientificos utilizando-se as bases de dados MEDLINE, Lilacs e SciELO, paginas de internet relevantes, livros tecnicos e publicacoes de consenso de organismos nacionais e internacionais. As palavras-chave utilizadas foram: early childhood caries, dental caries, dental decay e breastfeeding. Percebida a relevância, tambem se buscou diretamente as referencias indicadas nos artigos encontrados. SINTESE DOS DADOS: Os estudos que relacionam a carie com o aleitamento materno invariavelmente so observam os fatores inter-relacionados com o surgimento dessa doenca, deixando de lado aqueles associados a amamentacao. Muitos desses fatores atuam como variaveis de confusao porque, do mesmo modo que interferem no aleitamento materno, tambem tem influencia no surgimento da carie. Alem disso, estudos atuais tem demonstrado a cariogenicidade de varios alimentos dados as criancas e a nao-cariogenicidade do leite materno. CONCLUSOES: Nao ha evidencias cientificas que comprovem que o leite materno possa estar associado com o surgimento de carie, sendo essa relacao complexa e confundida por muitas variaveis.

Surfactant deficiency in full-term newborns with transient tachypnea delivered by elective C-section.

Previous studies have suggested that full‐term newborns delivered by elective cesarean section who develop transient tachypnea have low gastric microbubble counts. In the present study, microbubble concentrations in oral fluid samples were used to evaluate pulmonary maturity.

Comparação de técnicas não invasivas para medir a pressão arterial em recém-nascidos

OBJECTIVE: To compare blood pressure measurements in newborn infants using the flush method, pulse oximetry and oscillometry according to Doppler findings. METHODS: Noninvasive blood pressure measurements were made using three techniques (flush method, pulse oximetry and oscillometry) in three groups of newborns: 15 normal term infants, 16 stable preterm infants, and 14 critically ill infants. All measurements were video recorded, edited separately, coded and analyzed independently by three neonatologists. RESULTS: Fifty-seven measurements were made using each method. The flush method and pulse oximetry had a better correlation with Doppler findings than oscillometry (correlation coefficients: 0.89, 0.85, 0.71; p < 0.01). The difference between measurement means, their standard deviations and the 95% confidence intervals when compared with Doppler findings were: -5.2±7.9 (-21.1:10.7) mmHg for the flush method; 0.4±8.9 (-17.5:18.2) mmHg for pulse oximetry; and 6.4±16.1 (-25.8:8.6) mmHg for oscillometry. The flush method had a better agreement with Doppler findings for the diagnosis of hypotension than oximetry and oscillometry. CONCLUSIONS: The flush method and pulse oximetry seem to be useful techniques to measure systolic blood pressure in newborn infants; oscillometry had the poorest agreement with Doppler findings to detect hypotension.

Comparison of noninvasive techniques to measure blood pressure in newborns.

OBJECTIVE To compare blood pressure measurements in newborn infants using the flush method, pulse oximetry and oscillometry according to Doppler findings. METHODS Noninvasive blood pressure measurements were made using three techniques (flush method, pulse oximetry and oscillometry) in three groups of newborns: 15 normal term infants, 16 stable preterm infants, and 14 critically ill infants. All measurements were video recorded, edited separately, coded and analyzed independently by three neonatologists. RESULTS Fifty-seven measurements were made using each method. The flush method and pulse oximetry had a better correlation with Doppler findings than oscillometry (correlation coefficients: 0.89, 0.85, 0.71; p < 0.01). The difference between measurement means, their standard deviations and the 95% confidence intervals when compared with Doppler findings were: -5.2 ± 7.9 (-21.1:10.7) mmHg for the flush method; 0.4 ± 8.9 (-17.5:18.2) mmHg for pulse oximetry; and 6.4 ± 16.1 (-25.8:8.6) mmHg for oscillometry. The flush method had a better agreement with Doppler findings for the diagnosis of hypotension than oximetry and oscillometry. CONCLUSIONS The flush method and pulse oximetry seem to be useful techniques to measure systolic blood pressure in newborn infants; oscillometry had the poorest agreement with Doppler findings to detect hypotension.

Rapid diagnosis of respiratory distress syndrome by oral aspirate in premature newborns

OBJECTIVE The stable microbubble test on gastric aspirate and on amniotic fluid has been used for the diagnosis of respiratory distress syndrome in the newborn. However, no study has performed this test on oral aspirates from premature infants. The objective of this study was to evaluate the performance of the stable microbubble test on oral aspirates from preterm newborns to predict respiratory distress syndrome. METHOD This study included infants with gestational age <34 weeks. Oral fluids were obtained immediately after birth and gastric fluids were collected within the first 30min of life. The samples were frozen and tested within 72h. RESULTS The sample was composed of paired aspirates from 64 newborns, who were divided into two groups: respiratory distress syndrome group (n=21) and control group (n=43). The median (interquartile range) of the stable microbubble count in the oral samples of infants with respiratory distress syndrome was significantly lower than that of infants who did not develop respiratory symptoms: respiratory distress syndrome group=12 (8-22) stable microbubbles/mm2; control group=100 (48-230)microbubbles/mm2 (p<0.001). The correlation between microbubble count in gastric and oral aspirates was 0.90 (95% confidence interval=0.85-0.95; p<0.001). Considering a cut-off point of 25microbubbles/mm2, the sensitivity and the specificity of the stable microbubble test were 81.4% and 85.7%, respectively. CONCLUSION The study suggests that the stable microbubble test performed on oral aspirate is a reliable alternative to that performed on gastric fluid for the prediction of respiratory distress syndrome in the newborn.