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Article ; Online: Exclusive breastfeeding and length of hospital stay in premature infants at a Brazilian reference center for kangaroo mother care.

Campanha, Patrícia de Padua Andrade / de Magalhães-Barbosa, Maria Clara / Prata-Barbosa, Arnaldo / Rodrigues-Santos, Gustavo / da Cunha, Antônio José Ledo Alves

Jornal de pediatria

2024

Abstract: Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in preterm infants undergoing or not the Kangaroo-Mother Care Method (KMC).: Methods: A retrospective cohort study was conducted including preterm infants < 1800 ... ...

Abstract	Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in preterm infants undergoing or not the Kangaroo-Mother Care Method (KMC). Methods: A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. Results: 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85-109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76-0.86) compared to the non-KMC group. Conclusions: The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals.
Language	English
Publishing date	2024-03-21
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731324-x
ISSN	1678-4782 ; 0021-7557
ISSN (online)	1678-4782
ISSN	0021-7557
DOI	10.1016/j.jped.2024.01.004
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Article ; Online: Pediatric delirium in times of COVID-19.

Castro, Roberta Esteves Vieira de / Rodríguez-Rubio, Miguel / Magalhães-Barbosa, Maria Clara de / Prata-Barbosa, Arnaldo

Revista Brasileira de terapia intensiva

2022 Volume 33, Issue 4, Page(s) 483–486

Title translation	Delirium pediátrico em tempos da COVID-19.
MeSH term(s)	COVID-19 ; Child ; Delirium/diagnosis ; Humans ; SARS-CoV-2
Language	Portuguese
Publishing date	2022-01-24
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2732162-9
ISSN	1982-4335 ; 1982-4335
ISSN (online)	1982-4335
ISSN	1982-4335
DOI	10.5935/0103-507X.20210070
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Article: Pediatric Sepsis Research: Where Are We and Where Are We Going?

Massaud-Ribeiro, Letícia / Silami, Pedro Henrique Nunes Costa / Lima-Setta, Fernanda / Prata-Barbosa, Arnaldo

Frontiers in pediatrics

2022 Volume 10, Page(s) 829119

Abstract: Sepsis continues to be one of the leading causes of admission to the Pediatric Intensive Care Unit, representing a great challenge for researchers and healthcare staff. This mini review aims to assess research on pediatric sepsis over the years. Of the 2, ...

Abstract	Sepsis continues to be one of the leading causes of admission to the Pediatric Intensive Care Unit, representing a great challenge for researchers and healthcare staff. This mini review aims to assess research on pediatric sepsis over the years. Of the 2,698 articles retrieved from the Scopus database, the 100 most cited were selected (50 published since 2000 and 50 published since 2016). The most cited studies, published in the 21st century, are highlighted, with their main findings and perspectives.
Language	English
Publishing date	2022-02-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.829119
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Article ; Online: Maternal-fetal and neonatal characteristics associated with Kangaroo-Mother Care Method adherence.

Campanha, Patrícia de Padua Andrade / Magalhães-Barbosa, Maria Clara de / Rodrigues-Santos, Gustavo / Prata-Barbosa, Arnaldo / Cunha, Antônio José Ledo Alves da

Jornal de pediatria

2023 Volume 99, Issue 4, Page(s) 355–361

Abstract: Objective: To describe the association of maternal and neonatal characteristics with the adherence status to the in-hospital stages of the Kangaroo-Mother Care Method - KMC (full, partial, and no-adherence).: Methods: Retrospective cohort study ... ...

Abstract	Objective: To describe the association of maternal and neonatal characteristics with the adherence status to the in-hospital stages of the Kangaroo-Mother Care Method - KMC (full, partial, and no-adherence). Methods: Retrospective cohort study including infants < 2500 g admitted to a reference maternity hospital for the KMC in Rio de Janeiro from January to December 2018. Maternal and neonatal characteristics were distributed according to the adherence status to the KMC in-hospital stages. In the first stage, KMC is performed in Neonatal Intensive Care Unit and Conventional Neonatal Intermediate Care Unit. The second stage is completed in Kangaroo Neonatal Intermediate Care Unit. Multinomial multiple regression was performed with KMC adherence as a three-category dependent variable and maternal and neonatal characteristics as independent variables. Results: Of 166 dyads, 102 (61.5%) participated in two stages. Those who did not participate in any stage (n = 52; 31.3%) had a lower level of education, a higher frequency of adverse conditions, and were more often single mothers; mothers who participated only in the first stage (n = 12; 7,2%) had more premature and sick infants. Conditions associated with adherence to the two stages compared to no adherence were: high school education (OR = 2.34; 95% CI = 1.08-5.07), presence of a partner (OR = 3.82; 95% CI = 1.7-8.61), no adverse conditions (OR = 3.54; 95% CI = 1.59-7.89) and no neonatal resuscitation (OR = 2.73; 95% CI = 1.22-6.1). Conclusions: The study identified maternal and neonatal conditions associated with adherence status to the KMC. The results suggest opportunities to improve adherence.
MeSH term(s)	Infant ; Child ; Infant, Newborn ; Humans ; Female ; Pregnancy ; Kangaroo-Mother Care Method/methods ; Retrospective Studies ; Brazil ; Mothers ; Length of Stay
Language	English
Publishing date	2023-01-27
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731324-x
ISSN	1678-4782 ; 0021-7557
ISSN (online)	1678-4782
ISSN	0021-7557
DOI	10.1016/j.jped.2022.12.005
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Article ; Online: Update on SARS-CoV-2 infection in children.

Martins, Marlos Melo / Prata-Barbosa, Arnaldo / da Cunha, Antônio José Ledo Alves

Paediatrics and international child health

2021 Volume 41, Issue 1, Page(s) 56–64

Abstract: Despite the worldwide spread of SARS-CoV-2 infection (COVID-19), knowledge of the different clinical presentations, ways of transmission, severity and prognosis in children and adolescents is limited. An increasing number of reports describe some of ... ...

Abstract	Despite the worldwide spread of SARS-CoV-2 infection (COVID-19), knowledge of the different clinical presentations, ways of transmission, severity and prognosis in children and adolescents is limited. An increasing number of reports describe some of these characteristics in this age range. A non-systematic review was undertaken using MEDLINE (PubMed), LILACS (VHL), Scopus, Web of Science, Cochrane and CAPES Portal databases from 1 January until 30 September 2020 [103] with the search terms SARS-CoV-2, COVID-19, child, children, youth, adolescent and newborn to identify the more recent clinical aspects of SARS-CoV-2 infection in children. In general, SARS-CoV-2 infection in children tends to be asymptomatic or to have mild or moderate signs, and most young ones are infected by family members. Recent reports offer new insights into the disease. Current evidence on SARS-CoV-2 infection in children and adolescents is presented, especially concerning the clinical presentation, imaging and uncommon severe forms of the disease, particularly the COVID-19-associated multisystem inflammatory syndrome. The impact of COVID-19 infection in the perinatal period is described in detail. Knowledge of the various clinical presentations of SARS-CoV-2 in children and adolescents allows the paediatrician to diagnose earlier, monitor warnings signs, implement treatment and, especially, establish preventive measures.
MeSH term(s)	Adolescent ; COVID-19/complications ; COVID-19/etiology ; COVID-19/therapy ; COVID-19/transmission ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Mucocutaneous Lymph Node Syndrome/etiology ; Mucocutaneous Lymph Node Syndrome/therapy ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome/etiology ; Systemic Inflammatory Response Syndrome/therapy
Language	English
Publishing date	2021-02-22
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2649065-1
ISSN	2046-9055 ; 2046-9047
ISSN (online)	2046-9055
ISSN	2046-9047
DOI	10.1080/20469047.2021.1888026
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Zs.A 1674: Show issues

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Article ; Online: High-fidelity simulation versus case-based discussion for training undergraduate medical students in pediatric emergencies: a quasi-experimental study.

Moliterno, Nathalia Veiga / Paravidino, Vitor Barreto / Robaina, Jaqueline Rodrigues / Lima-Setta, Fernanda / da Cunha, Antônio José Ledo Alves / Prata-Barbosa, Arnaldo / de Magalhães-Barbosa, Maria Clara

Jornal de pediatria

2024

Abstract: Objective: To evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in ... ...

Abstract	Objective: To evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. Methods: 33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge's g. Results: Both groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (grouptime effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). Conclusion:* HFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge.
Language	English
Publishing date	2024-04-09
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731324-x
ISSN	1678-4782 ; 0021-7557
ISSN (online)	1678-4782
ISSN	0021-7557
DOI	10.1016/j.jped.2024.03.007
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Article ; Online: Toxic stress, epigenetics and child development.

de Magalhães-Barbosa, Maria Clara / Prata-Barbosa, Arnaldo / da Cunha, Antonio José Ledo Alves

Jornal de pediatria

2021 Volume 98 Suppl 1, Page(s) S13–S18

Abstract: Objectives: To describe the concept of toxic stress, present the basics of epigenetics and discuss their relationship with child development.: Data source: Narrative literature review through a search in the SciELO, Lilacs, Medline databases using ... ...

Abstract	Objectives: To describe the concept of toxic stress, present the basics of epigenetics and discuss their relationship with child development. Data source: Narrative literature review through a search in the SciELO, Lilacs, Medline databases using the terms Adverse Childhood Experience OR Early Life Stress, Epigenomic OR Epigenetic, Child Development OR Infant Development. Data synthesis: Continuing stress response, known as toxic stress, can occur when a child experiences intense, frequent, and/or prolonged adversity-such as physical or emotional abuse, chronic neglect, for example-without adequate adult support. This toxic stress can have harmful effects on learning, behavior, and health throughout life. Epigenetics, an emerging scientific research area, shows how environmental influences affect gene expressions and explains how early experiences can impact throughout life. Conclusions: Toxic stress causes changes in the human body response systems that can be explained in part by epigenetic changes, which can be temporary or long-lasting. Pediatricians must be aware of these mechanisms and their consequences, seeking to prevent them and thus promote the health, well-being, and quality of life of children, contributing to their full development.
MeSH term(s)	Adult ; Adverse Childhood Experiences ; Child ; Child Abuse ; Child Development ; Epigenesis, Genetic ; Epigenomics ; Humans ; Infant ; Quality of Life
Language	English
Publishing date	2021-11-16
Publishing country	Brazil
Document type	Journal Article ; Review
ZDB-ID	731324-x
ISSN	1678-4782 ; 0021-7557
ISSN (online)	1678-4782
ISSN	0021-7557
DOI	10.1016/j.jped.2021.09.007
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Article: Incidence of retinoblastoma in children and adolescents in Brazil: A population-based study.

Barbosa, Annamaria Ciminelli / de Magalhães-Barbosa, Maria Clara / Moreira, Jessica Pronestino de Lima / Colombini, Giovanni Nicola Umberto Italiano / Prata-Barbosa, Arnaldo

Frontiers in pediatrics

2022 Volume 10, Page(s) 1048792

Abstract: Objective: To estimate the incidence of retinoblastoma in children and adolescents in Brazil based on Population-Based Cancer Registry (PBCR), describing temporal trends and some quality indicators of this registry.: Methods: Based on secondary data ... ...

Abstract	Objective: To estimate the incidence of retinoblastoma in children and adolescents in Brazil based on Population-Based Cancer Registry (PBCR), describing temporal trends and some quality indicators of this registry. Methods: Based on secondary data from the PBCR of the National Institute of Cancer (INCA) (2000-2018), by selecting the morphological code of retinoblastoma, the annual incidences per million (0-19 years of age) in each local PBCR were estimated by sex and age group, global combined and by region, in addition to the percentage of diagnosis only by death certificate (DC) or not informed (NI), and the male/female ratio (M/F). An annual incidence trend in the five Brazilian geographic regions was also analyzed using the inflection point regression technique. Results: 675 patients were identified in 28 PBCR, 91% between 0 and 4 years of age. The overall combined incidence per million by age group was: 7.02 (0-4 years old), ranging from 5.25 in the Midwest to 11.26 in the Northeast; 0.46 (5-9 years old); 0.05 (10-14 years old) and 0.03 (15-19 years old). The combined incidence per million, adjusted for the world population, was 2.23 (0-14 years old) and 2.24 (0-19 years old). The DC and NI percentages were 13% and 18%, respectively; the M/F ratio was 1.3. The incidence remained stable throughout the study period, except for the city of São Paulo, where there was a significant reduction of 3.4% per year. Conclusions: In Brazil, except for the Northeast region, the incidences of retinoblastoma were lower than those reported in several countries worldwide, suggesting possible underreporting, and the time series analysis showed a stable trend. Although this pioneering study brings a recent panel of available data on retinoblastoma in Brazil, more precise estimates are needed and welcome for better planning of onco-ophthalmologic care in the country.
Language	English
Publishing date	2022-11-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.1048792
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Article ; Online: Validity of the Brazilian pediatric triage system CLARIPED at a secondary level of emergency care.

de Magalhães-Barbosa, Maria Clara / de Camargo Traldi, Paula / Raymundo, Carlos Eduardo / da Cunha, Antonio José Ledo Alves / Prata-Barbosa, Arnaldo

Jornal de pediatria

2022 Volume 99, Issue 3, Page(s) 247–253

Abstract: Objective: To evaluate the validity of the triage system CLARIPED in a pediatric population in the city of São Paulo, Brazil.: Methods: Prospective, observational study in a secondary-level pediatric emergency service from Sep-2018 to Ago-2019. A ... ...

Abstract	Objective: To evaluate the validity of the triage system CLARIPED in a pediatric population in the city of São Paulo, Brazil. Methods: Prospective, observational study in a secondary-level pediatric emergency service from Sep-2018 to Ago-2019. A convenience sample of all patients aged 0-18 years triaged by the computerized CLARIPED system was selected. Associations between urgency levels and patient outcomes were analyzed to assess construct validity. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) to identify the most urgent patients were estimated, as well as under-triage and over-triage rates. Results: The distribution of 24,338 visits was: RED 0.02%, ORANGE 0.9%, YELLOW 23.5%, GREEN 47.9%, and BLUE 27.7% (highest to the lowest level of urgency). The frequency of the following outcomes increased with increasing urgency: hospital admission (0.0%, 0.02%, 0.1%, 7.1% and 20%); stay in ED observation room (1.9%, 2,4%, 4.8%, 24.1%, 60%); use of ≥ 2 diagnostic/therapeutic resources (2.3%, 3.0%, 5.9%, 28.8%, 40%); ED length of stay (12, 12, 15, 99.5, 362 min). The most urgent patients (RED, ORANGE, and YELLOW) exhibited higher chances of using ≥ 2 resources (OR 2.55; 95%CI: 2.23-2.92) or of being hospitalized (OR 23.9; 95%CI: 7.17-79.62), compared to the least urgent (GREEN and BLUE). The sensitivity to identify urgency was 0.88 (95%CI: 0.70-0.98); specificity, 0.76 (95%CI: 0.75-0.76); NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 23.0%, and undertriage, 11.5%. Conclusion: This study corroborates the validity and safety of CLARIPED, demonstrating significant correlations with clinical outcomes, good sensitivity, and low undertriage rate in a secondary-level Brazilian pediatric emergency service.
MeSH term(s)	Child ; Humans ; Triage ; Brazil ; Prospective Studies ; Emergency Service, Hospital ; Emergency Medical Services
Language	English
Publishing date	2022-11-18
Publishing country	Brazil
Document type	Observational Study ; Journal Article
ZDB-ID	731324-x
ISSN	1678-4782 ; 0021-7557
ISSN (online)	1678-4782
ISSN	0021-7557
DOI	10.1016/j.jped.2022.10.005
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Article: Brazilian Portuguese Translation and Cross-Cultural Adaptation of the Sophia Observation Withdrawal Symptoms Pediatric Delirium Tool for the Diagnosis of Withdrawal Syndrome and Delirium in Children.

Castro, Roberta Esteves Vieira de / de Almeida, Juliana Patrícia Chaves / Monteiro Medeiros, Daniela Nasu / Cheniaux, Elie / Colleti Júnior, José / de Magalhães-Barbosa, Maria Clara / Prata-Barbosa, Arnaldo / Ista, Erwin

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 25, Issue 2, Page(s) e103–e104

MeSH term(s)	Child ; Humans ; Cross-Cultural Comparison ; Brazil ; Substance Withdrawal Syndrome/diagnosis ; Delirium/diagnosis ; Surveys and Questionnaires ; Translations ; Reproducibility of Results
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003364
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