Abstract Objectives: to evaluate the effect of oropharyngeal colostrum immunotherapy on the length of hospital stay in preterm newborns with very low birth weight. Methods: interventional ambispective study, which consisted of eight daily administrations of 0.2 ml (four drops) of colostrum, totaling up to 56 syringes (for up to seven days). The control was historic. The main independent variable: length of hospital stay (days). Survival analysis was performed using the Kaplan-Meier Method and the survival effect was estimated - Log Rank Test (Mantel-Cox) and Breslow Test (Generalized Wilcoxon). A significance level of 5% was adopted. Results: of the 109 mother/child pairs, 56 were part of the treatment and 53 were part of the control group. There was no association between oropharyngeal colostrum immunotherapy and length of stay for preterm newborns with very low birth weight in the general sample. However, after stratification, a shorter hospital stay (42 versus 51 days, HR= 1.78, CI95%=1.02-3.09, p=0.04) was demonstrated among premature infants with ≥28 gestational weeks undergoing oropharyngeal colostrum immunotherapy. Conclusions: we found an association between oropharyngeal colostrum immunotherapy and shorter median length of hospital stay in the subgroup of premature infants ≥ 28 weeks of gestational age, but we did not find significant differences in those <28 weeks. Objectives Methods study 02 0 2 0. four drops 5 days. days . days) historic variable (days) KaplanMeier Kaplan Meier MantelCox Mantel Cox (Mantel-Cox Generalized Wilcoxon. Wilcoxon Wilcoxon) adopted Results 10 motherchild mother child pairs group sample However stratification 42 (4 HR 178 1 78 1.78 CI95%=1.023.09, CI95102309 CI CI95%=1.02 3.09, CI95 3 09 CI95%=1.02-3.09 p=0.04 p004 p 04 ≥2 Conclusions age <2 (days 4 ( 17 7 1.7 023 CI95%=1.023.09 CI9510230 CI95102 CI95%=1.0 309 3.09 CI9 CI95%=1.02-3.0 p=0.0 p00 < 1. CI95%=1.023.0 CI951023 CI9510 CI95%=1. 30 3.0 CI95%=1.02-3. p=0. p0 CI95%=1.023. CI951 CI95%=1 3. CI95%=1.02-3 p=0 CI95%=1.023 CI95%= CI95%=1.02- p= CI95%

Resumo Objetivos: avaliar o efeito da imunoterapia orofaríngea de colostro no tempo de internamento hospitalar de recém-nascidos pré-termos de muito baixo peso. Métodos: estudo de intervenção, ambispectivo, que consistiu em oito administrações diárias de 0,2 ml (quatro gotas) de colostro, totalizando até 56 seringas (por até sete dias). O controle foi histórico. A variável independente principal: tempo de permanência hospitalar (dias). Realizada análise de sobrevivência pelo Método de Kaplan-Meier e estimado o efeito da sobrevida - Teste de Log Rank (Mantel-Cox) e Teste de Breslow (Wilcoxon Generalizado). Adotou-se o nível de significância de 5%. Resultados: das 109 duplas mães/filho, 56 fizeram parte da análise do grupo tratamento e 53 do controle. Não houve associação entre imunoterapia orofaríngea de colostro e tempo de internamento de recém-nascidos pré-termos de muito baixo peso na amostra geral. Após estratificação demonstrou-se menor tempo de permanência hospitalar (43 versus 51 dias, HR=1,78, IC95%= 1,02-3,09, p=0,04) entre os prematuros com ≥28 semanas gestacionais submetidos a imunoterapia orofaríngea de colostro. Conclusões: encontrou-se associação entre imunoterapia orofaríngea de colostro e menor mediana de tempo de internamento hospitalar no subgrupo de prematuros ≥ 28 semanas de idade gestacional, porém não foram encontradas diferenças significativas naqueles < 28 semanas. Objetivos recémnascidos recém nascidos prétermos pré termos Métodos intervenção ambispectivo 02 0 2 0, quatro gotas 5 por dias. dias . dias) histórico principal (dias) KaplanMeier Kaplan Meier MantelCox Mantel Cox (Mantel-Cox Wilcoxon Generalizado. Generalizado Generalizado) Adotouse Adotou se 5% Resultados 10 mãesfilho mães filho mães/filho geral demonstrouse demonstrou 43 (4 HR178 HR 1 78 HR=1,78 IC95 IC IC95% 1,023,09, 102309 1,02 3,09, 3 09 1,02-3,09 p=0,04 p004 p 04 ≥2 Conclusões encontrouse encontrou gestacional (dias 4 ( HR17 7 HR=1,7 IC9 023 1,023,09 10230 102 1,0 309 3,09 1,02-3,0 p=0,0 p00 HR1 HR=1, 1,023,0 1023 1, 30 3,0 1,02-3, p=0, p0 HR=1 1,023, 3, 1,02-3 p=0 HR= 1,023 1,02- p=

Abstract Objectives: to evaluate the effect of oropharyngeal colostrum immunotherapy in reducing cases of late-onset neonatal sepsis in preterm infants with very low birth weight. Methods: this is an intervention study, with a comparative analysis between the incidence of late-onset neonatal sepsis in the treatment group (in use of oropharyngeal colostrum immunotherapy) and the historical control group (newborns monitored in the same intensive care unit prior to the implementation of the oropharyngeal colostrum immunotherapy protocol). 81 premature babies born between 2016 and 2022 participated in the study separated according to whether or not they received oropharyngeal colostrum immunotherapy. The intervention consisted of eight daily applications of 0.2 mL of the mother's own raw colostrum to the newborns oral mucosa during the first seven days of life. Relative Risk and Absolute Risk Reduction and Number needed to Treat were calculated. Results: a protective effect of oropharyngeal colostrum immunotherapy against late neonatal sepsis was noted. Relative Risk: 0.43; CI95% = 0.21-0.91; Absolute Risk Reduction: 0.26; CI95%= 6.51 - 45.92 and Number Needed to Treat: 4 (2.17-15.34). Conclusion: administration of oropharyngeal colostrum proved to be a promising measure in protecting preterm newborns with VLBW against late-onset sepsis. Objectives lateonset onset weight Methods protocol. protocol . protocol) 8 201 202 02 0 2 0. mothers mother s life calculated Results noted 0.43 043 43 CI95 CI 0.210.91 021091 0.21 0.91 21 91 0.21-0.91 0.26 026 26 651 6 51 6.5 4592 45 92 45.9 2.1715.34. 2171534 2.17 15.34 17 15 34 (2.17-15.34) Conclusion 20 0.4 04 CI9 210 0.210.9 02109 021 091 0.9 9 0.21-0.9 65 5 6. 459 45. 1715 2.1715.34 217153 217 2.1 1534 15.3 1 3 (2.17-15.34 0.210. 0210 09 0.21-0. 171 2.1715.3 21715 2. 153 15. (2.17-15.3 0.210 0.21-0 2.1715. 2171 (2.17-15. 0.21- 2.1715 (2.17-15 2.171 (2.17-1 (2.17- (2.17 (2.1 (2. (2 (

Resumo Objetivos: avaliar o efeito da Imunoterapia Orofaríngea de Colostro na redução dos casos de sepse neonatal tardia, em recém-nascidos prematuros com muito baixo peso. Métodos: trata-se de um estudo de intervenção, com análise comparativa entre a incidência de sepse neonatal tardia do grupo tratamento (em uso da Imunoterapia Orofaríngea de Colostro) e grupo controle histórico (recém-nascidos acompanhados na mesma unidade de terapia intensiva neonatal, anteriormente à implementação do protocolo de Imunoterapia Orofaríngea de Colostro). Participaram do estudo 81 prematuros nascidos entre 2016 e 2022, separados de acordo com o recebimento ou não da Imunoterapia Orofaríngea de Colostro. A intervenção consistiu em oito aplicações diárias de 0,2 mL de colostro cru da própria mãe na mucosa oral dos participantes, durante os sete primeiros dias de vida. Foi feito cálculo de Risco Relativo e Redução Absoluto de Risco e do Número Necessário para Tratar. Resultados: notou-se efeito protetor da IOC contra a sepse neonatal tardia. Risco relativo: 0,43; IC95%=0,21-0,91; Redução absoluta de risco: 0,26; IC95%=6,51-45,92 e Número necessário para tratar: 4 (2,17-15,34). Conclusão: a administração orofaríngea de colostro se mostrou uma medida promissora na proteção de RN PT com MBP contra sepse tardia. Objetivos recémnascidos recém peso Métodos tratase trata . 8 201 2022 02 0 2 0, participantes vida Tratar Resultados notouse notou relativo 0,43 043 43 IC95%=0,210,91 IC95021091 IC IC95%=0,21 0,91 IC95 21 91 IC95%=0,21-0,91 risco 0,26 026 26 IC95%=6,5145,92 IC956514592 IC95%=6,51 45,92 6 51 45 92 IC95%=6,51-45,9 tratar 2,1715,34. 2171534 2,17 15,34 17 15 34 (2,17-15,34) Conclusão 20 202 0,4 04 210 IC95%=0,210,9 IC9502109 IC95021 IC95%=0,2 091 0,9 IC9 9 IC95%=0,21-0,9 5145 IC95%=6,5145,9 IC95651459 IC95651 IC95%=6,5 4592 45,9 5 IC95%=6,51-45, 1715 2,1715,34 217153 217 2,1 1534 15,3 1 3 (2,17-15,34 IC95%=0,210, IC950210 IC9502 IC95%=0, 09 IC95%=0,21-0, 514 IC95%=6,5145, IC9565145 IC9565 IC95%=6, 459 45, IC95%=6,51-45 171 2,1715,3 21715 2, 153 15, (2,17-15,3 IC95%=0,210 IC950 IC95%=0 IC95%=0,21-0 IC95%=6,5145 IC956514 IC956 IC95%=6 IC95%=6,51-4 2,1715, 2171 (2,17-15, IC95%= IC95%=0,21- IC95%=6,514 IC95%=6,51- 2,1715 (2,17-15 IC95% 2,171 (2,17-1 (2,17- (2,17 (2,1 (2, (2 (

ABSTRACT Background: The epidemic curve has been obtained based on the 7-day moving average of the events. Although it facilitates the visualization of discrete variables, it does not allow the calculation of the absolute variation rate. Recently, we demonstrated that the polynomial interpolation method can be used to accurately calculate the daily acceleration of cases and deaths due to COVID-19. This study aimed to measure the diversity of epidemic curves and understand the importance of socioeconomic variables in the acceleration, peak cases, and deaths due to COVID-19 in Brazilian states. Methods: Epidemiological data for COVID-19 from federative units in Brazil were obtained from the Ministry of Health’s website from February 25 to July 11, 2020. Socioeconomic data were obtained from the Instituto Brasileiro de Geografia e Estatística (https://www.ibge.gov.br/). Using the polynomial interpolation methods, daily cases, deaths and acceleration were calculated. Moreover, the correlation coefficient between the epidemic curve data and socioeconomic data was determined. Results: The combination of daily data and case acceleration determined that Brazilian states were in different stages of the epidemic. Maximum case acceleration, peak of cases, maximum death acceleration, and peak of deaths were associated with the Gini index of the gross domestic product of Brazilian states and population density but did not correlate with the per capita gross domestic product of Brazilian states. Conclusions: Brazilian states showed heterogeneous data curves. Population density and socioeconomic inequality were correlated with a more rapid exponential growth in new cases and deaths.

Abstract INTRODUCTION: The acceleration of new cases is important for the characterization and comparison of epidemic curves. The objective of this study was to quantify the acceleration of daily confirmed cases and death curves using the polynomial interpolation method. METHODS: Covid-19 epidemic curves from Brazil, Germany, the United States, and Russia were obtained. We calculated the instantaneous acceleration of the curve using the first derivative of the representative polynomial. RESULTS: The acceleration for all curves was obtained. CONCLUSIONS: Incorporating acceleration into an analysis of the Covid-19 time series may enable a better understanding of the epidemiological situation.