Search | SciELO

Abstract This article aims to evaluate the factors associated with a skin-to-skin contact time <180 min/day in newborns weighing up to 1,800 g during neonatal hospitalization. Prospective observational cohort study conducted in neonatal units of reference for the Kangaroo Method in Brazil. Data from 405 dyads (mother/child) were analyzed from May 2018 to March 2020. Maternal and neonatal explanatory variables were collected from medical records and interviews. Skin-to-skin contact was recorded in forms posted at the bedside, filled out by parents and staff. The outcome variable was the mean time of skin-to-skin contact < 180 min/day. Hierarchical modeling was performed by Poisson regression with robust variance. The variables associated with the outcome were “without easy access to the hospital”, “without previous knowledge of the kangaroo method” and “having had morbidities during pregnancy”. Mothers without easy access to the hospital and who are unaware of the kangaroo method should be priority targets for health policies to develop strategies that promote greater exposure to skin-to-skin contact during the hospitalization period of their children.

Resumo O objetivo deste artigo é avaliar os fatores associados ao tempo de contato pele a pele < 180 min/dia em recém-nascidos com peso até 1.800 g durante a internação neonatal. Estudo observacional tipo coorte prospectivo conduzido em unidades neonatais de referência no Brasil. Foram analisados dados de 405 díades (mãe/filho), no período de maio de 2018 a março de 2020. As características da mãe e do recém-nascido foram coletadas em prontuários e entrevistas, a realização do contato pele-a-pele era registrada em fichas anexadas ao leito, preenchidas pela equipe e pelos pais. A variável desfecho foi o tempo médio diário de contato pele-a-pele inferior a 180 minutos. Foi realizada modelagem hierarquizada utilizando a regressão de Poisson com variância robusta para cálculo das razões de prevalência. As variáveis que permaneceram independentemente associadas foram: “não ter fácil acesso ao hospital” (morar longe ou ter dificuldade de transporte), “não possuir conhecimento prévio sobre o método canguru” e “ter apresentado morbidades durante a gestação”. Mães sem fácil acesso ao hospital e que desconhecem o método canguru devem ser alvos prioritários das políticas de saúde para desenvolver estratégias que promovam maior exposição ao contato pele a pele durante o período de internação de seus filhos.

https://doi.org/10.1590/1413-81232023284.14822022

Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Cardoso, Viviane Cunha

; Grandi, Carlos

; Silveira, Rita C.

; Duarte, José Luiz Bandeira

; Viana, Maria Cândida Ferrarez Bouzada

; Ferreira, Daniela Marques de Lima Mota

; Alves Junior, José Mariano Sales

; Embrizi, Laís Furlan

; Gimenes, Carolina Boschi

; Mello e Silva, Nathalia Moura de

; Melo, Fernanda Pegoraro de Godoi

; Venzon, Paulyne Stadler

; Gomez, Dafne Barcala

; Vale, Marynéa Silva do

; Bentlin, Maria Regina

; Barros, Marina Carvalho de Moraes

; Bigélli, Laura Emilia Monteiro

; Diniz, Edna Maria de Albuquerque

; Luz, Jorge Hecker

; Marba, Sérgio Tadeu Martins

; Almeida, João Henrique Carvalho Leme de

; Aragon, Davi Casale

; Carmona, Fabio

Jornal de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jan 2023, Volume 99 N. 1 Pages 86 - 93

Abstract: En | Text: En | PDF: En

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.

https://doi.org/10.1016/j.jped.2022.07.007

Factors associated with skin-to-skin contact less than 180 min/day in newborns weighing up to 1,800 g: multicenter study
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Souza, Adna Nascimento

; Lamy, Zeni Carvalho

; Goudard, Marivanda Julia Furtado

; Marba, Sérgio Tadeu Martins

; Costa, Roberta

; Caldas, Laize Nogueira de

; Azevedo, Vivian Mara Gonçalves de Oliveira

; Lamy-Filho, Fernando

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 28 N. 4 Pages 1021 - 1029

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-81232023284.14822022

Características do contato pele a pele em unidades neonatais brasileiras: estudo multicêntrico
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Goudard, Marivanda Julia Furtado

; Lamy, Zeni Carvalho

; Caldas, Laize Nogueira de

; Marba, Sérgio Tadeu Martins

; Costa, Roberta

; Lima, Geisy Maria Souza de

; Azevedo, Vivian Mara Gonçalves de Oliveira

; Lamy Filho, Fernando

Acta Paulista de Enfermagem

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 36 elocation eAPE02442

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract Objective To describe the beginning, duration, location and who makes skin-to-skin contact in Brazilian neonatal units. Methods This is a descriptive, longitudinal multicenter study, carried out from May 2018 to March 2020, in five reference neonatal units for Kangaroo Mother Care in Brazil, which included newborns weighing up to 1,800 grams. Maternal and newborn characteristics were collected from medical records and interviews. Skin-to-skin contact was recorded on cards attached to the bed, filled in by the team and fathers. Analysis occurred through descriptive statistics. Results We included 405 newborns, 51.4% male, median gestational age of 31.4 weeks and birth weight of 1,412 grams. Regarding skin-to-skin contact time, the median daily contact frequency was 1.5 times (IQR: 1.2 - 2.4), the time/day was 147 min/day (IQR: 106.7 - 263.0) and the first contact at five days of life (IQR:4.0-8.0). The longest contact time/day was performed by mothers, with a median of 137.8 minutes per day (IQR:95.6-232.1), and the second stage of kangaroo Mother Care, kangaroo Intermediate Care Unit, was the place where contact was performed for the longest time, with a median of 184.4 minutes per day (IQR:124.7-455.4). Conclusion In the units assessed, skin-to-skin contact is practiced intermittently, a few times a day, predominantly by mothers and with longer exposure time in the second stage. It is necessary to seek ways that allow more encounters between mother/father-child and that gives conditions of greater permanence of fathers in the hospital.

Resumen Objetivo Describir el inicio, duración, lugar y quién realiza el contacto piel con piel en unidades neonatales brasileñas. Métodos Estudio multicéntrico descriptivo, longitudinal, realizado de mayo de 2018 a marzo de 2020, en cinco unidades neonatales de referencia del Método Canguro en Brasil, que incluyó recién nacidos de hasta 1800 g de peso. Las características maternas y de los recién nacidos fueron recopiladas en historias clínicas y entrevistas. La práctica del contacto piel con piel fue registrada en tarjetas anexadas a la cama, completadas por el equipo y por los padres. El análisis se realizó mediante estadística descriptiva. Resultados Se incluyeron 405 recién nacidos, 51,4 % de sexo masculino, mediana de 31,4 semanas de edad gestacional y de 1412 g de peso al nacer. Con relación al tiempo de realización del contacto piel con piel, la mediana de la frecuencia del contacto diario fue 1,5 veces (IIQ: 1,2 - 2,4), el tiempo/día fue de 147 min/día (IIQ: 106,7 - 263,0) y la realización del primer contacto a los cinco días de vida (IIQ:4,0-8,0). El mayor tiempo de contacto/día fue realizado por las madres, con una mediana de 137,8 min/día (IIQ:95,6-232,1) y la segunda etapa del Método Canguro, la Unidad de Cuidados Intermedios Canguro, fue el lugar donde se realizó el contacto por mayor tiempo, con una mediana de 184,4 min/día (IIQ:124,7-455,4). Conclusión En las unidades analizadas, el contacto piel con piel se practica de forma intermitente, pocas veces por día, predominantemente por las madres y con mayor tiempo de exposición en la segunda etapa. Es necesario buscar medios que permitan más encuentros entre madre/padre-hijo y que ofrezcan condiciones de mayor permanencia de los progenitores en el hospital.

Resumo Objetivo Descrever o início, duração, local e quem realiza o contato pele a pele em unidades neonatais brasileiras. Métodos Estudo multicêntrico descritivo, longitudinal, realizado de maio de 2018 a março de 2020, em cinco unidades neonatais referência para o Método Canguru no Brasil, que incluiu recém-nascidos com peso até 1800g. As características maternas e dos recém-nascidos foram coletadas em prontuários e entrevistas. A prática do contato pele a pele era registrada em cartões anexados ao leito, preenchidos pela equipe e pelos pais. A análise ocorreu por meio de estatística descritiva. Resultados Foram incluídos 405 recém-nascidos, 51,4% do sexo masculino, mediana de idade gestacional de 31,4 semanas e de peso ao nascimento de 1.412g. Em relação ao tempo de realização do contato pele a pele, a mediana da frequência do contato diário foi de 1,5 vezes (IIQ: 1,2 - 2,4), o tempo/dia de 147 min/dia (IIQ: 106,7 - 263,0) e a realização do primeiro contato aos cinco dias de vida (IIQ:4,0-8,0). O maior tempo de contato/dia foi realizado pelas mães, com mediana de 137,8 min/dia (IIQ:95,6-232,1) e a segunda etapa do Método Canguru, Unidade de Cuidados Intermediários Canguru, foi o local onde se realizou por maior tempo o contato, com mediana de 184,4 min/dia (IIQ:124,7-455,4). Conclusão Nas unidades avaliadas, o contato pele a pele é praticado de forma intermitente, poucas vezes por dia, predominantemente pelas mães e com maior tempo de exposição na segunda etapa. É necessário buscar meios que possibilitem mais encontros entre mãe/pai-filho e que dê condições de maior permanência dos genitores no hospital.

https://doi.org/10.37689/acta-ape/2023ao02442

Impact of resuscitation training program on neonatal outcomes in a region of high socioeconomic vulnerability in Brazil: an interventional study
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Lima, Renato Oliveira de

; Marba, Sérgio Tadeu Martins

; Almeida, Maria Fernanda Branco de

; Guinsburg, Ruth

Jornal de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2023, Volume 99 N. 6 Pages 561 - 567

Abstract: En | Text: En | PDF: En

Abstract Objectives: This pre/post-intervention study aimed to evaluate neonatal outcomes after the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. Method: This interventional study was conducted across five secondary healthcare regions that supported 62 cities in the southwestern mesoregion of Piauí. It included 431 healthcare professionals responsible for neonatal care in the study region. The participants were trained in neonatal resuscitation through the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics. Delivery room structuring, healthcare professionals’ knowledge, and neonatal care outcomes were analyzed immediately before and after intervention and after 12 months between February 2018 and March 2019, and healthcare professionals were evaluated. Results: Training was conducted for over 106 courses. As a participant could take multiple courses, 700 training sessions were conducted. Regarding delivery room structuring, the acquisition of materials required for resuscitation increased from 28.4 to 80.6% immediately after the intervention and to 83.3% after 12 months. Knowledge retention was significant in the post-training period, with a 95.5% approval rate, and knowledge acquisition was satisfactory after 12 months. The number of newborns transferred during the study period increased significantly. A 72.6% reduction in mortality at birth was recorded, and 479 newborns were resuscitated. Conclusion: Following the implementation of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, structural improvements in delivery rooms, adequate knowledge retention regarding neonatal resuscitation, and a consequent reduction in neonatal mortality were observed.

https://doi.org/10.1016/j.jped.2023.04.006

Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Camargo, Juliana Fernandes de

; Caldas, Jamil Pedro de Siqueira

; Marba, Sérgio Tadeu Martins

Revista Paulista de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 40 elocation e2020388

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Analisar a prevalência, as complicações e as condições de alta dos recém-nascidos ≥35 semanas com diagnóstico de sepse neonatal precoce. Métodos: Estudo transversal, com coleta retrospectiva de dados. Incluíram-se todos recém-nascidos com 35 semanas ou mais de idade gestacional, com diagnóstico de sepse precoce em um período de quatro anos (janeiro/2016 a dezembro/2019) em uma unidade neonatal nível III. Os diagnósticos realizaram-se segundo os critérios da Agência Nacional de Vigilância Sanitária e os episódios classificados segundo a confirmação microbiológica e o sítio de infecção. As complicações avaliadas foram: choque, distúrbio de coagulação e sequelas do sistema nervoso central. Também se avaliaram as condições de alta. Os dados coletados foram analisados utilizando estatística descritiva. Resultados: No período, 46 recém-nascidos apresentaram sepse precoce, correspondendo a 1,8% das internações e a uma prevalência de 4/1.000 nascidos vivos. Em três pacientes a sepse foi confirmada por culturas (0,3/1.000 nascidos vivos), respectivamente por S. pneumoniae, S. epidermidis e S. agalactiae. Quanto ao sítio de infecção, foram 35 casos de infecção primária da corrente sanguínea, 7 casos de pneumonia e 4 de meningite. A maior parte dos pacientes (78,3%) possuía pelo menos um fator de risco para sepse, e todos apresentaram-se sintomáticos. Não houve óbito. Complicações ocorreram em 28,2% dos casos, especialmente choque (10 casos – 21,7%). Conclusões: A prevalência de sepse neonatal precoce comprovada foi baixa. Apesar da ocorrência comum de complicações, não houve óbitos.

ABSTRACT Objective: To analyze the incidence, complications, and hospital discharge status in newborns with ≥35 weeks of gestational age with early neonatal sepsis. Methods: This is a cross-sectional, retrospective study. Cases of early-onset sepsis registered from January 2016 to December 2019 in neonates with gestational age of 35 weeks or more were reviewed in a level III neonatal unit. The diagnoses were performed based on the criteria by the Brazilian Health Regulatory Agency (Anvisa), and the episodes were classified according to microbiological classification and site of infection. The following complications were evaluated: shock, coagulation disorders, and sequelae of the central nervous system. The conditions at hospital discharge were also assessed. The collected data were analyzed with the descriptive analysis. Results: In the period, early neonatal sepsis occurred in 46 newborns, corresponding to 1.8% of all newborns admitted to the neonatal unit, with a prevalence of 4/1,000 live births. Culture confirmed sepsis ocurred in three patients (0.3/1,000 live births), with the following agents: S. pneumoniae, S. epidermidis and S. agalactiae. As to site of infection, there were 35 cases of primary bloodstream infection, seven cases of pneumonia and four cases of meningitis. Most patients (78.3%) had at least one risk factor for sepsis, and all were symptomatic at admission. There were no deaths. Complications occurred in 28.2% of the cases, especially shock (10 cases – 21.7%). Conclusions: The prevalence of proven early neonatal sepsis was low. Despite the common occurrence of complications, there were no deaths.

https://doi.org/10.1590/1984-0462/2022/40/2020388 241 downloads

The role of skin-to-skin contact in exclusive breastfeeding: a cohort study
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Goudard, Marivanda Julia Furtado

; Lamy, Zeni Carvalho

; Marba, Sérgio Tadeu Martins

; Lima, Geisy Maria de Souza

; Santos, Alcione Miranda dos

; Vale, Marynea Silva do

; Ribeiro, Talyta Garcia da Silva

; Costa, Roberta

; Azevedo, Vivian Mara Gonçalves de Oliveira

; Lamy-Filho, Fernando

Revista de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 56 elocation 71

Abstract: En | Text: En | PDF: En

ABSTRACT OBJETIVE To understand the role of exposure to skin-to-skin contact and its minimum duration in determining exclusive breastfeeding at hospital discharge in infants weighing up to 1,800g at birth. METHODS A multicenter cohort study was carried out in five Brazilian neonatal units. Infants weighing ≤ 1,800g at birth were eligible. Skin-to-skin contact time was recorded by the health care team and parents on an individual chart. Maternal and infant data was obtained from maternal questionnaires and medical records. The Classification Tree, a machine learning method, was used for data analysis; the tree growth algorithm, using statistical tests, partitions the dataset into mutually exclusive subsets that best describe the response variable and calculates appropriate cut-off points for continuous variables, thus generating an efficient explanatory model for the outcome under study. RESULTS A total of 388 infants participated in the study, with a median of 31.6 (IQR = 29–31.8) weeks of gestation age and birth weight of 1,429g (IQR = 1,202–1,610). The exclusive breastfeeding rate at discharge was 61.6%. For infant’s weighting between 1,125g and 1,655g, exposed to skin-to-skin contact was strongly associated with exclusive breastfeeding. Moreover, infants who made an average > 149.6 min/day of skin-to-skin contact had higher chances in this outcome (74% versus 46%). In this group, those who received a severity score (SNAPPE-II) equal to zero increased their chances of breastfeeding (83% versus 63%). CONCLUSION Skin-to-skin contact proved to be of great relevance in maintaining exclusive breastfeeding at hospital discharge for preterm infants weighing 1,125g–1,655g at birth, especially in those with lower severity scores.

https://doi.org/10.11606/s1518-8787.2022056004063

The role of skin-to-skin contact in exclusive breastfeeding: a cohort study
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Goudard, Marivanda Julia Furtado

; Lamy, Zeni Carvalho

; Marba, Sérgio Tadeu Martins

; Lima, Geisy Maria de Souza

; Santos, Alcione Miranda dos

; Vale, Marynea Silva do

; Ribeiro, Talyta Garcia da Silva

; Costa, Roberta

; Azevedo, Vivian Mara Gonçalves de Oliveira

; Lamy-Filho, Fernando

Revista de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 56 elocation 71

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2022056004063

Temporal trend in early sepsis in a very low birth weight infants' cohort: an opportunity for a rational antimicrobial use
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Caldas, Jamil Pedro de Siqueira

; Montera, Lorenna Cristina

; Calil, Roseli

; Marba, Sergio Tadeu Martins

Jornal de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

aug 2021, Volume 97 N. 4 Pages 414 - 419

Abstract: En | Text: En | PDF: En

Abstract Objective This study aimed to evaluate annual trends of early neonatal sepsis and antimicrobial use in very low birth weight infants for 12 years, as well as to identify microbiological agents, antimicrobial sensitivity profiles, and association with early neonatal death. Method This was a retrospective cohort study including 1254 very low birth weight infants admitted from 2006 to 2017. Four groups were evaluated: culture-confirmed sepsis; presumed neonatal sepsis; ruled out neonatal sepsis group; and infants not exposed to antibiotics. Results The medians of gestational age and birth weight were 29 weeks (27-31) and 1090 g (850-1310), respectively. The rates of culture-confirmed sepsis, presumed neonatal sepsis, ruled out neonatal sepsis, and not exposed to antibiotics were 1.3, 9.0, 15.4, and 74.3%, respectively. From the initial group of newborns whose antimicrobial treatment was administered for sepsis’ suspicion, it was possible to discontinue antibiotic in 44%. The culture-confirmed sepsis rates remained stable (p = 0.906). Significant tendencies of decreasing presumed sepsis rates (p < 0.001) and increased ruled out neonatal sepsis/not exposed to antibiotics rates (p < 0.001) were observed. Streptococcus agalactiae and enteric Gram-negative rods were the predominant agents and most of them were sensitive to crystalline penicillin/ampicillin (88.2%) and to ampicillin and/or amikacin. Early death occurred in 10.8%, specifically in the culture-confirmed sepsis and presumed neonatal sepsis groups. Conclusion The confirmed sepsis rate was low and remained stable. There was a significant downward trend in the presumed neonatal sepsis rate and a significant upward trend in the ruled out neonatal sepsis group. The rate of not exposed to antibiotics infants was high, also presenting a significant downward trend. The identified bacteria were those commonly found and showed usual antimicrobial susceptibility patterns. Death predominantly occurred in groups that received antibiotic treatment.

https://doi.org/10.1016/j.jped.2020.07.006 49 downloads

10.

[SciELO Preprints] - Kangaroo Care: how to guarantee and expand in Covid-19 times
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Custodio, Zaira Ap. de Oliveira Morsch, Denise Streit Marba, Sérgio Tadeu Martins Gomes, Maria Auxiliadora Mendes Machado, Luiza Geaquinto Lamy, Zeni Carvalho

Journal Metrics
- Sobre o periódico
- SciELO Analytics

Publication date: 2020-06-15

Abstract: En Pt

The low contamination by SARS-CoV-2 in pregnant women, puerperal women and even newborns (NB), does not prevent the presence of concern in families and health teams in Neonatal Units (NU). We must be aware of the different requests that arise in the face of Covid-19 threats, in the hospital environment. We understand that, together with the fear of contamination, the restrictions imposed by isolation and social distancing, with the consequent withdrawal of family and social support networks, an important support for the parents of NBs during hospitalization, creates space for the emergence of insecurity and even restlessness in many families. Not being able to count on this support in the formation of parenting, the parents only have their son, still a baby, and the health team to help them in this process. In light of this, the proposals of Humanized Care for the Newborn - Kangaroo Method, in Brazil, evaluated the indication of adaptations in their guidelines, guaranteeing the protection of all psychic/emotional/biological phenomena that this child and his family go through in this evolutionary moment. Thus, comprehensive and individualized care for this population starts to count even more with the support of the internal networks present in the NU, facilitated by the professionals of the psychology team. Support for the narratives of different family histories that discover new paths for the formation of their affective bonds, in this very special moment, receives a more careful look in the period of this pandemic. Proposals for psycho-affective management towards the newborn and his family are presented, ensuring skin-to-skin contact, differentiated support to parents, especially the maternal figure, and interaction with the health team at the present moment in the routines of neonatal units, establishing protection for future moments in this family history.

A baixa contaminação pelo SARS-CoV-2 em gestantes, puérperas e mesmo nos recém-nascidos (RN), não impede a presença de preocupação nas famílias e nas equipes de saúde da Unidades Neonatais (UN). É preciso estarmos atentos às diferentes solicitações que surgem diante das ameaças da Covid-19, neste espaço hospitalar. Entendemos que, aliadas ao temor de contaminação, as restrições impostas pelo isolamento e distanciamento social, com a consequente retirada das redes de apoio familiares e sociais, uma importante sustentação aos pais dos RN durante a internação, cria espaço para o surgimento de insegurança e até desassossego em muitas famílias. Não podendo contar com este suporte na formação da parentalidade, os pais possuem apenas o filho, ainda bebê, e a equipe de saúde para ajudá-los neste processo. Diante disto, as propostas da Atenção Humanizada ao Recém-Nascido - Método Canguru, no Brasil, avaliou a indicação de adaptações em suas orientações, garantindo a proteção de todos fenômenos psíquicos/emocionais/biológicos que percorrem esta criança e sua família neste momento evolutivo. Assim, o cuidado integral e individualizado a esta população passa a contar ainda mais com o apoio das redes internas presentes nas UN, facilitadas pelos profissionais da equipe de psicologia. O apoio às narrativas das diferentes histórias familiares que descobrem novos percursos para a formação de seus laços afetivos, neste momento tão especial, recebe um olhar mais cuidadoso no período desta pandemia. São apresentadas propostas de manejos psico-afetivos para com o recém-nascido e sua família, garantindo o contato pele a pele, o acolhimento diferenciado aos pais, especialmente da figura materna, e a interação com a equipe de saúde no momento presente das rotinas das unidades neonatais estabelecendo proteção para momentos futuros desta história familiar.

https://doi.org/10.1590/SciELOPreprints.773

11.

PREDICTIVE VALUE OF THE GENERAL MOVEMENTS ASSESSMENT IN PRETERM INFANTS: A META-ANALYSIS
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Pires, Camila da Silva

; Marba, Sérgio Tadeu Martins

; Caldas, Jamil Pedro de Siqueira

; Stopiglia, Mônica de Carvalho Sanchez

Revista Paulista de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2020, Volume 38 elocation e2018286

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Analisar o valor preditivo da General Movements Assessment para o diagnóstico de alterações do neurodesenvolvimento em recém-nascidos pré-termo. Fonte de dados: Foi realizada uma revisão sistemática da literatura utilizando as bases de dados: Scientific Electronic Library Online (SciELO), National Library of Medicine, National Institutes of Health (PubMed) e Excerpta Medica Database (EMBASE). Os artigos foram filtrados por idioma, ano de publicação, população de interesse, utilização do Método Prechtl de avaliação e presença das variáveis relacionadas ao valor preditivo da escala. O Quality Assessment of Diagnostic Accuracy Studies 2 foi utilizado para avaliar a metodologia dos artigos. Foi realizado o cálculo de sensibilidade, especificidade, Diagnostic Odds Ratio, razão de verossimilhanças positiva e negativa e parâmetro de acurácia. Síntese dos dados: Foram incluídos seis artigos dentre os 342 encontrados. A escala, quando realizada no período Writhing Movements, possui bom poder discriminativo para o desfecho paralisia cerebral, com valores elevados de sensibilidade e acurácia. Quando realizada no período Fidgety Movements, possui maior valor preditivo para paralisia cerebral, com valores elevados em todas as medidas de acurácia diagnóstica. O risco de viés foi considerado elevado na seleção de pacientes e no fluxo e momento da avaliação. Desse modo, a escala tem potencial para detectar indivíduos que evoluíram com alterações do neurodesenvolvimento, porém, os artigos apresentaram limitações quanto à seleção dos sujeitos e à forma de avaliação do desfecho neurológico. Conclusões: Apesar dos altos valores preditivos descritos para identificação de alterações neurológicas, novas pesquisas são necessárias, devido à heterogeneidade dos estudos e ao método de avaliação a longo prazo do neurodesenvolvimento.

ABSTRACT Objective: To discuss the predictive value of the General Movements Assessment for the diagnosis of neurodevelopment disorders in preterm newborns. Data source: We conducted a systematic literature review using the following databases: Scientific Electronic Library Online (SciELO), National Library of Medicine, National Institutes of Health (PubMed), and Excerpta Medica Database (EMBASE). The articles were filtered by language, year of publication, population of interest, use of Prechtl’s Method on the Qualitative Assessment of General Movements, and presence of variables related to the predictive value. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to assess the methodology of the included studies. Sensitivity, specificity, Diagnostic Odds Ratio, positive and negative likelihood ratio, and parameter of accuracy were calculated. Data synthesis: Six of 342 articles were included. The evaluation of Writhing Movements is a good indicator for recognizing cerebral palsy, as it has high values for the sensitivity and accuracy parameters. The evaluation of Fidgety Movements has the strongest predictive validity for cerebral palsy, as it has high values in all measures of diagnostic accuracy. The quality assessment shows high risk of bias for patient selection and flow and timing of the evaluation. Therefore, the scale has potential to detect individuals with neurodevelopment disorders. However, the studies presented limitations regarding the selection of subjects and the assessment of neurological outcomes. Conclusions: Despite the high predictive values of the tool to identify neurological disorders, research on the subject is required due to the heterogeneity of the current studies.

https://doi.org/10.1590/1984-0462/2020/38/2018286 1928 downloads

12.

EVALUATION OF USABILITY OF A NEONATAL HEALTH INFORMATION SYSTEM ACCORDING TO THE USER’S PERCEPTION
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Padrini-Andrade, Lucio

; Balda, Rita de Cássia Xavier

; Areco, Kelsy Catherina Nema

; Bandiera-Paiva, Paulo

; Nunes, Marynéa do Vale

; Marba, Sérgio Tadeu Martins

; Carvalho, Werther Brunow de

; Rugolo, Ligia Maria Suppo de Souza

; Almeida, João Henrique Carvalho de

; Procianoy, Renato Soibelmann

; Duarte, José Luiz Muniz Bandeira

; Rego, Maria Albertina Santiago

; Ferreira, Daniela Marques de Lima Mota

; Alves Filho, Navantino

; Guinsburg, Ruth

; Diniz, Edna Maria de Albuquerque

; Santos, Juliana Paula Ferraz dos

; Testoni, Daniela

; Silva, Nathalia Moura de Mello e

; Gonzales, Maria Rafaela Conde

; Silva, Regina Vieira Cavalcante da

; Meneses, Jucille

; Gonçalves-Ferri, Walusa Assad

; Perussi-e-Silva, Ricardo

; Bomfim, Olga

Revista Paulista de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jan 2019, Volume 37 N. 1 Pages 90 - 96

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Mensurar o grau de satisfação de profissionais de saúde quanto à usabilidade de um sistema de informação em saúde neonatal e identificar os fatores que podem influenciar na satisfação do usuário frente à usabilidade. Métodos: Estudo transversal e exploratório realizado com 50 profissionais de saúde integrantes dos centros da Rede Brasileira de Pesquisas Neonatais. Para avaliação da usabilidade foi utilizado o instrumento System Usability Scale entre fevereiro e março de 2017. Realizou-se a análise estatística descritiva e inferencial das variáveis coletadas, com a finalidade de descrever a amostra, quantificar o grau de satisfação dos usuários e identificar as variáveis associadas ao grau de satisfação do usuário em relação à usabilidade. Resultados: Da população avaliada, 75% era do sexo feminino, com idade média 52,8 anos, 58% com pós-graduação (doutorado); tempo médio da última formação de 17 anos; área de atuação em medicina (neonatologia), grau intermediário de conhecimento em informática e tempo de utilização média do sistema de 52 meses. Quanto à usabilidade, 94% avaliaram o sistema como “bom”, “excelente” ou “melhor impossível”. A usabilidade do sistema não foi associada a idade, sexo, escolaridade, profissão, área de atuação, nível de conhecimento em informática e tempo de uso do sistema. Conclusões: O grau de satisfação do usuário do sistema informatizado de saúde foi considerado bom. Não foram identificados fatores demográficos que influenciassem sua avaliação.

ABSTRACT Objective: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. Methods: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. Results: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as “good”, “excellent” or “better than imaginable”. The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. Conclusion: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.

https://doi.org/10.1590/1984-0462/;2019;37;1;00019 3877 downloads

13.

Effectiveness of a measure program to prevent admission hypothermia in very low-birth weight preterm infants,
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Caldas, Jamil Pedro de Siqueira

; Millen, Fernanda de Castro

; Camargo, Juliana Fernandes de

; Castro, Paula Almeida Cavalcanti

; Camilo, Ana Letícia da Fonseca

; Marba, Sérgio Tadeu Martins

Jornal de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

aug 2018, Volume 94 N. 4 Pages 368 - 373

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Avaliar a efetividade de um programa de medidas para prevenção de hipotermia à admissão em recém-nascidos pré-termo de muito baixo peso. Métodos: Estudo de intervenção com coleta retrospectiva de dados em unidade neonatal terciária que incluiu todos os recém-nascidos pré-termo de muito baixo peso (< 1.500 g) nascidos e admitidos na unidade. Foram comparados dois períodos: antes da intervenção PI - 01/01/2012 a 28/02/2014 e depois da intervenção PII - 01/04/2014 a 30/11/2016. O mês de março de 2014 foi o início da intervenção. Em PI as medidas em sala de parto foram: recepção em berço de calor radiante, portas sempre fechadas, uso de saco plástico corporal, colocação de dupla touca (plástico e malha) na cabeça, temperatura ambiental entre 24-27 ºC e transporte em incubadora aquecida (36-37,0 ºC). No PII reforçou-se a não abertura do saco plástico durante toda reanimação mesmo que avançada e dados antropométricos e cuidados rotineiros realizados na unidade de internação. Variáveis maternas, de parto e neonatais foram comparadas entre os dois períodos. Hipotermia à admissão foi considerada quando temperatura axilar < 36,0 ºC. Resultados parciais foram apresentados e discutidos com a equipe semestralmente. Resultados: A incidência da Hipotermia à admissão diminuiu significativamente em PII (37,2 x14,2%, p < 0,0001) e a mediana de temperatura foi mais elevada (36,1x36,5º C, p < 0,001). Houve aumento significativo do número de crianças transportadas com oxigênio em PII (49,5 x 75,5%, p < 0,0001). Não houve diferenças para peso ao nascer e idade gestacional. Conclusão: Houve redução acentuada de Hipotermia à admissão e melhora na mediana da temperatura de admissão hospitalar em recém-nascidos pré-termo de muito baixo peso após implantação do protocolo.

Abstract Objective: To evaluate the effectiveness of a thermoregulation bundle for preventing admission hypothermia in very low-birth weight preterm infants. Methods: Interventional study with retrospective evaluation of data undertaken in a tertiary neonatal unit including all very low-birth weight preterm infants (<1500 g) born at and admitted to the unit. Two periods were compared: before intervention (PI; 01/01/2012 to 02/28/2014_ and after intervention (PII; 04/01/2014 to 11/30/2016). The intervention started in March 2014. At PI procedures in the delivery room were: placement in a crib with a radiant heat source, doors always closed, polyethylene body plastic bag, double cap (plastic and cotton mesh), room temperature between 24 to 27 ºC and transport to neonatal unit in a pre-heated incubator (36-37.0 ºC). At PII, there was a reinforcement on not opening the plastic bag during the entire resuscitation process, even at an advanced stage, and the anthropometric measures and routine care were performed in the neonatal unit. Maternal, delivery, and neonatal variables were compared. Admission hypothermia was considered when admission axillary temperature was <36.0 ºC. Periodic results were shown to the team every six months and results were discussed. Results: The incidence of admission hypothermia was reduced significantly in PII (37.2 vs. 14.2%, p < 0.0001) and admission temperature medians were higher (36.1 vs. 36.5 ºC, p < 0.001). At PII, there was an increase in the number of infants transported with oxygen (49.5 vs. 75.5%, p < 0.0001). No differences were observed regarding birth weight and gestational age. Conclusion: There was a very important reduction in admission hypothermia incidence and a higher median admission temperature after continued protocol implementation.

https://doi.org/10.1016/j.jped.2017.06.016 2098 downloads

14.

COMPOSIÇÃO ELETROLÍTICA E MINERAL DO LEITE DE LACTANTES A TERMO PRÉ E PÓS-PASTEURIZAÇÃO E DE LEITE CRU DE MÃES DE RECÉM-NASCIDOS PRÉ-TERMO
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Codo, Carla Regina Bianchi

; Caldas, Jamil Pedro de Siqueira

; Peixoto, Rafaella Regina Alves

; Sanches, Vitor Lacerda

; Guiraldelo, Tamara Cristina

; Cadore, Solange

; Marba, Sérgio Tadeu Martins

Revista Paulista de Pediatria

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jun 2018, Volume 36 N. 2 Pages 141 - 147

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Determinar e comparar as concentrações de eletrólitos e minerais no leite humano em três grupos: amostras analisadas antes e após pasteurização de lactantes doadoras a termo e amostra de leite cru colhida à beira do leito de mães de recém-nascidos pré-termo. Métodos: Estudo descritivo de corte transversal. Foram dosadas concentrações de cálcio (Ca), fósforo (P), magnésio (Mg), sódio (Na) e potássio (K) em amostras aleatórias de leite humano nos três grupos. As amostras foram analisadas por mineralização ácida assistida por radiação micro-ondas e posteriormente por espectrometria de emissão óptica com plasma indutivamente acoplado e expressas em mg/L, com cálculo de médias e desvio padrão. A comparação entre os grupos foi feita por análise de variância (ANOVA)/teste de Tukey. Nível de significância aceito de 5%. Resultados: Observou-se redução significante dos teores de Ca (259,4±96,8 vs. 217,0±54,9; p=0,003), P (139,1±51,7 vs. 116,8±33,3; p=0,004) e K (580,8±177,1 vs. 470,9±109,4; p<0,0001) após a pasteurização. As amostras de leite cru colhidas à beira do leito apresentaram teores estatisticamente mais elevados de Na (2 vezes) do que o leite a termo de doadora. Ca e P só atingiriam a ingestão recomendada pela European Society of Pediatric Gastroenterology, Hepatology and Nutrition se o leite materno fosse ofertado em volume de 60 mL a cada 3 horas. Concentrações de Mg não diferiram entre os grupos. Conclusões: Houve uma redução significativa de Ca, P e K nas amostras após pasteurização e os valores de Na no leite cru coletado à beira do leito foram superiores àqueles pré-pasteurização.

ABSTRACT Objective: To determine and compare the concentrations of electrolytes and minerals in three different types of maternal milk samples: term donor milk before pasteurization, term donor milk after pasteurization and raw milk of mothers of preterm newborns at bedside. Methods: Descriptive cross-sectional study. Concentrations of calcium (Ca), phosphorous (P), magnesium (Mg), sodium (Na) and potassium (K) were measured in random samples of three human breast milk groups. Samples were analyzed using acid mineralization assisted by microwave radiation and further analysis by inductively coupled plasma optical emission spectrometry. Concentrations were expressed in mg/L, described as mean and standard deviation. The one-way ANOVA and Tukey’s post-test were applied to determine the variability between the means of each group. Significance level was set at 5%. Results: There was a significant reduction in the content of Ca (259.4±96.8 vs. 217.0±54.9; p=0.003), P (139.1±51.7 vs. 116.8±33.3; p=0.004) and K (580.8±177.1 vs. 470.9±109.4; p<0.0001) in donor maternal milk before and after pasteurization. Samples of raw milk presented higher contents of Na than the donated milk (twice). The elements P and Ca would only reach the daily intake levels recommended by the European Society of Pediatric Gastroenterology, Hepatology and Nutrition if at least 60 mL of milk could be offered every 3 hours. Mg levels were not different between the three groups. Conclusions: There was a significant reduction in Ca, P and K levels in samples after pasteurization. The Na value in raw milk, collected at bedside, was higher than in the samples of donor’s milk before pasteurization.

https://doi.org/10.1590/1984-0462/;2018;36;2;00015 2767 downloads

15.

Validação da Échelle Douleur Inconfort Nouveau-Né para a cultura brasileira
Facebook Twitter

Other social networks
Google+
LinkedIn
Reddit
StambleUpon
CiteULike
Mendeley
Other networks

Metrics
- SciELO Analytics
- Dimensions
- PlumX
- Altmetric

Dias, Flávia de Souza Barbosa

; Gasparino, Renata Cristina

; Carmona, Elenice Valentim

; Marba, Sérgio Tadeu Martins

Revista da Escola de Enfermagem da USP

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2017, Volume 51 elocation e03285

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective To evaluate the reliability and validity of the Brazilian version of the Échelle Douleur Inconfort Nouveau-Né, which measures prolonged pain in neonates. Method A methodological study carried out with 96 neonates. The Brazilian versions of the Échelle Douleur Inconfort Nouveau-Né and the Children’s and Infants’ Postoperative Pain Scale were used for data collection. For reliability, equivalence measured by intraobserver agreement and homogeneity were considered. To evaluate the validity, the convergent construct approach was considered correlating the Brazilian versions of the Échelle Douleur Inconfort Nouveau-Né and the Children’s and Infants’ Postoperative Pain Scale. Results In assessing reliability, the coefficient of agreement between observers varied between 0.64 and 0.85 for the items that make up the instrument, and 0.96 for the total score. Cronbach’s alpha was 0.82. Regarding the convergent validity evaluation, Spearman correlation coefficient between the values found for both scales was 0.79 (p< 0.0001). Conclusion The Brazilian version of the Échelle Douleur Inconfort Nouveau-Né is a reliable and valid instrument for assessing prolonged pain in neonates.

RESUMEN Objetivo Evaluar la confiabilidad y la validez de la versión brasileña de la Échelle Douleur Inconfort Nouveau-Né, que mide el dolor prolongado en recién nacidos. Método Estudio metodológico realizado junto con recién nacidos. Para la recolección fueron utilizadas las versiones brasileñas de la Échelle Douleur Inconfort Nouveau-Né y la Children’s and Infants’ Postoperative Pain Scale. Para la confiabilidad, fueron consideradas la equivalencia, medida por la concordancia entre observadores y la homogeneidad. Para evaluar la validez, se consideró el abordaje de constructo convergente correlacionando las versiones brasileñas de la Échelle Douleur Inconfort Nouveau-Né y la Children’s and Infants’ Postoperative Pain Scale. Resultados Compusieron la muestra final 96 recién nacidos. En la evaluación de la confiabilidad, el coeficiente de concordancia entre observadores varió entre 0,64 y 0,85 para los ítems que componen el instrumento y 0,96 para el puntaje total. El alfa de Cronbach fue de 0,82. En la evaluación de la validez convergente, el coeficiente de correlación de Spearman entre los valores encontrados para ambas escalas fue de 0,79 (p< 0,0001). Conclusión La versión brasileña de la Échelle Douleur Inconfort Nouveau-Né es un instrumento confiable y válido para evaluar el dolor prolongado en recién nacidos.

RESUMO Objetivo Avaliar a confiabilidade e a validade da versão brasileira da Échelle Douleur Inconfort Nouveau-Né, que mensura a dor prolongada em recém-nascidos. Método Estudo metodológico realizado junto com recém-nascidos. Para a coleta foram utilizadas as versões brasileiras da Échelle Douleur Inconfort Nouveau-Né e da Children’s and Infants’ Postoperative Pain Scale. Para a confiabilidade, foram consideradas a equivalência, mensurada pela concordância entre observadores, e a homogeneidade. Para avaliar a validade, foi considerada a abordagem de construto convergente correlacionando as versões brasileiras da Échelle Douleur Inconfort Nouveau-Né e da Children’s and Infants’ Postoperative Pain Scale. Resultados Compuseram a amostra final 96 recém-nascidos. Na avaliação da confiabilidade, o coeficiente de concordância entre observadores variou entre 0,64 e 0,85 para os itens que compõem o instrumento e 0,96 para o escore total. O alfa de Cronbach foi de 0,82. Na avaliação da validade convergente, o coeficiente de correlação de Spearman entre os valores encontrados para as duas escalas foi de 0,79 (p< 0,0001). Conclusão A versão brasileira da Échelle Douleur Inconfort Nouveau-Né é um instrumento confiável e válido para avaliar a dor prolongada em recém-nascidos.

https://doi.org/10.1590/s1980-220x2017008603285 39 downloads

Showing

itens per page

Page of 3 Next

Select one or more results

All Alphabetic

Results

Comparative chart Download CSV

Statistics of

Send result

To*

Use ; (semicolon) to insert more emails.

Send to email

This page

Selected records

All references (max. 300)

Your email

Subject

Comments

Export format:

RIS (for EndNote, ProCite, Reference Manager, RefWorks, Citavi, etc.)

BibTeX

Citation

CSV (for Excel, etc)

Export:

This page

Selected itens

All references (max. 2000)

Sem resultados

No documents were found for your search

Glossary and search help

You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

SciELO - Scientific Electronic Library Online
Rua Dr. Diogo de Faria, 1087 – 9º andar – Vila Clementino 04037-003 São Paulo/SP - Brasil
Email: scielo@scielo.org

All the contents of this site www.scielo.br, except where otherwise noted, is licensed under a Creative Commons Attribution License.
more »