Abstract Objectives To examine trends over time in diet and size of very preterm infants, and associations of diet with size at hospital discharge/transfer. Methods The authors studied 4062 surviving very preterm infants born < 32 weeks’ gestational age and < 1500 g between January 2012 and December 2020 from 12 Brazilian Neonatal Intensive Care Units. Diet type at discharge/transfer was classified as exclusive human milk, exclusive formula, or mixed. Outcomes were weight and head circumference at hospital discharge and the change in each from birth to discharge. The authors used linear regression to estimate adjusted associations of diet type with infant size, overall, and stratified by fetal growth category (small vs. appropriate for gestational age). The authors also examined trends in diet and infant size at discharge over the years. Results Infants’ mean gestational age at birth was 29.3 weeks, and the mean birth weight was 1136 g. Diet at discharge/transfer was exclusive human milk for 22 %, mixed for 62 %, and exclusive formula for 16 %. Infant size in weight and head circumference were substantially below the growth chart reference for all diets. Infants fed human milk and mixed diets were lighter and had smaller heads at discharge/transfer than infants fed formula only (weight z: −2.0, −1.8, and −1.5; head z: −1.3, −1.2 and −1.1 for exclusive human milk, mixed and exclusive formula respectively). Conclusion Results suggest high human milk use but gaps in nutrient delivery among hospitalized Brazilian very preterm infants, with little evidence of improvement over time. dischargetransfer transfer 406 3 weeks 150 201 202 1 Units overall small vs age. . age) years 293 29 29. 113 2 % 6 z 20 0 −2.0 18 8 −1.8 −1.5 15 5 13 −1.3 −1. 11 respectively. respectively respectively) 40 −2. −1 4 −2 −

Abstract Objective: To evaluate the success rate of high-flow nasal cannula (HFNC) therapy using an adapted obsolete mechanical ventilator (MV), Optiflow™ and Vapotherm™ in newborns (NBs). Method: This was a retrospective observational study conducted in the neonatal intensive care unit (NICU). The sample comprised NBs who underwent HFNC therapy due to ventilatory dysfunction, for weaning from non-invasive ventilation (NIV), or post-extubation. The three groups, stratified according to gestational age (GA) and birth weight, and corrected GA and weight at the beginning of HFNC use, were as follows: Optiflow ™, Vapotherm ™, and obsolete Mechanical Ventilator (MV) adapted for high flow therapy. Subsequently, the NBs were divided into a success group (SG) and a failure group (FG). HFNC success was defined as a therapy duration exceeding 72 h. Results: A total of 209 NBs were evaluated, with 31.1 % using HFNC due to ventilatory dysfunction, 2.4 % after extubation, and 66.5 % after NIV weaning. HFNC success rate was observed in 90.9 % of the NBs, with no difference between equipment types (Vapotherm ™, Optiflow ™, and adapted VM). Conclusion: Different types of HFNC equipment are equally effective when used in neonatology for respiratory dysfunction, as a method of weaning from NIV and post-extubation. Adapted obsolete MV can be an alternative for HFCN therapy in resource-constrained settings. Objective highflow (HFNC MV, , NBs. . (NBs) Method NICU. NICU (NICU) dysfunction noninvasive non invasive NIV, (NIV) postextubation. postextubation post extubation. extubation post-extubation groups (GA use follows ™ (MV Subsequently SG (SG FG. FG (FG) 7 h Results 20 evaluated 311 31 1 31. 24 2 4 2. 665 66 5 66. 909 90 9 90. VM. VM VM) Conclusion resourceconstrained resource constrained settings (NBs (NICU (NIV (FG 3 6

RESUMO Objetivo Avaliar a história pregressa de sífilis em mulheres trans e travestis (MTTr) e identificar os fatores associados à incompletude do tratamento. Métodos Estudo transversal multicêntrico, entre 2019 e 2021, com participantes recrutadas por respondent-driven sampling, em cinco capitais brasileiras. Variável dependente: “tratamento referido de sífilis no último ano”, “não/incompleto” ou “completo”. Modelo multivariável-logístico foi utilizado para identificar fatores associados à completude. Resultados Das 1.317 participantes, 16,0% relataram sífilis pregressa. Dessas, 68,9% eram negras, 54,6% ganhavam até 1 salário mínimo e 61,1% completaram o tratamento. A completude de tratamento foi mais baixa em São Paulo (42,7%) e para quem sofreu agressão verbal (53,6%; ORa 0,46; IC95% 0,25;0,85). Conclusão Na amostra, foram elevadas: a prevalência de sífilis autorreferida e a proporção de participantes que refere não ter iniciado/completado o tratamento. É necessário identificar as barreiras enfrentadas por MTTr que impactam o acesso à saúde, e identificar suas necessidades, para assegurar diagnóstico e tratamento adequados.

ABSTRACT Objective To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness. Methods : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: “reported syphilis treatment in the last year”, “no/incomplete” or “complete”. A multivariate-logistic model was used to identify factors associated with completeness. Results : Of the 1,317 participants, 16.0% reported previous history of syphilis. Of these, 68.9% were Black, 54.6% earned up to 1 minimum wage and 61.1% completed the treatment. Treatment completion was lower in São Paulo (42.7%) and among those who experienced verbal abuse (53.6%; ORa 0.46; 95%CI 0.25;0.85). Conclusion In this sample, both the prevalence of self-reported syphilis and the proportion of participants who reported not having started/completed treatment were high. It is essential to identify the barriers faced by TWTs that hinder healthcare access, and identify their needs in order to ensure adequate diagnosis and treatment.

RESUMEN Objetivo Evaluar historia previa de sífilis en mujeres transgénero y travestis (MTT), identificar factores asociados al tratamiento incompleto. Métodos Estudio transversal multicéntrico, entre 2019-2021, con participantes reclutadas por Respondent-Driven Sampling, en cinco capitales brasileñas. Variable dependiente: “tratamiento de sífilis reportado el último año”: ‘no/incompleto’ o ‘completo’. Se utilizó un modelo logístico multivariable para identificar factores asociados a la incompletitud. Resultados 1.317 participantes, 16,0% refirieron sífilis previa. De estas 68,9% eran negras y 54,6% ganaban hasta 1 salario mínimo; 61,1% completaron tratamiento. La finalización del tratamiento fue menor en San Pablo (42,7%) y entre las que sufrieron agresión verbal (53,6%; ORa 0,46; IC95% 0,25;0,85). Conclusión Tanto prevalencia de sífilis autorreferida como proporción de participantes que informaron no haber iniciado/finalizado el tratamiento fueron elevadas. Es necesario identificar barreras enfrentadas por MTT que impactan su acceso a atención de salud, además, identificar sus necesidades específicas para garantizar un diagnóstico y tratamiento adecuados.

Abstract Objectives To compare LISA with INSURE technique for surfactant administration in preterm with gestational age (GA) < 36 weeks with RDS in respect to the incidence of pneumothorax, bronchopulmonary dysplasia (BPD), need for mechanical ventilation (MV), regional cerebral oxygen saturation (rSO2), peri‑intraventricular hemorrhage (PIVH) and mortality. Methods A systematic search in PubMed, Embase, Lilacs, CINAHL, SciELO databases, Brazilian Registry of Randomized Clinical Trials (ReBEC), Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. RCTs evaluating the effects of the LISA technique versus INSURE in preterm infants with gestational age < 36 weeks and that had as outcomes evaluation of the rates of pneumothorax, BPD, need for MV, rSO2, PIVH, and mortality were included in the meta-analysis. Random effects and hazard ratio models were used to combine all study results. Inter-study heterogeneity was assessed using Cochrane Q statistics and Higgin's I2 statistics. Results Sixteen RCTs published between 2012 and 2020 met the inclusion criteria, a total of 1,944 preterms. Eleven studies showed a shorter duration of MV and CPAP in the LISA group than in INSURE group. Two studies evaluated rSO2 and suggested that LISA and INSURE transiently affect brain autoregulation during surfactant administration. INSURE group had a higher risk for MV in the first 72 h of life, pneumothorax, PIVH and mortality in comparison to the LISA group. Conclusion This systematic review and meta-analyses provided evidence for the benefits of the LISA technique in the treatment of RDS, decreasing CPAP time, need for MV, BPD, pneumothorax, PIVH, and mortality when compared to INSURE. GA (GA 3 pneumothorax BPD , (BPD) (MV) rSO (rSO2) periintraventricular peri intraventricular (PIVH PubMed Embase Lilacs CINAHL databases ReBEC, ReBEC (ReBEC) Clinicaltrialsgov Clinicaltrials gov Clinicaltrials.gov CENTRAL (CENTRAL performed metaanalysis. metaanalysis meta analysis. analysis meta-analysis results Interstudy Inter Higgins Higgin s I 201 202 criteria 1944 1 944 1,94 preterms 7 life metaanalyses analyses time (BPD (MV (rSO2 (ReBEC 20 194 94 1,9 (rSO 2 19 9 1,

Abstract Objectives To make recommendations on the diagnosis and treatment of post-extubation laryngitis (PEL) in children with or without other comorbidities. Methods A three-iterative modified Delphi method was applied. Specialists were recruited representing pediatric otolaryngologists, pediatric and neonatal intensivists. Questions and statements approached topics encompassing definition, diagnosis, endoscopic airway evaluation, risk factors, comorbidities, management, and follow-up. A consensus was defined as a supermajority >70%. Results Stridor was considered the most frequent symptom and airway endoscopy was recommended for definitive diagnosis. Gastroesophageal reflux and previous history of intubation were considered risk factors. Specific length of intubation did not achieve a consensus as a risk factor. Systemic corticosteroids should be part of the medical treatment and dexamethasone was the drug of choice. No consensus was achieved regarding dosage of corticosteroids, although endoscopic findings help defining dosage and length of treatment. Non-invasive ventilation, laryngeal rest, and use of comfort sedation scales were recommended. Indications for microlaryngoscopy and bronchoscopy under anesthesia were symptoms progression or failure to improve after the first 72-h of medical treatment post-extubation, after two failed extubations, and/or suspicion of severe lesions on flexible fiberoptic laryngoscopy. Conclusions Management of post-extubation laryngitis is challenging and can be facilitated by a multidisciplinary approach. Airway endoscopy is mandatory and impacts decision-making, although there is no consensus regarding dosage and length of treatment. postextubation post extubation PEL (PEL comorbidities threeiterative three iterative applied otolaryngologists intensivists definition evaluation factors management followup. followup follow up. up follow-up 70 >70% factor choice Noninvasive Non invasive ventilation rest 72h h 72 postextubation, extubation, extubations andor laryngoscopy approach decisionmaking, decisionmaking decision making, making decision-making 7 >70 >7 >

RESUMO Objetivo Avaliar a história pregressa de sífilis em mulheres trans e travestis (MTTr) e identificar os fatores associados à incompletude do tratamento. Métodos Estudo transversal multicêntrico, entre 2019 e 2021, com participantes recrutadas por respondent-driven sampling, em cinco capitais brasileiras. Variável dependente: “tratamento referido de sífilis no último ano”, “não/incompleto” ou “completo”. Modelo multivariável-logístico foi utilizado para identificar fatores associados à completude. Resultados Das 1.317 participantes, 16,0% relataram sífilis pregressa. Dessas, 68,9% eram negras, 54,6% ganhavam até 1 salário mínimo e 61,1% completaram o tratamento. A completude de tratamento foi mais baixa em São Paulo (42,7%) e para quem sofreu agressão verbal (53,6%; ORa 0,46; IC95% 0,25;0,85). Conclusão Na amostra, foram elevadas: a prevalência de sífilis autorreferida e a proporção de participantes que refere não ter iniciado/completado o tratamento. É necessário identificar as barreiras enfrentadas por MTTr que impactam o acesso à saúde, e identificar suas necessidades, para assegurar diagnóstico e tratamento adequados. (MTTr multicêntrico 201 2021 respondentdriven respondent driven sampling brasileiras dependente ano, ano , ano” não/incompleto nãoincompleto incompleto “não/incompleto completo. completo . “completo” multivariávellogístico multivariável logístico 1317 317 1.31 160 16 0 16,0 Dessas 689 68 9 68,9 negras 546 54 6 54,6 611 61 61,1 42,7% 427 42 7 (42,7% 53,6% 536 53 (53,6% 0,46 046 46 IC95 IC 0,250,85. 025085 0,25 0,85 25 85 0,25;0,85) amostra elevadas iniciadocompletado iniciado completado saúde necessidades adequados 20 202 “completo 131 31 1.3 16, 68, 5 54, 61, 42,7 4 (42,7 53,6 (53,6 0,4 04 IC9 250 0,250,85 02508 025 0,2 085 0,8 2 8 0,25;0,85 13 3 1. 42, (42, 53, (53, 0, 0,250,8 0250 02 08 0,25;0,8 (42 (53 0,250, 0,25;0, (4 (5 0,250 0,25;0 ( 0,25;

ABSTRACT Objective To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness. Methods : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: “reported syphilis treatment in the last year”, “no/incomplete” or “complete”. A multivariate-logistic model was used to identify factors associated with completeness. Results : Of the 1,317 participants, 16.0% reported previous history of syphilis. Of these, 68.9% were Black, 54.6% earned up to 1 minimum wage and 61.1% completed the treatment. Treatment completion was lower in São Paulo (42.7%) and among those who experienced verbal abuse (53.6%; ORa 0.46; 95%CI 0.25;0.85). Conclusion In this sample, both the prevalence of self-reported syphilis and the proportion of participants who reported not having started/completed treatment were high. It is essential to identify the barriers faced by TWTs that hinder healthcare access, and identify their needs in order to ensure adequate diagnosis and treatment. (TWTs incompleteness crosssectional cross sectional 201 2021 respondentdriven respondent driven sampling capitals variable year, year , year” no/incomplete noincomplete no incomplete “no/incomplete complete. complete . “complete” multivariatelogistic multivariate logistic completeness 1317 317 1,31 160 16 0 16.0 these 689 68 9 68.9 Black 546 54 6 54.6 611 61 61.1 42.7% 427 42 7 (42.7% 53.6% 536 53 (53.6% 0.46 046 46 95CI CI 95 0.250.85. 025085 0.25 0.85 25 85 0.25;0.85) sample selfreported self startedcompleted started high access 20 202 “complete 131 31 1,3 16. 68. 5 54. 61. 42.7 4 (42.7 53.6 (53.6 0.4 04 250 0.250.85 02508 025 0.2 085 0.8 2 8 0.25;0.85 13 3 1, 42. (42. 53. (53. 0. 0.250.8 0250 02 08 0.25;0.8 (42 (53 0.250. 0.25;0. (4 (5 0.250 0.25;0 ( 0.25;

RESUMEN Objetivo Evaluar historia previa de sífilis en mujeres transgénero y travestis (MTT), identificar factores asociados al tratamiento incompleto. Métodos Estudio transversal multicéntrico, entre 2019-2021, con participantes reclutadas por Respondent-Driven Sampling, en cinco capitales brasileñas. Variable dependiente: “tratamiento de sífilis reportado el último año”: ‘no/incompleto’ o ‘completo’. Se utilizó un modelo logístico multivariable para identificar factores asociados a la incompletitud. Resultados 1.317 participantes, 16,0% refirieron sífilis previa. De estas 68,9% eran negras y 54,6% ganaban hasta 1 salario mínimo; 61,1% completaron tratamiento. La finalización del tratamiento fue menor en San Pablo (42,7%) y entre las que sufrieron agresión verbal (53,6%; ORa 0,46; IC95% 0,25;0,85). Conclusión Tanto prevalencia de sífilis autorreferida como proporción de participantes que informaron no haber iniciado/finalizado el tratamiento fueron elevadas. Es necesario identificar barreras enfrentadas por MTT que impactan su acceso a atención de salud, además, identificar sus necesidades específicas para garantizar un diagnóstico y tratamiento adecuados. MTT, , (MTT) incompleto multicéntrico 20192021, 20192021 2019 2021, 2021 2019-2021 RespondentDriven Respondent Driven Sampling brasileñas dependiente año año” ‘no/incompleto noincompleto ‘completo. completo ‘completo . ‘completo’ incompletitud 1317 317 1.31 160 16 0 16,0 689 68 9 68,9 546 54 6 54,6 mínimo 611 61 61,1 42,7% 427 42 7 (42,7% 53,6% 536 53 (53,6% 0,46 046 46 IC95 IC 0,250,85. 025085 0,25 0,85 25 85 0,25;0,85) iniciadofinalizado iniciado finalizado elevadas salud además adecuados (MTT 2019202 201 202 2019-202 131 31 1.3 16, 68, 5 54, 61, 42,7 4 (42,7 53,6 (53,6 0,4 04 IC9 250 0,250,85 02508 025 0,2 085 0,8 2 8 0,25;0,85 201920 20 2019-20 13 3 1. 42, (42, 53, (53, 0, 0,250,8 0250 02 08 0,25;0,8 20192 2019-2 (42 (53 0,250, 0,25;0, 2019- (4 (5 0,250 0,25;0 ( 0,25;

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. Objective INTERGROWTH21st INTERGROWTHst INTERGROWTH 21st st IG . (IG21) Methods (BNRN VLBW (VLBW tertiarycare tertiary care hospitals Outcome (CNMM inhospital hospital death 4 enterocolitis smallforgestationalage small gestational age SGA (SGA rd SGA3 (SGA3 th SGA10 (SGA10 BW largeforgestationalage large LGA (LGA BMI logbinomial log binomial Results 4072 072 4,07 included BNRN/IG21 BNRNIG21 BNRNIG (BNRN/IG21) 145 1 45 1.4 0.92–2.31/1.60 092231160 0.92–2.31 /1.60 0 92 31 60 (0.92–2.31)/1.6 1.27–2.02 127202 27 02 (1.27–2.02 090 90 0.9 0.55–1.47/1.05 055147105 0.55–1.47 /1.05 55 47 05 (0.55–1.47)/1.0 0.55–1.99 055199 99 (0.55–1.99 165 65 1.6 1.08–2.51/1.58 108251158 1.08–2.51 /1.58 08 51 58 (1.08–2.51)/1.5 1.28–1.96 128196 28 96 (1.28–1.96 stunting 148 48 1.02–2.17 102217 17 (1.02–2.17 variable >95% 95 (>95% 7090%, 7090 70 90% , (70-90%) Conclusion IG2 outcomes (IG21 SGA1 (SGA1 407 07 4,0 BNRN/IG2 BNRNIG2 (BNRN/IG21 14 1. 0.92–2.31/1.6 09223116 092231 0.92–2.3 160 /1.6 9 6 (0.92–2.31)/1. 1.27–2.0 12720 (1.27–2.0 09 0. 0.55–1.47/1.0 05514710 055147 0.55–1.4 105 /1.0 5 (0.55–1.47)/1. 0.55–1.9 05519 (0.55–1.9 16 1.08–2.51/1.5 10825115 108251 1.08–2.5 158 /1.5 (1.08–2.51)/1. 1.28–1.9 12819 (1.28–1.9 1.02–2.1 10221 (1.02–2.1 >95 (>95 7090% 709 7 (70-90% (IG2 40 BNRN/IG (BNRN/IG2 0.92–2.31/1. 0922311 09223 0.92–2. /1. (0.92–2.31)/1 1.27–2. 1272 (1.27–2. 0.55–1.47/1. 0551471 05514 0.55–1. 10 (0.55–1.47)/1 0551 (0.55–1. 1.08–2.51/1. 1082511 10825 1.08–2. 15 (1.08–2.51)/1 1.28–1. 1281 (1.28–1. 1.02–2. 1022 (1.02–2. >9 (>9 (70-90 (IG (BNRN/IG 0.92–2.31/1 0922 0.92–2 /1 (0.92–2.31)/ 1.27–2 127 (1.27–2 0.55–1.47/1 0.55–1 (0.55–1.47)/ 055 (0.55–1 1.08–2.51/1 1082 1.08–2 (1.08–2.51)/ 1.28–1 128 (1.28–1 1.02–2 102 (1.02–2 (> (70-9 0.92–2.31/ 092 0.92– / (0.92–2.31) 1.27– 12 (1.27– 0.55–1.47/ 0.55– (0.55–1.47) (0.55– 1.08–2.51/ 108 1.08– (1.08–2.51) 1.28– (1.28– 1.02– (1.02– ( (70- 0.92 (0.92–2.31 1.27 (1.27 0.55 (0.55–1.47 (0.55 1.08 (1.08–2.51 1.28 (1.28 1.02 (1.02 (70 (0.92–2.3 1.2 (1.2 0.5 (0.55–1.4 (0.5 1.0 (1.08–2.5 (1.0 (7 (0.92–2. (1. (0. (1.08–2. (0.92–2 (1 (0 (1.08–2 (0.92– (1.08– (0.92 (1.08 (0.9

Abstract Objectives To evaluate neonatal autopsy rates at a tertiary hospital in southern Brazil ascertain the level of agreement between premortem and postmortem diagnosis. Methods The authors reviewed all neonatal autopsies performed over a 10-year period and described the percentage of neonates who died and underwent autopsy. The authors tested for agreement between autopsy findings and the cause of death as defined by the neonatologist. Agreement between clinical diagnosis and autopsy findings was classified using the modified Goldman criteria. Additional findings at autopsy were grouped by organ system. Linear regression and multiple comparisons were used for statistical analyses. Results During the study period, 382 neonates died at the Neonatal Intensive Care Unit (NICU). Consent to perform an autopsy was obtained for 73 (19.1%). The complete agreement between autopsy findings and the neonatologist's premortem diagnosis was found in 48 patients (65.8%). Additional findings were obtained at autopsy in 25 cases (34.2%). In 5 cases (6.9%), the autopsy findings contributed to subsequent genetic counseling. Seven autopsies (9.6%) revealed a diagnosis that would have changed patient management if established premortem. The autopsy rate increased by an average of 1.87% each year. Conclusion Despite a high level of agreement between clinical diagnosis and pathological findings, autopsies provided relevant data regarding the cause of death, providing additional clinical information to neonatologists and allowing genetic counseling of family members.

Abstract This study aimed to evaluate the antioxidant potential of the Coffea arabica Lineu (L.) leaf extract and its effects on platelet aggregation of dyslipidemic rats. The extract was obtained by the percolation of C. arabica L. leaves in hydroethanolic solution 70% (v/v). The mass spectrometry FIA-ESI-MS² suggested the presence of chlorogenic acid, rutin acid, and quinic acid. The DPPH• radicals scavenging capacity was demonstrated (IC50 = 0.06 mg/mL). The extract was administered to rats by gavage (300 mg/kg/day) for 56 days. Dyslipidemia was induced by administering Triton WR-1339 (300 mg/kg body weight) on the 54th day. On day 56, blood was collected by puncturing the abdominal aorta artery and the aortic artery was removed. Lipid profile, markers of renal and hepatic injury, lipid peroxidation, and platelet aggregation tests were carried out. The ingestion of extract reduced the lipid peroxidation (aorta and plasma) and platelet aggregation in dyslipidemic rats. The extract did not affect markers of renal and hepatic function as analyzed in this study, suggesting neither impaired liver nor kidney function in these animals. Therefore, our results demonstrate that the extract of leaves of C. arabica L. show antioxidant potential in vitro and in vivo as well as anti-platelet aggregation in dyslipidemic animals.

Abstract Introduction Deficits in executive functioning, especially in inhibitory control, are present in children born very premature and/or with very low birth weight (VP/VLBW) and in children with attention-deficit/hyperactivity disorder (ADHD). Objective To evaluate whether ADHD imposes additional inhibitory control (IC) deficits in preschoolers born VP/VLBW. Methods 79 VP/VLBW (4 to 7 years) children were assessed for ADHD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children – Present and Lifetime Version (K-SADS-PL). IC was measured with Conners’ Kiddie Continuous Performance Test (K-CPT 2) and the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P).Results: No significant differences were found between ADHD (n = 24) and non-ADHD children (n = 55) for any of the measures (p = 0.062 to p = 0.903). Both groups had deficits in most K-CPT 2 scores compared to normative samples, indicating poor IC and inconsistent reaction times. Conclusions ADHD does not aggravate IC deficits in VP/VLBW children. Either neuropsychological tasks and parent reports of executive functions (EFs) may not be sensitive enough to differentiate VP/VLBW preschoolers with and without ADHD, or these children’s EFs are already so impaired that there is not much room for additional impairments imposed by ADHD.

Resumo Objetivos Apresentar evidências atuais na etiologia, fatores de risco, diagnóstico e manejo da sepse neonatal precoce e tardia. Fontes de dados Revisão não sistemática feita nas bases de dados Medline (PubMed), Scopus, Web of Science, Cochrane, Google Scholar sobre os temas sepse neonatal, sepse neonatal precoce, sepse neonatal tardia, antibioticoterapia empírica, sepsis calculator, vancomicina, recém-nascido, recém-nascido pré-termo. Síntese de dados A sepse neonatal é uma causa frequente de morbimortalidade neonatal. O seu diagnóstico é difícil. A observação contínua do paciente é fundamental para uma suspeição diagnóstica. Ao se suspeitar de sepse neonatal devem-se coletar exames bacteriológicos. Não usar, rotineiramente, vancomicina no esquema empírico de antibiótico na sepse neonatal tardia. Os principais mecanismos protetores da sepse neonatal são a lavagem de mãos e o uso do leite materno. Conclusões Os recém-nascidos constituem um grupo mais vulnerável à sepse. O conhecimento dos fatores de risco e dos agentes etiológicos permite uma melhor abordagem do recém-nascido séptico.

Abstract Objectives To present current evidence on the etiology, risk factors, diagnosis, and management of early and late neonatal sepsis. Source of data Non-systematic review of the Medline (PubMed), Scopus, Web of Science, Cochrane, and Google Scholar databases regarding the following terms: neonatal sepsis, early neonatal sepsis, late neonatal sepsis, empirical antibiotic therapy, sepsis calculator, vancomycin, newborn, preterm newborn. Data synthesis Neonatal sepsis is a frequent cause of neonatal morbidity and mortality. Its diagnosis is difficult. Continuous observation of the patient is critical to diagnostic suspicion. When neonatal sepsis is suspected, bacteriological tests should be collected. Vancomycin should not be routinely using in the empirical antibiotic regimen in late neonatal sepsis, and the main protective mechanisms against neonatal sepsis are handwashing and the use of breast milk. Conclusions Newborns constitute a group that is more vulnerable to sepsis. Knowledge of risk factors and etiological agents allows a better approach to the newborn with sepsis.

Resumo Objetivo: Avaliar a prevalência de síndrome metabólica "like" em população de crianças prematuras com muito baixo peso de nascimento (< 1500 gramas) aos dois anos de idade corrigida e identificar a ocorrência de fatores de risco associados. Métodos: Estudo transversal que incluiu prematuros nascidos durante um período de cinco anos com muito baixo peso de nascimento, avaliados aos dois anos de idade corrigida. A síndrome metabólica "like" foi definida pela presença de três ou mais desses critérios: circunferência abdominal ≥ percentil 90, glicemia de jejum ≥ 100 mg/dL, triglicerídeos ≥ 110 mg/dL, colesterol HDL ≤ 40 mg/dL e pressão arterial ≥ percentil 90. Resultados: Foram avaliados 214 prematuros abaixo de 1.500 gramas. A prevalência de síndrome metabólica "like" aos dois anos de idade corrigida foi 15,1%. Hipertensão arterial esteve presente em 57,5%, HDL ≤ 40 mg/dL em 29,2%, hipertrigliceridemia em 22,6% e aumento da circunferência abdominal acima do percentil 90 em 18,8%. Apenas 3,7% apresentaram hiperglicemia. A presença de leucomalácia periventricular foi um fator de risco independente para hipertensão arterial nessa idade (OR 2,34; IC 95% 0,079-0,69; p = 0,008); sobrepeso e obesidade aos dois anos de idade corrigida foram independentemente associados com síndrome metabólica "like" (OR 2,75, IC 95% CI 1,19-6,36; p = 0,018). Conclusão: Síndrome metabólica "like" ocorre em prematuros de muito baixo peso tão precocemente quanto dois anos de idade corrigida. Sobrepeso e obesidade de início precoce são fatores de risco significativos para síndrome metabólica "like", merecem intervenção apropriada para essa população de alto risco.

Abstract Objective: To assess the prevalence of metabolic syndrome-like symptoms in a population of preterm infants with very low birth weight (<1500 g) at 2 years of corrected age and identify the occurrence of associated risk factors. Methods: Cross-sectional study during a five-year period, including preterm infants born with very low birth weight evaluated at 2 years of corrected age. Metabolic syndrome-like symptoms was defined by the presence of three or more of these criteria: abdominal circumference ≥ 90th percentile, fasting blood glucose ≥ 100 mg/dL, triglycerides ≥ 110 mg/dL, HDL cholesterol ≤ 40 mg/dL, and blood pressure ≥ 90th percentile. Results: A total of 214 preterm infants with birth weight < 1500 g were evaluated. The prevalence of metabolic syndrome-like symptoms at 2 years of corrected age was 15.1%. Arterial hypertension was present in 57.5%, HDL ≤ 40 mg/dL in 29.2%, hypertriglyceridemia in 22.6%, and abdominal circumference above the 90th percentile in 18.8%. Only 3.7% had hyperglycemia. The presence of periventricular leukomalacia was an independent risk factor for arterial hypertension at this age (OR 2.34, 95% CI: 0.079–0.69, p = 0.008). Overweight and obesity at 2 years of corrected age were independently associated with metabolic syndrome-like symptoms (OR 2.75, 95% CI: 1.19–6.36, p = 0.018). Conclusion: Metabolic syndrome-like symptoms can be observed in very low birth weight preterm infants as early as 2 years of corrected age. Overweight and early-onset obesity are significant risk factors for metabolic syndrome-like symptoms, which deserves appropriate intervention for this high-risk population.

Resumo Objetivos: Inúmeros são os fatores que influenciam o crescimento pós-natal de prematuros. É fundamental a definição de como avaliar velocidade de crescimento de cada criança nascida prematura e sua trajetória individual, o tipo de curva de crescimento, seja com parâmetros de curvas prescritivas para prematuros saudáveis e sem morbidades ou no caso de um prematuro e seu "pacote de vulnerabilidades", curvas de crescimento que possam representar como eles realmente crescem, com a finalidade de direcionar o cuidado nutricional apropriado a cada faixa de idade gestacional. Fonte de dados: Foram revisados os principais estudos com curvas de crescimento na monitoração do crescimento e nos ajustes nutricionais apropriados que priorizaram a trajetória individual da velocidade de crescimento pós-natal. Foram consultados PubMed e Google Scholar. Síntese dos dados: O uso de dados neonatais longitudinais com diferentes idades gestacionais e considerando gestações de alto e médio risco provavelmente será fundamental para avaliar o padrão ótimo de crescimento. Conclusões: Priorizar e conhecer a trajetória individual de crescimento de cada criança nascida prematura é opção para prematuros com menos de 33 semanas. Para prematuros maiores, nascidos com idade gestacional acima de 33 semanas, as curvas Intergrowth 21 st são adequadas.

Abstract Objectives: There are several factors that influence the postnatal growth of preterm infants. It is crucial to define how to evaluate the growth rate of each preterm child and its individual trajectory, the type of growth curve, either with parameters of prescriptive curves for healthy preterm infants with no morbidities or, in the case of preterm infants and their "bundle of vulnerabilities", growth curves that may represent how they are actually growing, with the aim of directing appropriate nutritional care to each gestational age range. Data sources: The main studies with growth curves for growth monitoring and the appropriate nutritional adjustments that prioritized the individual trajectory of postnatal growth rate were reviewed. PubMed and Google Scholar were searched. Data synthesis: The use of longitudinal neonatal data with different gestational ages and considering high and medium-risk pregnancies will probably be essential to evaluate the optimal growth pattern. Conclusions: Prioritizing and knowing the individual growth trajectory of each preterm child is an alternative for preterm infants with less than 33 weeks of gestational age. For larger preterm infants born at gestational age >33 weeks, the Intergrowth 21st curves are adequate.

RESUMO Objetivos: Avaliar o possível efeito protetor do leite materno contra a retinopatia da prematuridade, através da comparação da quantidade de leite materno recebida entre os pacientes que desenvolveram retinopatia da prematuridade e aqueles livres da doença. Tentar determinar a quantidade mínima necessária e o momento em que o recém-nascido precisa receber o leite materno para que esse efeito seja significativo. Métodos: Estudo de coorte observacional incluindo recém-nascidos com peso de nascimento inferior a 1500 gramas e/ou com idade gestacional inferior a 32 semanas, nascidos no período de janeiro de 2011 a outubro de 2014 e internados nas primeiras 24 horas de vida na UTI Neonatal do Hospital da Criança Conceição em Porto Alegre. Resultados: A prevalência da retinopatia da prematuridade em qualquer grau foi de 31% (100 casos em 323 pacientes) e a de retinopatia da prematuridade grave foi de 9% (29 casos em 323 pacientes). A mediana da quantidade de leite materno recebida pelos pacientes foi de 10,2 mL/kg/dia entre os pacientes sem retinopatia da prematuridade (amplitude interquartil 1,5-25,5) e de 4,9 mL/kg/dia entre os pacientes com retinopatia da prematuridade (0,3-15,4). A quantidade de leite materno recebida nas primeiras seis semanas de vida foi inversamente associada à incidência de retinopatia da prematuridade em qualquer grau e de retinopatia da prematuridade grave nas análises univariadas, mas a significância estatística não se manteve após análise multivariada para controle de fatores confundidores na maioria dos períodos avaliados, exceto na sexta semana de vida. Conclusão: Pequenas quantidades de leite materno não são suficientes para prevenção de retinopatia da prematuridade em recém-nascidos com de risco para a doença.

ABSTRACT Purpose: To evaluate the possible protective effect of breast milk against retinopathy of prematurity by comparing the amount of breast milk received by patients who developed retinopathy of prematurity and those who did not and to determine both the required minimum amount of breast milk and the time of life during which neonates need to receive breast milk for this effect to be significant. Methods: Cohort study of newborns with a birth weight of <1500 g or gestational age of <32 weeks, or both, born between January 2011 and October 2014 and hospitalized within the first 24 h of life in the Hospital Criança Conceição Neonatal Intensive Care Unit in Porto Alegre, RS, Brazil. Results: The prevalence of retinopathy of prematurity of any degree was 31% (100 of 323 patients) and that of severe retinopathy of prematurity was of 9% (29 of 323 patients). The median amounts of breast milk received daily by patients with and without retinopathy of prematurity were 4.9 mL/kg (interquartile range, 0.3-15.4) and 10.2 mL/kg (1.5-25.5), respectively. The amount of breast milk received in the first 6 weeks of life was inversely associated with the incidence of both retinopathy of prematurity of any degree and severe retinopathy of prematurity in the univariate analyses. However, the statistical significance was maintained only during the sixth week of life in a per-period multivariate analysis controlling for confounding factors. Conclusions: Small amounts of breast milk are inadequate to prevent retinopathy of prematurity in premature newborns at risk for the disease.