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81.
W.A. Gon?alves-Ferri F.E. Martinez J.P.S. Caldas S.T.M. Marba S. Fekete L. Rugolo C. Tanuri C. Leone G.A. Sancho M.F.B. Almeida R. Guinsburg 《Brazilian journal of medical and biological research》2014,47(3):259-264
This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min. 相似文献
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In the last decades, international guidelines proposed different strategies of complementary foods introduction during weaning to prevent allergy. Avoidance measures, such as late introduction of allergenic foods, failed to show a significant preventive effect towards allergy. Recently, prospective randomized controlled studies suggested that the early introduction of solid foods ‐ rather than the late introduction ‐ could be a strategy to prevent allergic sensitization and food allergy. However, at today clear evidence of effectiveness and safety of early introduction are not yet available to recommend a radical change in the current clinical practice. A realistic advice for the general population could be to begin the weaning at 4–5 months with the progressive introduction of different foods. The advices for introduction of solid foods during weaning should also take in consideration the global development of child to chose the better timing of introduction of foods. 相似文献
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《Early child development and care》2012,182(2):233-247
The aim of this study was to explore the experience of parents and caregivers regarding young children in day care. The tiredness of children after day-care attendance was explored. In the autumn of 2009, 41 parents and 35 caregivers of children aged 1.5 years or younger living in the city of Trondheim and nearby communities were assessed using a semi-structured qualitative interview. There was agreement among parents and caregivers that children became very tired after full-time care. In spite of the good quality of the care, with a relatively low child/adult ratio and very experienced caregivers with high educational qualifications, most children became very tired at the end of the stay. Tiredness in children also seemed to accumulate during the week and reached its peak on Fridays. The children adjusted well to care; however, they got very tired when the stay lasted a full day. Children who were picked up somewhat earlier did not exhibit the same level of tiredness. 相似文献
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Tactile stimulation during neonatal transition and its effect on vital parameters in neonates during neonatal transition
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