Small children are a challenging group in whom to perform KT. This retrospective study analyzed the results of 62 KTs in children weighing <15 kg, performed between 1998 and 2010, using extraperitoneal access and anastomosis of the renal vessels of donors to the aorta and IVC or iliac vessels of the recipients. Thirty-two (51.6%) grafts were LRDTs and 30 (48.4%) were DDRTs-28 of them pediatric. The mean age at KT was 3.7 ± 2.2 yr (1-12), and the mean weight was 12.3 ± 2.1 kg (5.6-14.9). Ten children weighed <10 kg, and five (8.1%) children presented previous thrombosis of the venous system. At one and five yr, patient survival was 93.2% and 84.2%, and graft survival was 85.2% and 72.7%. There were no differences between the rates for LRDT and DDRT. There were six vascular complications (four vascular thromboses, one laceration, and one renal artery stenosis) and two perirenal collections. Extraperitoneal access is a valid KT technique in children weighing <15 kg.
RESUMO -A mortalidade perinatal e a incidência de sequelas neurológicas em prematuros têm diminuído, dado os avanços da perinatologia. A avaliação acurada da idade gestacional (IG) é um componente essencial para o manejo dessas crianças. Procuramos avaliar o desempenho do teste neurológico em comparação com as escalas obstétrica (DUM) e neonatais (de Dubowitz e de Capurro). e comparar as idades gestacionais obtidas após a aplicação das diferentes escalas. Foram examinados 35 recém-nascidos, sendo excluídos aqueles com qualquer comorbidade. Após a aplicação das escalas e determinação das idades gestacionais, realizou-se o exame neurológico e anamnese com os pais. Os resultados obtidos demonstraram que o método neurológico de André-Thomas avalia os padrões do exame neurológico clássico do recém-nascido e, embora não seja um método amplamente utilizado na prática médica, mostrou ser fidedigno para a avaliação da IG.PALAVRAS-CHAVE: recém-nascido prematuro, idade gestacional, exame neurológico.
Assessment of gestational age of preterm newborn based on neurological examination, obstetric dating criteria and pediatrics criteriaABSTRACT -Perinatal mortality and the incidence of neurological sequelae in preterm infants have diminished owing to advances in perinatology. The accurate assessment of gestational age is a very important component of the medical practice and for the newborn's management. Herein we provide a study to evaluate the neurological examination in comparison to the obstetrics dating criteria and pediatrics scales (Dubowitz and Capurro) to determine the gestational age as well as to compare the gestational age obtained with the different methods. We studied 35 preterm newborns leaving out those ones with any pathologies. The different scales to determine the gestational age were administered to each infant, beyond the neurological examination. We conclude that André-Thomas method is an appropriate clinical tool for reliable determining for gestational age in preterm newborns. . Os critérios físicos que amadurecem com o avançar da idade fetal incluem firmeza progressiva do pavilhão da orelha, volume crescente do tecido mamário, diminuição dos pêlos finos e imaturos de lanugem sobre o dorso e diminuição da opacidade da pele. Capurro também utilizou critérios somáticos para a determinação da IG. Tais sinais são avaliados durante o primeiro dia de vida e lhes são atribuídos pontos. Um valor cumulativo correlaciona-se com a IG e essa correlação geralmente é precisa, com margem de erro de 2 semanas 4 .
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.