Objective: To create an electronic instrument in order to analyze the adequacy of the
preterm infants’ nutritional therapy, checking the difference between the
prescribed and the administered diet.Methods: A prospective and observational study on newborns with birthweight ≤1,500g
and/or gestational age ≤32 weeks, without congenital malformations. The
electronic instrument was developed based on Microsoft Excel 2010
spreadsheets and aimed at automatically calculating body weight gain,
calories and macronutrients received daily by each patient from parenteral
nutrition, intravenous hydration and enteral feedings. The weekly means of
each nutrient were used to compare the prescribed and administered
diets.Results: To evaluate the instrument, 60 newborns with a birth weight of 1,289±305 g
and a gestational age of 30±2 weeks were included. Of them, 9.6% had
restricted growth at birth and 55% at discharge. The median length of stay
was 45±17 days. There were significant differences between prescribed and
administered diet for all of the macronutrients and for total calories in
the first three weeks. The lipid was the macronutrient with the greatest
percentage error in the first week of life.Conclusions: The use of a computational routine was important to verify differences
between the prescribed and the administered diet. This analysis is necessary
to minimize calculation errors and to speed up health providers’ decisions
about the nutritional approach, which can contribute to patients’ safety and
to good nutritional practice. Very low birth weight infants are extremely
vulnerable to nutritional deficiencies and any reduction in macronutrients
they receive may be harmful to achieve satisfactory growth.
Considering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.
Achromatopsia (ACHM) is a congenital cone photoreceptor disorder characterized by reduced visual acuity, nystagmus, photophobia, and very poor or absent color vision. Pathogenic variants in six genes encoding proteins composing the cone phototransduction cascade (CNGA3, CNGB3, PDE6C, PDE6H, GNAT2) and of the unfolded protein response (ATF6) have been related to ACHM cases, while CNGA3 and CNGB3 alone are responsible for most cases. Herein, we provide a clinical and molecular overview of 42 Brazilian patients from 38 families affected with ACHM related to biallelic pathogenic variants in the CNGA3 and CNGB3 genes. Patients’ genotype and phenotype were retrospectively evaluated. The majority of CNGA3 variants were missense, and the most prevalent CNGB3 variant was c.1148delC (p.Thr383Ilefs*13), resulting in a frameshift and premature stop codon, which is compatible with previous publications in the literature. A novel variant c.1893T > A (p.Tyr631*) in the CNGB3 gene is reported for the first time in this study. A great variability in morphologic findings was observed in our patients, although no consistent correlation with age and disease stage in OCT foveal morphology was found. The better understanding of the genetic variants landscape in the Brazilian population will help in the diagnosis of this disease.
Medical specialties have recognized that breaking bad news assists clinical practice by mitigating the impact of difficult conversations. This scenario also encourages various studies on breaking bad news in ophthalmology since certain ocular diagnoses can be considered bad news. Thus, the objective is to review the scientific literature on breaking bad news in ophthalmology. The literature databases like MEDLINE/PUBMED, EMBASE, LILACS, SCOPUS, COCHRANE, and SCIELO, were screened for related research publications. Two independent reviewers read all the articles and short--listed the most relevant ones. Seven articles, in the formats of original article, review, editorial, oral communication, and correspondence, were reviewed. Conclusively it reveals that ophthalmologists are concerned with communicating bad news effectively but lack related studies. Nevertheless, there is a growing realization that training in breaking bad news can increase physicians' confidence during communication, thus, benefiting the therapeutic relationship with the patient and his family. Therefore, it would be valuable to include breaking bad news training in the curriculum of residencies.
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.