BackgroundCongenital heart diseases are the most common type of congenital defects, and account for more deaths in the first year of life than any other condition, when infectious etiologies are ruled out.ObjectivesTo evaluate survival, and to identify risk factors in deaths in newborns with critical and/or complex congenital heart disease in the neonatal period.MethodsA cohort study, nested to a randomized case-control, was performed, considering the Confidence Interval of 95% (95% CI) and significance level of 5%, paired by gender of the newborn and maternal age. Case-finding, interviews, medical record analysis, clinical evaluation of pulse oximetry (heart test) and Doppler echocardiogram were performed, as well as survival analysis, and identification of death-related risk factors.ResultsThe risk factors found were newborns younger than 37 weeks (Relative Risk - RR: 2.89; 95% CI [1.49-5.56]; p = 0.0015), weight of less than 2,500 grams (RR: 2.33 [; 95% CI 1.26-4.29]; p = 0.0068), occurrence of twinning (RR: 11.96 [95% CI 1.43-99.85]; p = 0.022) and presence of comorbidity (RR: 2.27 [95% CI 1.58-3.26]; p < 0.0001). The incidence rate of mortality from congenital heart disease was 81 cases per 100,000 live births. The lethality attributed to critical congenital heart diseases was 64.7%, with proportional mortality of 12.0%. The survival rate at 28 days of life decreased by almost 70% in newborns with congenital heart disease. The main cause of death was cardiogenic shock.ConclusionPreterm infants with low birth weight and comorbidities presented a higher risk of mortality related to congenital heart diseases. This cohort was extinguished very quickly, signaling the need for greater investment in assistance technology in populations with this profile.

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OBJECTIVES: This study aims to summarize the current qualitative evidence on patients’ experiences of reading the ICU diaries. DATA SOURCES: We searched the online databases PubMed, Ovid, EMBASE, and EBSCO host from inception to July 2020. STUDY SELECTION: All studies that presented any qualitative findings regarding patients’ experiences of reading an ICU diary were included. DATA EXTRACTION: Study design, location, publication year, data collection method, and mode, all qualitative themes identified and reported, and participant quotations, when appropriate. We also extracted data regarding the diary structure, when available. A thematic synthesis approach was used to analyze and synthesize qualitative data. DATA SYNTHESIS: Seventeen studies were analyzed. Most patients reported positive experiences with the ICU diary, such as understanding what they survived during critical illness, better understanding the process of recovery, gaining coherence of nightmares and delusional memories, realizing the importance of the presence of family and loved ones during ICU stay, and humanizing healthcare professionals that helped them survive critical illness. Patients also reported which components of the diary were important for their recovery, such as the presence of photographs and reading the diary with a healthcare professional, allowing the improvement of the concept of the ICU diary. Conclusion: This qualitative synthesis shows that patients recommend having an ICU diary, enlightening benefits such as better coping with the slow recovery from critical illness, strengthening family ties, and humanizing the ICU staff. It also identifies characteristics of the diary valued by the patients, in order to standardize the ICU diary according to their perspectives, and allowing future comparability between randomized controlled trials.

<p class="Default" style="text-align: justify;"><strong><span style="font-size: 10.0pt;">Introdução</span></strong><span style="font-size: 10.0pt;">: A partir da década de 1960, com os avanços tecnológicos que ocorreram na assistência aos recém-nascidos, houve um aumento da sobrevida dos prematuros extremos, embora o Brasil ainda abrigue estatísticas preocupantes em relação à assistência pré-natal e ao nascimento desses neonatos. <strong>Objetivo</strong>: avaliar a associação entre prematuridade e o número de consultas de pré-natal em Salvador, nas regiões Nordeste e Sul e no Brasil, em 2011. <strong>Metodologia</strong>: Trata-se de um estudo ecológico espacial. São apresentados dados secundários, colhidos no banco de dados de estatísticas vitais do Sistema de Informações sobre Nascidos Vivos da Secretaria Estadual de Saúde da Bahia, no ano de 2011. <strong>Resultados:</strong> Observou-se que a maior frequência de nascimentos prematuros ocorreu entre as mães que não tiveram acesso à consulta pré-natal. Embora dados secundários sejam passíveis de questionamento, principalmente devido ao risco de subnotificação, os resultados mostram que a assistência pré-natal insuficiente pode levar ao aumento de partos prematuros na cidade de Salvador. <strong>Conclusão</strong>: Em Salvador nascem mais prematuros com um quantitativo menor de consultas pré-natal do que na maioria dos estados do Sul e Sudoeste brasileiro. </span></p>

results of the study revealed four overarching themes of interest to the practitioners, namely 1) the purpose and use of the Griffiths Scales of Child Development; 2) domains, content, and structure of the Griffiths Scales of Child Development; 3) the psychometric properties, standardisation, and norms of the Griffiths Scales of Child Development; and 4) the merits, limitations, and improvements of the Griffiths Scales of Child Development. Based on the findings of this study, recommendations were made that can be used in the next revision of the Griffiths Scales of Child Development. These recommendations relate to psychometric properties, a specialised version for children with an autism spectrum disorder, school readiness elements, universality of the scales, administration time, diagnosis and screening, cost, specific items, and report writing. Conclusion It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience, it may quickly be forgotten, or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated, and it is generalisations that allow new situations to be tackled effectively Gibbs (1988). By creating a continuous feedback mechanism with practitioners around the world, a place for meaningful interdisciplinary reflection and collaboration is created and in so doing serves to advance the scope, quality and use of the test.

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1312 Figure 1 Number of daily hospitalizations, by ICD-10 chapter, in children under 1 year of age, between 2016 and 2021, in Brazil.Abstract 1312 Figure 2 Hospitalizations for respiratory diseases in infants, in Brazil, between 2016-2021 and deaths resulting from these hospitalizations Conclusion From the collected data we were able to conclude that the pandemic period presented a decrease in hospitalizations and an inversely proportional increase in deaths. This reduction was directly proportional between the groups included in each analyzed variable, these being 'age group', 'sex' and 'color/race'; further studies are needed on mortality from respiratory diseases, whether COVID-19 or others. Nonetheless, it is also necessary to analyze hospitalizations for COVID-19 and other ICDs that may be associated with it.

SUMMARY OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture