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Introduction: We report a rare occurrence in which a term infant with intestinal anomalous congenital bands (ACB), presented with bloody stools and necrotizing enterocolitis (NEC), instead of the typical intestinal obstruction picture. Our case differs from the reported cases of ACB in its presentation as bloody stools and necrotizing enterocolitis, rather than the classic symptoms of intestinal obstruction (IO). Case presentation: A term neonate who was admitted to the Neonatal Intensive Care Unit (NICU) because of hypoglycemia, developed bloody stools and a clinical picture of NEC. She was treated by antibiotics and kept NPO for 7 days during which her symptoms resolved. Upon refeeding and after reaching full feeding volumes, her bloody stools recurred which warranted expanding the differential diagnosis and further investigations including lower gastrointestinal (GI) contrast study. The lower GI contrast study showed multiple filling defects indicating GI obstruction. Laparotomy was performed to explore and release the cause of obstruction. Laparotomy revealed Anomalous Congenital Bands (ACB) in the colon and cecum causing almost complete obstruction of the intestinal lumen. The ACB were excised, and the stricture segments of bowel were resected, and primary anastomosis was completed. Feeding was resumed with no recurrence of symptoms. Conclusion: Anomalous congenital bands may present with bloody stools and clinical picture of NEC rather that the classic presentation of intestinal obstruction.

Minimally invasive surfactant therapy (MIST) has emerged as a preferred method of surfactant delivery. Pioneers of this technique have described the use of direct laryngoscopy (DL) for MIST. With the increasing application of video laryngoscopy (VL) for neonatal airway management, it is speculated that MIST techniques can be adapted for use with VL. Objective: To compare procedural success, operator ease of use, and complication of MIST using VL vs. MIST using DL. Methods: This was a retrospective, observational cohort study conducted at a tertiary-level neonatal intensive care unit after obtaining ethical approval. We included neonates who received MIST between 1 October 2020 and 31 October 2022. Baseline demographic characteristics, along with procedural data, were collected. Primary outcome measures included the overall procedural success rate, the need for multiple attempts, and the total number of attempts. Secondary outcome measures included the occurrence of adverse events, the need for a second dose of surfactant, and the need for intubation within 7 days of the procedure. Means and SDs, independent t-tests, frequencies, and chi-square were used as appropriate. p-values < 0.05 were considered statistically significant. Results: Of the 79 neonates included, 37 neonates received MIST via VL, while 42 received MIST via DL. The median gestational age was lower in the VL group at 29.0 weeks vs. 30.5 weeks (p = 0.011) in the DL group. The median birthweight in the VL group was 1260 g, IQR (1080, 1690), which was significantly lower than the DL group, which was 1575 g, IQR (1220, 2251), p = 0.028. Purpose-built catheter use was higher in the DL group. The overall procedural success was similar between groups. The need for multiple attempts was lower with VL in comparison to DL [4 (11%) vs. 13 (31%); p = 0.034)] at the univariate level but not significant at multivariate analysis (p = 0.131). Procedural complications, the need for a second dose of surfactant, the need for mechanical ventilation post-MIST, and operator ease of use were similar. User comments emphasized the value of VL in providing real-time visual information to confirm catheter placement and guide operators/trainees. Conclusion: Overall, in our cohort, despite VL being a more recently adapted technology used more in smaller, sicker, and more premature neonates, procedural success, complications, and operator ease of use for MIST using VL and DL were comparable. Our findings show the successful application of VL for MIST and suggest procedural advantages that might facilitate universal adoption.

Introduction: Minimally invasive surfactant therapy (MIST) can be used to treat neonatal respiratory distress syndrome in neonatal intensive care units (NICUs). Clinical and institutional variances in MIST utilization persist globally with little published research regarding MIST utilization in Canada. Therefore, the objective of this study was to survey MIST utilization in NICUs in Canada. Methods: An online survey was emailed to the 33 participating centres of Canadian Neonatal NetworkTM (CNN) Evidence-based Practice for Improving Quality (EPIQ) Lung Health Group (LHG). Site demographics and surfactant therapy procedural details were categorically collected. Free text and multiple-choice questions were utilized to capture perceived barriers and individual preferences for MIST use. Results: Twenty-eight of 33 participating members of the CNN EPIQ-LHG completed the survey between April 2021 and October 2021 (85%); 17/28 (61%) respondents reported ongoing MIST utilization at their center. Most centers that used MIST techniques administered bovine lipid extract surfactant (68%), commonly using angiocatheters (47%) and purpose-built catheters (41%). MIST was widely used for patients at 26–33 weeks gestational age (88%). Nine centres had never used MIST (32%), and 3 indicated a plan to implement MIST within the next 2 years. Common barriers to MIST use included lack of consensus amongst clinicians (78%), lack of training (56%), and lack of experience with MIST (56%). Conclusion: While MIST is being increasingly used in Canadian NICUs, universal use is yet to be seen. Clinician inexperience and lack of consensus, formal training, and local guidelines contribute to underutilization of MIST. Training workshops, country-wide data collection, and uniform operating protocols are needed to standardize practice.

Neste artigo, são analisadas as variantes lexicais designativas do referente prostituta no falarmanauara. Como suporte teórico, seguimos Chambers & Trudgill (1994), Radke & Thun (1996) e Thun (2010). Para a realização do estudo, foram analisados os dados coletados por meio de uma pergunta feita a moradores de quatro bairros da cidade de Manaus, capital do estado do Amazonas, Brasil: Praça 14 de Janeiro (Zona Sul), Nova Cidade (Zona Norte), Zumbi dos Palmares (Zona Leste) e Glória (Zona Oeste). Em cada bairro foram selecionados oito informantes para compor a análise nas dimensões diatópica (quatro bairros), diassexual (homem e mulher), diageracional (de 18 a 30 anos e de 50 a 65 anos) e diastrática (Ensino Médio completo e Ensino Superior completo), caracterizando, dessa forma, uma pesquisa geolinguística na modalidade pluridimensional. O resultado mostrou que, nesses quatro bairros, a variável lexical prostituta apresenta 10 variantes lexicais: prostituta, puta, dama da noite, garota de programa, bagaça, mulher de programa, sem vergonha, vadia, mulher da vida e cesta básica.

The objective of this retrospective cohort study was to assess the impact of an enteral probiotics supplementation protocol on the incidence of necrotizing enterocolitis (NEC) in infants born

Abstract Background The use of less invasive surfactant administration (LISA)/minimally invasive surfactant therapy (MIST) has increased due to its potential advantage over traditional surfactant delivery methods through an endotracheal tube. Known complications for this procedure include failure of the first attempt at insertion, desaturation, and bradycardia. To the best of our knowledge, this is the first reported case of pneumomediastinum and subcutaneous emphysema following LISA. Case presentation A preterm newborn born at 27 weeks of gestation presented with respiratory distress syndrome requiring surfactant replacement. LISA using the Hobart method was completed. There was a report of procedural difficulty related to increased resistance to insertion of the 16G angiocath. The newborn was subsequently noted to have subcutaneous emphysema over the anterior aspect of the neck and substantial pneumomediastinum on radiological assessment. Associated complications included hypotension requiring inotropic support. The newborn was successfully managed conservatively, with complete resolution of the air leak. Conclusions Upper airway injury leading to air leak syndrome is a rare complication of the Hobart method for LISA. Awareness of such procedural complications is important as the use of the LISA method increases.

This paper addresses word formation with adjectives from Tupi origin, açu and mirim, in Amazonian Portuguese. The corpus for the analysis was constituted by the reading of books, and dictionaries, which include the formations by composition with these adjectives. For the purposes of the research, our theoretical foundation is based on the Generative Morphology model (ARONOFF, 1976; BASÍLIO, 2009; ROCHA, 2008; SPENCER, 1991) in order to make it possible to construct rules applicable to the bases that these adjectives select. The results show the existence of formations by composition mainly and the application of Structural Analysis Rules (SARs) and Word Formation Rules (WFRs). In addition, some constructions do not have entries in dictionaries and others do not characterize the formation process by composition. We concluded that there is an extensive list of words formed with -açu and mirim incorporated in Brazilian Portuguese, showing that they are very productive in the formation of compound words and sometimes in derivative word formation.

Este artigo aborda a formação de palavras com os adjetivos de origem tupi açu e mirim, no português amazônico. O corpus para a análise foi constituído a partir da leitura de livros e dicionários, nos quais constam as formações por composição com esses adjetivos. Para os propósitos da pesquisa, a fundamentação teórica é baseada no modelo da Morfologia Gerativa (ARONOFF, 1976; SPENCER, 1991; ROCHA, 2008; BASÍLIO, 2009), a fim de que fosse possível a construção de regras aplicáveis às bases que esses adjetivos selecionam. Os resultados mostram a existência de formações por composição, principalmente, e a aplicação da Regra de Análise Estrutural (RAE) e da Regra de Formação de Palavra (RFP). Algumas construções não possuem entradas em dicionários e outras não caracterizam o processo de formação por composição. Conclui-se que existe uma extensa lista de palavras formadas com -açu e com mirim incorporadas ao português brasileiro, demonstrando que são étimos bastante produtivos na formação de palavras compostas e, por vezes, na formação de palavras por derivação

O presente estudo aborda aspectos linguístico-etnográficos sobre a cultura da mandioca no Baixo Amazonas, localizado no estado do Pará. O cultivo da mandioca na Amazônia constitui um campo semântico e etnográfico de grande vitalidade lexical, que se desdobra e se correlaciona com outros aspectos da vida cotidiana das populações que lá habitam. Tendo isso em conta, o objetivo desta pesquisa foi descrever o léxico utilizado pelas populações da região, correlacionado ao mundo da roça. Na obtenção dos dados, foram entrevistadas 10 pessoas do Igarapé do Juriti-Velho (Região do Baixo Amazonas), as quais possuíam experiência no plantio da mandioca e na produção de seus derivados. No final, conseguimos elaborar um glossário com 222 itens lexicais sobre: os nomes das mandiocas cultivadas na região; os processos de produção dos derivados; os utensílios usados no cultivo da mandioca e na produção de seus derivados. A pesquisa, em uma perspectiva dialetológica, contribuiu para maior conhecimento do português amazônico.

We describe trends in the rates of admission of preterm twin and triplet infants to neonatal intensive care units (NICUs) across Canada and compare their neonatal outcomes over a 6-year period. Temporal trends of admission rates for 5193 twins and triplets < 33 weeks' gestational age to participating NICUs in the Canadian Neonatal Network between 2003 and 2008 were assessed. Trends in infant outcomes were evaluated using logistic regression. The proportion of twins increased from 26.1 to 28.0 per 100 admissions between 2003 and 2008 (7% increase, p = 0.02). In contrast, the proportion of triplets decreased from 5.0 to 3.3 per 100 admissions (34% reduction, p = 0.04). These trends were significant in mothers ≥ 35 years of age. Neonatal outcomes improved for preterm twins (mortality, p <  0.01; survival without any major morbidity, p <  0.01; severe neurological injury, p = 0.02; and severe retinopathy of prematurity, p = 0.03). Similar improvements were observed for triplets, but the sample size was insufficient to reach statistical significance. The rate of NICU admissions for preterm twins at < 33 weeks' gestation has increased in recent years, whereas for triplets it has gradually declined. Neonatal outcomes of preterm twins improved over the study period. [ABSTRACT FROM AUTHOR]

Resumo Objetivo Comparar a percepção de estudantes de enfermagem e as contribuições do ensino com simulação clínica ou aula prática convencional em laboratório de habilidades, na primeira experiência clínica hospitalar. Método Pesquisa descritiva, qualitativa, envolvendo estudantes de graduação em enfermagem de uma universidade pública do Brasil, submetidos à simulação clínica de alta fidelidade ou aula prática convencional, ocorrida entre 2015 e 2016. Para avaliação dos dados, utilizaram-se a nuvem de palavras e a análise de similitude do software IRAMUTEQ®. Resultados Participaram 54 estudantes, sendo 27 em cada grupo. As palavras mais evocadas pelo grupo simulação foram: “paciente real, não, mais e simulador”, relacionadas à capacidade de reflexão quanto ao seu conhecimento e preparo. As mais evocadas no grupo prática convencional foram: “mais, não, muito e sentir”, relacionadas com a percepção de que a aula convencional ajuda na aquisição de habilidades, contudo, é necessária maior frequência. Conclusão As duas estratégias contribuíram positivamente para a primeira experiência clínica hospitalar. Porém, a simulação proporcionou uma visão crítico-reflexiva sobre as competências, deficiências e maior autoconfiança em relação à prática convencional. Este estudo fortalece as evidências dos benefícios proporcionados pelo ensino baseado em simulação, e a importância de instituições de ensino fazerem uso adequado dessa estratégia.

Este trabalho compara a teoria apresentada por Christiaan Huygens no Tratado sobre a Luz, no século XVII, com a versão que aparece em alguns livros didáticos de Física para cursos superiores, e estuda a percepção dos alunos acerca do desenvolvimento dessa teoria. As informações veiculadas nesses livros incorporam contribuições posteriores, que levam a uma visão inadequada da evolução dessa teoria e a atribuir ao passado concepções atuais.This paper compares the theory presented by Christiaan Huygens in his Treatise on Light, in the XVII century, with the version that appears in some textbooks of Physics for undergraduate courses, and analysis the perception of students concerning the development of this theory. As a result, we found that the information presented in these books incorporated later contributions, which leads students to an incorrect view of the evolution of this theory and to attribute current conceptions to the past.

Investiga-se uma possível extensão ao ensino de física dos conceitos apolíneo e dionisíaco, categorias usadas por Friedrich Nietzsche em O Nascimento da Tragédia ou Helenismo e Pessimismo para descrever o Teatro Grego Clássico. Eles expressam duas características complementares do homem grego, ou da mente humana em geral. O apolíneo refere-se ao sentido visual, ao aspecto plástico e à forma, à moldura, é limitado, definido, preciso, individual; o dionisíaco refere-se ao sentido auditivo, é afigurado, amorfo, ilimitado, indefinido, impreciso, coletivo. A aplicação desses conceitos, por similaridade, a algumas tendências contemporâneas de ensino de física sugere que as tendências mais férteis buscariam explorar essa complementaridade, enquanto as tendências mais estéreis estariam relacionadas à predominância quase exclusiva de um deles.