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Proposta de protocolo para avaliação e monitoramento da função auditiva na Síndrome de Down

2026-09-04T11:28:55Z

Título: Proposta de protocolo para avaliação e monitoramento da função auditiva na Síndrome de Down Autor(es): Figueiredo, Emeline Ramos Prata Abstract: Objectives: I – To conduct an integrative review of the scientific literature on hearing assessment procedures and auditory monitoring protocols for children with Down syndrome (DS). II – To develop a proposed clinical care protocol for the assessment and monitoring of auditory function in children with DS. Methods: I – An integrative review of observational studies was conducted in the PubMed, Web of Science, Scopus, Embase, and Google Scholar databases, using the descriptors Down Syndrome, Trisomy 21, Audiological Assessment, Hearing Monitoring, Hearing Disorders, Hearing Loss, without time or language restrictions, from January to April 2025. Observational studies were included, with a sample composed of individuals diagnosed with DS and aged 12 years or younger, regardless of sex and ethnicity, that descriptively addressed the methods and protocols used in the assessment and monitoring of auditory function in children with DS. Methodological quality was assessed using the Joanna Briggs Institute's Critical Appraisal tool for Analytical Cross-Sectional Studies. II – The clinical care protocol was developed in three stages: (1) integrative review of the scientific literature; (2) development of the protocol in the form of a registration sheet; and (3) construction of a flowchart. The review identified scientific evidence on auditory assessment and monitoring in children with Down syndrome, which guided the choice of validated and appropriate objective procedures for the specificities of this population. The protocol includes the collection of identification and clinical history data, inspection of the external auditory canal, tympanometry, Auditory Brainstem Response (ABR), and Evoked Otacoustic Emissions (OAEs), and enables the diagnosis and monitoring of auditory function in children from zero to 12 years of age, regardless of active participation in the assessment. Results: I – The exploratory search in the databases resulted in 1,493 studies. After reading the titles and abstracts, 1,474 were excluded for not meeting the eligibility criteria. The 19 potentially relevant articles were evaluated in full, and eight were included in this review. The most frequently used tests were ABR and tympanometry, followed by behavioral audiometry and OAEs. The analysis revealed a lack of standardization and a shortage of specific hearing assessment and monitoring protocols for this population. II – A clinical care protocol was developed for the assessment and monitoring of auditory function in children with Down syndrome, with a graphical flowchart representation and registration sheet, which includes fields for patient identification, inspection of the external auditory canal, acoustic immittance measurements and investigation of acoustic reflex thresholds, in addition to electrophysiological evaluation through ABR and the performance of OAEs. The protocol allows for standardized recording of findings, diagnosis of the type and degree of hearing loss, and longitudinal monitoring of auditory function. Conclusion: I – The integrative review revealed the lack of standardized protocols for the assessment and monitoring of hearing in children with Down syndrome and highlighted the need for objective methods that consider their cognitive particularities, with ABR and tympanometry being the most frequently mentioned methods. II – The developed protocol presents an innovative character by establishing standardized guidelines for the evaluation and monitoring of auditory function in children with Down syndrome. It favors early diagnosis, reduces delays in intervention, and improves the quality of hearing health care by using tympanometry, ABR, and OAEs as diagnostic methods appropriate to the specificities of this population.

Proposta de instrumento de avaliação da alimentação para disfagia

2026-09-03T14:35:46Z

Título: Proposta de instrumento de avaliação da alimentação para disfagia Autor(es): Damasceno, Clara Sandes Abstract: Introduction: Feeding is a complex functional activity involving motor, sensory, cognitive, behavioral, and contextual components, with swallowing representing only one of its elements. In clinical dysphagia practice, speech-language pathology assessment remains predominantly focused on the safety and efficiency of swallowing, with limited systematization of the other aspects that influence feeding performance throughout the meal. Objective: To propose a structured instrument for the functional assessment of feeding in adult patients at risk of dysphagia. Methods: This is a methodological study developed in two stages. In the first stage, an integrative literature review was conducted through searches in the PubMed, Scopus, Web of Science, Embase, and gray literature databases, including observational and methodological studies addressing feeding assessment instruments for adults with dysphagia. In the second stage, the identified instruments were comparatively analyzed, followed by a literature search, systematization of the assessment criteria, and development of the prototype of the proposed instrument. Results: The integrative review resulted in the inclusion of four validated clinical instruments: Minimal Eating Observation Form (MEOF), Dysphagia Disorder Survey (DDS), Kuchi-Kara Taberu Index (KT Index), and Dysphagia Assessment Package (DAP). The comparative analysis showed that, although these instruments encompass relevant domains of the feeding process, their assessment criteria are distributed in a fragmented and heterogeneous manner, without operational integration aimed at the functional observation of feeding during the meal. Based on this evidence and complementary studies, the prototype of the Feeding Assessment Instrument for Dysphagia (IAAD-Fono) was developed as a comprehensive tool encompassing criteria related to overall functional status, respiratory safety, posture, dietary management, utensil handling, autonomy, feeding behavior, and food intake. Conclusion: The IAAD-Fono prototype represents a proposal aligned with the gaps identified in the literature by systematically organizing the main domains involved in the functional assessment of feeding in patients undergoing the diagnostic process for dysphagia. The instrument has the potential to broaden the speech-language pathology assessment of feeding as a continuous functional activity and to support therapeutic decision-making. Future studies should include content validation, reliability, and clinical applicability of the instrument.

Painel de monitoramento do NMN em Sergipe: subsídios para redução da mortalidade infantil

2026-02-24T19:16:16Z

Título: Painel de monitoramento do NMN em Sergipe: subsídios para redução da mortalidade infantil Autor(es): Teixeira, Luciana Alice Santana Abstract: Introduction: Neonatal NMN (NNM) is an important indicator of severe neonatal morbidity and contributes to understanding the determinants of infant mortality. The analysis of cases that nearly resulted in death but survived makes it possible to identify weaknesses and strengths in maternal and child healthcare. In the state of Sergipe, systematic monitoring of this outcome is still limited, hindering the implementation of prevention strategies. Objective: To monitor NNM cases in Sergipe, identifying epidemiological patterns, associated risk factors, and priority areas for intervention. Methods: A descriptive study based on secondary data from the Live Birth Information System (SINASC), referring to all live births in Sergipe between 2011 and 2023. The definition of NNM followed pragmatic criteria widely used in the literature: Apgar score < 7 at the 5th minute, birth weight < 1500 g, and gestational age (GA) < 32 weeks. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated, analyzing maternal, gestational, neonatal, and obstetric variables. For the development of the interactive dashboard, functionalities provided by Streamlit version 1.51.0 and the Python programming language version 3.14 were used through a virtual environment (venv). Results: The prevalence of NNM in the state of Sergipe was 14,200 cases, with a rate of 33.7 NNM per thousand live births, and the municipality of Malhada dos Bois presented the highest NNM rate. Lack of prenatal care was the factor most strongly associated with the outcome, while having seven or more prenatal visits showed a consistent protective effect. Low educational level, single marital status, and prematurity also stood out as significant determinants. Higher risk was identified among male neonates, multiple pregnancies, non-cephalic fetal presentations, births outside the hospital setting, and the presence of congenital anomalies. Neonates classified as NNM presented worse Apgar scores, lower birth weight, and reduced gestational age. Conclusion: The findings reveal that NNM in Sergipe is a multifactorial event, strongly influenced by biological conditions, social determinants, and characteristics of healthcare services. Lack of prenatal care, multiple pregnancies, and out-of-hospital births constitute the main risk factors. The results reinforce the need to strengthen prenatal care policies, expand access to safe childbirth, and improve the quality of neonatal care.

Oncocare System: uma ferramenta para auxiliar o gerenciamento assistencial da neutropenia em pacientes oncológicos

2026-01-14T11:48:59Z

Título: Oncocare System: uma ferramenta para auxiliar o gerenciamento assistencial da neutropenia em pacientes oncológicos Autor(es): Vieira, Marina Provinciali Mendonça Abstract: Introduction: Neutropenia, especially in its febrile form (NF), represents a serious and frequent complication in cancer patients, associated with high morbidity and mortality. It affects up to 80% of patients with hematological malignancies and generates serious complications in up to 30% of cases. Fever may be the only clinical sign present, requiring immediate empirical antibiotic diagnosis and treatment. Institutional strategies based on international guidelines and the incorporation of Information and Communication Technologies (ICT) have been fundamental in promoting rapid, safe, and standardized procedures, favoring early diagnosis and reducing mortality. Objective: o develop and describe the OncoCare System, composed of a prototype clinical surveillance software and a multidisciplinary care guide, to support the care management of febrile neutropenia in cancer patients hospitalized at the University Hospital of Sergipe, based on scientific evidence on strategies, challenges, and the use of technologies in the management of this condition. Methodology: his is characterized as a technological production study, aiming to develop a software prototype using the Scrum agile methodology. The research was structured in main stages: (i) prior art search, (ii) conducting an integrative literature review, (iii) developing the Oncocare system prototype, and (iv) creating a care guide for febrile neutropenia. Results: The integrative review identified challenges and opportunities in the use of information technologies for the management of NF, highlighting the need for tools that support risk stratification and clinical decision-making. Based on this evidence, the OncoCare System was developed, a software prototype created in partnership with the Computer Science Department of UFS, aimed at monitoring, alerting, and following up on cancer patients. In addition, a Febrile Neutropenia Care Guide was developed for the multidisciplinary team. Conclusions: The study achieved its purpose of integrating scientific fundamentals and technological innovation. The OncoCare System was developed based on real demands of the University Hospital of Sergipe, with the potential to improve safety, standardize procedures, and expedite clinical decisions. It was completed and registered with the INPI (Brazilian National Institute of Industrial Property) under number BR512024001695- 3. The Care Guide complements the tool, especially in educational contexts.