SARS-CoV-2 infection in newborn infants: descriptive epidemiological analysis of cases reported to the Colombian national surveillance system during the first pandemic year, March 2020-February 2021.

OBJECTIVE: To describe the clinical and epidemiological characteristics of newborn infants with SARS-CoV-2 infection notified in the Colombian Public Health Surveillance System. DESIGN: This epidemiological descriptive analysis was conducted using the data of all cases of newborn infants with confirmed SARS-CoV-2 infection notified in the surveillance system. Absolute frequencies and central tendency measures were calculated and a bivariate analysis comparing variables of interest with symptomatic and asymptomatic disease was performed. SETTING: Population-based descriptive analysis. PATIENTS: Laboratory-confirmed COVID-19 cases in newborn infants (aged ≤28 days of life) reported to the surveillance system from 1 March 2020 to 28 February 2021. RESULTS: 879 newborns were identified, corresponding to 0.04% of all reported cases in the country. The mean age at diagnosis was 13 days (range 0-28 days), 55.1% were male and most (57.6%) were classified as symptomatic. Preterm birth and low birth weight were identified in 24.0% and 24.4% of the cases, respectively. Common symptoms were fever (58.3%), cough (48.3%) and respiratory distress (34.9%). A higher prevalence of symptomatic newborns was seen in individuals with low birth weight for gestational age (prevalence ratio (PR): 1.51, 95% CI: 1.44 to 1.59) and newborns with underlying conditions (PR: 1.33, 95% CI: 1.13 to 1.55). CONCLUSIONS: There were a low proportion of confirmed COVID-19 cases in the newborn population. A substantial number of newborns were classified as symptomatic, having low birth weight and being preterm. Clinicians caring for COVID-19-infected newborns should be aware of population characteristics that potentially contribute to disease manifestations and severity.

Enfermedad neonatal temprana por Streptococcus agalactiae en una unidad de recién nacidos, factores de riesgo materno-fetales asociados a severidad y mortalidad / Streptococcus agalactiae early neonatal disease in a nursery, neonatal and maternal risk factors associated with severity and mortality / No início da doença neonatal causada pelo Streptococcus agalactiae em um viveiro, os fatores de risco materno-fetal associados com a gravidade e mortalidade

La colonización materna por estreptococo del grupo B (SGB) en países en desarrollo es del 4-20%; el 50% de sus hijos nacen colonizados y el 1-2% desarrollan enfermedad invasiva con alto riesgo de morbimortalidad y secuelas. Objetivo: determinar los factores de riesgo materno-fetales asociados a enfermedad severa y mortalidad neonatal por SGB en una unidad de recién nacidos. Materiales y métodos: se realizó un estudio observacional analítico de cohorte histórica durante un período de dos años. Se tomaron 11 casos con enfermedad invasiva y 15 controles. Se calcularon frecuencias absolutas y relativas, y se buscaron asociaciones mediante el cálculo del estadístico chi². Resultados: los factores maternos predictivos para enfermedad por SGB incluyeron fiebre periparto mayor a 37,5 grados centígrados (p < 0,05), corioamnionitis y ruptura de membranas mayor a 18 horas (p < 0,05). Los factores de riesgo neonatal incluyeron prematurez (< 37 semanas) y bajo peso al nacer (< 2.500 gramos) (p < 0,05). Se encontró una mortalidad de 5 (45%). Conclusiones: hubo relación estadísticamente significativa entre la corioaminionitis materna, la ruptura de membranas mayor a 18 horas, la prematurez y el peso bajo al nacer con la severidad de la enfermedad y la mortalidad. La incidencia estimada de infección neonatal en la unidad de recién nacidos fue de 1,8 casos/1.000 nacidos vivos, y la de colonización materna fue de 4,3 casos/1.000 maternas. Se deben realizar más estudios en el país para establecer la incidencia real de enfermedad neonatal por SGB y hacer investigación sobre la costo-efectividad de las medidas de prevención.

Maternal colonization of group B Streptococcus (GBS) in developing countries is 4-20%, 50% of their children born colonized and 1-2% develop invasive disease at high risk of mortality and sequelae. Objective: determine maternal-fetal risk factors associated with severe disease and mortality of GBS in a neonatal nursery. Materials and methods: an observational study of historical cohort during a period of 2 years. It took eleven cases with invasive disease and fifteen controls. We calculated absolute and relative frequencies and associations were sought by calculating the statistic chi². Results: The predictive maternal factors included GBS disease, peripartum fever greater than 37.5 degrees Celsius (p < 0.05), chorioamnionitis and rupture of membranes more than 18 hours (p < 0.05). Neonatal risk factors included prematurity (< 37 weeks) and low birth weight (< 2500 grams) (p < 0.05). We found a mortality of 5 (45%). Conclusions: There was a statistically significant relationship between maternal chorioamnionitis, rupture of membranes more than 18 hours, prematurity and low birth weight with disease severity and mortality. The estimated incidence of neonatal infection in the nursery was 1.8 per 1000 live births and maternal colonization was 4.3 cases per 1000 maternal. Further studies should be conducted in the country to establish the true incidence of neonatal GBS disease and do research on cost-effectiveness of preventive measures.

A colonização materna por estreptococo do grupo B (SGB) em países em desenvolvimento é de 4-20%, 50% de seus filhos nascem e o 1-2% desenvolvem doença invasiva com alto risco de morbimortalidade e seqüelas. Objetivo: determinar os fatores de risco materno-fetais associados à doença severa e mortalidade neonatal por SGB em uma unidade de recém-nascidos. Materiais e Métodos: realizou-se um estudo observacional analítico coorte histórica durante um período de 2 anos. Tomaram-se onze casos com doença invasiva e quinze controles. Calcularam-se freqüências absolutas e relativas e se procuraram associações mediante o cálculo do estadístico Chi². Resultados: os fatores maternos preditivos para doença por SGB incluíram, febre periparto maior a 37,5 graus centígrados (p <0.05), corioamnionite e rotura de membranas maior a 18 horas (p<0.05). Os fatores de risco neonatal incluíram prematuridade (<37 semanas) e baixo peso ao nascer (<2500 gramas) (p<0.05). Encontrou-se uma mortalidade de 5(45%). Conclusões: houve relação estadisticamente significativa entre a corioamnionite materna, a rotura de membranas maior a 18 horas, a prematuridade e o baixo peso ao nascer com a severidade da doença e a mortalidade. A incidência estimada de infecção neonatal na unidade de recém-nascidos foi de 1,8 casos/1000 nascidos vivos e a clonização materna foi de 4,3 casos/1000 maternas. Devem-se realizar mais estudos no país para estabelecer a incidência real de doença neonatal por SGB e fazer pesquisa sobre a custo-efetividade das medidas de prevenção.

Maternal acculturation: could it impact oral health practices of mexican-american mothers and their children?

A mother's cultural beliefs can affect her infant's health, but the influence of acculturation of Mexican-American women on their young children's oral health is unknown. The authors hypothesized that maternal acculturation impacts very young children's oral health practices favoring, in particular, the mothers who are more Anglo-oriented. A convenience sample of 204 predominantly Mexican-American women attending the Women, Infants, and Children Clinic in San Antonio, Texas, completed the Knowledge, Attitudes, Beliefs, Social Support, and Self-Efficacy of Oral Health (KASE-OH) and Acculturation Questionnaires. Results indicated that mothers with strong Anglo orientation were more likely educated in the United States, first visited a dentist while in elementary school, and breast-fed their children. Children belonging to Anglo-oriented Mexican-American mothers had stronger oral health practices, were more likely to breast-feed, were exposed to more sugary and acidic drinks, consumed higher levels of candy, had Medicaid coverage, and had stronger supervisions of tooth brushing practices.

Urinary fluoride levels in Jamaican children in 2008, after 21 years of salt fluoridation.

RATIONALE: In 1984, the DMFT12 in Jamaican children was 6.7 (very severe). In 1987, national salt fluoridation was implemented (250 mg F-/kg salt). In 1995, a national survey showed a substantial decrease of caries severity (DMFT12 of 1.8). OBJECTIVES: To see whether the favorable exposure of fluoride was continued. METHODS: Assessment of urinary fluoride parameters based on WHO guidelines. Children were sampled in two urban and two rural sites. Valid nocturnal and daytime urinary collections were obtained from 128 children (mean age 4.7 y). A questionnaire administered to parents provided information on oral hygiene practice, and use of fluoride via salt, dentifrices or supplements. RESULTS: Excretion rate values extrapolated to 24 h were 271 in urban and 330 microgF/24 h in rural, F-concentrations were in the range of 1.13 and 1.30. Almost all children were reported to use toothpaste, most with 600 to 1000 ppm F; 65% of children use more than the recommended amount of toothpaste. Fluoridated salt was consumed by 98% of the children. There was no other apparent usage of fluorides. CONCLUSIONS: Urinary excretion results point to a suboptimal exposure of fluoride, whereas concentrations would suggest an optimal or slightly higher intake. Dentifrices with 500 ppm F should be made available in order to minimize the risk of enamel fluorosis.

Epidemiologic survey of erosive tooth wear in San Antonio, Texas.

OBJECTIVES: To estimate the prevalence of erosive tooth wear in children aged 12-17 years in the southwest region of San Antonio, Texas, within Bexar County. METHODS: A convenience sample of 307 children aged 12-17 years was selected from two junior high schools. The population consisted predominantly of Hispanic Mexican Americans. The true prevalence of erosive tooth wear within the US is known from only one study, and then only for limited sectors of the population. The Tooth Wear Index, Screening for Oral Health using the Association of State and Territorial Dental Directors (ASTDD) criteria and oral health and dietary assessment questionnaires were used as survey parameters. The questionnaire included data on detailed dietary habits relating primarily to the consumption of acidic beverages and foods. RESULTS: The overall prevalence of erosion within our convenience sample was 5.5 percent. All affected children showed erosive tooth wear low in severity and confined to the enamel with no exposed dentin. A chi-square test was performed to test for associations between the presence of erosion and consumption level of certain acidic foods at a significance level of 5 percent. Few significant and consistent associations were found between erosive tooth wear and consumption frequency categories of groups of acidic foods and beverages using a non-validated food intake questionnaire on purported risk foods. Soda drinks were associated. Mexican acidic foods were not. CONCLUSION: This study indicated a low prevalence and low severity of dental erosion in a convenience sample of children aged 12-17 years in southwest San Antonio, Texas. Issues of sampling and response bias preclude these findings being generalized to other populations and regions.The results should be viewed with caution. Because the local consumption of some purported risk foods appears to be increasing, this study provides a base-line for future assessments of erosive tooth wear in this population.

Urinary fluoride excretion by children 4-6 years old in a south Texas community / Excreción urinaria de fluoruro en niños de cuatro a seis años de edad en una comunidad del sur de Texas

This study evaluated urinary fluoride excretion by school children 4-6 years old who were living in a south Texas rural community that had concentrations of fluoride in drinking water supplies generally around the optimal level. We took supervised collections of urine samples in the morning and afternoon at school, and parents of the participating students collected nocturnal samples. We recorded the beginning and end times of the three collection periods and then determined the urinary volume and urinary flow for each of the periods. We measured urinary fluoride concentrations and calculated the urinary excretion rate per hour. The children had breakfast and lunch provided at the school, where the drinking water contained 1.0-1.3 milligrams/liter (mg/L) fluoride. Fluoride concentrations in the tested household water supplies, from wells, ranged from 0.1 to 3.2 mg/L fluoride. The children's average urinary fluoride concentrations found for the day were similar to those for the night, with means ranging from 1.26 mg/L to 1.42 mg/L. Average excretion was 36.4 mg/h in the morning, 45.6 mg/h in the afternoon, and 17.5 mg/h at night. The lower nocturnal excretion rates are easily explained by low urinary flow at night. Based on the 15 hours of urine collected, the extrapolated 24-hour fluoride excretion was 749 µg. In conjunction with similar studies, the data from this study will help in developing upper limits for urinary fluoride excretion that are appropriate for avoiding unsightly fluorosis while providing optimal protection against dental decay

Análisis comparativo de calidad de vida de pacientes en tratamiento con hemodiálisis vs. diálisis peritoneal Clínica San Pedro Claver / Quality of life between haemodyalisis versus peritoneal dyalisis

Hemos realizado un trabajo descriptivo multicéntrico comparativo; para tratar de establecer si la calidad de vida en los pacientes con enfermedad renal terminal, es mejor con hemodiálisis o diálisis peritoneal, después de haber iniciado el tratamiento y comparar estos resultados con otros trabajos al respecto encontrados en la literatura. La muestra escogida fué de 80 pacientes, excluyéndose 30 pacientes, quedando una muestra de 50 pacientes de los cuales 25 pacientes pertenecían a hemodiálisis y 25 pacientes a diálisis peritoneal, de dos instituciones de nuestra Pais: Clínica San Pedro Claver y Clínica de los Comuneros de Bucaramanga. A diferencia de los resultados de otros trabajos encontrados en la literatura, el nuestro mostró una diferencia significativa con una mejor calidad de vida a favor de los pacientes tratados con hemodiálisis.