Neonatal screening of ABO/RhD blood group and direct antiglobulin Coombs test. Experience of a single institution.

BACKGROUND: Evaluating the ABO/RhD blood group and the direct antiglobulin Coombs test (DAT) at birth is recommended good practice, but there is variability in its universal implementation. This study aims to show the comparative results in various variables of clinical impact during the hospital stay of neonates with positive DAT compared with those with negative DAT, based on the systematic detection of the ABO/RhD group and DAT at birth. METHODS: Newborns between 2017 and 2020 in a high-risk pregnancy care hospital were included. The ABO/RhD and DAT group was determined in umbilical cord samples or the first 24 hours of life. Demographic, maternal, and neonatal variables were recorded. The association between the variables was estimated using the odds ratio (OR). RESULTS: 8721 pairs were included. The DAT was positive in 239 newborns (2.7%), with the variables associated with positive PDC being maternal age > 40 years (OR: 1.5; 95% CI: 1.0 to 2.3), birth by cesarean section (1.4; 1.1-2.0), mother group O (6.4; 3.8-11.8), prematurity (3.6; 2.6-5.0), birth weight < 2500 g (2.1; 1.6-2.8), newborn group A (15.7; 10.7-23.1) and group B (17.6; 11.4-27.2), hemoglobin at birth < 13.5 g/dl (4.5; 2.8-7.1) and reticulocytosis > 9% (1.9; 1.2 to 3.1). DISCUSSION: The frequency of neonatal positive PDC was 2.7%, with a significant association with maternal/neonatal incompatibility to the ABO and RhD group, with a substantial impact on various neonatal variables. These results support the policy of universal implementation at the birth of the ABO/RhD and DAT determination.

INTRODUCCIÓN: La determinación del grupo sanguíneo ABO/RhD y la prueba directa de Coombs (PDC) al nacimiento son una práctica recomendada, pero existe variabilidad en su implementación universal. Se presentan los resultados de la determinación al nacimiento del grupo ABO/RhD y la PDC en una cohorte institucional. MÉTODOS: Se incluyeron los recién nacidos entre 2017 y 2020 en un hospital de atención a embarazos de alto riesgo. Se determinó el grupo ABO/RhD y se realizó la PDC en muestras de cordón umbilical o en las primeras 24 horas de vida. Se registraron las variables demográficas, maternas y neonatales. Se estimó la asociación entre las variables mediante la razón de probabilidad (OR). RESULTADOS: Se incluyeron 8721 binomios. La PDC fue positiva en 239 recién nacidos (2.7%), siendo las variables asociadas a la PDC positiva la edad materna > 40 años (OR: 1.5;IC95%: 1.0-2.3), el nacimiento por vía cesárea (1.4; 1.1-2.0), la madre del grupo O (6.4; 3.8-11.8), la prematuridad (3.6; 2.6-5.0); el peso al nacer < 2500 g (2.1; 1.6-2.8); el neonato del grupo A (15.7; 10.7-23.1) o del grupo B (17.6; 11.4-27.2), la hemoglobina al nacer < 13.5 g/dl (4.5; 2.8-7.1) y la reticulocitosis > 9% (1.9; 1.2 a 3.1). DISCUSIÓN: La frecuencia de PDC positiva neonatal es del 2.7%, con asociación significativa la incompatibilidad materna/neonatal al grupo ABO y RhD, con impacto significativo en diversas variables neonatales. Estos resultados apoyan la política de implementación universal al nacimiento de la determinación de ABO/RhD y PDC.

Use of computational biology to compare the theoretical tertiary structures of the most common forms of RhCE and RhD.

BACKGROUND AND OBJECTIVES: Computational biology analyses the theoretical tertiary structure of proteins and identifies the 'topological' differences between RhD and RhCE. Our aim was to identify the theoretical structural differences between the four isoforms of RhCE and RhD using computational biological tools. MATERIALS AND METHODS: Physicochemical profile was determined by hydrophobicity and electrostatic potential analysis. Secondary and tertiary structures were generated using computational biology tools. The structures were evaluated and validated using Ramachandran algorithm, which calculates the single score, p-value and root mean square deviation (RMSD). Structures were overlaid on local refinement of 'RhAG-RhCE-ANK' (PBDID 7uzq) and RhAG to compare their spatial distribution within the membrane. RESULTS: All proteins differed in surface area and electrostatic distance due to variations in hydrophobicity and electrostatic potential. The RMSD between RhD and RhCE was 0.46 ± 0.04 Å, and the comparison within RhCE was 0.57 ± 0.08 Å. The percentage of amino acids in the hydrophobic thickness was 50.24% for RhD while for RhCE it ranged between 73.08% and 76.68%. The RHAG hydrophobic thickness was 34.2 Å, and RhCE's hydrophobic thickness was 33.83 Å. We suggest that the C/c antigens differ exofacially at loops L1 and L2. For the E/e antigens, the difference lies in L6. By contrast, L4 is the same for all proteins except Rhce. CONCLUSION: The physicochemical properties of Rh proteins made them different, although their genes are homologous. Using computational biology, we model structures with sufficient precision, similar to those obtained experimentally. An amino acid variation alters the folding of the tertiary structure and the interactions with other proteins, modifying the electrostatic environment, the spatial conformations and therefore the antigenic recognition.

Analysis of a Novel Mexican Variant of the HBB Gene Associated with ß-Thalassemia Using Bioinformatic Tools.

We present a study performed on 54 unrelated subjects, with and without thalassemic features. Two primer pairs were proposed to perform Sanger sequencing of the complete HBB gene. The bioinformatic analysis was performed taking advantage of the availability of free online tools. In the sample, we found 11 variants, 10 reported, and one novel. Among the variants found, six are clinically important: three encode a premature stop codon [codon 39 (C>T) (HBB: c.118C>T); IVS-II-1 (G>A) (HBB: c.315+1G>A), and one not reported], a double substitution within the same allele [Hb Borås (HBB: c.266T>G) and Hb Santa Giusta Sardegna (HBB: c.282T>C)], and one whose pathogenicity is not yet defined [Hb Fannin-Lubbock I (HBB: c.359G>A)]. Even though the variants Hb Borås and Hb Santa Giusta Sardegna have been described, there is no report of their combined occurrence on the same allele, which could cause hemolytic anemia. Although the p.Leu88Arg and p.Cys93Trp variants do not alter the final length of the protein, the bioinformatic results suggest that there are differences in the tertiary structure of ß-globin genes, mainly affecting helices E and F, being the motifs of interaction with the heme group. The novel variant is a 4 bp insertion that modifies the open reading frame, changing the last amino acid residue and causing a premature stop codon (HBB: c.291-294insGCAC). The variant was associated with ß-thalassemia (ß-thal). Bioinformatic analysis made it possible to predict the consequences that the new variant of the HBB gene caused on the ß-globin tertiary structure.

Embarazo y COVID-19. Consideraciones en la práctica de la hematología / Pregnancy and COVID-19. Considerations in the practice of Hematology

Resumen La enfermedad por coronavirus 2019 (COVID-19) en una población vulnerable, como es el caso de la mujer embarazada, feto y recién nacido, obliga a establecer estrategias efectivas y seguras centradas en la seguridad del binomio madre-hijo. El objetivo del presente reporte es presentar los resultados de la revisión de las fuentes de información secundaria (metaanálisis y revisión sistemática) del estado del arte en el avance del conocimiento de la COVID-19 durante el embarazo. En diferentes reportes se ha insistido en que la mortalidad materna por COVID-19 es baja. Sin embargo, la razón de mortalidad materna (RMM) aumentó de 30.9 a 45.5 defunciones por cada 100,000 nacimientos, es decir, mostró un incremento del 36.32% respecto a la misma semana del 2019. Pero el tema no se limita a la COVID-19, el aumento en la RMM es del 24.% para hemorragia materna, del 20% para la enfermedad hipertensiva y del 28.5% para sepsis puerperal. Sin embargo, por su naturaleza de condición inédita y el comportamiento particular de la COVID-19 durante el periodo perinatal, la generación de nuevos datos, su integración a información accesible y su análisis clínico epidemiológico inevitablemente proporcionarán nuevas evidencias que deberán integrarse a la gestión y práctica clínica. No existe un comportamiento hematológico característico o de las complicaciones trombóticas o hemorrágicas de la paciente con COVID-19, son características clínicas similares a las que se presenta en sus pares sin embarazo. El aumento global en todas las causas de mortalidad materna no son exclusivas de la COVID-19, lo que expone las deficiencias del sistema de salud en términos de atención primaria de la salud, vigilancia prenatal y planificación familiar, entre otros programas más; adicional al impacto de la COVID-19. Es una necesidad imperiosa el rediseño de las políticas públicas en términos de atención primaria para la salud a toda la población, en particular para las mujeres embarazadas.

Abstract Coronavirus disease 2019 (COVID-19) in a vulnerable population, such as the pregnant woman, fetus, and newborn, requires an establishment of effective and safe strategies focused on the safety of the mother-child binomial. The objective of this report is to present the results of the review of secondary information sources (meta-analysis and systematic review), of the state of the art in the advancement of knowledge of the disease due to COVID-19 during pregnancy. Different reports have insisted that maternal mortality from COVID-19 is low. However, the maternal mortality ratio (MMR) increased from 30.9 to 45.5 deaths per 100,000 births, that is, it showed an increase of 36.32% compared to the same week of 2019. Due to its unprecedented condition and the particular behavior of the COVID-19 disease during the perinatal period, the generation of new data, its integration into accessible information and its epidemiological clinical analysis will inevitably provide new evidence that must be integrated into clinical management and practice. But the issue is not limited to COVID-19, the increase in MMR is 24% for maternal obstetric hemorrhage, 20% for hypertensive disease, and 28.5% for puerperal sepsis. There is no characteristic hematological behavior and the appearance of thrombotic or hemorrhagic complications in the patient with COVID-19, without clinical characteristics similar to those seen in her non-pregnant peers. The global increase in all causes of maternal mortality are not exclusive to COVID-19, which exposes the deficiencies of the health system in terms of primary health care, prenatal surveillance, family planning, among other programs; additional to the impact of COVID-19. The redesign of public policies in terms of primary health care for the entire population is an urgent need, particularly for pregnant women.

Design of a protocol for obtaining genomic DNA from saliva using mouthwash: Samples taken from patients with periodontal disease.

BACKGROUND: Obtaining high quality genomic DNA safely and economically is vital for diverse studies of large populations aimed at evaluating the role of genetic factors in susceptibility to disease. AIM: This study was to test a protocol for the extraction of high quality genomic DNA from saliva samples obtained with mouthwash and taken from patients with periodontal disease. METHODS: Saliva samples were taken from 60 patients and then stored at room temperature. DNA extraction was carried out at distinct post-sampling times (10, 20 and 30 days). Evaluation of genomic DNA was performed with spectrophotometry, electrophoresis, and PCR genotyping and sequencing. RESULTS: The greatest concentration of DNA obtained was 352 µg at 10 days post-sampling, followed by 121.025 µg and 19.59 µg at 20 and 30 days, respectively. When determining the purity of DNA with the spectrophotometric ratio of 260/230, the relations of 1.20, 1.40 and 0.781 were obtained for 10, 20 and 30 days, respectively. In all samples, it was possible to amplify the product of 485 bp and the sequence of the amplicons showed 95% similarity to the reference sequence. CONCLUSION: The present protocol represents an easy, safe and economical technique for obtaining high quality genomic DNA.

Evaluación del estado en la reserva neonatal de hierro y las mutaciones del gen HFE / Assessment of neonatal iron store and HFE gene mutations

Introducción: Se presenta la evaluación de la asociación entre la reserva de hierro (Fe) y los polimorfismos del gen de la hemocromatosis (HFE) en neonatos de alto riesgo perinatal. Métodos: Se incluyó una serie de neonatos de alto riesgo perinatal en los que se evaluó la reserva de Fe con la medición de la ferritina sérica (FS). Se dividieron en tres grupos: sobrecarga de Fe (SoFe), con FS >1,000 µg/l; reserva normal de Fe, con FS de 154-1,000 µg/l; y reserva baja de Fe, con FS <154 µg/l. Mediante PCR en tiempo real se buscaron las mutaciones C282Y, H63D y S65C del gen HFE. Resultados: Se estudiaron 97 neonatos. De ellos, 24 casos presentaron SoFe (proporción 0.247) y FS de 1,789 µg/l (IC 95% 1,376-2,201); 36 casos, reserva normal de FS (0.371), FS de 461 µg/l (389-533); y 37 casos, reserva baja de FS (0.381) y FS 82 µg/l (69-96). No hubo casos detectados para las mutaciones C282Y o S65C. Se identificó la variante H63D HFE en 18 neonatos (frecuencia génica de 0.185): la condición de heterocigoto (H63D/WT) en doce casos (frecuencia génica 0.124) y de homocigoto (H63D/H63D) en seis casos (frecuencia génica 0.062). La frecuencia alélica de H63D fue de 0.092. Los variante H63D HFE no mostró asociación con los neonatos de reserva normal de Fe contra reserva baja (OR 1.2; IC 95% 0.3-4.3) ni los de reserva normal contra neonatos con SoFe (OR 2.5; 0.7-9.2). Conclusiones: Cerca del 25% de neonatos de alto riesgo tendrá sobrecarga de Fe. Aún con el posible sesgo de selección, las variantes del gen HFE no influyen sobre el estado de la reserva de Fe.

Background: The association between iron stores (Fe) and HFE gene polymorphisms on high-risk neonates is shown. Methods: We included newborns with high perinatal risk. Newborns were divided into three groups for measurements of serum ferritin (SF): iron overload (IO) with SF 1000 µg/L, normal iron stores (NIS) with SF 154-1000 µg/L and low iron stores (LIS) with SF <154 µg/L. We used real-time PCR for identification of polymorphisms C282Y, H63DE, and S65C of the HFE gene. Results: We studied 97 newborns with IO in 24 cases (ratio 0.247) and SF 1789 µg/L (95% CI 1376-2201), NIS in 36 cases (0.371), and SF of 461 µg/L (389-533) and LIS in 37 cases (0.381) and SF 82 µg/L (69-96). There were no cases detected for C282Y or S65C mutations. We identified 18 neonates with H63D HFE variant (gene frequency 0.185) with heterozygous condition (H63D/ WT) in 12 cases (gene frequency 0.124) and homozygote (H63D/H63D) in six cases (gene frequency 0.062). H63D allele frequency was 0.092. The HFE H63D variant showed no association for comparing infants with NIS vs. LIS (OR 1.2, 95% CI 0.3-4.3) and NIS vs. IO newborn infant (OR 2.5, 0.7-9.2). Conclusions: In high-risk neonates ∼25% show IO even with the possible selection bias. HFE gene variants do not influence on the neonatal iron stores.

Hepatic expression of ghrelin and adiponectin and their receptors in patients with nonalcoholic fatty liver disease.

BACKGROUND & AIM: Adiponectin and ghrelin are hormones that participate in hepatic lipid metabolism, and their expression in liver tissue could have important implications for nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the hepatic expression of ghrelin, adiponectin, AdipoR, and IL-6 in patients with NAFLD and normal liver. METHODS: We studied patients with clinical-pathological diagnosis of NAFLD or a normal liver. Patients were classified according to their diagnosis into three groups: normal liver, nonalcoholic hepatic steatosis, and nonalcoholic steatohepatitis (NASH). Adiponectin, AdipoR1, AdipoR2, IL-6, and ghrelin mRNA levels were assessed in biopsies by reverse transcriptase-polymerase chain reaction. RESULTS: Of the 21 patients, three had a normal liver biopsy, 14 had nonalcoholic steatosis, and four had NASH. Patients with NAFLD exhibited significantly higher HOMA-IR and triglyceride concentration (both P<0.05). There was a nonsignificant trend towards higher ghrelin expression in patients with NASH > nonalcoholic steatosis > normal liver. Patients with NASH had significantly higher mRNA adiponectin levels and lower IL-6 levels than did those with a normal liver (P<0.05). AdipoR expression did not differ significantly between groups. CONCLUSION: Adiponectin overexpression was observed in patients with NASH. The role of hepatic ghrelin in NAFLD requires further research.

Association of HFE mutations (C282Y and H63D) with iron overload in blood donors from Mexico City.

BACKGROUND AND OBJECTIVE: Iron overload has been associated with HFE mutations (C282Y and H63D). We investigated the association between these mutations and high serum ferritin in a sample of healthy adult men. DESIGN AND METHODS: We enrolled unrelated blood donors from three hospitals in Mexico City in a crosssectional study. Serum ferritin (SF) was determined to define iron overload, and HFE gene mutations were identified by PCR-RFLP. RESULTS: We evaluated 2524 male blood donors and included 246 individuals for each group. We identified 108 individuals with HFE gene mutation, 20.5 % were heterozygote (wt/H63D or wt/C282Y) and the remaining homozygote (H63D/ H63D). The genotype wt/C282Y was observed in two cases, none cases with C282Y/C282Y. The allelic frequency of H63D and C282Y was 0.115 and 0.002, respectively. We observed different association for H63D allele with iron overload (OR 1.54, CI 95 %1.16-2.03) and none in allele C282Y. Although values averages were different, the extreme dispersion of serum ferritin not showed statistically significant differences between H63D and C282Y alleles and ferritin concentrations. CONCLUSIONS: The male unrelated blood donors from Mexico City with iron overload prevalence of 13.8% hold similarities with other populations from Europe o America continent, respecting the allele frequency H63D. Nevertheless, allele frequency C282Y is lower than that observed in descendents from northern Europe. We have not observed statistic difference of SF or iron overload frequency by effect of both alleles.

Risk factors and prevalence of hepatitis virus B and C serum markers among nurses at a tertiary-care hospital in Mexico City, Mexico: a descriptive study.

BACKGROUND & AIM: Alcohol consumption and viral infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) are the first causes of chronic hepatopathy in Mexico. Medical personnel are at high risk of developing HBV and HCV infection because both viruses are transmitted parenteraly. The aim of this study was to determine the prevalence of HCV and HBV infection as well as risk factors in nurses working at Medica Sur Clinic and Foundation. METHODS: The complete nurse staff personal from our hospital was included; a questionnaire of risk factors for HCV and HBV infection was assessed. HBV and HCV infection (anti-HCV anti-HBc, and HBsAg) was determined to all of them. In anti-HCV positive persons HCV genotype and viral load was assessed. RESULTS: Three hundred seventy six nurses where studied, Anti-HBc was positive in 1.6% of all participants, none were positive for HBsAg. 0.8% of all studied population was positive for anti- HCV. Major risk factors for HBV infection where tattooing and having more than 4 sexual partners previously, and for HCV infection transfusions before 1992 and age. Only one person was anti-HCV positive with a viral charge of 5 X 106 copies, genotype 2b. CONCLUSIONS: HCV seropositivity in people with high risk was lower than general population. None was positive for HBV infection.

Obesity-related leptin receptor polymorphisms and gallstones disease.

OBJECTIVE: Investigate the association between polymorphisms in the leptin receptor gene associated with obesity and gallstone disease. DESIGN: We conducted a cross-sectional study, carried out at a tertiary setting. SUBJECTS: We enrolled 97 subjects, comprising 54 subjects with gallstones (cases) and 43 controls (without gallstones). MEASUREMENTS: Diet was assessed using a validated questionnaire for the Mexican population. Body mass index, waist circumference, serum glucose,insulin, leptin, lipids and lipoproteins levels were measured. Insulin resistance was calculated by HOMA-IR. Genomic DNA was isolated from lymphoblastoid cells, and Q223R and K656N polymorphisms in the leptin receptor gene were typed using polymerase chain reaction. Unconditional univariate logistic regression analysis was conducted to estimate the probability of gallstone disease associated with the polymorphisms as main effect. RESULTS: Cases were different in gender(40.74% males in cases vs 74.41% in controls; p < 0.001), older (49.74 vs 44.83 years; p < 0.05), and had more body fat (32.34% vs 28.14%; p = 0.01). Individuals carrying the polymorphism Q223R exhibited a higher BMI (28.44 +/- 6.6 kg/m2 vs 25.94 +/- 3.67 kg/m2, p < 0.05) and waist circumference (96.7 +/- 16.39 cm vs 89.2 +/- 11.05 cm, p < 0.05). In univariate analysis, we did not observe a relation between the presence of a R223 or N656 genotype and gallstone disease in our population (OR = 0.78, 95% CI 0.35-1.73). CONCLUSION: Obesity-related leptin receptor polymorphisms are not associated with gallstones disease.

Low serum levels of ghrelin are associated with gallstone disease.

AIM: To explore the role of ghrelin in gallstone disease. METHODS: We carried out a cross-sectional study in 150 subjects, 38 with gallstones (cases) and 112 controls. We also did a real-time PCR-RT study in twenty gallbladder samples each. Body mass index (BMI), serum insulin, ghrelin, and serum lipids were measured. Logistic regression analyses (univariate and multivariate) were conducted to estimate the probability of gallstone disease associated with serum ghrelin concentrations. RESULTS: Cases were statistically different from controls in gender distribution (P = 0.01), age (53 vs 44 yr, P = 0.002), BMI (28 vs 25; P = 0.004), and glucose (5.26 vs 4.98 mmol/L; P = 0.05). The prevalence of ghrelin serum levels above the third tercile was lower in subjects without metabolic syndrome (P < 0.05). In a multivariate model, we found a protective effect, when ghrelin values were higher than the median value (OR = 0.27, 95%CI 0.09-0.82, P = 0.02). Twenty (20%) gallbladder specimens expressed ghrelin mRNA. CONCLUSION: Serum ghrelin concentrations are associated with a protective effect of GD.

[Hepatitis C virus infection in patients with hemophilia]. / Infección por hepatitis C en pacientes con hemofilia.

After the introduction of second generation ELISA and confirmatory tests clinically available, it was possible to determine that prevalence of infection with HCV was 98% among hemophiliacs exposed to factor VIII concentrates that weren't submitted to viral inactivation. Liver failure is 4.2 times more probable among patients also infected with HIV. The hepatocellular carcinoma studies show similar findings. They report a rate of 1.4 for every 1,000 hemophiliacs, and almost all patients have antibodies for hepatitis C virus. The studies with hemophiliacs exposed to unsafe blood products for HCV showed a significant increase in mortality from different liver diseases, as compared to control subjects. Mortality rate shows an important increase in the hemophiliacs also infected with human immunodeficiency virus. Combination therapy (ribavirin and interferon) doesn't seem to make a difference in the response rate as compared to patients without hemophilia. In spite of the best efforts to improve the safety of factor VIII concentrates, it has been impossible to eliminate the risk of transmission of other infective agents. That's why it seems that recombinant technology will be the answer in obtaining the concentrates.

Cambios en los valores plasmáticos de interleucina 1-ß y TNF-alfa al nacimiento / Changes on plasmatic values of interleukine 1ß and NTF-alpha in healthy newborn

Objetivo. Describir los cambios durante el periodo de transición del TNF- a e IL-1b en neonatos sanos, bajo efecto de la vía de nacimiento. Material y métodos. Se seleccionaron aleatoriamente a recién nacidos a término, con bajo riesgo perinatal. Se cuantificaron las concentraciones plasmáticas de TNF- a e IL-1b, al nacimiento, a la hora y 24 horas de vida. Resultados. Se incluyeron 110 neonatos, se obtuvieron concentraciones de TNF- a e UL-1b, cuantificados al nacimiento, a la hora de vida y a las 24 horas de vida; fueron de 7.4, 8.7 y 9.3 pg/mL y de 1.1, 1.3 y 0.7 pg/mL, respectivamente. En el TNF- a, se encontró diferencia significativa al nacimiento (12.9 vs 4.4 pg/mL) y la hora de vida (14.7 vs 5.6 pg/mL), con valores más elevados en los nacidos por vía vaginal (p <0.01). No hubo el mismo efecto para la IL-1b. No hubo influencia estadística en relación con sexo, peso al nacer o edad gestacional. Conclusiones. El TNF- a pero no la IL-1b, presentó cambios estadísticos asociados al parto vaginal.

Evaluación de la enfermedad hemolítica por anti-D: resultados en el recién nacido / evaluationEvaluation of hemolytic disease by anti-D. Results in the newborn

Introducción. Objetivo: describir la condición al nacimiento y evolución intrahospitalaria del neonato con enfermedad hemolítica por anti-D.Material y métodos. Se estudiaron a embarazadas Rh negativo, con isoinmunización al antígeno RhD y sometidas a espectrofotometría de bilirrubina (Br) en líquido amniótico (EBLA). Se compararon los datos clínicos y demográficos de neonatos con enfermedad hemolítica (EH), comparándose el último estudio de EBLA con el esquema de Liley-Sentíes. Se formaron los grupos 1, 2 y 3, para estratificar la EH fetal como leve, moderada y grave.Resultados. Se incluyeron 67 casos, con 31, 17 y 19 neonatos, para cada grupo. Los casos del grupo 3 fueron de menor edad gestacional, 34.4 semanas (P< 0.001), peso 2 223 g (P <0.001) y hematócrito 36 por ciento (P <0.01). Los valores máximos de Br y días de estancia en fototerapia fueron similares. La transfusión eritrocitaria fue en proporción de 0.09, 0.23 y 0.52, para cada grupo (P <0.003). La exsanguinotransfusión fue de 0.16, 0.29 y 0.68 (P< 0.001). Los días de estancia fueron de 5, 9 y 23 días, respectivamente (P< 0.001).Conclusión. La estancia hospitalaria prolongada depende de la edad gestacional, la severidad de la EH y de la morbilidad hospitalaria asociada. El esquema de Liley-Sentíes, es un criterio vigente para la estratificación de la EH con utilidad pronóstica y terapéutica.

Evaluación ultrasonográfica de las mediciones renales en el neonato de término / Ultrasound evaluation of renal measures in normal full term newborn infant

Objetivo. Presentar la distribución de los valores en la medición renal en recién nacidos a término, sin patología agregada, bajo la posible influencia de las variables de edad gestacional, peso al nacer y sexo. Material y métodos. Se incluyeron a recién nacidos a término, sin patología agregada; fueron resgistradas las variables de edad gestacional, sexo y peso al nacer, evaluadas en los primeros tres días de vida. Se realizó ultrasonido abdominal, empleando un transductor sectorial multifrecuencia de 7.5 MHz. Se efectuaron las mediciones longitudinal y anteroposterior, así como el cálculo de perímetro y el área de ambos riñones. Resultados. Se incluyeron 83 neonatos. No se observaron diferencias significativas en las mediciones ultrasonográficas entre ambos riñones, ni con respecto a las variables de sexo, edad gestacional o peso al nacer. Los valores promedios de toda la muestra, fueron de 4.1, 2.0, 10.3 cm y 6.8 cm2, para las mediciones longitudinal, diámetro anteroposterior, perímetro y área, respectivamente. Se reportaron los valores percetilares de cada medición. Conclusiones. No se documentó el efecto de las varibles de sexo, edad gestacional o peso al nacimiento sobre mediciones renales; estos resultados pueden ser útiles como referencia en la evaluación de la morfología y tamaño de la silueta renal en la población neonatal de recién nacidos de término