[Palliativer medicine in surgery]. / Medicina paliativa en cirugía.

The concepts and background of palliative medicine, the patient-health team relationship and the right of the patients to receive palliative care, its application in surgery, the criterion defining the terminally ill, proportionate and disproportionate measures, where it is applied and what this consists of, drugs and procedures used, who should administrate them and for how long, the requirements for advanc directives and avoidance of therapeutic obstinacy, were reviewed. It describes and reflects their ethical and legal bases. It describes the main changes to the law in México in 2009 and 2012. It concludes that palliative medicine is not against scientific and technological progress, but promotes its appropriate use with respect to the will and dignity of the patient. It should be applied by a multidisciplinary team, who accompany the patient throughout the progression of their condition, strengthening the doctor's and health team's relationship with the patients and their families.

Visual, cognitive, and language assessments at 39 months: a follow-up study of children fed formulas containing long-chain polyunsaturated fatty acids to 1 year of age

Objective. Docosahexaenoic acid (DHA)and arachidonic acid (ARA) are long-chain polyunsaturated fatty acids found in breast milk and recently added to infant formulas...

A breast-feeding assessment score to evaluate the risk for cessation of breast-feeding by 7 to 10 days of age.

OBJECTIVES: To develop a succinct and comprehensive breast-feeding assessment score (BAS) to accurately identify infants at risk for early cessation of breast-feeding before initial hospital discharge. STUDY DESIGN: Mothers who intended to breast-feed their infants were solicited from 9 suburban hospitals. Two detailed data forms covering 107 items were completed before hospital discharge. A third form was completed at 7 to 10 days of age after telephone contact with the mother. RESULTS: Cessation of breast-feeding occurred in 113 of 1075 infants (10.5%). A multiple logistic regression analysis revealed 8 variables that were significant (P <.05) in predicting breast feeding cessation. A BAS was developed based on the odds ratios and relative risks of breast-feeding cessation for these 8 variables. CONCLUSIONS: The BAS was easily and quickly performed before hospital discharge for near term and term infants, which accurately predicted the risk of breast-feeding cessation within 7 to 10 days of age in the population studied.

Docosahexaenoic acid and arachidonic acid enhance growth with no adverse effects in preterm infants fed formula.

OBJECTIVE: To determine if docosahexaenoic acid (DHA) and arachidonic acid (ARA) supplementation influences growth or visual acuity of formula-fed premature infants. STUDY DESIGN: Double-blind, multi-center study of 194 premature infants given preterm formula with no DHA or ARA (control), 0.15% energy DHA, or 0.14% DHA + 0.27% ARA from single-cell triglycerides for at least 28 days and then fed term formula (no DHA or ARA) to 57 weeks postmenstrual age (PMA), with 90 breast-fed term infants as reference. RESULTS: Infants fed DHA+ARA formula gained weight significantly faster (post-hoc analysis) during preterm formula feeding than control infants (34.7 vs. 30.7 g/d) and had weights and weight:length ratios not different from term breast-fed infants at 48 and 57 weeks PMA. Infants fed control or DHA formula had lower body weights than term infants. Red blood cell phosphatidylethanolamine ARA was significantly correlated to weight gain during preterm formula feeding and to weight and length at 40, 48, and 57 weeks PMA (r = 0.19 to 0.24, P =.004-.02). Providing DHA or DHA+ARA during the preterm period had no effect on subsequent visual acuity or incidence of adverse events. CONCLUSIONS: Feeding DHA+ARA from single-cell triglycerides enhances weight gain in formula-fed premature infants with no evidence of adverse effects.