'Supporting a first-time mother': Assessment of success of a breastfeeding promotion programme.

BACKGROUND: The aim of this study was to measure the effectiveness on breast feeding rates by the program 'Supporting a First-time Mother', a web-based platform of interactionbetween first-time mothers and breastfeeding-experienced women who act as peer-supporters. METHODS: A randomized study with a control and intervention group was conducted between April and October 2016. Participants were recruited from Hospital Universitario de Canarias (Spain). Inclusive criteria were singleton pregnancy, healthy term baby, vaginal or assisted delivery. Participants were randomly assigned to either an intervention or control group. Type of feeding (exclusive, partial or artificial) was noted at 3 and 6 months. The study also gathered information from the peer-supporters. RESULTS: Data showed higher rates of exclusive breastfeeding in the intervention group,at both 3 and 6 months post delivery (76% vs 56%, p = 0.020; 47% vs 35%, p = 0.049). Taking part in the study also increased the overall success of breastfeeding 2.65 times (IC95%, 1.21-5.78, p = 0.014) at 3 months and 3.30 times (IC95% 1.52-7.17, p = 0.003) at 6 months. CONCLUSIONS: A limitation of the study is mainly related to participation in the intervention. In spite of this limitation, this support programme increased breastfeeding rates 3 fold.

Manejo del Triage Obstétrico y Código Mater en el Estado de México / Obstetric Triage and Management Mater Code in the State of Mexico

A pesar de las vanas iniciativas de solución que han sido promovidas en años recientes, la muerte de mujeres durante el embarazo, el alumbramiento, y el postparto sigue siendo un problema grave. El número de muertes maternas ha estado disminuyendo desde el año 2000, sin embargo la tasa aún se encuentra lejos del objetivo de las Metas del Milenio. De acuerdo a la OMS, prevalecen las tres principales causas de mortalidad materna: Trastornos hipertensivos del embarazo, las hemorragias durante el evento obstétrico y sepsis y otras infecciones puerperales. El ISEM consciente de la gran responsabilidad que esta población demanda, implementó una serie de estrategias y protocolos para proveer a las mujeres embarazadas con atención oportuna en la detección de factores de riesgo que determinen un diagnóstico y tratamiento temprano para contribuir a reducir la mortalidad materna. Los protocolos implementados son dos: Triage Obstétrico y Código Mater. El Objetivo de este artículo es difundir los protocolos y estrategias ya establecidos, que han permitido agilizar la atención en la gestante y disminuir la mortalidad materna en el Hospital General de Ecatepec "Las Américas" en el estado de México. Conclusiones: La evidencia sugiere que los protocolos y estrategias implementados contribuyeron significativamente a reducir las muertes maternas en el Hospital. Este resultado se basa en la continua capacitación del equipo multidisciplinara de salud para responder a las emergencias obstétricas.

Despite the various initiatives for a solution which have been promoted in recent years, the death of women during pregnancy, childbirth and postpartum remains an unsolved problem. Although, the number of maternal deaths has been decreasing since the year 2000, this rate is still far from the target of the Millennium Goals. According to the WHO, the three major causes of maternal mortality are; hypertensive disorders of pregnancy, severe bleeding during the obstetric event, and sepsis. The ISEM, aware of the great responsibility which this population demands, implemented a series of strategies and protocols in order to provide pregnant women with timely attention, detect risk factors, determine early diagnoses, and offer appropriate treatments to further contribute to reduce the maternal mortality; the protocols are; The Obstetric Triage and The Mater Code. Objective; To disseminate the established protocols and strategies those have enabled faster care in pregnant women and reduce maternal mortality in General Hospital Ecatepec "The Americas" in the state of Mexico. Conclusions; The evidence suggests that the protocols and strategies implemented significantly contributed to reduce the Hospital's maternal deaths. This outcome can also be attributed to the continued training of the multidisciplinary health team in the response of obstetric emergencies.

Nueva metodología de preformulación galénica para la caracterización de sustancias en relación a su viabilidad para la compresión: Diagrama SeDeM / An original methodology of galenic preformulation for characterization solid substances for compression: SDM Method

Se propone una nueva y original metodología (Método SeDeM) para la caracterización de sustancia sólidas con el fin de facilitar los estudios de formulación para la obtención de comprimidos por vía directa. Esta nueva metodología es de aplicación en los estudios de preformulación de comprimidos y consiste en la determinación de una serie de parámetros que convenientemente analizados proporcionan la información necesaria para conocer si la sustancia sólida estudiada, sea principio activo o excipiente, es apta para la compresión directa. Los parámetros propuestos se pueden tratar matemáticamente y expresar gráficamente mediante el diagrama SeDeM. Se aporta un ejemplo de aplicación sobre un principio activo del cual se determinan aquellas características que son correctas para su posterior compresión y aquellas características deficitarias que deben ser corregidas. Se concluye que el método SeDeM es eficaz y válido, por lo que puede adoptarse como una nueva herramienta a aplicar en los estudios de preformulación de medicamentos, cuyo objetivo es aportar la información farmacotécnica necesaria para facilitar la formulación del medicamento en forma de comprimido y para definir la tecnología de fabricación más adecuada

We propose a new and original methodology (the SeDeM Method) for characterizing solid substances with the aim of facilitating formulation studies for direct compression of tablets. This new methodology is useful in preformulation studies for tablets and involves measuring and analysing a series of parameters that provide necessary information as to whether the solid substance under study (an active ingredient or an excipient) is suitable for direct compression. The parameters proposed can be mathematically processed and graphically expressed as a SeDeM diagram. An example is provided of the application using an active ingredient. The characteristics that make the ingredient suitable for subsequent compression and those that must be corrected are identified. SeDeM is an effective and valid method, which means it can be adopted as a new tool to be applied in drug-preformulation studies designed to provide the pharmacotechnical information required to facilitate the formulation of drugs in tablet form and define the most suitable manufacturing technology

[Forearm bone mineral density in healthy children]. / Densidad mineral ósea del antebrazo en niños sanos.

OBJECTIVE: In order to establish the normal patterns of forearm bone mineral density (BMD), BMD in the cortical and trabecular parts of the distal forearm were studied in a normal pediatric population. PATIENTS AND METHODS: BMD was measured by dual-energy X-ray absorptiometry (HOLOGIC QDR-1000) in the distal third forearm of 246 normal children and adolescents (111 boys and 135 girls) ranging from 2.8 to 20.8 years of age. BMD was correlated by multiple regression analysis with age, weight, body mass index (BMI), sex and pubertal Tanner stage. RESULTS: Forearm BMD increased progressively with age, weight, height, BMI and maturity, with the maximal increase in all forearm bone sites occurring at the onset of puberty in girls and boys. A statistically significant correlation was found between forearm BMD and all of these variables (r = 0.65 to 0.92). Mean BMD was higher in boys than in girls in cortical, trabecular and cortical-trabecular sites of the distal forearm. Maximal differences in BMD between boys and girls occurred at 17-18 years of age, especially the trabecular-dominated (ultradistal) part of the distal forearm (0.446 vs 0.384 g/cm2). CONCLUSIONS: Forearm BMD studies permit information of both cortical and trabecular bone mineralization to be obtained at the same time. This study reports normative data for forearm BMD in a healthy pediatric population. The values obtained may be used as a reference of normality when evaluating bone density in situations where skeletal mineralization may be compromised.