Effectiveness of 2 interventions for independent oral feeding in preterms.

INTRODUCTION: Oral feeding of preterm newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T + K + OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge. PATIENTS AND METHODS: A clinical study of 2 randomized groups (OS vs. T + K + OS) was carried out on 42 PTNB with gestational age between 27-32 weeks and birth weight > 900 g. The stimulation programs were carried out in sessions of 15 min, for 10 days. RESULTS: The PTNBs in the T + K + OS group achieved independent oral feeding earlier, compared to the OS group (24.9 ± 10.1 vs. 34.1 ± 15.6 days, P = .02). An analysis of covariance was performed, which confirmed that the birth weight and gestational age covariates had significant effects on time to reach suction feeding (birth weight: F[1, 38] = 5.79; P = .021; gestational age: F[1, 38] = 14.12; P = .001) and that once its effect was controlled, the intervention continued to have a significant effect (F[1, 38] = 6.07; P = .018). The T + K + OS group, compared to the OS group, achieved an earlier hospital discharge (39 ± 15 vs. 45 ± 18 days), although the differences were not significant (P = .21). CONCLUSIONS: Combined therapies that include T + K + OS are more effective than OS alone, in order to achieve independent oral feeding in PTNBs.

Eficacia de 2 intervenciones para la alimentación oral independiente en pretérminos / Effectiveness of 2 interventions for independent oral feeding in preterms

Introducción: La alimentación oral de los recién nacidos pretérmino (RNPT) está dificultada por su inmadurez y enfermedades intercurrentes, lo que puede prolongar su estancia hospitalaria. El objetivo de este estudio fue valorar la efectividad de un programa que combina la estimulación táctil, kinestésica y oral (ET+K+O) frente a otro de estimulación oral sola (EO), en el tiempo necesario para lograr la alimentación independiente y el alta hospitalaria. Pacientes y métodos: Estudio clínico de 2 grupos aleatorizados (EO vs. ET+K+O), realizado en 42 RNPT con una edad gestacional entre 27-32 semanas y un peso al nacimiento>900g. Los programas de estimulación fueron realizados en sesiones de 15min, durante 10 días. Resultados: Los RNPT del grupo de ET+K+O consiguieron antes la alimentación oral independiente, en comparación con el grupo de EO (24,9±10,1 vs. 34,1±15,6 días, p=0,02). Se realizó un análisis de covarianza, observando que las covariables PN y EG tuvieron efectos significativos en el tiempo hasta alcanzar la alimentación por succión (peso al nacimiento: F[1, 38]=5,79; p=0,021; edad gestacional: F[1, 38]=14,12; p=0,001) y que una vez controlado su efecto, la intervención seguía teniendo un efecto significativo (F[1, 38]=6,07; p=0,018). El grupo de ET+K+O, en comparación con el de EO, consiguió antes el alta hospitalaria (39±15 vs. 45±18 días), si bien la diferencia no fue significativa (p=0,21). Conclusiones: Las terapias combinadas que asocian ET+K+O son más eficaces que la EO sola, para lograr la alimentación oral independiente en los RNPT. (AU)

Introduction: Oral feeding of pre-term newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T+K+OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge. Patients and methods: A clinical study of 2 randomized groups (OS vs. T+K+OS) was carried out on 42 PTNB with gestational age between 27-32 weeks and birth weight>900g. The stimulation programs were carried out in sessions of 15min, for 10 days. Results: The PTNBs in the T+K+OS group achieved independent oral feeding earlier, compared to the OS group (24.9±10.1 vs. 34.1±15.6 days, P=.02). An analysis of covariance was performed, which confirmed that the birth weight and gestational age covariates had significant effects on time to reach suction feeding (birth weight: F[1, 38]=5.79; P=.021; gestational age: F[1, 38]=14.12; P=.001) and that once its effect was controlled, the intervention continued to have a significant effect (F[1, 38]=6.07; P=.018). The T+K+OS group, compared to the OS group, achieved an earlier hospital discharge (39±15 vs. 45±18 days), although the differences were not significant (P=.21). Conclusions: Combined therapies that include T+K+OS are more effective than OS alone, in order to achieve independent oral feeding in PTNBs. (AU)

[Effectiveness of 2 interventions for independent oral feeding in pre-terms]. / Eficacia de 2 intervenciones para la alimentación oral independiente en pretérminos.

INTRODUCTION: Oral feeding of pre-term newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T+K+OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge. PATIENTS AND METHODS: A clinical study of 2 randomized groups (OS vs. T+K+OS) was carried out on 42 PTNB with gestational age between 27-32 weeks and birth weight>900g. The stimulation programs were carried out in sessions of 15min, for 10 days. RESULTS: The PTNBs in the T+K+OS group achieved independent oral feeding earlier, compared to the OS group (24.9±10.1 vs. 34.1±15.6 days, P=.02). An analysis of covariance was performed, which confirmed that the birth weight and gestational age covariates had significant effects on time to reach suction feeding (birth weight: F[1, 38]=5.79; P=.021; gestational age: F[1, 38]=14.12; P=.001) and that once its effect was controlled, the intervention continued to have a significant effect (F[1, 38]=6.07; P=.018). The T+K+OS group, compared to the OS group, achieved an earlier hospital discharge (39±15 vs. 45±18 days), although the differences were not significant (P=.21). CONCLUSIONS: Combined therapies that include T+K+OS are more effective than OS alone, in order to achieve independent oral feeding in PTNBs.

FLIP-2 Study: risk factors linked to respiratory syncytial virus infection requiring hospitalization in premature infants born in Spain at a gestational age of 32 to 35 weeks.

BACKGROUND: Ex-premature infants are more predisposed to complicated primary respiratory syncytial virus (RSV) infection. The aim of the present study was to validate the risk factors found in a previous epidemiologic case-control study regarding hospitalization as a result of RSV infection in premature infants born at 32-35 weeks of gestational age (WGA) in Spain. METHODS: A prospective 2-cohort study was conducted during the 2005-2006 (October 2005 to April 2006) and 2006-2007 (October 2006 to April 2007) RSV seasons, respectively. Cases were premature infants hospitalized for RSV infection whereas controls were premature infants of the same age who did not require any hospitalization for respiratory causes. RESULTS: During the study period 5441 children from 37 Spanish hospitals were included in the risk factor analysis. Two hundred two (3.7%) were cases and the rest controls. Of the cases, 17.8% were admitted to the intensive care unit and 7.4% required mechanical ventilation. None of the patients died. Logistic regression analysis demonstrated that the risk of RSV-related respiratory infection requiring hospital admission in preterm infants (32-35 WGA) was associated with the following factors: absolute chronologic age of < or = 10 weeks at the onset of RSV season [odds ratio (OR): 2.99; 95% confidence interval (CI): 2.23-4.01]; presence of school-age siblings or day care attendance (OR: 2.04; 95% CI: 1.53-2.74); and smoking during pregnancy (OR: 1.61; 95% CI: 1.16-2.25). CONCLUSIONS: In premature infants (32-35 WGA), only 3 independent risk factors were found to significantly increase the risk of RSV-related respiratory infection and hospitalization.

Introducción del sistema europea de transferencia de créditos (ECTS) en la Facultad de Medicina de La Laguna / Introduction of the European Credit Transfer System (ECTS) in the medical school of the University of La Laguna

Para la convergencia europea se deben modificar los planes de estudios de las facultades de medicina de forma que el Sistema de Transferencia de Créditos Europeo (ECTS) esté incorporado a los nuevos planes del estudio antes del 2010 Objetivos: Experimentar la introducción del ECTS en el segundo cuatrimestre de quinto curso, modificando la metodología docente. Diseño del estudio: Se adaptaron los programas teóricos y prácticos y se establecieron unos objetivos docentes y un sistema de evaluación para las asignaturas de Patología Médica de la Sangre y de la Hematopoyesis, de las Enfermedades Infecciosas y del Sistema Endocrino y Nutrición, Pediatría y Patología Quirúrgica de Cara, Cuello, Mama y Glándulas Endocrinas. Se realizaron encuestas a los alumnos en el transcurso de cuatrimestre, utilizando para las respuestas una escala de tipo Likert con cinco grados. Se analizó la priorización de las competencias genéricas y específicas de los alumnos. Para el análisis de los resultados se aplicaron pruebas no paramétricas. Resultados: Los 37 créditos actuales se transformaron en 29.5 ECTS, con 736.5 horas de trabajo para los alumnos. Se redujeron los programas teóricos de 186 lecciones en total a 134 (reducción del 27.96 %). Los alumnos prepararon y presentaron 58 casos clínicos bajo la supervisión de sus tutores. Los profesores consideraron que el aprendizaje teórico había sido similar al de cursos anteriores (66.6 %) y el práctico había sido mejor (73.3 %). El 73.3 % de los alumnos contestaron que el proyecto debía mejorarse, mediante la reducción de la carga de trabajo de los alumnos y mejora del sistema de evaluación. Los alumnos apreciaron de forma estadísticamente significativa que mejoró la docencia práctica y su capacidad para preparar y presentar casos clínicos. El rendimiento académico de los alumnos fue significativamente mejor que el de los alumnos del curso anterior. Los estudiantes estuvieron de acuerdo con la prioridad de competencias de la CND para 9/9 de las generales y 4/17 de las específicas. Conclusiones: La introducción experimental del ECTS mejoró el rendimiento académico, la formación práctica y el autoaprendizaje de los alumnos. La experiencia fue satisfactoria para profesores y alumnos. La estimación de la carga de trabajo de los alumnos fue subestimada (AU)

Introduction: To comply with the requirements of European convergence, faculties of medicine must modify their curricula and incorporate the European Credit Transfer System (ECTS) before 2010. Objectives: To test the introduction of ECTS in the 2nd term of the 5th year medicine course and the appropriately modified teaching methodology. Study design: Theoretical and practical programs were adapted; academic objectives and student evaluation system were established for the following subjects: medical pathology of blood and haematopoiesis, infectious diseases and endocrine system and nutrition, paediatrics and surgical pathology of the face, neck, breast and endocrine glands. Students were surveyed during the term, using a 5-point Likert-type scale. We recorded student priorities for general and specific parameters, and the results were analyzed using non-parametric tests. Results: Thirty-seven credits were converted into 29.5 ECTS credits, representing 736.5 student working hours. The theory program was reduced from 186 to 134 lectures (a reduction of 28%). Students presented 58 tutor-supervised clinical cases. The teaching staff considered that learning of theory was similar to previous years (66.6%) but that practical learning improved (73.3%). Most students (73.2%) thought the program should be improved, especially the examination system, and the workload reduced. Students reported a statistically significant improvement in practical teaching and in their capacity to present clinical cases. Academic performance was significantly higher than that of the 5th year students the previous year. Students agreed with the National Deans Conference priorities for the 9/9 general and 4/17 specific competences. Conclusions: Introducing ECTS improved academic performance, practical training and self-learning. The project proved satisfactory for staff and students. Student workload was underestimated in the new plan (AU)