[Care pathway for Covid-19 patients in a hospital in Luxembourg]. / Parcours de soins des patients atteints de la Covid-19 dans un centre hospitalier au Luxembourg.

The current care pathway for COVID-19 patients was set up at the Centre Hospitalier de Luxembourg following the experiences of the first wave. The role of the nurse in this pathway is fundamental: she coordinates care and the multidisciplinary team as well as the families, in addition to monitoring and treating the patients. Her tool is clinical reasoning, which is the guarantee of care adapted to the needs and expectations of the patients.

Morbidity and mortality of preterm infants less than 26 weeks of gestational age.

BACKGROUND: Extreme preterm infants have a high risk of morbidity and mortality. Newborns delivered between 23+0 and 25+6 weeks, are considered to be in the "gray zone" and have uncertain prognosis. For these children medical decision-making becomes complex and controversial. The present study intends to evaluate the neonatal morbidity and mortality of preterm infants born between 23 weeks and 25+6 weeks of gestational age. METHODS: A retrospective study was conducted including all inborn preterm infants, with a gestational age between 23+0 and 25+6 weeks, admitted to a level IIIC NICU, between January 1st, 1996 and December 31st, 2014. RESULTS: A total of 72 preterm neonates were included, 18.1% had a full cycle of antenatal steroids. The most frequent major morbidities were RDS (95.4%), patent ductus arteriosus (81.3%), sepsis (55.7%, being 19.7% early sepsis, and 36.1% late sepsis), intraventricular hemorrhage (34.4%), retinopathy of prematurity (21.9%) and necrotizing enterocolitis (10.9%). Fifty-four (75%) children died. The only factor adjusted to age associated with high mortality founded was hypotension (OR=4.99, P<0.019). Morbidity at discharge was: severe bronchopulmonary dysplasia (77.8%), retinopathy of prematurity (72.2%), intraventricular hemorrhage (16.7%), cystic periventricular leukomalacia (11.1%), and sequalae of necrotizing enterocolitis (5.6%). CONCLUSIONS: The survival rate was 25% and a high morbidity at discharge was observed, which leave us with the huge responsibility to improve this result in a near future. Extreme prematurity is still a very controversial and complex issue and particular challenge for neonatologists. The use of antenatal steroid in the more immature preterm infants should be encouraged.

Incidencia de la translocación 1/29 en vacas criollas destinadas a la reproducción / Incidence of 1/29 translocation in creole breeding cows

Con el fin de mejorar la producción animal se ha utilizado el análisis cromosómico de los reproductores. Esta técnica permitió demostrar, por primera vez en Venezuela, la existencia de la translocación Robertsoniana 1/29 (Rb 1/29) en toros Criollos Río Limón de la Estación Experimental Guárico (FONAIAP). El presente estudio fué realizado en la misma estación experimental, evaluando cromosómicamente el total de vacas Criollas Río Limón destinadas a la reproducción, con el propósito de establecer la presencia de anomalías cromosómicas en hembras. Se utilizó la técnica del cultivo de linfocitos de sangre periférica estimulados con mitógeno, para obtener placas metafásicas, que fueron teñidas con Giemsa y marcadas en bandeo G. De las 21 vacas analizadas se obtuvo una portadora de la Rb 1/29 (4,8 por ciento) en condición de heterocigosis. Esta incidencia en comparación con el 16,6 por ciento obtenida en 30 toros, indica que la selección por eficacia reproductiva aplicada al rebaño durante aproximadamente 30 años, elimina con mayor eficacia a las vacas portadoras de la translocación. Así como es imprescindible evaluar cromosómicamente a los toros destinados a la reproducción, también es importante evaluar a vacas reproductoras jóvenes, ya que la evaluación citogenética elimina más rápidamente la dispersión de anomalías cromosómicas que la selección por eficacia reproductiva