Comparación entre los niveles de prolactina de madres en relactancia y madres con lactancia materna exclusiva / Comparison between levels of prolactin of mother in relactation and exclusive breast feeding mothers

Estudio no experimental, prospectivo, comparativo y longitudinal, realizado con el objetivo de comparar los niveles de prolactina en 15 madres (Grupo estudio) con más de dos semanas de haber suspendido la lactancia materna y entrenadas para relactar según método recomendado por Organización Mundial de la Salud: Estimulación del pezón y del pecho, Técnica de chorrear y gotear y Extracción mecánica y manual y en 25 madres (grupo control) que lactaban en forma exclusiva, cuyos hijos menores de seis meses, fueron hospitalizados por diversas patologías, en la División Pediátrica del Servicio Autónomo Hospital Universitario de Maracaibo, desde noviembre 2010 a octubre 2011. Las madres tuvieron entre 15 y 25 años de edad en ambos grupos (p=0,58); la causa principal del abandono de la lactancia fue escasa producción láctea (46,67%).El tiempo de aparición de la secreción láctea fue de 6+1,60 días.Los niveles de prolactina de madres del grupo estudio en las primeras 24 horas del ingreso del lactante fue 35,58+18,04 ng/ml y en el grupo control 129,83+35,01 ng/ml, estadísticamente significativo (p=0,01). Iniciada la secreción láctea fue de 121,20+16,90 ng/ml, estadísticamente significativo (p=0,01) comparado con el valor inicial del grupo estudio, pero al comparar con el grupo control fue estadísticamente no significativo (p=0,13).Se concluye que en este grupo de madres que abandonaron la lactancia, una vez iniciada la relactación presentaron un aumento significativo de los niveles de prolactina, similares a los niveles en madres lactando en forma exclusiva.

Not experimental, prospective, comparative, and longitudinal study conducted in order to compare the levels of prolactin in 15 mothers (study group) with more than two weeks of having suspended the breastfeeding, and trained to relactate according to the method recommended by World Health Organization: nipple and breast stimulation, technique of dripping and drip and mechanical and manual removal, and 25mothers (control group) that breastfeeding exclusively, whose children less than six months, were hospitalized with various diseases, in the Division of Pediatric of University Hospital in Maracaibo, from November 2010 to October 2011. The mothers had between 15 and 25 years of age in both groups (p =0.58), the main cause of the abandonment of breastfeeding was insufficient milk production (46.67%). The time of occurrence of milk secretion was 6+1.60 days. Prolactin levels in the study group mothers in the first 24 hours of admission was 35.58+18.04 ng/ml, and in the control group 129.83+ 35.01 ng/ml, statistically significant (p=0.01). Initiated the milk secretion was 121.20+16.90 ng/ml, statistically significant (p =0.01 compared to base line study group, but when was compared to the control group was not statistically significant (p =0.13). It concludes that in this group of mothers who left nursing, once started relactation had significantly higher prolactin levels, similar to the levels in mothers exclusively breastfeeding.

[Comparison between levels of prolactin of mother in relactation and exclusive breast feeding mothers]. / Comparación entre los niveles de prolactina de madres en relactancia y madres con lactancia maternal exclusiva.

Not experimental, prospective, comparative, and longitudinal study conducted in order to compare the levels of prolactin in 15 mothers (study group) with more than two weeks of having suspended the breastfeeding, and trained to relactate according to the method recommended by World Health Organization: nipple and breast stimulation, technique of dripping and drip and mechanical and manual removal, and 25mothers (control group) that breastfeeding exclusively, whose children less than six months, were hospitalized with various diseases, in the Division of Pediatric of University Hospital in Maracaibo, from November 2010 to October 2011. The mothers had between 15 and 25 years of age in both groups (p =0.58), the main cause of the abandonment of breastfeeding was insufficient milk production (46.67%). The time of occurrence of milk secretion was 6+1.60 days. Prolactin levels in the study group mothers in the first 24 hours of admission was 35.58 +18.04 ng/ml, and in the control group 129.83 + 35.01 ng/ml, statistically significant (p=0.01). Initiated the milk secretion was 121.20+16.90 ng/ml, statistically significant (p =0.01 compared to base line study group, but when was compared to the control group was not statistically significant (p =0.13). It concludes that in this group of mothers who left nursing, once started relactation had significantly higher prolactin levels, similar to the levels in mothers exclusively breastfeeding.

Factores de riesgo asociados a la prematuridad en recién nacidos de madres adolescentes / Risk factors associated with prematurity in preterm born to teenage mothers

OBJETIVO: determinar factores de riesgo asociados a prematuridad en neonatos hijos de 205 madres adolescentes en la Maternidad “Dr. Armando Castillo Plaza”, Maracaibo, desde enero - agosto 2012. MÉTODOS: Estudio descriptivo, prospectivo y transversal, se realizó entrevista a la madre y revisión de historias clínicas de la madre y del neonato; indicadores recopilados: factores personales, socioeconómicos, demográficos, gineco-obstétricos y del nacimiento. RESULTADOS: Hubo 15,13 % adolescentes con hijos prematuros; entre 17-19 años (67,31 %); índice de masa corporal: 18,5-24,99 kg/m2 (71,13 %); no estudiaban (41,46.%), no completaron la secundaria (78,54.%), dedicadas a oficios del hogar (68,29 %); en concubinato (55,12 %), estrato socioeconómico: nivel V (52,68 %); sin consumo de alcohol, drogas o tabaco (100 %); venezolanas (97,56 %), raza mestiza (61,46.%); residenciadas en zonas urbanas (62,44.%); viven con familia materna y padre del niño (41,95.%), familias disfuncionales (55,61 %); rechazo familiar (65,85 %); embarazos no deseados (88,29 %); sin intentos de aborto en 82,93 %. Menarquía con media de 11,81 ±1,09 años, inicio de relaciones sexuales: 14,67±1,11 años; mal control prenatal (64,39 %), primiparidad (72,68.%) nacimiento por parto (56,59 %), entre 34 y menores de 38 semanas de gestación (79,51 %); neonato hembra (58,05 %); peso entre 1 501-2.500 g (45,37 %); adecuados para la edad gestacional (79,51 %); buen Apgar al minuto (56,59 %), a los cinco (74,63 %). Presentaron patologías maternas (100 %) y del neonato (89 %). CONCLUSIONES: El bajo nivel socioeconómico y factores de riesgo familiar se relacionan con la prematuridad en el embarazo de estas adolescentes.

OBJECTIVE: to determine risk factors associated with prematurity in infants children of 205 teenagers at the Dr. Armando Castillo Plaza”, Maracaibo, maternity leave from January - August 2012. METHOD: Descriptive, prospective and transversal study was interviewing the mother and review of clinical histories, the mother and the newborn; collected indicators: personal, socio-economic, demographic, gyneco-obstetrical and birth factors. RESULTS: There were 15.13 % adolescents with premature children; between 17 and 19 years old (67.31 %); body mass index: 18, 5-24, 99 kg/m2 (71.13 %); not studied (41.46 %), have not completed high school (78.54 %), dedicated to offices of the household (68,29 %); in concubinage (55.12.%), socio-economic stratum: level V (52.68 %); no consumption of alcohol, drugs or tobacco (100.%). Venezuelans (97.56 %), mixed race (61.46 %); domiciled in urban areas (62.44 %); living with mother’s family and the father of the child (41.95 %), dysfunctional families (55.61 %); family rejection (65,85 %) and unwanted pregnancies (88.29 %); no attempts of abortion in 82.93 %. Menarche with average of 11.81 ±1, 09 years, home of intercourse: 14, 67±1, 11 years; poor prenatal care (64.39 %), primiparidad (72.68 %) birth by birth (56.59 %), between 34 and 38 weeks of gestation (79.51 %) children; female neonate (58.05 %), weight between 1 501-2 500 g (45.37 %); appropriate for gestational age (79.51 %); good Apgar score at the minute (56.59 %), five (74.63 %). They presented maternal diseases (100 %) and neonatal (89 %). CONCLUSIONS: Low socioeconomic and family risk factors is related to prematurity in these teen pregnancy.

Vasculitis gingival como complicación de sepsis de punto de partida enteral / Vasculitis gingival sepsis complicating enteral starting point

Vasculitis es la inflamación de vasos sanguíneos, con isquemia, necrosis y compromiso sistémico. se describe el manejo multidisciplinario de niña de 4 meses quien ingresó al hospital universitario de Maracaibo con fiebre, diarrea, deshidratación, consciente, con períodos de somnolencia, abdomen distendido, ausencia de ruidos hidroaéreos. Posteriormente presenta convulsión, deterioro del estado general, lesiones eritematosas múltiples y en rodetes gingivales, de color blanco parduzco, necróticas, manifestaciones de shock séptico. Antecedente de ingestión de n-butilbromuro de hioscina. laboratorio: anemia, leucocitosis, proteína c reactiva elevada, cultivos negativos. Biopsia del rodete gingival: vasos sanguíneos con paredes infiltradas por células inflamatoriasmononucleares y polimorfonucleares dispersas y necróticas, destrucción y oclusión del endotelio, confirmando la vasculitis gingival. Recibió antibioticoterapia, soporte hemodinámico, cirugía de zonas necrosadas. egresó a los 15 días con diagnóstico de vasculitis gingival por sepsis de origen enteral. el manejo interdisciplinario médico-odontológico facilita la resolución de situaciones generales con compromiso bucodental

Vasculitis is the inflammation of blood vessels, with ischemia, necrosis and systemic involvement. this paper describes the multidisciplinary management of a 4 month old female infant that was admitted to the hospital universitario de Maracaibo with fever,diarrhea, dehydration, periods of somnolence, distended abdomen, and absence of bowel sounds. later, the patient presented seizures, deterioration of her general condition, multiple erythematous and brownish white, necrotic lesions of the gingival border mucosa, and septic shock manifestations. the patient had a history of ingestion of n-butylbromid hyoscine. laboratory tests: anemia, leukocytosis,elevated c-reactive protein, negative cultures, biopsy of the gingival border: blood vessel walls infiltrated by scattered and necrotic polymorphonuclear and mononuclear inflammatory cells, destruction and occlusion of the endothelium confirming gingival vasculitis. treatment included antibiotics, surgery of necrotic areas and hemodynamic support. she was discharged after 15 days with the diagnosis of gingival vasculitis secondary to enteral sepsis. Medical and dentistry interdisciplinary management facilitates the resolution of generalsituations with oral involvement