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1.
Nutr. hosp ; 36(5): 1139-1149, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184638

RESUMO

Introducción: la leche materna es el primer alimento fundamental de los neonatos y proporciona todas las fuentes de energía, nutrientes y protección inmunológica que necesitan durante sus primeros meses de vida. Lamentablemente, existen circunstancias específicas que implican que la madre no pueda alimentar correctamente a su bebé, ya que las necesidades nutricionales de la madre difieren en cierta medida durante los diversos periodos de la vida, especialmente en la lactancia, ya que se aumentan las necesidades nutricionales debido a la pérdida de nutrientes, primero por el calostro y luego a través de la leche materna. Objetivo: demostrar la influencia de la dieta de mujeres mexicanas sobre la calidad nutricional y la presencia de microorganismos benéficos en la leche humana. Métodos: se llevaron a cabo 70 encuestas descriptivas de nutrición y toma de muestras de leche a mujeres en estado lactante. Las leches fueron sometidas a diversos análisis bromatológicos y microbiológicos para evaluar su calidad nutricional y posible actividad probiótica. Resultados: se demostró que la ingesta de alimentos de la madre influye en la calidad nutricional de la leche. Asimismo, afecta el desarrollo y crecimiento de las bacterias lácticas. Se aislaron e identificaron diversas cepas en leche humana del género Lactobacillus, además de bacterias patógenas como el caso de Lodderomyces elongisporus, entre otros. Conclusiones: la alimentación de las madres se refleja directamente en la calidad nutricional de la leche. Se observó que la cantidad de nutrientes esenciales de la leche, como son los hidratos de carbono, lípidos y proteínas, varían conforme a la alimentación y el ritmo de vida de las madres, así como la disminución significativa de bacterias lácticas con potencial probiótico


Introduction: breast milk is the first fundamental food of newborns and it provides all the sources of energy, nutrients and the immunological protection they need during their first months of life. Unfortunately, there are specific circumstances that imply that the mother cannot feed her baby correctly, since the mother's nutritional needs differ to a certain extent during different periods of life. Especially in breastfeeding, since nutritional needs are increased, due to the loss of nutrients, first by colostrum and then by breast milk. Objective: to demonstrate the influence of the diet of Mexican women on the nutritional quality and the presence of beneficial microorganisms in human milk. Methods: seventy descriptive surveys of nutrition and sampling of milk to women in nursing state were carried out. The milks were subjected to various bromatological and microbiological analyzes to evaluate their nutritional quality and possible probiotic activity. Results: it was shown that the mother's food intake influences the nutritional quality of the milk. Likewise, it affects the development and growth of lactic acid bacteria. Several strains were isolated and identified in human milk of the genus Lactobacillus, as well as pathogenic bacteria such as Lodderomyces elongisporus among others. Conclusions: the mothers' nutrition is directly reflected in the nutritional quality of the milk. It was observed that the amount of essential nutrients of milk such as carbohydrates, lipids and proteins vary according to the diet and life rhythm of the mothers, as well as the significant decrease of lactic bacteria with probiotic potential


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Dieta , Leite Humano/microbiologia , Avaliação Nutricional , Qualidade dos Alimentos , Nutrientes , Qualidade da Assistência à Saúde , Inquéritos Nutricionais , Epidemiologia Descritiva , Análise de Alimentos/métodos , Carboidratos , Proteínas
2.
Nutr Hosp ; 36(5): 1139-1149, 2019 Oct 17.
Artigo em Espanhol | MEDLINE | ID: mdl-31475839

RESUMO

Introduction: Introduction: breast milk is the first fundamental food of newborns and it provides all the sources of energy, nutrients and the immunological protection they need during their first months of life. Unfortunately, there are specific circumstances that imply that the mother cannot feed her baby correctly, since the mother's nutritional needs differ to a certain extent during different periods of life. Especially in breastfeeding, since nutritional needs are increased, due to the loss of nutrients, first by colostrum and then by breast milk. Objective: to demonstrate the influence of the diet of Mexican women on the nutritional quality and the presence of beneficial microorganisms in human milk. Methods: seventy descriptive surveys of nutrition and sampling of milk to women in nursing state were carried out. The milks were subjected to various bromatological and microbiological analyzes to evaluate their nutritional quality and possible probiotic activity. Results: it was shown that the mother's food intake influences the nutritional quality of the milk. Likewise, it affects the development and growth of lactic acid bacteria. Several strains were isolated and identified in human milk of the genus Lactobacillus, as well as pathogenic bacteria such as Lodderomyces elongisporus among others. Conclusions: the mothers' nutrition is directly reflected in the nutritional quality of the milk. It was observed that the amount of essential nutrients of milk such as carbohydrates, lipids and proteins vary according to the diet and life rhythm of the mothers, as well as the significant decrease of lactic bacteria with probiotic potential.

3.
Pediatr Res ; 81(3): 473-479, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27842054

RESUMO

BACKGROUND: Retinopathy of prematurity (ROP) is a potentially blinding, retinal neovascular disease. Systemic prolactin accesses the retina to regulate blood vessels. Prolactin is proangiogenic and can be cleaved to antiangiogenic vasoinhibins. We investigated whether circulating prolactin and vasoinhibins associate with incidence and progression of ROP. METHODS: A prospective, longitudinal, case-control study covering postnatal weeks 1 to 9 measured serum prolactin, vasoinhibins, and vascular endothelial growth factor (VEGF) weekly in 90 premature infants diagnosed as ROP or control. RESULTS: Prolactin levels were higher in ROP than in control patients before (106.2 ± 11.3 (SEM) vs. 64.7 ± 4.9 ng/ml, postnatal week 1) and during (120.6 ± 10 vs. 84.7 ± 7.5ng/ml, postnatal week 5) ROP diagnosis. Prolactin, but not gestational age, birth weight, Apgar score, sepsis, or ventilation time, correlated with ROP. The relative risk (RR) of developing ROP increased if Prolactin (PRL) levels were higher than thresholds of 80 ng/ml (RR = 1.55, 95% CI: 1.06-2.28), 100 ng/ml (RR = 1.63, 95% CI: 1.14-2.34), or 120 ng/ml (RR = 1.95, 95% CI: 1.41-2.68). Vasoinhibin levels were 39.7% higher (95% CI: 4.5-77.5) in the circulation of ROP than in control patients at postnatal week 1 and similar thereafter, whereas VEGF serum levels were always similar. CONCLUSION: High serum prolactin and vasoinhibin levels predict and may impact ROP progression.


Assuntos
Proteínas de Ciclo Celular/sangue , Prolactina/sangue , Retinopatia da Prematuridade/sangue , Inibidores da Angiogênese/uso terapêutico , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Estudos Prospectivos , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/patologia , Fator A de Crescimento do Endotélio Vascular/sangue
4.
Neonatology ; 110(2): 135-40, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27088589

RESUMO

BACKGROUND: Retinopathy of prematurity (ROP), a potentially blinding disease, affects preterm infants. High levels of oxygen saturation are a well-known risk factor for ROP. OBJECTIVES: To assess the frequency of ROP type 1 needing treatment after improved oxygen monitoring (2011) in a Mexican preterm population selected for WINROP analyses and to retrospectively revalidate WINROP, an online surveillance system identifying infants at risk of developing ROP type 1. METHODS: Preterm infants born with birth weight (BW) <1,750 g and/or at gestational age (GA) ≤34 weeks, screened for ROP in 2012-2014 at the Hospital Civil de Guadalajara, Mexico were included (n = 151). Eighty-five infants with GA <32 weeks qualified for WINROP analyses. GA, BW, maximal ROP stage, ROP treatment and weekly weights were recorded. The results in the present study were compared to those of a previous WINROP study in the same hospital (2005-2010; n = 352). RESULTS: In the present WINROP cohort, 11.8% of the infants born at GA <32 weeks received treatment compared to 51.0% of the infants in the previous WINROP cohort. One infant (3%) born at GA ≥32 weeks received treatment during the present study period compared to 35.6% during the previous period. WINROP displayed 80.0% sensitivity in infants born at GA <32 weeks in the present study compared to 84.7% in the previous study. CONCLUSIONS: Uncontrolled oxygen supplementation is the major risk factor for severe ROP in infants born at GA ≥32 weeks. After improved oxygen monitoring, the frequency of ROP treatment was dramatically reduced at the Hospital Civil de Guadalajara, Mexico.


Assuntos
Lactente Extremamente Prematuro , Recém-Nascido de muito Baixo Peso , Oxigênio/efeitos adversos , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/prevenção & controle , Algoritmos , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , México/epidemiologia , Triagem Neonatal , Oxigênio/uso terapêutico , Estudos Retrospectivos , Fatores de Risco
5.
Gac Med Mex ; 151(4): 519-24, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26290029

RESUMO

INTRODUCTION: The Guadalajara International Book Fair (FIL) is a mass gathering, hosting publishing companies from 40 countries and more than 750,000 visitors. It is necessary to prioritize preventive measures focusing on earthquakes, fires, terrorist acts, and prevention of infections. The objective of this study is to describe and analyze the health problems encountered during FIL 2013 in order to improve civil protection services during future events. MATERIAL AND METHODS: Descriptive, cross-sectional study, collecting medical histories in accordance with Mexican Official Standard NOM-004-SSA3-2012, and classifying respondents into age groups. A total of 794 medical sheets for patients who received assistance at the Mobile Health Units were analyzed. RESULTS: Altogether, 794 (0.1%) patients were medically evaluated out of 750,987 fair visitors during the study period. Of these, 32 patients were <12 years old; 111 were 13-20 years old; 540 were 20-50 years old; and 111 were >50 years old. There were no complicated medical cases. A favorable impact of preventives strategies was observed. CONCLUSIONS: Non-complicated medical incidents were observed. It is necessary to increase the knowledge on health among the general public who attend this type of event. Training health professionals is a priority in prevention measures and providing care during mass events of this kind in Mexico's territory.


Assuntos
Serviços Médicos de Emergência , Adolescente , Adulto , Livros , Criança , Pré-Escolar , Congressos como Assunto , Estudos Transversais , Planejamento em Desastres , Humanos , Lactente , México , Pessoa de Meia-Idade , Adulto Jovem
6.
Perinatol. reprod. hum ; 28(3): 129-133, jul.-sep. 2014. tab
Artigo em Espanhol | LILACS-Express | ID: lil-744092

RESUMO

En los neonatos en estado crítico es necesario establecer un sistema de farmacovigilancia con el cual se les proteja de posibles reacciones adversas a los medicamentos; estas reacciones pueden ser por el efecto farmacológico, la interacción con otros medicamentos, errores de dosificación y la idiosincrasia del paciente, de acuerdo con la Norma Oficial Mexicana 220. Objetivo: Conocer el estado actual de la farmacovigilancia en unidades de cuidado intensivo neonatal del estado de Jalisco. Material y métodos: Mediante un cuestionario estructurado de 12 preguntas, se practicó una encuesta de opinión en referencia a los programas de farmacovigilancia en los recién nacidos en estado crítico en instituciones del área metropolitana de Guadalajara y el interior del estado de Jalisco. Se aplicó en ocho centros hospitalarios que cuentan con terapia intensiva neonatal y en un congreso estatal de pediatría en el año 2011. A todos los participantes se les pidió que de manera voluntaria, llenaran una documento ad hoc; los resultados se procesaron en el programa Epi info 2010. Discusión y conclusiones: Los resultados demuestran que no se está cumpliendo la NOM 220. Existe un gran déficit de unidades con programas implementados de farmacovigilancia y proceso de notificación de reacciones adversas a medicamentos; la cobertura es menor al 50%. Al parecer, el problema es aún mayor en instituciones particulares. Es necesario cumplir con la NOM 220 para asegurar la calidad de atención en los recién nacidos críticos en el estado de Jalisco.


There is a need to establish medication surveillance/monitoring systemsfor newborn patients in critical condition in order to protect these patients from possible adverse reactions to prescribed drugs. In accordance with Mexican official standard NOM 220, these reactions may result from pharmacological effects, interaction with other drugs, dosage errors, and the patient's nature/idiosyncrasy. Objective: Our goal was to gain knowledge on the current situation regarding medication surveillance in neonatal intensive care units within the state of Jalisco. Material and methods: By means of a structured questionnaire involving 12 questions, an opinion poll was carried out with reference to medication surveillance programs for newborn patients in critical condition at institutions within Guadalajara's metropolitan area and the State of Jalisco. The survey was conducted in 8 hospital centers that provide neonatal intensive care and at a state congress on pediatrics that took place in 2011. All of the respondents were asked to voluntarily fill out a questionnaire Ad-hoc, and the results were processed using the Epi Info 2010 program. Discussion and conclusions: The results show that there is widespread noncompliance of NOM 220. There is a considerable deficit with respect to units implementing medication surveillance systems and methods to notify adverse reactions to medication, with implementation rates lower than 50%. It appears that the problem is even greater in private institutions. Compliance with NOM 220 is essential in order to guarantee the quality of the care provided to newborn patients in critical condition within the state of Jalisco.

7.
Ginecol Obstet Mex ; 82(7): 441-7, 2014 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-25102669

RESUMO

BACKGROUND: Pregnancy in women addicted represents, in itself, a major risk of destruction of physical and mental health of the unborn child; urgent prevention is the same as essential to providing quality care to the mother and child knowledge. OBJECTIVE: Describe the physical and sociodemographic characteristics of neonates in intensive care units, born of mothers with addictions. MATERIALS AND METHOD: Cross-sectional, descriptive study of neonates with addict mothers, analyzing age, gender, clinical symptoms and complications. Findings for frequency-percentages with regard to qualitative variables, and medians and ranges for quantitative variables. SPSS-20.0-Windows Statistics software package. RESULTS: 618 patients admitted to the NICU, 180(29%) showing withdrawal symptoms; irritability in 117 (63%), intensive crying in 93 (51%), spontaneous Moro reflex 74 (42%), diarrhea 61 (30%), fever 61 (30%). Birth defects 124 (20%), from greater to lesser occurrence: disorders in central nervous system, digestive tract and abdominal wall, extremities, kidneys, and others. 309 (50%) weight lower than 2600g. The most frequent metabolic disorders were hypoglycemia, Metabolic Acidosis and jaundice, among others. CONCLUSIONS: Every day, we see more children born of substance-dependent mothers in the Mexico. Our study reveals high mortality rate and many complications for this group; thus, it becomes necessary to institute preventive measures among Mexican women of childbearing age in order to prevent illegal drug use and to increase treatment among pregnant addicts. Gynecologists, pediatricians and neonatologists must have extensive knowledge regarding the entire clinical-social spectrum of symptoms that may be observed in children of mothers suffering addictions.


Assuntos
Filho de Pais Incapacitados , Anormalidades Congênitas/epidemiologia , Mães , Transtornos Relacionados ao Uso de Substâncias , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , México , Adulto Jovem
8.
Bol. méd. Hosp. Infant. Méx ; 70(5): 344-350, sep.-oct. 2013. tab
Artigo em Espanhol | LILACS-Express | ID: lil-702410

RESUMO

El aumento en la sobrevida de los recién nacidos prematuros, las características del cuidado neonatal y la escasez de programas para la prevención, detección y tratamiento de la retinopatía del prematuro provocan que esta enfermedad sea la principal causa de ceguera infantil prevenible en México. El advenimiento de agentes antiangiogénicos de uso oncológico, y su uso -no autorizado, aunque con buenos resultados- en el tratamiento de enfermedades vaso proliferativas en la retina del paciente adulto, así como la presencia de reportes anecdóticos en la literatura y series de casos con serias fallas metodológicas han sugerido su utilización en el tratamiento de la retinopatía del prematuro. Desafortunadamente, estos agentes, utilizados indiscriminadamente, presentan absorción sistémica y causan efectos secundarios en el organismo del paciente prematuro. Además, no existen estudios de seguimiento a largo plazo que garanticen la seguridad de su uso en esta población. El presente artículo describe la situación en nuestro país y advierte sobre los riesgos de estos medicamentos en la población de pacientes prematuros.


The increase in survival rates among preterm infants, characteristics of neonatal care for such infants and a lack of suitable programs for preventing, detecting and treating retinopathy of prematurity (ROP) are factors that have made this disease the main cause of preventable blindness among children in Mexico. The advent of antiangiogenic agents in cancer treatment and their off-label use with favorable results in the treatment of proliferative vessel disease of the retina among adult patients, as well as anecdotal reports in the literature and a series of cases showing serious methodological flaws, have prompted their use in the treatment of retinopathy of prematurity. Unfortunately, these agents used indiscriminately in our country have a systemic absorption and secondary effects on the preterm patient's body. There are no long-term monitoring studies that guarantee their safe use in this segment of the population. This article describes the situation in our country and warns of the risks posed by the use of this type of drug on the preterm infant population.

9.
Graefes Arch Clin Exp Ophthalmol ; 251(9): 2093-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23546400

RESUMO

BACKGROUND: Fluorescein angiography has been fundamental for the understanding and description of vascular disorders affecting the retina and choroid. The aim of this report is to assess the early anatomic retinal changes visible with angiography, and their relation with the clinical findings of retinopathy of prematurity. METHODS: Ten babies were included in the study, the initial examination being at 2 weeks after birth. Two cycles of tropicamide 0.8 % and phenylephrine 5 % eye drops were instilled into both eyes 30 min before examination. A RetCam II was used to obtain digital retinal images, after instilling topical anesthesia (tetracain 0.5 %) and using a contact gel. Fluorescein angiography was undertaken following administration of an intravenous bolus of 0.1 ml/kg saline fluorescein 10 % followed by a 3.0-ml isotonic saline flush, with the assistance of the neonatologist; the right and left eyes were imaged. RESULTS: We observed that some of the vascular abnormalities described for threshold disease by Lepore were already present at the second week of life, preceding the diagnosis of threshold disease by 3-4 weeks in two cases. The main findings in our cases were arterio-venous shunts, surrounded by areas of capillary non-perfusion, rosary-bead-like hyper-fluorescence, tortuosity and leakage from distal arterioles, none of which were detectable in the digital fundus pictures. CONCLUSIONS: Early ROP screening at the NICU that includes FA is a safe procedure, and gives the examiner details of vascular changes that are not detectable by indirect ophthalmoscopy, which could predict the progression to threshold disease, and provide an alert about the need of therapeutic interventions.


Assuntos
Angiofluoresceinografia/métodos , Triagem Neonatal , Vasos Retinianos/patologia , Retinopatia da Prematuridade/diagnóstico , Diagnóstico Precoce , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Masculino , Midriáticos/administração & dosagem , Fotografação , Pupila/efeitos dos fármacos
12.
Arch Ophthalmol ; 130(6): 720-3, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22801831

RESUMO

OBJECTIVE: To retrospectively validate the WINROP (weight, insulin-like growth factor I, neonatal, retinopathy of prematurity [ROP]) algorithm in identification of type 1 ROP in a Mexican population of preterm infants. METHODS: In infants admitted to the neonatal intensive care unit at Hospital Civil de Guadalajara from 2005 to 2010, weight measurements had been recorded once weekly for 192 very preterm infants (gestational age [GA] <32 weeks) and for 160 moderately preterm infants (GA ≥32 weeks). Repeated eye examinations had been performed and maximal ROP stage had been recorded. Data are part of a case-control database for severe ROP risk factors. RESULTS: Type 1 ROP was found in 51.0% of very preterm and 35.6% of moderately preterm infants. The WINROP algorithm correctly identified type 1 ROP in 84.7% of very preterm infants but in only 5.3% of moderately preterm infants. For infants with GA less than 32 weeks, the specificity was 26.6%, and for those with GA 32 weeks or more, it was 88.3%. CONCLUSIONS: In this Mexican population of preterm infants, WINROP detected type 1 ROP early in 84.7% of very preterm infants and correctly identified 26.6% of infants who did not develop type 1 ROP. Uncertainties in dating of pregnancies and differences in postnatal conditions may be factors explaining the different outcomes of WINROP in this population.


Assuntos
Algoritmos , Peso ao Nascer/fisiologia , Recém-Nascido Prematuro , Fator de Crescimento Insulin-Like I/metabolismo , Triagem Neonatal/métodos , Retinopatia da Prematuridade/diagnóstico , Países em Desenvolvimento , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , México , Retinopatia da Prematuridade/sangue , Retinopatia da Prematuridade/classificação , Estudos Retrospectivos
13.
Perinatol. reprod. hum ; 26(2): 83-89, abr.-jun. 2012. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: lil-695079

RESUMO

Introducción: Las malformaciones congénitas (MC) son un problema importante de salud pública y la principal causa de muerte en niños. Representan el 20% de la mortalidad infantil en el primer año de vida. Objetivo: Evaluar la contribución de las MC como causa de hospitalización en una Unidad de Terapia Intensiva Neonatal, basado en el uso de datos obtenidos de una población de neonatos. Material y métodos: Estudio descriptivo en 2,907 neonatos del año 2005-2009, evaluados y categorizados por MC a través de CIE-10, OMS, obtenido por medio del expediente clínico al ingreso a la UCINEX, Hospital Civil de Guadalajara ''Fray Antonio Alcalde''. Los resultados fueron evaluados en porcentaje y medidas de tendencia central. Resultados: Doscientos noventa y cinco neonatos (10%) presentaron MC; 67% fueron masculinos y 33%, femeninos. Mielomeningocele fue la MC más frecuente (13%), mientras que el aparato gastrointestinal fue el más afectado con 27% de las MC. Las anormalidades cromosómicas generaron la estancia intrahospitalaria más elevada (20.5 ± 5.5 días), el sistema cardiovascular presentó 34% de defunción. La mortalidad resultó en 14.2%; 60% de las MC se intervinieron quirúrgicamente y el 64.5% radicaba en la zona metropolitana del Estado de Jalisco. Conclusiones: El conocimiento de la contribución de las MC en la mortalidad neonatal es importante para la integración de medidas preventivas y planificación de estrategias eficaces de atención a la salud, especialmente en las causas, tratamiento y prevención de estos trastornos. Esta información resalta la importancia de estudiar más a fondo el reconocimiento precoz de la morbimortalidad en la población pediátrica.


Introduction: Congenital malformations (CM) are a major public health problem and the leading cause of death in children; representing 20% of infant mortality in the first year of life. Objective: To evaluate the contribution of CM as a cause of hospitalization in a Neonatal Intensive Care Unit. Material and methods: We performed a retrospective, observational, transversal and descriptive study, in which we reviewed the medical records of 2,907 neonates, which entered the External Service of Neonatal Intensive Care (UCINEX) of the Hospital Civil de Guadalajara ''Fray Antonio Alcalde'', in the period 2005-2009 with the diagnostic of congenital malformations (CM) according to the WHO ICD-10. Statistics: measures of central tendency and percentages were done. Results: Two hundred ninety five infants (10.14%) had CM, 67% male and 33% female. CM myelomeningocele was the most frequent (12.9%). The gastrointestinal tract was the most affected with 27.4% of CM, chromosomal abnormalities generated more days of hospitalization (20.5 ± 5.5 days), the cardiovascular system showed 34.2% of deaths. The overall mortality was 14.2%; 60% of CM was treated surgically and 64.5% of the mothers of these infants were living in the metropolitan area of Jalisco State. Conclusions: Knowledge of the contribution of CM to neonatal mortality is important for the integration of preventive measures and plan effective strategies for its prevention, identify their causes and establish treatment. This information highlights the importance of further study of early recognition of the morbidity and mortality in the pediatric population.

14.
Perinatol. reprod. hum ; 26(1): 30-34, ene.-mar. 2012. tab
Artigo em Espanhol | LILACS-Express | ID: lil-695074

RESUMO

Introducción: En México existe incertidumbre acerca de los recursos humanos y tecnológicos disponibles para el diagnóstico de la neurodiscapacidad, es por eso que el objetivo de este estudio fue conocer la disponibilidad de dichos recursos, así como identificar la existencia de programas para establecer el diagnóstico en el periodo neonatal, en los diferentes centros de trabajo del país. Material y métodos: Durante el XVI Congreso Nacional de Neonatología que celebró la Federación Nacional de Neonatología de México, en febrero de 2011 en Cancún, México, se realizó una encuesta entre los pediatras, neonatólogos, enfermeras y personal de salud del país. Resultados: El 65% respondió que en su lugar de trabajo cuentan con programas de tamizaje para retinopatía del prematuro, sordera, parálisis cerebral, epilepsia y retraso mental; también los encuestados mencionaron tener los siguientes especialistas en sus instituciones: neurólogos, oftalmólogos y personal para la detección de problemas de sordera. Conclusiones: El panorama es sombrío, ya que en todas las áreas de cobertura se reporta menos del 70% de estos recursos. Se hace notar que para la detección de la ceguera y la sordera se cuenta con más recursos disponibles. El resto de los problemas investigados presenta graves indicadores negativos, por lo tanto, es urgente legislar en el campo de acción de la neonatología, cuestionando la eficacia y seguridad de algunos de los tratamientos y su contribución al daño neurológico.


Introduction: In Mexico there is uncertainty about the human and technological resources available for the diagnosis of neurodisability, so the objective of the present study was: to determine the availability of those resources and to identify the existence of programs to establish the diagnosis in the neonatal period, in different workplaces in the country. Material and methods: During the Sixteenth National Congress of Neonatology, held by the National Federation of Neonatology of Mexico, in February 2011 in Cancún, Mexico. It was conducted a survey among pediatricians, neonatologists, nurses, and health personnel working in the country. Results: 65% answered that in their workplace have screening programs for: retinopathy of prematurity, deafness, cerebral palsy, mental retardation epilepsy, also the respondents mentioned that count with the following specialists at their institutions: neurologists, ophthalmologist and personal for the detection of deafness. Conclusions: The picture is bleak; in all areas reported coverage less than 70%. It is noted that for detection of blindness and deafness there are more resources available. The rest of the problems investigated have severe negative indicators. So it is urgent to legislate currently in the field of neonatology, questioning the efficacy and safety of some treatments and their contribution to neurological damage.

15.
Bol. méd. Hosp. Infant. Méx ; 69(1): 50-55, ene.-feb. 2012. ilus
Artigo em Espanhol | LILACS-Express | ID: lil-700979

RESUMO

Introducción. Las transiciones demográfica y epidemiológica en México permiten que aumente la frecuencia de enfermedades relacionadas con el consumo de drogas ilegales en mujeres que se encuentran en edad reproductiva. El consumo materno de cocaína durante el embarazo está asociado con efectos teratogénicos en el embrión, principalmente en órganos como cerebro, corazón, tracto genitourinario y extremidades, lo que afecta gravemente su función y la calidad de vida de los recién nacidos. Caso clínico. Paciente masculino de tres días de vida extrauterina que presenta meromelia transversa en las cuatro extremidades con facies característica. La madre informó que consumió cocaína antes y durante el primer trimestre del embarazo; esto se confirmó con el reporte toxicológico de la orina. Conclusiones. Es importante llevar a cabo el estudio de los casos asociados con el consumo de agentes teratogénicos, para ampliar el conocimiento científico, y establecer medidas de prevención y tratamiento de estas patologías.


Background. The epidemiological and demographic transition in Mexico demonstrates the frequency of health-related conditions related to illegal drug use in women of childbearing age. Maternal abuse of cocaine during pregnancy is associated with teratogenic effects in the embryo affecting chiefly brain, heart, urogenital tract and extremities, with serious consequences affecting function and/or quality of life of the newborns. Case report. We present the case of a 3-day-old male who presented transverse meromelia in all four limbs with characteristic facie. Parents reported consumption of cocaine. The mother reported consuming cocaine prior to and during the first trimester of pregnancy and self-report was verified along with toxicological urine testing. Conclusions. Studies associated with consumption of teratogenic agents are important to carry out in order to expand scientific knowledge and to establish measures of prevention and treatment of these pathologies.

16.
Ophthalmic Epidemiol ; 18(6): 264-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22053835

RESUMO

BACKGROUND: Retinopathy of Prematurity (ROP) is the main cause of preventable blindness in premature babies. Currently, there is a shortage of trained ophthalmologists, which has resulted in an alarming increase in cases of vision loss and related complications. This study's aim was to determine the utility of examinations conducted by non-ophthalmologist physicians to assess posterior pole vessel abnormalities in eyes at risk for ROP. METHOD: Non-ophthalmologist physicians (pediatrician and neonatologist) were trained to use an indirect ophthalmoscope to view the posterior pole of babies at risk for ROP. Examinations were conducted on both eyes of premature infants born before 35 weeks gestational age (GA) starting at the third week after birth and weekly thereafter. The presence of Plus disease was identified by the non-ophthalmologist and results compared to the clinical examination by a pediatric ophthalmologist experienced in ROP detection and treatment. Chi-square was used for proportions and the Mann Whitney U test for medians. Fagan's nomogram was determined for diagnostic usability. The Kappa index was used to rate inter-observer agreement. RESULTS: Results of 228 examinations performed on 150 premature infants were analyzed to determine the correlation of the non-ophthalmologist findings and the eye examination. For any vascular change in posterior pole diagnostic, findings were 87% and 87% accuracy for pediatrician and neonatologist, 82% and 83% sensitivity, 90% and 90% specificity respectively. There was no significant difference found in the detection of Plus disease for the examinations performed by the ophthalmologist compared to those performed by the non-ophthalmologist (P < 0.05). CONCLUSIONS: After training in the use of an indirect ophthalmoscope, non-ophthalmologist physicians can reliably detect posterior pole retinal vessel changes for ROP diagnosis.


Assuntos
Triagem Neonatal/métodos , Retinopatia da Prematuridade/diagnóstico , Distribuição de Qui-Quadrado , Humanos , Recém-Nascido , Recém-Nascido Prematuro , México , Neonatologia/métodos , Oftalmoscopia/métodos , Pediatria/métodos , Estatísticas não Paramétricas
17.
Bol. méd. Hosp. Infant. Méx ; 68(1): 34-39, ene.-feb. 2011. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: lil-700876

RESUMO

Introducción. El transporte neonatal desde las unidades médicas hasta las unidades de tercer nivel en muchos casos es desorganizado y arriesgado, situación que compromete aún más el estado de salud del neonato enfermo. El objetivo del estudio fue analizar el impacto del programa S.T.A.B.L.E. (de las siglas en inglés: Sugar and Safe care, Temperature, Airway, Blood, Lab work, Emotional support) en la morbimortalidad de los neonatos trasladados del interior del estado de Jalisco y de la zona metropolitana de Guadalajara, a la Unidad de Cuidados Intensivos Neonatales Externos (UCIN-EX) del Hospital Civil de Guadalajara. Métodos. Se diseñó un estudio prospectivo de 2005 a 2009. El proceso de intervención se basó en la aplicación del programa S.T.A.B.L.E. a todo neonato que requirió ser trasladado. Esto se logró con la intervención de los médicos reguladores del Sistema de Atención Médica de Urgencias (SAMU) del estado de Jalisco. Se implementó un curso de capacitación para el personal médico y paramédico de los centros de atención que refieren pacientes a nuestra unidad, con el fin darles a conocer el programa S.T.A.B.L.E. y su forma de aplicación. Resultados. Un total de 3,277 neonatos fueron incluidos en el estudio, 384 antes de implementar el programa y 2,893 con la aplicación del programa S.T.A.B.L.E. En el grupo con intervención se observó una frecuencia mayor de pacientes con temperatura corporal normal a su ingreso a la unidad receptora [516 (87%) vs. 227 (59%) p < 0.01 ], así como cifras de glicemia en rangos normales [690 (93%) vs. 173 (45%) p < 0.001]. La mortalidad durante el periodo de hospitalización en la unidad receptora fue menor en el grupo con intervención [405 (14%) vs. 84 (22%) p < 0.05]. Después del proceso de intervención, más pacientes fueron trasladados en incubadora [2,806 (97%) vs. 200 (52%) p < 0.001]; de igual forma, en más pacientes se aplicaron métodos de monitoreo de oximetría de pulso [2,575 (89%) vs. 235 (61 %) p < 0.01 ]. En cuanto al número de transportes neonatales regulados y autorizados por el sistema SAMU, se observó un incremento a favor del grupo con intervención [2,806 (97%) vs. 234(61%) p < 0.001]. La frecuencia de defunciones durante el transporte neonatal no presentó diferencias [30 (1 %) vs. 10 (2.6%) p = NS]. Conclusiones. El traslado de neonatos enfermos al tercer nivel de atención médica en el estado de Jalisco se realizó de forma segura, con una mejoría importante en la morbilidad. El programa S.T.A.B.L.E. fue altamente eficiente y de fácil aplicación. La disminución de la mortalidad de los pacientes con intervención del programa durante el periodo de hospitalización requiere estudios especialmente diseñados para establecer posibles asociaciones.


Background. Transporting newborn infants to third-level units is often disorganized, thus entailing several risks that may further compromise the health of newborn patients. Methods. A prospective study was designed in orderto assess the impact ofthe S.T.A.B.L.E. program (Sugarand Safe Care, Temperature, Airway, Blood, Lab work, Emotional support) from 2005 to 2009 in regard to morbidity and mortality rates of newborn patients who had to be transferred from other regions within Jalisco state or within Guadalajara's metropolitan area to the Neonatal Intensive Care Unit ofthe Civil Hospital in Guadalajara. The intervention process was based on applying the S.T.A.B.L.E. program to all newborns who needed to be transferred and was achieved with the intervention ofthe physicians regulating the Emergency Medical Assistance System (SAMU) of the state of Jalisco. A training course, as well as an educational brochure, was given to medical and paramedical staff from the medical assistance centers referring patients to our unit in orderto provide them with information on the S.T.A.B.L.E. program and its implementation. Results. A total of 3,277 newborn infants were included in the study, 384 before the intervention program and 2,893 once the S.T.A.B.L.E. program was implemented. Within the group transferred after the program's implementation, we observed a greater incidence of patients with normal body temperature upon admission to the receiving unit [516 (87%) vs. 227 (59%); p < 0.01 ] as well as with blood glucose figures within the normal range [690 (93%) vs. 173 (45%); p < 0.001]. Mortality during the hospitalization period in the receiving unit was lower in the group treated after the program's implementation [405 (14%) vs. 84 (22%); p < 0.05]. After the intervention process, more patients were transported in incubators [2,806 (97%) vs. 200 (52%); p < 0.001] and equally, pulse oximetry monitoring methods were applied in a greater number of patients [2,575 (89%) vs. 235 (61 %); p < 0.01 ]. With regard to the number of transfers of newborns that were regulated and authorized by the SAMU system, we also observed an increase in such numbers for the group treated after the intervention program [2,806 (97%) vs. 234 (61 %); p < 0.001]. There was no difference in the incidence of death during the newborns' transport [30 (1%) vs. 10 (2.6%); p = NS]. Conclusions. Transfer of ill newborns to third-level medical care units in the state of Jalisco was safely undertaken with a significant improvement in morbidity rates. The S.T.A.B.L.E. program was highly effective and easy to implement. The decrease in mortality during the hospitalization period of patients treated after the intervention program merits further studies especially designed to establish possible associations.

18.
Ginecol Obstet Mex ; 78(8): 418-22, 2010 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-20939250

RESUMO

BACKGROUND: Birth without medical assistance, or outs hospitals is defined as one that occurs without the optimal medical and health care conditions for mother and son pairing. Frequency of this phenomenon is not known in Mexico. OBJECTIVE: To observe clinical outcomes, morbidity, mortality, epidemiological and geographical patterns. MATERIAL AND METHOD: A retrospective study including newborns of mothers who have had deliveries without medical assistance in accidental conditions, admitted to Unidad de Cuidados Intensivos Neonatales Externos, Hospital Civil de Guadalajara Fray Antonio Alcalde (Mexico). From January 2000 to December 2009. RESULTS: In 4,762 (100%) neonatal records evaluated, 582 (12%) were newborns birth for deliveries out of hospital. 314 (54%) female and 268 (46%) male, first mother's gravidity 195 (33%) and second o more gravidity 387 (68%) were registered. The Hospital stay average was 3-day. Discharge diagnoses: healthy 463 (79%), neonatal sepsis 16 (4%), respiratory distress 35 (6%), jaundice 33 (6%), pneumonia 12 (2%), metabolic disorders 13 (3%), other diagnoses 10 (2%). Place of births: 366 Guadalajara metropolitan area (63%), state of Jalisco, 180 (31%) other states of the Mexican Republic 36 (6%). Lambed at home 117 (20%), 52 bath home (9%), toilet bowl 29 (5%), car 128 (22%), road 58 (10%), hospital admission 104 (18%), Ambulance 42 (7%) Other 52 (9%). CONCLUSION: In our study we observed that 79% of the newborns were healthy. They are the third leading cause of admission to Neonatal Intensive Care Unit External. The most common neonatal complications were solved without consequence. No neonatal mortality cases were founded.


Assuntos
Parto Domiciliar/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Masculino , México , Gravidez , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
19.
Kidney Int Suppl ; (116): S2-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20186176

RESUMO

The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community screening program aimed at early detection of kidney disease among high-risk individuals. A pilot phase of KEEP México began in 2008 in México City and Jalisco State. Adults with diabetes, hypertension, or family history of diabetes, hypertension, or chronic kidney disease (CKD) were invited to participate through advertising campaigns. All participants completed a questionnaire. Blood pressure, weight, and height were measured; blood and urine tests included albuminuria and serum creatinine to estimate glomerular filtration rate using the Modification of Diet in Renal Disease Study equation. Mean age of KEEP México City and KEEP Jalisco participants was 46 and 53 years, respectively; >70% were women. CKD prevalence was 22% in KEEP México City and 33% in KEEP Jalisco, not significantly different from reported KEEP US prevalence of 26%. CKD stages 1 and 2 were more frequent in KEEP México and stage 3 in KEEP US. In KEEP México City, CKD prevalence was higher than the overall prevalence among participants with diabetes (38%) or diabetes and hypertension (42%). Most KEEP México participants were unaware of the CKD diagnosis, despite that 71% in KEEP México City had seen a doctor in the previous year. CKD is highly prevalent, underdiagnosed, and underrecognized among high-risk individuals in México. KEEP is an effective screening program that can successfully be adapted for use in México.


Assuntos
Falência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Falência Renal Crônica/diagnóstico , Masculino , Programas de Rastreamento , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia
20.
Am J Kidney Dis ; 55(3): 474-84, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19850389

RESUMO

BACKGROUND: Chronic kidney disease (CKD) is a major cause of morbidity and mortality in Mexico. However, many residents of underserved areas may be unaware that they potentially are affected. STUDY DESIGN: In an observational cross-sectional study, we examined the diagnostic yield of screening for CKD and cardiovascular disease risk factors using mobile units that traveled to poor communities in Jalisco, Mexico. SETTING & PARTICIPANTS: We excluded individuals who were aware that they had CKD and those < 18 years of age. OUTCOMES: Glomerular filtration rate, cardiovascular risk. MEASUREMENTS: Demographic data, socioeconomic status, blood pressure, fasting glucose, and dipstick urinalysis. RESULTS: 3,734 participants; 29.3% men and mean age of 57.4 +/- 13.0 years. Most (99.7%) had no history of cardiovascular disease; however, 43.5% had a history of diabetes, 11.4% had dipstick-positive proteinuria, 62.0% had blood pressure in the hypertensive range, and 15.8% had an estimated glomerular filtration rate compatible with stages 3-5 CKD. In patients with no history of cardiovascular disease, proportions with predicted 5-year risks of new cardiovascular events <5%, 5%-10%, 10.1%-20%, 20.1%-30%, and >30% were 10.0%, 11.7%, 26.6%, 20.7%, and 30.9%, respectively. Screening 18 participants aged < 40 years would be expected to detect 6 new cases of hypertension or 2 new cases of diabetes. LIMITATIONS: Data may not be generalizable to all low-income settings or other regions of Mexico. CONCLUSIONS: Impaired kidney function, proteinuria, and cardiovascular risk factors were detected frequently when mobile units were used to perform screening in poor areas of Jalisco, Mexico. This suggests that trials of targeted screening and intervention are feasible and warranted.


Assuntos
Doenças Cardiovasculares/diagnóstico , Nefropatias/diagnóstico , Unidades Móveis de Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doença Crônica , Estudos Transversais , Feminino , Humanos , Nefropatias/epidemiologia , Masculino , México , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
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