Ingestão de açúcar por crianças com dificuldades alimentares menores de 2 anos - estudo em um centro de referência brasileiro / Sugar intake by children with eating difficulties under2 years of age - study in a Brazilian reference center

Introdução: os primeiros anos de vida são essenciais para o crescimento e o desenvolvimento. A criança já nasce com a preferência pelo sabor doce, e ao consumir preparações açucaradas, propicia--se uma alimentação de baixa qualidade nutricional. O objetivo do estudo é descrever a ingestão de alimentos que contenham açúcar por crianças com dificuldades alimentares menores de 2 anos atendidas em um centro especializado. Material e métodos: trata-se de um estudo observacional retrospectivo, com dados obtidos do prontuário de crianças de ambos os sexos, atendidas no Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), localizado no município de São Paulo. Dentre os alimentos consumidos foram selecionados aqueles que continham açúcar de adição em sua composição. Para categorizar os alimentos foi usada a classificação da What We Eat in America (WWEIA). Resultados: participaram do estudo 31 crianças com dificuldades alimentares, 77,4% apresentaram consumo de pelo menos um alimento contendo açúcar. Os alimentos mais consumidos foram biscoitos e brownies, bolos e tortas, milk-shakes e outras bebidas lácteas. Discussões e Conclusão: a fase de alimentação complementar pode se tornar um grande desafio para os pais e cuidadores, a mesma foi o ponto de partida para a maioria das crianças com dificuldade alimentares. O aprendizado do comer é um processo complexo que exige aquisição de habilidades na oferta de alimentos adequados e variados, contudo, o contexto se torna favorável com as práticas inadequadas, sendo uma delas a permissão do consumo de alimentos e produtos adoçados pelas mesmas.

Introduction: the first years of life are essential for growth and development. Children are born with a preference for sweet tastes, and through sugary consumption, they are provided with a diet of low nutritional quality. The objective of the study is to describe the intake of foods containing sugar by children with eating difficulties under 2 years of age treated in a specialized center. Material and methods: this is a retrospective observational study, with data obtained from the medical records of children of both sexes, attended at the Center for Excellence in Nutrition and Eating Difficulties (CENDA), located in the city of São Paulo. Among the foods consumed, those that contained added sugar in their composition were selected. To categorize foods, the What We Eat in America (WWEIA) classification was used. Results: 31 children with eating difficulties participated in the study, 77.4% consumed at least one food containing sugar. The most consumed foods were cookies and brownies, cakes and pies, milkshakes and other dairy drinks. Discussions and Conclusion: the complementary feeding phase can become a great challenge for parents and caregivers, as it was the starting point for the majority of children with eating difficulties. Learning to eat is a complex process that requires the acquisition of skills in offering adequate and varied foods. However, the context becomes favorable to inappropriate practices, one of which is allowing the consumption of sweetened foods and products, for the same reasons.

Postbióticos: un nuevo miembro en la familia de los bióticos / Postbiotics: A new member in the biotics family

Los postbióticos fueron definidos en 2021 por la Asociación Científica Internacional de Probióticos y Prebióticos (ISAPP) como "una preparación de microorganismos inanimados y/o sus componentes celulares capaces de conferir un efecto benéfico al hospedador". El campo de los postbióticos es un área nueva dentro de la familia de los bióticos; se han desarrollado ya numerosos productos con aplicaciones clínicas, como la estimulación inmunológica, el manejo de diarreas en niños y adultos, el abordaje del intestino irritable, además de tres fórmulas infantiles. En particular, las fórmulas infantiles con postbióticos obtenidos a partir de la fermentación de la leche con Bifidobacterium breve C50 y Streptococcus thermophilus O65, y sus metabolitos, incluido el oligosacárido 3'-GL, han demostrado seguridad y contribución al desarrollo de la microbiota intestinal y el sistema inmune asociado al intestino. Estas modificaciones contribuyen a la prevención y el manejo de los trastornos funcionales digestivos del lactante.

Postbiotics were defined in 2021 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) as a "preparation of inanimate microorganisms and/or their cellular components that confers a health benefit to the host." The field of postbiotics is a new area within the biotics family; numerous products have already been developed for clinical applications, such as immune stimulation, the management of diarrhea in children and adults, the management of irritable bowel syndrome, and 3 infant formulas. In particular, infant formulas with postbiotics obtained from milk fermented with Bifidobacterium breve C50 and Streptococcus thermophilus O65 ­and their metabolites­, including the oligosaccharide 3'-GL, have demonstrated to be safe and to contribute to the development of the gut microbiota and the gutassociated immune system. These modifications help to prevent and manage functional gastrointestinal disorders in infants.

Cost-Effectiveness of Bivalent Respiratory Syncytial Virus Prefusion F (RSVpreF) Vaccine During Pregnancy for Prevention of Respiratory Syncytial Virus Among Infants in Argentina.

INTRODUCTION: Lower respiratory tract illness (LRTI) caused by respiratory syncytial virus (RSV) is common among young children in Argentina. Use of the currently available prophylactic agent is limited to children aged ≤ 2 years with selected high-risk conditions, and thus the majority of infants remain unprotected. We estimated the value-based price (VBP) of a novel RSVpreF vaccine for use among pregnant people for prevention of RSV-LRTI among infants during the first year of life. METHODS: Clinical outcomes and economic costs of RSV-LRTI during infancy and expected impact of RSVpreF vaccination during pregnancy were projected using a population-based Markov-type cohort model. Model results-estimated on the basis of gestational age at birth, disease/fatality rates, and mother's vaccination status-include total numbers of RSV-LRTI cases, RSV-LRTI-related deaths, and associated costs. Base case analyses (RSVpreF vs. no vaccine) were conducted from the healthcare system perspective. Probabilistic sensitivity analyses (PSA; 1000 replications) were also conducted. Willingness-to-pay (WTP) was $10,636 per quality-adjusted life-year (QALY; i.e., 1 × 2021 gross domestic product [GDP] per capita) in base case analyses and PSA. Costs are reported in USD, estimated on the basis of the June 22, 2023 exchange rate. RESULTS: Use of RSVpreF among 342,110 pregnant persons provided protection to 330,079 infants at birth. In total, RSVpreF prevented 3915 RSV hospitalizations, 6399 RSV cases requiring emergency department care, 6182 RSV cases requiring a physician office visit, and 67 disease-related deaths. Direct costs were projected to be reduced by $5.0 million. With 2061 QALYs gained and vaccine administration cost of $1.4 million, the VBP of RSVpreF was estimated to be $74.46 per dose. In PSA, mean VBP was $75.02 (95% confidence interval 54.24-97.30). CONCLUSIONS: RSVpreF among pregnant persons would significantly reduce the clinical and economic burden of RSV-LRTI among infants in Argentina and would be considered a cost-effective intervention up to a price of approximately $75.

Cognitive and motor improvement by tummy time practice in preemies from low-income settings: a randomized clinical trial.

Introduction: Early intervention and parental education for preemies are limited in some low-income countries. Thus, this study aimed to assess whether daily tummy time (TT) associated with usual care (UC) enhances motor and cognitive development in preemies from low-income countries. The main and secondary aim was to assess prone head elevation (PHE) and motor and cognitive functions, respectively. Methods: Thirty-one preemies with a mean gestational age at birth of 33.3 ± 1.6 weeks and weighing <2,500 g were included and 18 completed all assessments. Parents from the TT group were asked to perform TT with their preemies for at least 20 min during daily activities and playtime. Motor and cognitive functions were assessed by a blinded examiner using the motor and cognitive composite scores of Bayley-III after two and four months of corrected age. PHE was given by the angle from the tragus of the ear to the supporting surface of the infant; measurements were obtained using the Kinovea® software at baseline, after two, three, and four months of corrected age. Results: The Bayley-III motor composite score of the TT group was higher than the UC group after two and four months of corrected age. The PHE angle increased over time but did not differ between groups. Discussion: Nevertheless, TT expanded the perspective of preemies to explore their bodies and environment, favoring the stimuli for motor and cognitive patterns. The loss of participants (31%) was one of the limitations of the study, illustrating the challenge of providing continued early interventions to preemies from low-income countries. In this sense, TT practice is a home intervention that may improve motor and cognitive function of preemies immediately after hospital discharge.

Fumonisins in infant cereals marketed as complementary food in Argentina.

Infant cereals are typically the first foods introduced as complementary foods. Cereals used to elaborate complementary foods, such as wheat, maize and rice, are susceptible to mycotoxin contamination. Among mycotoxins, fumonisins have been epidemiologically associated, in humans, with oesophageal cancer, neural tube defects and stunting. Fumonisins have been found in maize and wheat grains in Argentina. In the present study, a survey was conducted to determine their occurrence in 82 wheat-based and multicereal-based infant cereal items collected from retail stores in Rio Cuarto, Argentina, using HPLC-MS. Of these samples, 84% showed FBs contamination with levels ranging from 0.05 to 992 µg/kg). Although FB1 was the most prevalent fumonisin, FB2 was found at higher levels. Most samples had levels below the limit of 200 µg/kg set for Argentinean cereal products for children. The outcome of this survey provides information on the naturally presence of fumonisin in infant cereal intended for children in Argentina, which can be helpful to consider relevant monitoring programmes.

Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis.

Objective: To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis. Data sources: We searched PubMed, Embase, and Cochrane Central in May 2023. Study selection: The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models. Data synthesis: We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine. Conclusion: non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment. PROSPERO: CRD42023421814.

Multicystic encephalopathy: an ultimate manifestation of ischemic-hypoxic injury.

Multicystic encephalopathy is a rare neurological finding characterized by the appearance of multiple cystic or cavitary lesions as the result of repetitive episodes of hypoxic-ischemic injury in neonates and infants. We present a rare case of multicystic encephalopathy in a 3-month-old male, born at 34 weeks with Tetralogy of Fallot and multiple comorbidities. Gross examination of the brain during the autopsy revealed multiple irregular cystic lesions and distortion of the brain parenchyma. This case report highlights the uniqueness of multicystic encephalopathy and offers an extensive review of the existing literature, including etiology, clinical presentation, and histopathologic findings.

Evaluation of statistical process control charts for infant mortality monitoring in Brazilian cities with different population sizes.

OBJECTIVES: The control chart is a classic statistical technique in epidemiology for identifying trends, patterns, or alerts. One meaningful use is monitoring and tracking Infant Mortality Rates, which is a priority both domestically and for the World Health Organization, as it reflects the effectiveness of public policies and the progress of nations. This study aims to evaluate the applicability and performance of this technique in Brazilian cities with different population sizes using infant mortality data. RESULTS: In this article, we evaluate the effectiveness of the statistical process control chart in the context of Brazilian cities. We present three categories of city groups, divided based on population size and classified according to the quality of the analyses when subjected to the control method: consistent, interpretable, and inconsistent. In cities with a large population, the data in these contexts show a lower noise level and reliable results. However, in intermediate and small-sized cities, the technique becomes limited in detecting deviations from expected behaviors, resulting in reduced reliability of the generated patterns and alerts.

Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study.

Objective: To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants. Methods: Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models. Results: The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates. Conclusion: No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.

Errores en la interpretación de la radiografía de tórax en el lactante: ¿qué tenemos que saber de la técnica? / Errors in the Interpretation of chest X-rays in Infants: what do we need to know about the technique?

La radiografía de tórax sigue siendo fundamental para la evaluación de patologías torácicas en lactantes. Antes de iniciar su interpretación, muchos autores sugieren revisar la técnica radiológica, ya que a esta edad se presentan varias particularidades técnicas que deben tenerse en cuenta para evitar errores interpretativos y no confundir hallazgos técnicos con patologías. Entre estas particularidades técnicas se deben evaluar: el centraje transversal o rotación, el centraje longitudinal o posición lordótica, el grado de inspiración, la posición de la vía aérea superior, la penetración o exposición de la radiografía, tipos de proyecciones y el movimiento. El objetivo de esta revisión es comentar y ejemplificar las peculiaridades técnicas que presenta la radiografía de tórax en lactantes y que pueden llevar a interpretaciones erróneas.

The chest X-ray remains essential for evaluating thoracic pathology in infants. Before beginning its interpretation, many authors recommend assessing the radiographic technique, as several technical peculiarities must be considered at this age to avoid interpretive errors and prevent mistaking technical artifacts for pathology. The technical aspects to be evaluated include transverse centering or rotation, longitudinal centering or lordotic position, degree of inspiration, upper airway positioning, radiograph penetration or exposure, projection types, and movement. The objective of this review is to discuss and illustrate the technical peculiarities of infant chest X-rays that can lead to erroneous interpretations.

Hallazgo incidental de hernia de Amyand en un lactante de 10 meses de edad con antecedente de prematuridad extrema: Presentación de caso y propuesta de manejo / Incidental finding of Amyand's hernia in a 10-month-old infant with a history of extreme prematurity: Case report and proposed management

Introducción. La hernia de Amyand es una condición en la que el apéndice cecal está contenido dentro del saco herniario inguinal. Su diagnóstico y su manejo continúan siendo un reto al tratarse de una patología poco frecuente. Caso clínico. Lactante varón de 10 meses con antecedente de prematuridad extrema, quien presentó hernia de Amyand derecha con apéndice normal. Se retornó el apéndice a la cavidad y se procedió a la reparación de la hernia. Resultado. Después de un año de seguimiento, el paciente no presentó complicaciones. Conclusiones. Se ha reportado que el riesgo de incarceración en niños nacidos a término es del 12 % y en prematuros del 39 %, por tanto, la reparación quirúrgica de una hernia inguinal siempre es necesaria. No existe un tratamiento estándar para la hernia de Amyand en niños, por tanto, la clasificación CiX podría considerarse para el manejo. Se presenta una propuesta de tratamiento en la población pediátrica, donde se incluyeron 3 tipos, considerando el estadio evolutivo del apéndice cecal y que casi la totalidad de hernias inguinales en niños son debidas a persistencia del proceso vaginal, por tanto, el tratamiento quirúrgico solo incluye herniotomía. Al no utilizar material protésico, se facilita el manejo y se reduce el riesgo de infección.

Introduction. Amyand's hernia is a condition in which the cecal appendix is contained within the inguinal hernia sac, its diagnosis and management continue to be a challenge as it is a rare pathology. Case report. A 10-month-old male infant with a history of extreme prematurity presented a right Amyand's hernia and a normal appendix. The appendix was returned to the cavity and the hernia was repaired. Result. After one year of follow-up, the patient had no complications. Conclusions. Has been reported that the risk of incarceration in full-term children is 12% and in premature babies it is 39%, therefore, surgical repair of an inguinal hernia is always necessary. There is no standard treatment for Amyand hernia in children, therefore the CiX classification could be considered for management. A treatment proposal is presented in the pediatric population, where three types were included, considering the evolutionary stage of the cecal appendix and that almost all inguinal hernias in children are due to persistence of the vaginal process; therefore, surgical treatment only includes herniotomy. By not using prosthetic material, handling is facilitated and the risk of infection is reduced.

Newborn pulse oximetry screening coverage in a nationwide complex survey sample: An assessment of a congenital heart disease early detection program at the regional level in Brazil.

OBJECTIVES: To estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results. METHODS: Coverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance. RESULTS: The POS coverage was 66.3 % (95 %CI: 65.5-67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7-79.5) versus 61.1 % (60.2-62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7-70.1) was lower than that in the South (82.5 %, 79.4-85.6) and the Southeast (81.5 %, 79.3-83.6); it was even lower in SUS in the North (44.0 %; 42.4-45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2-59.1) to 64.6 % (63.3-65.9). The proportion of positive screening tests was 9.2 % (8.9-9.5) in SUS and 7.8 % (7.3-8.3) in PFHs, of which 40.8 % (40.5-41.1) underwent complementary exams in SUS and 57.2 % (56.7-57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests. CONCLUSIONS: Inequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.

Dissecting Cellulitis and Alopecic and Aseptic Nodules of the Scalp in Pediatric Patients: An Atypical Age of Presentation Observed in Two Cases.

Dissecting cellulitis of the scalp (DCS) is a rare inflammatory condition that progresses from papules and pustules to nodules and abscesses, ultimately leading to cicatricial alopecia. It primarily affects African men between the ages of 15 and 62, with exceptionally low prevalence in children. A milder form, described as "alopecic and aseptic nodules of the scalp" (AANS), presents as aseptic nodules associated with non-scarring alopecia and has a good prognosis. We report two atypical cases of DCS in Hispanic pediatric patients: an 18-month-old female infant and an 11-year-old male child who had a rapid and favorable clinical resolution consistent with AANS.

Theophylline impact on weaning in oxygen-dependent infants followed in an outpatient Kangaroo Program.

Background: Theophylline was an orally administered xanthine used for treatment of apnea of prematurity and Bronchopulmonary Dysplasia in ambulatory follow-up of Low-Birth-Weight infants (LBWI) with oxygen-dependency in the outpatient Kangaroo Mother Care Program (KMCP). Theophylline's main metabolic product is caffeine; therefore, it was an alternative due to the frequent lack of ambulatory oral caffeine in low and middle-income countries. Objective: To assess the effectiveness of oral theophylline in decreasing days with oxygen and to describe frequency of adverse related events. Methods: Quasi-experiment before and after withdrawal of theophylline given systematically to LBWI with ambulatory oxygen in two KMCPs. Results: 729 patients were recruited; period 1: 319 infants when theophylline was given routinely and period 2: 410 infants when theophylline was no longer used. The theophylline cohort had less gestational age, less weight at birth, more days in Neonatal Intensive Care Unit, more days of oxygen-dependency at KMCP admission, and more frequencies of Intrauterine Growth Restriction and apneas. After adjusting with propensity score matching, multiple linear regression showed that nutrition was associated with days of oxygen-dependency, but theophylline treatment not. No differences were found in frequencies of readmissions up to 40 weeks, intraventricular hemorrhage or neurodevelopmental problems. Participants in period 2 had more tachycardia episodes. Conclusions: We did not find association between oral theophylline treatment and the reduction of days with ambulatory oxygen. For the current management of oxygen-dependency in LBW infants, the importance of nutrition based on exclusive breast feeding whenever possible, is the challenge.

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories.

BACKGROUND: There is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF. METHODS: Women of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels. RESULTS: Hospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding. CONCLUSIONS: The cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

[Contribution of the Ibero-American Academy of Neuropediatrics to the knowledge of self-limited epilepsy in infants]. / Aporte de la Academia Iberoamericana de Neuropediatría al conocimiento de la epilepsia autolimitada del lactante.

Since the first presentation at the IV Iberoamerican Academy of Neuropediatrics Congress in 1995, our group has studied self-limited infantile epilepsy (SeLIE), both familial and non-familial, corroborating that they belong to the same entity due to their clinical and electroencephalographic characteristics and excellent prognosis. Associations were found with paroxysmal dyskinesias and migraine, as well as with hemiplegic migraine, episodic ataxia and intellectual disability in atypical cases. Mutations in PRRT2 are the main cause of SeLIE, however, other genes, such as SCN2A, KCNQ2-3 and SCN8A, have been recognized. Drugs for focal seizures that act on sodium channels are indicated. In emergencies, during cluster seizures, the use of benzodiazepines is important. In this publication, we review our contribution in SeLIE from our first report to the present and review the existing literature on the subject.

Desde la primera presentación en el IV Congreso de la Academia Iberoamericana de Neurología Pediátrica en 1995, nuestro grupo ha estudiado las epilepsias autolimitadas del lactante (EAL), tanto familiares y no familiares, corroborando que pertenecen a una misma entidad por sus características clínicas, electroencefalográficas y excelente pronóstico. Se encontraron asociaciones con discinesias paroxísticas y migraña, como también con la migraña hemipléjica, la ataxia episódica y la discapacidad intelectual en casos atípicas. Las mutaciones en PRRT2 son la principal causa de EAL. Sin embargo, otros genes, como SCN2A, KCNQ2-3 y SCN8A, han sido reconocidos. Los fármacos para las crisis focales que actúan sobre los canales de sodio son los indicados. En emergencias, durante las convulsiones agrupadas, es importante el uso de benzodiacepinas. En esta publicación, hacemos un recorrido de nuestro aporte en EAL desde nuestra primera contribución hasta la actualidad y además realizamos una revisión de la literatura existente sobre el tema.

Genome sequences of 70 multidrug-resistant Gram-negative isolates in high-risk neonates in the Northeast of Mexico.

Infections by multidrug-resistant pathogens are steadily increasing worldwide. A considerable proportion of neonatal intensive care admissions have a bacterial infection with multidrug-resistant bacteria during their hospital stay. In this work, we report draft genome sequences of 70 selected isolates from high-risk neonates in the Northeast of Mexico.

Validation of the Dutch Infant Crying and Parent Well-Being Screening Tool in Parents of Infants Less than 12 Months of Age.

OBJECTIVE: To evaluate reliability and validity of the Dutch version of the Infant Crying and Parent Well-Being (ICPW) tool in identifying parents struggling with infant crying in the first year of life. STUDY DESIGN: The original ICPW tool was translated into Dutch following established guidelines. The internal consistency and criterion validity of the Dutch ICPW tool were evaluated using a cross-sectional design. The translated ICPW tool and validated questionnaires on parental depression, stress, anxiety, and parenting balance were presented to parents of infants under 12 months during child health care visits and online. RESULTS: The survey was completed by 488 parents, 400 mothers and 88 fathers. Of these, 172 participated after a child health care visit and 316 via online platforms. The Dutch ICPW showed satisfactory internal consistency (α = 0.69) and excellent criterion validity with parental mental health measures (r = 0.53-0.85). ICPW scores demonstrated positive correlations with parental depression, stress, and anxiety levels, and a negative correlation with parenting balance. Both mothers and fathers with a positive ICPW screen (≥3) reported significantly higher levels of parental mental health issues compared with those with a negative screen (P < .001). The ICPW was positive in 32% of the parents (n = 155), with consistent total scores regardless of the infant's increasing age (r = -0.024, P = .59). The ICPW tool exhibited a strong negative predictive value (93%) for diagnosing postpartum depression. CONCLUSIONS: The Dutch ICPW tool is a reliable and valid screening instrument for identifying parents struggling with infant crying.

Supplemental Iron and Recombinant Erythropoietin for Anemia in Infants Born Very Preterm: A Survey of Clinical Practice in Europe.

OBJECTIVES: To survey practices of iron and recombinant human erythropoietin (rhEpo) administration to infants born preterm across Europe. STUDY DESIGN: Over a 3-month period, we conducted an online survey in 597 neonatal intensive care units (NICUs) of 18 European countries treating infants born with a gestational age of <32 weeks. RESULTS: We included 343 NICUs (response rate 56.3%) in the survey. Almost all NICUs (97.7%) routinely supplement enteral iron, and 74.3% of respondents to all infants born <32 weeks of gestation. We found that 65.3% of NICUs routinely evaluate erythropoiesis and iron parameters beyond day 28 after birth. Most NICUs initiate iron supplementation at postnatal age of 2 weeks and stop after 6 months (34.3%) or 12 months (34.3%). Routine use of rhEpo was reported in 22.2% of NICUs, and in individual cases in 6.9%. RhEpo was mostly administered subcutaneously (70.1%) and most frequently at a dose of 250 U/kg 3 times a week (44.3%), but the dose varied greatly between centers. CONCLUSIONS: This survey highlights wide heterogeneity in evaluating erythropoietic activity and iron deficiency in infants born preterm. Variation in iron supplementation during infancy likely reflects an inadequate evidence base. Current evidence on the efficacy and safety profile of rhEpo is only poorly translated into clinical practice. This survey demonstrates a need for standards to optimize patient blood management in anemia of prematurity.

Intersectional configuration of infant mortality due to malnutrition in Colombia: a mini-review.

This mini review delves into the complex issue of mortality linked to malnutrition, highlighting its multifaceted nature beyond just biomedical factors, presenting it as an intricate intersectional phenomenon. Method: The mini-review methodology involved a systematic literature search across databases like PubMed and Scielo, focusing on malnutrition and infant mortality in Colombia. We used specific keywords and Boolean operators to identify relevant studies, emphasizing socio-economic, gender, and ethnic factors, while excluding non-peer-reviewed and outdated publications. Results: The relationship between gender and food/nutrition has deep historical and cultural roots. Patriarchal norms influence dietary habits based on gender roles, often placing undue responsibility on mothers for children's nutritional health, reflecting profound social intersections. Mortality due to malnutrition is most prevalent among indigenous and Afro-descendant children in rural, conflict-affected areas with limited access to healthcare. Unpaid domestic work restricts women's economic independence, intensifying challenges for single-parent households. Conclusion: A comprehensive understanding can shift institutional attitudes toward mothers, leading to more coherent policy strategies and effective interventions.