Age of sitting unsupported and independent walking in very low birth weight preterm infants with normal motor development at 2 years.

AIMS: The aims of this study is to (i) determine the age of sitting unsupported and independent walking in preterm infants with birth weight under 1500 g (very low birth weight, VLBW); (ii) estimate differences between VLBW children and a reference population and (iii) estimate the association between clinical characteristics and late age at sitting and walking. METHODS: A longitudinal study was conducted of a cohort of 876 children with VLBW. The World Health Organization (WHO) motor development study population was used as a reference. Ages for both skills were established by interview with parents. Means were compared with t-test, ANOVA and Bonferroni adjustment where appropriate. RESULTS: The inclusion criteria were complied with 694 patients; 50% of VLBW sat at 7 m corrected age (CA) and walked at 13 m CA. Both motor skills were acquired later (7.3 +/- 1.5 and 13.6 +/- 2.8 m) compared with the control group (6 +/- 1.1 and 12.1 +/- 1.8 m). Weight or head circumference at birth below the 10th percentile or the presence of bronchopulmonary dysplasia were associated with delayed acquisition of both skills. CONCLUSION: Very low birth weight infants typically sit unsupported and walk later than term infants. Tables describing reference values for milestones acquisition for different categories of infants (gestational age, birth weight and other determinants) may contribute to inform the decision making process on access to available resources.

[Tracheopatia osteochondroplastica. A case report]. / Traqueopatía osteocondroplástica. A propósito de un caso.

Tracheoplastia osteoplastica is a rare benign disease of the trachea and major bronchi that is characterized by bony and cartilaginous submucosal nodules covered by normal mucosa. Localized lesions rarely produce clinical manifestations and most symptomatic patients have extensive, diffuse lesions. The bronchoscopic findings are typical and the diagnosis is confirmed by biopsy. We report a case of tracheopathia osteoplastica diagnosed by bronchoscopy in a 64-year-old woman.

[Effect of freezing on the "creamatocrit" measurement of the lipid content of human donor milk]. / Medida por crematocrito del contenido calórico de la leche materna donada congelada.

OBJECTIVE: To determine, by the creamatocrit measurement, the effect on the fat content of raw and pasteurized donor milk of freezing during 3 months at -20 °C. METHODS: The evolution of the creamatocrit measurement (following Lucas technique) on frozen (-20 °C), raw and pasteurized human milk, was analyzed during 3 months. RESULTS: The fat content of raw milk (n=44) was 3.19 g/dl at the beginning and 2.86 g/dl after 3 months frozen (p=0.02). In pasteurized milk (n=36) fat content at the first determination was 2.59 g/dl and 2.20 g/dl after 1 month frozen (p=0.01). Afterwards there were no significant changes up to 3 months frozen. Variability was observed in the intermediate values. CONCLUSIONS: A reduction on the fat content measurement of raw and pasteurized donor human milk after freezing was observed. Freezing does not inactivate the milk lipase but does destroy the fat globule. Creamatocrit measurement may not be the best method to determine the fat content of processed human milk.

XV Congreso SEINAP. Cómo se pone en marcha y cómo funciona un banco de leche. Experiencia del Hospital 12 de Octubre / XV Congreso SEINAP. How a milk bank is initiated and how it works. Experience of the Hospital 12 de Octubre

No disponible

Dudas sobre la justificación del cribado universal de la infección por citomegalovirus en prematuros de menos de 1.500g / No disponible

No disponible

Incoherencia entre el nivel asistencial de las Unidades Neonatales y los pacientes atendidos / Inconsistency between the level of care in Neonatal Units and the patients in care

No disponible

Medida por crematocrito del contenido calórico de la leche materna donada congelada / Effect of freezing on the "creamatocrit" measurement of the lipid content of human donor milk

OBJETIVO: Determinar, mediante crematocrito, las modificaciones del contenido graso de la leche materna cruda y pasteurizada a lo largo de 3 meses de congelación. MÉTODO: Se analizó la evolución del crematocrito (fórmula de Lucas) en leche cruda y pasteurizada a lo largo de 3 meses de congelación a −20°C. RESULTADOS: La grasa en leche cruda (n=44) fue 3,19g/dl al inicio y 2,86g/dl a los 3meses de congelación (p = 0,02). En leche pasteurizada (n=36), al inicio fue 2,59g/dl y 2,20g/dl al mes de congelación (p = 0,01), posteriormente, hasta los 3 meses, no hubo cambios significativos. Se observó variabilidad en los valores intermedios. CONCLUSIONES: Se observó una disminución en la medida de la grasa tras congelación en leche cruda y pasteurizada. La congelación no impide la acción de la lipasa y también afecta al glóbulo de grasa. Probablemente, el crematocrito no sea el método óptimo para cuantificar la grasa en leche ya procesada

OBJECTIVE: To determine, by the creamatocrit measurement, the effect on the fat content of raw and pasteurized donor milk of freezing during 3 months at −20 °C. METHODS: The evolution of the creamatocrit measurement (following Lucas technique) on frozen (−20 °C), raw and pasteurized human milk, was analyzed during 3 months. RESULTS: The fat content of raw milk (n=44) was 3.19 g/dl at the beginning and 2.86 g/dl after 3 months frozen (p = 0.02). In pasteurized milk (n=36) fat content at the first determination was 2.59 g/dl and 2.20 g/dl after 1 month frozen (p = 0.01). Afterwards there were no significant changes up to 3 months frozen. Variability was observed in the intermediate values. CONCLUSIONS: A reduction on the fat content measurement of raw and pasteurized donor human milk after freezing was observed. Freezing does not inactivate the milk lipase but does destroy the fat globule. Creamatocrit measurement may not be the best method to determine the fat content of processed human milk

[Visceral leishmaniasis and AIDS. Apropos of 2 cases with different clinical course patterns]. / Leishmaniasis visceral y SIDA. A propósito de dos casos con patrón clínico-evolutivo distinto.

We present two cases of visceral leishmaniasis in patients with AIDS which represent two different clinical patterns of the disease. Special emphasis is made on the need to lavish bone marrow studies in those patients with AIDS who present fever of unknown origin since immunodepression can modify the classical clinical picture of the disease. According to our experience, visceral leishmaniasis should be included amongst the infections indicative of AIDS in patients with HIV infection.

[Immunotherapy with an oral Alternaria extract in childhood asthma. Clinical safety and efficacy and effects on in vivo and in vitro parameters]. / Inmunoterapia con un extracto oral de Alternaria en el asma infantil. Eficacia clínica, seguridad, repercusiones sobre parámetros in vivo e in vitro.

Studies of immunotherapy with oral Alternaria extracts are scarce. We decided to perform a clinical trial of the clinical safety and efficacy of this extract as well as of its effects on in vivo and in vitro parameters in 39 patients with Alternaria allergy, aged between 7 and 17 years, who are also sensitized extract was used. Allergic activity was determined through RAST inhibition and skin prick test. Quantification of the principal allerten (Alt a 1) was performed through the 2-site binding assay, with a mean content of 34.2 ng Alt a 1/micro g protein. The parameters analyzed were the symptom-medication score, skin prick using the end-point technique, specific bronchial challenge test, peak flow, total and specific IgE and IgG4. Nineteen patiens received active treatment with oral immunotherapy and another 19 received symptomatic treatment. The initial phase of immunotherapy lasted 3 months until the maximum dose was reached. This was maintained for 12 months; the mean accumulated dos was 280,000 PNU. Significant differences were found in reduction in the symptom-medication score in the treated group after 12 months of immunotherapy. No differences were found in the control group. Immunotherapy was well tolerated with 0.42 adverse reactions per 100 doses administered. All adverse reactions were mild-to-moderate. In the treated group, papule size was significantly reduced. Values for the specific bronchial challenge test, expressed through PD20, were significantly higher in the immunotherapy group. Peak flow showed no changes in either group. Values of IgG4 were significantly higher in the immunotherapy group. Total and specific IgE levels showed no significant changes in either group. In conclusion, oral immunotherapy with Alternaria extract is clinically effective in pediatric patients. In general, the therapy was well tolerated. It modified specific cutaneous and bronchial reactivity in our sample and increased levels of specific IgG4, wich are implicated in humoral response.

Puesta en marcha del banco de leche materna donada en una unidad neonatal / Setting up a donor milk bank within a neonatal unit

La leche materna es el alimento de elección para todos los recién nacidos. Cuando no hay suficiente leche de madre propia, la leche donada es la mejor alternativa. Hay numerosos bancos de leche en Europa, Estados Unidos, Australia, Centroamérica y Sudamérica. En 2007 abrió sus puertas el segundo banco de leche humana del Hospital 12 Octubre (BLHDO) de España, en su Servicio de Neonatología. No hay recomendaciones internacionales acerca del funcionamiento de un banco de leche, pero internacionalmente hay varias asociaciones de bancos de leche, cada una con sus guías de actuación; en el BLHDO se decidió seguir el modelo brasileño, ya que aporta parámetros de calidad, y no sólo de seguridad de la leche, comunes con la industria alimentaria. Al no haber legislación que regule la donación de leche se siguen las guías de otros bancos de leche y se han establecido sistemas de seguridad y de trazabilidad igual de estrictos que para la donación de sangre. En este artículo se comentan los distintos procedimientos que se llevan a cabo en el BLHDO, la experiencia de este primer año y los proyectos futuros de éste (AU)

Breast milk is the best choice to feed premature and ill babies, but when there is not enough mother milk available donor breast milk is the best alternative. Nowadays, Milk Banks are present worldwide. In December 2007 the second Spanish Milk Bank opened within the Department of Neonatology of the Hospital 12 Octubre, Madrid (BLHDO). There are no international recommendations for processing breast milk, therefore other Milk Banks guidelines are the only standards to follow. BLHDO uses the Brazilian model as they focus on milk quality, in addition to safety issues. Lack of legislation for human milk processing in Spain has led to BLHDO complying with Spanish Law on blood and tissues donation with its strict regulations on safety issues and record keeping. This article summarises the first year of operating the BLHDO and its future projects and developments (AU)

Inmunoterapia con un extracto oral del Alternaria en el asma infantil. Eficacia clínica, seguridad, repercusines sobre parámetros in vivo e in vitro / Immunotherapy with an oral Alternaria extract in chilhood asthma. Clinical safety and efficacy and effects on in vivo and in vitro

Ante la escasez de trabajos con inmunoterapia oral de Alternaria, planteamos la realización de un ensayo clínico en 39 pacientes, con edades comprendidas entre 7 y 17 años, alérgicos a Alternaria, y sensibilizados también a pólenes y epitelios para evaluar su eficacia clínica y seguridad, así como las repercusiones sobre parámetros in vivo e in vitro. Se empleó un extracto estandarizado, determinando la actividad alérgica mediante RAST inhibición y prick test cutáneo. La cuantificación del alergeno principal (Alt a 1) se llevó a cabo mediante la técnica de fijación en dos lugares, siendo el contenido medio de 34,2 ng Alt a 1/ g de proteína. Los parámetros analizados fueron la puntuación de síntomas-medicación, prick test cutáneo a punto final (TC), test de bronco provocación específico (TBPE), pico de flujo (PF), IgE total y específica e IgG4.Diecinueve pacientes recibieron tratamiento activo con inmunoterapia oral (ITO) y otros diecinueve recibieron tratamiento sintomático. La fase de inicio de la inmunoterapia duró 3 meses, hasta llegar a dosis máxima, que se mantuvo durante 12 meses, alcanzando una dosis acumulada media de 280.000 PNU. Se hallaron diferencias significativas en la disminución de la puntuación de síntomas-medicación en el grupo tratado, tras los 12 meses de inmunoterapia (ITO). No se encontraron diferencias en el grupo control. La inmunoterapia fue bien tolerada, presentando 0,42 reacciones adversas (RA) por 100 dosis administradas, siendo de carácter leve-moderado exclusivamente. Se encontró disminución significativa del tamaño de pápula en el grupo tratado. El TBPE expresado mediante la PD20 mostró cifras significativamente más altas en el grupo con ITO. El pico de flujo no mostró cambios en ninguno de los dos grupos. Los valores de la IgG4 fueron significativamente más altos en el grupo con inmunoterapia. Los niveles de IgE total y específica no mostraron cambios significativos en ambos grupos. En conclusión, la Inmunoterapia Oral con extracto de Alternaria ha demostrado eficacia clínica en pacientes pediátricos, siendo en general bien tolerada, modificando la reactividad específica cutánea y bronquial con incremento de los niveles de IgG4 específica implicados en la respuesta humoral (AU)

Studies of immunotherapy with oral Alternaria extracts are scarce. We decided to perform a clinical trial of the clinical safety and efficacy of this extract as well as of its effects on in vivo and in vitro parameters in 39 patients with Alternaria allergy, aged between 7 and 17 years, who are also sensitized extract was used. Allergic activity was determined through RAST inhibition and skin prick test. Quantification of the principal allerten (Alt a 1) was performed through the 2-site binding assay, with a mean content of 34.2 ng Alt a 1/μg protein. The parameters analyzed were the symptom-medication score, skin prick using the end-point technique, specific bronchial challenge test, peak flow, total and specific IgE and IgG4. Nineteen patiens received active treatment with oral immunotherapy and another 19 received symptomatic treatment. The initial phase of immunotherapy lasted 3 months until the maximum dose was reached. This was maintained for 12 months; the mean accumulated dos was 280,000 PNU. Significant differences were found in reduction in the symptom-medication score in the treated group after 12 months of immunotherapy. No differences were found in the control group. Immunotherapy was well tolerated with 0.42 adverse reactions per 100 doses administered. All adverse reactions were mild-to-moderate. In the treated group, papule size was significantly reduced. Values for the specific bronchial challenge test, expressed through PD20, were significantly higher in the immunotherapy group. Peak flow showed no changes in either group. Values of IgG4 were significantly higher in the immunotherapy group. Total and specific IgE levels showed no significant changes in either group. In conclusion, oral immunotherapy with Alternaria extract is clinically effective in pediatric patients. In general, the therapy was well tolerated. It modified specific cutaneous and bronchial reactivity in our sample and increased levels of specific IgG4, wich are implicated in humoral response (AU)