Servicio de Neonatologia

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Servicio de Neonatologia

Spain
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Toca M.D.C.,Hospital Nacional Profesor Alejandro Posadas | Tonietti M.,Hospital Of Ninos Ricardo Gutierrez | Vecchiarelli C.,Servicio de Neonatologia
Archivos Argentinos de Pediatria | Year: 2015

Nutrition in early stages of life is one of the most influential environmental factors for the good development of organs and systems and the wellbeing of the child. Epigenetic mechanisms can explain how prenatal and postnatal nutrition affects genes expression with the subsequent risk of immune and metabolic diseases. The objective of this paper is to update the knowledge of the role the nutritional status and dietary practices of pregnant women and the child's feeding patterns over the first year of life have in the risk of future diseases. © 2015, Sociedad Argentina de Pediatria. All rights reserved.


Chirdo F.G.,National University of La Plata | Menendez A.M.,University of Belgrano | Pita Martin De Portela M.L.,Catedra de Nutricion | Sosa P.,Hospital Nacional Prof Dr Alejandro Posadas | And 3 more authors.
Archivos Argentinos de Pediatria | Year: 2011

The composition of human milk is the main base for the development of infant formulas concerning its macronutrients and micronutrients contents and bioactive compounds. Technological advances in the composition of human milk have identified a great number of bioactive compounds such as prebiotics which are responsible for immunological protection and the prevention of different pathologies. In order to achieve similar benefits, they are part of the contents of infant formulas.


Objectives. To analyze growth patterns, tolerance, adherence and incidence of minor digestive disorders and their resolution in infants with modified commercial adapted formula. Patients and methods. A longitudinal, prospective, open-label and controlled study in Primary Health Care. Healthy infants with indication of artificial feeding, group A (Almiron 1, adapted formula) and group B with minor digestive disorders (Almiron Digest, modified formula) were included. Epidemiological and anthropometric variables (weight, length, head circumference, weight/length ratio), digestive disorders, tolerance, adherence and satisfaction survey for parents/professionals in the controls (baseline, at one month, 3 and 6 months) were recorded. Results. From November 2007 to May 2008, 172 pediatricians included 777 infants, 537 in group A (69%) and 240 in group B (31%). Inclusion age of 3.35 weeks ± 3.4 days (42% younger than 1 month); 54% were males. No statistically significant differences were found between groups for epidemiological variables, personal backgrounds or anthropometric parameters in any visit. The growth pattern was adequate according to the reference curves. In the baseline visit, statistically significant differences were observed between groups A and B for regurgitations (236 infants, 22% versus 49.5%), dyschezia (111 infants, 5% versus 35%), cholics in infants (301 infants, 20% versus 81%), constipation (162 infants, 11% versus 43%). Decrease of digestive disorders was significantly greater in group B (p< 0.001) in months 1 and 3. No statistically significant differences were observed for tolerance, adherence or in satisfaction surveys, these being adequate in both groups Conclusions. The growth patterns were adequate in both groups, reaching reference curves at the end of the study. The minor digestive disorders improved in the modified formula group at month 1 and 3 of initiation of its administration. Acceptability and adherence in the modified formula group were very satisfactory.


Trevino-Baez J.D.,Servicio de Neonatologia | Cantu-Cruz J.A.,Servicio de Ginecologia y Obstetricia | Medina-Mercado J.,Servicio de Oncologia Ginecologica | Abundis A.,Servicio de Oncologia Ginecologica
Cirugia y Cirujanos | Year: 2016

Background The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. Objective To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. Material and methods A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. Results The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. Conclusions The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. © 2015 Academia Mexicana de Cirugía A.C.


Although error could be present in almost every medical practice, they are more frequent and potentially more dangerous in neonatal intensive care units (NICU). To determine prescription error rate of intravenous drugs in a Neonatal Intensive Care Unit (NICU), and to describe type of error (dose, dilution, and interval) and medication (antibiotics, inotropics, or analgesics). Observational study including medical records of patients hospitalized in a NICU, receiving any of the above mentioned drugs. Each prescription was compared with one provided by a specific software. Prescription error was defined as >10% of difference between both values. 362 prescriptions from 82 patients were analyzed. An error was observed in 42.5% (95%CI 37.4 - 47.8) of all prescriptions, including 148 (96.1%; 95%CI: 91.3-98.4) antibiotics prescriptions, 5 (3.2%; 95%CI: 1.2-7.7) inotropics prescriptions and 1 (0.7%; 95%CI: 0.01-4.2) analgesics prescriptions. Prescription errors were due to frequency error in 53.8% 95%CI: 45.6-61.8 of cases and to volume error in 46.1% (95%CI: 38.1-54.3). Almost half of the intravenous drugs prescriptions included an error, being more frequently related to interval, followed by dosing; no errors in dilution were detected. Using prescription software could improve patient's safety.


The rate of sudden infant death decreased after the publication of the first guidelines regarding infant sleep position and safe environment in 1992. From 2005 onwards, infant deaths by suffocation, choking or entrapment have increased. Some of them were associated with wedges, positioning devices, and bumper pads. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising, but there is a lack of control over this. We emphasize the important role of health professionals in disseminating the recommendation for a safe infant sleep environment. Key words: sudden infant death syndrome, infant mortality, infant sleep, risk factors, prevention.


Gonzaio Calderon C.,University of Santiago de Chile | Rosario Moore V.,University of Santiago de Chile | Enrica Pittaiuga P.,Servicio de Neonatologia | Potin Marcel S.,University of Santiago de Chile
Revista Chilena de Infectologia | Year: 2011

Preterm neonates less than 1500 gr. or younger than 32 weeks have an increased morbidity and mortality due to infectious diseases. Immunization of these children is critical but is often incomplete and delayed. Objectives: To describe the adherence of scheduled and additional vaccines recommended in pre terms less than 1500 gr. and to compare the level of compliance in two centers. Patients and Methods: Pre matures less than 1500 gr. born between January 2006 and December 2008 in a private center (HCPUC) and in a public health system (HSR) were included. Neonatal charts and follow up records were reviewed. Demographic data, diagnosis, scheduled vaccines, delays and its causes, prescription of additional vaccines were registered. Results: 92 children were included in HCPUC and 246 in HSR. Among these 60-70% respectively had delayed immunizations. The reasons for these were considered not justified in almost 80% of the cases, being the primary reason oversight or lack of parental time. The use of additional vaccines is still low in both centers. Conclusions: Vaccination of pre matures in Chile requires important improvements; education of healthcare personnel and parents, inclusion of modern computerized records and inclusion of new efficacious and safe vaccines in the regular immunization program with no cost to the patient.


Prostaglandin E1 (PGE1) infusion is usually administered for short periods to maintain patency of ductus arteriosus in infants with cyanotic heart disease. Prolonged therapy may be necessary while patients are awaiting surgical treatment. Several side effects occur at the onset of the treatment, most of them reversible once the treatment is discontinued. Cortical hyperostosis is a frequent complication of prolonged PGE1 infusion. Objective is to determine the incidence and severity of cortical hyperostosis in newborn requiring prolonged prostaglandin E1 infusion. 61 newborn babies were admitted in the Neonatal Intensive Care Unit at Bazterrica Clinic, Buenos Aires City, from January 2006 to May 2010. Five newborn received prolonged PGE1 therapy defined as a longer-than-one-week treatment. Four of them had radiologic evidence of cortical hyperostosis and elevated serum alkaline phosphatase. Accurate and rapid diagnosis of this condition is critical to reduce unnecessary laboratory tests and to avoid cardiac surgery canceling. © 2011 Sociedad Argentina de Pediatría.


PubMed | Servicio de Ginecologia y Obstetricia, Servicio de Neonatologia and Servicio de Oncologia Ginecologica
Type: Journal Article | Journal: Cirugia y cirujanos | Year: 2016

The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200.To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results.A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II 200 or greater than this.The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266.The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%.


PubMed | Hospital San Jose, University of Santiago de Chile and Servicio de Neonatologia
Type: Journal Article | Journal: Revista chilena de pediatria | Year: 2016

Recommendations based on current publications are presented for postnatal preterm nutrition, depending on birth weight: less 1000g, between 1000 and 1500g, and above 1500g, as well for the development periods: adaptation, stabilisation, and growth. A review is also presented on the nutritional management of morbidities that affect or may affect nutrition, such as: osteopenia, bronchopulmonary dysplasia, patent ductus arteriosus, red cell transfusion, and short bowel syndrome.

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