The impact of clinical maternal chorioamnionitis on neurological and pshicological sequelae in very-low-birthweight infants: a case-control study

Aims: To assess the relationship between clinically maternal chorioamnionitis and outcome in preterm very-low-birth weight (VLBW) infants. Methods: An observational case-control study was conducted in the neonatology departments of 12 acute care teaching hospitals in Spain. Between January 2004 and December 2006, all consecutive VLBW (F1500 g) infants who were born to a mother with clinical chorioamnionitis were enrolled. The controls included infants who were born to mothers without chorioamnionitis, matched by gestational age, and immediately born after each index case. At a corrected age of 24 months, a neurological examination and a psychological assessment of the surviving children were performed.Results: Sixty-six of the newborn infants died; therefore, 262 infants from the original sample were available for the study. Follow-up data were obtained at a corrected age of 24 months from a total of 209 children (106 cases and 103 controls, 80% of the original sample size). Seventy children (33.5%) were diagnosed with some type of sequelae. The following conditions were all more prevalent in infants born to mothers with chorioamnionitis in comparison to controls: low development quotient (98.3'12.15 vs. 95.9'15.64; Ps0.497), cerebral palsy (4.9% vs. 10.4%; Ps0.138), seizures (1.0% vs. 3.8%; Ps0.369), and other neurological or sensorial sequelae (32.0% vs. 34.9%; Ps0.611). Conclusions: After controlling for gestational age, the study population demonstrated that the neurological outcomes in infants at a corrected age of 24 months was not worsened by chorioamnionitis.

Low birthweight, preterm, and small for gestational age babies in Scotland, 1981-1984.

The aim was to examine the effect of maternal age, gravidity, marital status, previous perinatal deaths, and parental social class on babies born low birthweight, preterm, and small for gestational age. DESIGN--The study used data on discharge summaries from all maternity hospitals in Scotland. SETTING--The study was based on all singleton deliveries in Scotland. PARTICIPANTS--The analysis involved information on 259,462 singleton babies born during the four years 1981-84 in Scotland. MEASUREMENTS AND MAIN RESULTS--Previous perinatal death was found to be the strongest predictor for both preterm and low birthweight. Single mothers were at particularly high risk of having a small for gestational age baby and those who were previously married of having a preterm baby. Women aged less than 20 years old, those over 34 years old, nulligravidae, and those of parity 3 or more were also at increased risk of adverse pregnancy outcome. Mothers and fathers in manual social classes and those who could not be assigned a social class on the basis of their occupation were at increased risk for all three adverse outcomes studied. The babies of parents who were in manual occupations were twice as likely as those of parents in non-manual occupations to be small for gestational age and almost twice as likely to be low birthweight. CONCLUSIONS--Mother's social class is a risk factor for adverse pregnancy outcome independent of maternal age, parity, and adverse reproductive history, and also independent of father's social class. Information on both parents' occupations should be collected in maternity discharge systems.

El balbuceig dels nadons és la clau del llenguatge

Un estudi demostra que els primers sons que vocalitzen els nens més petits tenen un significat més complex del que s'havia pensat fins ara

L'herència dels traumes

Un estudi demostra que els fets traumàtics que el pare hagi pogut viure un temps abans de la concepció d"un fill afecten el creixement del futur nadó. La causa se situaria en els canvis epigenètics provocats pel trauma en qüestió, que afectarien els espermatozous

L'herència dels traumes

Un estudi demostra que els fets traumàtics que el pare hagi pogut viure un temps abans de la concepció d"un fill afecten el creixement del futur nadó. La causa se situaria en els canvis epigenètics provocats pel trauma en qüestió, que afectarien els espermatozous

El fill de mare diabètica: un experiment de la Natura

Del fill de mare diabètica (FMD) s´ha dit que es tracta d'un autèntic 'experiment de la natura' per tractar-se d'un ésser que al llarg dels seus creixement i desenvolupament intrauterins es relaciona amb un medi ambient diferent al d'una gestació normal. Enfront d'aquesta anomalia, l'embrió primer i el fetus més tard no resten passius, sinó que generen una resposta adaptativa al medi estrany arribant a un altre nivell d'homeostasi però definitivament compensadora de la nova situació. Ara bé, en néixer i 'normalitzar-se' l'ambient, es fa palesa la malaltia...

Acrodermatitis enteropática: tratamiento con Zinc

Se presenta un nuevo caso de Acrodermatitis Enteropática en un lactante de 2,5 meses de vida, fruto de embarazo gemelar bivitelino pretérmino (36 S), de aparición gradual desde los 15 días de vida. Había seguido lactancia artificial exclusivamente desde su nacimiento, al igual que su hermano gemelo que no presentó la enfermedad. Entre los exámenes complementarios destacaba una importante hipozincemia, fosfatasas alcalinas descendidas, alteraciones en la inmunidad celular, rasgos de inmadurez cerebral en el EEG y discreta atrofia vellositaria en la muestra biópsica intestinal. El Tratamiento con sulfato de Zinc a la dosis de 10 mg/Kg/día hizo remitir el cuadro clínico y analítico en pocos días. A los 4 meses de edad abandonó el tratamiento, reapareciendo a los 22 días los síntomas digestivos y cutáneos; la zincemia en ese momento era elevada (175 mcg/dl). Esta falta de relación entre la zincemia y la clínica sugiere que en la Acrodermatitis Enteropática el defecto de transporte del Zn afecta no sólo al enterocito sino también a otras células del organismo y que el criterio para mantener el tratamiento y fijar la dosis debe ser clínico y no analítico.

Recién nacido con imagen torácica densa

Presentamos un recien nacido varón de 48 horas de vida que ingresa por cianosis, bradicardia e hipotonia. Es fruto de la séptima gestación de una madre añosa de 41 años de edad entre cuyos antecedentes sólo resaltan tres abortos previos al embarazo actual, dos de ellos provocados.Este embarazo fue bien controlado..

El primer plor

«Ja el nàixer és un gran plor», ens canta Raimon. Hi ha dos moments crucials que fiten tota vida humana: el naixement i la mort.

Metodologies educatives en les pràctiques aquàtiques per a nadons: revisió i anàlisi de propostes suaus

El present article reflexiona al voltant de les metodologies educatives suaus que trobem en les activitats aquàtiques per a nadons. Per fer-ho, el text descriu què entén per metodologia suau i n"analitza algunes propostes de referència que, tot i ser totes elles respectuoses amb el desenvolupament de l"infant, es mostren ben diferenciades en l"exercici professional. Aquest procés descriptiu de les diverses metodologies que concorren en l"enfocament suau permet plantejar els debats educatius de com ha de ser la metodologia suau i quin és el centre d"atenció de les activitats aquàtiques per a nadons. Aquest debat, ja en les conclusions, dóna peu a plantejar quins han de ser els reptes educatius que les entitats, clubs o institucions de caire no formal que endeguen projectes d"aquest tipus haurien de tenir en compte.

Marxism, social metabolism, and ecologically unequal exchange

Authors working on "industrial metabolism" or "social metabolism" look at the economy in terms of flows of energy and materials. Together with the ecological economists, they see the economy as a subsystem of a larger physical system. Marx and Engels followed with a few years’ delay many of the remarkable scientific and technical novelties of their time.

Societal metabolism of societies: the bifurcation between Spain and Ecuador

This paper presents an application of the Multiple-Scale Integrated Assessment of Societal Metabolism to the recent economic history of Ecuador and Spain. Understanding the relationship between the Gross Domestic Product (GDP) and the throughput of matter and energy over time in modern societies is crucial for understanding the sustainability predicament as it is linked to economic growth. When considering the dynamics of economic development, Spain was able to take a different path than Ecuador thanks to the different characteristics of its energy budget and other key variables. This and other changes are described using economic and biophysical variables (both extensive and intensive referring to different hierarchical levels). The representation of these parallel changes (on different levels and describable only using different variables) can be kept in coherence by adopting the frame provided by MSIASM.

Multi-Scale Integrated Analysis of Societal and Ecosystem Metabolism (MUSIASEM): an outline of rationale and theory

This paper presents an outline of rationale and theory of the MuSIASEM scheme (Multi-Scale Integrated Analysis of Societal and Ecosystem Metabolism). First, three points of the rationale behind our MuSIASEM scheme are discussed: (i) endosomatic and exosomatic metabolism in relation to Georgescu-Roegen’s flow-fund scheme; (2) the bioeconomic analogy of hypercycle and dissipative parts in ecosystems; (3) the dramatic reallocation of human time and land use patterns in various sectors of modern economy. Next, a flow-fund representation of the MUSIASEM scheme on three levels (the whole national level, the paid work sectors level, and the agricultural sector level) is illustrated to look at the structure of the human economy in relation to two primary factors: (i) human time - a fund; and (ii) exosomatic energy - a flow. The three levels representation uses extensive and intensive variables simultaneously. Key conceptual tools of the MuSIASEM scheme - mosaic effects and impredicative loop analysis - are explained using the three level flow-fund representation. Finally, we claim that the MuSIASEM scheme can be seen as a multi-purpose grammar useful to deal with sustainability issues.

An application of MSIASM to Chinese exosomatic energy metabolism

The methodology of Multi-Scale Integrated The methodology of Multi-Scale Integrated Analysis of Societal Metabolism (MSIASM) is applied to analyze the Chinese economy. This paper presents four tasks: (i) identifying a set of benchmarks that makes it possible to compare various characteristics of the Chinese economy with those of other country groups and the world (level) average; (ii) explaining the differences over the selected set of benchmarks, by looking at the characteristics of the various sub-sectors of the Chinese economy; (iii) understanding existing trends and future feasible future development paths for China by studying the existence of reciprocal constraints between the whole economy and its sub-sectors; and (iv) examining plausible future scenarios of development.

Different trajectories of exosomatic energy metabolism for Brazil, Chile and Venezuela: using the MSIASM approach

Economic development goes hand in hand with an increase in the consumption of natural resources. Some analysts use material flows to describe such relationship [Eurostat 2001, Weisz et al., 2006], or exergy [Ayres et al., 2003]. Instead this paper will use a characterisation of the exosomatic energy metabolism based on expected benchmark values to describe possible constraints to economic development posed by available human time and energy. The aim of the paper is to identify types of exosomatic energy metabolism of different societies to interpret its consequences for economic development. This is done with the application of the accounting methodology called Multi-Scale Integrated Analysis of Societal Metabolism (MSIASM) to the particular case of energy metabolism for the analysis of the economies of Brazil, Chile and Venezuela.