Suivi neurodéveloppemental de l'enfant né prématuré dans l'Arc lémanique [Neurodevelopmental follow-up of premature children in Lausanne and Geneva].

Preterm children born before 32 weeks of gestation represent 1% of the annual births in Switzerland, and are the most at risk of neurodevelopmental disabilities. A neurological surveillance is thus implemented in the neonatal units, and multidisciplinary neurodevelopmental follow-up is offered to all our preterm patients. The follow-up clinics of the University hospitals in Lausanne and Geneva follow the Swiss guidelines for follow-up. An extended history and neurological examination is taken at each appointment, and a standardized test of development is performed. These examinations, which take place between the ages of 3 months and 9 years old, allow the early identification and treatment of developmental disorders frequent in this population, such as motor, cognitive or behavioral disorders, as well as the monitoring of the quality of neonatal care.

16q24.1 microdeletion in a premature newborn: Usefulness of array-based comparative genomic hybridization in persistent pulmonary hypertension of the newborn.

OBJECTIVE:: Report of a 16q24.1 deletion in a premature newborn, demonstrating the usefulness of array-based comparative genomic hybridization in persistent pulmonary hypertension of the newborn and multiple congenital malformations. DESIGN:: Descriptive case report. SETTING:: Genetic department and neonatal intensive care unit of a tertiary care children's hospital. INTERVENTIONS:: None. PATIENT:: We report the case of a preterm male infant, born at 26 wks of gestation. A cardiac malformation and bilateral hydronephrosis were diagnosed at 19 wks of gestation. Karyotype analysis was normal, and a 22q11.2 microdeletion was excluded by fluorescence in situ hybridization analysis. A cesarean section was performed due to fetal distress. The patient developed persistent pulmonary hypertension unresponsive to mechanical ventilation and nitric oxide treatment and expired at 16 hrs of life. MEASUREMENTS AND MAIN RESULTS:: An autopsy revealed partial atrioventricular canal malformation and showed bilateral dilation of the renal pelvocaliceal system with bilateral ureteral stenosis and annular pancreas. Array-based comparative genomic hybridization analysis (Agilent oligoNT 44K, Agilent Technologies, Santa Clara, CA) showed an interstitial microdeletion encompassing the forkhead box gene cluster in 16q24.1. Review of the pulmonary microscopic examination showed the characteristic features of alveolar capillary dysplasia with misalignment of pulmonary veins. Some features were less prominent due to the gestational age. CONCLUSIONS:: Our review of the literature shows that alveolar capillary dysplasia with misalignment of pulmonary veins is rare but probably underreported. Prematurity is not a usual presentation, and histologic features are difficult to interpret. In our case, array-based comparative genomic hybridization revealed a 16q24.1 deletion, leading to the final diagnosis of alveolar capillary dysplasia with misalignment of pulmonary veins. It emphasizes the usefulness of array-based comparative genomic hybridization analysis as a diagnostic tool with implications for both prognosis and management decisions in newborns with refractory persistent pulmonary hypertension and multiple congenital malformations.

Composite Photographs - William Woodruff and his children

The composite includes photos of: Richard Woodruff (1822-1887) brother of Samuel Woodruff, son of William Woodruff. He married Cornelia McCrumb. His son-in- law was Samuel Zimmerman of the bank. Richard was a director of the Niagara Suspension Bridge. Joseph Woodruff (1820-1886) son of William Woodruff. He married Julia Claus. He was the Sherriff of Lincoln County and one of the incorporators of the Zimmerman Bank. Samuel DeVeaux Woodruff (1819-1904) who was the son of William Woodruff. He married Jane Caroline Sanderson (1827-1912) William Woodruff (1793-1860) who was the son of Ezekiel Woodruff who was born on July 29, 1763 and moved to the Niagara area from Litchfield Connecticut. He died in Niagara on Nov. 26, 1836. Henry Counter Woodruff (1833-1916) was the 7th child of William Woodruff. He married Emma Eloise Osgood (1835-1925) Dr. William Woodruff (1830-1908) of London, Ont. was the son of William Woodruff. Helena Woodruff (1828-1892) was the daughter of William Woodruff. She married Joseph Patterson Boomer. Julia Woodruff (1825-1870) was the sister of Samuel DeVeaux Woodruff and the daughter of William Woodruff.

Low CD4(+) T-Cell Levels and B-Cell Apoptosis in Vertically HIV-exposed Noninfected Children and Adolescents

Lymphocyte subsets, activation markers and apoptosis were assessed in 20 HIV-exposed noninfected (ENI) children born to HIV-infected women who were or not exposed to antiretroviral (ARV) drugs during pregnancy and early infancy. ENI children and adolescents were aged 6-18 years and they were compared to 25 age-matched healthy non-HIV-exposed children and adolescents (Control). ENI individuals presented lower CD4(+) T cells/mm(3) than Control group (control: 1120.3 vs. ENI: 876.3; t-test, p=0.030). ENI individuals had higher B-cell apoptosis than Control group (Control: 36.6%, ARV exposed: 82.3%, ARV nonexposed: 68.5%; Kruskal-Wallis, p < 0.05), but no statistical difference was noticed between those exposed and not exposed to ARV. Immune activation in CD4(+) T, CD8(+) T and in B cells was comparable in ENI and in Control children and adolescents. Subtle long-term immune alterations might persist among ENI individuals, but the clinical consequences if any are unknown, and these children require continued monitoring.

Household survey of hepatitis B vaccine coverage among Brazilian children

We conducted a multi-stage household cluster survey to calculate hepatitis B vaccine coverage among children 18-30 months of age in 27 Brazilian cities. Hepatitis B vaccine is administered at birth, 1 month and 6 months of age by Brazil`s national immunization program. Among 17,749 children surveyed, 40.2% received a birth dose within one day of birth, 94.8% received at least one dose of hepatitis B vaccine, and 86.7% completed the three-dose series by 12 months of age. Increased coverage with the birth dose and administration of hepatitis B in combination with diphtheria-tetanus-pertussis-Haemophilus influenzae type b antigens could improve protection against hepatitis B. (C) 2009 Elsevier Ltd. All rights reserved.

Parenthood in transition : Somali-born parents' experiences of and needs for parenting support programmes

BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Avaliação do retinol em parturientes com diabetes mellitus gestacional no pós parto imediato

Micronutrient deficiencies affect individuals mainly in developing countries, where vitamin A deficiency is a public health problem worldwide more worrying, especially in groups with increased physiological needs such as children and women of reproductive age. Vitamin A is supplied to the body through diet and has an important role in the visual process, cell differentiation, maintenance of epithelial tissue, reproductive and resistance to infection. The literature has demonstrated the relationship between vitamin A and diabetes, including gestational, leading to a risk to both mother and child. Gestational diabetes is any decrease in glucose tolerance of variable magnitude diagnosed each the first time during pregnancy, and may or may not persist after delivery. Insulin resistance during pregnancy is associated with placental hormones, as well as excess fat. Studies have shown that retinol transport protein produced in adipose tissue in high concentrations, this would be associated with resistance by interfering with insulin signaling. Therefore, this study aimed to evaluate the concentration of retinol in serum and colostrum from healthy and diabetic mothers in the immediate postpartum period. One hundred and nine parturient women were recruited, representing seventy-three healthy and thirty-six diabetic. Retinol was extracted and subsequently analyzed by High Performance Liquid Chromatography. Among the results highlights the mothers with gestational diabetes were older than mothers healthy, had more children and a higher prevalence of cases of cesarean section. Fetal macrosomia was present in 1.4% of healthy parturient women and in 22.2% of diabetic mothers. The maternal serum retinol showed an average of 39.7 ± 12.5 mg/dL for healthy parturients 35.12 ± 15 mg/dL for diabetic and showed no statistical difference. It was observed that in the group of diabetic had 17% vitamin A deficiency, whereas in the healthy group, only 4% of the women were deficentes. Colostrum, the concentration of retinol in healthy was 131.3 ± 56.2 mg/dL and 125.3 ± 41.9 mg/dL in diabetic did not differ statistically. This concentration of retinol found in colostrum provides approximately 656.5 mg/day for infants born to healthy mothers and 626.5 mg/day for infants of diabetic mothers, based on a daily consumption of 500 mL of breast milk and need Vitamin A 400 mg/day, thus reaching the requirement of the infant. The diabetic mothers showed significant risk factors and complications related to gestational diabetes. Although no 11 difference was found in serum retinol concentration and colostrum among women with and without gestational diabetes, the individual analysis shows that parturients women with diabetes are 4.9 times more likely to develop vitamin A deficiency than healthy parturients. However, the supply of vitamin A to the newborn was not committed in the presence of gestational diabetes

Geoprocessamento para identificar padrões do perfil de nascimentos na região do Vale do Paraíba

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Molar incisor hypomineralisation: Possible aetiological factors in children from urban and rural areas

Aim: To analyse factors potentially associated with molar incisor hypomineralisation (MIH) development. METHODS: A population-based study was carried out with 903 children aged from 6-12 years old, born and residing in rural and urban areas of the town of Botelhos, State of Minas Gerais, Brazil. Their mothers completed a structured medical history questionnaire, from pregnancy to the child's 3rd year of life. Two examiners evaluated children for MIH according to criteria suggested by the European Academy of Paediatric Dentistry. Descriptive analyses of the data and odds ratios (OR) with 95% test-based confidence intervals (CI) were estimated. Chisquare test was used to evaluate the differences between groups. RESULTS: The prevalence of MIH in children from rural area (RA) was significantly higher than those from the urban area (UA) (24.9% versus 17.8%, p= 0.01). In urban children, neither significant associations with MIH nor medical problems were found. In rural children, however, MIH was significantly more common among those whose mothers had experienced medical problems during pregnancy (OR=2.11; 1.01-4.37 CI 95%; p=0.04), who had throat infections (OR=2.93; 1.47-5.87 CI 95%; p=0.01), who had high fever (OR=1.91; 1.07-3.39 CI 95%; p=0.02), and who had used amoxicillin associated with other antibiotics (OR=1.92; 1.02-3.62 CI 95%; p=0.04) during the first 3 years of life. CONCLUSION: This study suggests a link between MIH and health problems during pregnancy, as well as environmental factors.

Aetiology of molar-incisor hypomineralisation (MIH) in Brazilian children

Aim: To determine the potential aetiological factors related to molar-incisor hypomineralisation (MIH) in Brazilian children. Methods: A total of 1,151 children aged 7-12 years (mean 8.86 ± 1.28), born and living in the urban area of Araraquara, Brazil, were examined by two examiners evaluating the presence of MIH according to criteria suggested by the European Academy of Paediatric Dentistry (2003). Their mothers completed a structured questionnaire about medical history, from pregnancy to the first 3 years of the children's life. Descriptive analyses of data and odds ratios (OR) with 95 % test-based confidence intervals (CI) were estimated. Chi-square test was used to evaluate the differences between groups. Results: The prevalence of MIH in the children was 12.3 %. The interviewing response rate was 90.4 %. The prevalence of miscarriage history (25 vs. 15.4 %; OR = 1.21; 95 % CI 0.30-4.92) and occurrence of anaemia (23 vs. 12.4 %; OR = 2.07; 95 % CI 0.50-8.63) were higher in mothers from MIH group than those from non-MIH group. However, these associations were not statically significant. In the children's medical history, rhinitis, bronchitis (56.5 vs. 52.5 %; OR = 1.17; 95 % CI 0.82-1.68), and high fever (20.4 vs. 18.2 %; OR = 1.14; 0.73-1.76) were more prevalent in MIH group, but there were no significant differences between the groups (p > 0.05). Conclusions: No possible aetiological factor investigated was associated with MIH. Prospective studies are needed to define the aetiological factors involved with MIH. © 2013 European Academy of Paediatric Dentistry.

Correlação dos níveis de lactato sanguíneo com o estado neurológico e cardiorrespiratório de filhotes de cães nascidos de parto normal ou cesariana sob anestesia geral inalatória

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of four anaesthetic protocols on the neurological and cardiorespiratory variables of puppies born by caesarean section

Twenty-four bitches which had been in labour for less than 12 hours were randomly divided into four groups of six. They all received 0(.)5 mg/kg of chlorpromazine intravenously as premedication, followed 15 minutes later by either 8 mg/kg of thiopentone intravenously (group 1), 2 mg/kg of ketamine and 0-5 mg/kg of midazolam intravenously (group 2), 5 mg/kg of propofol intravenously (group 3), or 2(.)5 mg/kg of 2 per cent lidocaine with adrenaline and 0(.)625 mg/kg of 0(.)5 per cent bupivacaine with adrenaline epidurally (group 4). Except for group 4, the bitches were intubated and anaesthesia was maintained with enflurane. The puppies' heart and respiratory rates and their pain, sucking, anogenital, magnum and flexion reflexes were measured as they were removed from the uterus. The puppies' respiratory rate was higher after epidural anaesthesia. in general the puppies' neurological reflexes were most depressed after midazolam/ketamine, followed by thiopentone, propofol and epidural anaesthesia.

A Culture of Relationships: Early Care for Italian and American Children

A culture of childhood is a shared vision – an agreed upon vision – of the needs and rights of children, including ideas about how the people of the community can collectively nurture them and at the same time be renewed by them. In other words, it is a set of values, beliefs, and practices that people have created to guide their way of nurturing young children and their families. The vision is about investing in young children and investing in the supports and relationships that children need to learn and grow, both for the reason that children carry our future and because they carry our hopes and dreams for the future. These hopes and dreams begin with birth. Sensitive, emotionally available parents create the framework for interaction with their children by responding to the baby’s cues, engaging the baby in mutual gazes, and imitating the baby. The baby, born with a primary ability to share emotions with other human beings eagerly joins the relationship dance. The intimate family circle soon widens. Providers, teachers, and directors of early childhood programs become significant figures in children’s lives—implicit or explicit partners in a "relationship dance" (Edwards & Raikes, 2002). These close relationships are believed to be critical to healthy intellectual, emotional, social, and physical development in childhood and adolescence as well. These conclusions have been documented by diverse fields of science, ranging from cognitive science to communication studies and social and personality psychology. Close relationships contribute to security and trust, promote skill development and understanding, nurture healthy physical growth, infuse developing self-understanding and self-confidence, enable self-control and emotion regulation, and strengthen emotional connections with others that contribute to prosocial motivation (Dunn, 1993; Fogel, 1993; Thompson, 1996). Furthermore, many studies showing how relationship dysfunction is linked to child abuse and neglect, aggression, criminality, and other problems involving the lack of significant human connections (Shankoff & Meisels, 2000). In extending the dance of primary relationships to new relationships, a childcare teacher can play a primary role. The teacher makes the space ready--creating a beautiful place that causes everyone to feel like dancing. Gradually, as the dance between them becomes smooth and familiar, the teacher encourages the baby to try out more complex steps and learn how to dance to new compositions, beats, and tempos. As the baby alternates dancing sometimes with one or two partners, sometimes with many, the dance itself becomes a story about who the child has been and who the child is becoming, a reciprocal self created through close relationships.

Birth in Brazil: national survey into labour and birth

Background: Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction. Methods: Nationwide hospital-based cohort study of postnatal women and their offspring with follow-up at 45 to 60 days after birth. The sample was stratified by geographic macro-region, type of the municipality and by type of hospital governance. The number of postnatal women sampled was 23,940, distributed in 191 municipalities throughout Brazil. Two electronic questionnaires were applied to the postnatal women, one baseline face-to-face and one follow-up telephone interview. Two other questionnaires were filled with information on patients' medical records and to assess hospital facilities. The primary outcome was the percentage of Caesarean sections (total, elective and according to Robson's groups). Secondary outcomes were: post-partum pain; breastfeeding initiation; severe/near miss maternal morbidity; reasons for maternal mortality; prematurity; low birth weight; use of oxygen use after birth and mechanical ventilation; admission to neonatal ICU; stillbirths; neonatal mortality; readmission in hospital; use of surfactant; asphyxia; severe/near miss neonatal morbidity. The association between variables were investigated using bivariate, stratified and multivariate model analyses. Statistical tests were applied according to data distribution and homogeneity of variances of groups to be compared. All analyses were taken into consideration for the complex sample design. Discussion: This study, for the first time, depicts a national panorama of labour and birth outcomes in Brazil. Regardless of the socioeconomic level, demand for Caesarean section appears to be based on the belief that the quality of obstetric care is closely associated to the technology used in labour and birth. Within this context, it was justified to conduct a nationwide study to understand the reasons that lead pregnant women to submit to Caesarean sections and to verify any association between this type of birth and it's consequences on postnatal health.

Intellectual outcome, motor skills and BMI of children with congenital hypothyroidism: a population-based study

AIM: To evaluate intellectual outcome, motor skills and anthropometric data of children with congenital hypothyroidism (CH). METHODS: Children with permanent CH who were born in 1999 in Bavaria were eligible for this prospective, population-based study. Cognitive performance was evaluated by the Kaufman Assessment Battery for Children and motor skills were assessed by the motor test, Motoriktest für vier-bis sechsjahrige Kinder (MOT) 4-6. RESULTS: Eighteen of 21 eligible children participated (86%). Median age of the children was 5.5 years (range 4.9-5.8). Treatment with levothyroxine was started after a median of 7.2 days (range 4-15) with a median dose of 12.0 microg/kg (range 7.2-17.0). Mean intelligence quotient (IQ) of the children was 100.4 (standard deviation [SD] 10.1): no children had IQ values below the normal range. Reactivity and speed of movement were significantly reduced in children with CH. Children with an initial thyroid-stimulating hormone (TSH) value of >200 mU/L performed significantly worse than children with TSH value of Children with CH had a significant increased risk for overweight (risk ratio [RR] 3.91, 95% confidence interval [CI] 1.22-11.75, p=0.005) compared to the Bavarian reference children. CONCLUSION: In this study, children with CH had an increased prevalence of overweight compared to reference data. Partially impaired motor skills could be shown, whereas the intellectual development was normal.