943 resultados para Infants hiperactius -- Tractament
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Actualment en les industries farmacèutiques per aconseguir un producte amb unes condicionsespecifiques necessiten una sèrie de matèries primes per aconseguir-ho. L’aigua, es una de lesmes importants, d’aquí a la utilització d’una planta de tractament ja que ha de complir una sèriede requisit de qualitat determinats. Actualment en les industries farmacèutiques per aconseguir un producte amb unes condicionsespecifiques necessiten una sèrie de matèries primes per aconseguir-ho. L’aigua, es una de lesmes importants, d’aquí a la utilització d’una planta de tractament ja que ha de complir una sèriede requisit de qualitat determinats. Físicament, una planta d’aigua es podria descriure com un sistema estructurat de canonades idipòsits per on circula aigua i s’acumula mentre es depurada de forma continua. A mesura ques’aconsegueixen les condicions de puresa desitjades, el líquid es desvia a un altre anellanomenat llaç, en aquest s’acumula en un moviment circulatori constant mentre que les sevescaracterístiques es mantenen vigilades.Des de el llaç. L’aigua pura es distribueix per les diferents zones de la instal•lació, a unatemperatura determinada, a traves de sortidors anomenats punts d’us (POU) ((Point Of Use). El control es farà amb autòmat siemens S7-300 i una pantalla tàctil utilitzant comunicacióprofibus entre ells. Esta previst comunicació amb una scada existent, per intercanviar dadesnomés de visualització de l’estat de la planta. A partir d’un mòdul de teleservei serà possible lacomunicació amb el programa de l’autòmat via mòdem.La combinació de PLC mes pantalla tàctil esdevé una solució robusta i fiable, cosa quegaranteix una gran fiabilitat de la màquina
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BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. METHODS: This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. RESULTS: 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. DISCUSSION: In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children.
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Objective: Imipenem is a broad spectrum antibiotic used to treat severe infections in critically ill patients. Imipenem pharmacokinetics (PK) was evaluated in a cohort of neonates treated in the Neonatal Intensive Care Unit of the Lausanne University Hospital. The objective of our study was to identify key demographic and clinical factors influencing imipenem exposure in this population. Method: PK data from neonates and infants with at least one imipenem concentration measured between 2002 and 2013 were analyzed applying population PK modeling methods. Measurement of plasma concentrations were performed upon the decision of the physician within the frame of a therapeutic drug monitoring (TDM) programme. Effects of demographic (sex, body weight, gestational age, postnatal age) and clinical factors (serum creatinine as a measure of kidney function; co-administration of furosemide, spironolactone, hydrochlorothiazide, vancomycin, metronidazole and erythromycin) on imipenem PK were explored. Model-based simulations were performed (with a median creatinine value of 46 μmol/l) to compare various dosing regimens with respect to their ability to maintain drug levels above predefined minimum inhibitory concentrations (MIC) for at least 40 % of the dosing interval. Results: A total of 144 plasma samples was collected in 68 neonates and infants, predominantly preterm newborns, with median gestational age of 27 weeks (24 - 41 weeks) and postnatal age of 21 days (2 - 153 days). A two-compartment model best characterized imipenem disposition. Actual body weight exhibited the greatest impact on PK parameters, followed by age (gestational age and postnatal age) and serum creatinine on clearance. They explain 19%, 9%, 14% and 9% of the interindividual variability in clearance respectively. Model-based simulations suggested that 15 mg/kg every 12 hours maintain drug concentrations over a MIC of 2 mg/l for at least 40% of the dosing interval during the first days of life, whereas neonates older than 14 days of life required a dose of 20 mg/kg every 12 hours. Conclusion: Dosing strategies based on body weight and post-natal age are recommended for imipenem in all critically ill neonates and infants. Most current guidelines seem adequate for newborns and TDM should be restricted to some particular clinical situations.
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En aquest estudi qualitatiu s’investiga la influència de les dinàmiques de grup en la millora de la cohesió de grup i l’estabilitat emocional dels infants. La mostra està constituïda per 24 infants, d’edats compreses entre els 5 i 6 anys, i per una mestra de 58 anys. Es realitza una intervenció educativa, basada en quatre dinàmiques de grup diferents, per tal d’avaluar la seva incidència en relació a la cohesió de grup i l’estabilitat emocional dels infants. Els instruments utilitzats són de naturalesa qualitativa, concretament, l’entrevista i l’observació, que s’apliquen pre i post intervenció per tal d’identificar possibles canvis. En els resultats, no es poden observar grans canvis a nivell de cohesió de grup ni d’estabilitat emocional dels infants, però sí, una actitud positiva i de motivació en relació a l’aplicació de dinàmiques de grup. La curta durada de la intervenció educativa ha estat la principal limitació d’aquesta investigació, fet pel qual no s’han pogut extreure uns resultats significatius. És per això que a les conclusions es mostren un seguit d’aspectes a tenir en compte en futurs estudis.
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Aquest treball d’investigació pretén aprofundir en les nocions relatives al paisatge sonor; un tema poc treballat en l’àrea curricular d’Educació Musical. Primerament amb la fonamentació, s’han extret les principals idees dels diferents autors que han treballat i investigat el tema del paisatge sonor. Posteriorment, analitzant aquest marc teòric s’ha intentat aprofundir en el tema i, per escollir i dissenyar activitats que hem realitzat a l’aula. A fi de poder analitzar i observar in situ aquest procés s’ha aplicat durant dos mesos a dues aules de música amb alumnes d’entre 7 i 8 anys i, pel que fa resultats, no hi ha dubte que amb aquest enfocament del fenomen de l’escolta –buscant una centralització en allò essencial i elemental del fet perceptiu-, podem constatar que es produeix un increment quantitatiu i qualitatiu del reconeixement dels sons de l’entorn, i una millora en la percepció de les qualitats del so i la capacitat de reflexió i descripció.
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Actualment, la participació infantil és una responsabilitat compartida per municipi i escola. L"experiència del projecte La participació dels infants a la ciutat, des de 1998, treballa per promoure la participació dels infants a la ciutat. En els resultats del projecte, que s"emmarca en una investigació-acció, destaquen els elements que els infants identifiquen que han après i la seva utilitat, com també els aspectes que consideren que els han agradat més i menys del conjunt del projecte dut a terme a l"aula. La percepció dels infants ajuda a avaluar i identificar innovacions de forma participada.
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BACKGROUND/AIMS: Primary hypoaldosteronism is a rare inborn disorder with life-threatening symptoms in newborns and infants due to an aldosterone synthase defect. Diagnosis is often difficult as the plasma aldosterone concentration (PAC) can remain within the normal range and thus lead to misinterpretation and delayed initiation of life-saving therapy. We aimed to test the eligibility of the PAC/plasma renin concentration (PRC) ratio as a tool for the diagnosis of primary hypoaldosteronism in newborns and infants. Meth ods: Data of 9 patients aged 15 days to 12 months at the time of diagnosis were collected. The diagnosis of primary hypoaldosteronism was based on clinical and laboratory findings over a period of 12 years in 3 different centers in Switzerland. To enable a valid comparison, the values of PAC and PRC were correlated to reference methods. RESULTS: In 6 patients, the PAC/PRC ratio could be determined and showed constantly decreased values <1 (pmol/l)/(mU/l). In 2 patients, renin was noted as plasma renin activity (PRA). PAC/PRA ratios were also clearly decreased. The diagnosis was subsequently genetically confirmed in 8 patients. CONCLUSION: A PAC/PRC ratio <1 pmol/mU and a PAC/PRA ratio <28 (pmol/l)/(ng/ml × h) are reliable tools to identify primary hypoaldosteronism in newborns and infants and help to diagnose this life-threatening disease faster. © 2015 S. Karger AG, Basel.
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BACKGROUND: Lung clearance index (LCI), a marker of ventilation inhomogeneity, is elevated early in children with cystic fibrosis (CF). However, in infants with CF, LCI values are found to be normal, although structural lung abnormalities are often detectable. We hypothesized that this discrepancy is due to inadequate algorithms of the available software package. AIM: Our aim was to challenge the validity of these software algorithms. METHODS: We compared multiple breath washout (MBW) results of current software algorithms (automatic modus) to refined algorithms (manual modus) in 17 asymptomatic infants with CF, and 24 matched healthy term-born infants. The main difference between these two analysis methods lies in the calculation of the molar mass differences that the system uses to define the completion of the measurement. RESULTS: In infants with CF the refined manual modus revealed clearly elevated LCI above 9 in 8 out of 35 measurements (23%), all showing LCI values below 8.3 using the automatic modus (paired t-test comparing the means, P < 0.001). Healthy infants showed normal LCI values using both analysis methods (n = 47, paired t-test, P = 0.79). The most relevant reason for false normal LCI values in infants with CF using the automatic modus was the incorrect recognition of the end-of-test too early during the washout. CONCLUSION: We recommend the use of the manual modus for the analysis of MBW outcomes in infants in order to obtain more accurate results. This will allow appropriate use of infant lung function results for clinical and scientific purposes. Pediatr Pulmonol. 2015; 50:970-977. © 2015 Wiley Periodicals, Inc.
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BACKGROUND: Port-wine stains (PWS) are malformations of capillaries in 0.3% of newborn children. The treatment of choice is by pulsed dye LASER (PDL), and requires several sessions. The efficacy of this treatment is at present evaluated on the basis of clinical inspection and of digital photographs taken throughout the treatment. LASER-Doppler imaging (LDI) is a noninvasive method of imaging the perfusion of the tissues by the microcirculatory system (capillaries). The aim of this paper is to demonstrate that LDI allows a quantitative, numerical evaluation of the efficacy of the PDL treatment of PWS. METHOD: The PDL sessions were organized according to the usual scheme, every other month, from September 1, 2012, to September 30, 2013. LDI imaging was performed at the start and at the conclusion of the PDL treatment, and simultaneously on healthy skin in order to obtain reference values. The results evidenced by LDI were analyzed according to the "Wilcoxon signed-rank" test before and after each session, and in the intervals between the three PDL treatment sessions. RESULTS: Our prospective study is based on 20 new children. On average, the vascularization of the PWS was reduced by 56% after three laser sessions. Compared with healthy skin, initial vascularization of PWS was 62% higher than that of healthy skin at the start of treatment, and 6% higher after three sessions. During the 2 months between two sessions, vascularization of the capillary network increased by 27%. CONCLUSION: This study shows that LDI can demonstrate and measure the efficacy of PDL treatment of PWS in children. The figures obtained when measuring the results by LDI corroborate the clinical assessments and may allow us to refine, and perhaps even modify, our present use of PDL and thus improve the efficacy of the treatment.