The Association between Growth and Neurodevelopment in Very Preterm Infants – A Follow-up Study in the PIPARI Study

Placental insufficiency is one major cause of intrauterine growth restriction and also relates to neurodevelopment. Preterm infants with very low birth weight are at risk of postnatal growth restriction as well as neurodevelopmental impairments. However, the optimal postnatal growth for long-term neurodevelopment is still unclear. The objective of this study was thus to investigate the association between growth and neurodevelopment in very preterm infants. The study populations consisted of 83 (I), 55 (II), 36 (III) and 181 (IV) infants with very low birth weight (below 1501 grams), and very or extremely low gestational age (below 32 and 26 weeks). Foetal blood circulation in relation to two-year neurodevelopment and the association between early growth and brain maturation at term age were studied. Postnatal growth, and its association with five-year cognitive outcome, was analysed. Changes in foetal blood circulation related to placental insufficiency associated with an adverse two-year cognitive outcome. Early postnatal growth in extremely preterm infants was comparable to a similar Swedish cohort. Preterm infants with slow intrauterine growth had less mature brains at term age; rapid catch-up growth until term age did not eliminate this difference. Weight gain and head circumference growth from birth until two years of age associated positively with five-year cognitive outcome in appropriate for gestational age infants. In small for gestational age infants, head circumference growth from term age to four months (corrected age) associated positively with their five-year cognitive outcome. The association between postnatal growth and neurodevelopment was different for prenatally normally grown versus slow grown preterm infants.

Studies of the small bowel surface by scanning electron microscopy in infants with persistent diarrhea

We describe the ultrastructural abnormalities of the small bowel surface in 16 infants with persistent diarrhea. The age range of the patients was 2 to 10 months, mean 4.8 months. All patients had diarrhea lasting 14 or more days. Bacterial overgrowth of the colonic microflora in the jejunal secretion, at concentrations above 10(4) colonies/ml, was present in 11 (68.7%) patients. The stool culture was positive for an enteropathogenic agent in 8 (50.0%) patients: for EPEC O111 in 2, EPEC O119 in 1, EAEC in 1, and Shigella flexneri in 1; mixed infections due to EPEC O111 and EAEC in 1 patient, EPEC O119 and EAEC in 1 and EPEC O55, EPEC O111, EAEC and Shigella sonnei in 1. Morphological abnormalities in the small bowel mucosa were observed in all 16 patients, varying in intensity from moderate 9 (56.3%) to severe 7 (43.7%). The scanning electron microscopic study of small bowel biopsies from these subjects showed several surface abnormalities. At low magnification (100X) most of the villi showed mild to moderate stunting, but on several occasions there was subtotal villus atrophy. At higher magnification (7,500X) photomicrographs showed derangement of the enterocytes; on several occasions the cell borders were not clearly defined and very often microvilli were decreased in number and height; in some areas there was a total disappearance of the microvilli. In half of the patients a mucus-fibrinoid pseudomembrane was seen partially coating the enterocytes, a finding that provides additional information on the pathophysiology of persistent diarrhea.

Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05), primiparity (P < 0.005), less than four stools (P < 0.001), pink diaper (P < 0.001), delay at initiation of first breast giving (P < 0.01), birth by cesarean section (P < 0.05), extra heater usage (P < 0.005), extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001), mean weight loss in neonates with pink diaper (P < 0.05), mean uric acid concentration in neonates with pink diaper (P < 0.0001), fever in hypernatremic neonates (P < 0.02), and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02) were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.

A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea

The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5% of the cases (8/13) before treatment and in 76.9% (10/13) after treatment. In the placebo group these values were 71.4% (5/7) and 57.1% (4/7), respectively. By the 7th day, clinical cure was observed in 84.6% of the cases (11/13) in the polymyxin group and in 71.4% (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7%) in the polymyxin group and 6/11 cases (54.5%) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3%) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions.

Justinianus I, imperator, Institutiones , cum glossa ordinaria.

F. 1, tables.F. 1v-2, tableau des actions et commentaires.F. 3-68v. Justinianus, Institutiones. "In nomine domini nostri Jhesu Christi Imperator Caesar Flavius Justinianus Alemanicus Gotichus...Imperatoria majestate non solum armis...-... alioquin diligentior eorum scientia vobis ex latioribus digestorum sive pandectarum libris deo propitio adventura est... Domini Justiniani liber explicit Institutionum seu Elementotum."F. 69-72v. Justinianus, Authenticum (Nov. 1 et Nov. 2, début du chap. II). "In nomine domini nostri Jesus Christi librorum Authenticorum seu Constitutionum Novellarum incipit collatio, id est de heredibus et falcidia. Imperator Justinianus Johannis... Hoccupatis nobis circa totius rei publice...-... Nam si non filio forte, sed alicui extra[neo]..." (incomplet).Au bas du f. 72v, mention effacée illisible : "Ex [...]niadus [...]dit quod f[..]ler..."

Using the Reliable Change Index Statistic to Analyze Developmental Changes in Infants at Risk for Autism Spectrum Disorder

Longitudinal studies of the development of autism spectrum disorders (ASD) provide an understanding of which variables may be important predictors of an ASD. The objective of the current study is to apply the reliable change index (RCI) statistic to examine whether the Parent Observation of Early Markers Scale (POEMS) is sensitive to developmental change, and whether these changes can be quantified along a child’s developmental trajectory. Ninety-six children with older siblings with autism were followed from 1-36 months of age. Group-based RCI analysis confirms that the POEMS is capable of detecting significant changes within pre-defined diagnostic groups. Within-subject analysis suggests that ongoing monitoring of a child at-risk for an ASD requires interpretation of both significant intervals identified by the RCI statistic, as well as the presence of repeated high (i.e., >70) scores. This study provides preliminary evidence for a reasonably sensitive and specific means by which individual change can be clinically monitored via parent report.

Modelo de intervención para mejorar la comprensión lectora de los estudiantes de español I de la Preparatoria No 2

Tesis (Maestra en Enseñanza Superior) U.A.N.L.

Lecturas y apuntes literarios, I los griegos [por] Lydia Solís Ortegón, Cecilia Nieto de Rangel [y] Homero Fdo. Villarreal Alanís

UANL

I Plan de Salud Laboral y Prevención de Riesgos Laborales del personal docente de los Centros Públicos.

Monográfico con el título: 'Información y formación para la salud y la seguridad en la escuela'. Resumen basado en el de la publicación

Guía didáctica para la formación de mediadores en el I.E.S. María Galiana.

Resumen tomado de la publicación

I Jornadas de educaci??n vial

Se presenta experiencia educativa que propone la educaci??n vial como tema transversal realizando actuaciones con el alumnado de infantil y primaria. Se realiza en el CEIP La Almohada en Belicena, Granada. Los objetivos son: concienciar a toda la comunidad educativa de la necesidad de trabajar la educaci??n vial para modificar comportamientos viales inadecuados; buscar, analizar, elaborar y organizar materiales did??cticos de educaci??n vial; dise??ar, implementar y evaluar actividades de educaci??n vial para todo el centro. El proceso consta de varias fases: realizaci??n de una campa??a escolar; bloque de contenidos del alumnado como usuario de la v??a p??blica; dedicado a la prevenci??n.

Tecnología industrial I : una ventana abierta a la investigación y experimentación en bachillerato.

Se presenta memoria final de proyecto educativo que propone la estructuración de los bloques temáticos de la asignatura de tecnología industrial I perteneciente al bachillerato tecnológico, a través de dos grandes centros de interés, uno de ellos estará basado en el azulejo sevillano y el otro en el aprovechamiento energético del sol. Se realiza en el IES Pablo Picasso en Sevilla. Los objetivos son: superar el anquilosamiento de un sistema excesivamente teórico; despertar el interés por el derecho que asiste a los pueblos a conocer a su cultura, valorando nuestro patrimonio tecnológico como bien social e irrenunciable; promover un proceso de aprendizaje en la línea de 'aprender a aprender'; aproximar al alumno a un contexto sociolocacional cultural de su entorno; despertar en el alumnado interés por la experimentación y la investigación; permitir un acercamiento globalizador o interdisciplinar con otras áreas; fomentar y ejercitar la creatividad, la capacidad de diseño, organización a nivel grupal e ingenio investigando y construyendo artilugios con materiales de desecho; habilitar a adquirir conocimientos también fuera del aula; descubrir con ambas propuestas las posibilidades de integración laboral; contribuir a que el alumnado tengan cabezas bien hechas que no bien llenas. El proceso consta de varias fases: aproximación, conocimiento, implicación y aportaciones; organización por grupos, asumir roles, directrices a seguir; concreción de contenidos; de desarrollo, salidas diversas, recogida de información; elaboración y organización de 'carpetas-dossier'; elaboración de documentos resumen; revisión y montaje de documentos definitivos; presentación de trabajos.

Percepció i comprensió : propostes d'aprentatge integrat : educació infantil. 'Percepción y comprensión : propuestas de aprendizaje integrado : educación infantil'.

Cada ficha contiene una explicación de la actividad a realizar, objetivos, contenidos y materiales necesarios. El cuaderno se dirige a los alumnos de 3 años de educación infantil

Experiencias en la did??ctica de la Lengua Castellana y la Literatura : actas del I Encuentro Regional sobre intercambio de experiencias en Did??ctica de la Lengua Castellana y la Literatura. Mayo 1999

Ponencias y comunicaciones presentadas en el primer encuentro regional sobre did??ctica de la Lengua y la Literatura, dirigidas al profesorado de secundaria y primaria en el que se abordaron distintos temas: cine y Literatura, los gr??ficos en la ense??anza de la Lengua y la Literatura, l??xico, Literatura comparada, intertextualidad, etc. adem??s de la comunicaci??n de experiencias educativas y recursos did??cticos.

Del yo al euro : una propuesta didáctica de cooperación transnacional : educación permanente de adultos. 'From the I to the euro : a didactic proposal for transnational cooperation : permanent adult education'.

La obra se presenta en edición bilingue español/inglés .- Incluye una sección de apéndices en la que aparecen tablas y gráficos que recogen datos estadísticos sobre la experiencia didáctica, así como información general sobre la UE