Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants.

OBJECTIVE: To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function.Study design: A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/dL) was carried out in 85 small-for-gestational-age preterm neonates. Prospective serial evaluations of physical growth and psychomotor development were performed. Retrospectively, infants were grouped according to their glycemic status. RESULTS: The incidence of hypoglycemia was 72.9%. Infants with repeated episodes of hypoglycemia had significantly reduced head circumferences and lower scores in specific psychometric tests at 3.5 years of age. Hypoglycemia also caused reduced head circumferences at 18 months and lower psychometric scores at 5 years of age. Infants with moderate recurrent hypoglycemia had lower scores at 3.5 and 5 years of age compared with the group of infants who had 1 single severe hypoglycemic episode. CONCLUSION: Recurrent episodes of hypoglycemia were strongly correlated with persistent neurodevelopmental and physical growth deficits until 5 years of age. Recurrent hypoglycemia also was a more predictable factor for long-term effects than the severity of a single hypoglycemic episode. Therefore repetitive blood glucose monitoring and rapid treatment even for mild hypoglycemia are recommended for small-for-gestational-age infants in the neonatal period.

Influência da soma térmica e da chuva durante o desenvolvimento de laranjas-'Valência' e 'Natal' na relação entre sólidos solúveis e acidez e no índice tecnológico do suco

Este trabalho foi realizado com o objetivo de conhecer a influência que algumas variáveis meteorológicas exercem na razão entre sólidos solúveis totais e acidez total titulável ("ratio") e no índice tecnológico dos frutos da primeira florada das laranjeiras-'Natal' e 'Valência', na região de Bebedouro-SP, mediante a utilização de métodos estatísticos de regressão. Foram utilizados dados de amostragens de rotina para o processamento industrial durante 4 anos, os quais permitiram desenvolver equações de regressão linear e quadrática, com a soma térmica (graus-dia) como variável independente, e de regressão múltipla, utilizando graus-dia e chuva como variáveis independentes. A equação de melhor ajuste para o índice tecnológico foi a quadrática, enquanto para o "ratio" a equação linear apresentou o melhor ajuste. A temperatura do ar, representada por graus-dia, foi a variável que exerceu maior influência nos indicadores de qualidade dos frutos.

Effects of nasal continuous airway pressure on pulmonary and systemic output in preterm infants

Objective: Respiratory assistance with nasal continuous positive airway pressure (n-CPAP) is an effective treatment in premature newborns presenting respiratory distress. The aim of the study was to depict cardiac function, systemic (Qs) and pulmonary output (Qp) by echocardiography in stable premature infants requiring prolonged n-CPAP. Our hypothesis was that n-CPAP could reduce pulmonary blood flow. Patients and methods: All premature infants < 32 weeks gestation, > 7 days-old, requiring n-CPAP without severe respiratory compromise nor need for additional oxygen were prospectively included. Every patient had a first echocardiography while on n-CPAP. N-CPAP was then discontinued for two hours and a second echocardiography was performed. Results: 17 premature infants were included. Mean gestational age was 28 ± 2 weeks and mean weight 1.1 ± 0.3 kg. Following retrieval of n-CPAP we observed an increase in Qp of 53 ml/kg/min (95% CI 19-87 ml/kg/min), but no significant change in Qs. Consecutively a significant increase in Qp/Qs ratio of 16% was found (95% CI 7-29%). Conclusions: Nasal continuous positive airway pressure has hemodynamic effects in preterm infants in stable pulmonary and cardiac conditions. It reduces pulmonary output without interference with systemic output.

Associated anomalies in multi-malformed infants with cleft lip and palate: An epidemiologic study of nearly 6 million births in 23 EUROCAT registries.

We studied 5,449 cases of cleft lip (CL) with or without cleft palate (CL/P) identified between 1980 and 2000 from the EUROCAT network of 23 registers (nearly 6 million births) in 14 European countries. We investigated specific types of defects associated with clefts. Among CL/P cases (prevalence = 9.1 per 10,000), 1,996 (36.6%) affected only the lip (CL) and 3,453 (63.4%) involved CL and palate (CLP). A total of 3,860 CL/P cases (70.8%) occurred as isolated anomalies and 1,589 (29.2%) were associated with other defects such as multiple congenital anomalies of unknown origin (970), chromosomal (455) and recognized syndromes (164). Associated malformations were more frequent in infants who had CLP (34.0%) than in infants with CL only (20.8%). Among multi-malformed infants, 2 unrelated anomalies were found in 351 cases, 3 in 242 cases, and 4 or more in 377 cases. Among 5,449 CL/P cases, 4,719 were live births (LB) (86.6%), 203 stillbirths (SB) (3.7%), while 508 (9.3%) were terminations of pregnancy (ToP). CL/P occurred significantly more frequently in males (M/F = 1.70), especially among total isolated cases (M/F = 1.87) and CLP isolated cases (M/F = 1.92). The study confirmed that musculoskeletal, cardiovascular, and central nervous system defects are frequently associated with CL/P. An association with reduction anomalies of the brain was found. This association suggests that clinicians should seek to identify structural brain anomalies in these patients with CL/P as the potential functional consequences may be important for rehabilitation and clinical management.

Crescimento inicial de laranjeira 'Valência' sobre dois porta-enxertos em função da adubação nitrogenada no plantio

Avaliou-se o crescimento de laranjeira 'Valência' sobre os porta-enxertos limão 'Cravo' e citrumelo 'Swingle' durante o primeiro ano de plantio, em função da adubação nitrogenada, comparando-se dois fertilizantes solúveis (uréia e nitrato de amônio) com um fertilizante de liberação lenta (uréia recoberta por enxofre). A aplicação da dose de 80,0 g de N / planta foi parcelada em quatro vezes para os fertilizantes solúveis e em uma e duas vezes para o fertilizante de liberação lenta, também avaliado nas doses de 22,2 e 50,0 g de N / planta. Dados biométricos coletados incluíram: altura, diâmetros do tronco e da copa, teor foliar de clorofila e análise química foliar. Citrumelo 'Swingle' induziu maior diâmetro de tronco que limão 'Cravo', 12 meses após o plantio. As diferentes doses, fontes e parcelamentos do N não determinaram diferenças de crescimento vegetativo da laranjeira 'Valência' enxertada sobre os dois porta-enxertos.

Urbanisme i monument a Catalunya en la segona meitat del segle XIX

Els canvis socials i economics ocorreguts durant el segle XIX van comportar la introducció d'importants transformacions urbanístiques per adequar la ciutat a les noves necessitats dominants. Diversos problemes de la ciutat reclamaven la recerca de solucions urgents: la millora de la viabilitat dels nuclis urbans, les precaries condicions de vida en els barris obrers -denunciades reiteradament- o, en fi, la necessitat d'encabir la creixent població urbana. La resposta, el conjunt de mesures urbanístiques encaminades a pal·liar aquests déficits, es concreta en la redacció dels plans de reforma i eixample aprovats per la majoria de ciutats catalanes durant la segona meitat del segle.

El pensament polític a la Lleida del XIX (1808-1840)

El present estudi avalua l’evolució del pensament polític a Lleida durant les primeres quatre dècades del segle XIX. La raó principal per a l’elecció d’aquest període cronològic rau en el doble fet que, per una banda, assistim a l’enfrontament ideològic entre l’absolutisme –que sustentava dogmàticament la monarquia de Ferran VII– i el liberalisme –teoria política emergent en aquell moment que plantejava una seriosa alternativa de govern socialment més participativa–. Paral.lelament, aquest trentenni va veure l’evolució del discurs ideològic liberal fins al punt de plantejar-se una divisió entre els més moderats en les reformes, i els radicals, més ambiciosos que els anteriors, anomenats «progressistes», més o menys, des del 1837, data que emmarcava l’aprovació de la Constitució d’aquell any i el punt d’inflexió definitiu en les discòrdies entre ambdues tendències.

La lluita política del poder local en la primera meitat del segle XIX i la formació de la identitat social de la Lledia contemporània

El darrer decenni ha estat molt profitós per la historiografia local lleidatana dedicada a la investigació de la primera meitat del segle XIX. Diversos treballs impulsats sota la protecció del “modern” Estudi General i, darrerament, de l’autònoma Universitat de Lleida han anat emplenant algunes peces del complex trencaclosques històric en què s’ha convertit l’estudi de la substitució del caduc sistema feudal per l’estat liberal. La síntesi històrica a través dels textos apareguts fins ara, que es presenta en aquest congrés, pretén mostrar una aproximació a la configuració d’unes identitats socials a nivell local, que tingueren el seu origen en la lluita per controlar el poder en els primers cinquanta anys del segle XIX. Tot i que encara no ha acabat el buidatge exhaustiu de tota la documentació oficial i privada que en els diversos arxius de la ciutat hi ha acumulada, si que es comencen a manifestar una sèrie de constants en el comportament social dels grups urbans a mesura que els treballs de recerca donen a conèixer realitats històriques emmarcades en estudis més concrets. Així, cada cop s’ha pogut anar precisant amb més exactitud les línies mestres de la situació evolutiva en què es trobava la Lleida decimonònica en els aspectes socials, econòmics i polítics.