Progeny, March 2009, Vol. 25, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

Progeny, June 2009, Vol. 25, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

Progeny, September 2009, Vol. 25, no. 3

This newsletter from The Department of Public Health about perinatal health care and statistics.

Progeny, December 2009, Vol. 25, no. 4

This newsletter from The Department of Public Health about perinatal health care and statistics.

Progeny, March 2010, Vol. 26, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

Gestión de los documentos digitales: estrategias para su conservación

La voluntad de conservar de forma permanente los documentos digitales ha estado presente desde los primeros tiempos de la revolución informática. Sin embargo, han sido pocas las experiencias de crear archivos digitales, debido principalmente a la dificultad para encontrar soluciones técnicas a los problemas de obsolescencia, al alto coste económico y a la ausencia de instituciones que asuman esta responsabilidad. Este artículo analiza las estrategias de conservación aplicadas hasta el momento, y reflexiona sobre los planteamientos metodológicos que han inspirado las mismas, las tendencias actuales y su viabilidad futura. A continuación expone las dos opciones para identificar el documento digital y establecer sus límites, operación previa a la aplicación de cualquier estrategia de conservación. Finalmente describe cómo se puede facilitar esta identificación aplicando metodologías de evaluación y selección propias de la archivística, y propone las reglas de evaluación documental como la herramienta fundamental que permite definir una política de conservación de los documentos digitales.

Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant.

BACKGROUND: Progress in perinatal medicine has made it possible to increase the survival of very or extremely low birthweight infants. Developmental outcomes of surviving preterm infants have been analysed at the paediatric, neurological, cognitive, and behavioural levels, and a series of perinatal and environmental risk factors have been identified. The threat to the child's survival and invasive medical procedures can be very traumatic for the parents. Few empirical reports have considered post-traumatic stress reactions of the parents as a possible variable affecting a child's outcome. Some studies have described sleeping and eating problems as related to prematurity; these problems are especially critical for the parents. OBJECTIVE: To examine the effects of post-traumatic reactions of the parents on sleeping and eating problems of the children. DESIGN: Fifty families with a premature infant (25-33 gestation weeks) and a control group of 25 families with a full term infant participated in the study. Perinatal risks were evaluated during the hospital stay. Mothers and fathers were interviewed when their children were 18 months old about the child's problems and filled in a perinatal post-traumatic stress disorder questionnaire (PPQ). RESULTS: The severity of the perinatal risks only partly predicts a child's problems. Independently of the perinatal risks, the intensity of the post-traumatic reactions of the parents is an important predictor of these problems. CONCLUSIONS: These findings suggest that the parental response to premature birth mediates the risks of later adverse outcomes. Preventive intervention should be promoted.

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.

Neonatal steroids induce a down-regulation of tenascin-C and elastin and cause a deceleration of the first phase and an acceleration of the second phase of lung alveolarization.

Pre- and postnatal corticosteroids are often used in perinatal medicine to improve pulmonary function in preterm infants. To mimic this clinical situation, newborn rats were treated systemically with dexamethasone (Dex), 0.1-0.01 mg/kg/day on days P1-P4. We hypothesized that postnatal Dex may have an impact on alveolarization by interfering with extracellular matrix proteins and cellular differentiation. Morphological alterations were observed on 3D images obtained by high-resolution synchrotron radiation X-ray tomographic microscopy. Alveolarization was quantified stereologically by estimating the formation of new septa between days P4 and P60. The parenchymal expression of tenascin-C (TNC), smooth muscle actin (SMA), and elastin was measured by immunofluorescence and gene expression for TNC by qRT-PCR. After Dex treatment, the first phase of alveolarization was significantly delayed between days P6 and P10, whereas the second phase was accelerated. Elastin and SMA expressions were delayed by Dex treatment, whereas TNC expression was delayed and prolonged. A short course of neonatal steroids impairs the first phase of alveolarization, most likely by altering the TNC and elastin expression. Due to an overshooting catch-up during the second phase of alveolarization, the differences disappear when the animals reach adulthood.

Cardiac and neurologic outcome of cardiac rhabdomyoma considerations for prenatal counseling

Abstract : Cardíac rhabdomyomas are benign cardiac tumors with few cardiac complications but with a known association to tuberous sclerosis that affects the neurologic outcome of the patients. Thís study analyses the long-term cardiac and neurological outcome of patients with cardiac rhabdomyomas in order to allow comprehensive prenatal counseling. qll prenatal and postnatal cases with echocardiographic diagnosis of cardiac rhabdomyomas encountered from August 1982 -September 2007 have been recorded. Independent factors, such às the number and the location of the tumors, have been analyzed for association with a diagnosis of tuberous sclerosis, in order to predict the cardiac and neurologic outcome of the patients. Cardiac complications include arrhythmias, outflow tract obstruction, secondary cardiogenic shock. Arrhythmias are the most often encountered problems during the neonatal period. Supraventricular tachycardia is the commonest rhythm disturbance identified. However, no specific dimension or location of the cardiac rhabdomyomas may predict the rhythm disturbances. The importance of the diagnosis of tuberous sclerosis in patients presenting with cardiac rhabdomyomas is exemplified by the neurodevelopmental complications showing 80% of cases with epilepsy and 63% of cases with a delayed development. The presence of multiple cardiac tumors in patients suggests a higher risk to be affected by tuberous sclerosis, compared to patients with a single tumor. Cardiac rhabdomyomas generally regress aftér birth and after the perinatal period cardiac-related problems are rare, but tuberous sclerosis and the associated neurodevelopmental complications dominate the clinical picture and should form an important aspect of the prenatal counseling of parents. Résumé : Les rhabdomyomes cardiaques sont des tumeurs cardiaques bénignes avec toutefois des complications. cardiaques possibles et surtout avec une association pour la sclérose tubéreuse de Bourneville qui détermine le pronostic neurologique. Cette étude présente une analyse du suivi cardiologique. et neurologique à long terme d'enfants avec un diagnostic de rhabdomyomes cardiaques dans le but de mieux informer les parents lors de la consultation anténatale. L'ensemble des cas de rhabdomyomes cardiaques diagnostiqués au moyen de l'échocardiographie pendant la période anténatale ainsi que postnatale a été répertorié d'août 1982 à septembre 2007. Des facteurs indépendants, tels que le nombre et la localisation des tumeurs, ont été analysés pour leur association avec le diagnostic de la sclérose tubéreuse de Bourneville, afin de prédire le pronostic cardiaque et neurologique de ces patients. Les complications cardiaques retrouvées sont les arythmies, les obstructions des voies d'éjection ventriculaire et le choc cardiogène secondaire. Les arythmies sont les problèmes les plus fréquemment rencontrés pendant la période néonatale.. La tachycardie supraventriculaire est le trouble de rythme le plus souvent identifié. Néanmoins, il n'y a pas de dimension ou de localisation.- spécifique d'un rhabdomyome cardiaque qui pourrait prédire ces troubles du rythme. L'importance de l'association au diagnostic de la sclérose tubéreuse de Bourneville chez les patients atteints de rhabdomyomes est démontrée à travers les complications du développement neurologique avec une attéinte épileptique dans 80% des cas ainsi qu'un retard de développement dans 63% des cas. La présence de multiples tumeurs cardiaques chez un patient suggère un risque accru d'être atteint de la sclérose tubéreuse de Bourneville comparé à un patient atteint d'une tumeur unique. Les rhabdomyomes cardiaques régressent après la naissance et après la période périnatale les complications cardiaques deviennent rares. Toutefois, l'association à la sclérose tubéreuse de Bourneville domine le tableau clinique avec des complications au niveau du développement neurologique et formé donc un aspect important lors de la consultation anténatale.

Differential responses of newborn pulmonary arteries and veins to atrial and C-type natriuretic peptides.

Atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) are important dilators of the pulmonary circulation during the perinatal period. We compared the responses of pulmonary arteries (PA) and veins (PV) of newborn lambs to these peptides. ANP caused a greater relaxation of PA than of PV, and CNP caused a greater relaxation of PV than of PA. RIA showed that ANP induced a greater increase in cGMP content of PA than CNP. In PV, ANP and CNP caused a similar moderate increase in cGMP content. Receptor binding study showed more specific binding sites for ANP than for CNP in PA and more for CNP than for ANP in PV. Relative quantitative RT-PCR for natriuretic peptide receptor A (NPR-A) and B (NPR-B) mRNAs show that, in PA, NPR-A mRNA is more prevalent than NPR-B mRNA, whereas, in PV, NPR-B mRNA is more prevalent than NPR-A mRNA. In conclusion, in the pulmonary circulation, arteries are the major site of action for ANP, and veins are the major site for CNP. Furthermore, the differences in receptor abundance and the involvement of a cGMP-independent mechanism may contribute to the heterogeneous effects of the natriuretic peptides in PA and PV of newborn lambs.

The dynamic adjustment of local government budgets : Does Spain behave differently?

[spa] El objetivo de este trabajo es analizar si los municipios españoles se ajustan en presencia de un shock presupuestario y (si es así) qué elementos del presupuesto son los que realizan el ajuste. La metodología utilizada para contestar estas preguntas es un mecanismo de corrección del error, VECM, que estimamos con un panel de datos de los municipios españoles durante el período 1988-2006. Nuestros resultados confirman que, en primer lugar, los municipios se ajustan en presencia de un shock fiscal (es decir, el déficit es estacionario en el largo plazo). En segundo lugar, obtenemos que cuando el shock afecta a los ingresos el ajuste lo soporta principalmente el municipio reduciendo el gasto, las transferencias tienen un papel muy reducido en este proceso de ajuste. Por el contrario, cuando el shock afecta al gasto, el ajuste es compartido en términos similares entre el municipio – incrementado los impuestos – y los gobiernos de niveles superiores – incrementando las transferencias. Estos resultados sugieren que la viabilidad de las finanzas pública locales es factible con diferentes entornos institucionales.

The dynamic adjustment of local government budgets : Does Spain behave differently?

[spa] El objetivo de este trabajo es analizar si los municipios españoles se ajustan en presencia de un shock presupuestario y (si es así) qué elementos del presupuesto son los que realizan el ajuste. La metodología utilizada para contestar estas preguntas es un mecanismo de corrección del error, VECM, que estimamos con un panel de datos de los municipios españoles durante el período 1988-2006. Nuestros resultados confirman que, en primer lugar, los municipios se ajustan en presencia de un shock fiscal (es decir, el déficit es estacionario en el largo plazo). En segundo lugar, obtenemos que cuando el shock afecta a los ingresos el ajuste lo soporta principalmente el municipio reduciendo el gasto, las transferencias tienen un papel muy reducido en este proceso de ajuste. Por el contrario, cuando el shock afecta al gasto, el ajuste es compartido en términos similares entre el municipio – incrementado los impuestos – y los gobiernos de niveles superiores – incrementando las transferencias. Estos resultados sugieren que la viabilidad de las finanzas pública locales es factible con diferentes entornos institucionales.

Transitional effects of a pension system change in Spain

This paper studies the output effects, transition costs and the change in pension benefits derived from the substitution of the current unfunded pension system by a fully funded pension system financed through mandatory savings.These effects are estimated by using reduced versions of the neoclassical and endogenous growth frameworks. Because of the greater capital accumulation during the transition phase, final output increases by 23,6% (neoclassicalframework); and a 24,5-31,5% (endogenous growth framework). The initial revenue loss for the government would represent a 4,8% of the GDP, raising very slowly during the transition period. Given the new growth rates, rates of return ofphysical capital, and financial intermediation costs, we have that the capitalization pension benefits obtained by all 30-contribution-year worker would be more than twice than those that guarantee the financial sustainability of thepublic pension system