Patogenia de la contractura en rotación interna del hombro en la parálisis braquial del neonato: estudio en un modelo murino

La patogènia de la contractura en rotació interna de l'espatlla (CRIE) és poc entesa, explicada per dos teories: la denervació muscular i el desequilibri de l'espatlla. Creem un model en rata que va avaluar la hipòtesi que el desequilibri muscular és un factor que contribueix a la reducció del creixement dels músculs, causant la CRIE. Realitzem neurectomia del supraescapular creant disbalanç muscular entre rotadors de l'espatlla. Els estudis van mostrar disminució de rotació externa, atròfia del infraespinatus i del subescapularis donant suport a la teoria que el desequilibri muscular produeix atròfia i CRIE.

Passive smoking in babies: The BIBE Study (Brief Intervention in babies. Effectiveness)

Background: There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth.The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS).Methods/DesignCluster randomized field trial (control and intervention group), multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia.The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care.Discussion: Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health. The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS.

Acrodermatitis enteropática: tratamiento con Zinc

Se presenta un nuevo caso de Acrodermatitis Enteropática en un lactante de 2,5 meses de vida, fruto de embarazo gemelar bivitelino pretérmino (36 S), de aparición gradual desde los 15 días de vida. Había seguido lactancia artificial exclusivamente desde su nacimiento, al igual que su hermano gemelo que no presentó la enfermedad. Entre los exámenes complementarios destacaba una importante hipozincemia, fosfatasas alcalinas descendidas, alteraciones en la inmunidad celular, rasgos de inmadurez cerebral en el EEG y discreta atrofia vellositaria en la muestra biópsica intestinal. El Tratamiento con sulfato de Zinc a la dosis de 10 mg/Kg/día hizo remitir el cuadro clínico y analítico en pocos días. A los 4 meses de edad abandonó el tratamiento, reapareciendo a los 22 días los síntomas digestivos y cutáneos; la zincemia en ese momento era elevada (175 mcg/dl). Esta falta de relación entre la zincemia y la clínica sugiere que en la Acrodermatitis Enteropática el defecto de transporte del Zn afecta no sólo al enterocito sino también a otras células del organismo y que el criterio para mantener el tratamiento y fijar la dosis debe ser clínico y no analítico.

Recién nacido con imagen torácica densa

Presentamos un recien nacido varón de 48 horas de vida que ingresa por cianosis, bradicardia e hipotonia. Es fruto de la séptima gestación de una madre añosa de 41 años de edad entre cuyos antecedentes sólo resaltan tres abortos previos al embarazo actual, dos de ellos provocados.Este embarazo fue bien controlado..

El balbuceig dels nadons és la clau del llenguatge

Un estudi demostra que els primers sons que vocalitzen els nens més petits tenen un significat més complex del que s'havia pensat fins ara

Metodologies educatives en les pràctiques aquàtiques per a nadons: revisió i anàlisi de propostes suaus

El present article reflexiona al voltant de les metodologies educatives suaus que trobem en les activitats aquàtiques per a nadons. Per fer-ho, el text descriu què entén per metodologia suau i n"analitza algunes propostes de referència que, tot i ser totes elles respectuoses amb el desenvolupament de l"infant, es mostren ben diferenciades en l"exercici professional. Aquest procés descriptiu de les diverses metodologies que concorren en l"enfocament suau permet plantejar els debats educatius de com ha de ser la metodologia suau i quin és el centre d"atenció de les activitats aquàtiques per a nadons. Aquest debat, ja en les conclusions, dóna peu a plantejar quins han de ser els reptes educatius que les entitats, clubs o institucions de caire no formal que endeguen projectes d"aquest tipus haurien de tenir en compte.

Measuring the child mortality impact of official aid for fighting infectious diseases, 2000-2010

Aid for fighting infectious and parasitic diseases has had a statistically significant role in the under-five mortality reduction in the last decade. Point estimates indicate a country average reduction of 1.4 deaths per thousand under fives live-born attributable to aid at its average level in 2000-2010. The effect would be an average drop of 3.3 in the under-five mortality rate at the aid levels of 2010. By components, a dollar per capita spent in fighting malaria has caused the largest average impact, statistically higher than a dollar per capita spent in STD/HIV control. We do not find statistically significant effects of other infectious disease aid, including aid for the control of tuberculosis.

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.

L'herència dels traumes

Un estudi demostra que els fets traumàtics que el pare hagi pogut viure un temps abans de la concepció d"un fill afecten el creixement del futur nadó. La causa se situaria en els canvis epigenètics provocats pel trauma en qüestió, que afectarien els espermatozous

L'herència dels traumes

Un estudi demostra que els fets traumàtics que el pare hagi pogut viure un temps abans de la concepció d"un fill afecten el creixement del futur nadó. La causa se situaria en els canvis epigenètics provocats pel trauma en qüestió, que afectarien els espermatozous

Risk of hypoglycemia in newborns from mothers with gestacional diabetes

There are not enough previous publications which are focused on mothers withwell-controlled gestational diabetes mellitus (GDM) as a risk factor that determines the occurrence of neonatal hypoglycemia. In addition, approaches to blood glucose monitoring have been inconsistent and poorly defined. Our objective is to determine if being a newborn from a mother with well-controlled gestational diabetes (regardless insulin treatment) have a higher risk to develop hypoglycemia than a healthy newborn, using a defined and strict protocol. The project will take place in a regional hospital of Girona. We will recruit from 2014 to 2015 a cohort of 623 infants born in this center without any malformation or any perinatal pathology or complication, selected with a consecutive sampling. We will record sex, ethnicity and gestational age information. We will measure blood glucose levels and anthropometric measurements in newborns always taking into account the presence of well-controlled maternal gestational diabetes or not. Patients will be followed up during 24 hours to determine the incidence of hypoglycemia. We will analyze the contribution between exposure factors that we have studied and the incidence of the outcome using a multivariate analysis

Systematic review protocol to define classical IgE-associated diseases from birth to adolescence: the MeDALL study

BACKGROUND: Classical disease phenotypes are mainly based on descriptions of symptoms and the hypothesis that a given pattern of symptoms provides a diagnosis. With refined technologies there is growing evidence that disease expression in patients is much more diverse and subtypes need to be defined to allow a better targeted treatment. One of the aims of the Mechanisms of the Development of Allergy Project (MeDALL,FP7) is to re-define the classical phenotypes of IgE-associated allergic diseases from birth to adolescence, by consensus among experts using a systematic review of the literature and identify possible gaps in research for new disease markers. This paper describes the methods to be used for the systematic review of the classical IgE-associated phenotypes applicable in general to other systematic reviews also addressing phenotype definitions based on evidence. METHODS/DESIGN: Eligible papers were identified by PubMed search (complete database through April 2011). This search yielded 12,043 citations. The review includes intervention studies (randomized and clinical controlled trials) and observational studies (cohort studies including birth cohorts, case-control studies) as well as case series. Systematic and non-systematic reviews, guidelines, position papers and editorials are not excluded but dealt with separately. Two independent reviewers in parallel conducted consecutive title and abstract filtering scans. For publications where title and abstract fulfilled the inclusion criteria the full text was assessed. In the final step, two independent reviewers abstracted data using a pre-designed data extraction form with disagreements resolved by discussion among investigators. DISCUSSION: The systematic review protocol described here allows to generate broad,multi-phenotype reviews and consensus phenotype definitions. The in-depth analysis of the existing literature on the classification of IgE-associated allergic diseases through such a systematic review will 1) provide relevant information on the current epidemiologic definitions of allergic diseases, 2) address heterogeneity and interrelationships and 3) identify gaps in knowledge.

El fill de mare diabètica: un experiment de la Natura

Del fill de mare diabètica (FMD) s´ha dit que es tracta d'un autèntic 'experiment de la natura' per tractar-se d'un ésser que al llarg dels seus creixement i desenvolupament intrauterins es relaciona amb un medi ambient diferent al d'una gestació normal. Enfront d'aquesta anomalia, l'embrió primer i el fetus més tard no resten passius, sinó que generen una resposta adaptativa al medi estrany arribant a un altre nivell d'homeostasi però definitivament compensadora de la nova situació. Ara bé, en néixer i 'normalitzar-se' l'ambient, es fa palesa la malaltia...

Risk of hypoglycemia in newborns from mothers with gestacional diabetes

There are not enough previous publications which are focused on mothers with well-controlled gestational diabetes mellitus (GDM) as a risk factor that determines the occurrence of neonatal hypoglycemia. In addition, approaches to blood glucose monitoring have been inconsistent and poorly defined. Our objective is to determine if being a newborn from a mother with well-controlled gestational diabetes (regardless insulin treatment) have a higher risk to develop hypoglycemia than a healthy newborn, using a defined and strict protocol. The project will take place in a regional hospital of Girona. We will recruit from 2014 to 2015 a cohort of 623 infants born in this center without any malformation or any perinatal pathology or complication, selected with a consecutive sampling. We will record sex, ethnicity and gestational age information. We will measure blood glucose levels and anthropometric measurements in newborns always taking into account the presence of well-controlled maternal gestational diabetes or not. Patients will be followed up during 24 hours to determine the incidence of hypoglycemia. We will analyze the contribution between exposure factors that we have studied and the incidence of the outcome using a multivariate analysis

El primer plor

«Ja el nàixer és un gran plor», ens canta Raimon. Hi ha dos moments crucials que fiten tota vida humana: el naixement i la mort.