Knowing about the Nutritional and Immunological Benefits of Breast Milk Does not Reduce Early Weaning

Breastfeeding brings great benefits to the child and the mother, however it is known that the practice requires encouragement and proper guidance. Even knowing the nutritional and immunological benefits of breastmilk, many mothers interrupt lactation and add artificial formulas in infant feeding, most often due to myths or difficulties in breastfeeding management. The aim of this study was to identify factors that influence early weaning in Ibiá, Minas Gerais, Brazil. It was an exploratory, transversal and quantitative research, conducted through questionnaires administered to mothers of children of 0-6 months. As for the most common problems related to breastfeeding experienced by respondents, the main reported was the presence of "milk weak "or“little milk” with 53.84%. When asked if their children were using pacifiers, 69.73% of respondents reported so. The family and professional support is of utmost importance to the practice of breastfeeding. Nursing should advise on lactation management as well as on the numerous benefits of breast feeding. The nursing team has na important role in this regard, promoting breastfeeding, with preventive actions that contribute to this important stage of the childrens life, thus, breast feeding can belived fully and satisfactorily

Probiotics for preventing acute otitis media in children

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: to assess the effects of probiotics to prevent the occurrence and reduce the severity of acute otitis media in children.</p

Iniciativa Hospital Amigo del Niño: una política de promoción, protección y apoyo a la lactancia materna

OBJECTIVE: To conduct a literature review about the ten steps of the Baby Friendly Hospital Initiative (BFHI). METHODS: We sought documents and scientific papers published in the databases of PubMED, Medline, SciELO and LILACS. RESULTS: We initially identified 110 references about the BFHI, between the years of 1979 to 2009. Approximately 21% were published in the 1990s and 79% between 2000 and 2009; 10.8% were published in books and official documents of the Ministry of Health, Pan American Health Organization and World Health Organization; and, 89.2% were in articles indexed in the consulted databases. Of these, 35 references were selected. The analyzed studies showed that changes in hospital practices according to the Ten Steps of BFHI increased the prevalence of breastfeeding. CONCLUSION: Through the studies analyzed, the BFHI showed effectiveness in increasing breastfeeding in many regions of the world, contributing to the reduction of infant morbidity and mortality.OBJETIVO: Realizar una revisión de la literatura sobre los diez pasos de la Iniciativa Hospital Amigo del Niño (IHAN). MÉTODOS: Se buscó documentos y artículos científicos publicados en bases de datos PubMED, Medline, SciELO y LILACS. RESULTADOS: Fueron identificados inicialmente 110 referencias sobre la IHAN, entre los años de 1979 a 2009. Aproximadamente el 21% fueron publicadas en la década de 1990 y el 79% entre 2000 a 2009, siendo el 10,8% en libros y documentos oficiales del Ministerio de Salud, Organización Panamericana de la Salud y Organización Mundial de la Salud y el 89,2% en artículos indexados en las bases de datos consultadas. De éstos fueron seleccionadas 35 referencias. Los estudios analizados evidenciaron que los cambios en las prácticas hospitalarias de acuerdo con los Diez Pasos de la IHAN aumentaron la prevalencia de la lactancia materna. CONCLUSIÓN: Por medio de los estudios analizados la IHAN se ha mostrado efectiva en el aumento de la práctica del amamantamiento en muchas regiones del mundo, contribuyendo con la reducción de la morbimortalidad infantil.OBJETIVO: Realizar uma revisão da literatura sobre os dez passos da Iniciativa Hospital Amigo da Criança (IHAC). MÉTODOS: Buscou-se documentos e artigos científicos publicados em bases de dados PubMED, Medline, SciELO e LILACS. RESULTADOS: Foram identificadas inicialmente 110 referências sobre a IHAC, entre os anos de 1979 a 2009. Aproximadamente 21% foram publicadas na década de 1990 e 79% entre 2000 a 2009, sendo 10,8% em livros e documentos oficiais do Ministério da Saúde, Organização Panamericana de Saúde e Organização Mundial da Saúde e 89,2% em artigos indexados nas bases de dados consultadas. Destes foram selecionadas 35 referências. Os estudos analisados evidenciaram que as mudanças nas práticas hospitalares de acordo com os Dez Passos da IHAC aumentaram a prevalência do aleitamento materno. CONCLUSÃO: Por meio dos estudos analisados a IHAC tem se mostrado efetiva no aumento da prática da amamentação em muitas regiões do mundo, contribuindo com a redução da morbi-mortalidade infantil.Hospital Maternidade Leonor Mendes de BarrosHospital Maternidade Leonor Mendes de Barros Banco de LeiteUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Drug-coated balloons to improve femoropopliteal artery patency: rationale and design of the LEVANT 2 trial

Background Atherosclerotic peripheral artery disease (PAD) is common and results in limitations in quality of life and potential progression to limb loss. Options for therapy include medical therapy, supervised exercise, surgical revascularization, and, more recently, endovascular therapies to restore arterial perfusion to the limb. Endovascular revascularization has evolved over the past 2 decades, from percutaneous transluminal angioplasty (PTA) to self-expanding stents, atherectomy, laser angioplasty, and drug-eluting stents. Despite impressive technologic advances, PTA remains the standard of care at many institutions and is the recommended primary treatment modality for femoral-popliteal PAD according to current American College of Cardiology Foundation/American Heart Association guidelines. However, restenosis after PTA is common. Therefore, a significant clinical need remains for a device that is able to achieve more durable patency than PTA but does not require a permanent implant. Drug-coated balloons (DCBs) have the potential to address this need. Several randomized controlled clinical trials of PTA balloons coated with different formulations of paclitaxel have been conducted in Europe (N Engl J Med 2008;358:689-699) (Circulation 2008;118:1358-1365) (Circ Cardiovasc Interv 2012;5:831-840) (JACC Cardiovas Interv 2014;7:10-19) and demonstrated more durable efficacy than PTA with comparable safety. These studies were limited by small sample sizes and powered solely for an angiographic primary end point. The pivotal LEVANT 2 trial was designed in collaboration with the US Food and Drug Administration to demonstrate safety and efficacy in a large population and to obtain US Food and Drug Administration approval. Methods A prospective, multicenter, single-blind trial comparing the Lutonix DCB (Bard Lutonix; New Hope, MN) versus PTA for treatment of femoropopliteal PAD (LEVANT 2) is the first US-based 2:1 randomized controlled trial of 476 patients with femoral-popliteal PAD designed to demonstrate superior efficacy and noninferior safety of a novel paclitaxel DCB compared with PTA. The primary efficacy end point is primary patency at 12 months. The primary safety end point is composite freedom at 12 months from perioperative death, index limb amputation, reintervention, and limb-related mortality. A series of important secondary end points include physical functioning, quality of life, revascularizations, and alternative measures of patency. To minimize bias potential for confounding variables, LEVANT 2 (1) excluded patients stented after predilation before randomization, (2) incorporated very stringent criteria for bailout stenting, (3) did not count bailout stenting as a target lesion revascularization or failure of any end point, (4) required a blinded clinician to perform clinical evaluations at follow-up, and (5) required clinical assessment before review of duplex ultrasound results. Conclusions LEVANT 2 represents the first US-inclusive multicenter, randomized controlled trial to assess the safety and efficacy of a novel DCB compared with PTA as primary therapy for symptomatic PAD on the background of standard medical therapy

Self‐Reported Explanations of Recurrent Chlamydia Infections and Urban Females

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92065/1/jogn1362_2.pd

WHO Technical Consultation on Postpartum and Postnatal Care

Публикација од техничкиот серијал на СЗО за ревизија на Клиничките упатства на светско ниво во областа на перинатологијата. Главен консултнт од областа на неонатологија и автор на тој дел е проф д-р Зисовска, и нејзината систематички преглед е печатен во публикација на СЗ

SCN9A channelopathy associated autosomal recessive Congenital Indifference to Pain : a case report

Background: Congenital Indifference to Pain (CIP) is a rare condition that inhibits the ability of patients to perceive physical pain but otherwise keeps normal sensory modalities. The condition has been mapped to an autosomal recessive trait to chromosome 2q 24.3 with mutations on the SCN9A gene. Case report: A 2 year old Caucasian female presented with CIP. Bite injuries, tongue wounds and unaccounted dental trauma episodes were frequently reported. Preventive instructions and possible treatment modalities were discussed with the parents. Conclusion: The cornerstone of treating CIP patients is an extensive preventive approach alongside regular oral examination at home by parents as well as routine recall appointments with dentists

Exploring the impact of the Baby-Friendly Hospital Initiative on mothers, infants, and hospitals

The Baby-Friendly Hospital lnitiative (BFHI), developed in 1991 by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), is an international program that recognizes certain hospitals and birthing centers that provide the best care for infant feeding and bonding of the mother and baby. In order to be designated Baby-Friendly, a hospital or birthing facility must practice The Ten Steps to Successful Breastfeeding, which include training staff members on the set breastfeeding policy, offering mothers the information and skills needed to begin and continue breastfeeding their babies, as well as allowing the mothers and infants to be together 24 hours a day and giving no pacifiers or artificial nipples. The hospital must also implement the International Code of Marketing of Breast-Milk Substitutes, which includes no advertisement of breast milk substitutes, no free samples or supplies, no pictures that promote artificial feeding, and the information on artificial feeding must explain the benefits of breastfeeding versus the costs and risks of artificial feeding. Using evidence-based practice, we created a research paper that looked into the creation of the Baby-Friendly Hospital Initiative, how a facility can reach this accreditation, and the effects on mothers, infants, and the hospital as a whole.Honors CollegeThesis (B.?