Crecimiento intraútero retardado. Evolución antropométrica a los dos años de vida posnatal

Aim: Evaluate child´s growth suffer from IGR´s (intrauterine growth retardation) in the second year of life. Study’s design: It was studied 49 child suffer from IGR.We obtained until 90 epidemiologic and antropometric «variables», at birth, 6,12 and 24 months.The statistic analysis was done with SPSS programme. Results: The average weigth at 24 months was 10,658 Kg and 11,391 Kg (girls-boys).The «catch-up» was done by 82,6% at 24 months.The average height at 24 months was 84,43 cm for girls (little greater than 25 percentil) and 87,20 cm for boys.The «catch-up» was done by 95,7% at 24 months.The percentage of «catch-up» didn´t present statistic differences between simetric-asimetric IGR and term-preterm IGR. The relationship between birth weigth, birth height, sex, gestational age, kind of IGR with the «catch-up» didn´t result significative, while it was significative with maternal height (p<0,05). Conclusions: Child suffer from IGR continue being shorter and thinner than the rest of child.A bigger percentage have done he «catch-up» at 6 months, being greater at 24 months, being bigger in height.The evolution has been similar for term-preterm and simetric-asimetric IGR.As predict factor for the «cath-up» can be considered the height maternal.Objetivo: Evaluar el crecimiento del niño con CIR (crecimiento intraútero restringido) a los dos años de vida posnatal. Diseño del estudio: Se estudian 49 casos afectos de CIR. Se recogen 90 variables epidemiológicas y antropométricas a los 6,12,18 y 24 meses de edad. El análisis estadístico se realizó mediante el programa SPSS, versión 12. Resultados: El peso medio de niñas-niños a los 24 meses fue de 10,658 kg y de 11,391 kg respectivamente, realizaron un crecimiento recuperador a esa edad un 82,6%. La talla media fue de 84,43 cm y 87,20 cm (niñas-niños). Alcanzando un crecimiento recuperador a los 24 meses el 95,7%. No resultó significativa la relación del crecimiento recuperador con las variables sexo, peso al nacimiento, longitud al nacimiento, edad gestacional y tipo de CIR, mientras sí lo fue con la talla de la progenitora. Conclusiones: Globalmente los niños con CIR siguen siendo más delgados y bajos que la población general. La media en peso y talla se sitúa inferior al percentil 50. Un porcentaje elevado han realizado el crecimiento recuperador a los 6 meses, siendo más importante a los dos años; de forma superior en talla que en peso. La evolución ha sido similar en el grupo CIR término-pretérmino y simétrico-asimétrico. Como factor predictivo se puede considerar la talla materna

Taquipnea transitoria del recién nacido: principales factores de riesgo, evolución y complicaciones

Introduction: The transient tachypnea in the newborn (TTN) is a benign and self-limited disorder, that affects one percent of live births. It is produced by a delay in removing of the pulmonar fetal liquid. Objectives: To know the incidence of TTN, the associated perinatal factors, the treatment received and the complications. Patients and methods: A descriptive and retrospective study of inpatiens between the years 2010 y 2014 with the disgnosis of TTN, collecting the variables of the data base Neosoft and the general population dates through the 2013 National Statistics Institute (INE). Results: n=206, incidence 1:105 (0.95%), males: 62%, gestational age 36.47 +/-2.49 weeks, newborn weight 2768.1 +/-709.3 grams. The main risk factors in the univariant analysis were the cesarean birth (49.7% vs 24%), gestational age less than 38 weeks (52% vs 7%) and resucitation in delivery room (22.3% vs 10%). 66% of the patients required non-invasive ventilation and 72’8% intravenous fluids and antibiotics. The enteral nutrition was started at 26.9 +/-23.6 hours of life. Total days of stay were 10.4 +/8.6. 9 patients, 4.3%, presented complications (pneumothorax and pulmonary hypertension). Conclusions: The main risk factors associated to TTN were the cesarean delivery and the moderate-late prematurity. The prognosis is excellent but it is not free of complications, it supposes the newborn hospitalitation and the delay of enteral feeding, interfering with the mother-child bond.Introducción: La taquipnea transitoria del recién nacido (TTRN) es un trastorno benigno y autolimitado que afecta al 1% de los recién nacidos vivos. Se produce por un retraso en la eliminación del líquido pulmonar fetal. Objetivos: Conocer la incidencia de TTRN, los factores perinatales asociados, el tratamiento recibido y las complicaciones. Pacientes y métodos: Estudio descriptivo retrospectivo de los pacientes ingresados entre los años 2010 a 2014 con el diagnóstico de TTRN, recogiendo las variables de la base de datos Neosof, y datos de población general a través del Instituto Nacional de Estadística (INE) del 2013. Resultados: n= 206, incidencia 1:105 (0,95%), varones: 62%, edad gestacional 36,47 +/-2,49 semanas, peso RN: 2768,1+/-709,3 gramos. Destacan como factores de riesgo el nacimiento por cesárea (49,7% vs 24%), edad gestacional menor de 38 semanas (52% vs 7%) y precisar reanimación en sala de partos (22,3% vs 10%). Precisaron ventilación no invasiva el 66% de los pacientes, fluidoterapia y antibioterapia intravenosas el 72,8%. Se inició la nutrición enteral a las 26,9+/-23,6 horas de vida. Los días totales de estancia fueron 10,4+/-8,6. Presentaron complicaciones (neumotórax e hipertensión pulmonar) 9 pacientes (4,3%). Conclusiones: Los principales factores de riesgo asociados a TTRN fueron el parto por cesárea y la prematuridad moderada-tardía. Su pronóstico es excelente, pero no está exento de complicaciones, supone la hospitalización del recién nacido y el retraso en el inicio de la alimentación enteral, interfiriendo con el vínculo madre-hijo

Crisis convulsivas en el servicio de urgencias: valoración de nuestro protocolo

Introduction:In our Hospital we are working in a «plan of improvement of paediatric emergencies», one of the objectivesis the protocolization and permanent evaluation of the most prevalent and/or important emergencies.Patients and methods:The registries of emergencies and clinical histories of the children who suffered from seizures inEmergency Service were reviewed from September 15 th, 2004 to April 16 tf, 2005. Several information was analyzed, spe-cially the written certainty of 4 established indicators to evaluate the fulfillment of the protocol.Results:A total of 42 episodes of seizures in emergencies were considered, those correspond to 39 children. During the firsthour of the seizure cease Glasgow was registered in 20 cases and the existence or absence of suitable movements of the 4extremities in 21 cases (7 exceptions admitted by enter in UCIP, in both indicators). Venous access was obtained in 33 cases,and oxygen saturation was registered in 25 cases. There was certainty of the temperature in 41 cases, cardiac frequency in29, heart rhythm in 12 and arterial tension in 28 casos. Discussion:It has been tried to evaluate vital aspects such as clinical control of the constants and oxygenation and signs ofencefalopaty as the state of conscience and critic or postcritic focal signs, that are determinant in therapeutic and diagnosticinterventions. The continued protocolization and evaluation are important in the procese of learning and improvement, bothlinked to work excellenceIntroducción:En nuestro hospital se está trabajando en un «plan de mejora de urgencias pediátricas», uno de cuyosobjetivos es la protocolización y evaluación permanente, de las urgencias más prevalentes y/o importantes.Pacientes y métodos:Se revisaron los registros de urgencias y las historias clínicas de los niños que presentaronconvulsiones en urgencias desde el 15 de septiembre de 2004 hasta el 16 de abril de 2005. Se analizan diversos datos,especialmente la constancia escrita de los 4 indicadores establecidos para evaluar el cumplimiento del protocolo.Resultados:Se recogieron un total de 42 episodios de convulsión en urgencias correspondientes a 39 niños.Durante la primera hora del cese de crisis constaba el Glasgow en 20 casos y la existencia o no de movimientosadecuados de las 4 extremidades en 21 casos (7 excepciones admitidas por ingreso en UCIP, en ambos indicadores).Se obtuvo vía venosa en 33 casos, y determinó la saturación de oxígeno en 25 casos. Había constancia de la tempe-ratura en 41 casos, de la frecuencia cardíaca en 29, del ritmo cardíaco en 12 y de la tensión arterial en 28 casos.Comentarios:Se ha pretendido evaluar aspectos vitales como el control clínico de las constantes y la oxigenacióny signos de encefalopatía como el estado de conciencia y las focalidades críticas o postcríticas, que son determi-nantes en las intervenciones terapéuticas y diagnósticas, estrechamente relacionadas. La protocolización y evaluacióncontinuadas introducen en el ciclo de aprendizaje y mejora, vinculados a la excelencia del trabaj

Repurposing the antibacterial agents peptide 19-4LF and peptide 19-2.5 for treatment of cutaneous leishmaniasis

The lack of safe and cost-effective treatments against leishmaniasis highlights the urgent need to develop improved leishmanicidal agents. Antimicrobial peptides (AMPs) are an emerging category of therapeutics exerting a wide range of biological activities such as anti-bacterial, anti-fungal, anti-parasitic and anti-tumoral. In the present study, the approach of repurposing AMPs as antileishmanial drugs was applied. The leishmanicidal activity of two synthetic anti-lipopolysaccharide peptides (SALPs), so-called 19-2.5 and 19-4LF was characterized in Leishmania major. In vitro, both peptides were highly active against intracellular Leishmania major in mouse macrophages without exerting toxicity in host cells. Then, q-PCR-based gene profiling, revealed that this activity was related to the downregulation of several genes involved in drug resistance (yip1), virulence (gp63) and parasite proliferation (Cyclin 1 and Cyclin 6). Importantly, the treatment of BALB/c mice with any of the two AMPs caused a significant reduction in L. major infective burden. This effect was associated with an increase in Th1 cytokine levels (IL-12p35, TNF-¿, and iNOS) in the skin lesion and spleen of the L. major infected mice while the Th2-associated genes were downregulated (IL-4 and IL-6). Lastly, we investigated the effect of both peptides in the gene expression profile of the P2X7 purinergic receptor, which has been reported as a therapeutic target in several diseases. The results showed ..

Repurposing the antibacterial agents peptide 19-4LF and peptide 19-2.5 for treatment of cutaneous leishmaniasis

The lack of safe and cost-effective treatments against leishmaniasis highlights the urgent need to develop improved leishmanicidal agents. Antimicrobial peptides (AMPs) are an emerging category of therapeutics exerting a wide range of biological activities such as anti-bacterial, anti-fungal, anti-parasitic and anti-tumoral. In the present study, the approach of repurposing AMPs as antileishmanial drugs was applied. The leishmanicidal activity of two synthetic anti-lipopolysaccharide peptides (SALPs), so-called 19-2.5 and 19-4LF was characterized in Leishmania major. In vitro, both peptides were highly active against intracellular Leishmania major in mouse macrophages without exerting toxicity in host cells. Then, q-PCR-based gene profiling, revealed that this activity was related to the downregulation of several genes involved in drug resistance (yip1), virulence (gp63) and parasite proliferation (Cyclin 1 and Cyclin 6). Importantly, the treatment of BALB/c mice with any of the two AMPs caused a significant reduction in L. major infective burden. This effect was associated with an increase in Th1 cytokine levels (IL-12p35, TNF-¿, and iNOS) in the skin lesion and spleen of the L. major infected mice while the Th2-associated genes were downregulated (IL-4 and IL-6). Lastly, we investigated the effect of both peptides in the gene expression profile of the P2X7 purinergic receptor, which has been reported as a therapeutic target in several diseases. The results showed ..

Limits to redistribution in late democratic transitions: the case of Spain

This chapter reviews the experience of one country from the European periphery, Spain, in the period 1960 to 1990. It addresses the possibilities to build up an operative welfare state after recent democratization—past the golden age of economic growth in Western economies, and during the second globalization. The new context made it difficult to develop determined redistributive policies where they had been absent before. Economic distress, increasing capital mobility, and new tax ideas challenged the chances of progressive taxation. Furthermore, the recent dictatorship cast long-lasting shadows in the new representative institutions. This study of the Spanish experience is thus an analysis of time-specific and polity-specific constraints on redistribution, which other new democracies might have faced or could encounter in the near future