RESUMEN
UNLABELLED: We report a case of a profoundly hypothermic newborn with a core temperature of 25 degrees C with a successful recovery and normal neurological outcome at 3 and 6 months. This term male infant had been exposed to a temperature of -3 degrees C for approximately 30 min. Slow re-warming, using external modalities was used in addition to volume expansion, heparinization, antibiotics and sedation. There is limited information available concerning the safest and most effective method of re-warming hypothermic newborns. Slow re-warming has been advocated as it replicates the normal physiological process in a neonate, which minimizes a negative therapy impact. CONCLUSION: The most significant decision regarding treatment is the identification of the most appropriate method and speed of re-warming. This report supports recommendations for gradual re-warming of a severely hypothermic newborn. Physiological cardiovascular mechanisms seemed to be intact during slow re-warming; this might be applicable to the treatment of profound hypothermia of the newborn.
Asunto(s)
Hipotermia/terapia , Recalentamiento , Temperatura Corporal , Humanos , Hipotermia/complicaciones , Recién Nacido , Masculino , Resucitación , Recalentamiento/métodos , Factores de TiempoRESUMEN
The purpose of the article is to present the National Breastfeeding Promotion Programme in the Czech Republic in the course of the last decade. It summarizes the main strategies, education and training activities of the National Breastfeeding Committee, its collaboration with the Government, Parliament, IBFAN and UNICEF. The article reviews the relevant studies on infant feeding which illustrate the increase of the prevalence of breastfeeding in the course of the 1990's and reflect the effect of the programme. Recent negotiations with the Ministry of Health have outlined the implementation of the WHO global strategy for infant and young child feeding in the Czech Republic.
Asunto(s)
Lactancia Materna , Ciencias de la Nutrición del Niño/educación , Promoción de la Salud/métodos , Fenómenos Fisiológicos Nutricionales del Lactante , República Checa , Educación en Salud/métodos , Humanos , Lactante , Recién Nacido , Programas Nacionales de Salud , Naciones Unidas , Organización Mundial de la SaludRESUMEN
OBJECTIVE: To find out the state of breastfeeding support in prenatal and perinatal care and infant feeding in first 6 months in 6 big cities of Czech Republic in 1998-1999. DESIGN: Cross-sectional multicentre descriptive study of 6 medical schools. SETTING: Centre of Preventive Medicine, 3rd Medical Faculty, Charles University, Prague. METHODS: In the first year of the study (1998), 1104 mothers were interviewed by neonatologists at the discharge from 9 maternity hospitals. After 6 months, 1019 mothers of the same sample were interviewed again by students and staff members of 6 medical schools. Obtained data were analyzed in EpiInfo 6 programme using ANOVA and x2 test. RESULTS: 29 percent of mothers participated in prenatal classes. 70 percent of newborns were put to the breast within two hours after birth. 44 percent of mothers reported problems with breastfeeding in the hospital. 77 percent of mothers appreciated the assistance with breastfeeding in the hospital. Mothers with higher education, living with partner or husband, mothers who participated in prenatal classes, mothers after vaginal labour, mothers whose children were put to the breast within two hours after birth and mothers who did not have problems with breastfeeding in the hospital were breastfeeding fully for significantly longer period. At the discharge from the hospital, 93.5 percent of newborns were fully breastfed. At the end of the 6th month, 23.1 percent of infants were fully breastfed and 29.9 percent of infants were breastfed while receiving complementary food. CONCLUSION: Breastfeeding rate at the end of the 6th month of age of infants increased apparently in mothers from 6 big cities of Czech Republic in comparison with national data from 1991.
Asunto(s)
Lactancia Materna/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Maternidades/estadística & datos numéricos , Atención Posnatal , Femenino , Humanos , Recién Nacido , Embarazo , Atención PrenatalRESUMEN
The submitted investigation describes long-term changes of 3 main cephalic dimensions (head circumference, maximal length and maximal width of the head) and analyses the possible influence of positioning of infants after birth (prone, supine and side sleeping position) on these changes. Information about children aged 6 months to 3.99 years, where the need of up-to-date data is greatest, were collected as part of an extensive anthropological survey implemented in 1995 to 1997 in the entire Czech Republic. The authors confirmed the trend of debrachycephalization, which is manifested by a statistically significant increase of the maximal length of the head and a statistically significant decrease of the maximal width of the head, as compared with children examined in the anthropological survey in 1956 to 1962 (1). These changes were established in the group of boys (200 boys) as well as in the group of girls (167 girls). The differences of the magnitude of long-term changes between boys and girls were not significant. Evaluation of the long-term changes of the head circumference in the entire group of 366 children aged 0.5-3.99 years (the head circumference of one girl was not measured) revealed a statistically significant increase of this dimension. During the period from 1956/62 till 1996, the influence of positioning on the magnitude of long-term changes of head circumference was not proved. We can say the same about the maximal length of the head of boys and girls and about the maximal width of the head of girls. Only between three differently positioned groups of boys (prone, side, supine) statistically significant differences in the magnitude of long-term changes of the maximal width of the head were found (p < 0.05). Highly significant changes of the maximum width and maximum length of the head occurred as compared with a reference group in all three groups of positioning of infants and in both sexes. The trend of debrachycephalization seems to be thus a more potent factor, which affects long-term changes in the shape of the head, then the predominating sleeping position during the first months after birth. This conclusion is supported by the persisting trend of debrachycephalization, although the supine position is now preferred.
Asunto(s)
Cuidado del Lactante/métodos , Postura , Cráneo/anatomía & histología , Cráneo/crecimiento & desarrollo , Sueño , Análisis de Varianza , Cefalometría , Preescolar , Estudios Transversales , República Checa , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Valores de Referencia , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
With the support of the Internal Grant Agency of the Ministry of Health of the Czech Republic in 1997-1999 work proceeded on the grant "Semi-longitudinal study of the somatic growth of school children in the Czech Republic". The objective of this project is to assess the growth rate of the basic bodily characteristics in children and youth aged 6 to 14 years, to confirm the positive secular trend in height and body weight or its slowing or stagnation, and also to evaluate the growth and development of children under the new socio-economic conditions. In addition to thirty somatic characteristics which are assessed repeatedly every six months, in 1,925 children some supplementary data were obtained from parents. From hitherto assembled data ensues that there was no significant change of the mean length at birth nor of the birth weight as compared with 1989. The increase in height up to adolescence continues, in the higher age groups probably stagnation occurs. Despite a slight increase of mean body weight values since 1981, a gradual decline of the BMI values was observed. In boys this tendency is less marked than in girls, in particular in the oldest age groups. This trend was confirmed also by the results of the present investigation. As compared with the results of the 5th Nationwide Anthropological Survey in 1991 the group of overweight children, i.e. those above the 90th percentile of BMI comprises 6.9% boys and 8.9% girls from a total of almost 2,000 children, as compared with the expected 10%.
Asunto(s)
Desarrollo Infantil , Adolescente , Peso al Nacer , Estatura , Índice de Masa Corporal , Niño , Preescolar , República Checa , Recolección de Datos , Femenino , Humanos , Recién Nacido , Estudios Longitudinales , Masculino , Valores de Referencia , Clase SocialRESUMEN
The authors investigated the relationship between histologically confirmed chorioamnionitis and the development of adnatal infection in the neonate. From a total of 4,144 deliveries during the investigation period-January 1, 1988 to December 31, 1989-252 placentas of neonates after pathological deliveries were examined. Chorioamnionitis was recorded in 28.6%, i.e. in 72 placentas inflammatory changes were found. Adnatal infections of neonates with chorioamnionitis were detected in 20.8%, i.e. 15 neonates. On the other hand, in the group of neonates where no inflammatory changes of the placenta were present adnatal infections were recorded in 8 infants, i.e. 4.4% (p = 0.00004). The mortality rate from adnatal infections in the group of neonates with chorioamnionitis was 4.16%. In the group of neonates without chorioamnionitis no death due to adnatal infection was recorded (p = 0.00000). Chorioamnionitis is thus associated with a significantly higher incidence of clinical adnatal infection in neonates and mortality due to this infection.
Asunto(s)
Corioamnionitis/complicaciones , Infecciones/etiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Infecciones/mortalidad , EmbarazoAsunto(s)
Mama/anatomía & histología , Lactancia/fisiología , Mama/fisiología , Lactancia Materna , Femenino , Humanos , Recién NacidoRESUMEN
The suspicion of prenatal meconium ileus syndrome was raised in a pregnancy in a family with no history of cystic fibrosis because of significantly higher maternal serum alpha-fetoprotein in the 16th and 19th week of gestation, dispersed areas with increased echogenity in the fetal abdomen, slight fetal ascites in the 24th-25th weeks of gestation, decreased amniotic fluid gamma-glutamyltranspeptidase (GGT) activity and alpha-fetoprotein level in the 25th-26th weeks, and normal 46,XY karotype of the fetus. The detection of a homozygous deltaF508 cystic fibrosis transmembrane regulator (CFTR) gene mutation, by means of PCR from a small amount of white blood cells and urine sediment cells, substantiated the diagnosis of cystic fibrosis in a prematurely delivered boy in the 28th week of gestation. The repeated sweat test was unsuccessful. The autopsy examination confirmed the diagnosis of cystic fibrosis. Fetal meconium ileus syndrome was complicated by peritonitis and by formation of a meconium pseudocyst. Direct PCR typing improves postnatal diagnostic possibilities in the early neonatal period in prematurely delivered babies when the sweat test is difficult to perform.
Asunto(s)
Fibrosis Quística/genética , Enfermedades Fetales/etiología , Recien Nacido Prematuro , Seudoobstrucción Intestinal/etiología , Meconio , Proteínas de la Membrana/genética , Mutación/genética , Deleción Cromosómica , Fibrosis Quística/complicaciones , Fibrosis Quística/diagnóstico , Regulador de Conductancia de Transmembrana de Fibrosis Quística , Ligamiento Genético/genética , Marcadores Genéticos/genética , Humanos , Recién Nacido , Masculino , Proteínas de la Membrana/análisis , Reacción en Cadena de la Polimerasa , Polimorfismo Genético/genética , alfa-Fetoproteínas/análisisAsunto(s)
Bilirrubina/sangre , Ictericia Neonatal/sangre , Fototerapia , Humanos , Recién Nacido , Ictericia Neonatal/terapiaRESUMEN
A total of 1132 samples of maternal milk expressed from the disinfected breast on the first days after parturition were subjected to microbiological examination. Contamination by group B streptococci (Streptococcus agalactiae) was demonstrated in 40 samples (3.53%). Strains carrying the antigens Ia, Ia/c, Ib/c, II, III and R were represented among the isolates. Type Ia/c was the commonest; antigens II and III were always combined with the R antigen. The milk was either very strongly contaminated with almost pure culture demonstrable by direct cultivation of the milk sediment, or only isolated colonies were obtained in primary culture, often not until after enrichment. If the first samples gave dense growths, second-sample cultures were also positive. The strains isolated from samples of the individual mothers milk differed by their antigenic type structure; this gave evidence that the infection was not of nosocomial origin. Immunoglobulin levels in the whey of positive samples were not different from the whey of mothers not shedding group B streptococci. The health of both mothers and infants did not deviate from the general average for normal mothers and infants. No signs common to all the mothers shedding group B streptococci in their milk and no marked effect on the infants' health up to the age of 1-2 years were established.