RESUMO
OBJECTIVE: To identify cases of congenital rubella syndrome (CRS) and their form of presentation in children aged < 3 months in the National Children's Hospital of Costa Rica between 1996 and 2000. METHODS: Between 1996 and 2000, patients aged 1 day to 3 months with positive IgM serology for rubella, identified by means of the computerized database of the National Children's Hospital Laboratory, were selected. Their corresponding medical records were reviewed and the characteristics of these patients were analyzed. RESULTS: Sixty-six children with positive serology were identified, of which 49 had a complete medical record that allowed review. Of these, 29 (60 %) were boys. The mean age at which IgM serology was requested was 33 days. The principal manifestations leading to serology were hepatosplenomegaly, microcephaly and multiple congenital anomalies. The initial diagnosis was TORCH infection. Of the 49 patients, 45 were classified as CRS and four as infection with rubella. CONCLUSIONS: The present study highlights the need to increase active surveillance of CRS. Greater vigilance in applying the criteria for clinical diagnosis is required to allow an adequate degree of suspicion and early reporting of cases.
Assuntos
Síndrome da Rubéola Congênita/epidemiologia , Costa Rica/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Vigilância da População , Estudos Retrospectivos , Síndrome da Rubéola Congênita/prevenção & controleRESUMO
Este documento tiene la finalidad de actualizar los conocimientos relacionados con la atención nutricional del recién nacido de pretérmino. Estos niños, por nacer antes de término normal de la gestación, presentan una inmadurez generalizada, en consecuencia, sus procesos metabólicos se alteran, su secreción pancreática y biliar es deficiente y tienen una función enzimática y renal anormal. Por todo ello, sus requerimientos dietéticos varían, en calidad y cantidad, de los del niño de término. Su requerimiento energético promedio es de 150 Kcal/kg/día, el protéico de 2.25 a 4.5 g de prot/kg/día y el de lípidos de 4 g de grasa/kg/día, con un 3% de ácido linoleico y un 40% de triglicéridos de cadena media. La recomendación hídrica es de 150 a 200 cc/kg/día y deben dárseles suplementos de minerales y vitaminas. Las leches producidas por madres de niños de pretérmino satisfacen sus requerimientos de proteínas y calorías, sin embargo es deficiente en algunas vitaminas y minerales. La leche materna de madres de niños de término, debe fortificarse con varios nutrientes para usarla en niños de pretérmino, si se desea alcanzar velocidades de crecimiento adecuadas. Las fórmulas lácteas comerciales adaptadas para los niños de pretérmino, generan buenas tasas de crecimiento y son útiles cuando no se cuenta con leche materna para su alimentación.
Assuntos
Humanos , Recém-Nascido , Lactente , Necessidades Nutricionais , Costa Rica , Recém-Nascido , Recém-Nascido Prematuro , Nutrição do Lactente , Estado NutricionalAssuntos
Insuficiência de Crescimento/terapia , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-NascidoRESUMO
This paper presents a multidisciplinary approach to treat children with failure to thrive (FTT). The FTT team of the Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA) is composed of professional staff, including pediatrician, nutritionist, psychologist and social worker. They evaluate each patient and provide an integrated treatment. The early detection and the appropriate management of children with FTT will improve the physical and psychosocial condition of these patients.
Assuntos
Insuficiência de Crescimento/terapia , Assistência Ambulatorial , Criança , Criança Hospitalizada/psicologia , Pré-Escolar , Terapia Combinada , Costa Rica , Insuficiência de Crescimento/diagnóstico , Insuficiência de Crescimento/psicologia , Seguimentos , Humanos , LactenteRESUMO
To determinate the different characteristics of growth and development that could categorize the etiology of failure to thrive (FTT), we analyzed 174 patients hospitalized because of FTT. Forty-eight percent had "organic and psychosocial" causes, and fifty-two percent had "non- organic" causes. The predominant organic factors were intrauterine retardation (41%) and gastrointestinal pathology (24%). Children with genetic and neurologic diseases were significantly more stunted and wasted than those of the "non-organic category (p less than 0.05). At discharge, the anthropometric data of the patients with genetic pathology remained with lower values than the ones observed in the other categories (p less than 0.05). The genetic and neurologic categories had the higher percentages of psychomotor retardation, and this impairment didn't improve after treatment. In all the categories, the motor areas were most retarded at the time of admission; nevertheless, they showed the higher percentage of recovery.
Assuntos
Insuficiência de Crescimento/etiologia , Antropometria , Criança , Pré-Escolar , Insuficiência de Crescimento/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Desempenho Psicomotor/fisiologiaRESUMO
Mean serum cholesterol and triglyceride concentrations were higher for two groups of sedentary middle-aged and elderly men than for a group of physically-active, middle-aged farmers, all from rural Puriscal, Costa Rica. The mean serum cholesterol, triglyceride, and high-density lipoprotein (HDL)-risk factor levels of the three groups were all higher than the comparable US means. Dietary fat and cholesterol intake were also greater for the Puriscal men than for the comparable US counterpart. No correlations were found between dietary fat or cholesterol and the corresponding serum levels. Age was correlated with serum cholesterol and HDL-risk factor values. Weight was also correlated with these variables as well as with serum triglyceride concentrations. A high prevalence of obesity was found among the middle-aged sedentary men.
Assuntos
Colesterol/sangue , Gorduras na Dieta/administração & dosagem , Lipoproteínas HDL/sangue , Esforço Físico , Triglicerídeos/sangue , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Peso Corporal , Costa Rica , Gorduras na Dieta/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Saúde da População RuralRESUMO
The nutritional status of aged persons living in a small Costa Rican community was evaluated using anthropometric measurements, clinical findings and dietary surveys. Eighteen per cent of the aged were overweight, a condition that occurred more frequently in women than in men. In a random sample of subjects, serum albumin values were low in 45%, serum cholesterol values high in 39%, and hemoglobin values low in 3%. The subjects consumed a simple, repetitive diet with few processed foods which met 80% of requirements for protein, calcium, and iron, although calorie and vitamin A values appeared low. The lack of severe nutritional problems of the elderly was attributed to the family structure, good hygiene and protection from debilitating infectious disease, good community health services, and simple balanced diets.
Assuntos
Idoso , Fenômenos Fisiológicos da Nutrição , Estatura , Peso Corporal , Colesterol/sangue , Costa Rica , Dieta , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Masculino , Albumina Sérica/análise , Fatores SocioeconômicosRESUMO
Se evaluo el estado nutricional de las personas de edad avanzada de una pequena comunidad costarricense, valiendose de mediciones antropometricas, hallazgos clinicos, y encuestas dieteticas. Segun revelaron los resultados, el 18% de dichas personas tenian sobrepeso, condicion que se observo con mayor frecuencia en las mujeres que en los hombres (P < 0.025). En una muestra de sujetos seleccionada al azar, los valores sericos de albumina fueron bajos en un 45%, los de colesterol, altos en un 39%, y los de hemoglobina, bajos en un 3%. Los sujetos consumian una dieta sencilla, repetitiva, que incluia pocos productos procesados y que satisfacia el 80% de los requerimientos establecidos por la Organizacion Mundial de la Salud (OMS) para proteina, calcio y hierro, aunque aparentemente, los valores para calorias y vitamina A eran bajos. La ausencia de problemas nutricionales graves entre las personas de edad avanzada de Palmares se atribuyo a la estructura familiar, buena higiene y proteccion contra las enfermedades infecciosas debilitantes, servicios de salud en la comunidade efectivos, y dietas simples y balanceadas
Assuntos
Humanos , Masculino , Feminino , Idoso , Ciências da Nutrição , Costa RicaRESUMO
Twenty-eight healthy neonates from the San Juan de Dios Hospital were studied to determine the pattern of antibiotic resistance of indigenous intestinal bacteria. Sixty-eight per cent of infants had enterobacteriaceae resistant to several wide-spectrum antibiotics, including ampicillin; 28 per cent of the cultures had plasmid-mediated ampicillin resistance. In the course of the study, an outbreak of 10 acute cases of diarrhea occurred, not associated to any of the commonly known agents, including the rotaviruses. Enterobacteriaceae multiple resistant were isolated from all cases; ampicillin-resistant strains were found in all; those resistances were mediated by transmissible plasmids. Several sites of the Neonatology Ward were sampled and two yielded E. coli with resistance to 8 drugs transmissible in vitro. The outbreak was controlled after strict hygienic measures were established in the ward. A following sample showed a decrease in indigenous antibiotic-resistant strains, especially E. coli; however, plasmid mediated resistant Klebsiella was still isolated several months later. The need to regulate the use of antibiotics; to educate the medical personnel and the public in general and to modify the hospital norms and regulations are discussed in the paper.