Monitoreo de morbilidad materna extrema (near miss como compromiso internacional para complementar la calidad de la atención en salud materna

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C.E. Franco-Yáñez

2016-01-01

Conclusión: Un adecuado monitoreo no solo de la mortalidad, sino también la morbilidad materna y la morbilidad materna grave o extrema, forma parte de las prácticas que en nuestro país deben adoptarse a fin de tener un adecuado cumplimiento de compromisos internacionales en salud.

Combined enteral and parenteral nutrition.

Science.gov (United States)

Wernerman, Jan

2012-03-01

To review and discuss the evidence and arguments to combine enteral nutrition and parenteral nutrition in the ICU, in particular with reference to the Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (EPaNIC) study. The EPaNIC study shows an advantage in terms of discharges alive from the ICU when parenteral nutrition is delayed to day 8 as compared with combining enteral nutrition and parenteral nutrition from day 3 of ICU stay. The difference between the guidelines from the European Society of Enteral and Parenteral Nutrition in Europe and American Society for Parenteral and Enteral Nutrition/Society of Critical Care Medicine in North America concerning the combination of enteral nutrition and parenteral nutrition during the initial week of ICU stay was reviewed. The EPaNIC study clearly demonstrates that early parenteral nutrition in the ICU is not in the best interests of most patients. Exactly at what time point the combination of enteral nutrition and parenteral nutrition should be considered is still an open question.

Efeitos da hidroterapia na recuperação do equilíbrio e prevenção de quedas em idosas Effects of hydrotherapy in balance and prevention of falls among elderly women

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SM Resende

2008-02-01

Full Text Available CONTEXTO: A hidroterapia é utilizada para tratar doenças reumáticas, ortopédicas e neurológicas. Na atualidade, é alvo de investigações na recuperação do equilíbrio em idosos. OBJETIVO: Avaliar o efeito de um programa de hidroterapia no equilíbrio e no risco de quedas em idosas. MÉTODOS: Trata-se de um estudo quase-experimental antes/depois sem grupo controle. Foram avaliadas 25 idosas por meio de duas escalas, a Escala de Equilíbrio de Berg e Timed Up & Go. Posteriormente, foram submetidas a um programa de hidroterapia para equilíbrio, de baixa a moderada intensidade, que consistiu de três fases: fase de adaptação ao meio aquático, fase de alongamento e fase de exercícios estáticos e dinâmicos para equilíbrio. O programa foi aplicado durante 12 semanas, sendo duas sessões semanais com 40 minutos de duração cada sessão. As idosas foram reavaliadas após a sexta e a 12ª semanas do programa de hidroterapia. Os dados foram analisados estatisticamente pelo teste t, para amostras pareadas, e pelo teste de Wilcoxon. RESULTADOS: A hidroterapia promoveu aumento significativo do equilíbrio das idosas, avaliado por meio da Escala de Equilíbrio de Berg (pBACKGROUND: Hydrotherapy is used to treat rheumatic, orthopedic and neurological disorders. It has been the subject of investigations regarding balance recovery in elderly people. OBJECTIVE: To evaluate the effect of a hydrotherapy program for balance, in relation to the risk of falls in elderly women. METHODS: This was a quasi-experimental before/after study without a control group. Twenty-five elderly women were evaluated using two scales: the Berg Balance Scale and Timed Up & Go. The subjects underwent, subsequently, a low to moderate intensity hydrotherapy program for balance, which consisted of three phases: a phase of adaptation to the aquatic environment, a stretching phase and a phase of static and dynamic balance exercises. The program was applied for 12 weeks, with

Total parenteral nutrition

Science.gov (United States)

... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

Parenteral nutrition.

Science.gov (United States)

Inayet, N; Neild, P

2015-03-01

Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.

Fomento de lactancia materna, centro de salud de Ermitagaña

OpenAIRE

López de Sabando Güenechea, Marina

2013-01-01

En este trabajo se han desarrollado los aspectos principales sobre la lactancia materna (L.M.): anatomía de la mama, fisiología de la lactancia, técnicas de amamantamiento, beneficios de la lactancia materna, pecho en bebés prematuros, extracción y conservación de la leche, bancos de leche materna, problemas más frecuentes; lactancia, medicamentos, plantas y tóxicos; contraindicaciones para la lactancia y asociaciones de apoyo. Todo ello para que las madres pacientes del cen...

Componentes biol??gicamente activos de la leche materna

OpenAIRE

Bar?? Rodr??guez, Luis; Jim??nez, J.; Mart??nez-F??rez, Antonio; Boza Puerta, Julio Jos??

2001-01-01

La leche materna es un complejo fluido biol??gico que aporta la energ??a y los nutrientes esenciales para el desarrollo y crecimiento del reci??n nacido. Pero adem??s, la leche materna contiene toda una serie de compuestos bioactivos como enzimas, hormonas, factores de crecimiento, prote??nas espec??ficas, poliaminas, nucle??tidos, oligosac??ridos, etc., que ejercen efectos biol??gicos y que en conjunto reciben el nombre de ???factores tr??ficos de la leche???. Estos compuestos bi...

Influencia del contacto precoz, nacionalidad, tipo de parto y prematuridad en la lactancia materna

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Ana Belén Laviña Castan

2015-01-01

Full Text Available Conocer si en el HUMS existe asociación entre lactancia materna y nacionalidad, prematuridad, tipo de parto, contacto precoz piel con piel. Estudio de cohortes, en una muestra de 541 puérperas del HUMS en octubre-noviembre 2011. Las variables: nacionalidad, tipo de parto, contacto precoz, parto prematuro e inicio lactancia materna se recogieron antes del alta hospitalaria mediante cuestionario. A los dos meses postparto se contactó telefónicamente con las madres para conocer el tipo de lactancia en ese momento. El 70,32 % iniciaron la lactancia materna en las dos primeras horas postparto y el 55,58% daban Lactancia materna exclusiva (LME a los dos meses. Influyen en la lactancia materna el tipo de parto, contacto precoz y parto prematuro. La probabilidad de lactancia materna es 3,65 veces más alta si se ha realizado contacto precoz (RR 3,65; IC 95% 2,72-4,88; p=0,001. El inicio de lactancia materna en las 2 primeras horas y la nacionalidad española influye positivamente en la LME a los 2 meses. Las prácticas hospitalarias en el postparto deben promover el contacto precoz madre-recién nacido y el inicio de lactancia materna en las dos primeras horas, principalmente en las cesáreas.

21 CFR 201.323 - Aluminum in large and small volume parenterals used in total parenteral nutrition.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Aluminum in large and small volume parenterals... for Specific Drug Products § 201.323 Aluminum in large and small volume parenterals used in total parenteral nutrition. (a) The aluminum content of large volume parenteral (LVP) drug products used in total...

Impacto de la lactancia materna en la vacunación infantil

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Deyanira La Rosa Hernández

2013-03-01

Full Text Available Dos de los factores más importantes que intervienen en la prevención de enfermedades infecciosas en el menor de un año son: la lactancia materna y la vacunación infantil. En el desarrollo de las respuestas inmunitarias inducidas por vacunas se precisa de un sistema inmunitario competente, en el que la lactancia materna juega un papel esencial como inductor de madurez inmunológica de la etapa posnatal. La lactancia materna exclusiva potencia las respuestas inmunitarias de la mayoría de los inmunógenos vacunales aplicados en los programas de inmunización infantil. Para enriquecer nuestros conocimientos sobre el efecto de la leche humana sobre la vacunación se realizó una revisión bibliográfica tras consultar las bases de datos Google, Medline y el Localizador de Información de Salud de Infomed con la utilización de descriptores como lactancia materna, vacunas, breast-feeding and vaccine.

Lactancia materna y caries de la infancia temprana

OpenAIRE

Mario Alberto Maldonado Ramírez; Alejandra González Hernández; Enrique E. Huitzil Muñoz; Hilda Isassi Hernández; Ricardo Reyes Flores

2016-01-01

La lactancia materna es una práctica natural destinada a favorecer el crecimiento y desarrollo del lactante, sin embargo, a pesar de que proporciona inmunidad contra ciertos patógenos, se cree que favorece el proceso de la caries dental. Objetivo: El propósito del presente estudio fue comprobar si la lactancia materna contribuye en la aparición de caries dental de la primera infancia. Materiales y Métodos: El presente es un estudio transversal analítico. La muestra incluyó a 164 menores cuyas...

Análisis del comportamiento de la mortalidad materna y perinatal

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Angélica Uribe-Meneses

2011-12-01

Full Text Available Este estudio se orientó a identificar las causas, calcular la tasa y caracterizar los casos de mortalidad materna y perinatal en la Empresa Social del Estado Hospital Regional Noroccidental del departamento Norte de Santander, entre los años 2006 a 2009. La investigación es de carácter cuantitativo, descriptivo, con enfoque retrospectivo. Se emplearon los siguientes instrumentos para la recolección de información: Ficha SIVIGILA de notificación mortalidad materno perinatal del Instituto Nacional de Salud, encuesta de visita de campo del protocolo para la vigilancia de la mortalidad materno-perinatal del Instituto Nacional de Salud, historias clínicas de cada uno de los casos objeto de estudio. La población es tomada del total de muertes maternas y perinatales de procedencia de la Empresa Social del Estado Hospital Regional Noroccidental del departamento Norte de Santander, la muestra está representada en el 100% de los de casos de mortalidad materna y perinatal de la ESE, que en total son 65 casos, 7 de mortalidad materna y 58 de mortalidad perinatal. Entre las causas identificadas como más prevalentes para la mortalidad materna fueron la eclampsia y/ pre-eclampsia, y la causa de mortalidad perinatal fue el síndrome de dificultad respiratoria, la tasa más alta de mortalidad materna la presentó el municipio del Carmen con 1.49 y convención con 1.41 por 10.000 MEF y la tasa de mortalidad perinatal la presentó el municipio del Carmen con una tasa de 29.65 por 1.000 nacidos vivos.

Home parenteral nutrition in children

International Nuclear Information System (INIS)

Kalousova, J.; Rouskova, B.; Styblova, J.

2011-01-01

Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized. (author)

Realidad actual de la triste y desesperante mortalidad materna

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Fadlalla Bahsas Bahsas

2015-05-01

Full Text Available Si bien el anuncio viene a completar el mandato del Plan de la Patria 2013-2019, que tiene entre sus objetivos “garantizar que los partos sean atendidos en condiciones seguras y reducir las tasas de mortalidad materna, perinatal e infantil”. “La tasa de mortalidad Infantil y Materna son indicadores que determinan el nivel del desarrollo del País”, sin embargo en la práctica en nuestro país, la mortalidad infantil y materna ha ido en ascenso en los últimos años. La muerte materna es un indicador claro de injusticia social, inequidad de género y pobreza: el que un embarazo o parto desemboque en la muerte de la mujer refleja problemas estructurales, tanto de acceso como de atención a la salud; de hecho es el más dramático de una serie de eventos que revelan la falta de acciones para atender la situación de atraso, marginación y rezago en la que vive un sector de las mujeres pobres; así como las personas que conviven con ellas, del personal de salud y autoridades gubernamentales. Por otro lado, da cuenta de una serie de relaciones económicas, sociales y culturales que ubican a la mujer en una franca desventaja.

Total parenteral nutrition - infants

Science.gov (United States)

... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

Atención prenatal y mortalidad materna hospitalaria en Tijuana, Baja California

OpenAIRE

Gonzaga-Soriano, María Rode; Zonana-Nacach, Abraham; Anzaldo-Campos, María Cecilia; Olazarán-Gutiérrez, Asbeidi

2014-01-01

Objetivo. Describir la atención médica prenatal recibida en mujeres con mortalidad materna hospitalaria en el IMSS durante 2005-2012 en Tijuana, Baja California, México. Material y métodos. La información se obtuvo de los archivos de los Comités de Mortalidad Materna y revisión del expediente. Resultados. Hubo 44 muertes maternas (MM). Treinta (68%) asistieron a atención prenatal (AP), el promedio de citas fue de 3.8 y 18 (41%) tuvieron una AP adecuada (≥ 5 citas). Seis (14%) mujeres no sabía...

Lactancia materna exclusiva: ¿la conocen las madres realmente?

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Yeis Miguel Borre Ortiz

2014-11-01

Full Text Available Introducción: La Organización Mundial de la Salud declara que la lactancia materna es un hábito ligado íntimamente a la supervivencia de la especie humana desde tiempo inmemorial. A nivel mundial, únicamente el 35% de los bebés son amamantados durante sus primeros cuatro meses de vida. La literatura evidencia que aún existen madres que desconocen su importancia. Por ello, el objetivo del presente estudio fue identificar si las madres de una localidad determinada de Santa Marta, conocían los beneficios y consecuencias de la lactancia materna exclusiva. Materiales y Métodos: Estudio descriptivo, transversal, cuantitativo, en el que se encuestaron 90 madres que acudieron al Centro de Salud 11 de Noviembre de Santa Marta (Colombia; seleccionadas por muestreo intencional, no probabilístico. Se preservaron aspectos éticos y metodológicos que dieran cuenta del rigor científico correspondiente. Resultados: De las 90 madres encuestadas, el 51% tiene edades entre 15 a 25 años, el 30% entre 26 a 35 años, y el 19% son mayores de 35 años. El 85.6% posee conocimientos adecuados sobre lactancia materna exclusiva. El 48.9% conoce la técnica de amamantamiento adecuada, mientras que el 51.1% restante no tiene idea de ello. Discusión: Los resultados del presente estudio guardan relación con estudios similares realizados a nivel nacional e internacional, los cuales muestran que aunque la LM es un factor fundamental para el adecuado desarrollo de la primera infancia, infancia y adolescencia, requiere que las madres estén más educadas y mejor informadas. Conclusiones: Las madres continúan mostrando altos índices de desinformación con respecto a la lactancia materna. Por tanto, se necesita el desarrollo y establecimiento de programas de educación, que permitan educar a esta población y a futuras madres lactantes; específicamente, a primigestantes y adolescentes.Palabras clave: Lactancia Materna, Madres, Conocimiento. (Fuente: DeCS BIREME

Causas externas e mortalidade materna: proposta de classificacao

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Mercia Maria Rodrigues Alves

2013-06-01

Full Text Available OBJETIVO: Analisar os óbitos por causas externas e causas mal definidas em mulheres em idade fértil ocorridos na gravidez e no puerpério precoce. MÉTODOS: Foram estudados 399 óbitos de mulheres em idade fértil de Recife, PE, de 2004 a 2006. A pesquisa utilizou o método Reproductive Age Mortality Survey e um conjunto de instrumentos de investigação padronizados. Foram usados como fontes de dados laudos do Instituto Médico Legal, prontuários hospitalares e da Estratégia Saúde da Família e entrevistas com os familiares das mulheres falecidas. Óbitos por causa externa na gravidez foram classificados de acordo com a circunstância da morte usando-se o código O93 e calculadas as razões de mortalidade materna antes e depois da classificação. RESULTADOS: Foram identificados 18 óbitos na presença de gravidez. A maioria das mulheres tinha entre 20 e 29 anos, de quatro a sete anos de estudo, eram negras, solteiras. Quinze óbitos foram classificados com o código O93 como morte relacionada à gravidez (13 por homicídio - O93.7; dois por suicídio - O93.6 e três mortes maternas obstétricas indiretas (uma homicídio - O93.7 e duas por suicídio - O93.6. Houve incremento médio de 35,0% nas razões de mortalidade materna após classificação. CONCLUSÕES: Os óbitos por causas mal definidas e no puerpério precoce não ocorrem por acaso e sua exclusão dos cálculos dos indicadores de mortalidade materna aumentam os níveis de subinformação.

Relación entre las reservas de hierro maternas y del recién nacido

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Vásquez-Molina María Eugenia

2001-01-01

Full Text Available Objetivo. Determinar la relación de los valores hematológicos maternos y neonatales en casos de reservas maternas de hierro bajas, moderadas y normales. Material y métodos. Diseño transversal en el que se incluyó a 163 mujeres embarazadas y sus neonatos de término, derechohabientes del Hospital de Ginecología y Obstetricia número 15 del Instituto Mexicano del Seguro Social (IMSS en Chihuahua, Chih., México. Se analizaron antecedentes maternos. Se determinaron niveles de hemoglobina, hematocrito y ferritina sérica en muestras maternas y de cordón umbilical. Se definieron reservas de hierro maternas de acuerdo a ferritina (µg /l: bajas o = 20.1. Se utilizó la prueba de Kruskal Wallis para establecer diferencias entre grupos, ji cuadrada para diferencia de proporciones y r de Pearson para establecer la relación entre reservas de hierro maternas y del recién nacido. Resultados. Se determinó una débil correlación entre la ferritina materna y neonatal r=0.14 (p=0.07. Las medias geométricas de ferritina neonatal respecto a las reservas maternas bajas, moderadas y normales fue de 4.77, 4.85 y 5.02, respectivamente (p=0.12. Las reservas de hierro maternas se modificaron con el suplemento de hierro (p=0.01. Conclusiones. Las reservas de hierro en el recién nacido están en estrecha relación con las maternas. Las mujeres que toman suplementos con hierro durante la gestación tienen reservas mayores al final del embarazo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Parenteral nutrition in the critically ill.

Science.gov (United States)

Gunst, Jan; Van den Berghe, Greet

2017-04-01

Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

Relación entre el período de lactancia materna y maloclusiones

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Rosa Gabriela Rondón

2012-02-01

Full Text Available Los beneficios de la lactancia materna en la prevención de las maloclusiones han sido descritos en la literatura odontológica, destacando que lactar exclusivamente más de 6 meses disminuye su prevalencia. Objetivo: determinar la relación entre periodo de Lactancia Materna y Maloclusiones. Material y métodos: se examinó una muestra de 59 niños en edades entre 6 y 13 años en la parroquia Higuerote, Miranda, Venezuela. Se aplicó un cuestionario a cada representante para obtener datos sobre el periodo de lactancia materna recibida por el niño y se efectuó un examen clínico bucal observando variables ortodóncicas en cada niño. Se realizó un modelo de análisis de significancia p<0,05, mediante la prueba de Fisher a través del Análisis de Varianza Univariado (ANOVA, para evidenciar si existían diferencias estadísticamente significativas entre periodo de lactancia materna y las variables: relación molar permanente, mordida abierta anterior y mordida cruzada posterior. También se aplicó la prueba no paramétrica de Kruskal-Wallis en aquellos casos en donde la muestra fue menor de 30 observaciones. Resultados: existe relación estadística significativa entre un periodo de lactancia materna menor de 6 meses y relación molar en clase II de Angle y mordida abierta anterior, sin embargo para mordida cruzada posterior no se halló significancia estadística. Se encontró relación estadísticamente significativa entre un periodo de lactancia materna mayor de 6 meses con relación molar en clase I de Angle. Conclusión: se plantea que un periodo de lactancia materna mayor de 6 meses se relaciona con la ausencia de maloclusión en el grupo estudiado.

Lactancia Materna y VIH/SIDA

Science.gov (United States)

Valeria Cortés, F.; Jaime Pérez, A.; Lilian Ferrer, L.; Rosina Cianelli, A.; Báltica Cabieses, V.

2009-01-01

Resumen VIH/SIDA es una pandemia que afecta a hombres, mujeres y niños, pero que presenta una tendencia hacia la feminización, afectando especialmente a mujeres jóvenes. Su consecuencia es el aumento de la transmisión vertical, durante el embarazo, parto o lactancia materna. Este estudio bibliográfico describe la relación entre VIH/SIDA y lactancia materna, explicitando factores que influyen en la elección de la modalidad de alimentación de madres viviendo con VIH/SIDA. Se describen causas de morbimortalidad infantil asociada y recomendaciones internacionales de lactancia en mujeres con VIH/SIDA. En un mundo globalizado con constantes migraciones poblacionales, estos resultados representan un llamado de atención para profesionales de salud quienes deben considerar factores sociales que influenciarán la toma de decisión de madres viviendo con VIH/SIDA al escoger la modalidad de lactancia. No sólo basta conocer el riesgo de transmisión vertical, sino que se debe tomar conciencia de aquellos factores dinámicos y específicos de cada comunidad. PMID:20046815

Maternal death due to domestic violence: an unrecognized critical component of maternal mortality Muerte materna ocasionada por violencia doméstica: componente crítico e inadvertido de la mortalidad materna

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Henry Espinoza

2005-02-01

Full Text Available En este trabajo subrayamos la necesidad de contar las muertes maternas que ocurren como resultado de episodios de violencia doméstica, y también exponemos algunas de las principales dificultades que se enfrentan al tratar de hacerlo. Examinamos algunos elementos básicos que deben tenerse presentes al contar las muertes maternas de este tipo y explicamos cómo una definición de mortalidad materna que dé cabida a la violencia doméstica como causa de muerte mejorará la vigilancia epidemiológica y las intervenciones de salud. Lograr un acuerdo general acerca de la definición de "muerte materna por violencia doméstica" y un marco estratégico para responder a ese tipo de muerte constituiría un logro de gran importancia para los sectores de la comunidad internacional que velan por la salud de la mujer y la equidad de género.

Lactancia materna, alimentación complementaria y el riesgo de obesidad infantil

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Luis Sandoval Jurado

2016-11-01

Conclusiones: La lactancia materna exclusiva menor a 3 meses de duración se presenta casi 4 veces más en los niños con obesidad, existiendo una diferencia para edad de inicio de alimentación complementaria, tiempo de lactancia materna y tiempo de consumo de leche de fórmula entre los niños con y sin obesidad.

ESPEN Guidelines on Parenteral Nutrition: gastroenterology

DEFF Research Database (Denmark)

A., Van Gossum; Cabre, E.; Hebuterne, X.

2009-01-01

. There is a lack of data supporting specific nutrients in these conditions. Parenteral nutrition is mandatory in case of intestinal failure, at least in the acute period. In patients with short bowel, specific attention should be paid to water and electrolyte supplementation. Currently, the use of growth hormone......-based recommendations for the indications, application and type of parenteral formula to be used in acute and chronic phases of illness. Parenteral nutrition is not recommended as a primary treatment in CD and UC. The use of parenteral nutrition is however reliable when oral/enteral feeding is not possible...

Trauma na gestante: análise da mortalidade materna e fetal

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Paulo Roberto Corsi

Full Text Available Foram analisadas retrospectivamente 26 pacientes gestantes traumatizadas, num período de nove anos. A média de idade foi 23,7 anos (16-42. A idade gestacional variou de dez a quarenta semanas (média 21,5 semanas; a maioria (46,1% no segundo trimestre. O mecanismo predominante (65,3% foi o trauma abdominal fechado por acidente automobilístico (atropelamento ou colisão. Na admissão, oito (30,7% pacientes apresentavam alterações hemodinâmicas. Seis doentes (23,0% apresentavam sangramento vaginal e, destas, quatro estavam hemodinamicamente normais. Analisamos a mortalidade materna, a mortalidade fetal e suas causas. Comparamos também a mediana dos valores do RTS e TRISS entre os grupos, sobrevida materno-fetal, sobrevida materna e óbito materno-fetal. Todas as gestantes admitidas com sangramento vaginal apresentaram óbito fetal. A mortalidade materna foi de 11,5%, por choque hemorrágico. A mortalidade fetal foi de 30,7%, sendo que 37,5% destes óbitos foram provocados pela morte materna. A principal causa de mortalidade fetal foi o descolamento de placenta (50,0%. Os índices de trauma, RTS e TRISS, foram significativamente menor (p=0,0025 e p<0,0001 no grupo óbito materno-fetal, porém esses índices não apresentaram valor prognóstico na mortalidade fetal.

Early versus Late Parenteral Nutrition in Critically Ill Children.

Science.gov (United States)

Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Wouters, Pieter J; Vanhorebeek, Ilse; Debaveye, Yves; Vlasselaers, Dirk; Desmet, Lars; Casaer, Michael P; Garcia Guerra, Gonzalo; Hanot, Jan; Joffe, Ari; Tibboel, Dick; Joosten, Koen; Van den Berghe, Greet

2016-03-24

Recent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. We conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition. Fluid loading was similar in the two groups. The two primary end points were new infection acquired during the ICU stay and the adjusted duration of ICU dependency, as assessed by the number of days in the ICU and as time to discharge alive from ICU. For the 723 patients receiving early parenteral nutrition, parenteral nutrition was initiated within 24 hours after ICU admission, whereas for the 717 patients receiving late parenteral nutrition, parenteral nutrition was not provided until the morning of the 8th day in the ICU. In both groups, enteral nutrition was attempted early and intravenous micronutrients were provided. Although mortality was similar in the two groups, the percentage of patients with a new infection was 10.7% in the group receiving late parenteral nutrition, as compared with 18.5% in the group receiving early parenteral nutrition (adjusted odds ratio, 0.48; 95% confidence interval [CI], 0.35 to 0.66). The mean (±SE) duration of ICU stay was 6.5±0.4 days in the group receiving late parenteral nutrition, as compared with 9.2±0.8 days in the group receiving early parenteral nutrition; there was also a higher likelihood of an earlier live discharge from the ICU at any time in the late-parenteral-nutrition group (adjusted hazard ratio, 1.23; 95% CI, 1.11 to 1.37). Late parenteral nutrition was associated with a shorter duration of mechanical ventilatory support than was early parenteral nutrition (P=0.001), as well as a smaller proportion of patients

Morte materna mascarada: um caminho para sua identificação Muerte materna enmascarada: un camino para su identificación Identification of concealed or presumable maternal deaths

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Flávia Azevedo Gomes

2006-12-01

Full Text Available OBJETIVO: verificar a presença de mortes maternas mascaradas ou presumíveis a partir de procedimentos obstétricos e diagnósticos secundários registrados no Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS, nos Estados de São Paulo, Paraná, Pará, Ceará e Mato Grosso, nos anos de 1999 e 2000. MÉTODOS: utilizamos dados secundários dos CD-ROMs Movimento de Autorização de Internação Hospitalar (AIH do Sistema Único de Saúde, por meio de formulários das Autorização (AIHs. RESULTADOS: identificamos 651 mortes maternas declaradas pelo sistema e 55 foram mortes maternas mascaradas ou presumíveis, obtidas a partir de procedimentos obstétricos e diagnósticos secundários pertencentes ao Capítulo XV da CID 10 - Gravidez, parto e puerpério, registrados no SIH-SUS. CONCLUSÃO: o presente estudo revelou que tal sistema de informação pode ser utilizado como medida complementar para a identificação de mortes maternas não informadas.OBJETIVO: verificar la presencia de muertes maternas enmascaradas o presumibles a partir de procedimientos obstétricos y diagnósticos secundarios registrados en el Sistema de Informaciones Hospitalarios del Sistema Único de Salud (SIH-SUS, en los Estados de São Paulo, Paraná, Pará, Ceará e Mato Grosso, en los años de 1999 y 2000. MÉTODOS: utilizamos datos secundarios de los CD-ROMs Movimiento de Autorización de Internamiento Hospitalario (AIH del Sistema Único de Salud, por medio de formularios de las AIHs. RESULTADOS: identificamos 651 muertes maternas declaradas en el sistema y 55 fueron muertes maternas enmascaradas o presumibles, obtenidas a partir de procedimientos obstétricos y diagnósticos secundarios pertenecientes al Capítulo XV de la CID 10 - Embarazo, parto y puerperio, registrados en el SIH-SUS. CONCLUSIÓN: el presente estudio reveló que tal sistema de información puede ser utilizado como medida complementaria para la identificación de muertes

Lactancia materna en México

OpenAIRE

David Kershenobich

2017-01-01

En primer lugar, estuvo coordinado por una verdadera autoridad en el tema de la lactancia materna: la doctora Teresita González de Cosío Martínez. La valiosa experiencia de Teresita, en combinación con las de colaboradores muy reconocidos en los ámbitos académico, político y de organizaciones civiles, otorga al lector un panorama exhaustivo sobre la situación de la lactancia en México...

Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products.

Science.gov (United States)

Palm, Eric; Dotson, Bryan

2015-11-01

Drug shortages in the United States, including parenteral nutrition (PN) components, have been common in recent years and can adversely affect patient care. Here we report a case of copper and zinc deficiency in a patient receiving PN during a shortage of parenteral trace element products. The management of the patient's deficiencies, including the use of an imported parenteral multi-trace element product, is described. © 2014 American Society for Parenteral and Enteral Nutrition.

La mortalidad infantil y la mortalidad materna en el siglo XXI

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Aguirre, Alejandro

2009-01-01

La mortalidad infantil y la mortalidad materna han sido reducidas de manera sustancial en los países desarrollados, por lo cual en esas naciones la mortalidad tiende a concentrarse en las edades avanzadas de las poblaciones. Sin embargo, en países como México no está ocurriendo un avance relevante en la disminución de la mortalidad infantil y materna, pues a pesar de los notables progresos conseguidos en ese sentido durante las décadas recientes, para seguir avanzando se requieren fuertes inv...

Lactancia materna en México

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David Kershenobich

2017-05-01

Full Text Available En primer lugar, estuvo coordinado por una verdadera autoridad en el tema de la lactancia materna: la doctora Teresita González de Cosío Martínez. La valiosa experiencia de Teresita, en combinación con las de colaboradores muy reconocidos en los ámbitos académico, político y de organizaciones civiles, otorga al lector un panorama exhaustivo sobre la situación de la lactancia en México...

Hidroterapia no equilíbrio dinâmico e nas atividades de vida diária de pacientes com neurotoxoplasmose associada à Síndrome da Imunodeficiência Adquirida

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Larissa de Salgado de Oliveira

2016-05-01

Full Text Available Introdução: Por comprometer as células de defesa do organismo, o Vírus da Imunodeficiência Humana torna o indivíduo vulnerável ao aparecimento de diversas doenças, entre elas a neurotoxoplasmose. Objetivo: Verificar a influência de um protocolo de hidroterapia no equilíbrio dinâmico e nas atividades de vida diária de pacientes com neurotoxoplasmose associada à Síndrome da Imunodeficiência Adquirida (SIDA. Métodos: Participaram 15 voluntários, três (20% do sexo feminino e 12 (80% do masculino, com média de idade de 37,44±5,5 anos e diagnóstico de neurotoxoplasmose decorrente da SIDA, cadastrados na Unidade de Referência Especializada em Doenças Infectocontagiosas Parasitárias Especiais. Foram submetidos à avaliação do equilíbrio dinâmico pelo Índice de Marcha Dinâmico e à avaliação das atividades de vida diária pelo Índice de Barthel, pré- e pós-hidroterapia, em piscina à temperatura média de 35°C, três vezes por semana em dias alternados, durante 50 minutos, totalizando oito semanas, ou seja, 24 sessões. Foi utilizado o teste de Shapiro-Wilk para análise de variâncias do Índice de Marcha Dinâmica e do Índice de Barthel, e o teste t de Student para as comparações pré e pós-tratamento e nível de significância de   α=0.05. Resultados: O equilíbrio dinâmico, considerando o escore total, apresentou significância estatística (p<0,0001, quando comparado pós-teste (20,3±2,5 em relação ao pré-teste (13,2±3,2. Quanto às atividades de vida diária, foi evidenciado valor estatisticamente significante (p=0,049 no pós-teste (98,8±2.2 quando comparado ao pré-teste (95,6±3.9. Conclusão: Neste estudo, o protocolo de hidroterapia melhorou o equilíbrio dinâmico e as atividades de vida diária de pacientes com neurotoxoplasmose associada à SIDA.

Influencia de la lactancia materna sobre el desarrollo psicomotor y mental del niño

OpenAIRE

Gómez Sanchiz, Manuela

2003-01-01

En 1929 Hoefer y Hardy plantearon la hipótesis que la lactancia materna influía sobre el desarrollo mental del niño, además del físico. Los resultados de las investigaciones realizadas en esta área, hasta el momento, son contradictorios; no obstante una meta-análisis publicado en el año 1999 concluye que la lactancia materna influye positivamente sobre el desarrollo mental del niño, tanto a término como pretérmino. El objetivo del estudio fue analizar los efectos de la lactancia materna sobre...

Efectividad de un programa nacional de fomento de la lactancia materna en Chile 1993-2002

OpenAIRE

Atalah S, Eduardo; Castillo L, Cecilia; Reyes A, Cecilia

2004-01-01

El fomento de la lactancia materna ha sido una prioridad del Ministerio de Salud en la última década. El objetivo del estudio fue evaluar la tendencia de la lactancia materna en menores de 18 meses, controlados en el sistema público de salud, según los resultados de cuatro encuestas nacionales. Por una entrevista estructurada se exploró cada 3 años la alimentación del día anterior (pecho, agua, jugos, fórmulas, alimentos sólidos) y la participación materna en trabajos fuera del hogar, en una ...

Advantages of enteral nutrition over parenteral nutrition

OpenAIRE

Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

2013-01-01

It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

Peripheral parenteral nutrition: an option for patients with an indication for short-term parenteral nutrition La nutrición parenteral periférica, alternativa para los pacientes con indicación de nutrición parenteral durante poco tiempo

OpenAIRE

M. I. T. D. Correia; J. Guimarâes; L. Cirino de Mattos; K. C. Araújo Gurgel; E. B. Cabral

2004-01-01

Objective: The aim of this study was to examine and describe our experience with the use of peripheral parenteral nutrition (PPN). Methods: Patients with an indication for parenteral nutrition for less than 15 days received it via a peripheral vein via a short, 20 or 22 gauge French polyurethane catheter. Parenteral nutrition had a final osmolality of 993 mOsm/l and was administered by infusion pump. The nutritional status of patients was assessed by the Subjective Global Assessment (SGA) tec...

Home parenteral nutrition in children: the Polish experience.

Science.gov (United States)

Ksiazyk, J; Lyszkowska, M; Kierkus, J; Bogucki, K; Ratyńska, A; Tondys, B; Socha, J

1999-02-01

Home parenteral nutrition has become routine for management of intestinal failure in patients. In Poland the main obstacle to widespread use of home parenteral nutrition is the lack of interest of commercial companies in delivering feedings and ancillaries to patients. Twenty-five home parenteral nutrition patients aged from 4 months to more than 13 years were reviewed. The mother or both parents were trained in home parenteral nutrition techniques for 4 to 6 weeks and compounded the nutrients themselves at home. The mean duration of home parenteral nutrition was 10,117 patient days. Hospital stays of patients receiving parenteral feedings were significantly shorter than the duration of administration of home parenteral nutrition (p rate of catheter occlusion decreased within the observation period, and in 1997 not one case of occlusion was observed. In 1997 only three catheters were removed during 7.8 patient years, and the overall incidence of catheter-related complications was 0.38 per patient year. The overall occurrence of septicemia was one case in 516 days and of catheter infection was one in 459 days. In 1997 a catheter was infected on average of once every 1419 days. There was significant improvement in the z score for weight during therapy. The average monthly cost of nutrients and ancillary items was approximately $1200 (4200 Polish zlotys [PLN]). These costs are 1.6 to 3 times lower than those recorded in other studies. Home parenteral nutrition in children with nutrients mixed by caregivers in the home setting is a safe and appropriate method of treatment that can be used in countries where home parenteral nutrition solutions are not manufactured or where commercial home parenteral nutrition is not economically feasible.

Género, salud materna y la paradoja perinatal

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Simone Grilo DINIZ

2010-12-01

Full Text Available En los últimos 20 años mejoraron prácticamente todos los indicadores de salud materna en el Brasil, así como hubo un amplio acceso a los servicios de salud. Gender, maternal health and the perinatal paradox1 Gênero, saúde materna e o paradoxo perinatal Género, salud materna y la paradoja perinatal REFLEXÕES SOBRE HUMANIZAÇÃO E A REALIDADE DOS SERVIÇOS REFLECTIONS ON HUMANIZATION AND THE REALITY OF HEALTH SERVICES REFLEXIONES SOBRE LA HUMANIZACIÓN Y LA REALIDAD DE LOS SERVICIOS 50 // Rev Tempus Actas Saúde Col Paradoxalmente, no existe ninguna evidencia de mejora de la mortalidad materna. El objetivo de este texto es ofrecer elementos para comprender esta paradoja, a través de la evaluación de los modelos típicos de asistencia al parto, en el Sistema Único de Salud (SUS y en el sector privado. Analizaremos las propuestas de cambio para una asistencia basada en evidencias sobre la seguridad de estos modelos, su relación con los derechos de las mujeres, y con los conflictos de interés y resistencias al cambio de los modelos. Examinamos los presupuestos de género que modulan la asistencia y los sesgos de género en la investigación en este campo, que se expresan en la sobrevalorización de los beneficios de la tecnología, y en la subvalorización o en la negación de los desconfortos y efectos adversos de las intervenciones. Creencias de la cultura sexual no raramente son consideradas como explicaciones ‘científicas’ sobre el cuerpo, la parturición y la sexualidad, y se reflejan en la imposición de sufrimientos y riesgos innecesarios, en las intervenciones dañinas a la integridad genital, y en la negación del derecho a acompañantes. Este ‘pesimismo del parto’ es instrumento para favorecer, por comparación, el modelo de la cesárea de rutina. Por fin, discutimos como el uso de la categoría género puede contribuir para promover derechos y cambios institucionales, como en el caso de los acompañantes en el parto.

Programas de lactancia materna en unidades de atención primaria y especializada

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Laura Gombau Giménez

2015-08-01

Full Text Available Las ventajas sanitarias de la lactancia materna evidenciadas han servido para elaborar numerosas recomendaciones. El abandono del amamantamiento puede traducirse en un problema con importantes repercusiones personales, sociales y sanitarias. La OMS (Organización Mundial de la Salud puede afirmar ahora con plena seguridad que la lactancia materna reduce la mortalidad infantil y tiene beneficios sanitarios que llegan hasta la edad adulta. Para el conjunto de la población se recomienda la lactancia materna exclusiva durante los seis primeros meses de vida y a partir de entonces su refuerzo con alimentos complementarios al menos hasta los dos años. La leche materna promueve el desarrollo sensorial y cognitivo, además de proteger al bebé de enfermedades infecciosas y crónicas. La lactancia natural exclusiva reduce la mortalidad infantil por enfermedades de la infancia, como la diarrea o la neumonía, y favorece un pronto restablecimiento en caso de enfermedad. La lactancia natural contribuye a la salud y el bienestar de la madre, ayuda a espaciar los embarazos, disminuye el riesgo de cáncer ovárico y mamario, incrementa los recursos de la familia y el país, es una forma segura de alimentación y resulta inocua para el medio ambiente.

Influencia del apoyo de la enfermera en el éxito de la lactancia materna

OpenAIRE

Martínez Dávila, Desirée

2013-01-01

La autora realiza una investigación en un hospital privado de Salamanca para conocer de primera mano qué tipo de información se le da a las madres acerca de la lactancia materna. Previamente la autora realiza un estudio sobre el puerperio, la lactancia materna y el apoyo que deben recibir las madres por parte del personal de enfermería.

Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model.

Science.gov (United States)

Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David

2015-08-01

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.

¿Por qué perciben algunos hombres la lactancia materna como una amenaza?.

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Magdalena Serpa de Cavelier

2003-08-01

Full Text Available

BARRERAS PSICOLÓGICAS MASCULINAS A LA LACTANCIA MATERNA.

La leche materna, recomendada por la Organización Mundial de la Salud (OMS, es reconocida como el alimento ideal durante los primeros 6 meses de vida. El costo de no amamantar es muy alto, bien sea desde el punto de vista económico o desde el punto de vista epidemiológico.

Desafortunadamente, en los Estados Unidos a pesar de grandes y sostenidos esfuerzos de programas gubernamentales de nutrición materno-infantil, un porcentaje muy bajo de mujeres inicia la lactancia materna, según datos nacionales recientes, 41.3% afro-americanas, 66.5% blancas y 63.6% “latinas”.

El presente trabajo lo desarrollé en mi calidad de Analista de Políticas y “Post Doctoral Fellow” del Centro de Investigación y Recursos para los hombres y la Familia de la Escuela de Higiene y Salud Pública de la Universidad de Johns Hopkins, en Baltimore, E.U.A. Forma parte de un proyecto macro “La lactancia materna es la mejor alimentación”, proyecto de investigación financiado con recursos del Departamento de Agricultura de los Estados Unidos.

Los patrones de baja prevalencia de amamantación tienen múltiples explicaciones. Si se aspira a cumplir los objetivos gubernamentales de Estados Unidos que proponen tasas de iniciación de 75% y de duración a los 6 meses del 35%, se hace necesario entender mejor las barreras y los factores facilitadores de la lactancia materna entre la población afro-americana.

Con esta investigación se acude a la teoría psicoanalítica de Melanie Klein, para explorar el impacto de variables de la psicología masculina que ayuden a entender la baja prevalencia de lactancia materna en los Estados Unidos en general y entre la población afro-americana en particular. Se presenta un modelo diagnóstico y un modelo de intervención, sencillos y extrapolables a poblaciones colombianas con dificultades similares para una óptima nutrición infantil...

Las grasas en la dieta materna, edad gestacional y peso al nacer

OpenAIRE

Rodríguez Enríquez, Yanik; Pita Rodríguez, Gisela; González, Isabel Martín; Ferret Martínez, Ana; Puentes Márquez, Ileana

2004-01-01

Las grasas en la dieta materna tienen funciones determinantes en el desarrollo de un embarazo normal, en la estructuración de un adecuado flujo útero-placentario, la formación de membranas celulares, el crecimiento intrauterino del feto y el desarrollo del sistema nervioso central. El objetivo de este trabajo fue medir la relación entre la composición de ácidos grasos en la dieta materna atendiendo a la edad gestacional y el peso al nacer de los recién nacidos. Se realizó un estudio transvers...

Lactancia materna, alimentación complementaria y el riesgo de obesidad infantil

OpenAIRE

Luis Sandoval Jurado; María Valeria Jiménez Báez; Sibli Olivares Juárez; Tomas de la Cruz Olvera

2016-01-01

Objetivo: Evaluar el patrón de lactancia materna y el inicio de alimentación complementaria como riesgo de obesidad en niños de edad preescolar de un centro de atención primaria. Diseño: Transversal analítico. Emplazamiento: Cancún, Quintana Roo (México). Participantes: Niños de 2 a 4 años de edad, pertenecientes a una Unidad de atención primaria. Mediciones principales: Tiempo de lactancia materna total y exclusiva, alimento de inicio de alimentación complementaria referido por l...

21 CFR 310.509 - Parenteral drug products in plastic containers.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Parenteral drug products in plastic containers... Parenteral drug products in plastic containers. (a) Any parenteral drug product packaged in a plastic... parenteral drug product for intravenous use in humans that is packaged in a plastic immediate container on or...

Alteraciones hepáticas inducidas por la nutrición parenteral

OpenAIRE

J Salas Salvado; A Recaséns Garica

1993-01-01

Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral Liver disorders induced by parenteral nutrition Alteraciones hepáticas inducidas por la nutrición parenteral

Violaciones al Código Internacional de Comercialización de Sucedáneos de Leche Materna en México

OpenAIRE

Erika Paola García-Flores; Nazarea Herrera-Maldonado; Liliana Martínez-Peñafiel; Eduardo Pesqueira- Villegas

2017-01-01

En nuestro país, a pesar de los grandes beneficios de la lactancia materna para la salud de las futuras generaciones, ésta se redujo de 22,3% en 2006 a 14,5% en 20121 y aunque recientemente, con las acciones de la Estrategia Nacional de Lactancia Materna se ha conseguido mejorar la lactancia materna a 30.8% en 2015,2 este indicador aún dista mucho de la meta global.

Violaciones al Código Internacional de Comercialización de Sucedáneos de Leche Materna en México

Directory of Open Access Journals (Sweden)

Erika Paola García-Flores

2017-06-01

Full Text Available En nuestro país, a pesar de los grandes beneficios de la lactancia materna para la salud de las futuras generaciones, ésta se redujo de 22,3% en 2006 a 14,5% en 20121 y aunque recientemente, con las acciones de la Estrategia Nacional de Lactancia Materna se ha conseguido mejorar la lactancia materna a 30.8% en 2015,2 este indicador aún dista mucho de la meta global.

Efectividad de la hidroterapia para disminuir el dolor y mejorar la calidad de vida y función física en adultos con osteoartritis de rodilla: revisión sistemática

OpenAIRE

J.L. Ibarra Cornejo; D.G. Quidequeo Reffers; D.A. Eugenin Vergara; E.A. Beltrán Maldonado; S.R. Ricci Muñoz; M.J. Fernández Lara

2015-01-01

Objetivo: determinar la efectividad de la hidroterapia para disminuir el dolor, mejorar la calidad de vida y función física en adultos con osteoartritis de rodilla, mediante la recopilación de los diferentes estudios científicos de alta calidad metodológica publicados a la fecha. Material y métodos: se realizó una revisión sistemática en las bases de datos de: PEDro y MEDLINE. Fueron incluidos ensayos controlados aleatorios con pacientes diagnosticados de osteoartritis de rodilla. Se seleccio...

Variables que influyen en el comportamiento de la lactancia materna exclusiva hasta el sexto mes

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William Cáceres Fernández

Full Text Available Introducción: la lactancia materna exclusiva hasta los 6 meses se considera la alimentación ideal para el recién nacido, pues se ha demostrado que garantiza el crecimiento y desarrollo, previene enfermedades frecuentes en la infancia y en la edad adulta, y brinda múltiples ventajas para los niños y las madres. Objetivo: determinar algunas variables que influyen en el comportamiento de la lactancia materna exclusiva hasta el 6to mes de vida del recién nacido. Métodos: se realizó un estudio descriptivo retrospectivo a través de la aplicación de una encuesta a 56 madres de niños mayores de 6 meses, pertenecientes a 4 consultorios del médico de la familia del policlínico «Héroes del Moncada», en el periodo comprendido desde enero hasta diciembre de 2012. Se tomaron los datos necesarios de la madre y el niño mediante la aplicación de una encuesta y se vaciaron en un formulario elaborado al efecto. Resultados: el grupo de edad de 20-35 años fue el que predominó en las madres que mantuvieron la lactancia materna exclusiva hasta el sexto mes, con un 73,2 %; fueron las madres con nivel universitario (21,4 % las que tenían más conocimiento sobre las ventajas de la lactancia materna. En el 42,3 % de los casos se interrumpió la lactancia materna exclusiva por la incorporación al trabajo; y se enfermaron más aquellos niños que interrumpieron la lactancia. Conclusiones: existen factores como la edad menor de 20 ó mayor de 35 años, el bajo nivel cultural y la necesidad de reincorporación al trabajo, que atentan contra mantener una lactancia materna exclusiva hasta el sexto mes de vida del recién nacido.

Amino acid composition in parenteral nutrition: what is the evidence?

Science.gov (United States)

Yarandi, Shadi S.; Zhao, Vivian M.; Hebbar, Gautam; Ziegler, Thomas R.

2011-01-01

Purpose of review Complete parenteral nutrition solutions contain mixed amino acid products providing all nine essential amino acids and a varying composition of nonessential amino acids. Relatively little rigorous comparative efficacy research on altered parenteral nutrition amino acid composition has been published in recent years. Recent findings Limited data from randomized, double-blind, adequately powered clinical trials to define optimal doses of total or individual amino acids in parenteral nutrition are available. An exception is the growing number of studies on the efficacy of glutamine supplementation of parenteral nutrition or given as a single parenteral agent. Parenteral glutamine appears to confer benefit in selected patients; however, additional data to define optimal glutamine dosing and the patient subgroups who may most benefit from this amino acid are needed. Although some promising studies have been published, little data are available in the current era of nutrition support on the clinical efficacy of altered doses of arginine, branched chain amino acids, cysteine, or taurine supplementation of parenteral nutrition. Summary Despite routine use of parenteral nutrition, surprisingly little clinical efficacy data are available to guide total or specific amino acid dosing in adult and pediatric patients requiring this therapy. This warrants increased attention by the research community and funding agencies to better define optimal amino acid administration strategies in patient subgroups requiring parenteral nutrition. PMID:21076291

Relación entre el período de lactancia materna y maloclusiones

OpenAIRE

Rosa Gabriela Rondón; Gabriel Alejandro Zambrano; María Elena Guerra

2012-01-01

Los beneficios de la lactancia materna en la prevención de las maloclusiones han sido descritos en la literatura odontológica, destacando que lactar exclusivamente más de 6 meses disminuye su prevalencia. Objetivo: determinar la relación entre periodo de Lactancia Materna y Maloclusiones. Material y métodos: se examinó una muestra de 59 niños en edades entre 6 y 13 años en la parroquia Higuerote, Miranda, Venezuela. Se aplicó un cuestionario a cada representante para obtener datos sobre el pe...

Parenteral nutrition in malnourished patients

International Nuclear Information System (INIS)

Lichvarova, I.

2011-01-01

Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)

Desigualdades y características sociodemográficas de la mortalidad materna en La Guajira, Colombia, 2010-2012

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Shirley Nájera Arregocés

Full Text Available OBJETIVO: Identificar las desigualdades y las características sociodemográficas que inciden negativamente en la mortalidad materna en el departamento de La Guajira, Colombia. MÉTODOS: Se realizó un estudio descriptivo, en el que se analizaron los casos de muerte materna ocurridos en el departamento de La Guajira entre 2010 y 2012, a partir de datos de fuentes secundarias. Se calculó la diferencia de las tasas, la razón de las tasas y el riesgo atribuible poblacional porcentual, además de los índices de Gini y de concentración. RESULTADOS: Se registraron 54 muertes maternas, de ellas, 61,1% eran indígenas y 16,7% afrocolombianas; la mayoría no tenía ningún estudio (33,3% o solo estudios primarios (29,6%. Se encontraron desigualdades en la diferencia de las tasas, la razón de las tasas y el riesgo atribuible poblacional porcentual, entre La Guajira y otros departamentos de la región Caribe y del país; sin embargo, esas diferencias no se reflejaron en los índices de Gini y de concentración. CONCLUSIONES: La mortalidad materna fue significativamente más elevada en las mujeres indígenas en comparación con las no indígenas. Se deben fortalecer los programas de salud sexual y reproductiva y adelantar dentro de las políticas de salud materna un enfoque multicultural para eliminar o reducir las desigualdades relacionadas con la mortalidad materna en esta población.

Influencia del contacto precoz, nacionalidad, tipo de parto y prematuridad en la lactancia materna

OpenAIRE

Ana Belén Laviña Castan

2015-01-01

Conocer si en el HUMS existe asociación entre lactancia materna y nacionalidad, prematuridad, tipo de parto, contacto precoz piel con piel. Estudio de cohortes, en una muestra de 541 puérperas del HUMS en octubre-noviembre 2011. Las variables: nacionalidad, tipo de parto, contacto precoz, parto prematuro e inicio lactancia materna se recogieron antes del alta hospitalaria mediante cuestionario. A los dos meses postparto se contactó telefónicamente con las madres para conocer el tipo de lactan...

Conocimiento y prácticas de lactancia materna en madres adolescentes que asisten al Centro de Salud Bagua, 2014

OpenAIRE

Bautista Hualpa, Yeny Rita

2016-01-01

La lactancia materna como única e irremplazable para cubrir las necesidades alimentarias del niño, es un derecho humano fundamental que debe ser promovido durante los primeros seis meses de vida y continuar con la lactancia materna junto con los alimentos. El estudio determinó el nivel de conocimientos y prácticas en lactancia materna de las madres adolescentes que asisten al Centro de Salud Bagua. La investigación es de tipo descriptivo, de corte transversal. La muestra estuvo conformada por...

Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.

Science.gov (United States)

Golekoh, Marjorie C; Cole, Conrad R; Jones, Nana-Hawa Yayah

2016-11-01

Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism. © 2015 American Society for Parenteral and Enteral Nutrition.

Morbidade Materna Grave e Near Misses em Hospital de Referência Regional

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Márcia Lait Morse

2011-06-01

Full Text Available OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary

Standardized Competencies for Parenteral Nutrition Order Review and Parenteral Nutrition Preparation, Including Compounding: The ASPEN Model.

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Boullata, Joseph I; Holcombe, Beverly; Sacks, Gordon; Gervasio, Jane; Adams, Stephen C; Christensen, Michael; Durfee, Sharon; Ayers, Phil; Marshall, Neil; Guenter, Peggi

2016-08-01

Parenteral nutrition (PN) is a high-alert medication with a complex drug use process. Key steps in the process include the review of each PN prescription followed by the preparation of the formulation. The preparation step includes compounding the PN or activating a standardized commercially available PN product. The verification and review, as well as preparation of this complex therapy, require competency that may be determined by using a standardized process for pharmacists and for pharmacy technicians involved with PN. An American Society for Parenteral and Enteral Nutrition (ASPEN) standardized model for PN order review and PN preparation competencies is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines, and is intended for institutions and agencies to use with their staff. © 2016 American Society for Parenteral and Enteral Nutrition.

Timing of the initiation of parenteral nutrition in critically ill children.

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Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

2017-05-01

To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

Temporal Trends in the Use of Parenteral Nutrition in Critically Ill Patients

Science.gov (United States)

Kahn, Jeremy M.; Wunsch, Hannah

2014-01-01

Background: Clinical practice guidelines recommend enteral over parenteral nutrition in critical illness and do not recommend early initiation. Few data are available on parenteral nutrition use or timing of initiation in the ICU or how this use may have changed over time. Methods: We used the Project IMPACT database to evaluate temporal trends in parenteral nutrition use (total and partial parenteral nutrition and lipid supplementation) and timing of initiation in adult ICU admissions from 2001 to 2008. We used χ2 tests and analysis of variance to examine characteristics of patients receiving parenteral nutrition and multilevel multivariate logistic regression models to assess parenteral nutrition use over time, in all patients and in specific subgroups. Results: Of 337,442 patients, 20,913 (6.2%) received parenteral nutrition. Adjusting for patient characteristics, the use of parenteral nutrition decreased modestly over time (adjusted probability, 7.2% in 2001-2002 vs 5.5% in 2007-2008, P nutrition use increased simultaneously (adjusted probability, 11.5% in 2001-2002 vs 15.3% in 2007-2008, P parenteral nutrition declined most rapidly in emergent surgical patients, patients with moderate illness severity, patients in the surgical ICU, and patients admitted to an academic facility (P ≤ .01 for all interactions with year). When used, parenteral nutrition was initiated a median of 2 days (interquartile range, 1-3), after ICU admission and > 90% of patients had parenteral nutrition initiated within 7 days; timing of initiation of parenteral nutrition did not change from 2001 to 2008. Conclusions: Use of parenteral nutrition in US ICUs declined from 2001 through 2008 in all patients and in all examined subgroups, with the majority of parenteral nutrition initiated within the first 7 days in ICU; enteral nutrition use coincidently increased over the same time period. PMID:24233390

Mortalidade materna na cidade do Recife Maternal mortality in Recife

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Aurélio Antônio Ribeiro Costa

2002-08-01

Full Text Available Objetivos: determinar a Razão de Mortalidade Materna (RMM entre mulheres residentes na cidade do Recife, pela análise de todas as declarações de óbito de mulheres na idade entre 10-49 anos. Determinar a taxa de sub-registro e estudar as principais características, causas básicas, classificação e evitabilidade das mortes maternas. Métodos: realizou-se estudo descritivo de base populacional, analisando-se todos as declarações de óbito de mulheres entre 10-40 anos e utilizando-se os critérios de Laurenti para classificá-los como declarados ou presumíveis. Estudaram-se os prontuários médicos e os dados de autópsia, quando disponíveis, determinando-se as causas básicas dos óbitos e calculando-se a taxa de sub-registro. A Razão de Mortalidade Materna foi calculada usando as informações sobre nascidos vivos do SINASC (Sistema de Informações dos Nascidos Vivos. Resultados: encontraram-se 144 mortes maternas, sendo 104 declaradas e 44 presumíveis, confirmadas após investigação. A Razão de Mortalidade Materna foi 75,5 por 100.000 nascidos vivos e o percentual de sub-registro foi 27,8%. Observou-se uma predominância de causas diretas, sendo as mais freqüentes hipertensão (19%, hemorragia (16% e infecção (11%. Cerca de 82% das mortes foram consideradas evitáveis por meio de assistência adequada ao pré-natal, parto e puerpério. Conclusões: a Razão de Mortalidade Materna é alta na cidade de Recife, e o percentual de subnotificação permanece elevado. Predominam as causas diretas e os óbitos evitáveis, evidenciando ausência de assistência adequada ao pré-natal, parto e puerpério.Purpose: to determine the Maternal Mortality Ratio (MMR among women living in the city of Recife, Brazil through the analysis of all death certificates of women aged 10-49 years from 1994 to 2000. To determine the underreporting rate and to study the main characteristics, basic causes, classification and avoidance of maternal deaths

Lactancia materna como factor protector de la obesidad infantil y en edades futuras

OpenAIRE

González López, Tamara

2016-01-01

Introducción: la lactancia materna (LM) previene numerosas enfermedades, tanto del niño como de la madre, y previene la obesidad del niño, tanto en la infancia, como en las demás etapas de la vida. Objetivo: El objetivo de esta revisión sistemática es analizar el valor de la lactancia materna como factor protector frente al sobrepeso y la obesidad infantil y edades futuras. Método: Se ha efectuado una búsqueda sistemática y se han obtenido más de 100 documentos diferentes sobre el tema. Aplic...

Total parenteral nutrition - Problems in compatibility and stability

DEFF Research Database (Denmark)

Schroder, A.M.

2008-01-01

Adding calcium, trace elements and vitamins could turn parenteral nutrition into a dangerous product, which could harm the patient. This article focuses on the major pharmaceutical problems of parenteral. nutrition when adding nutritional compounds Udgivelsesdato: 2008...

EL KRIOL COMO LENGUA MATERNA DE ENSEÑANZA EN LAS COMUNIDADES BROWN BANK Y TASBAPAUNI

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Silvia Marie Collins Hebberto

2012-02-01

Full Text Available Este artículo tiene de fuente la monografía en la licenciatura de Educación Intercultural Bilingüe, intitulada: La lengua kriol como lengua materna de enseñanza-aprendizaje en los primeros y segundos grados en las Escuelas Interculturales Bilingües Padre “Hugo Heinzen” en Brown Bank y Monseñor “Salvador Scheffl er” en Tasbapauni.Constituye un pilotaje al currículum de la Educación Intercultural Bilingüe/Multilingüe en el marco del Sistema Educativo Autonómico Regional – SEAR-. Se trata de contribuir a la consolidación de la enseñanza en kriol como lengua materna; asimismo, analizar la metodología y verifi car las actitudes de la comunidad educativa en cuanto al kriol como lengua de instrucción y objeto de estudio.Los resultados muestran las ventajas del uso de la lengua materna en la participación activa de la niñez, asimilación de los contenidos y desarrollo de las competencias trazadas.La difi cultad que se constató es la falta de textos en la escuela de Tasbapauni. En cuanto a las actitudes de la comunidad educativa, en Tasbapauni hay resistencia en cuanto al uso de kriol en la escuela, porque no corresponde a la lengua materna de la niñez y lo quieren sustituir por el miskitu. Se trata de una confusión en los conceptos: la lengua originaria o lengua ancestral de la población es miskitu, pero por el cambio lingüístico ocurrido, la lengua materna de la mayoría de la población es kriol.

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis Nutrição parenteral versus enteral em pacientes com pancreatite aguda grave

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Josiel Paiva Vieira

2010-10-01

Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS

Prevenção da mortalidade materna: desafio para o enfermeiro Prevención de la mortalidad materna: un desafío para la enfermera Maternal mortality prevention: a challenge for nurses

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Patrícia Santos Barbastefano

2009-04-01

Full Text Available Neste artigo analisamos os principais aspectos sobre a mortalidade materna, tendo como objetivo a promoção de ações preventivas para a morte materna evitável. Verifica-se que entidades como a ADVOCACY têm significativa participação nos projetos visando redução das taxas de mortalidade materna e o ajustamento de condutas de proteção aos direitos da mulher. Observa-se ainda que a SES, através das Resoluções nº 1.052/95 e nº 1.642/2001, expressa a política estadual para redução do problema. Conclui-se que há indícios de vontade política nas propostas e projetos para redução das taxas de mortalidade materna evitável, porém não há cobrança da sua efetividade. Profissionais da saúde como o enfermeiro, precisam reunir esforços, conscientização e sensibilização em suas ações preventivas.En este artículo se analizan los aspectos principales sobre mortalidad maternal que tiene como objetivo la promoción de acciones preventivas para la muerte materna evitable. Se verifica que las entidades como la ADVOCACY tienen participación significante en los proyectos que buscan la reducción de la tasa de mortalidad materna y el ajuste de procedimientos de protección de los derechos de la mujer. También se observa que la Secretaria Estatal de Salud, a través de las Resoluciones nº 1.052/95 y nº1.642/2001, expresa las políticas estatales para la reducción del problema. Se concluye que hay indicaciones de voluntad política sobre las propuestas y proyectos para reducir las tasas de mortalidad materna evitables. Sin embargo no hay demandas sobre su efectividad. Los profesionales de salud como enfermeras necesitan recoger los esfuerzos, y también una actitud de comprensión y sensibilidad en sus acciones preventivas.In this article theprincipal aspects about maternal mortality are analyzed, with the objective the promotion of preventive actions for the avoidable maternal death. It is verified that entities as ADVOCACY have

Caracterización de la lactancia materna en madres adolescentes

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Arnaldo Sena Barrios

2014-08-01

Full Text Available Introducción: la lactancia materna ha constituido el modo de alimentación que ha garantizado la supervivencia del género humano y las ventajas que ella proporciona son muy conocidas. Objetivo: caracterizar el comportamiento de la lactancia materna en madres adolescentes. Material y método: estudio descriptivo, transversal sobre el comportamiento de la lactancia materna en madres adolescentes del consultorio médico Libertad II, del Distrito 6 de la Zona de Pampa de la Isla en la Ciudad de Santa Cruz de la Sierra, Bolivia; en el período comprendido de Julio de 2011 a Julio de 2012. El universo estuvo constituido por 61 madres adolescentes. La selección de la muestra se realizó mediante un muestreo opinático, teniendo en cuenta criterio de expertos, quedando conformada por 53 madres adolescentes las cuales cumplieron con los criterios de inclusión y de exclusión. Resultados: predominaron las adolescentes de 18-19 años, de escolaridad secundaria. El mayor por ciento de las adolescentes lactó de 1-3 meses. Las amas de casa fueron las más representadas en el grupo de adolescentes estudiadas. Conclusiones: las infecciones respiratorias agudas fueron las enfermedades de mayor incidencia, seguida de las enfermedades diarreicas agudas y lesiones en piel, predominando en las adolescentes que lactaron menos de un mes. No existen en general, las condiciones psicosociales para enfrentar las responsabilidades que se derivan de tener un hijo a estas edades.

Estrés y ansiedad maternos y su relación con el éxito de la lactancia materna

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Remigio Rafael Gorrita Pérez

Full Text Available Introducción: la lactancia materna es la única forma natural de alimentar al bebé, e inigualable para su crecimiento y desarrollo. Múltiples son los factores que se han relacionado con el establecimiento o no de una lactancia materna exitosa. Objetivo: identificar en las madres, los niveles de vulnerabilidad al estrés y de ansiedad como estado, y su relación con el éxito de la lactancia materna. Métodos: se realizó un estudio prospectivo y descriptivo. Se estudiaron 101 madres y sus hijos de 13 consultorios del Policlínico "Luis Augusto Turcios Lima", de San José de las Lajas, Mayabeque, entre el 1ro. de febrero de 2012 y el 30 de enero de 2013. Resultados: el 76,2 % de madres estaba en el rango de 20 a 35 años, 89,8 % tenían pareja estable, el 50,5 % nivel preuniversitario y el 41,4 % de ellas padecían de asma bronquial. La vulnerabilidad al estrés y la ansiedad como estado se encontraban al final del tercer trimestre en el 46,5 y 56,4 % respectivamente. El 49,5 % de las madres ofreció lactancia materna exclusiva por 4 o 5 meses, y el 27,7 % hasta los 6 meses. Lograron mejores índices de lactancia materna exclusiva a los 4, 5 y 6 meses aquellas con menores niveles de vulnerabilidad al estrés y de estado de ansiedad. Conclusiones: se evidenció que existe una estrecha relación entre los niveles de estrés y ansiedad y el éxito de la lactancia materna.

Phytosterols, Lipid Administration, and Liver Disease During Parenteral Nutrition.

Science.gov (United States)

Zaloga, Gary P

2015-09-01

Phytosterols are plant-derived sterols that are structurally and functionally analogous to cholesterol in vertebrate animals. Phytosterols are found in many foods and are part of the normal human diet. However, absorption of phytosterols from the diet is minimal. Most lipid emulsions used for parenteral nutrition are based on vegetable oils. As a result, phytosterol administration occurs during intravenous administration of lipid. Levels of phytosterols in the blood and tissues may reach high levels during parenteral lipid administration and may be toxic to cells. Phytosterols are not fully metabolized by the human body and must be excreted through the hepatobiliary system. Accumulating scientific evidence suggests that administration of high doses of intravenous lipids that are high in phytosterols contributes to the development of parenteral nutrition-associated liver disease. In this review, mechanisms by which lipids and phytosterols may cause cholestasis are discussed. Human studies of the association of phytosterols with liver disease are reviewed. In addition, clinical studies of lipid/phytosterol reduction for reversing and/or preventing parenteral nutrition associated liver disease are discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

Efecto de la glicemia materna en la monitoría electrónica fetal

OpenAIRE

Perdomo Murcia, Luis Enrique

2013-01-01

Introducción: Después del ingreso de la monitoría fetal electrónica como estudio de bienestar fetal, se ha considerado por décadas que un aporte de carbohidratos a la gestante antes de la realización de la monitoría fetal influye en el reporte pero existen estudios que consideran que los niveles de glicemia materna no afecta la variabilidad de la monitoría fetal. Metodología: Se realizó un estudio de corte transversal, para evaluar el efecto de la glicemia materna en la monitoría fetal ...

Pharmaceutical Point of View on Parenteral Nutrition

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M. Stawny

2013-01-01

Full Text Available Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient’s energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them.

Pharmaceutical Point of View on Parenteral Nutrition

Science.gov (United States)

Stawny, M.; Olijarczyk, R.; Jaroszkiewicz, E.; Jelińska, A.

2013-01-01

Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient's energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them. PMID:24453847

Hypercalcemia and hypophosphatemia among preterm infants receiving aggressive parenteral nutrition.

Science.gov (United States)

Brener Dik, Pablo H; Galletti, María F; Bacigalupo, Leticia T; Fernández Jonusas, Silvia; L Mariani, Gonzalo

2018-06-01

Aggressive parenteral nutrition is the standard of care among very-low-birth weight preterm infants. However, in recent studies, its impact on short-term outcomes, has been evaluated. The objective was to compare the prevalence of hypercalcemia and hypophosphatemia among preterm infants receiving aggressive or standard parenteral nutrition. Observational, retrospective study comparing a group of preterm infants weighing less than 1250 grams who received aggressive parenteral nutrition with a historical control group. The prevalence of hypercalcemia was estimated and its association with aggressive parenteral nutrition was searched adjusting by confounders. The mean phosphate level was estimated for the control group by linear regression and was compared to the value in the other group. Forty patients per group were included. The prevalence of hypercalcemia was higher in the group who received aggressive parenteral nutrition (87.5% versus 35%, p= 0.001). Aggressive parenteral nutrition was associated with hypercalcemia when adjusting by birth weight, intrauterine growth restriction, amino acid, and calorie intake (adjusted odds ratio: 21.8, 95% confidence interval [CI]: 3.7-128). The mean calcium level was different between both groups (p= 0.002). Infants who received aggressive parenteral nutrition had more sepsis without reaching statistical significance and the mean phosphate level was lower than that estimated for the control group (p= 0.04). The prevalence of hypophosphatemia in this group was 90% (95% CI: 76-97%). Our data show an association between hypercalcemia/hypophosphatemia and aggressive parenteral nutrition. It is recommended to frequently monitor calcium and phosphate levels since they might be associated with adverse clinical outcomes. Sociedad Argentina de Pediatría.

Parenteral nutrition in patients with inborn errors of metabolism - a therapeutic problem.

Science.gov (United States)

Kaluzny, L; Szczepanik, M; Siwinska-Mrozek, Z; Borkowska-Klos, M; Cichy, W; Walkowiak, J

2014-06-01

Parenteral nutrition is now a standard part of supportive treatment in pediatric departments. We describe four cases in which parenteral nutrition was extremely difficult due to coincidence with inborn errors of metabolism. The first two cases was fatty acid beta-oxidation disorders associated with necrotizing enterocolitis and congenital heart disease. Thus, limitations of intravenous lipid intake made it difficult to maintain a good nutritional status. The third case was phenylketonuria associated with a facial region tumour (rhabdomyosarcoma), in which parenteral nutrition was complicated because of a high phenylalanine content in the amino acid formulas for parenteral nutrition. The fourth patient was a child with late-diagnosed tyrosinemia type 1, complicated with encephalopathy - during intensive care treatment the patient needed nutritional support, including parenteral nutrition - we observed amino acid formula problems similar to those in the phenylketonuria patient. Parenteral nutrition in children with inborn errors of metabolism is a rare, but very important therapeutic problem. Total parenteral nutrition formulas are not prepared for this group of diseases.

Potential of polymeric particles as future vaccine delivery systems/adjuvants for parenteral and non-parenteral immunization against tuberculosis: A systematic review

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Farzad Khademi

2018-02-01

Full Text Available Objective(s: Production of effective tuberculosis (TB vaccine is necessity. However, the development of new subunit vaccines is faced with concerns about their weak immunogenicity. To overcome such problems, polymers-based vaccine delivery systems have been proposed to be used via various routes. The purpose of this study was to determine the potential of polymeric particles as future vaccine delivery systems/adjuvants for parenteral and non-parenteral immunization against TB. Materials and Methods: PubMed, Scopus, Science-Direct, and the ISI web of knowledge databases were searched for related keywords. A total of 420 articles, written up to June 25, 2016, were collected on the potential of polymeric particles as TB vaccine delivery systems after parenteral and non-parenteral immunization. Thirty-one relevant articles were selected by applying inclusion and exclusion criteria. Results: It was shown that the immunogenicity of TB vaccines had been improved by using biodegradable and non-biodegradable synthetic polymers as well as natural polymers and they are better able to enhance the humoral and cellular immune responses, compared to TB vaccines alone. The present study revealed that various polymeric particles, after M. tuberculosis challenge in animal models, provide long-lasting protection against TB. PLGA (poly (lactide-co-glycolide and chitosan polymers were widely used as TB vaccine delivery systems/adjuvants. Conclusion: It seems that PLGA and chitosan polymers are well-suited particles for the parenteral and non-parenteral administration of TB vaccines, respectively. Non-biodegradable synthetic polymers in comparison with biodegradable synthetic and natural polymers have been used less frequently. Therefore, further study on this category of polymers is required.

Desenvolvimento de bebês prematuros relacionado a variáveis neonatais e maternas Desarrollo de bebés prematuros relacionado a variables neonatales y maternas Development of preterm infants related to neonatal and maternal variables

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Daniele Abruzzi de Fraga

2008-06-01

Full Text Available O estudo verificou a relação entre ansiedade materna, características neonatais e indicadores de desenvolvimento de crianças nascidas pré-termo aos 12 meses de idade cronológica corrigida. Foram avaliadas 14 crianças com as Escalas Bayley-II e suas mães com o Inventário de Ansiedade Traço-Estado. Os itens relativos à resolução de problemas, permanência do objeto, intencionalidade, linguagem e motricidade correlacionaram-se significativamente com variáveis neonatais do bebê e ansiedade materna. A maior gravidade de risco clínico neonatal associou-se com pior desempenho em itens relativos à permanência do objeto, linguagem e motricidade ampla. O nível de ansiedade materna mais elevado associou-se com melhor desempenho dos bebês em tarefas cognitivas e pior em tarefas de motricidade ampla e permanência do objeto. Dessa forma a ansiedade materna mostrou ter efeito diferencial em áreas do desenvolvimento da criança, podendo atuar como fator de risco ao desenvolvimento motor amplo e como mecanismo de proteção ao desenvolvimento cognitivo.El estudio verificó la relación entre ansiedad materna, características neonatales e indicadores de desarrollo de niños nacidos pré termo a los 12 meses de edad cronológica corregida. Fueron evaluados 14 niños con las Escalas Bayley-II y sus madres con el Inventario de Ansiedad Trazo-Estado. Los ítenes relativos a la resolución de problemas, permanencia del objeto, intencionalidad, lenguaje y motricidad se correlacionaron significativamente con variables neonatales del bebé y ansiedad materna. La mayor gravedad de riesgo clínico neonatal se asoció con peor desempeño en ítenes relativos a la permanencia del objeto, lenguaje y motricidad amplia. El nivel de ansiedad materna más elevado se asoció con mejor desempeño de los bebés en tareas cognitivas y peor en tareas de motricidad amplia y permanencia del objeto. De esa forma la ansiedad materna mostró tener efecto diferencial

Impact of Early Parenteral Nutrition on Metabolism and Kidney Injury

OpenAIRE

Gunst, Jan; Vanhorebeek, Ilse; Casaer, Michaël P.; Hermans, Greet; Wouters, Pieter J.; Dubois, Jasperina; Claes, Kathleen; Schetz, Miet; Van den Berghe, Greet

2013-01-01

A poor nutritional state and a caloric deficit associate with increased morbidity and mortality, but a recent multicenter, randomized controlled trial found that early parenteral nutrition to supplement insufficient enteral nutrition increases morbidity in the intensive care unit, including prolonging the duration of renal replacement therapy, compared with withholding parenteral nutrition for 1 week. Whether early versus late parenteral nutrition impacts the incidence and recovery of AKI is ...

A depressão materna e o comportamento de crianças em idade escolar

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Luciana Mian

Full Text Available A depressão materna caracteriza-se como condição de vulnerabilidade ao desenvolvimento infantil. No presente estudo, objetivou-se comparar o perfil comportamental, as percepções e os eventos de vida de escolares que convivem com a depressão materna (G1 aos daqueles que convivem com mães sem história psiquiátrica (G2, segundo as informações obtidas com as mães e as crianças. Avaliou-se 40 crianças, de 7 a 12 anos, por meio do Teste Raven, da Escala Infantil Piers-Harris de Autoconceito e da Entrevista de Eventos Vitais. As mães foram avaliadas pela Entrevista Clínica Estruturada para o DSM-IV para a confirmação diagnóstica, e responderam a Escala Comportamental Infantil A2 de Rutter. A depressão materna mostrou-se associada a problemas comportamentais das crianças, segundo o relato das mães e a percepção das crianças.

Mortalidade materna no município do Rio de Janeiro: magnitude e distribuição La mortalidad materna en el municipio de Rio de Janeiro: magnitud y distribuición Maternal morbidity in the district of Rio de Janeiro: magnitude and distribution

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Enirtes Caetano Prates Melo

2008-12-01

Full Text Available A mortalidade materna é um evento traçador da assistência por ser evitável em 92% dos casos. Trata-se de um estudo descritivo de base populacional que analisou as declarações de óbito das mulheres de 10 a 49 anos no Município do Rio de Janeiro, 1996-2004. Foram utilizados os dados do Sistema de Informações sobre Mortalidade, processados e mapeados através do TabWin. Verificou-se o predomínio do óbito materno entre mulheres solteiras e mulheres com 4 a 7 anos de estudo. A Razão de Mortalidade Materna permanece alta no município. Dois aglomerados chamam atenção na distribuição espacial dos óbitos maternos. O primeiro abrange a Zona Oeste e apresenta uma Razão de Mortalidade Materna muito alta. O segundo situa-se ao longo do subúrbio da Leopoldina e concentra uma mortalidade alta.La mortalidad materna es un acontecimiento que refleja de la asistencia prestada por expresar una muerte evitable en el 92% de los casos. Se trata de un estudio descriptivo de base poblacional que analizó los certificados de defunción de mujeres de 10 a 49 años, en la ciudad del Río de Janeiro, de 1996 a 2004. Fueron utilizados los datos del Sistema de Informaciones sobre Mortalidad, que fueran procesados y mapeados a través del TabWin. Se contató el predominio de la muerte materna en el grupo de mujeres solteras , con entre 4 a 7 años de formación . El indice de Mortalidad Materna sigue siendo alta en la ciudad. Dos aglomerados llaman la atención en la distribución espacial de las muertes maternas. El primero en la Zona Oeste que presenta indice de mortalidad materna muy alto . El segundo se situa a lo largo de la region de la Leopoldina donde se concentra un indice de mortalidad materna alto.Maternal mortality is an event that reflects the assistance provided because it deals with unavoidable deaths in 92% of the cases. This is a population-based study that analyzed the deaths certificates of women between 10 to 49 years in a Rio de

Hidrotórax secundário à nutrição parenteral: relato de caso Hydrothorax due to parenteral nutrition: a case report

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José Henrique Silvah

2011-09-01

Full Text Available Hidrotórax secundário à infusão de nutrição parenteral é uma condição rara, embora se apresente cada vez mais comum. Neste relato de caso, uma paciente com síndrome do intestino curto desenvolveu instabilidade hemodinâmica e insuficiência respiratória algumas horas após o início da infusão de nutrição parenteral. Ressaltamos também as manobras para evitar e tratar tal complicação.Hydrothorax due to parenteral nutrition infusion is a rare, although increasingly common event. This report shows a short bowel patient who developed hemodynamic instability and respiratory failure few hours after parenteral nutrition infusion's start. We also emphasize the maneuvers to avoid and treat such complication.

Casas Maternas in the Rural Highlands of Guatemala: A Mixed-Methods Case Study of the Introduction and Utilization of Birthing Facilities by an Indigenous Population.

Science.gov (United States)

Stollak, Ira; Valdez, Mario; Rivas, Karin; Perry, Henry

2016-03-01

An international NGO, with financial and managerial support from "partner" communities, established Casas Maternas (birthing facilities) in 3 municipalities in the isolated northwestern highlands of the department of Huehuetenango in Guatemala-an area with high maternal mortality ratio (338 maternal deaths per 100,000 live births). Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access to referral care is facilitated. We conducted a mixed-methods study in San Sebastian Coatán municipality to assess the contribution of 2 Casas Maternas to health facility deliveries among partner and non-partner communities, with particular emphasis on equity in access. We surveyed all women who delivered in the study area between April 2013 and March 2014, the first full year in which both Casas Maternas in the study area were operating. In addition, using purposive sampling, we conducted in-depth interviews with 22 women who delivered and 6 focus group discussions with 42 community leaders, traditional birth attendants, and Casas Maternas staff members. We analyzed the quantitative data using descriptive statstics and the qualitative data with descriptive content analysis. Of the 321 women eligible for inclusion in the study, we surveyed 275 women (14.3% could not be located or refused to participate). Between April 2013 and March 2014, 70% of women living in partner communities delivered in a health facility (54% in a Casa Materna) compared with 30% of women living in non-partner communities (17% in a Casa Materna). There was no statistically significant difference in uptake of the Casa Materna by maternal education and only a weak effect by household wealth. In contrast, distance from the Casa Materna had a pronounced effect. Traditional birth attendants were strong advocates for utilization of the Casa Materna and played an important role in the decision regarding where the birth would take

Use of parenteral testosterone in hypospadias cases

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Vikram Satav

2015-01-01

Full Text Available Objectives: The aim was to evaluate the effect of parenteral testosterone on penile length, preputial hood, vascularity of dartos pedicle in patients with hypospadias. Materials and Methods: A total of 42 patients with hypospadias were included in this study. Injection aquaviron (oily solution each ml containing testosterone propionate 25 mg was given deep intramuscularly in three doses with an interval of 3 weeks before reconstructive surgery at the dose of 2 mg/kg body weight. Preoperatively penile length, transverse preputial width and diameter at the base of the penis were measured. Basal testosterone levels were obtained before the institution of therapy and on the day of operation. Results: Following parenteral testosterone administration, the mean increase in penile length, transverse preputial width and diameter at the base of penis was 1.01 ± 0.25 cm (P < 0.001, 1.250 ± 0.52 cm and 0.61 ± 0.35 cm, respectively, (P < 0.001. Serum testosterone level after injection was well within normal range for that age. Conclusion: Parenteral testosterone increased phallus size, diameter and prepuce hypertrophy without any adverse effects. However, due to lack of a control group we cannot make any inferences. Controlled studies are required to establish the benefits of parenteral testosterone.

A aprendizagem da escrita e a escolaridade materna

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Amanda de Andrade Ferreira

2014-04-01

Full Text Available Objetivo investigar a escrita de crianças e a relação com o grau de instrução materno. Métodos as mães das crianças responderam a uma entrevista com a finalidade de conhecer seu nível de escolaridade, além de outros aspectos socioculturais. Em seguida, a escrita das crianças foi avaliada segundo o Roteiro de Observação Ortográfica de Zorzi (1998, composto por ditados de palavras, frases e textos, assim como produções textuais, utilizando-se o gênero narrativo, a partir de temas pré-estabelecidos. Foram avaliadas 30 crianças, todas matriculadas no 3º ano do ensino fundamental de uma escola municipal da cidade do Recife. Os dados foram tabulados em uma planilha do software de análise estatística SPSS. Resultado observou-se que 20% das crianças ainda não atingiram o nível alfabético do desenvolvimento da escrita, o que é um aspecto importante, considerando que no 3º ano as crianças já devem estar consolidando a leitura e escrita funcionais. Foram observadas correlações significantes entre a escolaridade materna e a aquisição do esquema narrativo de histórias, assim como entre a escolaridade materna e os hábitos de leitura das mães. Uma análise dos erros ortográficos revelou que as crianças cometiam os mesmos tipos de erros já observados em outras populações, apenas com uma frequência maior. Crianças que produziram as narrativas mais estruturadas foram as que cometeram mais erros ortográficos, o que comprova que o erro ortográfico é inerente ao processo de aquisição da escrita e não constitui obstáculo à produção textual. Conclusão a aprendizagem da escrita sofre influência de fatores sociais, como a escolaridade materna. Tais aspectos necessitam ser considerados na avaliação e diagnóstico fonoaudiológico, assim como nas práticas educativas oferecidas pela instituição escolar.

Fatores associados à morte materna em unidade de terapia intensiva

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Suzanne Vieira Saintrain

Full Text Available RESUMO Objetivo: Identificar os fatores associados à morte materna em pacientes internadas em unidade de terapia intensiva. Métodos: Estudo do tipo transversal realizado em unidade de terapia intensiva materna. Foram selecionados todos os prontuários de pacientes admitidas no período de janeiro de 2012 a dezembro de 2014. O critério de inclusão foi todas as pacientes obstétricas e puérperas, e o de exclusão as com diagnóstico de mola hidatiforme, gravidez ectópica e anembrionada, e as internadas por causas não obstétricas. Foi realizada análise comparativa entre os desfechos óbito e alta hospitalar. Resultados: Foram incluídas 373 pacientes, com idade entre 13 a 45 anos. As causas de internação na unidade de terapia intensiva foram síndromes hipertensivas relacionadas à gestação, cardiopatias, insuficiência respiratória e sepse; as complicações foram lesão renal aguda (24,1%, hipotensão (15,5%, hemorragia (10,2% e sepse (6,7%. Ocorreram 28 óbitos (7,5%. As causas de óbito foram choque hemorrágico, falência múltipla de órgãos, insuficiência respiratória e sepse. Os fatores de risco independentes para óbito foram lesão renal aguda (OR = 6,77, hipotensão (OR = 15,08 e insuficiência respiratória (OR = 3,65. Conclusão: A frequência de óbitos foi baixa. Lesão renal aguda, hipotensão e insuficiência respiratória foram os fatores de risco independentes associados à mortalidade materna.

Parenteral nutrition in intestinal failure

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Kurkchubasche AG

2015-01-01

Full Text Available Arlet G Kurkchubasche,1 Thomas J Herron,2 Marion F Winkler31Department of Surgery and Pediatrics, 2Department of Surgery, Alpert Medical School of Brown University, 3Department of Surgery/Nutritional Support Service, Rhode Island Hospital, Providence, RI, USAAbstract: Intestinal failure is a consequence of extensive surgical resection resulting in anatomic loss and/or functional impairment in motility or absorptive capacity. The condition is clinically characterized by the inability to maintain fluid, energy, protein, electrolyte, or micronutrient balance when on a conventionally accepted, normal diet. Parenteral nutrition (PN is the cornerstone of management until intestinal adaptation returns the patient to a PN-independent state. Intestinal length, residual anatomic segments and motility determine the need for and duration of parenteral support. The goals of therapy are to provide sufficient nutrients to enable normal growth and development in children, and support a healthy functional status in adults. This review addresses indications for PN, the formulation of the PN solution, patient monitoring, and considerations for prevention of PN-associated complications. With the ultimate goal of achieving enteral autonomy, the important role of diet, pharmacologic interventions, and surgery is discussed.Keywords: intestinal failure, short-bowel syndrome, parenteral nutrition, home nutrition support, intestinal rehabilitation

Total parenteral nutrition in diabetic rats

International Nuclear Information System (INIS)

Norcross, E.D.; Stein, T.P.

1986-01-01

Parenteral Nutrition with hypertonic glucose is frequently given to diabetic patients. Large amounts of insulin can be required. The purpose of this investigation was to develop a totally parenterally nourished diabetic rat model. 200 g Female Sprague Dawley rats were made diabetic by i.v. injection of streptozotocin (50 mg/kg). Rats were then allowed to recover for at least 1 week before undergoing surgical insertion of a central venous catheter for parenteral feeding. TPN was begun 3 days after surgery. Prior to this they were allowed unlimited access to food and water. Control (non-streptozotocin treated) rats were run at the same time. Protein turnover was investigated by using 15 N glycine. Preliminary results: diabetic rats given mostly fat as a calorie source survived well in the absence of exogenous insulin whereas those that were given glucose only as their non-protein calorie source showed poor survival even with exogenous insulin. N balance and protein turnover in the lipid treated diabetic rats were comparable to the non-diabetic control rats

Parenteral nutrition in the ICU setting: need for a shift in utilization.

Science.gov (United States)

Oshima, Taku; Hiesmayr, Michael; Pichard, Claude

2016-03-01

The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes. However, it must be acknowledged that the risk of relative overfeeding is greater when using parenteral nutrition and the risk of underfeeding is greater when using enteral nutrition because of gastrointestinal intolerance. Both overfeeding and underfeeding in the critically ill patients are associated with deleterious outcomes. Thus, early and adequate feeding according to the specific energy needs can be recommended as the optimal feeding strategy. Parenteral nutrition can be used to substitute or supplement enteral nutrition, if adequately prescribed. Testing for enteral nutrition tolerance during 2-3 days after ICU admission provides the perfect timing to start parenteral nutrition, if needed. In case of absolute contraindication for enteral nutrition, consider starting parenteral nutrition carefully to avoid overfeeding.

Influencia de la lactancia materna en la prevención de hábitos bucales deformantes

OpenAIRE

Fuguet Boullon, Julia R; Betancourt García, Ana Ibis; Ochoa Jiménez, Lourdes; González Pérez, Marlén; Crespo García, Arelis; Viera Rodríguez, Dianeya

2014-01-01

Introducción: la lactancia materna constituye uno de los pilares fundamentales de la promoción de salud y la prevención de numerosas enfermedades. Objetivo: identificar la influencia de la lactancia materna exclusiva con la presencia de hábitos bucales deformantes. Métodos: se realizó un estudio observacional descriptivo de corte transversal en niños 3-5 años de ambos sexos, pertenecientes al círculo infantil “20 primaveras”, del municipio de Cienfuegos, en el período comprendido entre septie...

Casas Maternas in the Rural Highlands of Guatemala: A Mixed-Methods Case Study of the Introduction and Utilization of Birthing Facilities by an Indigenous Population

Science.gov (United States)

Stollak, Ira; Valdez, Mario; Rivas, Karin; Perry, Henry

2016-01-01

ABSTRACT Background: An international NGO, with financial and managerial support from “partner” communities, established Casas Maternas (birthing facilities) in 3 municipalities in the isolated northwestern highlands of the department of Huehuetenango in Guatemala—an area with high maternal mortality ratio (338 maternal deaths per 100,000 live births). Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access to referral care is facilitated. Methods: We conducted a mixed-methods study in San Sebastian Coatán municipality to assess the contribution of 2 Casas Maternas to health facility deliveries among partner and non-partner communities, with particular emphasis on equity in access. We surveyed all women who delivered in the study area between April 2013 and March 2014, the first full year in which both Casas Maternas in the study area were operating. In addition, using purposive sampling, we conducted in-depth interviews with 22 women who delivered and 6 focus group discussions with 42 community leaders, traditional birth attendants, and Casas Maternas staff members. We analyzed the quantitative data using descriptive statstics and the qualitative data with descriptive content analysis. Results: Of the 321 women eligible for inclusion in the study, we surveyed 275 women (14.3% could not be located or refused to participate). Between April 2013 and March 2014, 70% of women living in partner communities delivered in a health facility (54% in a Casa Materna) compared with 30% of women living in non-partner communities (17% in a Casa Materna). There was no statistically significant difference in uptake of the Casa Materna by maternal education and only a weak effect by household wealth. In contrast, distance from the Casa Materna had a pronounced effect. Traditional birth attendants were strong advocates for utilization of the Casa Materna and played an important role in the

Lactancia materna, alimentación artificial y el primer contacto con azúcar

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Fabian Calixto Fraiz

2013-01-01

Full Text Available Objetivo: Este estudio evaluó los cambios en el patrón de lactancia materna, alimentación artificial y en la introducción de azúcar en la dieta de niños de 0 a 36 meses, a través de dos estudios, con un intervalo de 13 años en la ciudad de Curitiba, Paraná, Brasil. Material y métodos: Poblaciones semejantes de una misma región geográfica fueron evaluadas a través de un cuestionario, en los años de 1993 y 2006, envolviendo, respectivamente, las madres de 180 y 94 niños. Introducción de azúcar en la dieta fue considerada precoz cuando ocurrió antes del 6º mes completo de vida. Los datos fueron analizados estadísticamente a través del test de qui-cuadrado y test exacto de Fisher (α= 0,05. Resultados: Hubo diferencias en la frecuencia del primer contacto con azúcar (p <0,001, que ocurrió en el primer mes de vida en 61,7% de los niños del primer estudio y en sólo 3,2% de los niños del segundo estudio. Hubo diferencias en el patrón de lactancia materna (p = 0,02, siendo la prevalencia de niños amamantados mayor en el segundo estudio. No fueron encontradas diferencias estadísticamente significativas en la prevalencia de uso de biberón, uso de biberón durante la noche y lactancia materna durante la noche, así como en el uso de biberón conteniendo azúcar. Conclusiones: Estos resultados indican que la lactancia materna puede, además de sus varias ventajas, también promover el aplazamiento de la introducción de azúcar en la dieta infantil. Nuevas investigaciones son necesarias para confirmar esta hipótesis.

Parenteral nutrition in radiation injuries

International Nuclear Information System (INIS)

Glants, R.M.

1985-01-01

Basing on the results of experiments on mice and rats and their clinical use in oncological patients treatment recommendations are given on use of parenteral nutrition in treatment of radiation disease

Parenteral nutrition in the elderly cancer patient.

Science.gov (United States)

Orrevall, Ylva

2015-04-01

Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

Vivir la violencia materna. La voz de los niños y las niñas

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Mauricio Hernando Bedoya

2011-01-01

Full Text Available El presente artículo informa acerca del significado que un grupo de hijos e hijas de madres que se nombran como maltratadoras le atribuyen a este vínculo afectivo. Método: fenomenológico hermenéutico del enfoque comprensivo-cualitativo con muestra multinivel. Técnicas de Producción de Información para el estudio general: entrevistas en profundidad con madres, grupos focales con sus hijos e hijas y con padres y madres de tres instituciones educativas. Aquí se desarrollan los hallazgos de los grupos focales con los hijos e hijas. Conclusiones: la violencia materna genera un estilo comunicacional fundamento en el desencuentro vincular; los niños y niñas que creen poder "torcer el destino", tienen unasestrategias de resistencia contra la violencia materna; el sentirse reconocido y captado en una trama vincular hace resilientes a los niños y niñas y, finalmente, se ratifica la importancia de un tercero que regule la violencia materna.

La lactancia materna desde la perspectiva de madres adolescentes de Bogotá

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Yibby Forero

2013-12-01

para lograr una lactancia materna exclusiva y una alimentación complementaria saludable. Entre las causas identificadas, sobresale la ausencia de acompañamiento acertado y oportuno.   doi: http://dx.doi.org/10.7705/biomedica.v33i4.1470

Diabetes mellitus tipo 1: posible relación con la interrupción precoz de la lactancia materna

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Dalila Teixeira Leal

2012-12-01

Full Text Available Introducción: La dieta es importante en la patogénesis de la diabetes tipo 1, los estudios indican una fuerte asociación entre la exposición temprana a la leche de vaca y la aparición de esta enfermedad. Objetivo: Verificar la existencia de la relación entre el destete precoz de la lactancia materna, la exposición a otras leches antes de seis meses de vida y el desarrollo de diabetes mellitus tipo 1. Materiales y Métodos: Investigación cuantitativa, a los padres respecto a los niños y adolescentes con diabetes tipo 1 que se registraron en el Departamento de Control de la Presión Arterial, Diabetes y Obesidad del Departamento Municipal de Salud de Juiz de Fora com una muestra total de 89 participantes. El instrumento utilizado para la recolección de datos fue un cuestionario estructurado aplicado a estos padres, los sujetos de la investigación fueron de ambos sexos y de todas las razas. Cabe señalar que el origen de esta investigación son los usuarios de los servicios de Diabetes Mellitus tipo 1, pero sólo los padres o tutores fueron entrevistados.Resultados: Se presentan datos sobre la caracterización de la muestra, la aparición o no de destete precoz de la lactancia materna, período de la lactancia materna exclusiva, si se ofreció dieta después del destete y las razones que llevaron a esta ocurrencia. Discusión y Conclusiones: La relación entre el destete precoz de la lactancia materna, con la consiguiente introducción de sustitutos de la leche materna, podría conllevar al desarrollo de diabetes mellitus tipo 1. (Rev Cuid 2012;3(3:293-9.Palabras clave: Diabetes Mellitus Tipo 1. Lactancia Materna. Enfermería. (Fuente: DeCS BIREME.

Tratamento da endometrite puerperal com antibioticoterapia parenteral exclusiva Treatment of puerperal endometritis using a regimen with exclusive parenteral antibiotics

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Geraldo Duarte

2005-08-01

Full Text Available OBJETIVO: analisar a efetividade e segurança da antibioticoterapia parenteral hospitalar exclusiva para tratamento da endometrite puerperal, em população de baixo nível socioeconômico. MÉTODOS: estudo clínico prospectivo, que avaliou 21 puérperas com diagnóstico de endometrite puerperal, cujas gestações foram resolvidas em hospital universitário por cesárea (52,4% ou parto normal (47,6. A amostra caracterizou-se por baixo nível socioeconômico e de escolaridade. Foram submetidas ao regime de antibioticoterapia parenteral exclusiva, apenas durante o período de internação (grupo ATP-EX. Os resultados foram comparados com aqueles obtidos de série histórica do mesmo serviço (20 casos submetidas a antibioticoterapia parenteral hospitalar, complementada por terapia via oral ambulatorial (grupo ATP+VO. As pacientes foram avaliadas clinicamente em retornos periódicos visando identificar casos de recidivas e complicações infecciosas. RESULTADOS: uma paciente do grupo ATP+VO necessitou de reinternação no 6º dia após a alta por recrudescência da endometrite. Não foi observada nenhuma complicação entre as pacientes do grupo ATP-EX. CONCLUSÃO: para o tratamento de endometrite puerperal, não foi observado benefício adicional com a adição da antibioticoterapia oral complementar após a alta. Os resultados com o uso da antibioticoterapia parenteral exclusiva durante a internação indicam que esse esquema pode ser utilizado com segurança em população de baixo nível socioeconômico.PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4% or normal delivery (47.6%. The sample was characterized by low socioeconomic and

Clinical significance of changes of serum TBA, CG, HA levels in neonate with parenteral nutrition

International Nuclear Information System (INIS)

Huang Weiliang; Zhou Jiongying; Zhang Xiaoyi; Lv Weihua; Ma Yunbao; He Qizhi

2010-01-01

Objective: To study the clinical significance of changes of serum levels of TBA, CG, HA in neonate with parenteral nutrition. Methods: Serum total bile acid (TBA, with biochemistry) and CG, HA (with RIA) contents were measured in 52 neonates (full-term 32, preterm 20) with parenteral nutrition and 28 neonates (full-term 16, preterm 12) without parenteral nutrition (as controls). Results: Before parenteral nutrition,the serum TBA, CG and HA levels in full-term neonates were not significantly different from those in the controls (P>0.05). After parenteral nutrition,serum levels were significantly higher than those before parenteral nutrition (P<0.01). The levels in pre-term neonates were significantly higher after parenteral nutrition than those in full-term neonates (P<0.05). Conclusion: Long term parenteral nutrition might be harmful to hepatic and gall bladder function in neonates especially in premature ones. (authors)

Depresión materna perinatal y vínculo madre-bebé: consideraciones clínicas

OpenAIRE

Marcia Paola Olhaberry Huber; Macarena Romero Jiménez; Ángela Miranda Largo

2015-01-01

La alta frecuencia de los trastornos depresivos en el mundo y las altas tasas reportadas durante el pre y postparto, alertan sobre la necesidad de profundizar en la comprensión de la depresión materna perinatal y sus repercusiones psicológicas en la madre y el niño/a. Se describen y analizan sus características, los factores protectores y de riesgo, los principales efectos en el vínculo madre-bebé, el desarrollo infantil y la identidad materna a partir de una revisión de la literatura existen...

Dialogia e função materna em casos de limitações práxicas verbais Dialogismo y función materna en casos de limitaciones verbales praxicas Dialogy and matern function in cases of verbal praxic limitation

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Inaê Costa Rechia

2010-06-01

Full Text Available O presente estudo analisou possíveis relações entre a interação dialógica da díade mãe-criança com limitações práxicas e o exercício da função materna. Especificamente, buscou-se categorizar os tipos de interações dialógicas encontradas, analisar a interferência ou não das limitações práxicas das crianças no processo de interpretação por parte da mãe e os reflexos da função materna sobre o diálogo mãe-criança. Participaram do estudo cinco díades mãe-filho, sendo realizadas filmagens da interação dessas díades, nas quais se analisaram o brincar, a relação mãe-filho, bem como o exercício das funções parentais, sobretudo a materna. Puderam-se observar vínculos precários entre mãe-filho, que evidenciavam dificuldades no exercício da função materna, mães diretivas, intrusivas ou afastadas e apáticas. A análise dialógica demonstrou que as limitações práxicas não impedem o processo de interpretação lingüística, podendo apenas limitá-lo. O exercício da função materna parece ter efeito importante no diálogo entre mãe e filho.El objetivo de esto artículo es apuntar y relacionar la función materna y la interacción en el diálogo madre-niño, esto con limitaciones práxicas. Más precisamente, plantease la categorización de las interacciones en el diálogo apuntadas, la análisis de la interferencia de las limitaciones práxicas en el proceso de interpretación lingüística de la madre relativamente a la habla de su hijo y los reflejos causados por la función materna en el diálogo madre-niño. Han participado del estudio cinco madres y sus hijos, cuyas interacciones en el jugar han sido filmadas. Fueran analizados la relación madre-niño, lo ejercicio de las funciones de los padres, principalmente la función materna. Han sido observados vínculos precarios de la madre con su hijo, los cuales han demostrado el ejercicio dificultoso de la función materna. Las madres han se comportado

Impacto de las redes de apoyo a la lactancia materna en la Región de Murcia

OpenAIRE

Baño Piñero, Isabel

2016-01-01

Antecedentes: Partimos de la hipótesis de que el impacto que ejercen las redes de apoyo a la lactancia materna, sobre las mujeres que lactan, es satisfactorio. Objetivos: Como objetivo general de este proyecto, nos proponemos conocer, valorar y descubrir cuál es el impacto real que ejercen las redes de apoyo a la lactancia materna sobre las mujeres que lactan a través de 5 objetivos específicos: 1. Conocer cuál es el grado de satisfacción percibido por las usuarias de los servicios de ...

Features of liver tissue remodeling in intestinal failure during and after weaning off parenteral nutrition.

Science.gov (United States)

Mutanen, Annika; Lohi, Jouko; Sorsa, Timo; Jalanko, Hannu; Pakarinen, Mikko P

2016-09-01

Intestinal failure is associated frequently with liver injury, which persists after weaning off parenteral nutrition. We compared features of liver remodeling in intestinal failure during and after weaning off parenteral nutrition. Liver biopsies and serum samples were obtained from 25 intestinal failure patients at a median age of 9.7 years (interquartile range: 4.6-18) and from age-matched control patients. Seven patients had been receiving parenteral nutrition for 53 months (22-160), and 18 patients had been weaned off parenteral nutrition 6.3 years (2.4-17) earlier, after having received parenteral nutrition for 10 months (3.3-34). Expression of alpha-smooth muscle actin, collagen 1, proinflammatory cytokines, growth factors, and matrix metalloproteinases (MMPs) was measured. Significant increases in immunohistochemical expression of alpha-smooth muscle actin and collagen 1 were observed predominantly in portal areas and were similar to increases seen in patients currently receiving parenteral nutrition and in patients weaned off parenteral nutrition. Gene and protein expressions of alpha-smooth muscle actin and collagen were interrelated. Gene expression of ACTA2, encoding alpha-smooth muscle actin, was increased only in patients who were receiving parenteral nutrition currently. Comparable upregulation of interleukin-1 (α and ß), epidermal growth factor, integrin-ß6, and MMP9 gene expression was observed in both patient groups, irrespective of whether they were receiving parenteral nutrition currently. Liver expression and serum levels of TIMP1 and MMP7 were increased only in the patients on parenteral nutrition currently but were not increased after weaning off parenteral nutrition. Intestinal failure is characterized by abnormal activation of hepatic myofibroblast and accumulation of collagen both during and after weaning off parenteral nutrition. Persistent transcriptional upregulation of proinflammatory and fibrogenic cytokines after weaning off

ALEITAMENTO MATERNO EXCLUSIVO E AUTOEFICÁCIA MATERNA ENTRE MULHERES EM SITUAÇÃO DE VIOLÊNCIA POR PARCEIRO ÍNTIMO

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Laura Marina Bandim Mariano

2016-01-01

Full Text Available Este estúdio tiene como evaluar la práctica de la lactancia materna entre mujeres em situación de violência del compañero íntimo durante elembarazo actual para la duración de lan lactancia materna exclusiva, el nivel de autoeficacia de amamantar y factores relacionados a la iniciación, el establecimiento de la lactancia y el destete precoz. Estudio transversal. 63 mujeres participaron em situación de violência del compañero íntimo em el embarazo actual, identificado por encuesta em el servicio prenatal. La recolección de datos se realizo em el prenatal y postparto. Se utilizo um cuestionario de identificación de violência del compañero íntimo, Breastfeeding Self-Efficacy Scale y información de los registros médicos. El promedio de días de lactancia materna exclusiva fue 19,08. No hubo asociacióne stadísticamente significativa entre la duración de la lactancia materna exclusiva a los 30 y 70 días después del parto y tipos de violência del compañero, asi como prácticas de cuidado con nível de autoeficacia de amamentar. Se encontro asociación entre el tipo de lactancia materna a los 30 y 70 días después del parto y mejores condiciones vitales de lo recien nacido con el nível de autoeficacia de amamentar.

Contaminación por mercurio de leche materna de madres lactantes de municipios de Antioquia con explotación minera de oro.

Science.gov (United States)

Molina, Carlos Federico; Arango, Catalina María; Sepúlveda, Hernán

2018-05-01

Introducción. La leche materna es esencial para el desarrollo del ser humano, pero puede contener sustancias tóxicas provenientes de la contaminación ambiental, especialmente en las áreas mineras.Objetivo. Determinar la prevalencia de la contaminación con mercurio de la leche materna de mujeres lactantes residentes en los municipios con explotación minera de oro.Materiales y métodos. Se hizo un estudio transversal de 150 madres lactantes de cuatro municipios mineros de Antioquia (El Bagre, Segovia, Remedios y Zaragoza), a quienes se les hizo una encuesta sobre factores sociodemográficos, ocupacionales y ambientales relacionados con el mercurio, y se les tomaron muestras de leche materna, de orina y de cabello. Se calculó el promedio de la concentración de mercurio y las prevalencias municipales de contaminación.Resultados. El promedio de la concentración de mercurio en la leche materna fue de 2,5 (± desviación estándar 9,2) μg/L. La prevalencia de muestras de leche materna con niveles altos de mercurio fue de 11,7 %.Conclusión. En este estudio se evidencia un grave problema en las regiones mineras auríferas de Antioquia por el efecto de la contaminación con mercurio en sectores de la población más vulnerable.

Lactancia materna ineficaz: prevalencia y factores asociados Ineffective Breastfeeding: prevalence and associated factors

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Elvinia Pinilla Gómez

2011-12-01

Full Text Available Introducción: Es posible evitar muertes neonatales mediante la lactancia materna desde el primer día de vida, pues la leche materna es el alimento óptimo para el lactante por su contenido nutricional necesario favorecer el crecimiento y desarrollo. Objetivo: Determinar la prevalencia y factores asociados al diagnóstico de enfermería "Lactancia materna ineficaz" en lactantes menores de 6 meses hospitalizados en una institución de tercer nivel. Metodología: Estudio de corte transversal. Se seleccionaron 108 binomios (madre e hijo hospitalizados en una institución de tercer nivel de atención en el año 2009, se aplicó un formato validado para identificar el diagnóstico. Se realizó análisis Rasch a las variables que representan las características definitorias del diagnóstico, con el cual se creó una escala de 0 a 100 y se construyó un modelo de regresión lineal con las variables asociadas a la medida del diagnóstico. Resultados: la prevalencia del diagnóstico fue de 93,5 %, la característica definitoria más fácil de encontrar fue Incapacidad del lactante para agarrarse al pecho materno y la más difícil fue agitación y llanto del lactante dentro de la primera hora después de la lactancia materna. La regresión lineal mostró factores asociados como: género femenino, peso del lactante y necesidad de la madre de ir a orinar. Conclusión: Existe una tendencia desfavorable tanto en la prevalencia como en la duración de la lactancia materna para los lactantes hospitalizados; la promoción de la lactancia materna debe ser un trabajo interdisciplinario; modificar las normas hospitalarias favoreciendo el contacto del binomio y la puesta temprana al pecho materno. Salud UIS 2011; 43 (3: 271-279Introduction: neonatal deaths can be prevented by breastfeeding from the first day of life, as is the optimal food for infants by their nutritional content required for better growth and development. Objective: To determine the prevalence

Safety of parenteral nutrition in newborns: Results from a nationwide prospective cohort study.

Science.gov (United States)

Lapillonne, Alexandre; Berleur, Marie-Pierre; Brasseur, Yvette; Calvez, Sophie

2018-04-01

Limited or delayed availability of parenteral nutrition (PN) solutions, as well as difficulties in ordering are often identified as reasons for non-compliance with international guidelines in newborns. This study aims at assessing the modality of use and safety of premixed standardized PN solutions in a nationwide prospective cohort of newborns treated in clinical practice. Two premixed fixed formulations with respective osmolarity of 715 and 790 mOsm/L specifically designed for neonates were made available throughout the country for clinical use from birth onwards. Descriptive data and modality of use were prospectively collected in a case report form, whereas all related and unrelated adverse events were recorded on a separate adverse event form. A total of 14,167 infants were prospectively included and 16,640 parenteral nutrition periods were analyzed. Mean age was 33 weeks of gestation, and mean weight was 2086 g. The majority of infants (81%) started the parenteral nutrition the first day of life or the day after. The route of parenteral nutrition delivery was peripheral in 47% of the parenteral nutrition periods. During the whole study, a total of 72 adverse events occurring in 68 infants were reported. Of these adverse events, 59 (0.37% of the nutrition periods), among which 19 serious adverse events, were reported as related to the parenteral nutrition solutions. The events related to parenteral nutrition solutions were general disorders and administration site conditions (n = 42 including 9 cases of cutaneous necrosis), and nutrition and metabolism disorders (n = 17). There was no case of thrombophlebitis. Six of the 19 serious events related to the parenteral nutrition solutions (32%) were due to the misuse of the infusion bag. These data support the concept that ready-to-use parenteral nutrition formulations can safely provide parenteral nutrition from birth onwards. They further support that parenteral solutions with an osmolarity up to 800�

Grau de escolaridade materna e baixo peso ao nascer: uma meta-análise

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Sonia Silvestrin

2013-08-01

Full Text Available OBJETIVO: Analisar a associação entre grau de escolaridade materna e peso de nascimento, considerando-se a hipótese de que a utilização em excesso das tecnologias na área da saúde, assim como a escassez de recursos, pode produzir desfechos similares. MÉTODOS: Realizou-se uma meta-análise com estudos transversais e de coorte, selecionados por revisão sistemática na base de dados bibliográficos MEDLINE com os descritores: socioeconomic factors; infant, low birth weight; cohort studies; cross-sectional studies. As medidas de sumário de efeito foram obtidas pelo modelo de efeito aleatório, e os seus resultados apresentados por intermédio dos gráficos Forest Plot. O viés de publicação foi analisado pelo Teste de Egger, e a avaliação da qualidade dos estudos utilizou a Escala de Newcastle-Ottawa. RESULTADOS: A busca inicial encontrou 729 artigos. Destes, foram excluídos 594, após a leitura do título e do resumo; 21, após reuniões de consenso entre os três revisores; 102, após leitura do texto completo; e três, por não possuírem o desfecho adequado. Dos nove artigos finais, 88,8% apresentavam uma qualidade igual ou superior a seis estrelas (Escala de Newcastle-Ottawa, configurando boa qualidade aos estudos. A heterogeneidade dos artigos foi considerada moderada. A escolaridade materna elevada mostrou um efeito protetor de 33% sobre o baixo peso ao nascer, enquanto que o grau médio não apresentou proteção significativa, quando comparados à escolaridade materna baixa. CONCLUSÕES: A hipótese de similaridade entre os graus extremos da distribuição social, traduzidas pelo nível de escolaridade materna, em relação à proporção de baixo peso ao nascer, não foi confirmada.

IODINE CONTENT OF ENTERAL AND PARENTERAL NUTRITION SOLUTIONS.

Science.gov (United States)

Willard, Devina L; Young, Lorraine S; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N

2017-07-01

Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations. The objective of this study was to determine the iodine content of U.S. adult enteral and parenteral nutrition solutions. This study also aimed to determine whether adult patients in the United States who are receiving long-term artificial nutrition may be at risk for iodine deficiency. Ten enteral nutrition solutions and 4 parenteral nutrition solutions were evaluated. The iodine contents of these solutions were measured spectrophotometrically and compared to the labeled contents. Measured and labeled EN iodine contents were similar (range 131-176 μg/L and 106-160 μg/L, respectively). In contrast, PN formulas were found to contain small, unlabeled amounts of iodine, averaging 27 μg/L. Typical fluid requirements are 30 to 40 mL/kg/day for adults receiving either total EN (TEN) or total PN (TPN). Adults on long-term TEN likely consume enough servings to meet their daily iodine requirements. However, patients on long-term TPN would require on average 5.6 L PN/day to meet the recommended daily allowance of iodine. This volume of PN is far in excess of typical consumption. Thus, U.S. patients requiring long-term TPN may be at risk for iodine deficiency. EN = enteral nutrition; PN = parenteral nutrition; TEN = total enteral nutrition; TPN = total parenteral nutrition; UIC = urinary iodine concentration.

Análise da mortalidade materna do município de Ribeirão Preto-SP - no período de 1991 a 1995

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Oba Maria das Dores do Vale

2001-01-01

Full Text Available O objetivo deste estudo foi conhecer e identificar as causas de morte materna. Os dados foram obtidos junto ao Comitê de Estudos e Prevenção de Morte Materna de Ribeirão Preto e atestados de óbitos. É um estudo exploratório, onde foram analisados 72 óbitos maternos, ocorridos em Ribeirão Preto, durante o período de 1991 a 1995. Em 1995 o coeficiente de mortalidade materna foi de 60,3 por 100.000 nascidos vivos, com predomínio de causas evitáveis, como a hemorragia (33,3%, outras causas (26,4%, hipertensão (15,3%, aborto (11,1%, infecção (8,3% e puerpério (5,6%. A mortalidade materna é um problema de saúde pública, que deve ser enfrentado pelas autoridades governamentais.

Identificación de territorios críticos en salud materna mediante indicadores

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Marcos Paz Ballivián

2002-07-01

Full Text Available Objetivos. El Ministerio de Salud y Previsión Social de Bolivia convocó a principios de 2000 a varios expertos para que, a partir de la información disponible, elaboraran un método que permitiera identificar territorios críticos en un tema de por sí prioritario --la salud materna y neonatal-- y crear un mapa de la situación y de la capacidad instalada en las 112 provincias nacionales. En este estudio se describe el método utilizado. Métodos. Se crearon índices de la situación de salud y de la capacidad instalada. Los pasos seguidos en este proceso fueron los siguientes: 1 identificación de las variables incluidas en cada índice; 2 ponderación de las variables de cada índice; creación de una fórmula para cada índice; 4 elaboración de una planilla con los datos de cada provincia correspondientes a las variables elegidas y al valor porcentual provincial de cada índice, obtenido mediante la aplicación de la respectiva fórmula; 5 identificación de tres categorías continuas para cada índice, y 6 definición de la taxonomía. Resultados. De este modo, se obtuvo un mapa nacional de la situación de salud materna y de la capacidad instalada en cada una de las 112 provincias bolivianas, lo cual permitió seleccionar un número mínimo de provincias para realizar intervenciones conjuntas entre el Ministerio de Salud y Previsión Social y otras instituciones. Las 9 provincias seleccionadas tienen un total de 26 municipios que implican a 17 distritos sanitarios y concentran el 29% de la población del país, el 33% de las muertes maternas y el 35% de las defunciones neonatales tempranas estimadas. Conclusiones. Basándose en información disponible, el método utilizado proporcionó un mapa de la situación global, en este caso de la salud materna, de las 112 provincias de los 9 departamentos bolivianos que permite identificar territorios críticos para las intervenciones en materia de salud.

Reconciling divergent results of the latest parenteral nutrition studies in the ICU.

Science.gov (United States)

Singer, Pierre; Pichard, Claude

2013-03-01

Recent studies on the optimal modalities to feed patients during the ICU stay show divergent results. The level and the timing of energy provision is a critical issue, associated with the clinical outcome. These results questioned the clinical relevance of the recent guidelines issued by American, Canadian and European academic societies. Four recent prospective randomized studies enrolled critically ill patients who received various nutritional regimens and tested the effect of nutritional support on outcome. The Tight Calorie balance Control Study (TICACOS) targeted on calorie administration according to measured energy expenditure and found increased ICU morbidity but improved hospital mortality. The large EpaNIC study compared 'early' with 'late' (parenteral nutrition) nutrition, mostly in patients after cardiac surgery, and found an increased morbidity associated with early parenteral nutrition. The supplemental parenteral nutrition (SPN) study randomized the patients after 3 days and targeted the calories administered by parenteral nutrition as a complement to unsuccessful enteral nutrition using indirect calorimetry. The SPN resulted in less nosocomial infections and shorter duration of mechanical ventilation. Finally, a recent Australian study enrolled patients unable to be early fed enterally to receive, or not, parenteral nutrition targeted at 1500 kcal. No complications were noted in the parenteral nutrition group. Lessons from all these studies are summarized and should help in designing better studies and guidelines. The critical analysis of recent prospective studies comparing various levels of calorie administration, enteral versus parenteral nutrition and enteral versus SPN confirms the recommendations to avoid underfeeding and overfeeding. Parenteral nutrition, required if enteral feeding is failing, and if adjusted up to a measured optimal level, may improve outcome. More studies on the optimal level of energy and protein administration to

Intervención grupal para reducir la sintomatología depresiva y promover la sensibilidad materna en embarazadas chilenas

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Marcia Olhaberry

2015-07-01

Full Text Available La sintomatología depresiva es frecuente en el embarazo y repercute en el posparto y en el vínculo madre-bebé. Se reportan los resultados de una intervención grupal de 5 sesiones para reducir la sintomatología depresiva y promover una adecuada sensibilidad materna. Participaron 134 embarazadas con antecedentes de depresión (grupo experimental = 88 y grupo control = 46. Se evaluó sintomatología depresiva (Inventario para la Depresión de Beck, resolución de problemas sociales (Inventario de Resolución de Problemas Sociales Abreviado, sensibilidad materna, cooperatividad infantil y riesgo vincular (Índice Experimental de Relación Niño-Adulto en ambos grupos. Se observó una reducción significativa de la sintomatología depresiva, así como un incremento de las habilidades para la resolución de problemas sociales en el grupo intervenido. Este grupo muestra también puntajes significativamente mayores en sensibilidad materna y cooperatividad infantil, así como menores frecuencias de riesgo vincular en la evaluación postintervención. Se discute la relevancia de desarrollar estrategias de intervención durante el embarazo, considerando su impacto en la sensibilidad materna, en la calidad de las interacciones madre-bebé y en las habilidades de las madres para resolver problemas.

Gerencia de un proyecto de investigación y capacitación en lactancia materna

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Ramírez Marina de

1993-04-01

Full Text Available

El propósito de este estudio es brindar algunas pautas sobre el manejo de un proyecto docente que ofrece investigación y capacitación en lactancia materna. a Investigación sobre conocimientos y prácticas de lactancia materna. b Capacitación a profesionales de salud, auxiliares, promotoras y líderes comunitarios en salud. Esta experiencia realizada en dos SILOS de Bogotá, permitió al autor el análisis de aspectos que merecen saltarse en el manejo y operacionalización de las actividades que conllevaron resultados positivos y aprendizajes a través de la práctica, al grupo de estudiantes y profesores comprometidos.

Parenteral Opioid Analgesics Utilization Pattern in Amir-al-Momenin Hospital, Zabol-IRAN

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Hossein Vatanpour

2016-08-01

Full Text Available Opioids are the most available medicines to get rid of any general severe pain and avoiding of any deleterious sequential that can worsen patient outcomes. Rational prescription of opioid analgesics with respect to the possibility of abuse is a big concern in the medical care costs. Zabol, where is located in eastern part of Iran and has common border with Afghanistanhas the most opioid traffic in the region. In this study the rational prescription of parenteral opioid in Amir-al-Momenin general hospital was investigated. A retrospective drug utilization review was performed on 509 in-patients who received parenteral opioids including Morphine, Pethidin, Pentazocin, Fentanyl, Alfentanil, Sufentanil and Methadone from March 21sttoSeptember 23rd, 2011. Multivariate conditional regression modeling was used to determine independent predictors for daily parenteral opioid consumption. Total daily parenteral opioid consumption was 38.63 DDDs/100bed-days for Morphine, Pethidine and Pentazocin and 84564.78 PFEQs/100bed-days for Fentanyl, Alfentanil and Sufentanil and 766 mg for Methadone. Pethidine was the most frequently prescribed parenteral opioid. Most patients who were prescribed by the intramuscular routes, ordered PRN. Daily parenteral opioid consumption was the highest in the emergency ward whereas it was considered as the lowest in the intensive care unit[ICU]. According to our findings, total daily parenteral opioid consumption was almost high in Amir-al-Momenin Hospital. Unlike to some relevant factors that can effect on the consumption of analgesic opioids like gender, age, drug-drug interaction and etc, we found no rational prescription and consumption in the mentioned hospital.

Diazepam parenteral no tratamento de epilepsias graves Treatment of severe epilepsies with parenteral diazepam

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José Geraldo Speciali

1971-09-01

Full Text Available As modificações dos quadros clínico e EEG foram estudadas em 9 pacientes com manifestações epilépticas rebeldes às medicações anticonvulsivantes habituais, quando submetidos à administração parenteral diária de diazepam (Valium e após sua interrupção. Houve diminuição do número e da duração das crises, superior a 75%, em três pacientes. Esses resultados são satisfatórios, considerando a gravidade dos quadros epilépticos e foram obtidos em pacientes com predomínio de alterações EEG lentas antes de iniciar o esquema terapêutico. Não se verificaram efeitos colaterais relevantes na época da administração parenteral. Em dois pacientes foi observado o aparecimento de crises tônicas coincidindo com o aumento de elementos EEG paroxísticos rápidos, localizados ou difusos.Changes of the clinical pictures and electroencephalographic patterns were studied in 9 patients suffering from epileptic seizures non responsive to common anticonvulsivants, when submitted to daily parenteral administration of diazepam (Valium and after its interruption. There was decrease of the number and duration of seizures, over to 75%, in 3 patients. These results can be considered as satisfatory, considering the intensity of the seizures. The best results were obtained in those patients which showed predominance of slow waves in the EEGs prior to the begin of the treatment. No side effects were observed during the treatment. Two patients developed tonic seizures coincident with the increasing of fast paroxistic EEG patterns, of localized or diffuse type.

Morbidade materna extremamente grave: uso do Sistema de Informação Hospitalar Morbilidad materna extremadamente grave: uso del sistema de información hospitalaria Severe acute maternal morbidity: use of the Brazilian Hospital Information System

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Maria da Consolação Magalhães

2012-06-01

Full Text Available OBJETIVO: Estimar a prevalência da morbidade materna extremamente grave e identificar procedimentos hospitalares associados. MÉTODOS: Foram utilizados dados do Sistema de Informação Hospitalar fornecidos pela Secretaria de Saúde de Juiz de Fora, MG, de 2006 a 2007. Foram selecionadas as internações para procedimentos obstétricos (n = 8.620 mulheres cujo diagnóstico principal compreendia todo o capítulo XV, gravidez, parto e puerpério, da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão. Foram identificados os códigos dos procedimentos realizados, procedimentos especiais e atos profissionais que pudessem contemplar o critério de morbidade materna extremamente grave da Organização Mundial da Saúde e outros procedimentos não habitualmente utilizados no período gravídico-puerperal. A análise de regressão logística foi utilizada para identificar associações entre desfecho e variáveis selecionadas. RESULTADOS: A prevalência de morbidade materna foi 37,8/1000 mulheres e a proporção de mortalidade foi 12/100.000 mulheres. O tempo de internação > 4 dias foi 13 vezes mais alto entre as mulheres que apresentaram alguma morbidade. Após análise ajustada, os fatores preditores de morbidade materna extremamente grave foram: tempo de internação, número de internações e filhos natimortos, e os procedimentos/condições mais frequentes foram a transfusão de hemoderivados (15,7/1.000, "permanência a maior" (9,5/1.000 e pré-eclâmpsia grave/eclâmpsia (8,2/1.000. CONCLUSÕES: Foi alta a prevalência de morbidade materna extremamente grave, associada principalmente às internações e variáveis relacionadas ao recém-nascido. O critério para identificação dos casos e o uso do Sistema de Informações Hospitalares mostraram-se úteis para a vigilância da morbimortalidade materna e para ampliar o conhecimento sobre os aspectos que a envolvem, contribuindo para a

Parenteral nutrition in childhood and consequences for dentition and gingivae.

Science.gov (United States)

Olczak-Kowalczyk, D; Danko, M; Banaś, E; Gozdowski, D; Popińska, K; Krasuska-Sławińska, E; Książyk, J

2017-03-01

Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities. The study involved 63 patients (aged 2.25-16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6±2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated. Medical records provided information on parenteral meals per week, age parenteral nutrition started, birth body mass, Apgar score, weight deficiency, and antibiotic therapy until aged 1 year. The Mann-Whitney test, chi-squared test, and Spearman rank correlation coefficient were used (p≤0.05). Dental developmental abnormalities occurred more often in PN subjects (71.87% vs. 25.80%). The prevalence of caries in PN (56.25% vs. 90.32%) and dmft (2.00±3.30 vs. 4.21±3.33) and DMFT (2.47±4.08 vs. 3.33±3.50) were lower. Positive caries Spearman's rank correlation coefficients: frequency of oral meals and frequency of cariogenic snacks consumption, and GI. Negative correlation coefficients: low birth body mass, antibiotic therapy, and low body mass in the first year of life. Positive dental developmental abnormality Spearman's coefficients: low birth body mass, Apgar score parenteral nutrition duration, low body mass and antibiotic therapy in the first year of life. Beta- lactam, aminoglycoside, glycopeptide and nitroimidazole treatments were related to enamel hypoplasia. Parenteral nutrition in childhood is related to the risk of dental developmental abnormalities, promoted by malnutrition and antibiotic therapy in infancy. Limiting the number of meals and cariogenic snacks, and most probably administration of antibiotics, decreases the risk of caries.

Plasma trace metals during total parenteral alimentation.

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Solomons, N W; Layden, T J; Rosenberg, I H; Vo-Khactu, K; Sandstead, H H

1976-06-01

The plasma concentrations of the trace metals zinc and copper were studied prospectively in 13 patients with gastrointestinal diseases treated with parenteral alimentation (TPA) for periods of from 8 days to 7 1/2 weeks. Plasma copper levels fell rapidly and consistently in all patients, with an overall rate of - 11 mug per 100 ml per week. Zinc concentrations declined in 10 of 13 patients at a more gradual rate. Analysis of the standard parenteral alimentation fluids revealed zinc content equivalent to 50% of the daily requirement and a negligible content of copper. From combined analysis of plasma zinc, hair zinc, and taste acuity, there is evidence that increased utilization or redistribution within the body may effect plasma concentrations in some patients. Neither an increase in urinary excretion nor a primary decrease in plasma binding proteins appeared to be a major factor in lowering plasma trace metal concentrations. These findings indicate that a marked decrease in plasma copper is regular and a decline in plasma zinc is common during TPA using fluids unsupplemented with trace metals. Supplementation of parenteral alimentation fluids with the trace metals zinc and copper is recommended.

ROLE OF PARENTERAL NUTRITION IN ONCOLOGIC PATIENTS WITH INTESTINAL OCCLUSION AND PERITONEAL CARCINOMATOSIS.

Science.gov (United States)

Aría Guerra, Eva; Cortés-Salgado, Alfonso; Mateo-Lobo, Raquel; Nattero, Lía; Riveiro, Javier; Vega-Piñero, Belén; Valbuena, Beatriz; Carabaña, Fátima; Carrero, Carmen; Grande, Enrique; Carrato, Alfredo; Botella-Carretero, José Ignacio

2015-09-01

the precise role of parenteral nutrition in the management of oncologic patients with intestinal occlusion is not well defined yet. We aimed to identify the effects of parenteral nutrition in these patients regarding prognosis. 55 patients with intestinal occlusion and peritoneal carcinomatosis were included. Parenteral nutrition aimed at 20-35 kcal/Kg/day, and 1.0 g/kg/day of amino-acids. Weight, body mass index, type of tumor, type of chemotherapy, and ECOG among others were recorded and analyzed. 69.1% of the patients had gastrointestinal tumors, 18.2% gynecologic and 12.7% others. Age was 60 ± 13y, baseline ECOG 1.5 ± 0.5 and body mass index 21.6 ± 4.3. Malnutrition was present in 85%. Survival from the start of parenteral nutrition was not significant when considering baseline ECOG (log rank = 0.593, p = 0.743), previous lines of chemotherapy (log rank = 2.117, p = 0.548), baseline BMI (log rank = 2.686, p = 0.261), or type of tumor (log rank = 2.066, p = 0.356). Survival in patients who received home parenteral nutrition after hospital discharge was higher than those who stayed in-hospital (log rank = 7.090, p = 0.008). Survival in patients who started chemotherapy during or after parenteral nutrition was higher than those who did not so (log rank = 17.316, p Parenteral nutrition in patients with advanced cancer and intestinal occlusion is safe, and in tho se who respond to chemotherapy, further administration of home parenteral nutrition together with chemotherapy may enhance prolonged survival. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

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Abunnaja, Salim; Cuviello, Andrea; Sanchez, Juan A.

2013-01-01

Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations. PMID:23429491

Morbilidad y mortalidad materna en una institución de salud en el año 2012

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Cecilia E. Guerra Gutiérrez

2014-01-01

Full Text Available Objetivo: Analizar la morbilidad y mortalidad materna en una institución de salud en 2012. Materiales y método: Estudio descriptivo transversal retrospectivo. La población estudiada fue tomada de la base datos del Comité materno-infantil del Hospital Universidad del Norte (HUN. Casos que clasificaron en los criterios MME establecidos durante 2012. Ya obtenida la información, en el análisis de los datos se utilizó la herramienta Statgraphics, para gestionar y analizar los valores estadísticos. También se utilizó Microsoft Word y Excel para organizar gráficos, tablas y redactar su respectivo análisis. Resultados: Del total de casos presentados, un alto porcentaje (97 % presentó morbilidad materna extrema, seguido de un 3 % que presentó mortalidad materna en 2012. Del total de casos presentados, un alto porcentaje (72 % se presentó en el primer semestre y un 28 % en el segundo semestre. Conclusión: Este tipo de análisis es el punto de partida para obtener una mayor comprensión del problema de Morbimortalidad Materna. Después de hacer una primera aproximación mediante la descripción de la situación, es decir, conocer los criterios que más incidencia tienen, el siguiente paso es identificar los factores determinantes que están influyendo para su presentación, pero ante todo, reconocer cuáles fueron las conductas o las condiciones que impidieron que estas madres murieran, con el fin de aplicar este conocimiento en la atención de futuras mujeres.

Conocimientos y prácticas de lactancia materna en madres adolescentes que asisten al Centro de Salud de Bagua.

OpenAIRE

Bautista-Hualpa, Yeny Rita; Díaz-Rivadeneira, Insolina Raquel

2017-01-01

La lactancia materna como única e irremplazable para cubrir las necesidades alimentarias del niño, es un derecho humano fundamental que debe ser promovido durante los primeros seis meses de vida. Objetivos: determinar el nivel de conocimientos y prácticas en lactancia materna de las madres adolescentes que asisten al Centro de Salud Bagua. Material y métodos: La investigación es de tipo descriptivo, de diseño transversal. La muestra estuvo conformada por 88 madres adolescentes con niños menor...

Factores que inciden en la duración de la lactancia materna exclusiva en una comunidad rural de Chile

OpenAIRE

Pino V, José Luis; López E, Miguel Ángel; Medel I, Andrea Pilar; Ortega S, Alejandra

2013-01-01

Introducción. Según las directrices del Ministerio de Salud de Chile, la lactancia materna exclusiva (LME) se debe suministrar como único alimento hasta los 6 meses de vida del lactante; sin embargo, las cifras de destete precoz han aumentado, influyendo en este aspecto motivos de índole social, familiar y personal de salud. Objetivo. Determinar los factores que inciden en la duración de la lactancia materna exclusiva hasta los seis meses en un centro de salud rural. Métodos. Estudio no exper...

Ceramide in lipid emulsions used in parenteral nutrition: an innocent bystander?

NARCIS (Netherlands)

Groener, Johanna E.; Serlie, Mireille J.; Poppema, Aldi; Mirzaian, Mina; Aerts, Johannes M.

2011-01-01

Parenteral nutrition-associated liver disease is a prevalent and severe complication of long term parenteral nutrition. We present here for the first time data on the presence of ceramide, a bioactive compound involved in a variety of metabolic processes, in different lipid emulsions used in

Diagnóstico prenatal no invasivo: Ácidos nucleicos de origen fetal en sangre materna

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Carla Sesarini

2010-12-01

Full Text Available Las técnicas actuales de diagnóstico prenatal de enfermedades génicas y cromosómicas incluyen procedimientos invasivos que conllevan un pequeño, pero significativo, riesgo. Por muchos años se ha estudiado la posibilidad de utilizar células fetales en circulación materna; sin embargo, ha fracasado su implementación clínica debido a su escasez y persistencia luego del parto. Desde hace más de una década se detectó ADN fetal libre en sangre de embarazadas. Este sería de origen placentario e indetectable después del parto, y fuente de material fetal para el desarrollo de técnicas diagnósticas utilizando sangre materna. No obstante, la mayoría del ADN libre en circulación materna es de origen materno con una contribución fetal del 3% al 6% aumentando a lo largo de la gestación. Dado que los métodos actuales no permiten separar el ADN libre fetal del materno, las aplicaciones se focalizan en el análisis de genes no presentes en la madre, tales como secuencias del cromosoma Y, o gen RHD en madres Rh negativas, o mutaciones paternas o de novo. Asimismo, la detección de ARN fetal libre en sangre de embarazadas abrió la posibilidad de obtener información acerca de patrones de expresión génica de tejidos embrionarios y, utilizando genes que se expresan sólo en la unidad feto-placentaria, se podría establecer un control de presencia de material fetal, independiente del material genético de la madre. El presente trabajo describe las evidencias acerca del pasaje de ácidos nucleicos fetales a circulación materna, su aplicación actual en el diagnóstico prenatal y posibles usos futuros.

Capacitación sobre lactancia materna al personal de enfermería del Hospital General de México

OpenAIRE

Hernández-Garduño Adolfo Gabriel; Rosa-Ruiz Leticia de la

2000-01-01

OBJETIVO: Evaluar el cambio de conocimientos acerca de la lactancia entre el personal de enfermería del Hospital General de México que asistió a un curso teórico-práctico sobre lactancia materna de 18 horas de duración. MATERIAL Y MÉTODOS: Se realizó una intervención educativa sobre lactancia materna, con evaluación inicial y final, en el Hospital General de México, de mayo de 1996 a mayo de 1997. Se capacitó a 152 enfermeras. Se aplicó la prueba t de Student para muestras dependientes y anál...

Nutrición parenteral precoz en el neonato grave

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Alina González Mustelier

2004-06-01

Full Text Available Se realizó un estudio descriptivo en el Servicio de Terapia Intensiva Neonatal del Hospital Ginecoobstétrico "Ramón González Coro" de Ciudad de La Habana, desde enero del 2000 hasta enero del 2002, con el objetivo de valorar las ventajas del uso de nutrición parenteral (NP precoz en los neonatos críticamente enfermos, durante la primera semana de vida. Se compararon 2 grupos de 23 recién nacidos críticos, uno de ellos recibió alimentación parenteral (grupo I y el otro no (grupo II. Se encontró homogeneidad en ambos grupos en cuanto a peso, edad gestacional, valoración nutricional al nacer, sexo y morbilidad inicial. La nutrición parenteral se caracterizó por su uso precoz (menos de 72 horas, conjuntamente con alimentación enteral mínima. La media del aporte máximo de macronutrientes fue de 16 g/kg/d de dextrosa, 1,2 g/kg/d de lípidos y 2 g/kg/d de proteínas. El desarrollo nutricional fue más favorable en el grupo con NP, porque le disminuyó a la mitad el tanto por ciento de peso perdido en la primera semana de vida, le sostuvo mayor aporte energético durante ese período y recupó 7 días antes su peso del nacimiento en relación con el grupo II. Las complicaciones fueron similares en ambos grupos, para concluir en que estas no estuvieron relacionadas con el uso de NP.A descriptive study was conducted at the Neonatal Intensive Therapy Service of "Ramón Gonzalez Coro" Gynecoobstetric Hospital, in Havana City, from January 2000, to January 2002, aimed at assessing the advantages of the use of early parenteral nutrition in the critically ill neonates during the first week of life. 2 groups of 23 critical newborn infants each were compared. One of them recieved parenteral nutrition (group 1 and the other one did not (group II. Homogeneity was found in both groups as regards weight, gestational age, nutritional assessment at birth and initial morbidity. The parenteral nutrition was characterized by its early use (less than 72

Lactancia materna versus lactancia artificial en el contexto colombiano

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Romina Izzedin-Bouquet de Durán

2011-01-01

Full Text Available En un primer momento, el artículo describe las propiedades nutritivas y los beneficios inmunológicos de la lactancia materna para luego informar acerca de la situación de la misma en el contexto internacional y colombiano comparándola con su mayor competidor la leche deformula. Finalmente, se hace mención a las estrategias que fomentan el amamantamiento pretendiendo concientizar a la población mundial acerca del compromiso que como individuos y sociedad tenemos con respecto a la salud materno-infantil.

Parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.

Science.gov (United States)

Bizari, Letícia; da Silva Santos, Andressa Feijó; Foss, Norma Tiraboschi; Marchini, Júlio Sérgio; Suen, Vivian Marques Miguel

2016-07-01

Short bowel syndrome is a severe malabsorption disorder, and prolonged parenteral nutrition is essential for survival in some cases. Among the undesirable effects of long-term parenteral nutrition is an increase in proinflammatory cytokines. The aim of the present study was to measure the serum levels of interleukin-6, interleukin-10, tumor necrosis factor alpha, and transforming growth factor beta, in patients with short bowel syndrome on cyclic parenteral nutrition and patients who had previously received but no longer require parenteral nutrition. The study was cross-sectional and observational. Three groups were studied as follows: Parenteral nutrition group, 9 patients with short bowel syndrome that receive cyclic parenteral nutrition; Oral nutrition group, 10 patients with the same syndrome who had been weaned off parenteral nutrition for at least 1 year prior to the study; Control group, 13 healthy adults, matched for age and sex to parenteral and oral groups. The following data were collected: age, tobacco use, drug therapies, dietary intake, body weight, height, blood collection. All interleukins were significantly higher in the parenteral group compared with the control group as follows: interleukin-6: 22 ± 19 vs 1.5 ± 1.4 pg/mL, P= .0002; transforming growth factor β: 854 ± 204 vs 607 ± 280 pg/mL, P= .04; interleukin-10: 8 ± 37 vs 0.6 ± 4, P= .03; tumor necrosis factor α: 20 ± 8 vs 8 ± 4 pg/mL, Pparenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison Between Premixed and Compounded Parenteral Nutrition Solutions in Hospitalized Patients Requiring Parenteral Nutrition.

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Beattie, Colleen; Allard, Johane; Raman, Maitreyi

2016-04-01

Parenteral nutrition (PN) may be provided through compounded or premixed solutions. To determine the proportion of stable custom-compounded PN prescriptions that would fit within a 20% deviance of an existing premixed PN solution. A retrospective study design was used. Inpatients who received PN in non-critical care units in the preceding year were screened for eligibility. Results are reported descriptively as means (95% confidence intervals) and proportions. We reviewed 97 PN prescriptions that met inclusion criteria. Stable hospital PN prescriptions compared with the reference premixed prescription provided 1838 (1777-1898) vs 1843 (1781-1905) kcal/d, P = .43; dextrose, 266 (254-277) vs 225 (216-234) g/d, P magnesium, 5.4 (4.8-5.4) vs 7.6 (7.4-7.9) mmol/L. Calories and protein were remarkably similar, but dextrose, lipid, and electrolytes differed between hospital PN and the reference premixed prescription. We believe that there may be a role for premixed solutions in quaternary centers in stable non-critically ill patients. © 2016 American Society for Parenteral and Enteral Nutrition.

Intensive medicine - Guidelines on Parenteral Nutrition, Chapter 14.

Science.gov (United States)

Kreymann, G; Adolph, M; Druml, W; Jauch, K W

2009-11-18

In intensive care patients parenteral nutrition (PN) should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5-7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day), carbohydrates (around 60% of the non-protein energy) and fat (around 40% of the non-protein energy) as well as electrolytes and micronutrients.

Leitura, literatura e tradução: a necessidade de adequações no ensino de línguas não-maternas

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Sérgio Flores Pedroso

2006-11-01

Full Text Available Neste artigo, a leitura em lingua não-materna é a abordada pela via do lugar que a literatura ocupa em livros didáticos de espanhol e mais concretamente através do gênero narrativa. A interpretação e a consideração da tradução no processo de ensino de línguas não-maternas em geral e da leitura em particular fazem parte dos aspectos problematizados em torno da relação literatura/ensino. Isso porque a premissa de que deriva este trabalho é que a língua materna gerencia toda aproximação de outra lingua, sendo que isso envolve os componentes ideológicos da linguagem.

[Clinical outcomes of parenterally administered shuxuetong--analysis of hospital information system data].

Science.gov (United States)

Zhi, Ying-Jie; Zhang, Hui; Xie, Yan-Ming; Yang, Wei; Yang, Hu; Zhuang, Yan

2013-09-01

Hospital information system data of cerebral infaction patients who received parenterally administered Shuxuetong was analyzed. This provided frequency data regarding patients' conditions and related information in order to provide a clinical reference guide. In this study, HIS data from 18 hospitals was analyzed. Patients receiving parenterally administered Shuxuetong for the treatment of cerebral infarction were included. Information on age, gender, costsand route of administration were collated. The average age of patients was 66 years old. Days of hospitalization ranged from 15 to 28 days. The majority of patients were classified as having phlegm and blood stasis syndrome, which is inaccordance with the indications for this drug. The most commonly used drugs used in combination with parenterally administered Shuxuetong were: aspirin, insulin and heparin. Patients with cerebral infarction crowd using parenterally administered Shuxuetong were a mostly elderly population, with an average age of 66. Although generally use was in accordance with indications, dosage, and route of administration, there were however some discrepancies. Therefore, doctors need to pay close attention to guidelines and closely observe patients when using parenterally administered Shuxuetong and to consider both the clinical benefits and risks.

Accelerated in-vitro release testing methods for extended-release parenteral dosage forms.

Science.gov (United States)

Shen, Jie; Burgess, Diane J

2012-07-01

This review highlights current methods and strategies for accelerated in-vitro drug release testing of extended-release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in-situ depot-forming systems and implants. Extended-release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, 'real-time' in-vitro release tests for these dosage forms are often run over a long time period. Accelerated in-vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in-vitro release methods using United States Pharmacopeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended-release parenteral dosage forms, along with the accelerated in-vitro release testing methods currently employed are discussed. Accelerated in-vitro release testing methods with good discriminatory ability are critical for quality control of extended-release parenteral products. Methods that can be used in the development of in-vitro-in-vivo correlation (IVIVC) are desirable; however, for complex parenteral products this may not always be achievable. © 2012 The Authors. JPP © 2012 Royal Pharmaceutical Society.

Accelerated in vitro release testing methods for extended release parenteral dosage forms

Science.gov (United States)

Shen, Jie; Burgess, Diane J.

2012-01-01

Objectives This review highlights current methods and strategies for accelerated in vitro drug release testing of extended release parenteral dosage forms such as polymeric microparticulate systems, lipid microparticulate systems, in situ depot-forming systems, and implants. Key findings Extended release parenteral dosage forms are typically designed to maintain the effective drug concentration over periods of weeks, months or even years. Consequently, “real-time” in vitro release tests for these dosage forms are often run over a long time period. Accelerated in vitro release methods can provide rapid evaluation and therefore are desirable for quality control purposes. To this end, different accelerated in vitro release methods using United States Pharmacopoeia (USP) apparatus have been developed. Different mechanisms of accelerating drug release from extended release parenteral dosage forms, along with the accelerated in vitro release testing methods currently employed are discussed. Conclusions Accelerated in vitro release testing methods with good discriminatory ability are critical for quality control of extended release parenteral products. Methods that can be used in the development of in vitro-in vivo correlation (IVIVC) are desirable, however for complex parenteral products this may not always be achievable. PMID:22686344

Enteral and Parenteral Nutrition in the Perioperative Period: State of the Art

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Juan A. Sanchez

2013-02-01

Full Text Available Nutritional support of surgical and critically ill patients has undergone significant advances since 1936 when Studley demonstrated a direct relationship between pre-operative weight loss and operative mortality. The advent of total parenteral nutrition followed by the extraordinary progress in parenteral and enteral feedings, in addition to the increased knowledge of cellular biology and biochemistry, have allowed clinicians to treat malnutrition and improve surgical patient’s outcomes. We reviewed the literature for the current status of perioperative nutrition comparing parenteral nutrition with enteral nutrition. In a surgical patient with established malnutrition, nutritional support should begin at least 7–10 days prior to surgery. Those patients in whom eating is not anticipated beyond the first five days following surgery should receive the benefits of early enteral or parenteral feeding depending on whether the gut can be used. Compared to parenteral nutrition, enteral nutrition is associated with fewer complications, a decrease in the length of hospital stay, and a favorable cost-benefit analysis. In addition, many patients may benefit from newer enteral formulations such as Immunonutrition as well as disease-specific formulations.

Intestine, immunity, and parenteral nutrition in an era of preferred enteral feeding.

Science.gov (United States)

Barrett, Meredith; Demehri, Farokh R; Teitelbaum, Daniel H

2015-09-01

To review the benefits of enteral nutrition in contrast to the inflammatory consequences of administration of parenteral nutrition and enteral deprivation. To present the most recent evidence for the mechanisms of these immunologic changes and discuss potential areas for modification to decrease infectious complications of its administration. There is significant data supporting the early initiation of enteral nutrition in both medical and surgical patients unable to meet their caloric goals via oral intake alone. Despite the preference for enteral nutrition, some patients are unable to utilize their gut for nutritious gain and therefore require parenteral nutrition administration, along with its infectious complications. The mechanisms behind these complications are multifactorial and have yet to be fully elucidated. Recent study utilizing both animal and human models has provided further information regarding parenteral nutrition's deleterious effect on intestinal epithelial barrier function along with the complications associated with enterocyte deprivation. Changes associated with parenteral nutrition administration and enteral deprivation are complex with multiple potential areas for modification to allow for safer administration. Recent discovery of the mechanisms behind these changes present exciting areas for future study as to make parenteral nutrition administration in the enterally deprived patient safer.

PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition

International Nuclear Information System (INIS)

Shuman, W.P.; Gibbs, P.; Rudd, T.G.; Mack, L.A.

1982-01-01

A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy

Evidence for the use of parenteral nutrition in the pediatric intensive care unit.

Science.gov (United States)

Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Joosten, Koen; Van den Berghe, Greet

2017-02-01

During hospitalization in a pediatric intensive care unit (PICU), critically ill children are fed artificially. Administered via the preferred enteral route, caloric targets are often not reached. Hence, parenteral nutrition is given to this patient population. In this review we analyzed the available evidence from randomized controlled trials (RCTs) that supports the use of parenteral nutrition in children during critical illness. A search strategy in Ovid MEDLINE and Ovid EMBASE was created and trial registries were screened to identify the relevant RCTs. Studies were included if they were randomized controlled trials, involved pediatric patients admitted to PICU, and compared different dosing/compositions of parenteral nutrition. Descriptive studies and reviews were excluded. Of the 584 articles identified by the search strategy, only 114 articles were retained after title screening. Further abstract and full text screening identified 6 small RCTs that compared two dosing/composition strategies of parenteral nutrition. These trials reported differences in surrogate endpoints without an effect on hard clinical endpoints. The RCTs observed improvements in these surrogate endpoints with the use of more calories or when parenteral glutamine or fish oil was added. The few RCTs suggest that surrogate endpoints can be affected by providing parenteral nutrition to critically ill children, but the studies were not statistically powered to draw meaningful clinical conclusions. Large RCTs with clinically relevant outcome measures are urgently needed to support the current nutritional guidelines that advise the use of parenteral nutrition in the PICU. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Steroidal Compounds in Commercial Parenteral Lipid Emulsions

Science.gov (United States)

Xu, Zhidong; Harvey, Kevin A.; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P.; Siddiqui, Rafat A.

2012-01-01

Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction. PMID:23016123

Steroidal compounds in commercial parenteral lipid emulsions.

Science.gov (United States)

Xu, Zhidong; Harvey, Kevin A; Pavlina, Thomas; Dutot, Guy; Hise, Mary; Zaloga, Gary P; Siddiqui, Rafat A

2012-08-01

Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn(®) II, Liposyn(®) III, Lipofundin(®) MCT, Lipofundin(®) N, Structolipid(®), Intralipid(®), Ivelip(®) and ClinOleic(®). Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.

Antibioticoterapia parenteral en la infección urinaria neonatal Parenteral antibiotic therapy in neonatal urinary infection

Directory of Open Access Journals (Sweden)

Manuel Díaz Álvarez

2006-03-01

Full Text Available Se realizó un estudio analítico, retrospectivo, en el que se conformaron dos grupos según el régimen de tratamiento antibiótico parenteral (TAP: corto y largo. Éste fue seguido de antibioticoterapia oral, lo cual generó un ciclo de tratamiento parenteral-oral secuencial al menos de 10 días de duración. Se determinó la tasa de curación de la infección del tracto urinario, las reinfecciones en los primeros 3 meses de edad y la presencia de cicatrices renales. El objetivo fue evaluar la efectividad de un régimen de tratamiento antibiótico parenteral de corta duración (3 días en recién nacidos con infección del tracto urinario alta, de evolución inicial favorable. La tasa de curación de la infección con el TAP corto fue de 93,9 % y con el largo de 97,0 % (p = 0,32. En 5 pacientes del grupo de TAP corto ocurrió reinfección dentro de los 3 meses de edad, mientras que sólo ocurrió en 3 de los que llevaron TAP largo (p = 0,49. En los casos estudiados con gammagrafía con DMSA renal, se constató la presencia de cicatrices renales en 3 de 32 (9,4 % del grupo de TAP corto y en 7 de 33 (21,2 % en los pacientes de TAP largo (p = 0,30. Ambos regímenes de TAP tuvieron similar efectividad.

Recomendaciones para una política nacional de promoción de la lactancia materna en México: postura de la Academia Nacional de Medicina

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Teresita González de Cosío-Martínez

2017-01-01

Full Text Available Para mejorar las prácticas de lactancia materna es necesario fortalecer acciones de promoción, protección y apoyo, y establecer una política nacional multisectorial que incluya elementos indispensables de diseño, implementación, monitoreo y evaluación de programas y políticas públicas, financiamiento para acciones e investigación, desarrollo de abogacía y voluntad política, y promoción de la lactancia materna, todo coordinado por un nivel central. Recientemente, México ha iniciado un proceso de reformas conducentes a la conformación de una Estrategia Nacional de Lactancia Materna (ENLM. Esta estrategia es el resultado de la disponibilidad de evidencia científica sobre los beneficios de la lactancia materna en la salud de la población y el desarrollo de capital humano así como de los datos alarmantes de su deterioro. La implementación integral de una ENLM que incluya el establecimiento de un Comité Nacional Operativo, coordinación intra e intersectorial de acciones, establecimiento de metas claras, monitoreo y penalización de las violaciones al Código Internacional de Comercialización de Sucedáneos de la Leche Materna, y financiamiento de estas acciones es la gran responsabilidad pendiente de la agenda de salud pública del país.

Iron deficiency anaemia in pregnancy: The role of parenteral iron.

Science.gov (United States)

Esen, Umo I

2017-01-01

Maternal and perinatal morbidity and mortality remain major challenges in the delivery of safe maternity care worldwide. Anaemia in pregnancy is an important contributor to this dismal picture, especially where blood transfusion services are poorly developed. An early diagnosis and treatment of iron deficiency anaemia in pregnancy using the new generation dextran-free parenteral iron preparations can save lives and reduce morbidity in selected pregnancies. It is time to cast aside the fears associated with the use of the old parenteral iron preparations which were associated a high incidence of anaphylaxis, and embrace the use of new parenteral iron products which have better side effect profiles and can deliver total dose infusions without the need for test dosing. In selected women, the benefits of this treatment far outweigh any disadvantages.

Clinical relevance of trace element measurement in patients on initiation of parenteral nutrition.

Science.gov (United States)

Salota, Rashim; Omar, Sohail; Sherwood, Roy A; Raja, Kishor; Vincent, Royce P

2016-11-01

Background and Aims Serum zinc, copper and selenium are measured in patients prior to commencing on parenteral nutrition; however, their interpretation can be difficult due to acute phase reactions. We assessed (i) the relationship of raised C-reactive protein with trace elements and albumin (ii) benefits of measuring trace elements when C-reactive protein is raised in patients requiring short-term parenteral nutrition. Methods Samples were collected for zinc, copper, selenium and albumin at baseline and then every two weeks and correlated with C-reactive protein results in patients on parenteral nutrition. Results were categorized into four groups based on the C-reactive protein concentrations: (i)  0.05), whereas selenium and albumin were lower in the group with C-reactive protein > 40 mg/L ( P parenteral nutrition, measurement of C-reactive protein is essential when interpreting zinc and selenium but not copper results. Routine measurement of trace elements prior to commencing parenteral nutrition has to be considered on an individual basis in patients with inflammation.

Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

Science.gov (United States)

Umpierrez, Guillermo E.

2013-01-01

Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369

Influencia de la lactancia materna en la formación del vínculo y en el desarrollo psicomotor

OpenAIRE

Marín Ospina, Jessica; Jiménez, Ángela María; Villamarín Betancourt, Eder

2016-01-01

La lactancia materna es un acto singular que tiene un valor importante para la madre y el lactante en lo biológico, lo psicológico y lo social. Esta investigación pretende describir la influencia que tiene la lactancia materna en la formación del vínculo afectivo y en el desarrollo psicomotor en niños amamantados y no amamantados de 6 a 8 meses de edad del hospital Mario Correa Rengifo de la ciudad de Cali, a partir de una investigación cualitativa, descriptiva, de tipo estudio de casos múlt...

Distancia anogenital en mujeres y su relación con exposiciones prenatales maternas

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Maria Pilar Mira-Escolano

2014-06-01

Full Text Available La distancia anogenital (DAG es un marcador de desarrollo genital que presenta un dimorfismo sexual en mamíferos. Diversos estudios experimentales han mostrado que la DAG al nacimiento refleja la exposición androgénica a la que el feto ha estado expuesto durante su desarrollo intraútero. El objetivo de nuestro estudio fue explorar la relación entre exposiciones prenatales (maternas a distintos productos o sustancias de uso cotidiano durante el embarazo y la DAG de sus hijas como marcador indirecto del ambiente hormonal intrauterino. Se trata de un estudio transversal que incluyó 100 jóvenes universitarias sanas entre 18 y 23 años. A cada participante se le realizó un examen ginecológico completo y se midieron dos variantes de DAG: ano-clítoris (DAGAC y ano-horquilla vulvar (DAGAH. Tanto las jóvenes como sus madres completaron un cuestionario epidemiológico sobre estilos de vida, incluyendo exposición a productos prenatales e historia ginecológica. Las asociaciones entre la exposición a productos prenatales y las DAG de las hijas se realizaron mediante análisis de regresión lineal y logística múltiple. Una mayor exposición materna a insecticidas/plaguicidas y disolventes/desengrasantes se asoció significativamente con una DAGAH alargada en las hijas (ORa: 3,9; IC 95 % 1,2,- 12,7 y 3,8; IC 95 % 1,1 - 12,6, respectivamente. Nuestros resultados respaldan que ciertas exposiciones prenatales maternas ambientales podrían estar asociadas con variaciones significativas de las DAG en sus hijas, un biomarcador que refleja la exposición androgénica fetal durante el desarrollo intraútero.

Lactancia materna asociada a crecimiento mandibular en niños de 3 años de edad. Instituto Especializado Materno Perinatal

OpenAIRE

Munayco Magallanes, Américo; Piedra Ríos, Rosa; Cortez Marino, María

2005-01-01

La lactancia materna es el alimento ideal para el niño durante los primeros meses de vida, aporta beneficios inmunológicos, nutritivos, afectivos y psicológicos, son muy poco conocidos los beneficios en el sistema estomatognático. Este estudio de casos y controles, tiene como propósito determinar si la lactancia materna favorece el crecimiento mandibular. El estudio se realizó en el Instituto Especializado Materno Perinatal Lima, Perú. Este es un centro de referencia para pa...

Reversal of growth arrest in adolescents with Crohn's disease after parenteral alimentation.

Science.gov (United States)

Layden, T; Rosenberg, F; Nemchausky, G; Elson, C; Rosenberg, I

1976-06-01

Growth arrest and delayed onset of puberty often complicate childhood onset Crohn's disease of the small bowel (granulomatous enteritis). Nutritional deficits arising from inadequate dietary intake, malabsorption, and increased caloric needs may contribute to growth retardation. To assess whether a sustained high caloric and nitrogen intake could reestablish growth, 4 children with extensive Crohn's disease of the small bowel were studied before and after parenteral alimentation which was instituted for symtomatic disease control. Weight gain, positive nitrogen balance, and improved nutritional status were achieved during parenteral alimentation in each patient. In 2 patients weight gain was sustained using oral nutritional supplements, and a substantial increase in linear skeletal growth continued in the ensuing months. One patient entered puberty within 4 months of parenteral alimentation and another had the onset of menarche and the development of secondary sex characteristics 4 months after parenteral alimentation and resection of diseased bowel. Growth may be reestablished in some growth-arrested children if intake is sufficient to establish a sustained positive caloric and nitrogen balance. Nutritional requirements imposed by the demands of growth and active disease and often compounded by the catabolic effects of corticosteroids may be excessive; growth may occur only if these needs are met orally and/or parenterally.

Chemical Incompatibility of Parenteral Drug Admixtures

African Journals Online (AJOL)

1974-09-21

Sep 21, 1974 ... made of a single drug injection at a separate locus. S. Afr. Med. J., 48, 1951 ... and nursing staff with the difficulties of administering safe parenteral ... needle and infusion bottle, but this practice is not common in South Africa.

Efeito da Idade Materna sobre os Resultados Perinatais

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Azevedo George Dantas de

2002-01-01

Full Text Available Objetivo: analisar a relação entre a idade materna e a ocorrência de resultados perinatais adversos na população do Rio Grande do Norte. Métodos: foram analisados os registros oficiais de 57.088 nascidos vivos no Estado do Rio Grande do Norte no ano de 1997. Os dados foram obtidos do Sistema de Informação sobre Nascidos Vivos do Ministério da Saúde. A população estudada foi dividida em Grupos I, II e III, segundo a faixa etária materna: 10 a 19, 20 a 34 e 35 anos ou mais, respectivamente. As variáveis analisadas foram: duração da gestação, peso ao nascer e tipo de parto. A análise estatística foi realizada utilizando-se o teste chi². Resultados: observamos uma maior incidência de parto pré-termo no Grupo I (4,3 %, em comparação ao Grupo II (3,7% (p = 0,0028. A taxa de cesariana foi menor nos Grupos I e III, em comparação ao Grupo II (p<0,0001. Evidenciamos freqüência significativamente maior de recém-nascidos de baixo peso nos Grupos I (8,4% e III (8,3%, quando comparados ao Grupo II (6,5% (p<0,0001. Conclusões: a gravidez nos extremos da vida reprodutiva esteve associada com maior freqüência de parto pré-termo e baixo peso ao nascer, entretanto, com relação ao tipo de parto, foi observada maior freqüência de parto normal do que no grupo de gestantes com idade entre 20 e 34 anos.

Sterilization of solutions for parenterals products. Problem analysis

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Yanelys Montes-González

2017-09-01

Full Text Available The solutions for the formulation of parenteral products must be sterile before the aseptic formulation process. For this reason, different methods of sterilization referred in the literature are analyzed. Thermodynamic criteria that rule the sterilization are presented. Furthermore, previous experiences in the sterilization of solutions for the formulation of parental products in an autoclave are analyzed, that take large time of processing and only low volumes of solution can be handled. Using jacketed stirred tanks for the sterilization may solve the problem and, therefore, criteria for the design of the later that allow to process high volumes of solution for the formulation of parenteral products are shown.

Steroidal Compounds in Commercial Parenteral Lipid Emulsions

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Rafat A. Siddiqui

2012-08-01

Full Text Available Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn^® II, Liposyn^® III, Lipofundin^® MCT, Lipofundin^® N, Structolipid^®, Intralipid^®, Ivelip^® and ClinOleic^®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.

Home parenteral nutrition in treatment of severe radiation enteritis

International Nuclear Information System (INIS)

Miller, D.G.; Ivey, M.; Young, J.

1979-01-01

Ten patients with radiation enteritis unresponsive to conventional medical and surgical therapy were put on long-term parenteral nutrition at home. Six of the patients are alive at home; four patients died, two from recurrent cancer. Some of the patients have been able to resume oral intake, but none have been able to discontinue parenteral nutrition. Fistulas healed or had a marked decrease in output. Two patients in our series were given prednisone and sulfasalazine without significant benefit, in contrast to previously reported clinical improvement of radiation enteritis with this therapy

El uso de la lengua materna en el aula de inglés como lengua extranjera en Formación Profesional

OpenAIRE

Benito-Fox, Michelle

2014-01-01

El uso de la lengua materna en el aula de lengua extranjera es algo habitual en diferentes contextos y con diversas finalidades. La pujanza del enfoque comunicativo provocó el rechazo del empleo de otras lenguas aparte de la lengua meta. No obstante, en los últimos años se ha abierto un debate en torno a las ventajas y desventajas que la lengua materna puede ocasionar en el proceso de aprendizaje. Con este trabajo queremos contribuir a esta polémica, ofreciendo argumentos a ...

O aborto como causa de mortalidade materna: um pensar para o cuidado de enfermagem El aborto como causa de mortalidad materna: una reflexión sobre el cuidado de enfermería Abortion as a cause of maternal death: a thought for nursing care

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Selisvane Ribeiro da Fonseca Domingos

2010-03-01

Full Text Available O aborto é um tema polêmico e um sério problema de saúde pública mundial, responsável pela manutenção das altas taxas de mortalidade materna em muitos países em desenvolvimento. No Brasil, por se tratar de um ato ilegal, muitas mulheres que não desejam manter uma gestação acabam por procurar clínicas clandestinas, submetendo-se ao aborto em condições precárias, o que acarreta graves consequências à sua saúde física e psicológica e à própria vida. Como enfermeiras, reconhecemos a magnitude das questões que permeiam as discussões sobre o abortamento e a mortalidade materna no cenário das políticas de saúde que envolvem a área da saúde da mulher e, dessa forma, nos propomos, com este artigo, realizar uma reflexão acerca do aborto como causa de mortalidade materna.El aborto es un tema polémico y un serio problema de salud pública mundial, responsable por el mantenimiento de las altas tasas de mortalidad materna en muchos países en desarrollo. En Brasil, por tratarse de un delito, muchas mujeres que no desean continuar con un embarazo acaban buscando clínicas clandestinas sometiéndose al aborto en condiciones precarias, lo que ocasiona graves consecuencias a su salud física y psicológica y a su propia vida. Como enfermeras, reconocemos la magnitud de las cuestiones que engloban las discursiones sobre el aborto y la mortalidad materna en el escenario de las políticas de salud relacionadas con el área de la salud de la mujer y, de esta forma, nos proponemos, con este artículo, realizar una reflexión sobre el aborto como causa de mortalidad materna.Abortion is a polemic theme and a serious public health problem in the world, responsible for the maintenance of high maternal death rates in many developing countries. In Brazil, even though it is an illegal act, many women who do not wish to maintain their pregnancy end up seeking underground clinics where they undergo abortions in precarious conditions, carrying

Impacto de la lactancia materna en la vacunación infantil Effect of the breastfeeding on the infant vaccination

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Deyanira La Rosa Hernández

2013-03-01

Full Text Available Dos de los factores más importantes que intervienen en la prevención de enfermedades infecciosas en el menor de un año son: la lactancia materna y la vacunación infantil. En el desarrollo de las respuestas inmunitarias inducidas por vacunas se precisa de un sistema inmunitario competente, en el que la lactancia materna juega un papel esencial como inductor de madurez inmunológica de la etapa posnatal. La lactancia materna exclusiva potencia las respuestas inmunitarias de la mayoría de los inmunógenos vacunales aplicados en los programas de inmunización infantil. Para enriquecer nuestros conocimientos sobre el efecto de la leche humana sobre la vacunación se realizó una revisión bibliográfica tras consultar las bases de datos Google, Medline y el Localizador de Información de Salud de Infomed con la utilización de descriptores como lactancia materna, vacunas, breast-feeding and vaccine.Two of the most important factors in the prevention of diseases in the under one-year old infants are breastfeeding and vaccination. The development of immune responses induced by vaccines requires an effective immune system in which the breastfeeding plays an essential role as an immune maturity inducer in the postnatal phase. Exclusive breastfeeding potentiates the immune responses from most of the vaccinal immunogens included in the infant vaccination programs. With the objective of expanding our knowledge on the effect of breastfeeding on vaccination, a literature review was made by using databases such as Google, Medline and the health information searcher from Infomed and breastfeeding and vaccine as subject headings.

Reducción de la mortalidad materna en Chile de 1990 a 2000 The reduction in maternal mortality in Chile, 1990­2000

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Enrique Donoso Siña

2004-05-01

Full Text Available OBJETIVO: Determinar si Chile alcanzó el objetivo de reducir en 50% la mortalidad materna entre 1990 y 2000, conforme a lo establecido en el Plan de Acción Regional para la Reducción de la Mortalidad Materna en las Américas. MÉTODOS: Se diseñó un estudio observacional y descriptivo que permitiera analizar la tendencia de la mortalidad materna en el país durante 1990­2000. Las variables evaluadas fueron la razón de mortalidad materna, las causas de muerte y la edad de las madres fallecidas. Las causas se clasificaron de acuerdo con la novena revisión de la Clasificación internacional de enfermedades,traumatismos y causas de defunción (CIE-9, y los datos brutos se obtuvieron de los anuarios del Instituto Nacional de Estadísticas de Chile. La fluctuación de las variables se estimó según el porcentaje de cambio acumulado, y la tendencia, mediante análisis de correlación de Pearson. RESULTADOS: El estudio demostró una reducción de la mortalidad materna de 60,3% de 1990 a 2000; la razón de mortalidad materna más baja, de 18,7/100 000 nacidos vivos, se registró en el año 2000. El análisis indica que las cinco causas más importantes de muerte materna fueron: hipertensión arterial, aborto, enfermedades maternas concurrentes (pregestacionales, sepsis puerperal y hemorragia posparto. Se observó una tendencia descendente significativa de la mortalidad materna por hipertensión arterial (r= ­0,712; P= 0,014, aborto (r= ­0,810; P = 0,003 y sepsis puerperal (r= ­0,718; P= 0,013, pero no se encontraron cambios estadísticamente significativos en la mortalidad por enfermedades maternas concurrentes ni por hemorragia posparto. La cifra más alta de mortalidad materna correspondió a las mujeres de 40 años de edad y mayores (100,2/100 000 nacidos vivos, y la más baja a las adolescentes de 15 a 19 años (18,7/100 000 nacidos vivos. CONCLUSIONES: Chile cumplió el objetivo del Plan de Acción Regional para la Reducción de la

Influencia de la lactancia materna en la formación del vínculo y en el desarrollo psicomotor

Directory of Open Access Journals (Sweden)

Marín Ospina, Jessica

2016-07-01

Full Text Available La lactancia materna es un acto singular que tiene un valor importante para la madre y el lactante en lo biológico, lo psicológico y lo social. Esta investigación pretende describir la influencia que tiene la lactancia materna en la formación del vínculo afectivo y en el desarrollo psicomotor en niños amamantados y no amamantados de 6 a 8 meses de edad del hospital Mario Correa Rengifo de la ciudad de Cali, a partir de una investigación cualitativa, descriptiva, de tipo estudio de casos múltiple, con corte transversal, donde se utilizarán técnicas para la recolección de datos como la entrevista, la observación y el diagnóstico funcional del desarrollo según método Munich. Se espera poder encontrar de qué manera influye este tipo de alimentación en los infantes y si existen diferencias en la formación del vínculo afectivo y del desarrollo psicomotor en los niños que reciben lactancia materna y los que no.

Parenteral nutrition facilitates activation of coagulation but not of fibrinolysis during human endotoxemia

NARCIS (Netherlands)

van der Poll, T.; Levi, M. [=Marcel M.; Braxton, C. C.; Coyle, S. M.; Roth, M.; ten Cate, J. W.; Lowry, S. F.

1998-01-01

Venous thrombosis and bacterial infections are common complications of parenteral nutrition. To test the hypothesis that infection facilitates activation of coagulation during parenteral nutrition, healthy subjects were intravenously injected with endotoxin (2 ng/kg) after they had received either 1

Compatibility of 5-fluorouracil and total parenteral nutrition solutions.

Science.gov (United States)

Hardin, T C; Clibon, U; Page, C P; Cruz, A B

1982-01-01

The physicochemical stability and availability of 0.1% 5-fluorouracil solutions in D5W and a typical total parenteral nutrition solution (hypertonic dextrose and crystalline amino acids) were studied in both glass and Viaflex delivery systems. Serial samples collected over a 48-hour period were assayed for 5-fluorouracil concentration using a high performance liquid chromatographic technique. Changes in the pH as well as precipitate formation were also investigated. There was no reduction in the amount of 5-fluorouracil at 48 hours in either the glass or plastic system, regardless of whether the drug was added to D5W or to the total parenteral nutrition solution. No pH changes or precipitates were observed. These findings indicate that 5-fluorouracil is compatible with and available from total parenteral solutions of hypertonic dextrose and amino acid in both plastic and glass containers. Use of such a system would allow for (1) a reduction in vascular access in patients receiving both treatments and (2) continued administration of nutritional support without the requirement for additional fluid volume.

Intensive medicine – Guidelines on Parenteral Nutrition, Chapter 14

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Kreymann, G.

2009-11-01

Full Text Available In intensive care patients parenteral nutrition (PN should not be carried out when adequate oral or enteral nutrition is possible. Critically ill patients without symptoms of malnutrition, who probably cannot be adequately nourished enterally for a period of <5 days, do not require full PN but should be given at least a basal supply of glucose. Critically ill patients should be nourished parenterally from the beginning of intensive care if they are unlikely to be adequately nourished orally or enterally even after 5–7 days. Critically ill and malnourished patients should, in addition to a possible partial enteral nutrition, be nourished parenterally. Energy supply should not be constant, but should be adapted to the stage, the disease has reached. Hyperalimentation should be avoided at an acute stage of disease in any case. Critically ill patients should be given, as PN, a mixture consisting of amino acids (between 0.8 and 1.5 g/kg/day, carbohydrates (around 60% of the non-protein energy and fat (around 40% of the non-protein energy as well as electrolytes and micronutrients.

O significado da nutrição parenteral para o cliente no contexto hospitalar

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Consuelo Helena Aires de Freitas Lopes

1996-06-01

Full Text Available A necessidade de compreender o significado da nutrição parenteral para o cliente no contexto hospitalar surgiu das nossas inquietações diante do cuidado de enfermagem. Realizaram-se observações participantes, entrevistas e anotações de campo junto a sete clientes hospitalizados, que se encontravam sob nutrição parenteral. O sentido das investigações foi centrado na indagação: como você está se sentindo com a nutrição parenteral? Os dados foram analisados numa abordagem interacionista, mostrando as dificuldades enfrentadas pelos clientes na assistência hospitalar, como percebiam eles a nutrição parenteral e que significados eram atribuídos a essa terapêutica. O estudo revelou os sentimentos, comportamentos e atitudes relacionados aos aspectos biológico, emocional e sócio-cultural do cliente, ligados à nutrição parenteral, demonstrando, também as limitações impostas ao cliente sob esse tratamento, bem como as dificuldades na assistência de enfermagem.

Pulmonary nodules secondary to total parenteral alimentation

International Nuclear Information System (INIS)

Landry, B.A.; Melhem, R.E.

1989-01-01

A seven-year-old male, who had a retroperitoneal alveolar rhabdomyosarcoma and was on total parenteral alimentation (TPN) developed muliple pulmonary nodules, indistinguishable from metastases. These proved to be multiple lipid emboli on open biopsy. (orig.)

Minimizing systemic infection during complete parenteral alimentation of small infants

Science.gov (United States)

Nelson, R.

1974-01-01

A regimen of parenteral alimentation for infants was designed to eliminate as many factors responsible for infection as possible. The most important features of the feeding regimen were as follows. (1) Infants were fed via indwelling silastic catheters inserted into the superior vena cava or the right atrium by a cutdown operation. (2) The parenteral feeding was fat free to simplify the administration system. Y connectors and 2- or 3-way taps were avoided. (3) Extreme care was taken of junctions within the infusion system. Only certain members of the hospital staff were allowed to break such junctions, e.g. during the changing of packs of solution or of the giving sets. These junctions were sprayed with antibacterial aerosols. (4) The hypertonic solutions of nutrients were prepared in plastic packs, which do not require ventilation. The infusion system was therefore not contaminated by the entry of unsterile outside air. (5) The infused solutions were passed through 0·22 μm millipore filters before entering the patient's blood stream. There was an infection rate of 9% which was less than the 25 to 45% infection rate previously reported during parenteral feeding through indwelling venous catheters, and is also less than that associated with ventriculoatrial shunts for hydrocephalus. There was no case of systemic candidiasis, which is the most frequent and most serious infection associated with parenteral feeding. PMID:4206445

Relación entre las reservas de hierro maternas y del recién nacido Relationship between maternal and neonatal iron stores

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María Eugenia Vásquez-Molina

2001-10-01

Full Text Available Objetivo. Determinar la relación de los valores hematológicos maternos y neonatales en casos de reservas maternas de hierro bajas, moderadas y normales. Material y métodos. Diseño transversal en el que se incluyó a 163 mujeres embarazadas y sus neonatos de término, derechohabientes del Hospital de Ginecología y Obstetricia número 15 del Instituto Mexicano del Seguro Social (IMSS en Chihuahua, Chih., México. Se analizaron antecedentes maternos. Se determinaron niveles de hemoglobina, hematocrito y ferritina sérica en muestras maternas y de cordón umbilical. Se definieron reservas de hierro maternas de acuerdo a ferritina (µg /l: bajas o = 20.1. Se utilizó la prueba de Kruskal Wallis para establecer diferencias entre grupos, ji cuadrada para diferencia de proporciones y r de Pearson para establecer la relación entre reservas de hierro maternas y del recién nacido. Resultados. Se determinó una débil correlación entre la ferritina materna y neonatal r=0.14 (p=0.07. Las medias geométricas de ferritina neonatal respecto a las reservas maternas bajas, moderadas y normales fue de 4.77, 4.85 y 5.02, respectivamente (p=0.12. Las reservas de hierro maternas se modificaron con el suplemento de hierro (p=0.01. Conclusiones. Las reservas de hierro en el recién nacido están en estrecha relación con las maternas. Las mujeres que toman suplementos con hierro durante la gestación tienen reservas mayores al final del embarazo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To establish the relationship of normal, low, and moderate blood iron values in mothers and their newborns. Material and Methods. A cross-sectional study was conducted among 163 pregnant women and their newborns, users of Hospital de Ginecología y Obstetricia número 15, Instituto Mexicano del Seguro Social, from Chihuahua, Mexico. The mothers' clinical histories were collected and analyzed; hemoglobin

Aspectos epidemiológicos relacionados con la lactancia materna durante el primer año de vida

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Orlando Díaz Tabares

2002-06-01

Full Text Available Se realizó un estudio transversal para determinar el comportamiento de algunas variables epidemiológicas relacionadas con la lactancia materna durante el primer año de vida, y se tomaron como muestra las 24 madres que viven en el área del Consejo Popular número 2 de San Cristóbal, que parieron en los meses de enero, febrero y marzo del año 2000, las cuales fueron encuestadas al cumplir el año de parida. Se encontró una duración media de la lactancia materna exclusiva equivalente a 77 días, y de la lactancia materna en general de 137. Se comprobó riesgo relativo para el destete antes del cuarto mes de parida los casos de uso de tetes y biberones y exposición al estrés. Predominó la infección del tracto urinario, seguida por la enfermedad diarreica aguda (EDA entre los niños que enfermaron, y la mayor protección de la lactancia materna exclusiva se observó para la EDA.A crosswise study was carried out to determine the performance of some epidemiological variables related to breast feeding during the first year of life of the newborn and the sample was composed by 24 mothers who live in an area of People´s council No. 2 of San Cristobal, gave birth in January, February and March, 2000 and were surveyed one year after their deliveries. . The average length of exclusive breast-feeding was 77 days and of general breast feeding was 137 days. Relative risks were demonstrated for weaning before the fourth month of life in cases using pacifiers and feeding bottles and exposed to stress. Urinary tract infection prevailed, followed by acute diarrhea among sick infants and the greatest protection of the exclusive breast feeding was provided for acute diarrhea.

Reduciendo las inequidades en salud y mejorando la salud materna mediante la mejora de los sistemas de información en salud: Wawared Perú

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José E. Pérez-Lu

Full Text Available En los países en desarrollo no existen datos de calidad para apoyar la toma de decisiones y la gobernanza, debido a inadecuados procesos de colección y transmisión de información. Nuestro proyecto WawaRed-Perú: "Reduciendo las inequidades en salud y mejorando la salud materna mediante la mejora de los sistemas de información en salud" propone mejorar los procesos e indicadores de salud materna a través de la implementación de estándares de interoperabilidad en los sistemas de información de salud materna para que los tomadores de decisión tengan información oportuna y de calidad. Con esto se desea apoyar a desarrollar mejores políticas de salud y, a su vez, contribuir a disminuir los problemas de equidad en salud de las mujeres peruanas, y potencialmente las mujeres de otros países en desarrollo. El objetivo de este artículo es presentar la situación actual de los sistemas de información de salud materna en el Perú

Parenteral nutrition in malnourished patients; Parenteralna vyziva u malnutricnych pacientov

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Lichvarova, I. [OAIM, Narodny onkologicky ustav, Bratislava (Slovakia)

2011-07-01

Parenteral nutrition became a routine therapeutic option in malnourished patients, if conventional nutritional enteral support is not effective. Cachexia and malnutrition prolong the wound healing, contribute to immunosuppression, increase morbidity and the cost of treatment. Using of a malnutrition protocol as a screening tool is necessary to sort out malnourished patients. Parenteral nutrition is therefore an important part of the multimodal therapy and from the medical and the ethical point of view is a great mistake not to feed a patient. (author)

Revelação do abuso sexual infantil: reações maternas

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Samara Silva dos Santos

Full Text Available A literatura tem indicado que mães de crianças vítimas de abuso sexual, ao tomarem conhecimento da situação de abuso de suas filhas, podem apresentar uma variedade de manifestações, que podem incluir ansiedade, depressão e estresse pós-traumático. Além disso, a reação frente à revelação pode ser de apoio e proteção ou, ainda, de evitação, indiferença ou ambivalência. Este estudo teve como objetivo investigar como mães de meninas abusadas sexualmente reagiram quando tomaram conhecimento do abuso. Foram entrevistadas 10 participantes que estavam sendo acolhidas em serviços especializados em situações de violência, em hospital público de Porto Alegre. As reações maternas foram classificadas em positivas e ambivalentes. A maioria das mães acreditou no relato das filhas e denunciou o abuso, embora nem todas tenham sido protetivas no sentido de afastar suas filhas do abusador ou de imediatamente procurar ajuda e realizar denúncia. Os fatores que contribuíram para as reações maternas também são discutidos.

Prolonged parenteral nutrition after neonatal gastrointestinal surgery

DEFF Research Database (Denmark)

Estmann, Anne; Qvist, Niels; Husby, Steffen

2002-01-01

to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...

ESPEN Guidelines on Parenteral Nutrition: home parenteral nutrition (HPN) in adult patients

DEFF Research Database (Denmark)

Staun, M.; Pironi, L.; Bozzetti, F.

2009-01-01

Home parenteral nutrition (HPN) was introduced as a treatment modality in the early 1970s primarily for the treatment of chronic intestinal failure in patients with benign disease. The relatively low morbidity and mortality associated with HPN has encouraged its widespread use in western countries....... Thus there is huge clinical experience, but there are still few controlled clinical studies of treatment effects and management of complications. The purpose of these guidelines is to highlight areas of good practice and promote the use of standardized treatment protocols between centers...

Factores psicosociales que influyen en el abandono de la lactancia materna

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Raisa Durán Menéndez

1999-06-01

Full Text Available Se realizó un estudio prospectivo sobre el abandono de la lactancia materna en 144 madres en la Consulta de Seguimiento del Servicio de Neonatología del Hospital General Docente "Enrique Cabrera", de Ciudad de La Habana, durante el período comprendido de junio de 1994 a diciembre de 1996. Se valoraron los niveles de escolaridad de los padres, ocupación, apoyo familiar y nivel de ansiedad de la madre, entre otros. El 59,1 % de los neonatos lactó hasta los primeros 4 meses de vida. El objetivo del trabajo fue determinar los factores psicosociales que influyeron en el abandono de la lactancia materna en estas madres. El 55,5 % de las madres estudiadas tenía entre 20 y 29 años y el abandono de la lactancia materna fue más frecuente en el grupo menor de 20 años y el de 35 años y más. Ni la edad, ni el nivel de escolaridad de la madre y el esposo influyeron en el abandono de la lactancia. En el grupo de madres estudiantes hubo un mayor porcentaje de abandono de dicho tipo de lactancia. El estado civil tampoco influyó en el abandono de la lactancia, aunque se observó un mayor porcentaje de madres que lactaran en el grupo de las casadas. Las madres que no recibieron apoyo familiar abandonaron con más frecuencia la lactancia materna, al igual que aquéllas que tenían un alto nivel de ansiedad, diferencias que fueron significativas entre ambos grupos con una p A prospective study on the giving up of breast feeding in 144 mothers was conducted at the Follow-up Department of the Neonatology Service of the "Enrique Cabrera" General Teaching Hospital, in Havana City, from June, 1994, to December, 1996. The educational level of the parents, occupation, family support, and the anxiety level of the mother were assessed, among others. 59.1 % of the neonates nursed until the first 4 months of life. The objetive of this paper was to determine the psychosocial factors that influenced on the giving up of breast feeding in these mothers. 55.5 % of the

MÉTODOS NO FARMACOLÓGICOS PARA INDUCIR LA LACTANCIA MATERNA EN ADOPCIÓN, SUBROGACIÓN Y EN LA MADRE NO GESTANTE EN PAREJAS LESBIANAS: REVISIÓN BIBLIOGRÁFICA

OpenAIRE

Cazorla-Ortiz, Gemma

2018-01-01

IntroducciónLa inducción de la lactancia materna permite a las madres que no han pasado por un parto —en caso de adopción, subrogación o en parejas formadas por dos mujeres— poder dar el pecho a su hijo. Existen métodos farmacológicos y métodos no farmacológicos para inducir la lactancia materna. ObjetivoEl objetivo de esta revisión es conocer los métodos no farmacológicos para inducir la lactancia materna. Material y MétodoSe realizó una búsqueda bibliográfica en las bases de datos Pubmed, C...

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

Science.gov (United States)

Akbulut, Gamze

2011-07-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

Solid lipid nanoparticles for parenteral drug delivery

NARCIS (Netherlands)

Wissing, S.A.; Kayser, Oliver; Muller, R.H.

2004-01-01

This review describes the use of nanoparticles based on solid lipids for the parenteral application of drugs. Firstly, different types of nanoparticles based on solid lipids such as "solid lipid nanoparticles" (SLN), "nanostructured lipid carriers" (NLC) and "lipid drug conjugate" (LDC)

Depresión materna perinatal y vínculo madre-bebé: consideraciones clínicas

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Marcia Paola Olhaberry Huber

2015-07-01

Full Text Available La alta frecuencia de los trastornos depresivos en el mundo y las altas tasas reportadas durante el pre y postparto, alertan sobre la necesidad de profundizar en la comprensión de la depresión materna perinatal y sus repercusiones psicológicas en la madre y el niño/a. Se describen y analizan sus características, los factores protectores y de riesgo, los principales efectos en el vínculo madre-bebé, el desarrollo infantil y la identidad materna a partir de una revisión de la literatura existente. Se reflexiona también sobre las implicancias clínicas de este trastorno, las alternativas de tratamiento y los desafíos actuales para su abordaje psicoterapéutico integral, considerando los distintos aspectos de la matriz relacional de la díada madre-hijo/a en interacción.

Información sanitaria en la Web 2.0: YouTube como fuente de divulgación del conocimiento sobre lactancia materna

OpenAIRE

Curbelo Castro, María Celeste

2015-01-01

Objetivo: Describir las características del material multimedia sobre lactancia materna contenida en YouTube y analizar la pertinencia de la información. Método: Para la obtención de los videos se realizó una búsqueda simple utilizando como término «lactancia materna», determinándose el número a estudio mediante muestreo aleatorio simple sin reposición, efectuando la estimación de parámetros poblacionales en una población infinita, seleccionándose 386 videos. Se estudiaron los indicadores des...

Casas Maternas in the Rural Highlands of Guatemala: A Mixed-Methods Case Study of the Introduction and Utilization of Birthing Facilities by an Indigenous Population

OpenAIRE

Stollak, Ira; Valdez, Mario; Rivas, Karin; Perry, Henry

2016-01-01

ABSTRACT Background: An international NGO, with financial and managerial support from ?partner? communities, established Casas Maternas (birthing facilities) in 3 municipalities in the isolated northwestern highlands of the department of Huehuetenango in Guatemala?an area with high maternal mortality ratio (338 maternal deaths per 100,000 live births). Traditional birth attendants are encouraged to bring patients for delivery at the Casas Maternas, where trained staff are present and access t...

Malnutrición por defecto de un recién nacido por psicosis puerperal materna: presentación de un caso

OpenAIRE

Gavilla González, Bárbara; Díaz Cabrera, Leticia

2011-01-01

En el siguiente trabajo se realizó el seguimiento de un niño desde la etapa de recién nacido hasta el año de edad por malnutrición por defecto, de causa materna por psicosis puerperal. En este caso, la madre rechazaba a su hijo, negándose a alimentarlo, privando al bebé de algo tan importante en esta etapa de la vida como la lactancia materna exclusiva, requiriendo de alimentación complementaria en edad temprana para lograr un aumento de peso adecuado y un desarrollo psicomotor que se igualar...

Malnutrición por defecto de un recién nacido por psicosis puerperal materna: presentación de un caso

OpenAIRE

Gavilla González, Bárbara; Díaz Cabrera, Leticia

2012-01-01

En el siguiente trabajo se realizó el seguimiento de un niño desde la etapa de recién nacido hasta el año de edad, por malnutrición por defecto, de causa materna por psicosis puerperal. En este caso, la madre rechazaba a su hijo, negándose a alimentarlo, privando al bebé de algo tan importante en esta etapa de la vida como la lactancia materna exclusiva, requiriendo de alimentación complementaria en edad temprana para lograr un aumento de peso adecuado y un desarrollo psicomotor que se iguala...

PROGRAMA “CASA DAS GESTANTES”: UMA NOVA LÓGICA DE ATENÇÃO À SAÚDE MATERNA E PERINATAL

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Adriano Maçal Pimenta

2010-01-01

Full Text Available El programa “Casa de las Embarazadas” es una estrategia del Ministerio de Salud Pública BR, teniendo en vista la equidad y humanización de la asistencia a las embarazadas de alto riesgo. Se trata de un estudio epidemiológico, transversal, descriptivo y exploratorio que se realizó en la “Casa de las Embarazadas” de una maternidad filantrópica en Belo Horizonte con el objetivo de evaluar el impacto de este programa en la salud materna de 292 embarazadas que usaron el servicio y de sus recién nacidos (RN. Para tanto, fueran analizados datos del libro de registro de la institución. Los resultados hallados fueron positivos para la salud materna y perinatal: la mejoría clínica de las embarazadas que tuvieron el alta o evolucionaron para el parto en la maternidad y alta proporción de RN con apgar superior a 7. La planificación de la asistencia ofrecida y los índices maternos y perinatales favorables muestran que este programa es una buena estrategia para reducir la mortalidad infantil y materna, Objetivos del Milenio propuestos por la Organización de las Naciones Unidas.

Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients.

Science.gov (United States)

Salih, Muhannad R M; Bahari, Mohd Baidi; Abd, Arwa Y

2010-12-31

To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010) for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM) library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics) interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This reassessment may be particularly imperative in certain clinical situations

Iron Deficiency in Long-Term Parenteral Nutrition Therapy.

Science.gov (United States)

Hwa, Yi L; Rashtak, Shahrooz; Kelly, Darlene G; Murray, Joseph A

2016-08-01

Iron is not routinely added to parenteral nutrition (PN) formulations in the United States because of the risk of anaphylaxis and concerns about incompatibilities. Studies have shown that iron dextran in non-lipid-containing PN solutions is safe. Data are limited on iron status, prevalence of iron deficiency anemia (IDA), and efficacy of intravenous iron infusion in long-term home PN (HPN). We aimed to determine the incidence of IDA and to examine the effectiveness of parenteral iron replacement in patients receiving HPN. Medical records of patients receiving HPN at the Mayo Clinic from 1977 to 2010 were reviewed. Diagnoses, time to IDA development, and hemoglobin, ferritin, and mean corpuscular volume (MCV) values were extracted. Response of iron indices to intravenous iron replacement was investigated. Of 185 patients (122 women), 60 (32.4%) were iron deficient. Five patients were iron deficient, and 18 had unknown iron status before HPN. Of 93 patients who had sufficient iron storage, 37 had IDA development after a mean of 27.2 months (range, 2-149 months) of therapy. Iron was replaced by adding maintenance iron dextran to PN or by therapeutic iron infusion. Patients with both replacement methods had significant improvement in iron status. With intravenous iron replacement, mean ferritin increased from 10.9 to 107.6 mcg/L (P Parenteral and Enteral Nutrition.

El rol del profesional de enfermería frente a la lactancia materna en la madre con VIH

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Mirtes Mara Carolino dos Santos

2012-12-01

Full Text Available Introducción: La lactancia materna es una práctica socialmente considerada como un acto de amor maternal que trae muchos beneficios para la madre y el recién nacido, principalmente mediante la protección contra infecciones, además de promover el crecimiento y el desarrollo. En los casos en que la madre es VIH positiva se da la recomendación de no amamantar porque puede causar un conflicto importante y despertar sentimientos negativos.Materiales y Métodos: Revisión de literatura que pretende ofrecer una reflexión sobre el desempeño del personal de enfermería en el reverso de la seropositividad impuesto a la madre que amamanta al recién nacido siendo portadora de virus de la inmunodeficiencia humana. Resultados: El descubrimiento de la madre de ser VIH positivo, la vista todos los días de la imposibilidad de la lactancia materna; Enfermería en el contexto de la lactancia materna inversa, impuesta por el estado serológico de la madre. Discusión y Conclusiones: Se trata de una población que necesita atención especializada y un equipo multidisciplinario dispuesto, el objetivo es asegurar el enfoque de la prevención de la transmisión vertical; por ello, los profesionales necesitan proporcionar una atención integral y humana que responda a las necesidades de cada mujer embarazada en los aspectos de apoyo emocional y psicológico al contexto social y familiar vivida. Además de proporcionar apoyo para no sentirse indiscriminada por no amamantar. Grande es el impacto por la dualidad lactancia y ser una madre portadora del virus de inmunodeficiencia humana. (Rev Cuid 2012;3(3:404-9.Palabras clave: Enfermería, Lactancia Materna, VIH. (Fuente: DeCS BIREME.

Home parenteral nutrition in management of patients with severe radiation enteritis

International Nuclear Information System (INIS)

Lavery, I.C.; Steiger, E.; Fazio, V.W.

1980-01-01

Five patients who would have been unable to survive because of intestinal complications of radiation therapy were able to lead an otherwise normal life with the use of parenteral nutrition administered at home. One patient died of recurrent carcinoma of the cervix after 14 months. Another patient died as the result of a totally avoidable pharmaceutical error after 2 1/2 years. The remaining three are still disease free without morbidity relating to the parenteral nutrition

Factores asociados al inicio de la lactancia materna en mujeres dominicanas

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Leonelo E. Bautista

1997-03-01

Full Text Available Las relaciones entre el inicio del amamantamiento y sus determinantes varían en distintas poblaciones, pero su conocimiento es fundamental para orientar los programas de promoción de la lactancia materna. Los datos de la Encuesta Demográfica y de Salud de 1991 de la República Dominicana se usaron para identificar factores asociados con el inicio del amamantamiento en una muestra aleatoria de mujeres en edad fértil. Aproximadamente 93% de 2714 madres informaron haber iniciado el amamantamiento en su último niño nacido vivo menor de 5 años y no hubo cambios importantes en este porcentaje en los últimos 5 años. Se realizó un análisis de regresión logística mediante el cual se calcularon valores de la razón de posibilidades (u odds ratio (psi, en inglés como medidas de asociación. Las madres que tuvieron alguna enfermedad durante el embarazo (psi = 2,3, las que tuvieron niños con bajo peso al nacer (psi= 2,9, las primíparas (psi = 1,9 y las de nivel de ingresos medio (psi = 1,6 y alto (psi = 2,1 tuvieron un riesgo significativamente mayor de no iniciar el amamantamiento. Estas mujeres deberían constituir grupos prioritarios en los programas de promoción de la lactancia materna.

Brief Parenteral Nutrition Accelerates Weight Gain, Head Growth Even in Healthy VLBWs

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Morisaki, Naho; Belfort, Mandy B.; McCormick, Marie C.; Mori, Rintaro; Noma, Hisashi; Kusuda, Satoshi; Fujimura, Masanori

2014-01-01

Introduction Whether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate. Methods We studied 4005 hospitalized VLBW, very preterm (23–32 weeks' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003–2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates. Discussion Even in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants. PMID:24586323

Early Post Operative Enteral Versus Parenteral Feeding after Esophageal Cancer Surgery

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Mohammadtaghi Rajabi Mashhadi

2015-09-01

Full Text Available Introduction: The incidence of malnutrition in hospitalized patients is reported to be high. In particular, patients with esophageal cancer are prone to malnutrition, due to preoperative digestive system dysfunctions and short-term non-oral feeding postoperatively. Selection of an appropriate method for feeding in the postoperative period is important in these patients.   Materials and Methods: In this randomized clinical trial, 40 patients with esophageal cancer who had undergone esophagectomy between September 2008 and October 2009 were randomly assigned into either enteral feeding or parenteral feeding groups, with the same calorie intake in each group. The level of serum total protein, albumin, prealbumin, transferrin, C3, C4 and hs-C-reactive protein          (hs-CRP, as well as the rate of surgical complications, restoration of bowel movements and cost was assessed in each group.   Results: Our results showed that there was no significant difference between the groups in terms of serum albumin, prealbumin or transferrin. However, C3 and C4 levels were significantly higher in the enteral feeding group compared with the parenteral group, while hs-CRP level was significantly lower in the enteral feeding group. Bowel movements were restored sooner and costs of treatment were lower in the enteral group. Postoperative complications did not differ significantly between the groups. There was one death in the parenteral group 10 days after surgery due to myocardial infarction.   Conclusion:  The results of our study showed that enteral feeding can be used effectively in the first days after surgery, with few early complications and similar nutritional outcomes compared with the parenteral method. Enteral feeding was associated with reduced inflammation and was associated with an improvement in immunological responses, quicker return of bowel movements, and reduced costs in comparison with parenteral feeding.

Delivery of vitamins E and C from parenteral alimentation solution.

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Shenai, J P; Borum, P R; Duke, E A

1982-01-01

We have previously shown that substantial losses of fat-soluble (FS) vitamin A from parenteral alimentation solution occur due to adsorption in the intravenous tubing and photodegradation in the bottle. This study assessed the delivery of other vitamins, viz, FS vitamin E and water-soluble (WS) vitamin C, from parenteral alimentation solution. The solution containing 2.0 ml/L of an aqueous multivitamin infusion was infused at a constant rate of 10 ml/h using a standard intravenous administration set. Multiple aliquots of the solution from the bottle and the effluent obtained sequentially in a 24-h period were analyzed for concentrations of vitamins E and C. Both vitamins remained relatively stable in the bottle. A significant amount (12%) of vitamin E was lost in the intravenous tubing. No losses of vitamin C were incurred in the intravenous tubing. The data suggest that delivery of FS vitamin E from parenteral alimentation solutions is less than optimum because of adsorptive losses. Similar losses are not encountered with WS vitamin C.

Selected pharmacokinetic issues of the use of antiepileptic drugs and parenteral nutrition in critically ill patients

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Abd Arwa Y

2010-12-01

Full Text Available Abstract Objectives To conduct a systematic review for the evidence supporting or disproving the reality of parenteral nutrition- antiepileptic drugs interaction, especially with respect to the plasma protein-binding of the drug. Methods The articles related to the topic were identified through Medline and PubMed search (1968-Feburary 2010 for English language on the interaction between parenteral nutrition and antiepileptic drugs; the search terms used were anti-epileptic drugs, parenteral nutrition, and/or interaction, and/or in vitro. The search looked for prospective randomized and nonrandomized controlled studies; prospective nonrandomized uncontrolled studies; retrospective studies; case reports; and in vitro studies. Full text of the articles were then traced from the Universiti Sains Malaysia (USM library subscribed databases, including Wiley-Blackwell Library, Cochrane Library, EBSCOHost, OVID, ScienceDirect, SAGE Premier, Scopus, SpringerLINK, and Wiley InterScience. The articles from journals not listed by USM library were traced through inter library loan. Results There were interactions between parenteral nutrition and drugs, including antiepileptics. Several guidelines were designed for the management of illnesses such as traumatic brain injuries or cancer patients, involving the use of parenteral nutrition and antiepileptics. Moreover, many studies demonstrated the in vitro and in vivo parenteral nutrition -drugs interactions, especially with antiepileptics. Conclusions There was no evidence supporting the existence of parenteral nutrition-antiepileptic drugs interaction. The issue has not been studied in formal researches, but several case reports and anecdotes demonstrate this drug-nutrition interaction. However, alteration in the drug-free fraction result from parenteral nutrition-drug (i.e. antiepileptics interactions may necessitate scrupulous reassessment of drug dosages in patients receiving these therapies. This

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

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AKBULUT, GAMZE

2011-01-01

Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559

Problemas que plantea la enseñanza de la lengua materna

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Gustavo Rodríguez

1988-06-01

Full Text Available Si leemos con detención el Programa de Castellano en lo referente a los objetivos, veremos que se ha considerado la enseñanza de la lengua materna desde tres enfoques: aspecto instrumental (el idioma se utiliza como medio para aprender; aspecto científico (reflexión y adquisición de patrones mentales de la lengua y, finalmente, el aspecto artístico (que se refiere a la creatividad. Nos referimos en este artículo a los dos primeros aspectos por considerarlos centrales en el tema que analizamos.

Factores psicosociales que influyen en el abandono de la lactancia materna

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Raisa Durán Menéndez; Déborah Villegas Cruz; Zeida Sobrado Rosales; Manuel Almanza Mas

1999-01-01

Se realizó un estudio prospectivo sobre el abandono de la lactancia materna en 144 madres en la Consulta de Seguimiento del Servicio de Neonatología del Hospital General Docente "Enrique Cabrera", de Ciudad de La Habana, durante el período comprendido de junio de 1994 a diciembre de 1996. Se valoraron los niveles de escolaridad de los padres, ocupación, apoyo familiar y nivel de ansiedad de la madre, entre otros. El 59,1 % de los neonatos lactó hasta los primeros 4 meses de vida. El objetivo ...

[Routine comparison of trace element deficiencies during parenteral alimentation].

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du Cailar, J; Mathieu-Daudé, J C; Kienlen, J; Béssou, D; Griffe, O; Bélé-Binda

1977-01-01

In 50 patients aged between 3 and 84 years treated in a multidisciplinary Intensive Care Unit and receiving parenteral alimentation, deficiency in certain trace elements or electrolytes (Cu++, Zn++, Mn++, Co++, PO-4, Mg++) was prevented or treated by the administration of a glucose solution (MB 147 G) enriched in trace elements. The aim of the present study was to demonstrate, on the basis of assay of serum levels of the trace elements involved, with the exception of Mn and Co, the effectiveness of treatment. Reference values were determined on the one hand in healthy individuals for normal figures and secondly on subjects included in the study, already on parenteral alimentation for several days, before treatment with MB 147 G, in order to demonstrate the existence of a deficiency (patient control values). In the case of PO--4, however, the patient control values concerned at one and the same time subjects in the study before treatment with MB 147 G and other patients receiving parenteral alimentation who were not part of the trial. MB 147 G solution was presented in units of 500 ml associated with glucose of varying concentrations (15 p. 100, 30 p. 100, 50 p. 100). The average daily amount administered, over a period of 236 days, was 3 unites per 24 hours, corresponding to an intake of copper of 3.78 mg, 3.90 mg of zinc, 0.20 mg of manganese, 0.24 mg of cobalt, 363 mg of magnesium, 240 mg of calcium and 15 mEz of phosphates. The results show that levels of copper, zinc, magnesium and phosphates were low during parenteral alimentation. The administration of MB 147 G resulted in a significant increase in these values, without there being any evidence of accumulation.

Lactancia materna en los neonatos nacidos durante primer cuatrimestre del año 2015 de las madres afiliadas al Hospital del IESS Riobamba

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Martínez Pozo, Aída Josefina

2016-01-01

A lo largo de toda la historia de la humanidad, la lactancia materna ha sido el principal factor de sobrevivencia del ser humano, la sobrevida de millones de niños depende de manera directa o indirecta del tiempo que reciben lactancia materna. Según la OMS en el año 2.008, murieron 10.5 millones de niños menores de 5 años, de ellos el 99% viven en países subdesarrollados, sus causas principales: malnutrición (54%), problemas perinatales (20%), neumonía (14%), diarrea (15%), sar...

Niveles de adiponectina en leche materna de madres con sobrepeso/obesidad y con peso normal del área metropolitana de Monterrey, México

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Galindo Gómez, Abelardo; Flores Scheufler, Pamela; Quevedo Escobar, Yamile; González Magaña, Regina; Rodríguez De Ita, Julieta

2015-01-01

Introducción: Con la actual epidemia de obesidad infantil se ha vuelto cada vez más importante conocer los factores de riesgo y de protección contra la misma. La alimentación con leche materna se considera un factor protector contra la obesidad infantil; sin embargo, se desconoce el mecanismo responsable de este efecto. Una de las teorías actuales analiza el papel de hormonas que contiene la leche materna, de las cuales la principal es la adiponectina. Con base en esta teoría, se compararon l...

MRI in children receiving total parenteral nutrition

International Nuclear Information System (INIS)

Quaghebeur, G.; Taylor, W.J.; Kingsley, D.P.E.; Fell, J.M.E.; Reynolds, A.P.; Milla, P.J.

1996-01-01

Cranial MRI was obtained in 13 of a group of 57 children receiving long-term parenteral nutrition, who were being investigated for hypermanganasaemia. Increased signal intensity on T1-weighted images has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in arc welding. It has been postulated that these changes are due to deposition of the paramagnetic trace element manganese. In excess manganese is hepato- and neurotoxic and we present the correlation of whole blood manganese levels with imaging findings. The age range of our patients was 6 months to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weighted images, with no abnormality on T2-weighted images. All patients had elevated whole blood manganese levels, suggesting that the basis for this abnormality is indeed deposition of manganese within the tissues. (orig.). With 3 figs

Maternal intelligence-mental health and child neuropsychological development at age 14 months Inteligencia y salud mental maternas y desarrollo neuropsicológico infantil a los 14 meses de edad

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Joan Forns

2012-10-01

Full Text Available Objective: To examine the relationship between maternal intelligence-mental health and neuropsychological development at age 14 months in a normal population, taking into account maternal occupational social class and education. Methods: We prospectively studied a population-based birth cohort, which forms part of the INMA (Environment and Childhood Project. Cognitive and psychomotor development was assessed at 14 months using Bayley Scales of Infant Development. Maternal intelligence and mental health were assessed by the Cattell and Cattell test and the General Health Questionnaire-12 respectively. Results: We observed a crude association between maternal intelligence and cognitive development in children at 14 months but this association disappeared when maternal education was included. The associations were stratified by maternal education and occupational social class. Within the manual maternal occupational social class, there was a significant difference in cognitive development between children whose mothers scored in the highest tertile of maternal IQ and those whose mothers scored in the lowest tertile. In contrast, no differences were observed among children whose mothers were in the non-manual occupational social class. Conclusions: The association between maternal intelligence and child cognitive development differed by occupational social class. While this association was not confounded by education or other variables in manual occupational social classes, maternal education explained this association among advantaged occupational social classes.Objetivos: Este estudio exploró la relación entre inteligencia y salud mental materna y desarrollo neuropsicológico infantil a los 14 meses de edad en población normal, teniendo en cuenta la clase social basada en la ocupación y el nivel educativo maternos. Métodos: Estudio prospectivo de cohortes de nacimiento englobado dentro del proyecto INMA (Infancia y Medio Ambiente. El

Parenteral treatment of episodic tension-type headache: a systematic review.

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Weinman, Danielle; Nicastro, Olivia; Akala, Olabiyi; Friedman, Benjamin W

2014-02-01

Tension-type headache is highly prevalent in the general population and is a consistent if not frequent cause of visits to acute care settings. Analgesics such as nonsteroidal anti-inflammatory drugs, acetaminophen, and salicylates are considered first-line therapy for treatment of tension-type headache. For patients who present to an acute care setting with persistent tension-type headache despite analgesic therapy, it is not clear which parenteral agent should be administered. We performed a systematic review of the medical literature to determine whether parenteral therapies other than salicylates or nonsteroidals are efficacious for acute tension-type headache. We performed a systematic review of Medline, EMBASE, CINAHL, Google scholar, and the Cochrane Central Registry of Controlled Trials from inception through August, 2012 using the search terms "tension-type headache" and "parenteral or subcutaneous or intramuscular or intravenous." Our goal was to identify randomized trials in which one parenteral treatment was compared to another active comparator or to placebo for the acute relief of tension-type headache. Parenteral was defined as intravenous, intramuscular, or subcutaneous administration. We only included studies that distinguished tension-type headache from other primary headache disorders, such as migraine. The primary outcome for this review was measures of efficacy one hour after medication administration. Data abstraction was performed by two authors. Disagreements were resolved by a third author. We assessed the internal validity of trials using the Cochrane Collaboration risk of bias tool. Because of the small number of trials identified, and the substantial heterogeneity among study design and medications, we decided that combining data and reporting summary statistics would serve no useful function. The results of individual studies are presented using Number Needed to Treat (NNT) with 95%CI when dichotomous outcomes were available and

Lactancia materna: evaluación nutricional en el recién nacido Breastfeeding: nutritional evaluation in the newborn

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Virginia Díaz-Argüelles Ramírez-Corría

2005-06-01

Full Text Available La leche materna es el alimento ideal para los lactantes prematuros aún cuando se requiera de la suplementación con algunos nutrientes específicos por la elevada velocidad de crecimiento de este grupo de recién nacidos. Se realiza una breve revisión bibliográfica y se exponen los criterios de la autora en relación con las ventajas de la leche materna para el niño prematuro y el malnutridoMaternal milk is the ideal food for premature infants, even when the supplement of specific nutrients necessary due the celerity of growth in this group of newborns is required. A brief bibliographic review is made and the authoress' criteria in relation to the advantages of maternal milk for the premature and malnourished child are exposed

Salud mental materna: factor de riesgo del bienestar socioemocional en niños mexicanos

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César Villaseñor

2017-04-01

Full Text Available RESUMEN Objetivos Estimar la prevalencia de síntomas depresivos y de ansiedad (SDyA en madres de tres zonas poblacionales (ZP del estado de San Luis Potosí, México, y analizar la asociación entre los SDyA y sus efectos en la salud emocional de sus hijos. Métodos Se evaluaron 173 parejas (madre-hijo de tres ZP: Zona urbana (ZU, rural (ZR y rural indígena (ZRI. Se estudiaron los SDyA de las mujeres, y las dificultades conductuales (DC de los niños. Resultados Se encontró una alta prevalencia de SDyA en las tres ZP. La mayor proporción de síntomas depresivos la presentaron la ZU y la ZR (38,7 y 38,6%. La prevalencia más alta de síntomas de ansiedad se observó en la ZR (31,8%. La asociación entre los SDyA y la depresión materna más fuerte se estimó en la ZR (razón de momios o RM = 11,0; IC95%: 1,3-95,5. En la ZRI se estimó la mayor prevalencia de DC en los niños (61%. Se encontró una asociación entre las DC y la ansiedad materna (RM = 2,2; IC95%: 1,1-4,3 y la depresión materna (RM = 2,5; IC95%: 1,3-4,6. Conclusiones La salud mental de las madres puede poner en riesgo el bienestar socioemocional de sus hijos, lo que viene respaldado por la alta prevalencia y la asociación entre SDyA y DC encontrada. En México se necesita disponer de información fiable sobre el estado de salud mental de las mujeres y los niños de las tres ZP, para implantar medidas que amplíen su cobertura evaluativa y preventiva.

Zinc: physiology, deficiency, and parenteral nutrition.

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Livingstone, Callum

2015-06-01

The essential trace element zinc (Zn) has a large number of physiologic roles, in particular being required for growth and functioning of the immune system. Adaptive mechanisms enable the body to maintain normal total body Zn status over a wide range of intakes, but deficiency can occur because of reduced absorption or increased gastrointestinal losses. Deficiency impairs physiologic processes, leading to clinical consequences that include failure to thrive, skin rash, and impaired wound healing. Mild deficiency that is not clinically overt may still cause nonspecific consequences, such as susceptibility to infection and poor growth. The plasma Zn concentration has poor sensitivity and specificity as a test of deficiency. Consequently, diagnosis of deficiency requires a combination of clinical assessment and biochemical tests. Patients receiving parenteral nutrition (PN) are susceptible to Zn deficiency and its consequences. Nutrition support teams should have a strategy for assessing Zn status and optimizing this by appropriate supplementation. Nutrition guidelines recommend generous Zn provision from the start of PN. This review covers the physiology of Zn, the consequences of its deficiency, and the assessment of its status, before discussing its role in PN. © 2015 American Society for Parenteral and Enteral Nutrition.

Factores socioculturales y psicológicos vinculados a la lactancia materna exclusiva Sociocultural and psychological factors linked to exclusive breastfeeding

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Regla Caridad Broche Candó

2011-06-01

Full Text Available Introducción: la lactancia materna ha sido la forma de alimentación más segura para el ser humano en toda su historia. Esta leche es la única que asegura al niño pequeño una alimentación adecuada y le protege de las infecciones. Objetivo: determinar el comportamiento de los principales factores socioculturales y psicológicos vinculados a la práctica y abandono de la lactancia materna exclusiva y su repercusión en el estado de salud de los lactantes. Métodos: se realizó un estudio descriptivo de corte transversal, en el municipio Diego Ibarra, Estado de Carabobo, en el año 2008. La muestra estuvo conformada por 96 lactantes cuyas madres dieron su consentimiento informado para participar en este. Resultados: se observó un predominio de las madres adolescentes asociado al abandono de la lactancia materna antes de los 4 meses, la secundaria fue el nivel escolar más frecuente en la serie, sin embargo, el predominio de la categoría de obrera o técnica se asoció a una lactancia menor de 4 meses. Conclusiones: al nacimiento predominó la lactancia materna mixta, con una tendencia progresiva al uso de la lactancia artificial a partir del cuarto mes. Se encontró mayor frecuencia de madres con conocimientos deficientes sobre la lactancia materna, y fueron estas las que lactaron a sus bebés por menor tiempo. Más de las tres cuartas partes de las mujeres refirieron como causa de abandono de la lactancia materna exclusiva, que el niño se quedaba con hambre y la insuficiente disponibilidad de leche en las mamas.Introduction: the breastfeeding has been the more safe feeding way for human being in all its history. This type of milk is the only assuring the infant a proper feeding while protecting him of infections. Objective: to determine the behavior of main sociocultural and psychological factors linked to practice and giving up of the exclusive breastfeeding and its repercussion on infant health status. Methods: a cross-sectional and

Adiposidade em adolescentes e obesidade materna Relationship between maternal obesity and adiposity in adolescents

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Maria Fernanda Petroli Frutoso

2011-02-01

Full Text Available OBJETIVO: Descrever a relação entre adiposidade na adolescência e obesidade materna. MÉTODOS: Foi realizado estudo transversal com 660 indivíduos de 8 a 18 anos, de ambos os sexos, matriculados em uma escola pública e outra privada do município de São Paulo. A coleta de dados foi realizada por meio de entrevista, medidas antropométricas e inquérito alimentar. A adiposidade na adolescência foi mensurada a partir do índice de massa corporal e, por meio de análise de regressão, verificou-se sua relação com a obesidade materna, ajustada por sexo, idade, estágio de maturação sexual, valor energético total da dieta, atividade física, sedentarismo, peso ao nascer e escolaridade materna. RESULTADOS: Dos adolescentes estudados, 64,7% eram do sexo feminino. A média (desvio-padrão de idade foi de 12,4 (1,80, variando de 8 a 17 anos. Verificou-se maior prevalência de excesso de peso e obesidade entre os indivíduos do sexo masculino, não sendo observada associação significativa entre estado nutricional e sexo. Após ajuste pelas covariáveis, detectou-se que filhos de mães obesas têm risco quatro vezes maior de ser obesos, quando comparados aos adolescentes filhos de mães não obesas. CONCLUSÃO: Conclui-se que a obesidade materna representa fator de risco importante para o desenvolvimento da obesidade na adolescência.OBJECTIVE: This study aimed to describe the relationship between teenager's adiposity and maternal obesity. METHODS: A cross-sectional study was done with 660 teenagers aged 8 to 18 years, of both genders, students of private and public schools of São Paulo. The data were collected by interviews, anthropometric measurements and food intake records. Teenagers' adiposity was determined by body mass index and regression analyses was used to verify its relationship with maternal obesity adjusted for gender, age, stage of sexual development, energy intake, physical activity, sedentary lifestyle, birth weight and

Product quality of parenteral vancomycin products in the United States.

Science.gov (United States)

Nambiar, S; Madurawe, R D; Zuk, S M; Khan, S R; Ellison, C D; Faustino, P J; Mans, D J; Trehy, M L; Hadwiger, M E; Boyne, M T; Biswas, K; Cox, E M

2012-06-01

In response to concerns raised about the quality of parenteral vancomycin products, the U.S. Food and Drug Administration (FDA) is investigating the product quality of all FDA-approved parenteral vancomycin products available in the United States. Product quality was evaluated independently at two FDA Office of Testing and Research (FDA-OTR) sites. In the next phase of the investigation, being done in collaboration with the National Institute of Allergy and Infectious Diseases, the in vivo activity of these products will be evaluated in an appropriate animal model. This paper summarizes results of the FDA investigation completed thus far. One site used a validated ultrahigh-pressure liquid chromatography method (OTR-UPLC), and the second site used the high-performance liquid chromatography (HPLC) method for related substances provided in the British Pharmacopeia (BP) monograph for vancomycin intravenous infusion. Similar results were obtained by the two FDA-OTR laboratories using two different analytical methods. The products tested had 90 to 95% vancomycin B (active component of vancomycin) by the BP-HPLC method and 89 to 94% vancomycin by OTR-UPLC methods. Total impurities were 5 to 10% by BP-HPLC and 6 to 11% by OTR-UPLC methods. No single impurity was >2.0%, and the CDP-1 level was ≤ 2.0% across all products. Some variability in impurity profiles of the various products was observed. No adverse product quality issues were identified with the six U.S. vancomycin parenteral products. The quality parameters of all parenteral vancomycin products tested surpassed the United States Pharmacopeia acceptance criteria. Additional testing will characterize in vivo performance characteristics of these products.

76 FR 50741 - 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality...

Science.gov (United States)

2011-08-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Joint Public Conference; Quality and...: Notice of public conference. The Food and Drug Administration (FDA), in cosponsorship with Parenteral...

Lactancia materna en el lactante enfermo con labio leporino y fisura palatina

OpenAIRE

Pérez Montero, Lidia

2016-01-01

El labio leporino y fisura palatina son malformaciones congénitas que afectan a la estructura maxilofacial, cuya incidencia estimada es de 1 por cada 700 nacidos vivos. Factores genéticos y medioambientales podrían intervenir en la aparición de estos defectos. Entre ellos la edad avanzada de los padres, la obesidad materna, infecciones durante el embarazo y el consumo del tabaco. Estos recién nacidos necesitan ser intervenidos quirúrgicamente, pero para ello deben estar bien alimentados. U...

Parenteral Nutrition Basics for the Clinician Caring for the Adult Patient.

Science.gov (United States)

Derenski, Karrie; Catlin, Jennifer; Allen, Livia

2016-10-01

Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns. © 2016 American Society for Parenteral and Enteral Nutrition.

Iodine Supplementation for Pediatric Patients Receiving Long-Term Parenteral Nutrition.

Science.gov (United States)

Santoro, Jonathan D; Nespor, Colleen; Poole, Robert L; Kerner, John A

2016-04-01

Patients dependent on parenteral nutrition (PN) are among a group at risk of developing iodine deficiency. Supplementation with iodine in this population has been debated in a number of studies, resulting in variable clinical practices. The Committee on Clinical Practice Issues of the American Society for Clinical Nutrition recommends a dose of 1 mcg/kg/d of parenteral iodine for patients receiving PN. At our institution, PN trace elements do not include iodine, although this is not the case internationally. Our study sought to assess iodine levels and thyroid function in a cohort of PN-dependent pediatric patients. A retrospective analysis studied 32 pediatric patients with a variety of medical diagnoses who received PN as a primary means of nutrition for 6 months or longer. Patients received variable proportions of their total caloric intake as PN, which ranged from 14%-100%. Iodine and thyroid function levels were obtained by serum sampling. No patient in our cohort of 32 demonstrated thyroid dysfunction or developed iodine deficiency. The length of time on PN and the percentage of total nutrition intake as PN were not associated with iodine levels (P Parenteral and Enteral Nutrition.

Estudo pré-natal da hiper-refringência endocárdica fetal e sua relação com toxoplasmose materna

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Nicoloso Luiz Henrique Soares

2004-01-01

Full Text Available OBJETIVO: Estudar, comparativamente, um grupo de fetos de mães com toxoplasmose aguda ou recente e um grupo sem doença sistêmica, analisando-se a presença de alterações da refringência endocárdica. MÉTODOS: Avaliados 91 fetos cujas mães tinham diagnóstico de toxoplasmose aguda ou recente, detectados por soroconversão ou presença de títulos elevados de IgM e IgG, confirmados através do teste de captura e comparados com um grupo controle constituído de 182 fetos, selecionados a partir de uma população de baixo risco, participante de um programa de rastreamento de cardiopatias pré-natais. RESULTADOS: Não houve diferença significativa entre as idades médias gestacionais (29,2±4,6 semanas; 29,2±4,6 semanas e maternas (25,7±6,7 anos; 26±5,4 anos nos dois grupos. Áreas de hiperecogenicidade endocárdica observadas em 69 fetos com toxoplasmose materna (75,8% e em apenas 6 fetos do grupo controle (3,3% (p<0,001. Em 52 dos casos do grupo de estudo (75,4% a hiper-refringência endocárdica era difusa e em 17 (24,3%, focal. No grupo controle, uma distribuição focal foi observada em 5 fetos (83,3%. CONCLUSÃO: A imagem ecocardiográfica pré-natal de hiper-refringência endocárdica focal ou difusa é mais prevalente em gestações com toxoplasmose materna do que naquelas normais, existindo associação entre a presença de hiperecogenicidade endocárdica fetal e doença materna.

Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol

Science.gov (United States)

2013-01-01

Background Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. Methods/Design The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. Discussion One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available

Fenilcetonúria materna: relato de caso Maternal phenylketonuria: a case report

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Ernesto Antonio Figueiró-Filho

2004-12-01

Full Text Available A fenilcetonúria materna é uma aminoacidopatia caracterizada por níveis elevados de fenilalanina plasmática na gestante, o que pode provocar anormalidades no desenvolvimento do feto, condição que se denomina síndrome de fenilcetonúria materna. Deve ser diagnosticada laboratorialmente, uma vez que as manifestações clínicas são inespecíficas. Relatamos um caso de paciente secundigesta, com antecedente pessoal de retardo do desenvolvimento cognitivo, sem antecedentes patológicos obstétricos, com diagnóstico laboratorial de hiperfenilalaninemia na atual gestação, sendo tratada com dieta específica. O recém-nato, nascido a termo, não apresentou alterações físicas ou defeitos congênitos confirmados. A gestação anterior, na qual não houve diagnóstico e controle da fenilcetonúria, resultou em criança com séria deficiência psicomotora confirmada, além de microcefalia e distúrbios auditivos e da fala. Com o conhecimento dos efeitos da hiperfenilalaninemia materna sobre o feto, tornam-se essenciais o diagnóstico e a instituição precoce do tratamento durante a gravidez em pacientes com suspeita clínica de fenilcetonúria. No caso aqui descrito, houve benefícios materno-fetais do tratamento dietoterápico oferecido, reforçando a importância da identificação de mulheres fenilcetonúricas em idade reprodutiva.Maternal phenylketonuria is an aminoacid pathology characterized by elevated plasma levels of phenylalanine in the pregnant woman that may cause abnormalities in fetus development, and which is called maternal phenylketonuria syndrome. As the clinical manifestations are non-specific, the disease should be diagnosed by laboratory screening. We present a case of a second pregnancy in a woman with a history of psycho-cognitive development retardation without previous obstetric history, with diagnosis of phenylketonuria in the present gestation, treated with specific phenylalanine-free diet. The newborn did not

El papel de enfermería en la promoción de la lactancia materna /

OpenAIRE

Valverde García, Leticia

2016-01-01

Se trata de que los profesionales de la salud tengan los puntos claves para conseguir que las madres que desean amamantar a sus bebés encuentren la ayuda necesaria. Además de informar de los conocimientos científicamente contrastados respecto a la lactancia materna, analizando los beneficios que tiene la misma, tanto para el bebé como para la madre

[Staff accreditation in parenteral nutrition production in hospital pharmacy].

Science.gov (United States)

Vrignaud, S; Le Pêcheur, V; Jouan, G; Valy, S; Clerc, M-A

2016-09-01

This work aims to provide staff accreditation methodology to harmonize and secure practices for parenteral nutrition bags preparation. The methodology used in the present study is inspired from project management and quality approach. Existing training supports were used to produce accreditation procedure and evaluation supports. We first defined abilities levels, from level 1, corresponding to accredited learning agent to level 3, corresponding to expert accredited agent. Elements assessed for accreditation are: clothing assessment either by practices audit or by microbiologic test, test bags preparation and handling assessment, bag production to assess aseptic filling for both manual or automatized method, practices audit, number of days of production, and non-conformity following. At Angers Hospital, in 2014, production staff is composed of 12 agents. Staff accreditation reveals that 2 agents achieve level 3, 8 agents achieve level 2 and 2 agents are level 1. We noted that non-conformity decreased as accreditation took place from 81 in 2009 to 0 in 2014. To date, there is no incident due to parenteral bag produced by Angers hospital for neonatal resuscitation children. Such a consistent study is essential to insure a secured nutrition parenteral production. This also provides a satisfying quality care for patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Parenteral nutrition-associated liver disease and lipid emulsions.

Science.gov (United States)

Zugasti Murillo, Ana; Petrina Jáuregui, Estrella; Elizondo Armendáriz, Javier

2015-01-01

Parenteral nutrition-associated liver disease (PNALD) is a particularly important problem in patients who need this type of nutritional support for a long time. Prevalence of the condition is highly variable depending on the series, and its clinical presentation is different in adults and children. The etiology of PNALD is not well defined, and participation of several factors at the same time has been suggested. When a bilirubin level >2 mg/dl is detected for a long time, other causes of liver disease should be ruled out and risk factors should be minimized. The composition of lipid emulsions used in parenteral nutrition is one of the factors related to PNALD. This article reviews the different types of lipid emulsions and the potential benefits of emulsions enriched with omega-3 fatty acids. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Changes in intestinal absorption of nutrients and brush border glycoproteins after total parenteral nutrition in rats.

Science.gov (United States)

Miura, S; Tanaka, S; Yoshioka, M; Serizawa, H; Tashiro, H; Shiozaki, H; Imaeda, H; Tsuchiya, M

1992-01-01

The effect of total parenteral nutrition on nutrients absorption and glycoprotein changes of brush border membrane was examined in rat small intestine. In total parenteral nutrition rats, a marked decrease in activity of brush border enzymes was observed mainly in the proximal and middle segments of the intestine. Galactose perfusion of jejunal segment showed that hexose absorption was significantly inhibited, while intestinal absorption of glycine or dipeptide, glycylglycine was not significantly affected by total parenteral nutrition treatment. When brush border membrane glycoprotein profile was examined by [3H]-glucosamine or [3H]-fucose incorporation into jejunal loops, significant changes were observed in the glycoprotein pattern of brush border membrane especially in the high molecular weight range over 120 kDa after total parenteral nutrition treatment, suggesting strong dependency of glycoprotein synthesis on luminal substances. Molecular weight of sucrase isomaltase in brush border membrane detected by specific antibody showed no significant difference, however, in total parenteral nutrition and control rats. Also, molecular weight of specific sodium glucose cotransporter of intestinal brush border membrane detected by selective photoaffinity labelling was not altered in total parenteral nutrition rats. It may be that prolonged absence of oral food intake may produce significant biochemical changes in brush border membrane glycoprotein and absorptive capacity of small intestine, but these changes were not observed in all brush border membrane glycoproteins. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:1582592

Quality of Life and Nutrition Condition of Patients Improve Under Home Parenteral Nutrition: An Exploratory Study.

Science.gov (United States)

Girke, Jutta; Seipt, Claudia; Markowski, Andrea; Luettig, Birgit; Schettler, Anika; Momma, Michael; Schneider, Andrea S

2016-10-01

Patients with end-stage cancer and advanced chronic bowel disease are often malnourished, which has a negative effect on patients' outcome, well-being, and activity. It is inconclusive whether these patients benefit from home parenteral nutrition. This prospective exploratory study investigates its influence on nutrition state, muscle strength, mobility, and quality of life. Patients ≥18 years old with an indication for home parenteral nutrition were included and followed for 2-24 months. Nutrition parameters, activity, and quality of life were assessed. Forty-eight patients participated (mean age 11.5 years), and 85% were severely malnourished (subjective global assessment score, class C). Four weeks after parenteral nutrition, patients with tumors demonstrated a deterioration in phase angle (from 3.9 to 3.4) and extracellular mass:body cell mass ratio (from 1.6 to 2.1), while patients with bowel disease improved (from 3.4 to 4.0 and 2.1 to 1.6, respectively); grip strength remained constant in both groups (difference: 1.11 and -2.11, respectively). Activity improved in patients with bowel disease but stayed the same in the tumor group (P = .02 and P = .33, respectively). When the groups were pooled, emotional and social functioning domain scores (P parenteral nutrition. Both groups seem to benefit from home parenteral nutrition without harmful side effects. If the indication is determined early, the patients' disease course could perhaps be improved. © 2016 American Society for Parenteral and Enteral Nutrition.

Cumplimiento de la lactancia materna. Una perspectiva desde las oficinas de farmacia

OpenAIRE

Pezzani V., Marcela; Soto H., Pamela; Pineda L., Rafael; Pinilla R., Elizabeth; Ruiz A., Inés

1998-01-01

Objetivo: describir conductas sobre lactancia materna en clientes de farmacias. Ambito: corte transversal entre clientes de productos infantiles y lácteos en farmacias. Personas y métodos: las personas que concurrieron a trece farmacias de Santiago Metropolitano por productos de uso infantil, fueron encuestadas por alumnos de la carrera de Química y Farmacia en dos períodos de los años 1996 y 1997. Se registró el tipo de alimentación que recibía el niño que motivaba la adquisición, los medica...

As representações maternas acerca do bebê que nasce com doenças orgânicas graves

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Ethel Cukierkorn Battikha

Full Text Available O nascimento de um bebê com doenças orgânicas graves tem profundas implicações na constituição do vínculo inicial mãe-bebê. O objetivo desta pesquisa é a investigação das representações psíquicas maternas acerca desse nascimento. Este estudo qualitativo está fundamentado no campo teórico-psicanalítico. Foram realizadas entrevistas semi-estruturadas, individuais, com 11 mães no período de internação do bebê na Unidade de Terapia Intensiva Neonatal. Os dados obtidos foram submetidos ao método de análise de conteúdo e revelaram que o nascimento do bebê com alterações orgânicas afeta a função materna já que desorganiza as representações que eram antes dirigidas ao bebê sadio imaginado, marcando uma tendência recorrente à equivalência desse bebê ao diagnóstico de sua doença. Este nascimento implica, portanto, o luto pelo filho desejado e o decréscimo da auto-estima materna. A participação nas entrevistas teve efeitos terapêuticos, sugerindo a necessidade de uma escuta analítica dessas mães durante o período de permanência do bebê na instituição hospitalar.

Habilidades maternas de mulheres vítimas de violência doméstica: uma revisão da literatura

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Sabrina Mazo D'Affonseca

Full Text Available O presente estudo objetivou revisar a literatura nacional e internacional de 2007 a 2010 sobre violência doméstica e habilidades maternas nas seguintes bases de dados: Bireme, Web of Science, Lilacs e Medline. A busca resultou em 85 artigos, sendo analisados 28 que se relacionavam com a proposta deste estudo, todos internacionais, divididos em quatro categorias: (1 prevalência, (2 intervenção, (3 relação entre violência conjugal e habilidades maternas e (4 impacto da violência conjugal nos filhos. A análise dos artigos permitiu verificar que uma parcela expressiva de crianças presencia desentendimentos violentos entre os pais e são afetadas direta ou indiretamente por eles. Nos artigos em que se buscou avaliar a relação entre a violência conjugal e as habilidades maternas, os resultados demonstraram os impactos negativos da exposição à violência conjugal e a importância de um relacionamento mãe-filho positivo para a diminuição dos problemas de comportamento dos filhos, sendo esse um fator importante quando se pensa em intervir nessa população. Destaca-se que todos os dados foram obtidos por meio de autorrelato das mulheres, sendo sugeridas pesquisas futuras que utilizem outras formas de coleta de dados, como fontes de informação diversas ou estudos observacionais sistematizados.

Conclusions to the first Baxter-Senpe workshop on: ready-to-use (RTU) products for parenteral nutrition

OpenAIRE

García de Lorenzo Mateos, A.; Bermejo Vicedo, T.; Gómez Candela, C.; Planas Vila, M.

2005-01-01

Conclusiones de la Mesa de Trabajo sobre productos listos para su uso (RTU) en nutrición parenteral. Se efectúa una aproximación a la definición y a las ventajas en comparación con otros modelos de nutrición parenteral. Destacan los aspectos relacionados con la gestión, composición de la RTU e indicaciones tanto intrahospitalarias como domiciliarias.Conclusions to the workshop on ready-to use (RTU) products for parenteral nutrition. An approximation is done to the definition and advantages in...

Razões maternas para colocar ou não o bebê na creche

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Cesar Augusto Piccinini

2016-01-01

Full Text Available El estudio investigó las razones maternas para inscribir o no al hijo en la guardería en el primer año. El estudio incluyó a 69 madres y sus hijos, de los cuales 26 estaban entrando en los centros de atención y 43 continuarían siendo cuidados por la madre u otros cuidadores. Se entrevistó a las madres sobre la maternidad y la elección de cuidado. El análisis de contenido reveló que la decisión de inscribir o no al hijo en los centros de atención en los primeros seis meses fue influenciada por razones relacionadas con el bebé, sus madres/padres y la red de apoyo. Además de eso, se verificó que las razones maternas para elegir cualquier cuidado estuvieron relacionadas con las necesidades de los hijos. En cuanto a los centros de atención, las madres destacaron su importancia para el desarrollo social y cognitivo, mientras que los otros cuidados, las madres enfatizaron la atención más individualizada. Independiente de las razones específicas, estas estaban involucradas en un proceso complejo y dinámico.

Vitamin E in new-generation lipid emulsions protects against parenteral nutrition-associated liver disease in parenteral nutrition-fed preterm pigs

Science.gov (United States)

Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipi...

Estado de salud de los niños de 8 a 14 meses según el tipo de lactancia materna

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Ener de Jesús Fernández Brizuela

Full Text Available Introducción: la lactancia materna ha probado su eficacia a lo largo de las generaciones y ha permitido la subsistencia de la humanidad, con beneficios ya reconocidos para la salud de la madre, el niño y la economía. Objetivo: caracterizar el estado de salud de los niños de 8 a 14 meses según el tipo de lactancia recibida en los primeros seis meses de vida. Métodos: se realizó un estudio de tipo observacional descriptivo retrospectivo en los 32 niños entre 8 y 14 meses pertenecientes a los consultorios del médico de la familia 20, 21, 22, 23, 25 y 27 del Policlínico de Céspedes, en Camagüey. La muestra no probabilística quedó constituida por 29 niños entre 8 y 14 meses de vida que cumplieron los criterios de inclusión y exclusión. Las variables estudiadas fueron: cantidad de episodios de neumonía, de otras infecciones respiratorias que hubieran requerido antimicrobianos o no, de enfermedades diarreicas, de ingresos hospitalarios por enfermedades infecciosas así como el estado nutricional. Resultados: del total de niños observados 11 fueron alimentados con lactancia materna exclusiva hasta el sexto mes de vida, lo que representó un 37,9 % del total. Las infecciones respiratorias agudas sin antimicrobianos y las infecciones respiratorias tratadas con antimicrobianos fueron los episodios mayormente observados en ambos grupos. Los niños con compromiso de su estado nutricional fueron más frecuentes en los pacientes que no tuvieron lactancia materna exclusiva hasta el sexto mes con un 17,3 % del total. Conclusiones: prevalecieron las prácticas inadecuadas de lactancia materna exclusiva y en estos niños son más frecuentes las enfermedades infecciosas, los ingresos por dichas causas y los trastornos del estado nutricional.

Standardised neonatal parenteral nutrition formulations – an Australasian group consensus 2012

Science.gov (United States)

2014-01-01

Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors. PMID:24548745

[When enteral nutrition is not possible in intensive care patients: whether to wait or use parenteral nutrition?

Science.gov (United States)

Habes, Q L M; Pickkers, P

2016-01-01

- Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition. This seems to be related to the higher calorie intake with parenteral nutrition rather than the route of administration.- In previously well-nourished patients, in whom enteral nutrition is only partially successful, it is safe to wait for up to 8 days before initiating supplemental parenteral nutrition.- In critically ill children, it is also safe to start supplemental parenteral nutrition at a late (on the 8th day after admission) rather than an early stage (within 24 hours of admission). Late supplemental parenteral nutrition may even result in fewer infectious complications and shorter hospitalisation.

Nivel del PH salival en niños de 6 meses a 18 meses de edad con ingesta de leche evaporada modificada y leche materna

OpenAIRE

Flores Concha, Paulita

2010-01-01

RESUMEN Objetivo: Determinar el nivel del pH salival en niños de 6 meses a 18 meses de edad con ingesta de leche evaporada modificada y leche materna, en el Programa Nacional Wawa Wasi del distrito de Villa María del Triunfo, según el tiempo transcurrido. Material y método: La muestra estuvo conformada por 40 niños de 6 meses a 18 meses de edad, distribuidos en dos grupos: 20 que consumieron leche materna y 20 que ingirieron leche evaporada modificada. Se les dio a tomar la leche ...

Recomendaciones para una política nacional de promoción de la lactancia materna en México: postura de la Academia Nacional de Medicina

OpenAIRE

Teresita González de Cosío-Martínez; Sonia Hernández-Cordero; Juan Rivera-Dommarco; Mauricio Hernández-Ávila

2017-01-01

Para mejorar las prácticas de lactancia materna es necesario fortalecer acciones de promoción, protección y apoyo, y establecer una política nacional multisectorial que incluya elementos indispensables de diseño, implementación, monitoreo y evaluación de programas y políticas públicas, financiamiento para acciones e investigación, desarrollo de abogacía y voluntad política, y promoción de la lactancia materna, todo coordinado por un nivel central. Recientemente, México ha iniciado un proceso ...

Parenteral nutrition dysregulates bile salt homeostasis in a rat model of parenteral nutrition-associated liver disease.

Science.gov (United States)

Koelfat, Kiran V K; Schaap, Frank G; Hodin, Caroline M J M; Visschers, Ruben G J; Svavarsson, Björn I; Lenicek, Martin; Shiri-Sverdlov, Ronit; Lenaerts, Kaatje; Olde Damink, Steven W M

2017-10-01

Parenteral nutrition (PN), a lifesaving therapy in patients with intestinal failure, has been associated with hepatobiliary complications including steatosis, cholestasis and fibrosis, collectively known as parenteral nutrition-associated liver disease (PNALD). To date, the pathogenesis of PNALD is poorly understood and therapeutic options are limited. Impaired bile salt homeostasis has been proposed to contribute PNALD. The objective of this study was to establish a PNALD model in rats and to evaluate the effects of continuous parenteral nutrition (PN) on bile salt homeostasis. Rats received either PN via the jugular vein or received normal diet for 3, 7 or 14 days. Serum biochemistry, hepatic triglycerides, circulating bile salts and C4, IL-6 and TNF-alpha, and lipogenic and bile salt homeostatic gene expression in liver and ileum were assessed. PN increased hepatic triglycerides already after 3 days of administration, and resulted in conjugated bilirubin elevation after 7 or more days. This indicates PN-induced steatosis and impaired canalicular secretion of bilirubin, the latter which is in line with reduced hepatic expression of Mrp2 mRNA. There was no histological evidence for liver inflammation after PN administration, and circulating levels of pro-inflammatory cytokines IL-6 and TNF-α, were comparable in all groups. Hepatic expression of Fxr mRNA was decreased after 7 days of PN, without apparent effect on expression of Fxr targets Bsep and Shp. Nonetheless, Cyp7a1 expression was reduced after 7 days of PN, indicative for lowered bile salt synthesis. Circulating levels of C4 (marker of bile salt synthesis) were also decreased after 3, 7 and 14 days of PN. Levels of circulating bile salts were not affected by PN. This study showed that PN in rats caused early mild steatosis and cholestasis, while hepatic and systemic inflammation were not present. The onset of these abnormalities was associated with alterations in bile salt synthesis and transport. This

Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.

Science.gov (United States)

Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra

2016-12-01

Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

A Review of the Parenteral Nutrition Supply Service in an Irish Neonatal Unit

LENUS (Irish Health Repository)

Smith, A

2018-06-01

Neonatal Intensive Care (NICU) patients have individual nutritional requirements often requiring Patient Specific Parenteral Nutrition (PSPN). From October 2015, the national PSPN compounding service availability changed from 7 days per week service to 5 days per week (i.e. no weekend and limited bank holiday ordering available). The aim of this study was to examine the introduction of a 5 day only PSPN supply on neonatal patient parenteral nutrition availability in a tertiary NICU.

Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies

NARCIS (Netherlands)

Iestra, J. A.; Fibbe, W. E.; Zwinderman, A. H.; Romijn, J. A.; Kromhout, D.

1999-01-01

Patients receiving intensive cytotoxic therapy are traditionally supported with parenteral nutrition (PN), although it is unclear whether all patients benefit from PN. This study aimed to identify regimen-associated differences in PN requirements, to reveal discrepancies between the number of PN

Métodos no farmacológicos para inducir la lactancia materna en adopción, subrogación y en la madre no gestante en parejas lesbianas: revisión bibliográfica

OpenAIRE

Cazorla Ortiz, Gemma

2018-01-01

IntroducciónLa inducción de la lactancia materna permite a las madres que no han pasado por un parto —en caso de adopción, subrogación o en parejas formadas por dos mujeres— poder dar el pecho a su hijo. Existen métodos farmacológicos y métodos no farmacológicos para inducir la lactancia materna.ObjetivoEl objetivo de esta revisión es conocer los métodos no farmacológicos para inducir la lactancia materna.Material y MétodoSe realizó una búsqueda bibliográfica en las bases de datos Pubmed, Cin...

Campaña contra mortalidad materna: un análisis de las estrategias discursivas feministas en Perú

Directory of Open Access Journals (Sweden)

Yin-Zu Chen

2013-01-01

Full Text Available Este artículo analiza las estrategias discursivas de la Campaña contra Mortalidad Materna de los movimientos feministas en el contexto sociopolítico del Perú, argumentando que los marcos interpretativos permiten intermediar entre las oportunidades contextuales y las acciones colectivas, influenciar a los debates públicos y los resultados políticos, aunque la dinámica discursiva está condicionada, a su vez, por las relaciones de poderes entre los actores públicos. En el caso analizado, el discurso sobre mortalidad materna, por basarse en valores tradicionales, permitió la introducción de la perspectiva de género en la salud pública, valores que limitan, sin embargo, la construcción de la mujer como sujeto autónomo. Frente a la resistencia del sector conservador y la intervención del Estado, las argumentaciones feministas sufrieron transformaciones y causaron resultados inesperados.

Higher versus lower amino acid intake in parenteral nutrition for newborn infants.

Science.gov (United States)

Osborn, David A; Schindler, Tim; Jones, Lisa J; Sinn, John Kh; Bolisetty, Srinivas

2018-03-05

Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition.Secondary objectives include determining whether:• higher versus lower starting or initial intake of amino acids is associated with improved growth and disability-free survival without side effects;• higher versus lower intake of amino acids at maximal intake is associated with improved growth and disability-free survival without side effects; and• increased amino acid intake should replace non-protein energy intake (glucose and lipid), should be added to non-protein energy intake, or should be provided simultaneously with non-protein energy intake.We conducted subgroup analyses to look for any differences in the effects of higher versus lower intake of amino acids according to gestational age, birth weight, age at commencement, and condition of the infant, or concomitant increases in fluid intake. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (2 June 2017), MEDLINE (1966 to 2 June 2017), Embase (1980 to 2 June 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2 June 2017). We also searched clinical trials databases, conference proceedings, and citations of articles. Randomised controlled trials of higher versus lower intake of AAs as parenteral nutrition in newborn infants. Comparisons of higher intake at commencement, at maximal intake, and at both commencement and maximal

Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design

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Mirković Dušica

2013-01-01

Full Text Available Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5

Distancia anogenital en mujeres y su relación con exposiciones prenatales maternas

OpenAIRE

Maria Pilar Mira-Escolano; Jaime Mendiola Olivares; Lidia Minguez-Alarcón; Manuela Roca; Jose Juan Lopez-Espin; Alberto Manuel Torres-Cantero

2014-01-01

La distancia anogenital (DAG) es un marcador de desarrollo genital que presenta un dimorfismo sexual en mamíferos. Diversos estudios experimentales han mostrado que la DAG al nacimiento refleja la exposición androgénica a la que el feto ha estado expuesto durante su desarrollo intraútero. El objetivo de nuestro estudio fue explorar la relación entre exposiciones prenatales (maternas) a distintos productos o sustancias de uso cotidiano durante el embarazo y la DAG de sus hijas como marcador in...

Plasma Aluminum Concentrations in Pediatric Patients Receiving Long-Term Parenteral Nutrition.

Science.gov (United States)

Courtney-Martin, Glenda; Kosar, Christina; Campbell, Alison; Avitzur, Yaron; Wales, Paul W; Steinberg, Karen; Harrison, Debra; Chambers, Kathryn

2015-07-01

Patients receiving long-term parenteral nutrition (PN) are at increased risk of aluminium (Al) toxicity because of bypass of the gastrointestinal tract during PN infusion. Complications of Al toxicity include metabolic bone disease (MBD), Al-associated encephalopathy in adults, and impaired neurological development in preterm infants. Unlike the United States, there are no regulations regarding Al content of large- and small-volume parenterals in Canada. We, therefore, aimed to present our data on plasma Al concentration and Al intake from our cohort of pediatric patients receiving long-term PN. Plasma Al concentration was retrospectively gathered from the patient charts of all 27 patients with intestinal failure (IF) receiving long-term PN at The Hospital for Sick Children, Toronto, Canada, and compared with age- and sex-matched controls recruited for comparison. In addition, Al concentration was measured in PN samples collected from 10 randomly selected patients with IF and used to determine their Al intake. The plasma Al concentration of patients with IF receiving long-term PN was significantly higher than that of control participants (1195 ± 710 vs 142 ± 63 nmol/L; P Parenteral and Enteral Nutrition.

Parenteral Nutrition-Associated Liver Disease: The Role of the Gut Microbiota.

Science.gov (United States)

Cahova, Monika; Bratova, Miriam; Wohl, Petr

2017-09-07

Parenteral nutrition (PN) provides life-saving nutritional support in situations where caloric supply via the enteral route cannot cover the necessary needs of the organism. However, it does have serious adverse effects, including parenteral nutrition-associated liver disease (PNALD). The development of liver injury associated with PN is multifactorial, including non-specific intestine inflammation, compromised intestinal permeability, and barrier function associated with increased bacterial translocation, primary and secondary cholangitis, cholelithiasis, short bowel syndrome, disturbance of hepatobiliary circulation, lack of enteral nutrition, shortage of some nutrients (proteins, essential fatty acids, choline, glycine, taurine, carnitine, etc.), and toxicity of components within the nutrition mixture itself (glucose, phytosterols, manganese, aluminium, etc.). Recently, an increasing number of studies have provided evidence that some of these factors are directly or indirectly associated with microbial dysbiosis in the intestine. In this review, we focus on PN-induced changes in the taxonomic and functional composition of the microbiome. We also discuss immune cell and microbial crosstalk during parenteral nutrition, and the implications for the onset and progression of PNALD. Finally, we provide an overview of recent advances in the therapeutic utilisation of pro- and prebiotics for the mitigation of PN-associated liver complications.

Phylodynamic and Phylogeographic Patterns of the HIV Type 1 Subtype F1 Parenteral Epidemic in Romania

Science.gov (United States)

Hué, Stéphane; Buckton, Andrew J.; Myers, Richard E.; Duiculescu, Dan; Ene, Luminita; Oprea, Cristiana; Tardei, Gratiela; Rugina, Sorin; Mardarescu, Mariana; Floch, Corinne; Notheis, Gundula; Zöhrer, Bettina; Cane, Patricia A.; Pillay, Deenan

2012-01-01

Abstract In the late 1980s an HIV-1 epidemic emerged in Romania that was dominated by subtype F1. The main route of infection is believed to be parenteral transmission in children. We sequenced partial pol coding regions of 70 subtype F1 samples from children and adolescents from the PENTA-EPPICC network of which 67 were from Romania. Phylogenetic reconstruction using the sequences and other publically available global subtype F sequences showed that 79% of Romanian F1 sequences formed a statistically robust monophyletic cluster. The monophyletic cluster was epidemiologically linked to parenteral transmission in children. Coalescent-based analysis dated the origins of the parenteral epidemic to 1983 [1981–1987; 95% HPD]. The analysis also shows that the epidemic's effective population size has remained fairly constant since the early 1990s suggesting limited onward spread of the virus within the population. Furthermore, phylogeographic analysis suggests that the root location of the parenteral epidemic was Bucharest. PMID:22251065

Condiciones de favorabilidad al maternaje y violencia materna

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Mauricio Hernando Bedoya

2010-10-01

Full Text Available Realizamos un acercamiento al problema de las prácticas de violencia materna hacia los niños y niñas y su impacto en el vínculo materno-filial. Objetivo: reconocer en madres que se nombran como maltratadoras, y en sus hijos e hijas maltratados, el significado dado a su vínculo afectivo. Método: fenomenológico-hermenéutico del enfoque cualitativo con muestra multinivel. Técnicas de Producción de Información: entrevistas en profundidad con madres, grupos focales con sus hijos e hijas y con madres y padres de tres instituciones educativas. Conclusiones: las madres explican la violencia hacia sus hijos e hijas acudiendo a una cadena vincular generacional con su propia madre; las condiciones de favorabilidad al maternaje adversas predicen tal violencia; no todo niño o niña violentado será padre violento o madre violenta y, finalmente, postulamos que existe una tipología de madre violenta.

Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

NARCIS (Netherlands)

Blok, C. de; Schilp, J.; Wagner, C.

2013-01-01

Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

Long-term follow-up of patients on home parenteral nutrition in Europe: implications for intestinal transplantation

DEFF Research Database (Denmark)

Pironi, Loris; Joly, Francisca; Forbes, Alastair

2011-01-01

The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions.......The indications for intestinal transplantation (ITx) are still debated. Knowing survival rates and causes of death on home parenteral nutrition (HPN) will improve decisions....

Nutritional requirements and parenteral nutrition in preterm infants ...

African Journals Online (AJOL)

Provision of appropriate nutritional requirements soon after birth is critical for normal development and growth of preterm infants. Preterm infants are often not able to tolerate volumes of oral feeds that will provide adequate daily requirements for growth within the first week or two of life, therefore parenteral nutrition is often ...

Lactancia materna: impacto de la consulta de apoyo a la madre que trabaja

OpenAIRE

Noy,Soledad Elgueta; Guzmán,Pamela Paz; Masalán,Patricia

1998-01-01

La presente investigación, descriptiva exploratoria, retrospectiva y transversal, pretende responder el siguiente cuestionamiento: ¿ Cuál es el impacto que la Consulta de apoyo a la madre que trabaja, del Centro de Diagnóstico de la Pontificia Universidad Católica de Chile, tiene en la prolongación de la lactancia materna?. La población estudiada la constituyen 82 madres atendidas en la Consulta de apoyo, durante el período de marzo y septiembre de 1995, de las cuales se tomó una muestra de t...

Protocol compliance of administering parenteral medication in Dutch hospitals: an evaluation and cost-estimation of the implementation.

NARCIS (Netherlands)

Schilp, J.; Boot, S.; Blok, C. de; Spreeuwenberg, P.; Wagner, C.

2014-01-01

Objectives: Preventable adverse drug events (ADEs) are closely related to administration processes of parenteral medication. The Dutch Patient Safety Program provided a protocol for administering parenteral medication to reduce the amount of ADEs. The execution of the protocol was evaluated and a

Pediatric parenteral nutrition-associated liver disease and cholestasis: Novel advances in pathomechanisms-based prevention and treatment.

Science.gov (United States)

Orso, Giuseppe; Mandato, Claudia; Veropalumbo, Claudio; Cecchi, Nicola; Garzi, Alfredo; Vajro, Pietro

2016-03-01

Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. Ursodeoxycholic acid has been proposed in patients with cholestatic hepatopathy, but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti TNFα. Lipid emulsions based on fish oil with a high content of long-chain polyunsaturated fatty acids ω-3 appear effective both in decreasing intrahepatic inflammation and in improving biliary flow. Most recent promising variations such as soybean/MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe liver impairment damage (PNALD and PNAC) in patients treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Perfil epidemiológico das mortes maternas ocorridas no Rio Grande do Sul, Brasil: 2004-2007 Epidemiological profile of maternal deaths in Rio Grande do Sul, Brazil: 2004-2007

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Ioná Carreno

2012-06-01

Full Text Available Foi analisado o perfil epidemiológico das mortes maternas ocorridas no período de 2004-2007, no Rio Grande do Sul, através da Razão de Mortalidade Materna e da Razão de Mortalidade Materna Específica. Foram utilizados dados do Sistema de Informações de Saúde, sendo observados 323 óbitos maternos. Para a análise dos indicadores foi empregada a regressão de Poisson e testes estatísticos. Observou-se que no Estado houve um decréscimo na razão de mortalidade materna (0,98, contudo não foram encontradas diferenças nas medidas de estimativas (IC95% 0,87-1,10. A RMME foi maior em mulheres com mais de 40 anos, com baixo nível de escolaridade, de cor preta e sem companheiro. O período de maior estimativa de risco na morte materna foi durante a gravidez e o parto, e entre as principais causas diretas observadas foram constatadas hipertensão arterial e hemorragia. A mortalidade materna é um indicador importante que deve ser enfrentado e reduzido, pois a maior parte dos óbitos pode ser evitada.This study analyzed the epidemiological profile of maternal deaths that occurred from 2004 to 2007 in Rio Grande do Sul, by means of Maternal Mortality Rates and Specific Maternal Mortality Ratio. Data was obtained from the Health Information System database and 323 maternal deaths were identified. In order to analyze indicators, Poisson regression and statistical tests were carried out. A decrease in maternal mortality rates (0.98 was identified, although there was no difference in estimate measures (CI95% 0.87-1.10. Maternal deaths were more frequent in women who were over 40 years old, had low schooling, black skin and no partners. The period of highest risk of maternal death was during pregnancy and birth, and the main direct causes were arterial hypertension and bleeding. Maternal mortality is an important issue to be confronted and reduced, given most maternal deaths could have been avoided.

Differences in essential fatty acid requirements by enteral and parenteral routes of administration in patients with fat malabsorption

DEFF Research Database (Denmark)

Jeppesen, Palle B; Høy, Carl-Erik; Mortensen, Per B

1999-01-01

Background: Essential fatty acid (EFA) requirements of patients receiving home parenteral nutrition (HPN) are uncertain. Objective: The objective was to evaluate the influence of the route of administration (enteral compared with parenteral) on plasma phospholipid EFA concentrations. Design......: Intestinal absorption, parenteral supplement of EFAs, and plasma phospholipid EFA concentrations were investigated in balance studies in 4 groups (A, B, C, and D) of 10 patients with short-bowel syndrome and a fecal loss of >2000 kJ/d. Groups A (fat malabsorption 50%) did...... absorption was negligible in groups C and D. Thus, intestinal absorption of EFAs in group A. corresponded to parenteral EFA supplements in group C, whereas group D was almost totally deprived of EFAs. The median plasma phospholipid concentration of linoleic acid decreased by 21.9%, > 16.3%, >13.8%, 11...

Adverse effects of parenteral dexamethasone in the treatment of pemphigus vulgaris

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Mohammad Jamal Uddin

2016-08-01

Full Text Available Background: Pemphigus vulgaris is associated with high morbidity as well as significant mortality rate. Today the risk of death in pemphigus from the side effect of oral prednisolone is greater than risk of death from the disease itself. Objec­tive: To observe the adverse effects of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Methods: An interventional study was carried out in the department of Dermatology and Venereol­ogy, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty and among them fifteen patients were treated with parenteral dexamethasone (Group-A and other fifteen were treated with oral prednisolone (Group-B. Results: The study showed statistically significant differences of skin lesion as well as mucosal lesion of pemphigus after 6 weeks of therapy between of two groups (P<0.05. The most common adverse effects were increased body weight(40%, increased appetite(40%, and puffy face(40% in dexamethasone group. In prednisolone group, these side effects were 60% of the subjects. Other side effects in dexamethasone group were hyperglycemia (33.33%, hypertension (26.66%, and sleep disturbance (13.33%. In prednisolone group, other side effects were hyperglycemia(33.33%, hypertension(40%, gastritis (33.33%, nausea, vomiting (13.33% in each , reactivation of tuberculosis, herpes zoster infection, sleep disturbance, and mood change were 6.66% in each group. Conclusion: In the light of the findings of the study, we conclude that each of the treatment of dexamethasone group and prednisolone group is individually effective and safe in the treatment of pemphigus vulgaris but adverse effects are less in parenteral dexamethasone group than oral prednisolone group. So parenteral dexamethasone can be used as an alternative drug in the treatment of pemphigus vulgaris.

Adaptação materna ao transtorno do espectro autismo: relações entre crenças, sentimentos e fatores psicossociais = Maternal adaptation to autism spectrum disorder: relationships between beliefs, feelings and psychosocial factors = Adaptación materna al trastorno del espectro autista: las relaciones entre las creencias, los sentimientos y los factores psicosociales

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Meimes, Maíra Ainhoren

2015-01-01

Full Text Available Crenças e sentimentos relacionados ao desenvolvimento do filho com Transtorno do Espectro Autismo (TEA exercem importante papel na adaptação materna. Entretanto, estes fatores nem sempre são compreendidos com base nos aspectos psicossociais associados. Objetivo: investigar crenças e sentimentos de mães de crianças com TEA relacionando-os a fatores psicossociais, com base no metamodelo biopsicossocial de Bradford. Delineamento: estudo de casos múltiplos, transversal e exploratório. Participantes: quatro mães (idade: 38 a 45 anos de meninos com TEA (idades: 3 anos e 5 meses a 6 anos e 9 meses. Instrumentos: Entrevista de Percepção Materna, Entrevista de Dados Demográficos e Desenvolvimento Infantil e Questionário de Saúde Geral de Goldberg (QSG. Resultados: crenças maternas sobre o desenvolvimento infantil, capacidade para identificar habilidades e seu senso de autoeficácia relacionam-se a diversos fatores psicossociais, como percepção dos recursos intra e extrafamiliares, qualidade dos sistemas de saúde. Discute-se que o impacto do diagnóstico pode ser mediado pelos fatores psicossociais

Introduction and methodology – Guidelines on Parenteral Nutrition, Chapter 1

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Jauch, K. W.

2009-11-01

Full Text Available Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/, in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication.

ABORTO TERAPÉUTICO EN NICARAGUA Y EL SALVADOR, LA MORTALIDAD MATERNA Y LOS OBJETIVOS DEL MILENIO

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Adlin Nerissa Bacon Bolaños

2013-10-01

Full Text Available La prohibición total del aborto terapéutico es un problema que no ha permitido brindar atención médica de calidad a mujeres embarazadas. La subsecuente mortalidad materna es una de las consecuencias de esta política. El objetivo de esta investigación documental fue explorar cómo esta prohibición del aborto va influenciar la mortalidad materna.El diseño metodológico fue cualitativo a través de una revisión literaria que trata el tema antes y después que la ley de aborto cambiara. La tesis fue construida con fuentes primarias y secundarias, analizadas críticamente para después ser comparadas con datos dentro del país y entre los países. Los principales hallazgos fueron que la mortalidad materna no se vio afectada por la prohibición del aborto, adicionalmente se redujo en ambos países; sin embargo, sigue siendo elevada en comparación a otras naciones.  La ley de aborto, entre otros factores es una de las causas de mortalidad materna. El Objetivo del Milenio número cinco fue alcanzado por El Salvador, de acuerdo al gobierno, mientras en Nicaragua el progreso para alcanzarlo se mantiene lento. Dentro de estas categorías hay similitudes, diferencias y debates que persisten, ya que el aborto, sea o no terapéutico, es aún un asunto controversial en muchos países.SummaryThe total prohibition of therapeutic abortion is an issue that has not allowed providing medical care with quality to pregnant women. The subsequent maternal mortality is one of the consequences of this policy. The objective of this documentary research was to explore how the prohibition of abortion will influence maternal mortality.We used a qualitative methodology based on literature review that addresses the issue before and after the abortion law changed. The thesis was built with primary and secondary sources, and was critically analyzed to be compared with data within the country and between countries. The main findings were that maternal mortality was not

Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design

OpenAIRE

Mirković, Dušica; Ibrić, Svetlana; Antunović, Mirjana

2013-01-01

Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN) admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5 m and that the presence of greater droplets should not exceed th...

Gluconeogenesis continues in premature infants receiving total parenteral nutrition

Science.gov (United States)

To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...

Anticoagulants for the prevention and treatment of catheter-related thrombosis in adults and children on parenteral nutrition: a systematic review and critical appraisal

NARCIS (Netherlands)

Barco, Stefano; Atema, Jasper J.; Coppens, Michiel; Serlie, Mireille J.; Middeldorp, Saskia

2017-01-01

Patients on parenteral nutrition require a central venous access and are at risk of catheter-related thrombosis, pulmonary embolism, and vena cava syndrome. Parenteral nutrition guidelines suggest anticoagulation for the primary prevention of catheter-related thrombosis during long-term parenteral

Parenteral Antibiotics Reduce Bifidobacteria Colonization and Diversity in Neonates

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Séamus Hussey

2011-01-01

Full Text Available We investigated the impact of parenteral antibiotic treatment in the early neonatal period on the evolution of bifidobacteria in the newborn. Nine babies treated with intravenous ampicillin/gentamicin in the first week of life and nine controls (no antibiotic treatment were studied. Denaturing gradient gel electrophoresis was used to investigate the composition of Bifidobacterium in stool samples taken at four and eight weeks. Bifidobacteria were detected in all control infants at both four and eight weeks, while only six of nine antibiotic-treated infants had detectable bifidobacteria at four weeks and eight of nine at eight weeks. Moreover, stool samples of controls showed greater diversity of Bifidobacterium spp. compared with antibiotic-treated infants. In conclusion, short-term parenteral antibiotic treatment of neonates causes a disturbance in the expected colonization pattern of bifidobacteria in the first months of life. Further studies are required to probiotic determine if supplementation is necessary in this patient group.

Normativa legal de protección a la lactancia materna en Venezuela

OpenAIRE

Niño, Evelyn Mercedes

2013-01-01

El abordaje y defensa de la lactancia materna exige al Pediatra, su participación activa en la implementación de su práctica. Su rol como guía es fundamental para que los infantes reciban una nutrición adecuada, que les garantice un comienzo óptimo en la vida y el derecho al más alto nivel posible de salud, así como también para que las madres dispongan de la información oportuna y veraz, que les permita decidir el modo de alimentar a sus hijos e hijas. Implica que debe ser más que un simple ...

Effects of parenteral administration of enrofloxacin on electrocardiographic parameters in hospitalized dogs

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Carlos Fernando Agudelo Ramírez

2012-01-01

Full Text Available The effect of enrofloxacin on the QT interval of the electrocardiogram was studied in 30 hospitalized dogs. The experimental group (n = 15 received enrofloxacin parenterally (subcutaneously at a dose of 5 mg/kg twice daily and amoxicillin-clavulanate intravenously at a dose of 22 mg/kg three times daily. The control group (n = 15 received only amoxicillin-clavulanate. Electrocardiography was carried out for 5 min once daily for 6 days. The QT interval was corrected by four different formulae. No differences were found between the two groups or within each group for the duration of the study. On the last day of the study the average QT interval for the control and experimental groups was 213.2 ms and 202.9 ms, respectively. Enrofloxacin did not cause prolongation of the QT or corrected QT intervals. We can conclude that the parenteral administration of enrofloxacin in non-cardiac dogs does not adversely affect the electrocardiographic indicators (no prolongation of the QT or corrected QT interval and does not induce ventricular arrhythmias. Parenteral use of enrofloxacin is thus safe and effective in non-cardiac dogs.

Induration at Injection or Infusion Site May Reduce Bioavailability of Parenteral Phenobarbital Administration.

Science.gov (United States)

Nakayama, Hirokazu; Echizen, Hirotoshi; Ogawa, Ryuichi; Akabane, Atsuya; Kato, Toshiaki; Orii, Takao

2017-06-01

Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at the injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection. A retrospective analysis was conducted on the medical data obtained from 18 patients who received chronic subcutaneous or intramuscular injections of phenobarbital for the prevention of convulsions and underwent plasma concentration monitoring of the drug. Patients whose concomitant medications were altered during the observation periods were excluded from the analysis. Comparisons were performed for concentration/dose (C/D) ratios obtained from patients with induration at injection or infusion sites (induration group, n = 6) and those without induration (noninduration group, n = 12). P phenobarbital may be reduced when induration develops at the injection or infusion site in patients treated parenterally by continuous subcutaneous infusion or intramuscular injection.

Parenteral Nutrition in Liver Resection

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Carlo Chiarla

2012-01-01

Full Text Available Albeit a very large number of experiments have assessed the impact of various substrates on liver regeneration after partial hepatectomy, a limited number of clinical studies have evaluated artificial nutrition in liver resection patients. This is a peculiar topic because many patients do not need artificial nutrition, while several patients need it because of malnutrition and/or prolonged inability to feeding caused by complications. The optimal nutritional regimen to support liver regeneration, within other postoperative problems or complications, is not yet exactly defined. This short review addresses relevant aspects and potential developments in the issue of postoperative parenteral nutrition after liver resection.

Taurolidine in Pediatric Home Parenteral Nutrition Patients.

Science.gov (United States)

Hulshof, Emma Claire; Hanff, Lidwien Marieke; Olieman, Joanne; de Vette, Susanna; Driessen, Gert-Jan; Meeussen, Conny; Escher, Johanna Caroline

2017-02-01

To reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients, the use of taurolidine was introduced in the Sophia Children's Hospital in 2011. This introduction led to a reduction in catheter-related bloodstream infections: 12.7/1000 catheter days before the use of taurolidine, compared with 4.3/1000 catheter days afterwards (n = 7) [relative risk = 0.36, 95% confidence interval: 0.20-0.65 (P = 0.018)].

Muerte materna por malaria grave por Plasmodium vivax

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Nancy Arróspide

Full Text Available Se presenta el caso de una mujer de 19 años con 29 semanas de gestación, procedente de Llumpe (Ancash con antecedentes de viajes a las localidades de Chanchamayo (Junín y Rinconada (Ancash. Ingresó al Hospital de Chacas (Ancash por presentar mal estado general, deshidratación, dificultad respiratoria, ictericia, sensación de alza térmica y dolor abdominal, tuvo reporte de: hemoparásitos 60% en frotis sanguíneo. Fue transferida al Hospital Ramos Guardia (Huaraz donde presentó mayor dificultad respiratoria, coluria, hematuria, disminución del débito urinario y reporte de Plasmodium (+, luego fue transferida al Hospital Cayetano Heredia (Lima donde ingresó a la Unidad de Cuidados Intensivos (UCI, con evolución a falla multiorgánica, óbito fetal y muerte materna. Se confirmó infección por Plasmodium vivax. Destacamos la importancia de mejorar nuestras capacidades de diagnóstico y manejo para brindar un tratamiento adecuado y oportuno.

Papel de la abuela en la lactancia materna

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Marta Elena Losa-Iglesias

2013-01-01

(94,7 %, como en el de obstáculo (26,7 %. En cuanto a la decisión de la madre sobre el patrón de alimentación de sus hijos, el 78 % refiere haber tomado la decisión antes del embarazo o en el primer trimestre. La convivencia con la abuela tuvo asociación positiva con dar agua o infusiones (PR regresión de Cox con IC 95 %: 1,51 [1,10-2,09]; p = 0,011. Conclusiones: a la luz de la revisión, la influencia detractora o no que ejerce la abuela sobre la lactancia materna la da sobre los tres factores principales. La influencia detractora ejercida por los consejos de la abuela parece estar relacionada con conocimientos erróneos adquiridos como “generación del biberón” más que con la intencionalidad, y es susceptible de modificarse con información adecuada, con resultados favorables sobre el patrón de alimentación.

Leitura, literatura e tradução: a necessidade de adequações no ensino de línguas não-maternas

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Sergio Flores Pedroso

2006-01-01

Full Text Available Neste artigo, a leitura em línguas não-maternas é abordada pela via do lugar que a literatura ocupa em livros didáticos de espanhol e, mais concretamente, através do gênero narrativa. A interpretação e a consideração da tradução no processo de ensino de línguas não-maternas em geral e da leitura em particular fazem parte dos aspectos problematizados em torno da relação literatura/ensino. Isso porque a premissa de que deriva este trabalho é a de que a língua materna gerencia toda aproximação de outra língua, sendo que isso envolve os componentes ideológicos da linguagem.This paper looks at reading in foreign languages from the place that textbooks of Spanish as a foreign language attribute to literature, especially through the narrative genre. Interpretation and translation are part of the aspects focused on. Two processes, the one of learning and the one of reading, are included within the link between literature and learning. That is because the premise of this paper is that the mother tongue is constituent of the process of foreign language learning. The ideological components of language play a definite role in it.

Complications relating to enteral and parenteral nutrition in trauma ...

African Journals Online (AJOL)

Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...

Síndrome do intestino curto na criança: tratamento com nutrição parenteral domiciliar Short bowel syndrome in children: treatment with home parenteral nutrition

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Uenis Tannuri

2004-09-01

Full Text Available OBJETIVO: Em 1979 o autor utilizou, pela primeira vez no Brasil, a nutrição parenteral prolongada domiciliar em criança. O objetivo deste trabalho é o de apresentar a experiência da utilização deste método no tratamento de crianças com síndrome do intestino curto nos últimos 23 anos. MÉTODOS: Dezenove crianças com esta afecção (ressecção de mais de 75% do comprimento intestinal foram tratadas inicialmente em hospital e a seguir no próprio domicílio. Os períodos totais de terapia nutricional variaram de quatro meses a quatro anos e meio, enquanto que as crianças permaneceram em nutrição parenteral domiciliar por períodos que variaram de uma semana a quatro anos, com mediana de oito meses. As soluções nutrientes completas, contendo aminoácidos, glicose, emulsão lipídica, eletrólitos, vitaminas e micro-elementos foram administradas através de catéteres venosos centrais do tipo Broviac ou Hickman. No domicílio, as soluções foram administradas durante o período diurno ou noturno, segundo a preferência dos familiares. RESULTADOS: Em todos os casos verificou-se ganho ponderal, crescimento e desenvolvimento satisfatórios, semelhantes aos obtidos durante nutrição oral. Obstruções do cateter, alterações hepáticas e infecção devida ao cateter foram as complicações mais freqüentes. Sete crianças (37% sobreviveram e estão fora de tratamento. Doze crianças faleceram (dez com resecção total do intestino delgado, sendo 11 por complicações relacionadas à nutrição parenteral (nove por infecção sistêmica e dois por embolia pulmonar maciça e uma por complicação neurológica, dois meses após transplante duplo de intestino e fígado. CONCLUSÃO: A nutrição parenteral domiciliar em crianças com síndrome do intestino curto traz indiscutíveis benefícios, permite redução do período de internação hospitalar, tornando possível a adaptação funcional do intestino remanescente e manutenção do

La contribución de la violencia a la mortalidad materna en Morelos, México The contribution of violence to maternal mortality in Morelos, Mexico

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Lourdes Campero

2006-01-01

Full Text Available OBJETIVO: Documentar el subregistro de muertes violentas relacionadas con el embarazo y la importancia de considerar, dentro de la definición de mortalidad materna, aquellas muertes producidas también por causas relacionadas con violencia. MATERIAL Y MÉTODOS: El estudio se realizó en el estado de Morelos, a partir de 394 certificados de defunción de mujeres entre 12 y 49 años de edad que murieron a lo largo del año 2001. Con base en una lista de diagnósticos de los certificados de defunción, se excluyeron 167 casos que, por las causas de muerte determinadas en el certificado de defunción, no se consideraron que podrían haber sido muertes maternas ni muertes violentas. Posteriormente se realizó el análisis de los 227 certificados restantes a través de la revisión de expedientes clínicos y/o autopsias verbales. RESULTADOS: Se encontraron 51 muertes violentas. Las estadísticas oficiales señalan que en 2001 hubo 18 muertes maternas, mientras que este estudio identificó 23 muertas maternas directas más cuatro muertas violentas durante el embarazo y el posparto. Es decir, se encontró que el evento reproductivo fue el factor que desencadenó el homicidio o suicidio de cuatro mujeres. Excepto en un caso, este hecho no está señalado ni relacionado en los registros oficiales. CONCLUSIONES: Se recomienda la inclusión de la violencia relacionada con la reproducción en los registros oficiales de mortalidad materna como una causa indirecta. Esto permitiría profundizar la comprensión de las causas de la mortalidad materna y orientaría la elaboración de políticas, programas y servicios de prevención y atención. La autopsia verbal (AV es una técnica que ayuda a la identificación de casos de embarazo y muertes maternas violentas.OBJECTIVE: To document the under-registration of violent deaths related to pregnancy and the importance of considering these violent deaths within the definition of maternal mortality. MATERIAL AND

Efectividad del "apoyo entre iguales" en la promoci??n de la lactancia materna: revisi??n sistem??tica = Systematic review of the effectiveness of breastfeeding counseling over other types of breastfeeding promotion.

OpenAIRE

Beltr??n Mu??oz, Carolina

2016-01-01

Tras el nacimiento, la lactancia materna se convierte en la forma de alimentaci??n natural del reci??n nacido, con m??ltiples beneficios tanto para la madre como para el ni??o. Organismos nacionales e internacionales recomiendan la lactancia materna como alimento exclusivo hasta los seis meses, y en combinaci??n con la alimentaci??n complementaria hasta los dos a??os. A pesar de ello, la proporci??n de lactancia exclusiva en Espa??a disminuye progresivamente durante las primera...

Comportamentos e práticas educativas maternas em famílias de mães solteiras e famílias nucleares Comportamientos y prácticas educativas maternas en familias de madres solteras y familias nucleares Maternal behavior and childrearing practices in single-mother families and two-parent families

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Angela Helena Marin

2007-04-01

Full Text Available O presente estudo investigou as eventuais diferenças nos comportamentos e práticas educativas maternas e no comportamento infantil entre famílias de mães solteiras e famílias nucleares. Participaram da pesquisa quatorze famílias, das quais sete de mães solteiras (mãe-criança e sete de mães casadas (mãe-pai-criança, selecionadas em hospitais e unidades de saúde de Porto Alegre. Estas famílias foram emparelhadas conforme idade, escolaridade e nível socioeconômico. Foi utilizada uma sessão de observação da interação familiar durante um almoço realizado na casa dos participantes, quando as crianças tinham de 30 a 36 meses de idade. Os comportamentos e práticas educativas maternas e os comportamentos infantis foram examinados através de um protocolo envolvendo diversas categorias. O Teste de Mann-Whitney não revelou diferenças significativas entre as famílias para as categorias examinadas. Os resultados sugerem que as configurações familiares investigadas não afetam, necessariamente, os comportamentos e as práticas educativas maternas, nem os comportamentos infantis.El presente estudio investigó las eventuales diferencias en los comportamientos y prácticas educativas maternas y en el comportamiento infantil entre familias de madres solteras y familias nucleares. Participaron de la investigación catorce familias, de las cuales siete de madres solteras (madre-niño y siete de madres casadas (madre-padre-niño, seleccionadas en hospitales y unidades de salud de Porto Alegre. Estas familias fueron organizadas conforme edad, escolaridad y nivel socioeconómico. Fue utilizada una sesión de observación de la interacción familiar durante un almuerzo realizado en la casa de los participantes, cuando los niños tenían de 30 a 36 meses de edad. Los comportamientos y prácticas educativas maternas y los comportamientos infantiles fueron examinados a través de un protocolo envolviendo diversas categorías. El Test de Mann

Pacientes assintomáticos apresentam infecção relacionada ao cateter venoso utilizado para terapia nutricional parenteral Asymptomatic patients present infection related to the central venous catheter used for total parenteral nutrition

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Juliana Deh Carvalho Machado

2009-12-01

Full Text Available OBJETIVO: Avaliar a freqüência de infecção relacionada ao cateter venoso central em pacientes submetidos a terapia nutricional parenteral. MÉTODOS: Foram analisados os cateteres venosos centrais de pacientes em terapia nutricional parenteral que tiveram a indicação de retirada do cateter venoso central por infecção, alta hospitalar, ou trombose. Os pacientes com infecção foram denominados de Grupo 1 e os demais de Grupo 2. RESULTADOS: Não houve diferença estatisticamente significante quanto ao estado nutricional dos 18 pacientes analisados. Foram analisados 28 cateteres e destes 68% estavam infectados, sendo 72% do Grupo 1 e 28% do Grupo 2 (assintomáticos. No Grupo 1, houve infecção sistêmica em 70% dos casos, já no Grupo 2 a hemocultura foi positiva em 17% dos casos. A colonização por Staphylococcus sp. ocorreu em 48% dos casos, seguida de Candida sp. (21%, Enterococcus faecalis (16%, Pseudomonas aerurginosa (10% e Proteus sp.(5%. CONCLUSÃO: A contaminação de cateter venoso central utilizado para terapia nutricional parenteral é freqüente. Mesmo pacientes assintomáticos recebendo nutrição parenteral têm uma incidência maior de infecção por Candida sp. Portanto é necessária a criação de barreiras que impeçam a colonização destes cateteres venosos centrais, a fim de diminuir a morbimortalidade de pacientes dependentes deste tipo de terapia.OBJECTIVE: The aim of this study was to evaluate the frequency of central venous catheter-related infections in hospitalized patients receiving total parenteral nutrition. METHODS: Central venous catheters were analyzed immediately after removal due to infection, hospital discharge or thrombosis. The patients with catheter-related infection were named Group 1 and the other patients were named Group 2. RESULTS: Eighteen patients were studied. There was no statistically significant difference in nutritional status between the two groups. A total of 28 catheters were analyzed

Alteration of lipid metabolism in rats with intestinal syndrome of raiation sickness in conditions of parenteral feeding with lipofundfin and infusolipol

International Nuclear Information System (INIS)

Stepanov, S.A.; Yusupova, I.U.; Grozdov, S.P.

1988-01-01

Local X-irradiation of rat abdomen (13.5 Gy) caused a pronounced intestinal syndrome which was partially coped with by parenteral feeding. The results indicate (1) a satisfactory assimilation of fatty emulsions used at certain doses and with certain parenteral diet composition, (2) a favourable effect of fatty emulsions on lipid metabolism in irradiated rats, and (3) some advantages of the parenteral feeding with infusolipol over lipofundin S

Descanso postnatal parental: experiencia en lactancia materna de madres trabajadoras usuarias del sistema público de salud en la Región de la Araucanía, de Chile

OpenAIRE

Baeza W, Bernardita; Henríquez K, Fabiola; Prieto G, Ruth

2016-01-01

La prevalencia de lactancia materna exclusiva hasta el sexto mes de edad en Chile no supera el 60%, a pesar de la promulgación de la Ley de Descanso Postnatal Parental el año 2011, la cual permite a las madres permanecer con el recién nacido hasta las veinticuatro semanas de vida. El objetivo de este trabajo fue explorar, desde la perspectiva de las madres, cuales son los aspectos involucrados en la duración del periodo de lactancia materna exclusiva. Sujetos y Métodos: Exploración cualitativ...

Safety, cost, and clinical considerations for the use of premixed parenteral nutrition.

Science.gov (United States)

Hall, Jacob W

2015-06-01

Premixed parenteral nutrition (PN) can be used for PN therapy in place of traditional compounded or customized PN. Premixed PN may have a number of advantages over compounded PN such as decreased costs, decreased compounding time, reduced chance for error, and reduced incidence of bloodstream infections. However, premixed PN may not be appropriate for all patients and may have other additional costs associated with its use. This article discusses the data available with regard to the use of premixed PN, focusing on the potential advantages and disadvantages of using premixed PN, and also discusses the implementation of premixed PN in a large tertiary cancer center. © 2015 American Society for Parenteral and Enteral Nutrition.

Vivências maternas associadas ao aleitamento materno exclusivo mais duradouro: um estudo etnográfico Vivencias de madres asociadas a la lactancia materna exclusiva más duradera: un estudio etnográfico Maternal experiences associated with longer term exclusive breastfeeding: an ethnographic study

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Carolina Guizardi Polido

2011-01-01

Full Text Available OBJETIVO: Descrever as experiências da amamentação de mães usuárias do Sistema Único de Saúde buscando, tanto aprender conhecimentos, expectativas, concepções e sentimentos envolvidos como identificar aspectos relevantes para o aleitamento materno exclusivo mais prolongado. MÉTODOS: Estudo qualitativo de cunho etnográfico realizado com oito primíparas e familiares de referência, mediante observação e entrevistas domiciliares durante o 1º semestre de vida dos bebês. Os dados foram sistematizados em três categorias: Iniciando a amamentação; Vivenciando o processo de desmame precoce; Mantendo o aleitamento materno exclusivo. RESULTADOS: A amamentação apresentou-se como evento particular nos diferentes contextos de sua ocorrência, porém foi possível identificar que o aleitamento exclusivo esteve ligado à determinação materna, a despeito das dificuldades vividas. O aleitamento materno exclusivo mais duradouro relacionou-se às mães que se mostraram motivadas com a prática, cientes de seus benefícios e apoiadas pela família, mesmo diante de interferência contrária de seu meio cultural. CONCLUSÃO: A ausência de determinação materna em amamentar exclusivamente deve ser investigada e, quando presente, receber abordagem especial pelos profissionais de saúde.OBJETIVO: Describir las experiencias del amamantamiento de madres usuarias del Sistema Único de Salud buscando, tanto aprender conocimientos, expectativas, concepciones y sentimientos involucrados como identificar aspectos relevantes para la lactancia materno exclusiva más prolongada. MÉTODOS: Estudio cualitativo de cuño etnográfico realizado con ocho primíparas y familiares de referencia, mediante observación y entrevistas domiciliarias durante el 1º semestre de vida de los bebés. Los datos fueron sistematizados en tres categorías: Iniciando el amamantamiento; Vivenciando el proceso de destete precoz; Manteniendo La lactancia materna exclusiva

Surgery and transplantation – Guidelines on Parenteral Nutrition, Chapter 18

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Holland-Cunz, S.

2009-11-01

Full Text Available In surgery, indications for artificial nutrition comprise prevention and treatment of catabolism and malnutrition. Thus in general, food intake should not be interrupted postoperatively and the re-establishing of oral (e.g. after anastomosis of the colon and rectum, kidney transplantation or enteral food intake (e.g. after an anastomosis in the upper gastrointestinal tract, liver transplantation is recommended within 24 h post surgery. To avoid increased mortality an indication for an immediate postoperatively artificial nutrition (enteral or parenteral nutrition (PN also exists in patients with no signs of malnutrition, but who will not receive oral food intake for more than 7 days perioperatively or whose oral food intake does not meet their needs (e.g. less than 60–80% for more than 14 days. In cases of absolute contraindication for enteral nutrition, there is an indication for total PN (TPN such as in chronic intestinal obstruction with a relevant passage obstruction e.g. a peritoneal carcinoma. If energy and nutrient requirements cannot be met by oral and enteral intake alone, a combination of enteral and parenteral nutrition is indicated. Delaying surgery for a systematic nutrition therapy (enteral and parenteral is only indicated if severe malnutrition is present. Preoperative nutrition therapy should preferably be conducted prior to hospital admission to lower the risk of nosocomial infections. The recommendations of early postoperative re-establishing oral feeding, generally apply also to paediatric patients. Standardised operative procedures should be established in order to guarantee an effective nutrition therapy.

[Domiciliary parenteral antibiotic therapy: a prospective analysis of the last 12 years].

Science.gov (United States)

Peláez Cantero, M J; Madrid Rodríguez, A; Urda Cardona, A L; Jurado Ortiz, A

2014-08-01

Parenteral antibiotic treatment has been classically developed in hospitals and is considered as a hospital procedure. The development of Hospital at Home Units (HHU) has led to an increase in outpatient parenteral antibiotic therapy (OPAT) in paediatrics patients. The objective of this study is to describe our experience, as an HHU integrated within a Paediatric Department, in home antimicrobial therapy over a period of 12 years. This prospective and descriptive study included every patient with a disease requiring parenteral antimicrobial therapy who was admitted to our HHU from January 2000 to December 2012. During the study there were 163 cases on OPAT. The mean age of the patients was 11.1 years, and the sample group was comprised of 33 males and 22 feamales. The main sources of the treated infections were respiratory tract (76%), catheter-related bloodstream (9.2%), and urinary tract infections (5.5%). Amikacin was the most widely used antibiotic. Almost all treatments (96.6%) were via an intravenous route. Catheter-associated complications were more common than drug-associated complications. Successful at-home treatment was observed in 90.2% of cases. OPAT is a good and safe alternative in many paediatric diseases. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Cost analysis of premixed multichamber bags versus compounded parenteral nutrition: breakeven point.

Science.gov (United States)

Bozat, Erkut; Korubuk, Gamze; Onar, Pelin; Abbasoglu, Osman

2014-02-01

Industrially premixed multichamber bags or hospital-manufactured compounded products can be used for parenteral nutrition. The aim of this study was to compare the cost of these 2 approaches. Costs of compounded parenteral nutrition bags in an university hospital were calculated. A total of 600 bags that were administered during 34 days between December 10, 2009 and February 17, 2010 were included in the analysis. For quality control, specific gravity evaluation of the filled bags was performed. It was calculated that the variable cost of a hospital compounded bag was $26.15. If we take the annual fixed costs into consideration, the production cost reaches $36.09 for each unit. It was estimated that the cost for the corresponding multichamber bag was $37.79. Taking the fixed and the variable costs into account, the breakeven point of the hospital compounded and the premixed multichamber bags was seen at 5,404 units per year. In specific gravity evaluation, it was observed that the mean and interval values were inside the upper and lower control margins. In this analysis, usage of hospital-compounded parenteral nutrition bags showed a cost advantage in hospitals that treat more than 15 patients per day. In small volume hospitals, premixed multichamber bags may be more beneficial.

Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data.

Science.gov (United States)

Santarpia, Lidia; Bozzetti, Federico

2018-02-01

Since there is no information regarding quality of life of caregivers assisting patients with advanced malignancy on home parenteral nutrition, herewith we report a preliminary series of 19 patients who received total parenteral nutrition at home under the strict supervision of their relatives. The relatives of 19 incurable patients with cancer-related cachexia, discharged from the hospital with a home parenteral nutrition program, were prospectively studied. They filled out a validated questionnaire, the Family Strain Questionnaire Short Form, prior to patient discharge and after 2 weeks of home care. The questionnaire included 30 items, which explored different domains regarding the superimposed burden on caregivers in relation to the assistance given to their relatives. Our findings show that the basal level of strain was relatively high (about three quarters of positive answers) but did not increase after 2 weeks of home care. Similarly, there was no difference in the nutritional status and quality of life of the patients. Eight patients and their relatives could be also analyzed after 2 months and the results maintained unchanged. This preliminary investigation shows that home parenteral nutrition does not exacerbate the level of strain on caregivers involved in surveillance of such a supportive intervention. It is possible that the perception of an active contribution to the benefit of patients, who maintained unchanged their nutritional status and quality of life, could gratify caregivers despite the objective burden in the constant supervision of administering Parenteral Nutrition.

Lactancia materna en bebés pretérminos: cuidados centrados en el desarrollo en el contexto palestino Breast feeding in premature babies: development-centered care in Palestine

OpenAIRE

M. J. Aguilar Cordero; S. M. Batran Ahmed; C. A. Padilla López; R. Guisado Barrilao; C. Gómez García

2012-01-01

El contacto precoz piel a piel provee beneficios para la madre y para el bebé, además de tener un papel importante en el establecimiento de la lactancia materna. Objetivo: El objetivo de este estudio fue informar a las madres de bebés pretérmino sobre la importancia del contacto piel con piel para la implantación de la lactancia materna y para un mejor vínculo entre ellos (cuidados centrados en el desarrollo CCD). Material y método: Se realizó un estudio de cohorte, prospectivo, en varios Hos...

Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure

DEFF Research Database (Denmark)

Brandt, Christopher Filtenborg; Tribler, Siri; Hvistendahl, Mark

2018-01-01

BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and conseque...

Behavioral and dermatologic changes and low serum zinc and copper concentrations in two premature infants after parenteral alimentation.

Science.gov (United States)

Sivasubramanian, K N; Henkin, R I

1978-11-01

Two premature infants were observed to develop behavioral and dermatologic changes and low serum zinc and copper concentrations following cessation of prolonged parenteral alimentation, while being fed exclusively with human milk. Following treatment with exogenous oral zinc supplementation, prompt relief of symptoms and increases of serum zinc and copper concentrations were observed in both infants. These patients comprise about 5% of our premature infants who are treated with parenteral alimentation for more than two weeks. We recommend that premature infants on prolonged parenteral alimentation should be monitored for changes in serum zinc and copper concentrations and, if a marked fall is observed, supplementation should be considered.

Results of home parenteral nutrition in patients with severe inflammatory bowel disease - an alternative for surgery of malnourished patients.

Science.gov (United States)

Turkot, Maryla; Sobocki, Jacek

2017-10-31

In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications. A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn's disease or ulcerative colitis. Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work. Home parenteral nutrition positively affects patient's general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.

A prova de trabalho de parto aumenta a morbidade materna e neonatal em primíparas com uma cesárea anterior?

Directory of Open Access Journals (Sweden)

Matias Jacinta Pereira

2003-01-01

Full Text Available OBJETIVO: comparar a morbidade materna e os resultados neonatais, bem como algumas características clínicas e epidemiológicas de primíparas com uma cesárea anterior, segundo a realização de cesárea eletiva (CE ou prova de trabalho de parto (PTP no segundo parto. PACIENTES E MÉTODO: trata-se de estudo de corte transversal retrospectivo do segundo parto em mulheres com uma cesárea prévia, atendidas no Centro de Atenção Integral à Saúde da Mulher (CAISM/UNICAMP, no período de 1986 a 1998. Os dados foram obtidos de 2068 prontuários clínicos que correspondiam a 322 casos de CE e 1746 de PTP. A análise dos dados foi realizada pela distribuição percentual dos casos de CE e PTP e das categorias das variáveis nestes dois grupos, com a diferença estatística avaliada pelos testes chi2, chi2 para tendência (chi2 trend e exato de Fisher, com nível de significância de 95%. RESULTADO: a indicação de CE diminuiu progressivamente com o tempo, passando de 22,6% em 1986 para 5% em 1998. A morbidade materna foi semelhante e reduzida nos dois grupos (1,24 e 1,21%. Não houve diferença significativa entre os grupos quanto ao índice de Apgar e natimortalidade, mas notou-se proporção significativamente maior de RN prematuros e com peso 4.000 g no grupo submetido à CE. A prevalência de CE foi significativamente maior em mulheres com idade >35 anos, história pregressa ou atual de síndrome hipertensiva, diabetes ou primeiro filho morto, bem como com alterações no volume do líquido amniótico. CONCLUSÕES: A realização da PTP aumentou progressivamente ao longo dos treze anos, sem aumento na morbidade materna e/ou neonatal. As indicações de CE obedeceram critério médico relacionado às condições clínicas maternas e/ou fetais desfavoráveis ao parto vaginal.

Use of parenteral glucocorticoids and the risk of new onset type 2 diabetes mellitus : A case-control study

NARCIS (Netherlands)

Keyany, Ala; Nielen, Johannes T H; Souverein, Patrick C.; de Vries, Frank; van den Bemt, Bart

2018-01-01

Background: Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type 2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data on the effect of parenteral GC use on T2DM. Objective: To assess the association between use of parenteral GCs and the risk

¿Mejora el bono de desarrollo humano la lactancia materna exclusiva en Ecuador?

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César Carranza Barona

2015-01-01

Full Text Available En este artículo se evalúa el impacto del Bono de Desarrollo Humano en Ecuador sobre la adopción de prácticas saludables de ali - mentación y nutrición, específicamente en el cumplimiento de la norma internacional sobre lactancia materna exclusiva propuesta por la organización Mundial de la Salud ( OMS . Mediante la técnica econométrica de evaluación de impacto, denominada regresión discontinua difusa, se encontró que el Bono de Desarrollo Humano no tiene impacto significativo en la adopción de esta norma por parte de sus beneficiarios

Lipid emulsions in parenteral nutrition: does one size fits all ...

African Journals Online (AJOL)

Dietary lipids significantly contribute to preserve the efficiency of human metabolism and restore it during disease. Therefore, in the absence of absolute contraindications, it would not appear reasonable to exclude lipid emulsions when prescribing parenteral nutrition (PN). The metabolic role of lipids has been elucidated, ...

Hipertiroidismo en gestación: Clínica, morbi-mortalidad materna, fetal y perinatal.

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Hermógenes Palacios Porras

1995-04-01

Full Text Available Objetivo: Determinar la prevalencia y características clínicas del hipertiroidismo en gestantes y definir la influencia de hipertiroidismo sobre la morbimortalidad materna, fetal y perinatal. Material y métodos: Se incluyeron 29 pacientes con diagnóstico de hipertiroidismo y gestación, que cumplieron los criterios de inclusión. Las pacientes fueron divididas en dos grupos, hipertiroidismo compensado durante toda o la mayor parte de la gestación (Grupo I, n=11 y con hipertiroidismo no compensado (Grupo II, n=18. Resultados: La prevalencia de hipertiroidismo y gestación fue de 0.03%. La enfermedad de Graves estuvo presente en el 96.5% de los casos; el 62% cursó con náuseas y vómitos y el 90% con bocio de 40 a 60 gramos. Comparando los grupos I y II, observamos en este último, una mayor frecuencia cardíaca y una menor ganancia de peso (p<0.001 y p<0.0002, respectivamente. Los productos del grupo II, tuvieron un mayor índice de prematuridad (5 de 7 y de bajo peso al nacer (p<0.0003; todos los abortos (4, óbitos (2 y malformaciones congénitas (2, se presentaron en este grupo. El tratamiento recibido fue metimazol a dosis variable (10 a 30 mg/día, no encontramos efectos deletéreos importantes atribuibles al tratamiento. Conclusiones: El hipertiroidismo mal controlado durante la gestación produce mayor morbimortalidad materna, fetal y perinatal. (Rev Med Hered 1995; 6: 107-114.

Management of Ready-to-Use Parenteral Nutrition in Newborns: Systematic Review.

Science.gov (United States)

Mena, Karen Daniela Romero; Espitia, Olga Lucia Pinzón; Vergara, José Alejandro Daza

2018-04-27

Parenteral support has increased the possibility of neonatal recovery. However, complications associated with its use have been documented. One commercial method developed to decrease the complications of this type of support is the ready-to-use parenteral nutrition (PN), a 3-chamber bag that provides a complete nutrient mix. This systematic review seeks, through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, to establish the benefits in newborns. Seven databases and gray literature were used. The search was limited to publications from 2007-2017 and to articles written in English, Spanish, and Portuguese. Articles that did not meet the inclusion criteria and studies with low quality evaluated with the Scottish Intercollegiate Guidelines Network guidelines, which were without information about the study or analytical methods, were excluded. A total of 24,193 articles were obtained, which were initially evaluated by title and abstract according to the inclusion criteria. A total of 24,167 articles were discarded, obtaining 27 eligible for follow-up evaluation. After a detailed evaluation of the full text, 13 articles were selected. It was found that ready-to-use PN has the potential benefit to reduce the risks for infections, provide an adequate supply of nutrients, generate growth within the expected range, provide ease of use, decrease prescription errors, and potentially reduce costs. It is necessary to evaluate the short- and long-term impact of its use. © 2018 American Society for Parenteral and Enteral Nutrition.

Comparison of the effects of enteral feeding with continuous and intermittent parenteral nutrition on hepatic triglyceride secretion in human beings

International Nuclear Information System (INIS)

Isabel-Martinez, L.; Skinner, C.; Parkin, A.; Hall, R.I.

1989-01-01

Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion

La consejería en lactancia materna exclusiva: de la teoría a la práctica

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Gloria Yaneth Pinzón Villate

2016-04-01

El conocimiento de las bases teóricas de la consejería permite orientar el acompañamiento a la madre para promover el inicio de la lactancia materna y la exclusividad hasta los seis meses de edad. Del mismo modo, es necesario tener en cuenta los retos que conlleva el pasar de la teoría a la práctica en el contexto colombiano.

Responsividade materna e teoria do apego: uma discussão crítica do papel de estudos transculturais Maternal responsiveness and attachment theory: a critical discussion of the role of cross-cultural studies

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Adriana F. Paes Ribas

2004-01-01

Full Text Available A responsividade materna tem sido considerada como um elemento central para a compreensão do desenvolvimento infantil e este conceito tem sido articulado com a teoria do apego. Este artigo tem como objetivo discutir criticamente o papel de estudos transculturais sobre responsividade materna, à luz da teoria do apego, a partir da revisão da literatura recente sobre o tema. Considerando a teoria do apego um referencial valioso para investigações sobre interações mãe-bebê e responsividade materna, as conclusões apontam, basicamente, para três questões: 1 a teoria do apego precisa ser investigada em diferentes contextos socioculturais e receber validação transcultural; 2 pesquisas sobre responsividade materna devem considerar a discussão sobre a teoria do apego e diferenças culturais; 3 a inclusão do estudo da responsividade materna em referenciais teóricos que levem em conta variáveis socioculturais é necessária.Maternal responsiveness has been considered as an important concept for the understanding of different aspects of infant development, and this concept has been articulated with attachment theory. The objective of this article is to discuss critically the role of transcultural studies about maternal responsiveness, based on attachment theory, and to review of the recent literature about this subject. Considering attachment a valuable theoretical basis for investigations on mother-infant interactions and maternal responsiveness, the conclusions basically point to three issues: 1 the attachment theory needs to be investigated in different socio-cultural contexts, to be tested in its limits and to receive a transcultural validation; 2 research on maternal responsiveness should take into account the discussion on attachment theory and cultural differences; 3 the inclusion of the study of maternal responsiveness in a theoretical framework that takes into account socio-cultural variables is necessary.

Hepatology – Guidelines on Parenteral Nutrition, Chapter 16

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Plauth, M.

2009-11-01

Full Text Available Parenteral nutrition (PN is indicated in alcoholic steatohepatitis (ASH and in cirrhotic patients with moderate or severe malnutrition. PN should be started immediately when sufficientl oral or enteral feeding is not possible. ASH and cirrhosis patients who can be sufficiently fed either orally or enterally, but who have to abstain from food over a period of more than 12 hours (including nocturnal fasting should receive basal glucose infusion (2–3 g/kg/d. Total PN is required if such fasting periods last longer than 72 h. PN in patients with higher-grade hepatic encephalopathy (HE; particularly in HE IV° with malfunction of swallowing and cough reflexes, and unprotected airways. Cirrhotic patients or patients after liver transplantation should receive early postoperative PN after surgery if they cannot be sufficiently rally or enterally nourished. No recommendation can be made on donor or organ conditioning by parenteral administration of glutamine and arginine, aiming at minimising ischemia/reperfusion damage. In acute liver failure artificial nutrition should be considered irrespective of the nutritional state and should be commenced when oral nutrition cannot be restarted within 5 to 7 days. Whenever feasible, enteral nutrition should be administered via a nasoduodenal feeding tube.

AVALIAÇÃO DA AUTOEFICÁCIA MATERNA PARA A PREVENÇÃO DA DIARREIA INFANTIL

OpenAIRE

Taís Capistrano Lopes; Anne Fayma Lopes Chaves; Emanuella Silva Joventino; Rebeca Silveira Rocha; Ana Rita Pimentel Castelo; Mônica Oliveira Batista Oriá

2013-01-01

El objetivo fue evaluar la autoeficacia para prevenir la diarrea infantil entre madres de niños de Quixadá-Ceará, Brasil. Estudio descriptivo, cuantitativo, en tres Unidades Básicas de Salud de Quixadá-CE, de marzo a mayo de 2012. Se entrevistaron 150 madres de niños menores de cinco años, mediante formulario sociodemográfico y Escala de Autoeficacia Materna para Prevención de la Diarrea Infantil. 51,3% de los niños tuvieron diarrea, 89% de las madres presentaron niveles menores de autoeficac...

El dominio de la lengua materna, una necesidad para el aprendizaje de la lengua inglesa

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lraida Quevedo Palomo

2017-11-01

Full Text Available En el artículo se hace una reflexión acerca del papel de la lengua materna en el proceso de enseñanza aprendizaje del inglés para lograr una buena comunicación, y la necesidad de alcanzar un dominio más pleno de ella, fundamentalmente en los estudiantes de la carrera de Lengua Inglesa. Se hace referencia al reto que tienen los docentes de inglés para lograr una nivelación que les permita avanzar en su programa de estudio

Mortalidade materna na cidade de Campinas, no período de 1992 a 1994 Maternal mortality in Campinas, during the period 1992 - 1994

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Mary Angela Parpinelli

1999-05-01

Full Text Available Objetivos: identificar e investigar as causas de mortes maternas ocorridas no município de Campinas, no período de 1992 a 1994. Métodos: foram selecionadas 204 declarações de óbito (DO, cuja causa de morte foi materna declarada e/ou presumível, dentre as 1.032 DO de mulheres de 10 a 49 anos, correspondentes ao total de mortes nesta faixa etária, ocorridas no período. Realizou-se investigação complementar em prontuários hospitalares, nos Serviços de Verificação de Óbito e em domicílios. Resultados: foram confirmadas 20 mortes maternas, o que correspondeu a uma razão de mortalidade materna (RMM de 42,2 mortes por 100.000 nascidos vivos. As causas obstétricas diretas foram responsáveis por 85% dos óbitos (17 casos. As complicações do aborto foram a principal causa de morte (7 casos, seguidas por hemorragias (4 casos, pré-eclâmpsia (3 casos e infecção puerperal (3 casos. Conclusões: apesar do aparente progresso quanto à redução de óbitos maternos por síndromes hipertensivas na gravidez, que constituíam a primeira causa em períodos anteriores, não houve redução da RMM no período estudado. Passaram a predominar, entretanto, as causas relacionadas às complicações do aborto. A maior cobertura e eficiência dos programas de planejamento familiar, além da necessária implantação de real vigilância epidemiológica da morte materna, bem como proteção social mais eficiente à grávida, mãe e recém-nascidos, poderá reduzir a ocorrência de morte materna e, em especial, as decorrentes de aborto.Purpose: to identify and investigate the causes of maternal death that occurred in Campinas from 1992 to 1994. Methods: a total of 204 death certificates (DC whose causes of death were maternal (declared and/or presumed were selected among the 1032 DC's of 10 to 49 year-old women. A complementary investigation was performed consulting hospital records, Death Survey Units, and households. Results: a total of 20 maternal

Characteristics of medication errors with parenteral cytotoxic drugs

OpenAIRE

Fyhr, A; Akselsson, R

2012-01-01

Errors involving cytotoxic drugs have the potential of being fatal and should therefore be prevented. The objective of this article is to identify the characteristics of medication errors involving parenteral cytotoxic drugs in Sweden. A total of 60 cases reported to the national error reporting systems from 1996 to 2008 were reviewed. Classification was made to identify cytotoxic drugs involved, type of error, where the error occurred, error detection mechanism, and consequences for the pati...

Comparison between Total Parenteral Nutrition Vs. Partial Parenteral Nutrition on Serum Lipids Among Chronic Ventilator Dependent Patients; A Multi Center Study.

Science.gov (United States)

Radpay, Rojan; Poor Zamany Nejat Kermany, Mahtab; Radpay, Badiozaman

2016-01-01

Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method. 97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14. We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (pnutritional status in each groups. This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.

Baixo peso ao nascer e condições maternas no pré-natal Bajo peso al nacer y condiciones maternas en el período prenatal Low birth weight and maternal conditions in pre-natal

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Áurea Tamami Minagawa

2006-12-01

Full Text Available Para verificar como o peso ao nascer se relaciona às condições maternas de trabalho, pré-natal, nutricionais (altura, peso inicial, final e ganho na gestação e sócio-econômico-demográficas (idade, situação conjugal, escolaridade, renda familiar, o presente estudo foi realizado na área de abrangência do Hospital Universitário da Universidade de São Paulo e a amostra foi constituída por 101 crianças. A ocorrência de baixo peso ao nascer (BPN foi de 5,1% e não se associou com o trabalho materno, nem com o pré-natal, porém mostrou associação significativa com as seguintes variáveis maternas: ganho de peso na gestação inferior a 7 kg, idade menor que 20 anos e não ter companheiro. Apesar da baixa ocorrência de BPN, os resultados evidenciaram a importância do pré-natal para reduzir a ocorrência de BPN, especialmente por meio do controle do ganho de peso na gestação, controle da gestação na adolescência e também priorizando a atenção das mulheres sem companheiro.El presente estudio realizado en la jurisdicción del Hospital Universitario de la Universidad de Sao Paulo tuvo como objetivo verificar cómo el peso al nacer se relaciona a las condiciones maternas de trabajo, el período prenatal, nutricionales (altura, peso inicial, final y ganancia en la gestación y socio-económico-demográficas (edad, situación conyugal, escolaridad, ingreso familiar. La muestra estuvo constituida por 101 niños. La ocurrencia de bajo peso al nacer (BPN fue del 5,1% y no se asoció con el trabajo materno, ni con el prenatal, sin embargo mostró asociación significativa con las siguientes variables maternas: ganancia de peso en la gestación inferior a 7 kg, edad menor a 20 años y no tener compañero. A pesar de la baja ocurrencia de BPN, los resultados evidenciaron la importancia del control prenatal para reducir la ocurrencia de BPN, especialmente por medio del control de ganancia de peso en la gestación, control de la gestaci

La epidemia del zika beneficia a la salud materna?

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Alberto Rizo-Gil

2016-02-01

Full Text Available En Colombia se reportan entre 550.000 y 700.000 nacimientos en 12 meses según estimaciones basadas en las tendencias de natalidad del primer decenio del siglo XXI. Según registros estadísticos y proyecciones de estudios recientes , en el país se reporto un promedio anual de 476 muertes de mujeres embarazadas entre 2005 y 2012, por diversas causas. El Análisis de Situación de Salud (asis del Ministerio de Salud reportó en 2012 una razón de mortalidad (rmm de 65.89 muertes maternas anuales por cada 100.000 nacimientos, cifra en descenso pero que no se compadece con el estado de desarrollo de Colombia. Si se compara la rmm del país con las de Cuba, Costa Rica o Chile, se podrá ver cuánto estos países, con bajas cifras de la rmm, (< 22 x 100.000 nos aventajan en el cuidado de la mujer durante su gestación, el parto y el puerperio.

An Overview of Chitosan Nanoparticles and Its Application in Non-Parenteral Drug Delivery

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Munawar A. Mohammed

2017-11-01

Full Text Available The focus of this review is to provide an overview of the chitosan based nanoparticles for various non-parenteral applications and also to put a spotlight on current research including sustained release and mucoadhesive chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer regarded as safe for human dietary use and approved for wound dressing applications. Chitosan has been used as a carrier in polymeric nanoparticles for drug delivery through various routes of administration. Chitosan has chemical functional groups that can be modified to achieve specific goals, making it a polymer with a tremendous range of potential applications. Nanoparticles (NP prepared with chitosan and chitosan derivatives typically possess a positive surface charge and mucoadhesive properties such that can adhere to mucus membranes and release the drug payload in a sustained release manner. Chitosan-based NP have various applications in non-parenteral drug delivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drug delivery to the brain and ocular infections which will be exemplified in this review. Chitosan shows low toxicity both in vitro and some in vivo models. This review explores recent research on chitosan based NP for non-parenteral drug delivery, chitosan properties, modification, toxicity, pharmacokinetics and preclinical studies.

[Indication and effectiveness of endoscopic percutaneous gastrostomy as a route of parenteral alimentation for the home care patient].

Science.gov (United States)

Ueda, T; Hida, S; Higasa, K; Shinomiya, S; Matsumoto, T; Fukuoka, K; Yamanaka, E; Ozaki, S; Takayama, E

2000-12-01

We are managing 8 home care patients who have a gastrostomy made using an endoscopic percutaneous technique as a route of parenteral alimentation. Based on our experience, the preconditions for an endoscopic percutaneous gastrostomy as a route of parenteral alimentation are 1. normal gastrointestinal function, 2. difficulty in swallowing, 3. possibility that the caregiver can manage the gastrostomy. When we performed an endoscopic percutaneous gastrostomy as a route of parenteral alimentation for 8 home care patients, we obtained the several advantages mentioned below. 1. Swallowing pneumonia was prevented. 2. Adequate amount of alimental liquid could be infused. 3. Patient could take a bath or shower with the gastrostomy, and good QOL was realized. 4. The home care patient with the gastrostomy could have a satisfactorily long life.

Percepción materna de leche insuficiente y lactogénesis II: Factores de riesgo en el postparto temprano y relación con el abandono prematuro de la lactancia.

OpenAIRE

Oliva Pérez, José

2017-01-01

Antecedentes: La lactancia materna es la alimentación idónea para cualquier neonato, recomendándose de manera exclusiva hasta los 6 meses de edad, y hasta los dos años o más junto con alimentación complementaria. Este tipo de alimentación aporta conocidos beneficios dosis dependiente al lactante y también a la madre. A pesar de las recomendaciones internacionales, a nivel mundial sólo el 37% de los bebés menores de 6 meses son alimentados con lactancia materna exclusiva, y en España el 28...

Recent developments in protein and peptide parenteral delivery approaches

Science.gov (United States)

Patel, Ashaben; Cholkar, Kishore; Mitra, Ashim K

2014-01-01

Discovery of insulin in the early 1900s initiated the research and development to improve the means of therapeutic protein delivery in patients. In the past decade, great emphasis has been placed on bringing protein and peptide therapeutics to market. Despite tremendous efforts, parenteral delivery still remains the major mode of administration for protein and peptide therapeutics. Other routes such as oral, nasal, pulmonary and buccal are considered more opportunistic rather than routine application. Improving biological half-life, stability and therapeutic efficacy is central to protein and peptide delivery. Several approaches have been tried in the past to improve protein and peptide in vitro/in vivo stability and performance. Approaches may be broadly categorized as chemical modification and colloidal delivery systems. In this review we have discussed various chemical approaches such as PEGylation, hyperglycosylation, mannosylation, and colloidal carriers including microparticles, nanoparticles, liposomes, carbon nanotubes and micelles for improving protein and peptide delivery. Recent developments on in situ thermosensitive gel-based protein and peptide delivery have also been described. This review summarizes recent developments on some currently existing approaches to improve stability, bioavailability and bioactivity of peptide and protein therapeutics following parenteral administration. PMID:24592957

Comparação dos efeitos da estimulação elétrica nervosa transcutânea e da hidroterapia na dor, flexibilidade e qualidade de vida de pacientes com fibromialgia Comparison of transcutaneous electrical nerve stimulation and hydrotherapy effects on pain, flexibility and quality of life in patients with fibromyalgia

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Tatiana Fernandes Gomes da Silva

2008-01-01

Full Text Available Este estudo visou comparar a eficácia da hidroterapia e da estimulação elétrica transcutânea do nervo (TENS na melhora da sintomatologia de pacientes com fibromialgia Participaram do estudo 10 sujeitos com fibromialgia (48,8±9,8 anos divididos em dois grupos: um tratado com hidroterapia e outro com TENS. Todos foram avaliados antes e após o tratamento quanto à flexibilidade (pelo índice terceiro dedo-solo, dor (por escala visual-analógica, qualidade de vida relacionada à saúde (pelos questionários SF-36 e Nottingham Health Profile - NHP e tendência à depressão (pelo Inventário de Beck. Os dados foram tratados estatisticamente, com nível de significância fixado em pThe purpose of this study was to compare the effects of hydrotherapy and of transcutaneous electric nerve stimulation (TENS on symptomology of patients with fibromyalgia. Ten subjects (aged 48.8±9.8 years with fibromyalgia were divided into two groups, one treated with hydrotherapy, the other with TENS. All were evaluated before and after treatment as to flexibility (by means of the fingertip-to-floor test, pain (by visual analogue scale, health-related quality of life (by the SF-36 and the Nottingham Health Profile - NHP - questionnaires and trend to depression (by the Beck's Depression Inventory. Data were statistically analysed, and significance level set at p<0.05. Results show that patients treated with TENS had significant pain reduction and better quality of life as measured by the SF-36 and some NHP items, while patients treated with hydrotherapy showed improvement in SF-36 scores. It may hence be said that both treatments were efficient in improving physical functioning, but TENS produced better results in relieving pain and in a greater number of variables, suggesting that it is more efficient for treating fibromyalgia.

Complicaciones maternas en adolescentes y adultas afiliadas al régimen subsidiado, 2012 / Maternal Complications in Adolescents and Adults Affiliated to the subsidized regime, 2012

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Lina M. Díaz B.

2015-09-01

Full Text Available RESUMEN La intervención de las complicaciones maternas y la minimización de sus efectos en la salud materno-infantil es prioridad para el cuidado en salud de esta población. La identificación de factores asociados a la complicación materna es de vital importancia para definir políticas y estrategias de intervención de esta problemática. Objetivo: determinar los factores asociados a complicaciones durante el tercer trimestre del embarazo, parto y puerperio de las maternas pertenecientes al régimen subsidiado atendidas en una institución de segundo nivel de complejidad de Medellín. Metodología: investigación de cohorte ambiespectivo, que tiene como factor de exposición la edad (expuesto: adolescentes entre 14 y 19 años, no expuesto: entre 20 y 34 años de edad y la complicación materna. Se calcularon frecuencias absolutas y relativas para las variables cualitativas y media, mediana y rango intercuartílico para las variables cuantitativas, se calculó proporción de incidencia de las complicaciones y el riesgo relativo crudo y ajustado por variables de confusión. Resultados: el principal factor de riesgo asociado a complicación materna fue la atención prenatal inadecuada (criterio de Kessner. Se encontró como factor protector la asistencia al curso psicoprofiláctico. Conclusión: no se encontraron grandes diferencias entre la población adolescente y adulta, pero sí se identificaron aspectos sociales (relaciones familiares, educacionales y de atención en salud que pueden afectar la salud materna de la población del régimen subsidiado atendida por una institución de segundo nivel de complejidad./ Abstract The intervention of maternal complications and the minimization of its impact on mother and child health is a priority for this population's health care. Identifying factors associated with maternal complications is critical to devising policies and intervention strategies against this problem. Objective: to determine the

Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat.

Science.gov (United States)

Knodell, R G; Spector, M H; Brooks, D A; Keller, F X; Kyner, W T

1980-12-01

Recent in vitro observations suggest that the intestine, in addition to the liver, may be an important organ of first-pass drug metabolism. While a variety of changes in intestinal morphology and function in response to continuous parenteral and enteral nutrition have been documented, the effect of different routes of alimentation on intestinal drug metabolism has not been previously investigated. Objectives of this study were to assess the contribution of intestinal pentobarbital metabolism to overall in vivo pentobarbital pharmacokinetics in the rat and to determine if differences in pentobarbital pharmacokinetics were seen between parenterally and enterally nourished animals. After 7 days of continuous infusion of amino acid-glucose mixture via a gastric or jugular vein catheter, pharmacokinetic parameters were determined after 40 mg/kg of pentobarbital was given orally or into the portal or femoral vein. Reduced systemic availability of pentobarbital after oral administration as compared to portal vein injection was seen in both alimentation groups indicating that significant intestinal metabolism of pentobarbital occurred in vivo. Total area under the pentobarbital plasma concentration-time curve was significantly greater in parenterally nourished animals as compared with enterally alimented animals after oral, portal vein and systemic vein drug administration. Differences in pentobarbital, pharmacokinetics between the two alimentation groups appeared to be primarly due to effects on hepatic pentobarbital metabolism. While the mechanism producing these changes has not been defined, differences in gut hormones release and/or pancreatic secretion in response to the two routes of alimentation may be contributory. The widespread use of enteral and parenteral alimentation in clinical medicine suggests that studies to determine if nutrition route of administration similarly influences drug metabolism in humans may be indicated.

Validation of the aseptic filling at the Parenteral Products Plant 3 in BioCen

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Marisol Álvarez-González

2016-07-01

Full Text Available As part of the continuous improvement process, a new parenterals production plant (PPP3 was constructed at the National Center for Bioproducts. The validation of the aseptic filling process is a key element to carry out before manufacturing products. Therefore, the aim of this work was to obtain documented evidence that all the operations were carried out according the regulations of Good Manufacturing Practices for liquid and lyophilized sterile products during the aseptic filling at the Parenterals Product Plant 3. The study was designed for lyophilized products connected to the manifold of the peristaltic pump and to the four rotary piston pumps. Besides, during the filling operation four interventions were planned. The validation was carried out with three consecutive batches of media fill. In the first processed lot no vial was contaminated, but in the second and third lots there was one contaminated vial. For that reason, an investigation was performed in order to know the cause of the contamination. Finally, with this wok the validated condition was obtained, following the regulations of Good Manufacturing Practices for sterile liquids and lyophilizes products during the aseptic filling process at the Parenterals Products Plant 3.

Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs

DEFF Research Database (Denmark)

Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei

2012-01-01

We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...

The prognosis of incurable cachectic cancer patients on home parenteral nutrition

DEFF Research Database (Denmark)

Bozzetti, F; Santarpia, L; Pironi, L

2014-01-01

BACKGROUND: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. PATIENTS AND METHODS: We studied prospectively 414 incurable cachectic (sub)obstruc...

Indicaciones no quirúrgicas de la nutrición parenteral periférica Parenteral periferic nutrition: non surgical indications

OpenAIRE

A. Ayúcar Ruiz de Galarreta; F. Pita Gutiérrez; F. Mosteiro Pereira; L. Cordero Lorenzana; S. Gómez Canosa; C. Seco Vilariño

2011-01-01

Introducción: La Nutrición Parenteral Perif��rica, definida como la mezcla de macronutrientes, vitaminas y minerales con osmolaridad menor de 800 mOsm/L, permite evitar los riesgos del catéter central. Clásicamente ha sido utilizada en postoperados, pero actualmente la patología médica también puede beneficiarse de ella, bien como única fuente de nutrientes, ya que un alto porcentaje de pacientes precisan menor aporte calórico de lo que se creía, o como complementaria. Objetivo: Evaluación de...

Accesibilidad en el ámbito de la salud materna de mujeres rurales de tres localidades del norte argentino

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Fernando Landini

2015-12-01

Full Text Available Si bien las mujeres rurales poseen mayor riesgo de morir por causas relacionadas con el embarazo, el parto y puerperio, los estudios que abordan el tema suelen prestar escasa atención a la variable 'ruralidad'. Se realizó un estudio comparativo de tres casos apoyado en un abordaje cualitativo orientado a identificar, describir y analizar las barreras de orden geográfico, económico y administrativo que limitan el acceso de mujeres rurales al sistema público de salud en el ámbito de la salud materna. Se seleccionaron tres territorios de diferentes provincias del norte argentino: el municipio de Goya (provincia de Corrientes, el municipio de Dos Arroyos (provincia de Misiones y la comuna de Ranchillos (provincia de Tucumán. En cada caso se realizaron 15 entrevistas, en su mayoría a mujeres rurales y a profesionales que atienden en el ámbito de la salud materna. Las entrevistas fueron transcriptas y los textos categorizados a partir de ejes temáticos expresados en los objetivos de la investigación. Se concluye que existen importantes barreras de accesibilidad que articulan problemas de nivel geográfico, económico y administrativo en ámbitos rurales.

Costos del tratamiento por enfermedades en niños privados de la lactancia materna exclusiva

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Efraín Figueredo Santana

1997-10-01

Full Text Available Se realizó un estudio descriptivo y transversal en el que se tuvieron en cuenta los costos del tratamiento por diversas afecciones en niños de 0 a 4 meses de edad que dejaron de recibir lactancia materna exclusiva, en su mayoría antes de cumplir los 3 meses. Hubo predominio de las afecciones respiratorias y gastrointestinales, las que ocasionaron el mayor costo intrahospitalario, a expensas fundamentalmente de la estadía. Se recomienda la utilización de técnicas afectivo-participativas para lograr una lactancia materna exclusiva como mínimo hasta los 4 meses, así como realizar estudios en los que se utilicen controles que permitan evaluar el costo-beneficio y las ventajas que ésta proporciona para organizar la atención a estos niños de forma planificada, para explotar en mayor medida los ingresos domiciliarios.A descriptiver and cross-sectional study on the cost of treatment diferent affections in children aged 0-4 months, who were deprived of exclusive breastfeeding, most of them before being 3 months, is conducted. There was a predominance of the respiratory and gastroiontestinal affections that caused the highest intrahospital cost due mainly to the stay. It is recommended the use of affective-participative techinique to attain an exclusive breastfeeding up to 4 months as a minimun, and to conduct studies using controls that allow to evaluate the cost-benefit and the advanteges it offers to give a planned attention to these children, and to exploit to a great extent the domestic incomes.

Estrategia para el desarrollo y transformación de la lengua materna en la Facultad de Cultura Física de Matanzas

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María de los Ángeles Cárdenas Hernández

2009-09-01

Full Text Available Se señala, y muy acertadamente, por Lomas, Osoro y Tusón, (1992 que la finalidad principal de la enseñanza de la lengua materna es dotar al alumnado de los recursos de expresión, comprensión, y reflexión sobre los usos lingüísticos y comunicativos, que le permitan una utilización adecuada de los diversos códigos lingüísticos y no lingüísticos disponibles en situaciones y contextos variados, con diferente grado de formalización o planificación en sus producciones orales y escritas. (En: Cárdenas 2004. Esto demanda trabajar con un enfoque funcional – comunicativo, sistémico e integrador que incida directa y favorablemente en el sujeto-objeto de la educación, el alumno, y que asegure en todos y cada uno de los niveles, un pensamiento creativo, desarrollador y transformador que a la vez implique el tránsito del conocimiento siempre de forma cualitativamente ascendente. La Competencia Comunicativa con la que el alumno debe poseer al acceder al nivel universitario asegurará la calidad de la docencia y contribuirá, en el plano real de las tareas de aprendizaje, a la comprensión y producción de significados en temas generales y especializados relacionados no solo con el deporte, y logre aprender y aplicar estrategias para interpretar el mundo mientras asume una actitud investigativa y responsable en el mejoramiento de su entorno, todo sobre la base del uso correcto de un instrumento básico: la lengua materna. La estrategia de la lengua materna en la Facultad de Cultura Física se proyecta sobre los siguientes fundamentos lingüísticos, psicológicos y metodológicos:

Desenvolvimento da narrativa oral e o nível de escolaridade materna

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Ana Carolina Francisca da Silva

2014-03-01

Full Text Available Objetivo : verificar a narrativa oral em crianças em função do nível de escolaridade materna.Métodos : o estudo foi realizado na Escola Pública Municipal Magalhães Bastos, no bairro da Várzea no Recife, com 20 crianças da 1ª série do ensino fundamental I, com faixa etária entre sete e oito anos. Para a avaliação foi utilizado um texto e um Mp3 para a gravação das crianças narrando a história.Resultados : observou-se que a maioria das crianças encontrava-se na categoria II do esquema narrativo, grande parte apresentou problemas coesivos em suas narrativas e em relação à coerência todas as crianças encontravam-se no nível IV de coerência. Quando os dados de esquema narrativo, coesão e coerência foram cruzados com os dados do nível de escolaridade das mães foi observado que não houve relação significante entre eles. Foi visto também que pouquíssimas mães têm o hábito de leitura no ambiente doméstico e a maioria delas nem chegou a concluir o ensino fundamental I. Também foi observado que quanto maior a escolaridade das mães, melhor o hábito de leitura delas.Conclusões : a escolaridade materna não influenciou significantemente na narrativa oral de crianças, isto se deve a diversos fatores que necessitam ser investigados com mais profundidade. Entretanto a variabilidade do desenvolvimento da narrativa oral das crianças observada no presente estudo, considerando que a idade e a escolaridade foram constantes, sugere a influência de outras variáveis linguísticas e sociais nesta aquisição.

Nutrition quality control in the prescription and administration of parenteral nutrition therapy for hospitalized patients.

Science.gov (United States)

Shiroma, Glaucia Midori; Horie, Lilian Mika; Castro, Melina Gouveia; Martins, Juliana R; Bittencourt, Amanda F; Logullo, Luciana; Teixeira da Silva, Maria de Lourdes; Waitzberg, Dan L

2015-06-01

Nutrition quality control in parenteral nutrition therapy (PNT) allows the identification of inadequate processes in parenteral nutrition (PN). The objective of this study was to assess the quality of PNT at a hospital with an established nutrition support team (NST). This observational, longitudinal, analytical, and prospective study examined 100 hospitalized PNT adult patients under the care of an NST for 21 days or until death/hospital discharge. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2007 guidelines for PNT prescription were followed. PNT indications were not in accordance with the A.S.P.E.N. 2007 guidelines in 15 patients. Among the remaining 85 patients, 48 (56.5%) did not receive adequate PNT (≥80% of the total volume prescribed). Non-NST medical orders, progression to and from enteral nutrition, changes in the central venous catheter, unknown causes, and operational errors (eg, medical prescription loss, PN nondelivery, pharmacy delays, inadequate PN bag temperature) were associated with PNT inadequacy (P nutrition therapy related to estimated energy expenditure and protein requirements and glycemia levels reached the expected targets; however, the central venous catheter infection rate was higher than 6 per 1000 catheters/d and did not meet the expected targets. Despite an established NST, there was a moderate level of PNT inadequacy in indications, administration, and monitoring. It is important to establish periodic meetings among different health professionals who prescribe and deliver PNT to define responsibilities and protocols. © 2015 American Society for Parenteral and Enteral Nutrition.

Parenteral nutrition in radiation therapy and combined treatment of patients with esophageal cancer

International Nuclear Information System (INIS)

Sudzhyan, A.V.; Buzovkina, L.P.; Biletov, B.V.; Breusenko, E.Ya.; Krasnova, A.I.; Tsaryuk, V.F.

1980-01-01

Results obtained while studying 165 patients with esophageal cancer are presented. It is shown that radiation therapy and combined treatment result in the body mass loss, in the increase of katabolic processes in organism, in the negative nitrogen balance. Weaken patients, being under starvation conditions, are subjected more often to reaction changes and complications developing during the treatment. A comparison characteristics of two methods providing the organism with nutrition is given, i.e. gastrostomy and parenteral nutrition. Shown is the advantage of the adequate parenteral nutrition preventing the appearence of reaction changes and complications, improving the subjective state of patients, homeostasis indices, promoting the elimination of esophagitis phenomena, general radiation response and reaction to chemical preparations; resulting in the increase of quantity of leucocytes at leukopenia

Recent advances in polymeric microspheres for parenteral drug delivery--part 1.

Science.gov (United States)

Mao, Shirui; Guo, Chunqiang; Shi, Yi; Li, Luk Chiu

2012-09-01

Polymeric microspheres have been established as a valuable parenteral drug delivery system for sustained release of therapeutic agents via subcutaneous or intramuscular injection. Biodegradable polymers which are either synthetic or from natural sources are reviewed with respect to recent advances in exploring their applications for microsphere fabrications. New information on the impact of formulation variables on the properties of microspheres formed by an emulsion method was also presented. The characterization of microspheres using advanced physical analytical techniques was also reviewed and the utilization of the information in assessing in vivo performance of the product was also highlighted. The broad clinical use of microspheres for delivery of therapeutic agents in particular biologics such as proteins has not been realized commercially. The limited availability of biodegradable polymers with a long history of regulatory approval and the challenges in gaining regulatory approval of a new polymer have hindered the development of microspheres for parenteral drug delivery.

FACTORES ASOCIADOS A LA CONDUCTA DE LACTANCIA MATERNA EXCLUSIVA HASTA EL SEXTO MES DE LA VIDA EN NIÑOS Y NIÑAS DE LA COMUNA DE SAN PEDRO DE LA PAZ

OpenAIRE

ROMERO GARCIA, STEPHANIE

2012-01-01

Introducción: La comuna de San Pedro de la Paz posee una baja prevalencia de lactancia materna exclusiva en todos sus períodos reportados. Objetivo: Identificar los factores asociados a la conducta de lactancia materna exclusiva en niños/as hasta el octavo mes de vida, que estén bajo control en la red asistencial de la comuna de San Pedro de la Paz. Material y Métodos: Estudio descriptivo transversal mediante aplicación de encuesta en domicilio a 253 madres de niños/as de 1 a 8 meses de vi...

Evolució i estabilitat d’àcids grassos i vitamines antioxidants a la llet materna

OpenAIRE

Moltó Puigmartí, Carolina

2008-01-01

Recerca realitzada durant el periode Gener 2006-Abril 2007, a la Facultat de Farmàcia de la Universitat de Barcelona sota la direcció de la Dra. M. Carmen López Sabater. La nutrició durant els primers anys de vida té una enorme importància, amb repercussions en el creixement i desenvolupament del nen i en les possibles malalties futures. Tenint en compte que la llet materna és l’aliment ideal per al nadó durant els primers sis mesos de vida, és important conéixer la composició nutricional de...

Factores asociados con lactancia materna exclusiva hasta el sexto mes en madres adolescentes. medellin, 2010

OpenAIRE

Gómez Aristizábal, Liliana Yanet; Díaz Ruíz, Carlos Eduardo; Manrique Hernández, Ruben Dario

2013-01-01

Objetivo Determinar los factores asociados con la lactancia materna exclusiva hasta el sexto mes en madres adolescentes de los niveles I y II del SISBEN de la ciudad de Medellín.Métodos Se realizó un estudio de casos y controles con 323 madres adolescentes, 197 casos y 126 controles de la “Estrategia Buen Comienzo Había una Vez-BCHV” de Metrosalud y la Alcaldía de Medellín. Se aplicó estadística descriptiva para el análisis univariado. Se hizo un análisis de correspondencias. La comparación d...

Supplemental parenteral nutrition in critically ill patients: a study protocol for a phase II randomised controlled trial.

Science.gov (United States)

Ridley, Emma J; Davies, Andrew R; Parke, Rachael; Bailey, Michael; McArthur, Colin; Gillanders, Lyn; Cooper, David J; McGuinness, Shay

2015-12-24

Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established. A multi-centre, randomised, clinical trial is currently underway to determine if prescribed energy requirements can be provided to critically ill patients by using a supplemental parenteral nutrition strategy in the critically ill. This prospective, multi-centre, randomised, stratified, parallel-group, controlled, phase II trial aims to determine whether a supplemental parenteral nutrition strategy will reliably and safely increase energy intake when compared to usual care. The study will be conducted for 100 critically ill adults with at least one organ system failure and evidence of insufficient enteral intake from six intensive care units in Australia and New Zealand. Enrolled patients will be allocated to either a supplemental parenteral nutrition strategy for 7 days post randomisation or to usual care with enteral nutrition. The primary outcome will be the average energy amount delivered from nutrition therapy over the first 7 days of the study period. Secondary outcomes include protein delivery for 7 days post randomisation; total energy and protein delivery, antibiotic use and organ failure rates (up to 28 days); duration of ventilation, length of intensive care unit and hospital stay. At both intensive care unit and hospital discharge strength and health-related quality of life assessments will be undertaken. Study participants will be followed up for health-related quality of life, resource utilisation and survival at 90 and 180 days post randomisation (unless death occurs first). This trial

Lactancia materna: su reproducción en los juegos de roles

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Migdalia Naranjo Arroyo

1998-04-01

Full Text Available Se realiza un estudio de intervención en 58 niñas preescolares del Círculo Infantil "Alegre Amanecer", ubicado en el área de salud José Martí de Santiago de Cuba, durante el período de marzo a julio de 1995, con la finalidad de determinar si reproducían en sus juegos la lactancia materna, aplicar técnicas educativas y comparar su efectividad. Se emplean como métodos: la observación, las entrevistas iniciales y finales, las narraciones orales en forma de cuentos, la demostración y los juegos de roles dirigidos. Las técnicas educativas se efectuaron en el 97 % de los casos y fueron muy efectivas, puesto que al final de las intervciones los resultados cambiaron a favor de la leche materna y el pecho, las niñas lactaron a sus muñecas y aprendieron la importancia de amamantar, por lo cual sería provechoso continuar este trabajo con niñas preescolares que no asisten al círculo infantil y además asesorar al personal de educación que labora en dichas instituciones sobre la utilización de estos procederes en los programas lúdicosAn intervention study of 58 preschool girls in the "Alegre Amanecer" day-care center located in José Martí health area, Santiago de Cuba province was carried out from march to july, 1995, for the purpose of determining the representation of breast feeding in child's games, applying educational techniques and comparing their effectiveness. Methods like observations, initial and final interviews story-telling, demonstrations and guided role-taking games were used. The educational techniques were employed in 97 % of the cases and they were really effective since at the end of the interventions, the results favoured breast feedings and milk, the girls nursed their dolls and learned the importance of breast feeding. Therefore, it would be useful to continue this type of work with preschool girls who do not attend day-care centers, and to give advisory to educational staff working in these centers on the

Essential fatty acid deficiency in patients receiving home parenteral nutrition 1,2

DEFF Research Database (Denmark)

Jeppesen, P. B.; Høy, Carl-Erik; Mortensen, Per B

1998-01-01

Home parenteral nutrition (HPN), initiated in patients with severe malabsorption or decreased oral intake, may exhaust stores of essential fatty acids and cause clinical manifestations, mainly dermatitis. Plasma fatty acid profiles were measured by gas-liquid chromatography in 37 healthy control...

Paracoccidioidomicose subaguda progressiva: tratamento de um doente com anfotericina B e nutrição parenteral

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Paulo Camara Marques Pereira

1985-10-01

Full Text Available Os Autores descrevem um caso de paracoccidioidomicose subaguda progressiva, com quadro clínico sugestivo de síndrome de má absorção, em que o doente não se beneficiara apenas com o tratamento antifúngico convencional. Ao se introduzir como medida auxiliar a nutrição parenteral houve evidente melhora clínica e laboratorial. Desta maneira os Autores propõe o uso associado da nutrição parenteral no tratamento de doentes com esta forma clínica de paracoccidioidomicose.

Independence From Parenteral Nutrition and Intravenous Fluid Support During Treatment With Teduglutide Among Patients With Intestinal Failure Associated With Short Bowel Syndrome

DEFF Research Database (Denmark)

Iyer, Kishore R; Kunecki, Marek; Boullata, Joseph I

2017-01-01

BACKGROUND: In phase III clinical studies, treatment with teduglutide was associated with clinically meaningful reductions (≥20% from baseline) in parenteral support (PS; parenteral nutrition and/or intravenous fluids) requirements in adult patients with intestinal failure associated with short...

Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.

Science.gov (United States)

Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin

2018-03-14

Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative

Third-Generation Fatty Emulsions as Part of Parenteral Feeding in Operated Cancer Patients

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S. V. Lomidze

2010-01-01

Full Text Available Objective: to study the efficacy of third- versus secondary-generation fatty emulsions as part of parenteral nutrition in patients operated on for gastric cancer. Subjects and methods. Envelope randomization was used to make up two groups, each comprising 10 patients, operated on for gastric cancer in the scope of gastrectomy. A control group received parenteral nutrition having the following components: Lipofundin MST/LST 20%, (500 ml daily + Nutriflex 48/150 (B. Braun (1000 ml daily, 1744 kcal/day. The study group patients were given Lipoplus 20% (500 ml daily + Nutriflex 48/150 (1000 ml daily, 1745 kcal/day. Parenteral nutrition was used on postoperative days 1 to 5. Results. Nutritional status evaluation revealed a significant increase in the concentration of total protein and albumin in the control and study group patients on postoperative day 6. The use of both second- and third-generation fatty emulsions caused a significant increase in the concentration of triglycerides on day 6 after surgery; no differences were found between the groups. On day 6 following surgery, there was a significant decrease in IL-4 in both groups (p<0.05. At the same time the Lipofundin MST/LST group showed a significantly lower concentration of IL-4 than did the study group (p<0.05. After termination of a parenteral nutrition course, the study and control groups showed a significant decrease in one of the major pro-inflammatory cytokines — IL-6. Conclusion. In the study group, the serum anti-inflammatory activity of IL-4 was more evident than that in the control group and the proinflammatory activity (IL-6 concentration decreased, which can support that as compared with the second-generation fatty emulsions, third-generation ones with a balanced omega 3 to omega-6 fatty acid ratio (1:2.7 had a normalizing effect on systemic inflammatory processes and cytokine balance with increased anti-inflammatory and reduced proinflammatory activities. Key words: third

Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

DEFF Research Database (Denmark)

Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre

2011-01-01

bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing......-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few...

Nitrogen sparing by 2-ketoisocaproate in parenterally fed rats

International Nuclear Information System (INIS)

Yagi, M.; Matthews, D.E.; Walser, M.

1990-01-01

In rats receiving total parenteral nutrition with or without sodium 2-ketoisocaproate (KIC; 2.48 g.kg-1.day-1), L-[1- 13 C]leucine and [1- 14 C]KIC were constantly infused for 6 h. CO 2 production, 14 CO 2 production, 13 CO 2 enrichment, urinary urea nitrogen (N) plus ammonia N and total urinary N were measured. Whole body protein synthesis (S) was calculated in non-KIC-infused rats and also in unfed rats infused with [1- 14 C]leucine from fractional oxidation of labeled leucine (1-F), where F is fractional utilization for protein synthesis, and urea N plus ammonia N excretion (C) as S = C x F/(1-F). Addition of KIC caused a significant reduction in N excretion and a significant improvement in N balance. Fractional oxidation of labeled KIC increased, whereas fractional utilization of labeled KIC for protein synthesis decreased, but the extent of incorporation of infused KIC into newly synthesized protein (as leucine) amounted to at least 40% of the total rate of leucine incorporation into newly synthesized whole body protein. We conclude that addition of KIC spares N in parenterally fed rats and becomes a major source of leucine for protein synthesis

Validation of cold chain during distribution of parenteral nutrition

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Federico Tuan

2015-09-01

Full Text Available Objective: this study aims to demonstrate the suitability of the process used to condition the extemporaneous mixtures of parenteral nutrition for distribution, considering the objective of preserving the cold chain during transport until it reaches the patient, necessary to ensure stability, effectiveness and safety of these mixtures. Method: concurrent validation, design and implementation of a protocol for evaluating the process of packaging and distribution of MNPE developed by a pharmaceutical laboratory. Running tests, according to predefined acceptance criteria. It is performed twice, in summer and on routes that require longer transfer time. Evaluation of conservation of temperature by monitoring the internal temperature values of each type of packaging, recorded by data loggers calibrated equipment. Results: the different tests meet the established criteria. The collected data ensure the maintenance of the cold chain for longer than the transfer time to the most distant points. Conclusions: this study establishes the suitability of the processes to maintaining the cold chain for transfer from the laboratory to the patient pharmacist. Whereas the breaking of cold chain can cause changes of compatibility and stability of parenteral nutrition and failures nutritional support, this study contributes to patient safety, one of the relevant dimensions of quality of care the health.

ROLE OF PARENTERAL AMINO ACIDS SUPPLEMENATION IN OLIGOHYDRAMNIOS & IUGR COMPLICATED PREGNANCIES

OpenAIRE

Anuradha; Malini; Sumit

2015-01-01

OBJECTIVES: To see whether parenteral nutritional supplementation of women with oligohydramnios/IUGR can improve the amount of liquor and to evaluate the role of pareneral therapy in improving maternal and perinatal outcome and to correlate between the occurrence of oligohydramnios and IUGR among women of different age, parity, education and socioe...

Managing an outpatient parenteral antibiotic therapy team: challenges and solutions.

Science.gov (United States)

Halilovic, Jenana; Christensen, Cinda L; Nguyen, Hien H

2014-01-01

Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.

Responses of Preterm Pigs to an Oral Fluid Supplement During Parenteral Nutrition

DEFF Research Database (Denmark)

Berding, Kirsten; Makarem, Patty; Hance, Brittany

2016-01-01

Background: Nutrients and electrolytes in amniotic fluid swallowed by fetuses are important for growth and development. Yet, preterm infants requiring parenteral nutrition (PN) receive minimal or no oral inputs. With the limited availability of amniotic fluid, we evaluated the responses of preterm...

Efecto de la alopregnanolona sobre la ansiedad en ratas con separación materna durante la lactancia

OpenAIRE

Riveros Barrera, Irene; Dueñas, Zulma

2014-01-01

Antecedentes. La relación madre-hijo y el cuidado parental al recién nacido son fundamentales en el desarrollo fisiológico y emocional de los individuos. Evidencias asocian el estrés temprano con el desarrollo de enfermedades mentales. El modelo de separación materna durante la lactancia (SMDL) se ha utilizado para inducir estrés temprano en ratas y estudiar efectos a largo plazo. Diversos estudios han encontrado que, en ratas separadas de sus madres, disminuyen los niveles del receptor GABA-...

Efecto de la alopregnanolona sobre la ansiedad en ratas con separación materna durante la lactancia

OpenAIRE

Irene Riveros Barrera; Zulma Dueñas

2014-01-01

Antecedentes. La relación madre-hijo y el cuidado parental al recién nacido son fundamentales en el desarrollo fisiológico y emocional de los individuos. Evidencias asocian el estrés temprano con el desarrollo de enfermedades mentales. El modelo de separación materna durante la lactancia (SMDL) se ha utilizado para inducir estrés temprano en ratas y estudiar efectos a largo plazo. Diversos estudios han encontrado que, en ratas separadas de sus madres, disminuyen los nivel...

Efeito de um programa de hidroterapia na flexibilidade e na força muscular de idosas Effect of a hydrotherapy program on flexibility and muscle strength in elderly women

Directory of Open Access Journals (Sweden)

JM Candeloro

2007-08-01

Full Text Available OBJETIVO: Avaliar o efeito de um programa de hidroterapia na flexibilidade e na força muscular de mulheres idosas sedentárias. SUJEITOS: 31 idosas, saudáveis e sedentárias, com idade entre 65 e 70 anos (16 no grupo experimental e 15 no grupo controle. PROCEDIMENTOS: Foram realizados testes de força muscular por meio de miometria em músculos do membro superior, inferior e tronco, e realizada avaliação fotográfica da flexibilidade, utilizando os testes de envergadura e flexão anterior do tronco, antes e depois do programa, que constou de 28 sessões de uma hora e foi aplicado durante 14 semanas consecutivas. Os exercícios físicos foram organizados em sete níveis de dificuldade, selecionados visando ganho de flexibilidade e força muscular. RESULTADOS: Encontrou-se diminuição estatisticamente significativa na flexão anterior de tronco de -15,4%, o que significou uma diminuição média de 19,3 cm (±22,4 distância processo estilóide da ulna - maléolo lateral e melhora de 4,2% no teste de envergadura, o que significou um aumento médio na distância dedo - dedo de 4,7 cm (±4,5. Nos músculos abdominais, glúteos e iliopsoas não ocorreu alteração estatisticamente significativa de força, e nos músculos quadríceps femoral, isquiotibiais, bíceps braquial, peitoral maior e médio e deltóide médio, obteve-se melhora estatisticamente significativa. CONCLUSÃO:O programa de hidroterapia proposto foi eficiente para melhorar a flexibilidade e, parcialmente, a força muscular das mulheres jovens idosas que participaram do estudo. Nossos resultados são compatíveis com os encontrados em estudos similares realizados no solo.OBJECTIVE: To evaluate the effect of a hydrotherapy program on flexibility and muscle strength among sedentary elderly women. METHOD: The participants were 31 healthy sedentary elderly women aged between 65 and 70 years (16 in the experimental group and 15 in the control group. Muscle strength tests were carried

Relationship between turnover rate and oxidation rate of alanine in the post-absorptive state and during parenteral nutrition before and after surgery

NARCIS (Netherlands)

Sauerwein, H. P.; Michels, R. P.; Cejka, V.

1985-01-01

The influence of total parenteral nutrition and stomach resection on alanine turnover rate and alanine oxidation rate was measured in ten patients after single injection of U-14 C-alanine. Sequential studies were done in three patients. During parenteral nutrition alanine turnover was significantly

Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

Science.gov (United States)

Friedman, B; Kanter, G; Titus, D

1994-04-01

Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

Maternal satisfaction with maternal-infant nursing care in Campeche, Mexico Satisfacción materna con el cuidado de la enfermera materno infantil en Campeche, Méjico Satisfação materna com o cuidado da enfermeira materno-infantil em Campeche, México

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Yolanda Flores Peña

2009-10-01

Full Text Available OBJECTIVE: Evaluate and compare maternal-satisfaction (global and areas with maternal-child nursing care (MSMINC and to explore the relationship of MSMINC with wait time, length of visit, and maternal age and education. METHODS: Cross-sectional descriptive study comprising 213 mothers. Group 1 (n = 84, mothers of children aged El objetivo de este estudio fue evaluar y comparar la satisfacción materna (global/áreas con el cuidado de la enfermera materno infantil (MSMINC y explorar la relación de MSMINC con el tiempo de espera, duración de la visita, edad y educación materna. Se trata de un estudio descriptivo transversal. Participaron 213 madres. Grupo 1, n = 84 madres de niños OBJETIVO: Avaliar e comparar a satisfação materna (global e áreas com o cuidado da enfermeira materno-infantil (SMAEMI e explorar a relação da SMAEMI com o tempo de espera e duração da visita, idade e educação da mãe. MÉTODOS: ESTUdo descritivo-transversal com a participação de 213 mães. Grupo 1, n = 84 mães de crianças <1 ano e Grupo 2, n = 129 mães de crianças de 1 a 4 anos. Aplicou-se a Escala de Satisfação do Paciente. RESULTADOS: O resultado global SMAEMI foi 76.26 e 79.21 para Grupos 1 e 2, respectivamente. Fatores associados não foram encontrados no Grupo 1. No Grupo 2, tempo de espera foi associado à SMAEMI na área técnico-profissional (F = 3.13; gl = 128; B = -0.21; p = 0.01. CONCLUSÕES: O FAto de que os participantes neste estudo identificaram somente fatores associados à SMAEMI na área técnico-profissional pode indicar que o cuidado está focado em procedimentos técnicos. Fatores associados à SMAEMI não foram identificados no Grupo 1, pelo que recomenda-se explorar as expectativas e percepções das mães com relação ao cuidado.

Evaluación de la calidad de un programa de lactancia materna en el HUBU

OpenAIRE

Riquelme Lozano, Cristina; Ruiz Magadán, Mónica; Sancho Temiño, Laura; Sassaf López, Soraya; Triguero Grijalvo, Rosa Mª

2015-01-01

Este trabajo de investigación en el que se presenta un minucioso análisis del estado de la investigación en sistemas de gestión de calidad en un servicio de obstetricia y ginecología en la atención después del parto y la orientación hacia la lactancia materna. Asimismo se incluyen instrumentos de evaluación de la satisfacción de las pacientes con la intervención de los distintos agentes implicados. La calidad del análisis y de los materiales utilizados hacen que este trabajo sea una guía para...

Causas de mortalidade materna segundo níveis de complexidade hospitalar Causes of maternal mortality according to levels of hospital complexity

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Vânia Muniz Néquer Soares

2012-12-01

Full Text Available OBJETIVOS: Identificar e analisar as causas da mortalidade materna, segundo os níveis de complexidade hospitalar. MÉTODOS: Estudo quantitativo, descritivo e de corte transversal das mortes maternas hospitalares ocorridas no Paraná, Brasil, nos triênios de 2005 - 2007 e 2008 - 2010. Foram utilizados dados dos estudos de casos de óbitos maternos, que foram elaborados pelo Comitê Estadual de Prevenção da Mortalidade Materna. As variáveis estudadas foram o local e as causas dos óbitos, a transferência hospitalar e a evitabilidade. Foram calculadas a razão de mortalidade materna, a proporção e a taxa de letalidade hospitalar, segundo os subgrupos hospitais de referência para gestações de alto e baixo risco. RESULTADOS: A razão de mortalidade materna, incluindo os óbitos maternos tardios, foi 65,9/100.000 nascidos vivos (de 2008 a 2010. O local do óbito foi o hospital em cerca de 90% dos casos, em ambos os períodos. No primeiro triênio, nos hospitais de referência para gestação de alto risco, a taxa de letalidade hospitalar foi de 158,4/100.000 partos e, no segundo, 132,5/100.000 e as principais causas foram: pré-eclampsia/eclampsia, infecção urinária, infecção puerperal e causas indiretas. Nos hospitais de referência para gestação de baixo risco, as taxas de letalidade hospitalar foram: 76,2/100.000 e 80,0/100.000, e como principais causas: hemorragias, embolias e complicações anestésicas. Em 64 (2005 - 2007 e 71% (2008 - 2010 dos casos, o óbito ocorreu no hospital do internamento inicial. Foram considerados evitáveis 90% dos óbitos no segundo triênio. CONCLUSÕES: Há dificuldades no atendimento das complicações obstétricas em ambos os níveis de atenção de baixa e alta complexidade. A capacitação dos profissionais para o atendimento às emergências obstétricas e o monitoramento do uso dos protocolos em todos os níveis hospitalares deve ser priorizada para a redução das mortes maternas evit

Sobre el arte de amamantar y el Simposio Lactancia Materna en el Instituto Nacional de Pediatría

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Irma Zazil Olivares Zandoval

2016-06-01

Full Text Available Desde hace 6 años hemos organizado el Simposio Lactancia Materna en el Instituto Nacional de Pediatría, institución formadora de profesionales de la salud, cuyo objetivo es el cuidado de los niños. Tiene especial dedicatoria para quienes nos ocupamos de la díada madre-hijo, para quienes dictamos las recomendaciones enfocadas a la conservación o recuperación de la salud.

Subunit Rotavirus Vaccine Administered Parenterally to Rabbits Induces Active Protective Immunity

Science.gov (United States)

Ciarlet, Max; Crawford, Sue E.; Barone, Christopher; Bertolotti-Ciarlet, Andrea; Ramig, Robert F.; Estes, Mary K.; Conner, Margaret E.

1998-01-01

Virus-like particles (VLPs) are being evaluated as a candidate rotavirus vaccine. The immunogenicity and protective efficacy of different formulations of VLPs administered parenterally to rabbits were tested. Two doses of VLPs (2/6-, G3 2/6/7-, or P[2], G3 2/4/6/7-VLPs) or SA11 simian rotavirus in Freund’s adjuvants, QS-21 (saponin adjuvant), or aluminum phosphate (AlP) were administered. Serological and mucosal immune responses were evaluated in all vaccinated and control rabbits before and after oral challenge with 103 50% infective doses of live P[14], G3 ALA lapine rotavirus. All VLP- and SA11-vaccinated rabbits developed high levels of rotavirus-specific serum and intestinal immunoglobulin G (IgG) antibodies but not intestinal IgA antibodies. SA11 and 2/4/6/7-VLPs afforded similar but much higher mean levels of protection than 2/6/7- or 2/6-VLPs in QS-21. The presence of neutralizing antibodies to VP4 correlated (P < 0.001, r = 0.55; Pearson’s correlation coefficient) with enhanced protection rates, suggesting that these antibodies are important for protection. Although the inclusion of VP4 resulted in higher mean protection levels, high levels of protection (87 to 100%) from infection were observed in individual rabbits immunized with 2/6/7- or 2/6-VLPs in Freund’s adjuvants. Therefore, neither VP7 nor VP4 was absolutely required to achieve protection from infection in the rabbit model when Freund’s adjuvant was used. Our results show that VLPs are immunogenic when administered parenterally to rabbits and that Freund’s adjuvant is a better adjuvant than QS-21. The use of the rabbit model may help further our understanding of the critical rotavirus proteins needed to induce active protection. VLPs are a promising candidate for a parenterally administered subunit rotavirus vaccine. PMID:9765471

Por uma aprendizagem significativa da língua materna: o ensino fundamentado em Saussure e Ausubel

OpenAIRE

Azevedo, Tânia Maris

2014-01-01

O tema da pesquisa é a proposição de conceitos da linguística saussuriana como fundamentos primeiros de um ensino cujo foco seja a aprendizagem significativa da língua materna. Para o desenvolvimento do tema, a investigação utilizar-se-á da linguística de Ferdinand de Saussure, mais especificamente, das noções de relação, de oposição, de diferença, de sistema e dos conceitos de língua/linguagem/fala e valor, bem como da Teoria da Aprendizagem Significativa, de David Ausubel, principalmente, d...

Deseos, aptitudes y conocimientos sobre lactancia materna de gestantes en su tercer trimestre

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Remigio Rafael Gorrita Pérez

2012-06-01

Full Text Available Introducción: la lactancia materna es la única forma natural de alimentar al bebé, y una forma inigualable de facilitar el alimento ideal para su crecimiento y desarrollo. Métodos: se realizó un estudio descriptivo, transversal, para evaluar deseos, aptitudes y conocimientos sobre lactancia materna en el tercer trimestre de 114 gestantes del Policlínico "Mártires del 9 de Abril", de San José de las Lajas. Entre marzo de 2010 y de 2011 se valoraron sus historias de salud individual y familiar, y se aplicó a tal efecto un cuestionario con 22 preguntas. Resultados: la información se incorporó a una base de datos y se utilizó para el análisis el estadígrafo chi cuadrado, que se consideró significativo con p< 0,05. La totalidad de las gestantes deseaban amamantar. Dos terceras partes se consideraron aptas o muy aptas para hacerlo, y que poseían los conocimientos necesarios para lograrlo, pero solo algo más de la quinta parte demostró que los poseía. La mayoría de las futuras madres se encontraban entre los 20 y 35 años, el nivel de escolaridad más frecuentemente alcanzado fue el técnico o preuniversitario (en 60 de ellas, para el 52,6 %, y el 46,5 % de las gestantes mantenían una unión consensuada, el 40,3 % eran casadas, y 15 solteras (13,2 %, aspectos que, indiscutiblemente influyen en los resultados. Conclusiones: además de otros resultados alcanzados, la investigación arrojó que aunque la totalidad de las gestantes en su tercer trimestre deseaban lactar a su futuro bebé y las dos terceras partes se consideraban aptas o muy aptas para hacerlo y con conocimientos suficientes al respecto, solo algo más de la quinta parte demostró efectivamente poseerlos.

Lactancia materna versus lactancia artificial en el contexto colombiano (Breastfeeding versus artificial feeding in the colombian context

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Romina Izzedin-Bouquet de Durán

2011-07-01

Full Text Available En un primer momento, el artículo describe las propiedades nutritivas y los beneficios inmunológicos de la lactancia materna para luego informar acerca de la situación de la misma en el contexto internacional y colombiano comparándola con su mayor competidor la leche de formula. Finalmente, se hace mención a las estrategias que fomentan el amamantamiento pretendiendo concientizar a la población mundial acerca del compromiso que como individuos y sociedad tenemos con respecto a la salud materno-infantil.

Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

International Nuclear Information System (INIS)

Fietkau, R.

1998-01-01

Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de

Nitrite and nitrate concentrations and metabolism in breast milk, infant formula, and parenteral nutrition.

Science.gov (United States)

Jones, Jesica A; Ninnis, Janet R; Hopper, Andrew O; Ibrahim, Yomna; Merritt, T Allen; Wan, Kim-Wah; Power, Gordon G; Blood, Arlin B

2014-09-01

Dietary nitrate and nitrite are sources of gastric NO, which modulates blood flow, mucus production, and microbial flora. However, the intake and importance of these anions in infants is largely unknown. Nitrate and nitrite levels were measured in breast milk of mothers of preterm and term infants, infant formulas, and parenteral nutrition. Nitrite metabolism in breast milk was measured after freeze-thawing, at different temperatures, varying oxygen tensions, and after inhibition of potential nitrite-metabolizing enzymes. Nitrite concentrations averaged 0.07 ± 0.01 μM in milk of mothers of preterm infants, less than that of term infants (0.13 ± 0.02 μM) (P milk. Concentrations in parenteral nutrition were equivalent to or lower than those of breast milk. Freeze-thawing decreased nitrite concentration ~64%, falling with a half-life of 32 minutes at 37°C. The disappearance of nitrite was oxygen-dependent and prevented by ferricyanide and 3 inhibitors of lactoperoxidase. Nitrite concentrations in breast milk decrease with storage and freeze-thawing, a decline likely mediated by lactoperoxidase. Compared to adults, infants ingest relatively little nitrite and nitrate, which may be of importance in the modulation of blood flow and the bacterial flora of the infant GI tract, especially given the protective effects of swallowed nitrite. © 2013 American Society for Parenteral and Enteral Nutrition.

[Role of parenteral cephalosporins for outpatients treatment of infections].

Science.gov (United States)

Esposito, S; Mazzei, T; Novelli, A

2001-12-01

OPAT (Outpatient Parenteral Antibiotic Therapy) arose in the early 1980s in the USA and later in many other countries from the primary consideration that outpatient treatment is more cost-effective than hospitalisation. Currently, several thousand patients undergo OPAT programmes all over the world and several different bacterial infections are included in the list of treatable diseases, especially those requiring long-term parenteral treatment such as osteomyelitis and soft tissue infections. All injectable antibiotics are suitable for OPAT according to their microbiological spectrum, although clearly some pharmacological properties make one antibiotic more preferable than another. Beta-lactams represent more than half of the antibiotic world market and two-thirds of them are cephalosporins. Such a widespread use of cephalosporins is certainly due to their wide antibacterial spectrum and good tolerability. Among third-generation cephalosporins, covering the majority of micro-organisms responsible for community-acquired infections, ceftriaxone is the only one with an 8-hour half-life, thereby permitting a single daily dose, which represents a great advantage when undertaking an OPAT programme. Analysis of antibiotic consumption used for OPAT therapies, based on data collected from the International OPAT Registry project, with the participation of many countries (USA, Canada, Britain, Argentina, etc.) including Italy, shows that ceftriaxone is the most widely used antibiotic for home therapy, clearly due to the above-mentioned properties.

Luteoma Recorrente da Gravidez com Virilização Materna e Fetal Recurrent Luteoma of Pregnancy with Maternal and Fetal Virilization

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Amadeu Ramos da Silva Filho

2001-09-01

Full Text Available Os luteomas da gravidez são pseudotumores ovarianos diagnosticados pelo exame ultra-sonográfico ou durante realização de cesariana e laqueadura pós-parto. Determinam, na segunda metade da prenhez, sinais de virilização materna em um quarto dos casos, o mesmo ocorrendo com a metade dos fetos femininos destas gestantes virilizadas nos quais se observa hipertrofia clitoridiana ou fusão labial. As dosagens séricas maternas dos hormônios androgênicos durante a prenhez e do sangue umbilical por ocasião do parto revelam taxas significativamente aumentadas. No exame ultra-sonográfico apresentam-se como estruturas sólidas ou cístico-sólidas, que após o parto tendem a regredir com o ovário readquirindo as dimensões normais em poucas semanas. Os autores apresentam uma paciente que em duas gestações sucessivas apresentou virilização materna e fetal. Ao exame ultra-sonográfico foram evidenciadas imagem ovariana nodular e dosagens elevadas dos androgênios plasmáticos.Luteomas of pregnancy are ovarian pseudotumors diagnosed by ultrasound, during cesarean section or at postdelivery tubal ligation. Twenty-five per cent of the cases appear around the second half of pregnancy. Usually there are signs of maternal virilization and 50% are detected because female newborns show clitorimegaly and/or labial fusion. The concentrations of androgenic steroids in the maternal blood during pregnancy and in the cord blood at child-birth show significantly increased rates. The ultrasound shows solid or cystic-solid structures and few weeks after the delivery they decrease and the ovary size returns to normal. The authors report a case of a patient who exhibited virilization signs in two consecutive pregnancies as well as in the two female fetuses. At adnexal sonographic examination a solid tumoral image was found in both pregnancies. Serum androgen levels were increased.

Estrategia educativa sobre lactancia materna. Policlínico "Joaquín de Agüero". Marzo 2007 a Marzo 2008

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Yoycet Ruiz de Villa Martínez

2011-01-01

Full Text Available Se analizó que no todas las madres conocen la necesidad de lactar a sus hijos en los primeros meses de vida, lo cual obstaculiza el éxito de la lactancia materna exclusiva (al sexto mes, por lo que se realizó una estrategia de intervención educativa con el objetivo de incrementar el nivel de conocimientos en las madres del Grupo Básico de Trabajo No.2 del Policlínico "Joaquín de Agüero y Agüero". El universo estuvo constituido por 149 madres de niños de 0 a 6 meses de edad, aplicando una encuesta para identificar las necesidades de aprendizaje sobre la lactancia materna. Posteriormente se llevó a cabo un programa educativo, utilizándose técnicas participativas y demostrativas, aplicándose finalmente la misma encuesta para poder comparar, a través de la evaluación, los resultados de la intervención. Al inicio predominó la evaluación de regular lo cual fue modificada al final, mostrándose la eficacia del programa aplicado. Se concluyó que la intervención fue efectiva predominado un criterio muy satisfactorio de las madres participantes.

Managing an outpatient parenteral antibiotic therapy team: challenges and solutions

OpenAIRE

Nguyen, Hien; Halilovic,Jenana; Christensen,Cinda

2014-01-01

Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and hig...

Régimen corto de antibioticoterapia parenteral frente a régimen largo: Análisis de minimización de costes A short-term parenteral antibiotic therapy regime versus a long-term regime: Analysis of cost reduction

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Martha Medina García

2006-06-01

Full Text Available Se realizó un estudio de análisis económico, del tipo de minimización de costes, con el objetivo de evaluar los costes de un régimen de tratamiento antibiótico parenteral de corta duración (3 días utilizado en recién nacidos con infección del tracto urinario alta, de evolución inicial favorable, en comparación con otro de larga duración (≥ 5 días. Se tuvo como base un estudio analítico, observacional, en el que se conformaron dos grupos según el régimen de tratamiento antibiótico parenteral (corto o largo seguido de antibioticoterapia oral, que generó un ciclo de tratamiento parenteral-oral secuencial de 10 días de duración. Se evaluaron los costes por concepto de tratamiento con antibióticos y de hospitalización. Con el tratamiento corto se habrían ahorrado 29 054,58 CU con respecto a los costes derivados del régimen de tratamiento largo, a lo que se suman otros beneficios en la esfera psico-social familiar. Con los resultados obtenidos concluimos que un régimen de tratamiento antibiótico parenteral de corta duración (3 días para el tratamiento de una infección del tracto urinario alta de evolución inicial favorable, tiene mayor eficiencia que un régimen largo (≥ 5 días, pues se logra minimizar los costes relativos al tratamiento antibiótico y a la hospitalización.

Review of macronutrients in parenteral nutrition for neonatal intensive care population.

Science.gov (United States)

Johnson, Patricia J

2014-01-01

Parenteral nutrition (PN) has become essential in the management of sick and growing newborn populations in the NICU. In the past few decades, PN has become fundamental in the nutritional management of the very low birth weight infant (macronutrients in PN, including carbohydrates, protein, and fat. A subsequent article will review the micronutrients in PN, including electrolytes, minerals, and vitamins.

Capacitación sobre lactancia materna al personal de enfermería del Hospital General de México

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Hernández-Garduño Adolfo Gabriel

2000-01-01

Full Text Available OBJETIVO: Evaluar el cambio de conocimientos acerca de la lactancia entre el personal de enfermería del Hospital General de México que asistió a un curso teórico-práctico sobre lactancia materna de 18 horas de duración. MATERIAL Y MÉTODOS: Se realizó una intervención educativa sobre lactancia materna, con evaluación inicial y final, en el Hospital General de México, de mayo de 1996 a mayo de 1997. Se capacitó a 152 enfermeras. Se aplicó la prueba t de Student para muestras dependientes y análisis de varianza. RESULTADOS: De 152 participantes, 140 (92% respondieron ambas evaluaciones. Los resultados globales de la evaluación inicial y final fueron 5.39±1.37 y 7.74±0.79, respectivamente, y resultaron estadísticamente significativos (p<0.001. La significancia se mantuvo aun después de ajustar por el nivel de instrucción de los participantes. En la evaluación final se observó que a mayor nivel de escolaridad, mayores conocimientos sobre lactancia (p=0.004. CONCLUSIONES: Un curso de capacitación en lactancia de tipo teórico-práctico y de 18 horas de duración, dirigido al personal de enfermería, permite un cambio significativo en los conocimientos alcanzados.

Rapid parenteral rehydration in children with dehydration due to acute diarrheal disease Hidratación parenteral rápida en pacientes deshidratados por enfermedad diarreica aguda

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Myriam Bastidas

1989-03-01

Full Text Available

Between May and July 1987, we studied 36 children with second or third degree dehydration secondary to acute diarrheal disease of less than one week duration; they had no serious associated problems. Parenteral rehydration was carried out with a solution similar in composition to the one recommended by the World Health Organization for Oral Rehydration Therapy (ORT. Rehydration was achieved in 30 patients within 6 hours and In 3 more within 12 hours; there were no cases of hypernatremia or hyperkalemia. It is concluded that parenteral rehydration with a solution similar to the one employed for ORT is an adequate alternative when oral rehydration is not indicated in children with diarrheal disease.

Entre mayo y julio de 1987 se estudiaron 36 niños que ingresaron al Hospital Infantil de Medellín con deshidratación de segundo o tercer grado, secundaria a enfermedad diarreica de evolución menor de una semana y sin enfermedad grave asociada. La hidratación se llevó a cabo parenteralmente empleando una mezcla de composición similar a la que recomienda la Organización Mundial de la Salud para la Terapia de Rehidratación Oral (TRO. Se logró la hidratación en un lapso de 6 horas en 30 de los 36 pacientes y en 3 más en las siguientes 6 horas; no se produjeron casos de hipernatremia ni de hiperkalemia. Se concluye que la hidratación parenteral, con una solución de composición similar a la de la TRO, es una alternativa adecuada cuando no está indicada la hidratación oral del niño con enfermedad diarreica.

A case of organophosphate poisoning presenting with seizure and unavailable history of parenteral suicide attempt

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Pandit Vinay

2011-01-01

Full Text Available Organophosphate (OP poisoning is common in India. Only few case reports of parenteral OP poisoning have been described. We report a case of self-injected methyl parathion poisoning, presenting after four days with seizure, altered sensorium, and respiratory distress which posed a diagnostic and therapeutic dilemma. Despite nonavailability of history of OP poisoning, he was treated based on suspicion and showed a good clinical response to treatment trial with atropine and pralidoxime, and had a successful recovery. Atypical presentations may be encountered following parenteral administration of OP poison, and even a slight suspicion of this warrants proper investigations and treatment for a favorable outcome. Persistently low plasma cholinesterase level is a useful marker for making the diagnosis.

Low-fat, high-carbohydrate parenteral nutrition (PN) may potentially reverse liver disease in long-term PN-dependent infants

DEFF Research Database (Denmark)

Jakobsen, Marianne Skytte; Jørgensen, Marianne Hørby; Husby, Steffen

2015-01-01

INTRODUCTION: Parenteral nutrition-associated cholestasis (PNAC) is a complication of long-term parenteral nutrition (PN). Removal of lipids may reverse PNAC but compromises the energy to ensure infant growth. The purpose of this study was to test whether a low-fat, high-carbohydrate PN regimen......, which prevents and reverses PNAC in adults, could do the same in infants. This regimen could potentially avoid the problem of diminished energy input after removing nutritional lipids. METHODS: Infants developing PNAC over a 2-year period were started on a low-fat PN regimen with calories primarily from...

Utilization of maternal health care services in the department of Matagalpa, Nicaragua Utilización de los servicios de salud materna en el departamento de Matagalpa, Nicaragua

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Lindsey Ann Lubbock

2008-08-01

Full Text Available OBJECTIVES: To better understand the individual and community factors and perceptions that influence women's health care-seeking behaviors during pregnancy in order to increase women's utilization of maternal health services. METHODS: This study investigates the logistical and sociocultural barriers influencing women's utilization of maternal health services through 37 semi-structured in-depth interviews with women from the department of Matagalpa, Nicaragua. RESULTS: Results reveal that delays in seeking health care during pregnancy are influenced not only by poor access to care and economic barriers but also by individual and community knowledge and acceptance of maternal health services. Partner support, previous maternal health care experiences, and the degree of communication with other women and health workers affect women's decisions to seek care. CONLUSIONS: Evidence suggests that in order to improve maternal health outcomes in this region, interventions must be targeted at a hierarchy of levels: individual, household, and community.OBJETIVOS: Mejorar el conocimiento sobre las percepciones y los factores personales y comunitarios que influyen en la búsqueda de atención médica durante el embarazo, con vistas a aumentar la utilización de los servicios de salud materna. MÉTODOS: Mediante 37 entrevistas semiestructuradas en profundidad aplicadas a mujeres del departamento de Matagalpa, Nicaragua, se investigaron las barreras logísticas y socioculturales que influyen en la utilización de los servicios de salud materna. RESULTADOS: Los resultados muestran que sobre la demora en la búsqueda de atención sanitaria durante el embarazo influyeron no solo el escaso acceso y las barreas económicas, sino también el conocimiento individual y comunitario sobre los servicios de salud materna y su grado de aceptación. El apoyo de la pareja, el haber recibido atención médica durante embarazos previos y el grado de comunicación con otras

Enteral nutrients potentiate glucagon-like peptide-2 action and reduce dependence on parenteral nutrition in a rat model of human intestinal failure

DEFF Research Database (Denmark)

Brinkman, Adam S; Murali, Sangita G; Hitt, Stacy

2012-01-01

human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg(-1)·day(-1)), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral...

Parenteral nutrition including polyamine under experimental irradiation of the abdomen

International Nuclear Information System (INIS)

Moroz, B.B.; Fedorovskij, L.L.; Lyashchenko, Yu.N.

1982-01-01

White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow

Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

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El Essawy R

2013-05-01

Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions

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Jensen, Gordon L.; Koletzko, Berthold V.; Singer, Pierre; Wanten, Geert J. A.

2010-01-01

Background Energy deficit is a common and serious problem in intensive care units and is associated with increased rates of complications, length of stay, and mortality. Parenteral nutrition (PN), either alone or in combination with enteral nutrition, can improve nutrient delivery to critically ill patients. Lipids provide a key source of calories within PN formulations, preventing or correcting energy deficits and improving outcomes. Discussion In this article, we review the role of parenteral lipid emulsions (LEs) in the management of critically ill patients and highlight important biologic activities associated with lipids. Soybean-oil-based LEs with high contents of polyunsaturated fatty acids (PUFA) were the first widely used formulations in the intensive care setting. However, they may be associated with increased rates of infection and lipid peroxidation, which can exacerbate oxidative stress. More recently developed parenteral LEs employ partial substitution of soybean oil with oils providing medium-chain triglycerides, ω-9 monounsaturated fatty acids or ω-3 PUFA. Many of these LEs have demonstrated reduced effects on oxidative stress, immune responses, and inflammation. However, the effects of these LEs on clinical outcomes have not been extensively evaluated. Conclusions Ongoing research using adequately designed and well-controlled studies that characterize the biologic properties of LEs should assist clinicians in selecting LEs within the critical care setting. Prescription of PN containing LEs should be based on available clinical data, while considering the individual patient’s physiologic profile and therapeutic requirements. PMID:20072779

Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy.

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Zhu, Xin-Hua; Wu, Ya-Fu; Qiu, Yu-Dong; Jiang, Chun-Ping; Ding, Yi-Tao

2013-09-21

To investigate the effect of early enteral nutrition (EEN) combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy (PD). From January 2006, all patients were given EEN combined with parenteral nutrition (PN) (EEN/PN group, n = 107), while patients prior to this date were given total parenteral nutrition (TPN) (TPN group, n = 67). Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery. The assessment of clinical outcome was based on postoperative complications. Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge. Readmission within 30 d after discharge was also recorded. Compared with the TPN group, a significant decrease in prealbumin (PAB) (P = 0.023) was seen in the EEN/PN group. Total bilirubin (TB), direct bilirubin (DB) and lactate dehydrogenase (LDH) were significantly decreased on day 6 in the EEN/PN group (P = 0.006, 0.004 and 0.032, respectively). The rate of grade I complications, grade II complications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased (P = 0.036, 0.028 and 0.021, respectively), and no hospital mortality was observed in our study. Compared with the TPN group (58.2%), the rate of infectious complications in the EEN/PN group (39.3%) was significantly decreased (P = 0.042). Eleven cases of delayed gastric emptying were noted in the TPN group, and 6 cases in the EEN/PN group. The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group (P = 0.031 and P = 0.040, respectively). Early enteral combined with PN can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing PD.

Factores de riesgo asociados a muerte materna por hemorragia posparto en el departamento de Antioquia en los años 2004-2006

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John Jairo Zuleta Tobón

2008-02-01

Full Text Available La mortalidad materna en Antioquia se calculó para los años 2004 y 2005 en 63,2 y 48,1 por 100.000 nacidos vivos, respectivamente; la principal causa fue la hemorragia posparto con 44% y 28% en los mismos años. Por cada caso de muerte se calcula en 30 los casos de eventos obstétricos que implican riesgo de morir. Al analizar estos casos se han encontrado algunos factores que impactan el desenlace. OBJETIVOS: describir las características generales de las pacientes que presentaron hemorragia obstétrica en el departamento de Antioquia en los años 2004-2006, así como identificar los factores de riesgo asociados a muerte en estas pacientes. TIPO DE ESTUDIO: de casos y controles. RESULTADOS Y CONCLUSIONES: en el departamento de Antioquia para los años 2004-2006 se informaron 35 casos de muerte materna por hemorragia posparto, y en la ciudad de Medellín, 42 casos de hemorragia obstétrica grave del tercer trimestre en los años 2005 y 2006. En el 47,6% de las pacientes con hemorragia obstétrica y en el 34,3% de las pacientes fallecidas se hizo manejo activo del alumbramiento con oxitocina. Los retrasos I y II fueron más frecuentes en el grupo de mortalidad con 54,5% y 21,2%, respectivamente, y el retraso tipo III fue similar para ambos grupos: 86,8% vs. 90,9%. El manejo de líquidos y la utilización de hemoderivados fueron similares en ambos grupos, aunque no fueron administrados según las recomendaciones para el manejo del choque hipovolémico. La hemorragia posparto continúa siendo la principal causa de mortalidad materna y de morbilidad obstétrica grave en el departamento de Antioquia, sin que se logre evidenciar diferencias claras que condicionen uno u otro desenlace.

Chronic parenteral nutrition induces hepatic inflammation, steatosis and insulin resistance in neonatal pigs

Science.gov (United States)

Prematurity and overfeeding in infants are associated with insulin resistance in childhood and may increase the risk of adult disease. Total parenteral nutrition (TPN) is a major source of infant nutrition support and may influence neonatal metabolic function. Our aim was to test the hypothesis that...

The parenteral nutritional regimen in pigs for basic studies in physiology of nutrition

International Nuclear Information System (INIS)

Matkowitz, R.; Harting, W.; Souffrant, W.B.; Junghans, P.; Boerner, P.

1983-01-01

Experimental studies concerning a parenteral nutritional regimen were performed in pigs aiming at comparative metabolic investigations to evaluate clinically relevant problems within nutritional research. By means of the 15 N tracer technique the evaluation of the postoperative protein turnover was rendered possible by this animal model

Concepções maternas sobre o desenvolvimento da criança deficiente visual Maternal conceptions concerning the development of children with visual impairment

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Carolina Silva de Medeiros

2012-06-01

Full Text Available este estudo teve por objetivo apreender as concepções maternas sobre o desenvolvimento de crianças deficientes visuais (cegueira e baixa visão severa, na faixa etária dos dois aos sete anos de idade. Participaram dez mães, com idades entre 22 e 39 anos e com nível educacional igual ou superior ao ensino fundamental completo. Foram realizadas entrevistas estruturadas com uso de um gravador digital e de um roteiro de perguntas com questões sobre o desenvolvimento da criança bem como sobre a percepção materna a respeito do momento do diagnóstico e suas implicações. As entrevistas foram transcritas integralmente e analisadas à luz da análise de conteúdo categorial temática, com categorias que foram definidas a partir do objetivo do estudo e dos discursos maternos. Quatro categorias foram elaboradas: detecção da deficiência visual; reações frente à descoberta da deficiência visual; avaliação das características da criança, a partir das subcategorias: motor, linguística e das relações sociais e a percepção do desenvolvimento atual da criança deficiente visual. As verbalizações maternas evidenciaram que o atendimento especializado desde cedo é importante para lidar com as possíveis expectativas em relação ao desenvolvimento infantil. Considera-se, portanto, que o acesso às concepções maternas é relevante, haja vista que estas concepções podem revelar o modo como as mães interagem com os filhos. Sugere-se que novos estudos sejam realizados e que contemplem tanto as concepções maternas sobre o desenvolvimento infantil, mas que também analisem a interação mãe-criança com deficiência visual, para subsidiar a elaboração de programas de intervenção.In order to understand maternal conceptions about child development, this paper studies the concepts mothers have of the development of children (two to seven years with visual impairments (blindness and severe low vision. The study was conducted with a

Validation of doubly labeled water for measuring energy expenditure during parenteral nutrition

International Nuclear Information System (INIS)

Schoeller, D.A.; Kushner, R.F.; Jones, P.J.

1986-01-01

The doubly labeled water method was compared with intake-balance for measuring energy expenditure in five patients receiving total parenteral nutrition (TPN). Because parenteral solutions were isotopically different from local water, patients had to be placed on TPN at least 10 days before the metabolic period. Approximately 0.1 g 2H2O and 0.25 g H2(18)O per kg total body water were given orally. We collected saliva before, 3 h, and 4 h after the dose for measurement of total body water and urine before, 1 day, and 14 days after the dose for measurement of isotope eliminations. On day 14, total body weight was remeasured and change in body energy stores was calculated, assuming constant hydration. Intake was assessed from weights of TPN fluids plus dietary record for any oral intake. Energy expenditure from doubly labeled water (+/- SD) averaged 3 +/- 6% greater than intake-balance. Doubly labeled water method is a noninvasive, nonrestrictive method for measuring energy expenditure in patients receiving TPN

Investigation of Possible Maillard Reaction Between Acyclovir and Dextrose upon Dilution Prior to Parenteral Administration.

Science.gov (United States)

Siahi Shadbad, Mohammad Reza; Ghaderi, Faranak; Hatami, Leila; Monajjemzadeh, Farnaz

2016-12-01

In this study the stability of parenteral acyclovir (ACV) when diluted in dextrose (DEX) as large volume intravenous fluid preparation (LVIF) was evaluated and the possible Maillard reaction adducts were monitored in the recommended infusion time. Different physicochemical methods were used to evaluate the Maillard reaction of dextrose with ACV to track the reaction in real infusion condition. Other large volume intravenous fluids were checked regarding the diluted drug stability profile. Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and mass data proved the reaction of glucose with dextrose. A Maillard-specific high performance liquid chromatography (HPLC) method was used to track the reaction in real infusion condition in vitro. The nucleophilic reaction occurred in diluted parenteral preparations of acyclovir in 5% dextrose solutions. The best diluent solution was also selected as sodium chloride and introduced based on drug stability and also its adsorption onto different infusion sets (PVC or non PVC) to provide an acceptable administration protocol in clinical practices. Although, the Maillard reaction was proved and successfully tracked in diluted solutions, and the level of drug loss when diluted in dextrose was reported to be between 0.27 up to 1.03% of the initial content. There was no drug adsorption to common infusion sets. The best diluent for parenteral acyclovir is sodium chloride large volume intravenous fluid.

Early optimal parenteral nutrition and metabolic acidosis in very preterm infants.

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Francesco Bonsante

Full Text Available It is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN.This observational study described the acid-base profile of very preterm infants (≤29 week's gestation receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3 nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate. The outcome measure to assess metabolic acidosis was the base excess (BE.161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d and lipids (2.8 ± 1.4 g/kg/d during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3; -6.4 ± 3.4 (group 2; -5.1 ± 3.0 (group 1]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes.Acid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24-26 week's gestation displayed greater acidotic disequilibrium

Recursos educativos TIC para la enseñanza/Aprendizaje del español como lengua materna, segunda y extranjera

OpenAIRE

Rodríguez Muñoz, Francisco J.; Níkleva, Dimitrinka G.

2015-01-01

Este artículo pretende mostrar la utilidad de los recursos TIC de cara a la enseñanza/aprendizaje del español como lengua materna, segunda y extranjera. Entre sus ventajas, las TIC facilitan la creación de redes para el intercambio del conocimiento, a partir del que se produce un aprendizaje colaborativo (o aprendizaje 2.0). En este sentido, las plataformas de enseñanza virtual se han convertido en un escenario habitual para el desarrollo de este tipo de aprendizaje. Asimismo, ...

[Studies on calf salmonellosis. 4. Oral and parenteral immunization with live (Smd) and killed antigens].

Science.gov (United States)

Meyer, H; Steinbach, G; Hartmann, H; Hauke, H; Koch, H; Stelzner, A; Linde, K; Schmerbauch, A; Kiupel, H

1977-01-01

Reported are results obtained from studies into oral and parenteral immunisation of calf. The approaches had included the use of live (Smd) or dead antigen from Salmonella (S.) dublin and a combination of the two immunisation methods. Live antigen (Smd) was superior to thermally activated dead antigen, when the oral route was used to prevent S.-dublin injection of calves. The above findings were supported by results from analogous studies in which S. typhimurium and S. dublin or live antigen (Smd) or dead antigen, made of the two, had been applied to mice. (One single subcutaneous) parenteral administration did hardly reveal any difference in favour of live vaccine (Smd). Parenteral administration of live or dead antigen proved to be less effective than repeated oral immunisation, particularly when live vaccine (Smd) was used. Immunity not less than up to six months of age against S. dublin wild strain infection can be provided for young calves by oral immunisation, with Smd vaccine (5. 1010 to 1. 1011 live germs/d) being given on ten consecutive days. Calves orally immunised with live antigen (ten repetitive applications of Smd mutants) are likely to develop an antibody titre (H-agglutinins) against S. dublin. Parenteral boostering,using live antigen, has been accompanied by sensitisation due to oral live antigen administration as well as by dose dependence, as was seen from the bactericidal values. Sensitisation was established from orally immunised calves up to three months old (typical booster reaction). Some of it was attributabale to confrontation with wild strains of Salmonella. The H-agglutinin titres of animals aged threemonths in a calf herd with salmonelloses in which all animals had been orally Smd-immunised were close to those recorded from calves in stocks with no salmonellosis occurrence. Under the conditions of oral immunisation, there had obviously been no action of the wild strain which might have triggered intensive antibody formation.

Análisis contrastivo de errores en el aprendizaje de E/LE de alumnos de lengua materna alemana y turca

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Ebru Yener Gökşenli

2017-05-01

Full Text Available Este trabajo se sitúa en el marco de una investigación constrastiva sobre la interlengua de alumnos que aprenden español como lengua extranjera. El propósito del presente trabajo es poner de manifiesto dónde se origina la dificultad a la hora de aprender español, intentando ver si existe alguna relación con sus distintas lenguas maternas. El corpus que le sirve de base consiste en 200 exámenes escritos, realizados por alumnos austríacos y turcos, procedentes por tanto de dos grupos lingüísticos diferentes: alemán y turco. Ambos grupos han sido alumnos de los Institutos Cervantes de Viena y Estambuldel nivel C1. El estudio analiza algunos contenidos gramaticales en los que ambos grupos de alumnos cometen errores repetidamente. Intentaremos hacer una definición de los errores errores fosilizables y fosilizados que se cometen en los exámenes. Mediante las figuras de análisis cuantitativos se podrán observar los porcentajes significativos que nos  ayudarán a tener una idea sobre los errores que podrían proceder de sus lenguas maternas. Aunque en su mayoría son distintos, hay también algunos puntos conflictivos en ambos idiomas.

Preventive effect of ursodeoxycholic acid on parenteral nutrition-associated liver disease in infants

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Simić Dušica

2014-01-01

Full Text Available Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g birth weight infants (n=30, as well as the group of pediatric (n=11 and surgical patients (n=15 treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively. The peak serum conjugated bilirubin (CB, AST, ALT and alkaline phosphatase (AP levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.

ASSOCIAÇÃO DAS MALFORMAÇÕES CONGÊNITAS COM VARIÁVEIS NEONATAIS E MATERNAS EM UNIDADES NEONATAIS NUMA CIDADE DO NORDESTE BRASILEIRO

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Fabíola Chaves Fontoura

2014-01-01

Full Text Available Malformaciones congénitas ocurrir debido a factores genéticos, ambientales, mistos o por causas desconocidas. Se objetivó investigar la relación entre tipo de malformación congénita, variables neonatales y maternas. Estudio prospectivo, cuantitativo, realizado en tres unidades neonatales públicas en Fortaleza-CE, Brasil. Los datos fueron recolectados del sistema de registro de 159 recién nacidos malformados y analizados por medio del test Chi cuadrado (χ 2 , nivel de significancia de 5% ( p <0,05. Prevalecieron 85 (53% recién nacidos del sexo masculino, 91 (57% a término y 82 (52% con peso entre 2500g y 3999g. Sobresalieron malformaciones del sistema nervoso central y óseo muscular. Variables como sexo, edad gestacional, peso al nascer, uso de drogas, edad materna, renta familiar, nivel de instrucción y cantidad de hijos demostraron significancia estadística, cuando asociadas a las categorías de malformaciones (p<0,05. Factores maternos y neonatales presentaron relación con el tipo de malformaciones, datos relevantes para el cuidado de enfermería junto al neonato.

Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation.

Science.gov (United States)

Bernstein, J; Chang, C H; Brough, A J; Heidelberger, K P

1977-03-01

Liver biopsy was performed to exclude anatomic obstruction of the biliary tract in five prematurely born infants who had developed conjugated hyperbilirubinemia during intravenous alimentation with a protein hydrolysate. Each was being treated after having undergone a segmental intestinal resection for necrotizing enterocolitis. Bacterial and viral infections, metabolic disorders, and isoimmune hemolytic disease were excluded as possible causes of jaundice. Light microscopic and ultrastructural analysis disclosed cholestasis and hepatocellular injury without significant inflammatory reaction. Jaundice abated following permanent discontinuation of parenteral alimentation. The jaundice and cholestasis are interpreted to be hepatotoxic effects because of (1) their temporal relationship to the treatment and (2) the presence of hepatocellular damage.

Studies with a safflower oil emulsion in total parenteral nutrition.

Science.gov (United States)

Wong, K. H.; Deitel, M.

1981-01-01

The prevention of essential fatty acid deficiency and the provision of adequate amounts of energy are two major concerns in total parenteral nutrition. Since earlier preparations of fat emulsion used to supplement the usual regimen of hypertonic glucose and amino acids have widely varying clinical acceptability, a new product, a safflower oil emulsion available in two concentrations (Liposyn), was evaluated. In four clinical trials the emulsion was used as a supplement to total parenteral nutrition. In five surgical patients 500 ml of the 10% emulsion infused every third day prevented or corrected essential fatty acid deficiency; however, in some cases in infusion every other day may be necessary. In 40 patients in severe catabolic states the emulsion provided 30% to 50% of the energy required daily: 10 patients received the 10% emulsion for 14 to 42 days, 9 patients received each emulsion in turn for 7 days, and 21 patient received the 20% emulsion for 14 to 28 days. All the patients survived and tolerated the lipid well; no adverse clinical effects were attributable to the lipid infusions. Transient mild, apparently clinically insignificant abnormalities in the results of one or more liver function tests and eosinophilia were observed in some patients. Thus, the safflower oil emulsion, at both concentrations, was safe and effective as a source of 30% to 50% of the energy required daily by seriously ill patients. PMID:6799182

Hyperintense brain lesions on T1-weighted MRI after parenteral nutrition

International Nuclear Information System (INIS)

Saitoh, Yoshiaki; Kimura, Seiji; Nezu, Atsuo; Ohtsuki, Noriyuki; Kobayashi, Takuya; Osaka, Hitoshi; Uehara, Saori

1996-01-01

We experienced five children having T 1 -shortening lesions in basal ganglia or thalami on magnetic resonance imaging (MRI), which were supposed to be caused by manganese (Mn) overdoses. Instead of the presence of above-mentioned lesions, no neurological manifestations corresponding to them had developed in all patients. This observation suggests that MRI is useful for detecting side effects caused by overdoses of Mn in patients having parenteral nutrition. (author)

Five-year survival and causes of death in patients on home parenteral nutrition for severe chronic and benign intestinal failure

DEFF Research Database (Denmark)

Joly, Francisca; Baxter, Janet; Staun, Michael

2018-01-01

BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underl......BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions...

Vitamin E in new Generation Lipid Emulsions Protects Against Parenteral Nutrition-Associated Liver disease in Parenteral Nutrition-Fed Preterm Pigs

DEFF Research Database (Denmark)

Kenneth, Ng; Stoll, Barbara; Chacko, Shaji

2016-01-01

Introduction: Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis: Whether modifying the phytosterol and vitamin E...... composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods: We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3......, OV, and PS compared to IL. Hepatic cholesterol 7-hydroxylase and organic solute transporter-α expression was lower (P E1 fatty acid...

Maternal Migration and Child Well-being in Peru(Migración materna y bienestar infantil en el Perú)

OpenAIRE

Javier Escobal; Eva Flores

2009-01-01

Este Documento de Trabajo encuentra que la migración no sólo influencia a los que emigran, sino que también puede tener efectos intergeneracionales en los hijos. La muestra de la investigación son las madres con antecedentes de migración interna que forman parte del estudio de largo plazo Niños del Milenio, conocido internacionalmente como Young Lives. Comparando a dichas madres con las que no migraron (con los controles adecuados), el estudio halló que la migración materna ha tenido un impac...

PROGRAMA “CASA DAS GESTANTES”: UMA NOVA LÓGICA DE ATENÇÃO À SAÚDE MATERNA E PERINATAL

OpenAIRE

Adriano Maçal Pimenta; Juliana Vieira Nazareth; Kleyde Ventura de Souza

2010-01-01

El programa “Casa de las Embarazadas” es una estrategia del Ministerio de Salud Pública BR, teniendo en vista la equidad y humanización de la asistencia a las embarazadas de alto riesgo. Se trata de un estudio epidemiológico, transversal, descriptivo y exploratorio que se realizó en la “Casa de las Embarazadas” de una maternidad filantrópica en Belo Horizonte con el objetivo de evaluar el impacto de este programa en la salud materna de 292 embarazadas que usaron el servicio y de sus recién na...

A rela??o entre os estilos de socializa??o materna e as concep??es de perd?o em adolescentes.

OpenAIRE

Santos, Lydia Maria Sena e

2014-01-01

O presente estudo buscou analisar a rela??o entre a percep??o dos adolescentes sobre os estilos de socializa??o materna e concep??es sobre perd?o. Os estilos de socializa??o parental s?o definidos como padr?es de atua??o caracter?sticos, que os pais utilizam em diversas situa??es do cotidiano. Esses padr?es caracterizam-se por um conjunto de t?cnicas e formas de atua??o dos pais, que abrangem desde atitudes de aceita??o at? atitudes de controle dos comportamentos indesejados, al?m da imposi??...

Información sobre la lactancia materna de las gestantes en su tercer trimestre Information on breast feeding found in pregnant women in their third trimester of gestation

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Remigio Rafael Gorrita Pérez

2012-12-01

Full Text Available Introducción: son universalmente reconocidas las virtudes de la lactancia materna -y es obvio que la mujer está dotada fisiológicamente para el amamantamiento y en un gran número de organizaciones internacionales de salud de diferentes países se han diseñado políticas con el objetivo de promover adecuadamente esta inigualable práctica- pero aún son múltiples los obstáculos que se presentan a su establecimiento exitoso, y los resultados, a largo plazo, no son satisfactorios. Objetivo: evaluar la información que, sobre lactancia materna, poseen las gestantes en el tercer trimestre de su embarazo, que pertenecen al Policlínico "Mártires del 9 de Abril", del municipio San José de las Lajas. Métodos: se realizó un estudio descriptivo, transversal, para conocer el nivel de información sobre lactancia materna, en el tercer trimestre, de 114 gestantes del Policlínico "Mártires del 9 de Abril", de San José de las Lajas. Se valoraron sus historias de salud individual y familiar, y se les aplicó un cuestionario con 22 preguntas que se evaluó cualitativa y cuantitativamente. Resultados: solo la quinta parte de las gestantes poseía la información suficiente sobre lactancia materna, aunque la mayoría había asumido que sí los tenía. Más de la mitad de los 17 aspectos explorados, eran deficientes en más del 50 % de las encuestadas. Los errores más frecuentes fueron: momento de dar agua al niño con lactancia materna exclusiva, cuándo brindar otro alimento, hasta cuándo mantener la lactancia materna, cómo debe ser la dieta de la madre, el alternamiento y el aseo de los pechos, y los impedimentos de la madre para la lactancia. Conclusiones: gran número de gestantes evidencian desconocimientos o actitudes equivocadas de diversa índole en relación con la lactancia materna exclusiva, aunque creen tener dominio del tema. Se deben explorar otros aspectos, además de los conocimientos sobre la lactancia, que, sin duda, atentan

Contaminantes orgánicos persistentes (COPs en leche materna de centros urbanos de la provincia de Buenos Aires

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Lara Sofia Della Ceca

2013-01-01

Full Text Available Los contaminantes orgánicos persistentes (COPs se acumulan en matrices ricas en materia grasa como la leche materna, que es un buen indicador de sus niveles en poblaciones humanas debido a su fácil y no invasiva extracción. Con el objeto de evaluar la exposición a COPs en la provincia de Buenos Aires y compararla con otras  áreas, se analizaron bifenilos policlorados (PCBs, diclorodifeniltricloroetano (DDT y sus metabolitos (DDT, TDE, hexaclorociclohexanos (?, ? y ?-HCH y clordanos (CHLDs: heptaclor y su epóxido, trans y cis clordanos y nonaclors en muestras de leche materna colectadas durante 2010 y 2011 en Punta Lara, Ensenada, Florencio Varela y Capital Federal.Las  muestras fueron colectadas con sacaleches manuales, centrifugadas para separar la crema que fue liofilizada y extraída con éter de petróleo y ultrasonido. Los extractos previamente tratados con ácido para eliminación parcial de lípidos, fueron purificados por cromatografía en gel de sílice y analizados por cromatografía gaseosa.Las concentraciones de COPs en ng.g-1 lípido decrecieron en el orden DDTs (76±91 ? PCBs (67±64 > HCHs (33±36 ³ CHLDs (22±24.  Los DDTs oscilaron entre 7.7-510 ng.g-1 lípido y  los PCBs entre 5-247 ng.g-1 lípido, estos valores son comparables al rango más bajo reportado en la literatura (DDTs Noruega: 39-292 ng.g-1 lípido; PCBs Vietnam: 26-210 ng.g-1, Japón: 23-370 ng.g-1. En cambio, las concentraciones de HCHs y CHLDs, que oscilaron entre 5.8-197 ng.g-1 lípido y  1.3-124 ng.g-1 lípido respectivamente, corresponden al rango medio reportado para otras áreas (HCHs Indonesia 1.6-120 ng.g-1; CHLDs 3.4-92 ng.g-1. La composición de residuos en la leche materna es relativamente conservativa para cada clase de COPs, así se observa uniforme predominancia de productos de degradación (p.ej. DDE: 90±17% de SDDTs; epóxido de heptaclor: 50±18% y t-nonaclordano: 34±13% de SCHLDs y los isómeros y congéneres más persistentes (?-HCH

Facility-based care for delivery and management of complications related to pregnancy and childbirth in Mexico

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Bernardo Hernández

2012-10-01

Full Text Available OBJECTIVE: To describe the incidence and management of severe maternal and newborn complications in selected health facilities in Mexico. MATERIALS AND METHODS: As part of the WHO Multicountry Survey on Maternal and Newborn health, information was collected from medical records of women with deliveries and/or severe maternal complications during pregnancy or puerperium in 14 hospitals in Mexico City and the state of Guanajuato, Mexico. RESULTS: Of 13 311 women, 157 (12 per 1 000 live births had severe maternal complications including 4 maternal deaths. The most frequent complications were preeclampsia, postpartum hemorrhage, and chronic hypertension. Adverse perinatal outcomes were more frequent among women with severe maternal complications. A high use of uterotonics and parenteral antibiotics was found. A small proportion of women with eclampsia received magnesium sulfate. CONCLUSION: This study provides indicators on the incidence and management of maternal and neonatal complications in Mexico, which may be useful in studying and evaluating the performance of obstetric services.OBJETIVO: Describir la incidencia y manejo de complicaciones maternas y neonatales severas en hospitales seleccionados de México. MATERIAL Y MÉTODOS: En el marco de la Encuesta Multipaís de la OMS sobre Salud Materna y Neonatal, se recolectó información de los expedientes médicos de las mujeres que tuvieron su parto o experimentaron complicaciones maternas severas durante el embarazo o puerperio en 14 hospitales de la Ciudad de México y el estado de Guanajuato, México. RESULTADOS: De 13 311 mujeres, 157 (12/1 000 nacidos vivos tuvieron complicaciones maternas severas, incluyendo 4 muertes maternas. Las complicaciones más frecuentes fueron preeclampsia, hemorragia postparto e hipertensión crónica. Los resultados perinatales adversos fueron más frecuentes en las mujeres con complicaciones severas. Hubo un uso amplio de uterotónicos y antibi

Ready-to-use parenteral amiodarone : A feasibility study towards a long-term stable product formulation

NARCIS (Netherlands)

Jacobs, Maartje S.; Luinstra, Marianne; Moes, Jan Reindert; Chan, Tiffany C. Y.; Minovic, Isidor; Frijlink, Henderik W.; Woerdenbag, Herman J.

Objectives To determine the feasibility of preparing a long-term stable ready-to-use parenteral amiodarone formulation using cyclodextrins as dissolution enhancer. Methods A preformulation study was performed with different molar ratios of hydroxypropyl-beta-cyclodextrin (HP-BCD) or

Alanine turnover in the postabsorptive state and during parenteral hyperalimentation before and after surgery

NARCIS (Netherlands)

Sauerwein, H. P.; Michels, R. P.; Cejka, V.

1981-01-01

Influence of total parenteral nutrition and operation on alanine turnover and venous alanine concentration was determined in 5 patients with stomach carcinoma using single technique of U-14C alanine. Every patient served at his own control. In the postabsorptive state alanine turnover was 1.63 +/-

ASSISTÊNCIA DE ENFERMAGEM A PACIENTES SUBMETIDOS À HIPERALIMENTAÇÃO PARENTERAL

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Maria Isabel Pedreira de Freitas Ceribelli

1975-03-01

Full Text Available RESUMO A hiperalimentação parenteral consiste no fornecimento de alta dosagem de glicose hipertónica, soluções de aminoácidos, sais minerais e vitaminas para garantir anabolismo proteico e síntese tissular em pacientes debitados. Está indicada em casos em que a via digestiva não pode ser utilizada ou não é suficiente para manter as necessidades metabólicas. Este procedimento requer conduta especializada com cuidadosa assistência de enfermagem relacionada ao preparo do paciente, do material para punção e da solução de hiperalimentação parenteral. Uma vez instalada, há necessidade de verificação sistemática quanto ao fluxo da solução, quanto às manifestações do paciente e quanto aos cuidados com o catéter de infusão. Os resultados obtidos são altamente significativos, mas o riscos a que o paciente está sujeito também são numerosos. Seu sucesso dependerá grandemente das disponibilidades econômicas locais e da especialização da equipe de saúde.

Development of cyclosporine A microemulsion for parenteral delivery.

Science.gov (United States)

Yuan, Yue; Che, Xin; Zhao, Mingyi; Wang, Yan; Liu, Yajun; Schwendeman, Anna; Li, Sanming

2015-01-01

The goal of this study was to develop a parenteral microemulsion formulation of cyclosporine A (CyA). The CyA solubility in caprylic capric triglyceride (GTCC), ethyl oleate and soybean oil were determined. The pseudo-ternary diagrams of oil (GTCC), surfactant (Solutol® HS-15), cosurfactants (ethanol/polyethylene glycol 400 [PEG 400] mixture) and water were constructed to identify boundaries for microemulsion existence. The CyA was added at 3, 6 and 9% w/w to the optimal microemulsion composition. Microemulsion particle size, solution viscosity and conductivity were examined. The microemulsion stability and haemolytic potential were examined after dilution in 5% dextrose solution for injection to 1 mg/mL CyA. Microemulsion stability was examined after a three-month storage at 4 and 25 °C. The GTCC was selected as an oil phase for CyA microemulsion based on solubility results. The optimum CyA microemulsion formulation consisted of 2.5% CyA, 9% GTCC, 24% Solutol® HS 15, 8% PEG 400, 4% ethanol and 52.5% water based on weight percent. The average particle sizes of the optimized blank and drug-loaded microemulsions were 68.7 nm and 71.6 nm, respectively and remained unchanged upon 25-fold dextrose dilution. The results of microemulsion physical and CyA chemical were confirmed by a three-month stability study at 4 and 25 °C. In vitro haemolysis studies indicated that CyA microemulsions were well tolerated by erythrocytes. The novel microemulsion formulation of CyA was developed that is suitable for parenteral administration. This new formulation could potentially have less vehicle-associated side effects that current commercial formulation of CyA based on Cremophor® EL and ethanol solution.

Iatrogenia institucional y muerte materna. Semmelweis y la fiebre puerperal

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Oswaldo Salaverry García

Full Text Available La fiebre puerperal es una enfermedad que asume carácter epidémico en el siglo XVIII como consecuencia de dos factores: las masas trabajadoras urbanas generadas por la revolución industrial, y la progresiva hegemonización y medicalización de la atención del parto en grandes hospitales públicos. La mortalidad materna institucionalizada alcanza cifras superiores al 30%, en tanto con la atención por parteras es menor al 2%. Semmelweis, médico húngaro, postula que los médicos contaminaban a las parturientas por insuficiente higiene luego de realizar necropsias, e implanta medidas profilácticas en el Hospital de Viena, las cuales reducen dramáticamente la mortalidad, pero sus ideas son rechazadas por que afectan el proceso de institucionalización de la medicina basado en el altruismo y honor, por los que supuestamente era imposible que causen daño a sus pacientes. Es obligado a retirarse del Hospital de Viena, y continua su lucha en Budapest, pero el rechazo y la incomprensión de sus colegas por su doctrina afecta su salud mental. Muere en un asilo, pocos años antes que Pasteur y Koch demuestren las bacterias causantes de enfermedades como la fiebre puerperal.

Iatrogenia institucional y muerte materna: semmelweis y la fiebre puerperal

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Oswaldo Salaverry García

Full Text Available La fiebre puerperal es una enfermedad que asume carácter epidémico en el siglo XVIII como consecuencia de dos factores: las masas trabajadoras urbanas generadas por la revolución industrial, y la progresiva hegemonización y medicalización de la atención del parto en grandes hospitales públicos. La mortalidad materna institucionalizada alcanza cifras superiores al 30%, en tanto con la atención por parteras es menor al 2%. Semmelweis, médico húngaro, postula que los médicos contaminaban a las parturientas por insuficiente higiene luego de realizar necropsias, e implanta medidas profilácticas en el Hospital de Viena, las cuales reducen dramáticamente la mortalidad, pero sus ideas son rechazadas por que afectan el proceso de institucionalización de la medicina basado en el altruismo y honor, por los que supuestamente era imposible que causen daño a sus pacientes. Es obligado a retirarse del Hospital de Viena, y continua su lucha en Budapest, pero el rechazo y la incomprensión de sus colegas por su doctrina afecta su salud mental. Muere en un asilo, pocos años antes que Pasteur y Koch demuestren las bacterias causantes de enfermedades como la fiebre puerperal.

Paternidade no contexto da depressão pós-parto materna: revisando a literatura Fatherhood in the context of maternal postpartum depression: a literature review

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Milena da Rosa Silva

2009-04-01

Full Text Available Esta revisão da literatura examina os achados de estudos recentes a respeito da paternidade no contexto da depressão pós-parto materna. Os estudos sobre este tema demonstram forte associação negativa entre depressão pós-parto materna e qualidade do relacionamento conjugal, apoio emocional oferecido pelo pai e seu envolvimento nos cuidados do bebê e no trabalho doméstico. Também têm mostrado que o pai pode diminuir o impacto da depressão materna sobre os filhos, caso mostre-se envolvido e mentalmente saudável, embora sejam raros os estudos descrevendo o modo como se dá a participação do pai nestas famílias. A literatura aponta, ainda, que os maridos de mulheres com depressão encontram-se em situação de risco para o desenvolvimento de psicopatologias, o que sugere que as intervenções clínicas neste contexto devem focalizar também as relações familiares.The literature review examines the findings of recent studies regarding fatherhood in the context of maternal postpartum depression. The studies on this theme demonstrate strong negative association between maternal postpartum depression and the quality of marital relationship, emotional support offered by the father and his involvement in taking care of the baby and in domestic work. They have also shown that the father can reduce the impact of maternal depression on children if he is involved and mentally healthy, although there are few studies describing how fathers participate in these families. The literature also shows that husbands of depressive women are in a risk situation for the development of psychopathology, suggesting that the clinical interventions in this context should also focus on family relationships.

La edad materna avanzada como elemento favorecedor de complicaciones obstétricas y del nacimiento

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Jorge Manuel Balestena Sánchez

2015-10-01

Full Text Available Introducción: el aumento actual del embarazo en mujeres añosas provoca un riesgo superior para la mujer y su feto. Objetivo: evaluar la edad materna avanzada como factor de complicaciones obstétricas y del nacimiento. Material y método: se efectuó una investigación observacional, retrospectiva, transversal y analítica en el Hospital General Docente "Abel Santamaría Cuadrado" de Pinar del Río entre 2012 y 2013. El universo de estudio fueron la totalidad de gestantes que ingresaron en el período estudiado. La muestra se formó con gestantes añosas (grupo estudio 360 pacientes y un grupo control (720 pacientes con embarazadas entre 25 y 30 años; ambos se escogieron por muestreo intencionado. Se resumieron las variables cualitativas mediante frecuencias absolutas y relativas porcentuales. Se utilizaron las pruebas de ji cuadrado, Odd Ratio. El intervalo de confianza para el Odd Ratio al 95%. Resultados: hubo un predominio de la embarazada con partos anteriores (92.8%, la normopeso (68.9%, el 34.4% padecían alguna enfermedad crónica, siendo la principal la hipertensión arterial; la anemia durante el embarazo estuvo presente en el 34.4%, el 88.3% parieron a término, de modo espontáneo; además preponderó la cesárea con un (52.2%. La morbilidad intraparto se manifestó en el 13.1%, mientras la puerperal en el 26.7%. Hubo una elevada asociación del embarazo prolongado con la enfermedad hipertensiva, el oligoamnios y la anemia (p < 0,001, también con la inducción del parto (p < 0,001 y la cesárea (p < 0,001, así como con la morbilidad puerperal (p < 0,001. Conclusiones: la edad materna avanzada es un factor de riesgo a tener en cuenta durante el proceso de la gestación y el nacimiento.

Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates.

Science.gov (United States)

Ainsworth, S B; Clerihew, L; McGuire, W

2007-07-18

Parenteral nutrition for neonates may be delivered via a short peripheral cannula or a central venous catheter. The latter may either be inserted via the umbilicus or percutaneously. Because of the complications associated with umbilical venous catheter use, many neonatal units prefer to use percutaneously inserted catheters following the initial stabilisation period. The method of parenteral nutrition delivery may affect nutrient input and consequently growth and development. Although potentially more difficult to place, percutaneous central venous catheters may be more stable than peripheral cannulae, and need less frequent replacement. These delivery methods may also be associated with different risks of adverse events, including acquired systemic infection and extravasation injury. To determine the effect of infusion via a percutaneous central venous catheter versus a peripheral cannula on nutrient input, growth and development, and complications including systemic infection, or extravasation injuries in newborn infants who require parenteral nutrition. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (1966 - February 2007), EMBASE (1980 - February 2007), conference proceedings, and previous reviews. Randomised controlled trials that compared the effect of delivering parenteral nutrition via a percutaneous central venous catheter versus a peripheral cannulae in neonates. Data were extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using relative risk, risk difference and mean difference. Four trials eligible for inclusion were found. These trials recruited a total of 368 infants and reported a number of different outcomes. One study showed that the use of a percutaneous

n-3 fatty acid-based parenteral nutrition improves postoperative recovery for cirrhotic patients with liver cancer: A randomized controlled clinical trial.

Science.gov (United States)

Zhang, Binhao; Wei, Gang; Li, Rui; Wang, Yanjun; Yu, Jie; Wang, Rui; Xiao, Hua; Wu, Chao; Leng, Chao; Zhang, Bixiang; Chen, Xiao-Ping

2017-10-01

A new lipid emulsion enriched in n-3 fatty acid has been reported to prevent hepatic inflammation in patients following major surgery. However, the role of n-3 fatty acid-based parenteral nutrition for postoperative patients with cirrhosis-related liver cancer is unclear. We investigated the safety and efficacy of n-3 fatty acid-based parenteral nutrition for cirrhotic patients with liver cancer followed hepatectomy. A prospective randomized controlled clinical trial (Registered under ClinicalTrials.gov Identifier no. NCT02321202) was conducted for cirrhotic patients with liver cancer that underwent hepatectomy between March 2010 and September 2013 in our institution. We compared isonitrogenous total parenteral nutrition with 20% Structolipid and 10% n-3 fatty acid (Omegaven, Fresenius-Kabi, Germany) (treatment group) to Structolipid alone (control group) for five days postoperatively, in the absence of enteral nutrition. We enrolled 320 patients, and 312 (97.5%) were included in analysis (155 in the control group and 157 in the treatment group). There was a significant reduction of morbidity and mortality in the treatment group, when compared with the control group (total complications 78 [50.32%] vs. 46 [29.30%]; P parenteral nutrition significantly improved postoperative recovery for cirrhotic patients with liver cancer following hepatectomy, with a significant reduction in overall mortality and length of hospital stay. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

Science.gov (United States)

Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

1994-01-01

The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

A clinical trial comparing parenteral oxytetracyline and enrofloxacin on time to recovery in sheep lame with acute or chronic footrot in Kashmir, India

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Kaler J

2012-01-01

Full Text Available Abstract Background No clinical trials have been conducted in India on the efficacy of parenteral antibacterials to treat footrot in sheep. In addition, there are no studies worldwide on the efficacy of parenteral antibacterials to treat chronic footrot. Sixty two sheep with acute footrot and 30 sheep with chronic footrot from 7 villages in Kashmir, India were recruited into two separate trials. Sheep with acute footrot were allocated to one of three treatments using stratified random sampling: long acting parenteral oxytetracycline, long acting parenteral enrofloxacin and topical application of potassium permanganate solution (a traditional treatment used by sheep farmers in India. In a quasi pre-post intervention design, sheep with chronic footrot that had not responded to treatment with potassium permanaganate were randomly allocated to treatment with one of the two parenteral antibacterials mentioned above. Sheep with acute footrot were treated on day 0 and those with chronic footrot on days 0, 3, 6 and 9. Sheep were monitored for up to 28 days after treatment. Time to recovery from lameness and initial healing of lesions was assessed using Kaplan-Meier survival curves, nonparametric log-rank and Wilcoxon sign-rank tests. Results There was significant correlation in recovery from lameness and presence of healing lesions in sheep with acute (r = 0.94 or chronic (r = 0.98 footrot. Sheep with acute footrot which were treated with parenteral antibacterials had a significantly more rapid recovery from lameness and had healing lesions (median = 7 days compared with those treated with topical potassium permanganate solution (less than 50% recovered in 28 days. The median time to recovery in sheep with chronic footrot treated with either antibacterial was 17 days; this was significantly lower than the median of 75 days lame before treatment with antibacterials. The median time to recovery for both acute and chronic footrot increased as the severity

Spinal muscular atrophy type II (intermediary and III (Kugelberg-Welander: evolution of 50 patients with physiotherapy and hydrotherapy in a swimming pool Atrofia muscular espinhal tipo II (intermediária e III (Kugelberg-Welander: evolução de 50 pacientes com fisioterapia e hidroterapia em piscina

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Márcia C. B. Cunha

1996-09-01

Full Text Available We added hydrotherapy to 50 patients with spinal muscular atrophy (SMA who were being treated with individual conventional physiotherapy. Hydrotherapy was performed at an approximate temperature of 30 degrees Celsius, twice a week, for thirty minutes in children and for forty-five minutes in adults during a 2-year period. The outcome derived from this combined modality of treatment was rated according to physiotherapeutic evaluations, the MMT (Manual Muscular Test, and the Barthel Ladder. Patients were reevaluated at 2-month intervals. After two years of ongoing treatment, we were able to observe that the deformities in hip, knee and foot were progressive in all SMA Type II patients, and in some Type III. Muscle strength stabilized in most SMA Type III patients, and improved in some. MMT was not done in SMA Type II. In all patients we were able to detect an improvement in the Barthel Ladder scale. This study suggests that a measurable improvement in the quality of daily living may be obtained in patients with SMA Types II and III subjected to conventional physiotherapy when associated with hydrotherapy.A hidroterapia foi realizada em SO pacientes com atrofia muscular espinhal, os quais foram também tratados com fisioterapia individual convencional. O tratamento hidroterápico foi realizado em piscina aquecida numa temperatura de aproximadamente 30° Celsius, duas vezes por semana, durante 30 minutos em crianças e 45 minutos em adultos num período de dois anos. Os benefícios deste tipo de tratamento foram avaliados de acordo com a evolução clínica, o MMT(Teste de Força Muscular e a Escala de Barthel. Os pacientes foram reavaliados a cada dois meses. Após dois anos de tratamento nós observamos que as deformidades nos quadris, joelhos e pés foram progressivas em todos os pacientes do Tipo II e em alguns do Tipo III. Houve estabilização da força muscular na maioria dos pacientes com SMA Tipo III, e melhora da força em alguns; nos

Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

DEFF Research Database (Denmark)

Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt

2004-01-01

It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

[Applied studies of structured triglycerides for parenteral nutrition in severe hemorrhagic shock patients after resuscitation].

Science.gov (United States)

Su, Mao-sheng; He, Lei; Liu, Zhi-wei; Ma, Huan-xian; Zhao, Qing-hua; Zhang, Wen-zhi

2012-03-27

To evaluate the effects of structured triglycerides in parenteral nutrition versus a physical medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) mixture on severe hemorrhagic shock patients after resuscitation. In a randomized trial, we studied 20 critical patients with a total blood loss of over 3000 ml perioperatively and/or intraoperatively. The use of triglycerides started from Day 3 postoperation and parenteral nutrition lasted for no less than 5 days. They were allocated to receive one of two nutrition regiments: structured triglycerides in Group A (n = 10) and MCT/LCT in Group B (n = 10). There were no significant differences of general conditions in two groups. Before the start of parenteral nutrition (d0), d1 d3 and d5 after start of infusion, the following parameters were measured: hemoglobin (Hb), platelet count (Plt), alanine aminotransferase (ALT), total bilirubin (TB), direct bilirubin (DB), serum triglycerides (TG), prealbumin (PA) and transferrin (TF). And mean artery pressure (MAP), heart rate (HR) and central vein pressure (CVP) were also recorded at the same time-points. Then the post-TG changes of the above data were compared in both groups. After the use of triglycerides, there were no significant differences of MAP, HR, CVP, Hb and Plt in both groups (P > 0.05). At D3 and D5, the serum levels of TG ((2.1 ± 0.4) vs (1.6 ± 0.6) mg/L, (2.3 ± 0.7) vs (1.5 ± 0.3) mg/L) and alanine aminotransferase ((133 ± 58) vs (97 ± 26) U/L; (116 ± 48) vs (77 ± 31) U/L) were significantly higher in Group B versus those receiving structured triglycerides in Group A (P 0.05). The serum levels of such nutrition markers as PA ((195 ± 55) vs (166 ± 55) mg/L,(245 ± 53) vs (195 ± 58) mg/L) and TF ((2.6 ± 0.5) vs (2.5 ± 0.6) g/L, (3.3 ± 0.8) vs (2.9 ± 0.6) g/L)were significantly higher in Group A than those in Group B (P synthesis and hepatocyte protection, structured triglycerides in parenteral nutrition is advantageous to standard MCT

The influence of breastfeeding on children’s health, well-being and development: A theoretical and empirical review / La influencia de la lactancia materna en la salud infantil, el bienestar y el desarrollo: una revisión teórica y empírica

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Ana M. Roch

2014-05-01

Full Text Available El objetivo fue examinar el efecto de la lactancia materna en la salud infantil, el bienestar y el desarrollo. La revisión de la literatura se acercó a varias dimensiones de la salud del niño y el desarrollo, a fin de evaluar en cuáles hay realmente beneficios de la leche materna y en cuáles no se encuentra una asociación positiva con la lactancia. La hipótesis general de la Organización Mundial de la Salud (oms de recomendar la lactancia materna durante los primeros seis meses de vida del niño no parece estar confirmada por la literatura, ya que los estudios disponibles se centran en los efectos benéficos muy específicos de la lactancia materna. Por otra parte, las limitaciones de la literatura incluyen la existencia de resultados incongruentes y aspectos metodológicos menos sólidos que deben ser resueltos en futuras investigaciones. Dadas las implicaciones clínicas, sociales y culturales de las políticas referentes a la lactancia materna, es necesario explicar las discrepancias encontradas entre los estudios, y confirmar si la lactancia materna se correlaciona significativamente con la salud de los niños y su bienestar o si en realidad son creencias de salud ective was to examine the impact of breastfeeding on children's health, well-being and development. This literature review approached several dimensions of the child's health and development, in order to assess which ones actually benefit from the maternal milk, and which dimensions do not support a positive association with breastfeeding. The general assumption of the World Health Organization (WHO of recommending breastfeeding during the first six months of the child's life does not seem to be confirmed by the literature, since the available studies are centred in very specific beneficial effects of maternal breastfeeding. Furthermore, the limitations of the literature include the existence of incongruent results and less solid methodological aspects that should be solved

Mothers'health in Brazil and recovering the training of midwives for care in the birth process El cuidado de la salud materna en Brasil y el rescate de la enseñanza de obstetras para asistencia al parto O cuidado a saúde materna no Brasil e o resgate do ensino de obstetrizes para assistência ao parto

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Miriam Aparecida Barbosa Merighi

2009-04-01

Full Text Available The authors briefly analyze the situation of maternal health care in Brazil and, based on their findings, they comment that there have been transformations in the health care model for women and families and propose some measures, including recovery of the work of the obstetric nurse or midwife (obstetriz, in Portuguese. They comment that women care tendencies in the delivery process presuppose incorporation of the paradigm of improving the physiology of valuing women's experience, the approach to the family, health advice that prioritizes prevention, education and relationships, without ignoring safety. They appoint that building this health care model, which includes the work of the midwife, may improve maternal health indicators.Los autores hacen un breve análisis de la situación del cuidado de la salud materna en Brasil, y con base en sus hallazgos, sugieren transformar el modelo de atención a la mujer y a sus familiares; proponen algunas medidas que incluyen la inserción del trabajo de la enfermera obstétrica y de la obstetra en el contexto actual. Comentan sobre la tendencia actual del cuidado materno en el proceso del nacimiento, el cual presupone la incorporación del paradigma que favorece la fisiología y la valorización de la experiencia femenina, el abordaje centrado en la familia con énfasis en la prevención, educación y relación interpersonal sin dejar de lado la seguridad. Consideran que el modelo del cuidado de la salud que incluye el trabajo de la obstetra, puede mejorar los indicadores de salud materna.Os autores fazem uma breve análise da situação do cuidado a saúde materna no Brasil, e com base nesses dados, apontam as transformações no modelo de assistência à mulher e às famílias e propõem algumas medidas, as quais inclui a inserção do trabalho da enfermeira obstétrica ou obstetriz no contexto atual. Comentam que a tendência atual do processo de nascimento pressupõe a incorporação do paradigma que

76 FR 25358 - 2011 Parenteral Drug Association/Food and Drug Administration Glass Quality Conference; Public...

Science.gov (United States)

2011-05-04

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] 2011 Parenteral Drug Association/Food and Drug Administration Glass Quality Conference; Public Conference AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public conference. SUMMARY: The Food...

Iniciativa para fortalecer la atención materna e infantil en un grupo de municipios en Colombia

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Pablo Montoya

2017-05-01

Full Text Available Objetivo: presentar los resultados de una iniciativa conjunta para mejorar la calidad de la atención en salud materna e infantil en 36 municipios colombianos. Metodología: se incluyen los principales resultados de una iniciativa en salud pública implementada entre 2012 y 2015 en 36 municipios. Su enfoque fue sistémico e incluyó cuatro componentes: 1 elaboración y seguimiento de planes de mejoramiento continuo de la calidad de los servicios de salud materno-infantil basados en necesidades locales, involucrando actores clave municipales/departamentales; 2 evaluación indirecta de la calidad de los servicios con revisión de historias clínicas; 3 capacitación, asistencia técnica y acompañamiento, y 4 retroalimentación periódica de resultados a las instituciones del sistema de salud. Resultados: esta iniciativa estimuló el mejoramiento de la calidad de atención en salud del binomio madrehijo en los municipios participantes y posiblemente incidió en la reducción de la razón de mortalidad materna en algunos territorios. Se documentan aciertos y problemas en la gestión de los servicios de salud de las instituciones participantes. Discusión: a pesar de las diferencias territoriales y múltiples factores internos y externos que inciden en la calidad de los servicios, el enfoque propuesto puede implementarse en territorios con contextos diversos. Los cambios, positivos en la mayoría de territorios, evidenciaron que el éxito y la sostenibilidad de las acciones son posibles aún en entornos complejos, pero se requiere aplicar con rigor la metodología propuesta y creatividad para formular soluciones locales.

ALEITAMENTO MATERNO E AS CRENÇAS ALIMENTARES LACTANCIA MATERNA Y LAS CREENCIAS ALIMENTARIAS BREASTFEEDING AND NUTRITIONAL BELIEFS

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Sueli Mutsumi Tsukuda Ichisato

2001-09-01

Full Text Available A hipogalactia tem levado ao desmame precoce. As crenças e os tabus influenciam a alimentação materna durante a lactação. O presente estudo tem como objetivo identificar lactogogos regionais utilizados como suporte do aleitamento materno (AM, pautados nos tabus e crenças. Trata-se de um estudo de caso utilizando a análise de prosa(12. Alimentar-se ou não de certos alimentos, ter vivenciado a amamentação, as crenças transmitidas por familiares e médicos, crescimento e desenvolvimento da criança foram os fatores que estimularam o AM na nossa pesquisaLa hipogalactacemia ha sido uno de las razones que han llevado a las madres al destete precoz. Las creencias y los tabúes influyen en la alimentación materna durante la lactancia. El presente estudio tiene como objetivo identificar lactogogos regionales utilizados como soporte del alimento materno (AM, basados en los tabues y las creencias. Se trata de un estudio de caso utilizando el análisis de prosa(12. Alimentarse o no de ciertos alimentos, haber vivido la lactancia, las creencias transmitidas por familiares y médicos, crecimiento y desarrollo del niño fueron los factores que estimularon el AM en nuestra investigación.Hypogalactia has been one of the reasons that lead mothers to early weaning. Beliefs and taboos influence breastfeeding during lactation. This study aims at identifying regional lactagogues used as a support to breastfeeding based on taboos and beliefs. It is a case report which uses prose analysis(12. The findings show that feeding oneself with certain types of food or not, having experienced breastfeeding, beliefs transmitted by family members and physicians and the child's growth and development were factors which stimulated breastfeeding.

Avaliação da hemorragia feto-materna em puérperas com indicação para ministração de imunoglobulina anti-D Evaluation of fetomaternal hemorrhage in postpartum patients with indication for administration of anti-D immunoglobulin

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Eduardo Baiochi

2005-10-01

Full Text Available Avaliamos a ocorrência da hemorragia feto-materna entre 343 puérperas que receberiam profilaxia da aloimunização Rh com emprego de imunoglobulina anti-D. Realizamos o teste de roseta para triagem dos casos que necessitariam determinação quantitativa do volume de sangue fetal transferido para circulação materna, que foi então apurado pelo teste de Kleihauer-Betke (K-B. O teste de roseta apresentou resultado positivo em 22 casos (6,4%. Em cinco dessas amostras o teste de K-B não apontou hemorragia feto-materna (falso positivo do teste de roseta de 1,45% e noutra a leitura do teste não foi conclusiva. Tivemos oito casos com volume apurado de hemorragia feto-materna This study evaluated fetomaternal hemorrhage (FMH in 343 postpartum patients who required prophylaxis of Rh alloimmunization with anti-D immunoglobulin. The rosette test was applied to screen for patients needing quantitative determination of fetal blood transferred from the maternal circulation, which was then measured by the Kleihauer-Betke test (K-B. The rosette test was positive in 22 cases (6.4%. In five of these cases, K-B did not show fetomaternal hemorrhage (a 1.45% false-positive rate for the rosette test, and in one case the test was inconclusive. There were 8 cases with FMH 30ml (0.58%, requiring a supplementary dose of anti-D. The study concludes that following the rosette test, additional evaluation of FMH using a quantitative test was unnecessary in 93.6% of the cases.

No Clinical or Biochemical Evidence for Essential Fatty Acid Deficiency in Home Patients Who Depend on Long-Term Mixed Olive Oil- and Soybean Oil-Based Parenteral Nutrition

NARCIS (Netherlands)

Olthof, E.D.; Roelofs, H.M.J.; Fisk, H.L.; Calder, P.C.; Wanten, G.J.A.

2016-01-01

BACKGROUND: Home parenteral nutrition (HPN) patients depend on lipid emulsions as part of their parenteral nutrition regimen to provide essential fatty acids (EFAs). Mixed-oil sources are used in modern lipid emulsions to decrease the amount of proinflammatory EFAs, mainly linoleic acid, which is

Catheter-Related Bloodstream Infections in Adults Receiving Home Parenteral Nutrition

DEFF Research Database (Denmark)

Tribler, Siri; Brandt, Christopher F; Hvistendahl, Mark

2018-01-01

BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI......) and European Society for Clinical Nutrition (ESPEN) CRBSI criteria. Employing a catheter-salvaging strategy, 40% of the CRBSI diagnoses were supported by the paired blood culture positivity criteria and only 6% by a positive catheter tip. In 53%, CRBSIs were categorized as a clinical or "probable CRBSI...

Home Parenteral Nutrition in Adult Patients with Chronic Intestinal Failure

DEFF Research Database (Denmark)

Brandt, Christopher Filtenborg; Hvistendahl, Mark; Naimi, Rahim M.

2017-01-01

in treating IF with home parenteral nutrition (HPN), this study documents the HPN evolution and describes the demographics and outcome in one of the world's largest single-center cohorts. Methods: We included patients with IF discharged with HPN from 1970-2010. Data were extracted according to European...... Society for Clinical Nutrition and Metabolism classifications from the Copenhagen IF database. Results: Over the decades, we observed an exponential increase in the number of HPN patients. The 508 patients with IF collectively received HPN for 1751 years. While receiving HPN, 211 patients with IF (42...

Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

DEFF Research Database (Denmark)

Colding, H; Møller, S; Andersen, G E

1982-01-01

Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

Parenteral structured triglyceride emulsion improves nitrogen balance and is cleared faster from the blood in moderately catabolic patients.

Science.gov (United States)

Kruimel, J W; Naber, T H; van der Vliet, J A; Carneheim, C; Katan, M B; Jansen, J B

2001-01-01

Most postoperative patients lose net protein mass, which reflects loss of muscle tissue and organ function. Perioperative parenteral nutrition may reduce the loss of protein, but in general, with conventional lipid emulsions a waste of protein still remains. We compared the effects on nitrogen balance of an emulsion containing structured triglycerides, a new type of synthesized triglycerides, with an emulsion of a physical mixture of medium- and long-chain triglycerides as part of parenteral feeding in moderately catabolic patients. The first 5 days after placement of an aortic prosthesis patients received total parenteral nutrition (TPN) providing 0.2 g of nitrogen per kg body weight per day; energy requirement was calculated using Harris and Benedict's equation, adding 300 kcal per day for activity. Twelve patients were treated with the structured triglyceride emulsion and 13 patients with the emulsion of the physical mixture of medium- and long-chain triglycerides. The design was a randomized, double-blind parallel study. In the patients who completed the study, the mean cumulative nitrogen balance over the first 5 postoperative days was -8+/-2 g in 10 patients on the structured triglyceride emulsion and -21+/-4 g in 9 patients on the emulsion of the physical mixture of medium- and long-chain triglycerides; the mean difference was 13 g of nitrogen (95% confidence interval 4 to 22, p = .015) in favor of the structured triglyceride emulsion. On the first postoperative day serum triglyceride and plasma medium-chain free fatty acid levels increased less during infusion of the structured triglyceride emulsion than with the physical mixture emulsion. The parenteral structured triglyceride emulsion improves the nitrogen balance and is cleared faster from the blood, compared with the emulsion of the physical mixture of medium- and long-chain triglycerides, in moderately catabolic patients.

El aborto como causa de mortalidad materna: una reflexión sobre el cuidado de enfermería

OpenAIRE

DOMINGOS, Selisvane Ribeiro da Fonseca; MERIGHI, Miriam Aparecida Barbosa

2010-01-01

O aborto é um tema polêmico e um sério problema de saúde pública mundial, responsável pela manutenção das altas taxas de mortalidade materna em muitos países em desenvolvimento. No Brasil, por se tratar de um ato ilegal, muitas mulheres que não desejam manter uma gestação acabam por procurar clínicas clandestinas, submetendo-se ao aborto em condições precárias, o que acarreta graves consequências à sua saúde física e psicológica e à própria vida. Como enfermeiras, reconhecemos a magnitude das...

Tuberculosis and parenteral viral hepatitides: incidence of mixed forms

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A. A. Asratyan

2014-01-01

Full Text Available Objective: to estimate the frequency of parenteral viral hepatitides (HB and HC (PVH in patients with tuberculosis in Moscow in relation to data on their incidence in the aggregate population of the capital.Materials and methods. The authors analyzed the incidence of (acute, chronic HB and HC (carriage and tuberculosis in Moscow in 2009. A total of 24,220 cards for infectious patients (No. 089/y and federal statistical follow-up forms (No. 2 were first processed to compare and search for personal data among the patients with tuberculosis and all forms of PVH and to establish the evidence of PVH and tuberculosis comorbidity.Results. The infection of tuberculosis patients with parenteral hepatitis B and C viruses was ascertained to be 5.5 to 284.9 times higher (in relation to the form of a hepatitis course than that in the aggregation population of Moscow, which suggests that PVH is of high significance for the tuberculosis patients and that it is necessary to improve a PVH prevention program among this cohort patients. Analysis of the sex-age structure shows that male tuberculosis patients in the 20-39-year-old group should be considered to be a special risk group that should attract special attention when implementing preventive measures. The tuberculosis mortality rate among mixed infected patients was 1.8-fold higher than among those who had PVH-uncomplicated tuberculosis.Conclusion. The results of the investigations are suggestive of the evidence of PVH and tuberculosis comorbidity. The mixed forms of these infections in different combinations have been established to be accompanied by their severer clinical course and high death rates. 

PROTEIN NEEDS OF CRITICALLY ILL PATIENTS RECEIVING PARENTERAL NUTRITION.

Science.gov (United States)

Germano Borges de Oliveira Nascimento Freitas, Renata; Negrão Nogueira, Roberto José; Hessel, Gabriel

2015-07-01

assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. longitudinal study with three evaluations made (during the first 72 hours, on the 7th and the 14th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3rd to 7th days of PN), and 30.9 ± 12.19 kcal/kg (7th to 14th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3rd to 7th days of PN) and 1.49 ± 0.69 g/kcal/kg (7th to 14th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

[Treatment of children with intestinal failure: intestinal rehabilitation, home parenteral nutrition or small intestine transplantation?

NARCIS (Netherlands)

Neelis, E.G.; Oers, H.A. van; Escher, J.C.; Damen, G.M.; Rings, E.H.; Tabbers, M.M.

2014-01-01

Intestinal failure is characterised by inadequate absorption of food or fluids, which is caused by insufficient bowel surface area or functioning. Children with chronic intestinal failure are dependent on parenteral nutrition (PN), which can be provided at home (HPN). In the Netherlands, HPN for

Effect of parenteral serum plant sterols on liver enzymes and cholesterol metabolism in a patient with short bowel syndrome.

Science.gov (United States)

Hallikainen, Maarit; Huikko, Laura; Kontra, Kirsi; Nissinen, Markku; Piironen, Vieno; Miettinen, Tatu; Gylling, Helena

2008-01-01

Hepatobiliary complications are common during parenteral nutrition. Lipid moiety in commercially available solutions contains plant sterols. It is not known whether plant sterols in parenteral nutrition interfere with hepatic function in adults. We detected how different amounts of plant sterols in parenteral nutrition solution affected serum plant sterol concentrations and liver enzymes during a 1.5-year follow-up in a patient with short bowel syndrome. Serum lipid, plant sterol, and liver enzyme levels were measured regularly during the transition from Intralipid (100% soy-based intravenous fat emulsion) to ClinOleic (an olive oil-based intravenous fat emulsion with 80% olive oil, 20% soy oil and lower plant sterols); the lipid supply was also gradually increased from 20 to 35 g/d. Plant sterols in parenteral nutrition solution and serum were measured with gas-liquid chromatography. During infusion of soy-based intravenous fat emulsion (30 g/d, total plant sterols 87 mg/d), the concentrations of sitosterol, campesterol, and stigmasterol were 4361, 1387, and 378 microg/dL, respectively, and serum liver enzyme values were >or= 2.5 times above upper limit of normal. After changing to olive oil-based intravenous fat emulsion (20-35 g/d, plant sterols 37-65 mg/d), concentrations decreased to 2148 to 2251 microg/dL for sitosterol, 569-297 microg/dL for campesterol, and 95-55 microg/dL for stigmasterol. Concomitantly, liver enzyme values decreased to 1.4 to 1.8 times above upper limit of normal at the end of follow-up. The nutrition status of the patient improved. The amount of plant sterols in lipid emulsion affects serum liver enzyme levels more than the amount of lipid.

Impact of Complete Parenteral Nutrition on Metabolic Processes in Cancer Patients in the Early Postoperative Period

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O. A. Obukhova

2011-01-01

Full Text Available Objective: to estimate blood glucose levels during complete parenteral nutrition (CPN, by using the three-in-one system with a high glucose level. Subjects and methods. Thirty adult patients without diabetes mellitus (including 18 men were examined. Twelve and 18 patients were operated on for colonic and gastric cancers, respectively. CPN (Oliclinomel No. 7 — 1000, 1500 ml; glucose, 240 g in 1500 ml, Baxter, Belgium was carried out at the Surgery Department in the early postoperative period (3-5 postoperative days with stable hemodynamics and no organ dysfunction (acute respiratory, renal, hepatic failure. The preparation was administered at a rate of about 83 ml/h over 18 hours. Insulin was not used. Serum glucose concentrations were measured before the study and then for 24 hours at an interval of 6 hours. Results. Glucose concentrations were not found to exceed the allowable values in the majority of patients during CPN at the given rate. In 5 (16.7% patients, short-term glucose increases up to 13.3 mmol/l were corrected, by decreasing the infusion rate. There was no hypoglycemia or other complications during CPN. Conclusion. Our findings suggest that three-in-one parenteral feeding is safe and causes no metabolic disturbances if simple principles are followed, the basic ones of which are to observe the intake of an adequate total dose and the rate of administration of nutrients. Key words: parenteral feeding, hyperglycemia, metabolic disturbances.

Intranasal boosting with an adenovirus-vectored vaccine markedly enhances protection by parenteral Mycobacterium bovis BCG immunization against pulmonary tuberculosis.

Science.gov (United States)

Santosuosso, Michael; McCormick, Sarah; Zhang, Xizhong; Zganiacz, Anna; Xing, Zhou

2006-08-01

Parenterally administered Mycobacterium bovis BCG vaccine confers only limited immune protection from pulmonary tuberculosis in humans. There is a need for developing effective boosting vaccination strategies. We examined a heterologous prime-boost regimen utilizing BCG as a prime vaccine and our recently described adenoviral vector expressing Ag85A (AdAg85A) as a boost vaccine. Since we recently demonstrated that a single intranasal but not intramuscular immunization with AdAg85A was able to induce potent protection from pulmonary Mycobacterium tuberculosis challenge in a mouse model, we compared the protective effects of parenteral and mucosal booster immunizations following subcutaneous BCG priming. Protection by BCG prime immunization was not effectively boosted by subcutaneous BCG or intramuscular AdAg85A. In contrast, protection by BCG priming was remarkably boosted by intranasal AdAg85A. Such enhanced protection by intranasal AdAg85A was correlated to the numbers of gamma interferon-positive CD4 and CD8 T cells residing in the airway lumen of the lung. Our study demonstrates that intranasal administration of AdAg85A represents an effective way to boost immune protection by parenteral BCG vaccination.

Refeeding syndrome in a small-for-dates micro-preemie receiving early parenteral nutrition.

Science.gov (United States)

Mizumoto, Hiroshi; Mikami, Masamitsu; Oda, Hirotsugu; Hata, Daisuke

2012-10-01

This report describes a small-for-date extremely low birth weight infant who manifested bradycardic events, respiratory failure, and hemolytic jaundice during her first week of life. These complications were attributed to severe hypophosphatemia and hypokalemia. Inadequate supply and refeeding syndrome triggered by early aggressive parenteral nutrition were responsible for electrolyte abnormalities. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

Parenteral Nutrition and Intestinal Failure.

Science.gov (United States)

Bielawska, Barbara; Allard, Johane P

2017-05-06

Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient's home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes.

Relación entre un periodo de lactancia materna exclusiva menor de 6 meses y presencia de hábitos parafuncionales en un grupo de niños y adolescentes venezolanos

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Rosa Gabriela Rondón

2018-01-01

Full Text Available Objetivo. Relacionar un periodo de lactancia materna exclusiva menor a 6 meses con la presencia de hábitos parafuncionales en un grupo de niños y adolescentes venezolanos que acudieron al Servicio de Odontología del Hospital Pediátrico San Juan de Dios de Caracas en el periodo Julio-Octubre de 2016. Materiales y métodos. Estudio epidemiológico de corte transversal, no experimental, de campo y de nivel correlacional, realizado en 183 niños y adolescentes entre 7 y 12 años. Se tomó una muestra no probabilística a conveniencia, con análisis de frecuencias, porcentajes, prueba de significancia estadística chi cuadrado y correlación de Pearson. Resultados. El género femenino ocupó un 56,3%, el promedio de edad fue de 8,4 ±1,29 años. El 100% de la población recibió lactancia materna exclusiva por algún tiempo: en el 53% fue de 0-3 meses y en el 47% de 4-5 meses. 131 pacientes (71.58% exhibieron uno o más hábitos parafuncionales, de los cuales, 83 pacientes (63,36% fueron amamantados de forma exclusiva de 0 a 3 meses y 48 pacientes (36,64% de 4 a 5 meses con una significancia estadística de p=0,000 (p-valor<0,05 y r=25,30%. En esta población, un periodo de lactancia materna exclusiva menor de 6 meses se relacionó con la presencia de succión digital (p=0,015 y r=18,10%, succión de cuerpo extraño (p=0,001 y r=24,70%, deglución atípica (p=0,047 y r=10,80% y respiración bucal (p=0,000 y r=33,10%. Conclusión. Se destaca la relación entre un periodo menor de 6 meses de lactancia materna exclusiva y la presencia de hábitos parafuncionales en la muestra analizada.

Utilización del conocimiento tácito por proveedores de atención a la salud materna: mapeo sistemático de la literatura

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Emmanuel Calderón Espinosa

2016-03-01

Conclusiones: Este mapeo muestra que el conocimiento tácito es un enfoque de investigación emergente, innovador y versátil, con mayores avances en los países de ingresos altos, y que encierra interesantes posibilidades de utilización como evidencia para mejorar las intervenciones en salud materna, especialmente en los países de ingresos medios y bajos, donde se requiere fortalecerlo.

La lactancia materna y su influencia en el comportamiento de las infecciones respiratorias agudas The breastfeeding and its influence on the behavior of acute respiratory infections

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Tatiana de la Vega Paitková

2010-09-01

Full Text Available INTRODUCCIÓN: la lactancia materna es reconocida como el mejor inductor de la maduración inmunológica de la etapa posnatal. La leche materna provee una nutrición completa para cualquier bebé desde el nacimiento hasta los 6 meses de vida. MÉTODOS: se estudiaron 80 transicionales, pertenecientes al Grupo Básico de Trabajo No. 2 del Policlínico "Ana Betancourt", con el objetivo de identificar la frecuencia y variedad de las infecciones respiratorias agudas en relación con el tipo de lactancia recibida. Para la recolección de los datos se consideró la información reflejada en las consultas de puericultura realizadas, durante el primer año de vida, contempladas en las historias clínicas pediátricas (revisión documental. RESULTADOS: predominaron los niños lactados (83 %, aunque de estos, solo el 25 % se alimentó de forma exclusiva. La lactancia mixta, aunque mayoritaria (58 %, predomina por debajo del cuarto mes de vida y el 17 % de los casos fue lactado de manera artificial. Las infecciones respiratorias agudas fueron más frecuentes en niños que recibieron poco tiempo de lactancia mixta (19 %, así como en los que se alimentaron de modo artificial (14 %, con predominio en ellos de la mayor parte de las otitis medias y la totalidad de las neumonías. Solo en 3 de estos pacientes fue necesaria la hospitalización, y la evolución en todos los casos fue satisfactoria. CONCLUSIONES: predominó la variedad mixta de lactancia materna. Se comprobó una alta morbilidad por infecciones respiratorias agudas en los transicionales estudiados. Mientras más breve es el período de lactancia materna, mayor es el riesgo de infección y la severidad de estas. Las dos terceras partes de la otitis media y la totalidad de las neumonías ocurren en casos con lactancia materna mixta breve o artificial.INTRODUCCIÓN: breastfeeding is recognized as the better inductor of the immunologic maturation of postnatal stage. Mother milk provides a complete

Patient Characteristics and Outcomes of Outpatient Parenteral Antimicrobial Therapy: A Retrospective Study

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Marie Yan

2016-01-01

Full Text Available Outpatient parenteral antimicrobial therapy (OPAT is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years were discharged home with parenteral antimicrobials. The most commonly treated syndromes included surgical site infections (33%, osteoarticular infections (28%, and bacteremia (21%. The most frequently prescribed antimicrobials were ceftriaxone (21% and cefazolin (20%. Only 56% of the patients received follow-up care from an infectious diseases specialist. In the 60 days following discharge, 43% of the patients returned to the emergency department, while 26% required readmission. Forty-eight percent of the return visits were due to infection relapse or treatment failure, and 23% could be attributed to OPAT-related complications. These results suggest that many OPAT patients have unplanned health care encounters because of issues related to their infection or treatment, and the creation of a formal OPAT clinic may help improve outcomes.

Aluminum Exposure from Parenteral Nutrition: Early Bile Canaliculus Changes of the Hepatocyte

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Amanda R. Hall

2018-06-01

Full Text Available Background: Neonates on long-term parenteral nutrition (PN may develop parenteral nutrition-associated liver disease (PNALD. Aluminum (Al is a known contaminant of infant PN, and we hypothesize that it substantially contributes to PNALD. In this study, we aim to assess the impact of Al on hepatocytes in a piglet model. Methods: We conducted a randomized control trial using a Yucatan piglet PN model. Piglets, aged 3–6 days, were placed into two groups. The high Al group (n = 8 received PN with 63 µg/kg/day of Al, while the low Al group (n = 7 received PN with 24 µg/kg/day of Al. Serum samples for total bile acids (TBA were collected over two weeks, and liver tissue was obtained at the end of the experiment. Bile canaliculus morphometry were studied by transmission electron microscopy (TEM and ImageJ software analysis. Results: The canalicular space was smaller and the microvilli were shorter in the high Al group than in the low Al group. There was no difference in the TBA between the groups. Conclusions: Al causes structural changes in the hepatocytes despite unaltered serum bile acids. High Al in PN is associated with short microvilli, which could decrease the functional excretion area of the hepatocytes and impair bile flow.

Influence of preoperative peripheral parenteral nutrition with micronutrients after colorectal cancer patients.

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Liu, Ming-Yi; Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan; Chang, Sue-Joan

2015-01-01

The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support.

Parenteral medium-chain triglyceride-induced neutrophil activation is not mediated by a Pertussis Toxin sensitive receptor.

NARCIS (Netherlands)

Versleijen, M.W.J.; Esterik, J.C. van; Schaap-Roelofs, H.M.J.; Emst-de Vries, S.E. van; Willems, P.H.G.M.; Wanten, G.J.A.

2009-01-01

BACKGROUND & AIMS: Lipid-induced immune modulation might contribute to the increased infection rate that is observed in patients using parenteral nutrition. We previously showed that emulsions containing medium-chain triglycerides (LCT/MCTs or pure MCTs), but not pure long-chain triglycerides

Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos = Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases

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Vicente De Paula Antunes Teixeira

2010-07-01

Full Text Available Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo quanto individual, assim como antes da primeira sessão de hidroterapia quando comparada com a última. O estudo sugere que a hidroterapia promove melhora da flexibilidade em relação à cadeia muscular posterior de crianças com PC diparéticas, pelo relaxamento global e consequente diminuição dotônus muscular, quando associada a exercícios de alongamentos passivos. To evaluate the flexibility of the posterior muscle chain using the method proposed by Wells and Dillon, before and after each hydrotherapy session. The study verified the flexibility of three children with diplegic cerebral palsy (CP, aged 7 to 10. The values of flexibility were measured using the Wells’ Flexometer. There was a significant increase in the flexibility of posterior muscle chain of the patients after each session of hydrotherapy, both in the individual evaluation and in the group, as well as before the first session of hydrotherapy compared to the last. The study suggests that hydrotherapy promotes the improvement of flexibility, by relaxation of muscle tone of children with diplegic CP, in relation to the posterior muscle chain, when combined with passive stretching exercises.

Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos - doi: 10.4025/actascihealthsci.v32i2.8019 Flexibility evaluation by the method of Wells’ Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases - doi: 10.4025/actascihealthsci.v32i2.8019

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Vicente de Paula Antunes Teixeira

2010-09-01

Full Text Available Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo quanto individual, assim como antes da primeira sessão de hidroterapia quando comparada com a última. O estudo sugere que a hidroterapia promove melhora da flexibilidade em relação à cadeia muscular posterior de crianças com PC diparéticas, pelo relaxamento global e consequente diminuição do tônus muscular, quando associada a exercícios de alongamentos passivos.To evaluate the flexibility of the posterior muscle chain using the method proposed by Wells and Dillon, before and after each hydrotherapy session. The study verified the flexibility of three children with diplegic cerebral palsy (CP, aged 7 to 10. The values of flexibility were measured using the Wells’ Flexometer. There was a significant increase in the flexibility of posterior muscle chain of the patients after each session of hydrotherapy, both in the individual evaluation and in the group, as well as before the first session of hydrotherapy compared to the last. The study suggests that hydrotherapy promotes the improvement of flexibility, by relaxation of muscle tone of children with diplegic CP, in relation to the posterior muscle chain, when combined with passive stretching exercises.

Hypophosphatemia occurs with insulin administration during refeeding by total parenteral nutrition in rats.

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Kawamura, Hiromi; Tanaka, Sarasa; Uenami, Yuri; Tani, Mariko; Ishitani, Midori; Morii, Saeko; Sakaue, Motoyoshi; Ito, Mikiko

2018-01-01

Refeeding syndrome (RFS) is characterized by the metabolic and clinical changes that occur following aggressive nutritional supplementation in malnourished patients. Hypophosphatemia is the hallmark of RFS and is key to its prevention and treatment in clinical practice. However, the mechanism of hypophosphatemia during RFS is unclear because of the lack of an animal model. In this study, we developed a rat RFS model as a first step to clarifying the molecular mechanism. After establishing the parenteral route, rats were fasted for 5 days and refeeding was started using total parenteral nutrition. The animals were infused with a high calorie solution with or without insulin administration. Results showed that plasma phosphate levels did not decrease in rats infused with the high calorie solution alone;in contrast, a 20% reduction compared to baseline was observed in rats administered insulin. In addition, rats infused with the high calorie solution containing added phosphate did not present with hypophosphatemia. Thus, we developed a rat RFS model with hypophosphatemia by tube feeding and insulin administration, and demonstrated the importance of phosphate in preventing refeeding hypophosphatemia. J. Med. Invest. 65:50-55, February, 2018.

Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits

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Brennan, Ann-Marie; Fenton, Sarah; Murphy, Brendan P.

2018-01-01

The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase. PMID:29393903

O Impacto da Idade Materna Avançada sobre os Resultados da Gravidez Impact of Advanced Maternal Age on the Outcome of Pregnancy

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José G. Cecatti

1998-08-01

Full Text Available Objetivo: identificar o efeito da idade sobre os resultados maternos e perinatais das gestações ocorridas em mulheres com 40 anos ou mais. Métodos: comparamos 494 gestantes com mais de 40 anos, com 988 gestantes com idade entre 20 e 29 anos, pareando-as por paridade. Após controlar possíveis variáveis confundidoras pela análise multivariada, a idade materna avançada manteve associação com a maior prevalência de hipertensão arterial, apresentação anômala, parto por cesária, hemorragia puerperal, índice de Apgar baixo, morte perinatal, natimortalidade e sofrimento fetal intraparto. Resultados: a idade materna avançada esteve isoladamente associada à hipertensão arterial, apresentação anômala, diagnóstico de sofrimento fetal intraparto, parto por cesária e hemorragia puerperal. Com relação aos resultados neonatais, a idade materna avançada estava associada independentemente apenas ao baixo índice de Apgar, morte perinatal e óbito fetal. Conclusões: esses achados mostram a necessidade de assistência obstétrica adequada com atenção especial a esses fatores para procurar melhorar os resultados maternos e perinatais das gestantes com idade avançada.Most authors agree on the negative impact of pregnancy in women with advanced maternal age on maternal and perinatal outcome. However, it is not usual to evaluate if some considered risk factors are only confounders because they are present in women over forty years. In order to identify the isolated effect of age on maternal and perinatal outcome of pregnancies in women over forty, 494 pregnancies from this age group were compared to 988 pregnancies among women aged 20 to 29 years, matched by parity. After controlling possible confounding variables through multivariate analysis, advanced maternal age maintained its association with a higher prevalence of hypertension, malpresentation, cesarean section, postpartum hemorrhage, low Apgar score, perinatal death, late fetal

Utilidad de un método que determina simultáneamente retinol y α-tocoferol en leche materna por cromatografía líquida de alta resolución

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H. Martínez-Rojano

2016-10-01

Conclusión: El método fue selectivo, lineal, preciso, sensible y exacto, características que junto con su sencillez hacen de él un método conveniente para la determinación de retinol y α-tocoferol simultáneamente en leche materna.

Actitudes de los creoles de Bluefields hacia la implementación de su lengua materna kriol en Educación Primaria EIB

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Hermin Quinn Narcisso

2013-12-01

Full Text Available Este estudio se  realizó entre miembros de la comunidad creole de Bluefields para conocer sus actitudes sobre el uso del kriol en el Programa Educación Intercultural Bilingüe (EIB. Se ha aportado información sobre la importancia del uso de la lengua materna kriol como lengua de instrucción y educación  para la formación de la identidad  étnica, lingüística y cultural  de los niños y niñas creoles de la Costa Caribe nicaragüense.  Los resultados han revelado la existencia de factores históricos, económicos y sociales que han incidido en la actitud de los creoles hablantes en la implementación de su lengua materna  en las aulas de clase. Dichas actitudes son resultado en gran medida  a la  discriminación que ha sufrido la población creole por el origen de su lengua materna, la falta de oportunidades de empleo y de acceso a  la educación para el estudio de su lengua y cultura.Así mismo, en su mayoría, los kriol-hablantes  mantienen actitudes positivas hacia  la implementación de  su  lengua materna en las aulas de clase argumentando que, con su uso, los estudiantes aprenden a expresarse con mayor seguridad, logran mejores resultados académicos y fortalecen su autoestima. Paralelamente,  el grupo de estudio indicó que aspiran a que sus hijos e hijas aprendan, además del kriol, el  idioma Inglés  en vista de que  el aprendizaje de este idioma les brindará en el futuro mejores oportunidades laborales. Summary This study was conducted among members of the Creole community of Bluefields in order to know their attitudes related to the use of Kriol language in the Intercultural Bilingual Education Program (EIB in Spanish. The research has provided information on the importance of using the Kriol mother tongue as language of instruction and education in the training of ethnic, linguistic and cultural identity of Creole children of the Nicaraguan Caribbean Coast.The results have shown the existence of historical

Utilización de la lactancia materna como medida de analgesia no farmacológica en los procedimientos dolorosos en lactantes

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Torcida San Román, Elena

2017-01-01

Introducción: el dolor evoca en los niños respuestas negativas fisiológicas, metabólicas y de conducta. A lo largo de su primer año de vida, se estima que los lactantes van a sufrir alrededor de 15 procedimientos sanitarios dolorosos. Los métodos de analgesia no farmacológica en lactantes están encaminados a proporcionarles comodidad y tranquilidad, reduciendo el estrés que suponen los procedimientos a los que se ven sometidos, siendo la lactancia materna el más recomendado....

Metodología para la enseñanza-aprendizaje de la lengua materna como nodo interdisciplinar

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Carlos Moreira-Carbonell

2017-11-01

Full Text Available Se ofrece una metodología para la enseñanza-aprendizaje de la lengua materna como nodo interdisciplinar, a partir de una concepción amplia del texto como “conjunto sígnico coherente”, dotado de códigos de acuerdo con su función comunicativa según la semiótica. Se enfatiza en la utilización del texto más allá del marco de las humanidades. Con ello se potencia el proceso de enseñanza-aprendizaje a partir del trabajo con el texto por ser portador del contenido de aprendizaje, que actúa objetivamente como el objeto que satisface las necesidades de atribución y producción de los significados que necesita el estudiante para poder transformar sus conocimientos.

CONOCIMIENTOS, ACTITUDES Y PRÁCTICAS DE LACTANCIA MATERNA EN MADRES DE NIÑOS DE COMUNIDAD RURAL PERUANA Y SU ASOCIACIÓN CON LA DIARREA AGUDA INFECCIOSA

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LE Veramendi-Espinoza

2013-08-01

Full Text Available Objetivo:  Asociar los Conocimientos, Actitudes y Prácticas (CAP sobre la lactancia materna de las madres con la frecuencia de DAI en los últimos seis  meses del niño menor de dos  años. Metodología: Estudio analítico de corte transversal. Lugar: Centro poblado Huaylas, Ancash-Perú, durante febrero de 2011. Participantes:  34 madres de niños menores de 2 años. Intervenciones: Encuesta CAP mediante entrevista a domicilio y revisión de las historias clínicas para confirmar DAI. Principales medidas de resultados: Puntaje obtenido en la encuesta para las distintas variables CAP. Resultados: Se halló conocimiento de medio a bajo en 76,5% de las madres encuestadas, actitudes neutras en 58,8% y favorables en 20,6 y prácticas neutras en 64,7% e inadecuadas en 23,5%. No se encontró correlación entre estos. Conclusión: No se logró establecer ningún tipo de asociación estadísticamente significativa entre conocimientos, actitudes y prácticas de lactancia materna con diarreas agudas infecciosas.

CONOCIMIENTOS, ACTITUDES Y PRÁCTICAS DE LACTANCIA MATERNA EN MADRES DE NIÑOS DE COMUNIDAD RURAL PERUANA Y SU ASOCIACIÓN CON LA DIARREA AGUDA INFECCIOSA

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LE Veramendi-Espinoza

2012-01-01

Full Text Available Objetivo: Asociar los Conocimientos, Actitudes y Prácticas (CAP sobre la lactancia materna de las madres con la frecuencia de DAI en los últimos seis me- ses del niño menor de dos años. Metodología: Estudio analítico de corte transversal. Lugar: Centro poblado Huaylas, Ancash-Perú, durante febrero de 2011. Participantes: 34 madres de niños menores de 2 años. Intervenciones: Encuesta CAP mediante entrevista a domicilio y revisión de las historias clínicas para confirmar DAI. Principales medidas de resultados: Puntaje obtenido en la encuesta para las distintas variables CAP. Resultados: Se halló conocimiento de medio a bajo en 76,5% de las madres encuestadas, actitudes neutras en 58,8% y favorables en 20,6 y prácticas neutras en 64,7% e inadecuadas en 23,5%. No se encontró correlación entre estos. Conclusión: No se logró establecer ningún tipo de asociación estadísticamente significativa entre conocimientos, actitudes y prácticas de lactancia materna con diarreas agudas infecciosas.

Parenteral adjuvant potential of recombinant B subunit of Escherichia coli heat-labile enterotoxin

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Carlos Eduardo Pouey da Cunha

Full Text Available BACKGROUND The B subunit of Escherichia coli heat-labile enterotoxin (LTB is a potent mucosal immune adjuvant. However, there is little information about LTB's potential as a parenteral adjuvant. OBJECTIVES We aimed at evaluating and better understanding rLTB's potential as a parenteral adjuvant using the fused R1 repeat of Mycoplasma hyopneumoniae P97 adhesin as an antigen to characterise the humoral immune response induced by this construct and comparing it to that generated when aluminium hydroxide is used as adjuvant instead. METHODS BALB/c mice were immunised intraperitoneally with either rLTBR1 or recombinant R1 adsorbed onto aluminium hydroxide. The levels of systemic anti-rR1 antibodies (total Ig, IgG1, IgG2a, and IgA were assessed by enzyme-linked immunosorbent assay (ELISA. The ratio of IgG1 and IgG2a was used to characterise a Th1, Th2, or mixed Th1/Th2 immune response. FINDINGS Western blot confirmed rR1, either alone or fused to LTB, remained antigenic; anti-cholera toxin ELISA confirmed that LTB retained its activity when expressed in a heterologous system. Mice immunised with the rLTBR1 fusion protein produced approximately twice as much anti-rR1 immunoglobulins as mice vaccinated with rR1 adsorbed onto aluminium hydroxide. Animals vaccinated with either rLTBR1 or rR1 adsorbed onto aluminium hydroxide presented a mixed Th1/Th2 immune response. We speculate this might be a result of rR1 immune modulation rather than adjuvant modulation. Mice immunised with rLTBR1 produced approximately 1.5-fold more serum IgA than animals immunised with rR1 and aluminium hydroxide. MAIN CONCLUSIONS The results suggest that rLTB is a more powerful parenteral adjuvant than aluminium hydroxide when administered intraperitoneally as it induced higher antibody titres. Therefore, we recommend that rLTB be considered an alternative adjuvant, even if different administration routes are employed.

Capacidad bactericida de Bifidobacterium sp. aislada de leche materna y de heces de neonatos, frente a los principales causantes de enfermedades transmitidas por alimentos

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Vanegas, María Consuelo; González, Lina María; Arévalo, Stefany Alejandra

2010-01-01

Introducción. La microbiota del tubo digestivo humano contiene bacterias benéficas para la salud que regulan el funcionamiento del colon e inhiben algunos microorganismos patógenos intestinales. Las bifidobacterias aisladas de neonatos y de leche materna se usan como microorganismos probióticos para prevenir enfermedades infecciosas, incluidas las transmitidas por alimentos. Objetivo. Aislar e identificar Bifidobacterium sp. en humanos y determinar su capacidad bactericida frente a patógenos ...

Comportamiento de algunos factores biosociales en la lactancia materna en los menores de un año Behavior of some biosocial factors related to breastfeeding in babies aged less than 1 year

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María Marlen Avalos González

2011-09-01

Full Text Available INTRODUCCIÓN: El abandono progresivo de la lactancia materna se ha considerado "una nueva enfermedad propia de los siglos XX y XXI", en la cual han influido una serie de factores de muy diversa índole. OBJETIVO: Caracterizar el comportamiento de los factores biosociales en la lactancia materna en los menores de un año. MÉTODOS: Se realizó un estudio descriptivo de corte transversal, en un universo de 158 nacimientos ocurridos en el 2008 del área de salud "Aleida Fernández Chardiet". Se empleó el estudio bibliográfico, documental y la contrastación de criterios de diferentes autores como procedimiento teórico, además de procedimientos empíricos. RESULTADOS: Solo en el 55,7 % de los lactantes estudiados, se logró una lactancia materna exitosa, cifras por debajo de las recomendaciones internacionales. El destete precoz ocurrió en el 44,3 % y el motivo más frecuente fue la hipogalactia materna. CONCLUSIONES: El motivo más frecuente del destete precoz, fue sustentado por el criterio de las madres de que era insuficiente la producción y obtención de leche.INTRODUCTION: The progressive neglect of breastfeeding has been considered a "new disease own of XX and XXI centuries"where a series of very diverse factors have been influenced. OBJECTIVE: To characterize the behavior of biosocial factors related to breastfeeding in babies aged less than 1 year. METHODS: A cross-sectional and descriptive study was conducted in 158 births occurred in 2008 in "Aleida Chardiet"health area. Authors used the bibliographic, documentary study and the criteria contrast from different authors as a theoretical procedure, in addition to the empirical ones. RESULTS: Only in the 55.7 % of study infants it was possible to achieve a successful breastfeeding, figures under the international recommendations. The early wean occurred in the 44.3 % and the more frequent reason was the mother hypogalactia. CONCLUSIONS: The more frequent reason for the early wean was

Amino acids – Guidelines on Parenteral Nutrition, Chapter 4

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Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine

2009-11-01

Full Text Available Protein catabolism should be reduced and protein synthesis promoted with parenteral nutrion (PN. Amino acid (AA solutions should always be infused with PN. Standard AA solutions are generally used, whereas specially adapted AA solutions may be required in certain conditions such as severe disorders of AA utilisation or in inborn errors of AA metabolism. An AA intake of 0.8 g/kg/day is generally recommended for adult patients with a normal metabolism, which may be increased to 1.2–1.5 g/kg/day, or to 2.0 or 2.5 g/kg/day in exceptional cases. Sufficient non-nitrogen energy sources should be added in order to assure adequate utilisation of AA. A nitrogen calorie ratio of 1:130 to 1:170 (g N/kcal or 1:21 to 1:27 (g AA/kcal is recommended under normal metabolic conditions. In critically ill patients glutamine should be administered parenterally if indicated in the form of peptides, for example 0.3–0.4 g glutamine dipeptide/kg body weight/day (=0.2–0.26 g glutamine/kg body weight/day. No recommendation can be made for glutamine supplementation in PN for patients with acute pancreatitis or after bone marrow transplantation (BMT, and in newborns. The application of arginine is currently not warranted as a supplement in PN in adults. N-acetyl AA are only of limited use as alternative AA sources. There is currently no indication for use of AA solutions with an increased content of glycine, branched-chain AAs (BCAA and ornithine-α-ketoglutarate (OKG in all patients receiving PN. AA solutions with an increased proportion of BCAA are recommended in the treatment of hepatic encephalopathy (III–IV.

Alimentación del recién nacido prematuro: lactancia materna vs. leche de fórmula. Bancos de leche

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Mendoza Vicente, Irene

2015-01-01

La leche materna es, por excelencia, el mejor alimento para los recién nacidos y más aún para los prematuros, ya que supone un factor de protección frente a las infecciones y la enterocolitis necrotizante, además se tolera mejor, aporta defensas y contribuye a un mejor desarrollo cerebral del bebé. Ha sido redescubierta como uno de los factores claves en mejorar los resultados de estos recién nacidos pretérmino y es reconocida como un estándar de calidad para su cuidado en las Unidades de Neo...

Lactancia materna en puérperas con estimulación acupuntural

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Dunia Alvarez Matos

2014-10-01

Full Text Available Se realizó un estudio descriptivo y transversal, de casos y controles, en el Policlínico Docente "30 de Noviembre" de Santiago de Cuba, de enero de 2013 a igual mes del 2014, conformado por 20 puérperas pertenecientes al consultorio No. 29, en quienes se aplicó auriculoterapia para estimular la secreción láctea (grupo de estudio, e igual número de madres del consultorio homólogo No. 28, que no recibieron tratamiento (grupo de control, con vistas describir la práctica de la lactancia materna durante los primeros 6 meses de vida. En la serie, 40,0 % de las pacientes con auriculoterapia lactaron de forma exclusiva hasta los 6 meses y 25,0 % hasta los 5 meses, mientras que 40,0 % de las madres que no recibieron el tratamiento lo hicieron hasta los 4 meses y 35,0 % hasta los 3. Los niños del grupo de control presentaron, con mayor frecuencia, anemia (70,0 %, afecciones respiratorias (40,0 % y enfermedades diarreicas (20,0 %, así como más ingresos hospitalarios (35,0 %. En el grupo de estudio 40,0 % de los lactantes presentó anemia, y se redujeron en 50 % las enfermedades y en 10 % los ingresos hospitalarios

[Value of early application of different doses of amino acids in parenteral nutrition among preterm infants].

Science.gov (United States)

Liu, Zhi-Juan; Liu, Guo-Sheng; Chen, Yong-Ge; Zhang, Hui-Li; Wu, Xue-Fen

2015-01-01

To study the short-term response and tolerance of different doses of amino acids in parenteral nutrition among preterm infants. This study included 86 preterm infants who had a birth weight between 1 000 to 2 000 g and were admitted to the hospital within 24 hours of birth between March 2013 and June 2014. According to the early application of different doses of amino acids, they were randomized into low-dose group (n=29, 1.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.5 g/kg per day), medium-dose group (n=28, 2.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.7 g/kg per day), and high-dose group (n=29, 3.0 g/kg per day with an increase of 0.5-1.0 g/kg daily and a maximum of 4.0 g/kg per day). Other routine parenteral nutrition and enteral nutrition support were also applied. The maximum weight loss was lower and the growth rate of head circumference was greater in the high-dose group than in the low-dose group (Pnutrition, shorter duration of hospital stay, and less hospital cost than those in the low-dose group (P0.05). Parenteral administration of high-dose amino acids in preterm infants within 24 hours after birth can improve the short-term nutritional status of preterm infants, but there is a transient increase in BUN level.

[Should pediatric parenteral nutrition be individualized?].

Science.gov (United States)

Freitas, Renata Germano Borges de Oliveira Nascimento; Nogueira, Roberto José Negrão; Saron, Margareth Lopes Galvão; Lima, Alexandre Esteves Souza; Hessel, Gabriel

2014-12-01

Parenteral nutrition (PN) formulations are commonly individualized, since their standardization seem inadequate for the pediatric population. This study aimed to evaluate the nutritional state and the reasons for PN individualization in pediatric patients using PN hospitalized in a tertiary hospital in Campinas, São Paulo. This longitudinal study comprised patients using PN followed by up to 67 days. Nutritional status was classified according to the criteria established by the World Health Organization (WHO) (2006) and WHO (2007). The levels of the following elements on blood were analyzed: sodium, potassium, ionized calcium, chloride, magnesium, inorganic phosphorus and triglycerides (TGL). Among the criteria for individualization, were considered undeniable: significant reduction in blood levels of potassium (nutritional state of patients was considered critical in most cases. Thus, the individualization performed in the beginning of PN for energy protein adequacy was indispensable. In addition, the individualized PN was indispensable in at least 29.2% of PN for correction of alterations found in biochemical parameters. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Italiano a São Paulo: lingua materna, etnica, o lingua straniera da imparare e da insegnare? Come insegnarla?

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Loredana Caprara

2006-08-01

Full Text Available O italiano no Brasil, de língua materna e étnica, torna-se cada vez mais língua estrangeira a ser aprendida em cursos formais, escolas e universidades. Coloca-se o problema da formação adequada, cultural e lingüística dos professores, à qual os cursos universitários atuais reservam, a nosso ver, um número insuficiente de horas aula. Pensa-se na possibilidade de ampliar informalmente a oferta de aulas complementares para proporcionar uma melhor assimilação lingüística e cultural, mediante conversação e leitura, e chegar, assim, a um ensino mais amplo e rico.

Kinetics of phytosterol metabolism in neonates receiving parenteral nutrition.

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Nghiem-Rao, T Hang; Tunc, Ilker; Mavis, Alisha M; Cao, Yumei; Polzin, Elizabeth M; Firary, Mary F; Wang, Xujing; Simpson, Pippa M; Patel, Shailendra B

2015-08-01

Phytosterols in soybean oil (SO) lipids likely contribute to parenteral nutrition-associated liver disease (PNALD) in infants. No characterization of phytosterol metabolism has been done in infants receiving SO lipids. In a prospective cohort study, 45 neonates (36 SO lipid vs. 9 control) underwent serial blood sample measurements of sitosterol, campesterol, and stigmasterol. Mathematical modeling was used to determine pharmacokinetic parameters of phytosterol metabolism and phytosterol exposure. Compared to controls, SO lipid-exposed infants had significantly higher levels of sitosterol and campesterol (P Phytosterols in SO lipid accumulate rapidly in neonates. Very preterm infants receiving SO lipid have higher sitosterol exposure, and may have poorly developed mechanisms of eliminating phytosterols that may contribute to their vulnerability to PNALD.

Desenvolvimento, escolarização e síndrome de Down: expectativas maternas

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Laura Kolberg Lipp

2010-12-01

Full Text Available O presente estudo teve por objetivo investigar as expectativas maternas em relação ao desenvolvimento e escolarização do filho com síndrome de Down, a partir de uma perspectiva psicanalítica. Foi realizado um estudo qualitativo, por meio de entrevistas, que foram gravadas, transcritas e posteriormente analisadas, a partir de análise qualitativa de conteúdo. Participaram do estudo 12 mães de pessoas com síndrome de Down, com idades entre dois meses e 23 anos. Os resultados revelaram que o diagnóstico de síndrome de Down gera impacto nas mães. Em decorrência disso, as mães apresentaram dificuldade de construir expectativas em relação ao desenvolvimento e escolarização. Ressalta-se a importância do apoio e acompanhamento da mãe, no que se refere ao exercício da maternidade, bem como de professores que acompanharão o aluno com síndrome de Down a partir da idade escolar.

Calcium Chloride and Calcium Gluconate in Neonatal Parenteral Nutrition Solutions without Cysteine: Compatibility Studies Using Laser Light Obscuration Methodology

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Robert K. Huston

2018-02-01

Full Text Available There are no compatibility studies for neonatal parenteral nutrition solutions without cysteine containing calcium chloride or calcium gluconate using light obscuration as recommended by the United States Pharmacopeia (USP. The purpose of this study was to do compatibility testing for solutions containing calcium chloride and calcium gluconate without cysteine. Solutions of TrophAmine and Premasol (2.5% amino acids, containing calcium chloride or calcium gluconate were compounded without cysteine. Solutions were analyzed for particle counts using light obscuration. Maximum concentrations tested were 15 mmol/L of calcium and 12.5 mmol/L of phosphate. If the average particle count of three replicates exceeded USP guidelines, the solution was determined to be incompatible. This study found that 12.5 and 10 mmol/L of calcium and phosphate, respectively, are compatible in neonatal parenteral nutrition solutions compounded with 2.5% amino acids of either TrophAmine or Premasol. There did not appear to be significant differences in compatibility for solutions containing TrophAmine or Premasol when solutions were compounded with either CaCl2 or CaGlu-Pl. This study presents data in order to evaluate options for adding calcium and phosphate to neonatal parenteral nutrition solutions during shortages of calcium and cysteine.

Enteral bile acid treatment improves parenteral nutrition-related liver disease and intestinal mucosal atrophy in neonatal pigs

DEFF Research Database (Denmark)

Jain, Ajay Kumar; Stoll, Barbara; Burrin, Douglas G

2012-01-01

Total parenteral nutrition (TPN) is essential for patients with impaired gut function but leads to parenteral nutrition-associated liver disease (PNALD). TPN disrupts the normal enterohepatic circulation of bile acids, and we hypothesized that it would decrease intestinal expression of the newly...... described metabolic hormone fibroblast growth factor-19 (FGF19) and also glucagon-like peptides-1 and -2 (GLP-1 and GLP-2). We tested the effects of restoring bile acids by treating a neonatal piglet PNALD model with chenodeoxycholic acid (CDCA). Neonatal pigs received enteral feeding (EN), TPN, or TPN...... + CDCA for 14 days, and responses were assessed by serum markers, histology, and levels of key regulatory peptides. Cholestasis and steatosis were demonstrated in the TPN group relative to EN controls by elevated levels of serum total and direct bilirubin and also bile acids and liver triglyceride (TG...

Vitamin E in New-Generation Lipid Emulsions Protects Against Parenteral Nutrition–Associated Liver Disease in Parenteral Nutrition–Fed Preterm Pigs

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Ng, Kenneth; Stoll, Barbara; Chacko, Shaji; de Pipaon, Miguel Saenz; Lauridsen, Charlotte; Gray, Matthew; Squires, E. James; Marini, Juan; Zamora, Irving J.; Olutoye, Oluyinka O.; Burrin, Douglas G.

2015-01-01

Introduction Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. Hypothesis Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. Methods We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3) Omegaven (OV, 100% fish oil), or (4) Omegaven + phytosterols (PS, β-sitosterol, campesterol, and stigmasterol). Results Serum levels of direct bilirubin, gamma glutamyl transferase, serum triglyceride, low-density lipoprotein, and hepatic triglyceride content were significantly lower (P phytosterols to Omegaven did not produce evidence of PNALD. PMID:25596209

Effectiveness and tolerability of parenteral testosterone undecanoate: a post-marketing surveillance study.

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Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis

2017-12-01

This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.

Atención a la salud y morbimortalidad materna: un estudio de casos y controles de base hospitalaria en dos regiones de Colombia (Bogotá y Antioquia, 2009-2011

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Francisco J. Yepes

Full Text Available Resumen: El objetivo fue identificar si formas de pago y regímenes de aseguramiento están asociados con la mortalidad materna y morbilidad obstétrica extrema. Estudio de casos y controles de base hospitalaria en dos regiones de Colombia, 2009-2011. Los datos se obtuvieron de la historia clínica de cada gestante. Se utilizó regresión logística no condicional. El resultado fue: 1.011 pacientes, 337 casos y 674 controles. Ningún componente de calidad fue estadísticamente significativo en ambas regiones. En Bogotá, el riesgo de complicación obstétrica, significativamente mayor en Régimen Contributivo que en Subsidiado y no aseguradas; Antioquia, aunque hubo asociaciones similares, no estadísticamente significativas. Diferencias en morbilidad por régimen de pago no estadísticamente significativas en Antioquia ni Bogotá. Factores asociados a la morbimortalidad materna diferentes, según la población estudiada, lo que sugiere la necesidad de estudios locales para identificar factores determinantes propios y tomar decisiones pertinentes.

Access technique and its problems in parenteral nutrition - Guidelines on Parenteral Nutrition, Chapter 9.

Science.gov (United States)

Jauch, K W; Schregel, W; Stanga, Z; Bischoff, S C; Brass, P; Hartl, W; Muehlebach, S; Pscheidl, E; Thul, P; Volk, O

2009-11-18

Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7-10 days) parenteral nutrition (PN) requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7-10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.

Use of Piggyback Electrolytes for Patients Receiving Individually Prescribed vs Premixed Parenteral Nutrition.

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Busch, Rebecca A; Curtis, Caitlin S; Leverson, Glen E; Kudsk, Kenneth A

2015-07-01

Parenteral nutrition (PN) is available as individualized prescriptions frequently prepared with an automated compounding device or as commercially prepared premixed solutions. Our institution exclusively used individualized PN until an amino acid shortage forced a temporary switch to premixed solutions. In general, premixed solutions contain lower electrolyte levels than individualized formulations prescribed for patients with normal organ function. We aimed to quantify supplemental intravenous piggyback (IVPB) electrolyte use in adult patients receiving individualized and premixed PN and to quantify any effect on difference in the cost of therapy. We compared use of supplemental IVPB electrolytes administered to patients receiving PN during consecutive periods prior to and during the amino acid shortage. Electrolyte IVPBs tabulated were potassium chloride, 10 and 20 mEq; magnesium sulfate, 2 g and 4 g; potassium phosphate, 7.5 and 15 mmol; and sodium phosphate, 7.5 and 15 mmol IVPB. There was no statistical difference in the number of PN formulations administered per day during each period (14.7 ± 3.9 vs 14.0 ± 2.6, individualized vs premixed, respectively). Total IVPB electrolytes prescribed per day increased significantly from the individualized PN period to the premixed PN period (7.03 ± 3.8 vs 13.8 ± 6.8; P Parenteral and Enteral Nutrition.

Parenteral magnesium load testing with 28Mg in weanling and young adult rats

International Nuclear Information System (INIS)

Caddell, J.L.; Calhoun, N.R.; Howard, M.P.; Patterson, K.Y.; Smith, J.C. Jr.

1981-01-01

A sound diagnostic test for Mg deficiency is needed. This is a report of the parenteral Mg load test conducted in weanling and young adult rats fed a purified basal diet containing 3 mg magnesium/100 g with 150 mg of added magnesium/100 g (control) or 0 added magnesium (deficient). Weanlings were studied at about 1 week of dietary treatment and young adults at 2 weeks. The protocol included: a) a 6-hour preload urinary collection; b) an intraperitoneal load of 15 mg of magnesium/kg (weanlings) or 12 mg/kg (young adults) with 2 microCi 28Mg given simultaneously with each load; c) a 6-hour postload urinary collection; d) chemical analysis of selected tissues and urine for Mg; and e) 28Mg counting 6 and 24 hours postload. Controls all excreted large amounts of Mg pre- and postload, retaining less than 26% of nonradioactive loads. They had high urinary 28Mg counts. In Mg-deficient animals, the concentration of Mg in bone more than halved. These animals avidly conserved Mg and retained over 85% of nonradioactive Mg loads. Their 28Mg activity in vital organs was 3--6 times greater than in controls. We concluded that the parenteral Mg load test reliably identifies severe Mg deficiency

Construction and characterization of human rotavirus recombinant VP8* subunit parenteral vaccine candidates.

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Wen, Xiaobo; Cao, Dianjun; Jones, Ronald W; Li, Jianping; Szu, Shousun; Hoshino, Yasutaka

2012-09-21

Two currently licensed live oral rotavirus vaccines (Rotarix® and RotaTeq®) are highly efficacious against severe rotavirus diarrhea. However, the efficacy of such vaccines in selected low-income African and Asian countries is much lower than that in middle or high-income countries. Additionally, these two vaccines have recently been associated with rare case of intussusception in vaccinated infants. We developed a novel recombinant subunit parenteral rotavirus vaccine which may be more effective in low-income countries and also avert the potential problem of intussusception. Truncated recombinant VP8* (ΔVP8*) protein of human rotavirus strain Wa P[8], DS-1 P[4] or 1076 P[6] expressed in Escherichia coli was highly soluble and was generated in high yield. Guinea pigs hyperimmunized intramuscularly with each of the ΔVP8* proteins (i.e., P[8], P[4] or P[6]) developed high levels of homotypic as well as variable levels of heterotypic neutralizing antibodies. Moreover, the selected ΔVP8* proteins when administered to mice at a clinically relevant dosage, route and schedule, elicited high levels of serum anti-VP8* IgG and/or neutralizing antibodies. Our data indicated that the ΔVP8* proteins may be a plausible additional candidate as new parenteral rotavirus vaccines. Published by Elsevier Ltd.

[Evaluation of central parenteral alimentation in critically ill newborn infants at a provincial pediatric hospital].

Science.gov (United States)

Yunes-Zárraga, J L; de la Garza-Garza, G; Velázquez-Quintana, N

1989-04-01

A revision was made on files of newborns whom received total parenteral nutrition (TPN) in the neonatal intensive care unit of the Hospital Infantil de Tamaulipas during a two and a half years period. We try to correlate dosage and caloric intake with weight gain, survival and complications. We reviewed the principal indications that motivated the use of total parenteral nutrition. The average period of administration was 15 days and caloric intake average 75 cal. There was significance in weight gain in newborns older than 35 weeks (14.6 g/kg/day) compared with younger than 34 weeks (9.2 g/kg/day) (p less than 0.001). There was no relation between days and dosage in both groups. Only one case showed cholestatic jaundice. Hyperglycemia was present statistically more frequent in the group lesser gestational age. There were no important electrolytic disturbances. Necrotizing enterocolitis was present more frequent in the older group. Some comments are made in relation to sepsis and a discussion of possible causes that do no permit a better assimilation of nutrients in these babies.

Glycemia in newborns of hypertensive mothers according to maternal treatment Glicemia no recém-nascido de mãe hipertensa de acordo com a terapêutica materna

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Silvana Darcie

2004-01-01

Full Text Available PURPOSE: To evaluate the evolution of glycemic levels in newborns of hypertensive mothers according to maternal treatment. METHODS: Prospective randomized study, including 93 newborns of mothers treated with isradipine (n = 39, atenolol (n = 40, or low sodium diet (control group - n=14. Glycemia was determined at birth (mother and newborn by the oxidase glucose method and in the 1st, 3rd, 6th, 12th, and 24th hours after birth (newborn by a test strip method. The evolution of glycemia was analyzed in each group (Friedman test. The groups were compared regarding glycemia (Kruskall-Wallis test, and linear regression models were constructed for the analyses (independent variable = maternal glycemia; dependent variables = umbilical cord, 3rd, and 6th hour glycemia. RESULTS: There were no statistically significant differences among the mean blood glucose levels of the 3 groups in any of the assessments. There was a correlation between maternal and umbilical cord blood glucose in the isradipine (r = 0.61; P OBJETIVO: Avaliar o comportamento da glicemia em recém-nascidos (RN de mães hipertensas conforme o tratamento materno. MÉTODOS: Estudo prospectivo, randomizado, incluindo 93 RN de mães tratadas com isradipina(n=39, atenolol (n=40 ou dieta - controle (n=14. Determinou-se a glicemia ao nascimento (mãe e RN, pela glicose oxidase e na 1ª., 3ª., 6ª., 12ª. e 24ª. horas (RN, por fita reagente. A evolução da glicemia, em cada grupo, foi analisada (Teste de Friedman. Os grupos foram comparados, quanto às glicemias, em cada momento (Teste de Kruskall-Wallis e foram ajustados modelos de regressão linear para as glicemias (variável independente = glicemia materna; variáveis dependentes = glicemias de cordão, 3ª. e 6ª. horas. RESULTADOS: Não houve diferença estatisticamente significante entre as glicemias médias dos 3 grupos, em qualquer uma das coletas. Houve correlação entre as glicemias materna e de cordão umbilical nos grupos

Changes in Parenteral Nutrition During the First Week of Life Influence Early but Not Late Postnatal Growth in Very Low-Birth-Weight Infants.

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Izquierdo, Montserrat; Martínez-Monseny, Antonio Federico; Pociello, Neus; Gonzalez, Paloma; Del Rio, Ruth; Iriondo, Martin; Iglesias-Platas, Isabel

2016-10-01

Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol. We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol. We included 142 very low-birth-weight infants ≤32 weeks of gestation with a birth weight ≤1500 g. Data regarding nutrition intakes (parenteral and enteral) in the first week of life, growth during admission, and clinical outcomes were retrieved from clinical charts. Babies in period II received a higher nutrition supply during the first week of life, but no further differences were found after this period. Weight at 14 days of life was significantly higher in period II but not at day 28 of life or discharge. In our population, an enhanced PN regimen for very low-birth-weight infants led to a better growth at 14 days of life. However, this positive effect had disappeared at day 28 of life. Strategies to improve nutrient supply once the preterm baby is stable and on full enteral feeds should be implemented and analyzed. © 2016 American Society for Parenteral and Enteral Nutrition.

Drug Utilization Review of parenteral opioid analgesics in cardiovascular surgery department of Shahid Modarres Hospital, Tehran

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Vatanpour H, Soltani M,

2016-08-01

Full Text Available Persistent pain continues to be a common problem among patients undergoing cardiac operations and the need for controlling such pain is believed to be as a prime necessity in terms of the patient’s well being, health care costs and avoiding negative consequences provoked by the pain itself. Regarding to the newly established guidelines, opioid analgesic agents are considered as the mainstay of moderate to severe acute pain. Nonetheless, the underutilization of opioids for pain relief is still a persisting huge challenge. This survey, applying as a concurrent Drug Utilization Review using ATC/DDD system provided and recommended by the DUR group of the World Health Organization, conducted on 108 inpatients who received opioid drugs by parenteral route during 9 months from February to November 2013 at the post-ICU ward of Shahid Modarres Cardiovascular Hospital, affiliated to Shahid Beheshti University of Medical Science, in Tehran. Our findings revealed that morphine was the most commonly prescribed parenteral opioid in the hospitalized patients and pethidine usage was in the lowest level for the geriatric patients, resulting in satisfaction with the analgesic procedure among most of the cases in our study. Both of the mentioned drugs were prescribed by intramuscular route, regarding PRN way of injecting as well. Comparative results of our study with the literature revealed relatively moderate and roughly rational consumption of morphine (10.282 DDD/100bed-days and pethidine (0.013 DDD/100bed-days. Applying multivariate conditional regression modeling on the question of determining independent predictors for opioid usage, disclosed a direct correlation between the patient’s weight and daily dose of parenteral opioid consumption.

Saturación sensorial y lactancia materna como métodos analgésicos no farmacológicos: estudio randomizado controlado.

OpenAIRE

Rivara Dávila, Gustavo; Briceño Clemens, Diego; Bucher Oliva, Andrea; Liu Bejarano, Cinthia; Huaipar Rodríguez, Sonia; Salazar, Milagros; García Nores, Gabriela; San Martín Llosa, Susana; Villa Portella, Angie; Iglesias, Fiorella; Medina, Carmen; Zegarra, Cinthya; Talledo, Oscar; Yabar, Fiorella; Fontana, Pamela

2011-01-01

OBJETIVOVerificar el efecto analgésico de la saturación sensorial (Sat) y compararlo con la lactancia materna (LM) y un grupo control.MATERIAL Y MÉTODOSEnsayo clínico, randomizado con 167 recién nacidos a término sanos, en quiénes se cuantificó la intensidad de dolor agudo al recibir una vacuna (hepatitis  B) a las 48 horas de vida. Se formaron tres grupos de manera aleatoria: grupo 1 (control, sin método analgésico), grupo 2 (analgesia con LM) y grupo 3 (analgesia con Sat); los estímulos sen...

Concomitant parenteral nutrition and systemic cytotoxic therapy in a metastatic colorectal cancer patient

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A. A. Popov

2012-01-01

Full Text Available Pathologic nutrients metabolism presents a severe problem in metastatic colorectal cancer patients, especially those with canceromatosis. A hypermetabolism-catabolism syndrome frequently develops in in patients with progressing canceromatosis. This leads to cachexia anorexia syndrome, which significantly impedes available treatment options. Artificial nutrition allows to improve available treatment in such patients. We present a successful case of concomitant parenteral nutrition and systemic cytotoxic therapy in metastatic colorectal cancer patient with peritoneal canceromatosis.

Falhas na operação transitivista materna na síndrome de Münchhausen por procuração

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Adela Stoppel de Gueller

2009-06-01

Full Text Available A síndrome de Münchausen por procuração (Münchhausen syndrom by Proxy - MSBP, incluída desde 1980 no DSM-III, se configura quando uma pessoa próxima da criança (na grande maioria dos casos, a mãe sugere ou produz signos falsos para que ela seja examinada por médicos. O presente artigo propõe uma leitura dessa configuração desde a perspectiva psicanalítica. Trabalha-se com a hipótese de tratar-se de um quadro ocasionado por uma falha na operação transitivista materna.

Parenteral opioids for maternal pain management in labour.

Science.gov (United States)

Smith, Lesley A; Burns, Ethel; Cuthbert, Anna

2018-06-05

Parenteral opioids (intramuscular and intravenous drugs including patient-controlled analgesia) are used for pain relief in labour in many countries throughout the world. This review is an update of a review first published in 2010. To assess the effectiveness, safety and acceptability to women of different types, doses and modes of administration of parenteral opioid analgesia in labour. A second objective is to assess the effects of opioids in labour on the baby in terms of safety, condition at birth and early feeding. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (11 May 2017) and reference lists of retrieved studies. We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient-controlled analgesia) for women in labour. Cluster-randomised trials were also eligible for inclusion, although none were identified. We did not include quasi-randomised trials. We looked at studies comparing an opioid with another opioid, placebo, no treatment, other non-pharmacological interventions (transcutaneous electrical nerve stimulation (TENS)) or inhaled analgesia. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the quality of each evidence synthesis using the GRADE approach. We included 70 studies that compared an opioid with placebo or no treatment, another opioid administered intramuscularly or intravenously or compared with TENS applied to the back. Sixty-one studies involving more than 8000 women contributed data to the review and these studies reported on 34 different comparisons; for many comparisons and outcomes only one study contributed data. All of the studies were conducted in hospital settings, on healthy women with uncomplicated pregnancies at 37 to 42 weeks' gestation. We excluded studies focusing on women with pre

Correlation of Cesarean rates to maternal and infant mortality rates: an ecologic study of official international data Correlación de la tasa de cesáreas con las tasas de mortalidad materna e infantil: estudio ecológico basado en datos oficiales internacionales

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Fernando Madalena Volpe

2011-05-01

Full Text Available OBJECTIVE: To correlate international official data on Cesarean delivery rates to infant and maternal mortality rates and low weight-at-birth rates; and to test the hypothesis that Cesarean rates greater than 15% correlate to higher maternal and infant mortality rates. METHODS: Analyses were based on the most recent official data (2000-2009 available for 193 countries. Exponential models were compared to quadratic models to regress infant mortality rates, neonatal mortality rates, maternal mortality rates, and low weight-at-birth rates to Cesarean rates. Separate regressions were performed for countries with Cesarean rates greater than 15%. RESULTS: In countries with Cesarean rates less than 15%, higher Cesarean rates were associated to lower infant, neonatal, and maternal mortality rates, and to lower rates of low weightat-birth. In countries with Cesarean rates greater than 15%, Cesarean rates were not significantly associated with infant or maternal mortality rates. CONCLUSIONS: There is an inverse exponential relation between countries' rates of Cesarean deliveries and infant or maternal mortality rates. Very low Cesarean rates (less than 15% are associated with poorer maternal and child outcomes. Cesarean rates greater than 15% were neither correlated to higher maternal nor child mortality, nor to low weight-at-birth.OBJETIVO: Correlacionar los datos oficiales internacionales sobre las tasas de parto por cesárea con las tasas de mortalidad materna e infantil y con la tasa de bajo peso al nacer, y someter a prueba la hipótesis que sostiene que una tasa de cesáreas mayor de 15% se correlaciona con tasas de mortalidad materna e infantil más elevadas. MÉTODOS: Los análisis se basaron en los datos oficiales más recientes disponibles (2000-2009 de 193 países. Se compararon modelos exponenciales con modelos cuadráticos para hacer un análisis de regresión de las tasas de mortalidad infantil, neonatal y materna, así como de las tasas de

Effect of parenteral nutrition on postradiational metabolic changes under experimental conditions

International Nuclear Information System (INIS)

Grozdov, S.P.; Moroz, B.B.; Fedorovskij, L.L.; Vasil'evskaya, V.V.; Lyrshchikova, A.V.

1978-01-01

The assimilation of carbohydrates, nitrogen compounds, fat and electrolytes during parenteral feeding (PF) of irradiated animals was studied. Rats were subjected to PF from 2nd to 5th day after total gamma irradiation at 750 R, dogs - from 8th to 11th day after irradiation at 300 R. The results are indicative of a satisfactory assimilation of carbohydrates, nitrogen compounds, fat and electrolytes by animals in the cource of PF. The negative nitrogen balance characteristic of irradiated animals was expressed to a lesser degree. A trend to a lower sodium excretion has been observed during PF period

Taurolidine-citrate-heparin lock reduces catheter-related bloodstream infections in intestinal failure patients dependent on home parenteral support

DEFF Research Database (Denmark)

Tribler, Siri; Brandt, Christopher F.; Petersen, Anne H.

2017-01-01

Background: In patients with intestinal failure who are receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) inflict health impairment and high costs.Objective: This study investigates the efficacy and safety of the antimicrobial catheter lock solution, taurol...

Suplementação enteral e parenteral com glutamina em neonatos pré-termo e com baixo peso ao nascer Enteral and parenteral supplementation with glutamine in preterm and low-birth-weight neonates

Directory of Open Access Journals (Sweden)

Maria Carolina Borges

2008-03-01

Full Text Available A glutamina é o aminoácido livre mais abundante no sangue e no músculo esquelético, bem como é o principal substrato energético para células de elevado turnover, como enterócitos e leucócitos. Adicionalmente, a glutamina representa o principal aminoácido transferido para o feto pela placenta e, juntamente com o glutamato, constituem os aminoácidos mais abundantes no leite materno. Todavia, bebês nascidos prematuramente sofrem interrupção abrupta do fornecimento placentário de glutamina, o que acarreta em dependência exclusiva da síntese endógena ou do fornecimento exógeno deste aminoácido. Aliado a isso, neonatos pré-termo (PT e com baixo peso ao nascer (BPN, freqüentemente, recebem apenas nutrição parenteral total nas primeiras semanas de vida, a qual não contém glutamina. Cabe ainda destacar que esses bebês possuem pouca massa muscular e, portanto, seus estoques de glutamina são limitados. Uma vez que neonatos PT e com BPN estão sujeitos a intenso crescimento e a inúmeros estresses fisiológicos, é possível que a glutamina seja um nutriente condicionalmente essencial nessa fase da vida, fato que estimulou a realização de estudos com a finalidade de avaliar os possíveis benefícios clínicos da suplementação enteral e parenteral com glutamina em neonatos PT e com BPN.Glutamine is the most abundant amino acid found in the blood and skeletal muscle, and is the principal energetic substrate for cells with a high turnover, such as enterocytes and leucocytes. Furthermore, glutamine is the most important amino acid that is passed to the foetus via the placenta, and together with glutamate, is the most abundant amino acid in maternal milk. Preterm infants suffer an abrupt interruption in the supply of glutamine via the placenta, which leads to an exclusive dependence on the endogenous synthesis or the exogenous supply of this amino acid. Preterm neonates (PT as well as low-birth-weight neonates (LBW frequently

Pediatric parenteral nutrition: clinical practice guidelines from the Spanish Society of Parenteral and Enteral Nutrition (SENPE), the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH)

Science.gov (United States)

Pedrón Giner, Consuelo; Cuervas-Mons Vendrell, Margarita; Galera Martínez, Rafael; Gómez López, Lilianne; Gomis Muñoz, Pilar; Irastorza Terradillos, Iñaki; Martínez Costa, Cecilia; Moreno Villares, José Manuel; Pérez-Portabella Maristany, Cleofé; Pozas Del Río, M ª Teresa; Redecillas Ferreiro, Susana E; Prieto Bozano, Gerardo; Grupo de Estandarización de la Senpe, Senpe

2017-06-05

Introduction:Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifi cations in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.

Patients' experiences with home parenteral nutrition: A grounded theory study.

Science.gov (United States)

Wong, Christina; Lucas, Beverley; Wood, Diana

2018-04-01

Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting. Each interview was transcribed verbatim. The simultaneous process of data collection and analysis was followed reflecting the principles of the constant comparative approach. A total of 15 patients gave written consent, with 12 of them agreeing to be interviewed. All the participants had previously undergone surgery as a result of chronic ill health or sudden illness. Analysis revealed two core categories: stoma and HPN, and these were supported by the subcategories: maintaining stoma output, access to toilets, managing dietary changes, maintaining the HPN infusion routine, access to technical help to set up an HPN infusion, mobility with HPN equipment and general health changes. The strategy of living with loss was demonstrated by all the participants, and this was supported by the action strategies of maintaining daily activities and social interactions. This study generates new understanding and insight into the views and experiences of patients receiving HPN in the UK. The findings from these participants have been shown to resonate with the Kubler-Ross Model [1] of the five stages of grief. The theory of living with loss was generated by the use of a grounded theory methodology. This small scale exploratory study reveals opportunities for improvements in practice to be considered by the nutrition support team (NST) and other healthcare professionals involved in the patient's hospital stay prior to discharge on HPN. Copyright © 2018 European Society for Clinical Nutrition and

Administering different levels of parenteral phosphate and amino acids did not influence growth in extremely preterm infants

DEFF Research Database (Denmark)

Thomsen, Katrine Moe; Beck-Nielsen, Signe Sparre; Lando, Ane

2015-01-01

AIM: When a new high amino acid parenteral nutrition (PN) solution was introduced to our hospital, a design error led to decreased phosphate levels. This prompted us to examine the effect of three different PN solutions on plasma phosphate, plasma calcium and weight increases on extremely preterm...

Phytosterol Esterification is Markedly Decreased in Preterm Infants Receiving Routine Parenteral Nutrition.

Science.gov (United States)

Savini, Sara; Correani, Alessio; Pupillo, Daniele; D'Ascenzo, Rita; Biagetti, Chiara; Pompilio, Adriana; Simonato, Manuela; Verlato, Giovanna; Cogo, Paola; Taus, Marina; Nicolai, Albano; Carnielli, Virgilio Paolo

2016-12-01

Several studies reported the association between total plasma phytosterol concentrations and the parenteral nutrition-associated cholestasis (PNAC). To date, no data are available on phytosterol esterification in animals and in humans during parenteral nutrition (PN). We measured free and esterified sterols (cholesterol, campesterol, stigmasterol, and sitosterol) plasma concentrations during PN in 16 preterm infants (500-1249 g of birth weight; Preterm-PN), in 11 term infants (Term-PN) and in 12 adults (Adult-PN). Gas chromatography-mass spectrometry was used for measurements. Plasma concentrations of free cholesterol (Free-CHO), free phytosterols (Free-PHY) and esterified phytosterols (Ester-PHY) were not different among the three PN groups. Esterified cholesterol (Ester-CHO) was statistically lower in Preterm-PN than Adult-PN. Preterm-PN had significantly higher Free-CHO/Ester-CHO and Free-PHY/Ester-PHY ratios than Adult-PN (Free-CHO/Ester-CHO: 1.1 ± 0.7 vs. 0.6 ± 0.2; Free-PHY/Ester-PHY: 4.1 ± 2.6 vs. 1.3 ± 0.8; *P phytosterol intake in Preterm-PN. Free-PHY/Ester-PHY of Preterm-PN was positively correlated with the Free-CHO/Ester-CHO and negatively correlated with gestational age and birth weight. In conclusion, PHY were esterified to a lesser extent than CHO in all study groups; the esterification was markedly decreased in Preterm-PN compared to Adult-PN. The clinical consequences of these findings warrant further investigations.