ABSTRACT
Background: Postpartum depression (PPD) has adverse effects on psychomotor development of the offspring. Aim: To evaluate the relationship between PPD and psychomotor development in children aged 18 months, consulting in primary care. Material and Methods: Cross-sectional study with 360 infants and their mothers. Children had their psychomotor evaluation atl8 months and mothers completed the Edinburgh Postnatal Depression Scale at 4 and 12 weeks postpartum. The prevalence of both PPD and psychomotor alteration was estimated. The association between PPD and psychomotor alteration, including confounding variables, was estimated through logistic multiple regression analysis. Results: The prevalence of PPD and psychomotor alteration was 29 and 16%, respectively Mothers with PPD had twice the probability of havingan offspring with psychomotor alteration (Odds ratio = 2.0, confidence intervals = 1.07-3.68). This probability was significantly higher among single mothers or those with an unstable partner. Conclusions: PPD has a detrimental impact on psychomotor development of children.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Depression, Postpartum/psychology , Psychomotor Disorders/etiology , Birth Weight , Chile/epidemiology , Cross-Sectional Studies , Depression, Postpartum/epidemiology , Prevalence , Primary Health Care , Psychomotor Disorders/epidemiology , Risk FactorsABSTRACT
En un período de cinco meses y 25 días se investigó la portación intestinal de enterococos resistentes a vancomicina (EVR). Se estudiaron 124 pacientes (73%) de 171 admitidos en la unidad de terapia intensiva (UTI), 35 de los cuales (28%) resultaron ser portadores. Los aislamientos de EVR (n=35) fueron identificados como Enterococcus faecium (n=18), Enterococcus gallinarum (n=16) y Enterococcus raffinosus (n=1). Todos los aislamientos estudiados fueron resistentes a vancomicina (VAN) (CIM90= 512 µg/ml) y teicoplanina (CIM90= 32 µg/ml) y portaban el gen vanA. Los estudios de tipificación molecular mostraron un alto grado de homología entre los aislamientos de E. faecium (un clon dominante) y E. gallinarum (dos tipos clonales), sugiriendo su diseminación a modo de brote. No se encontraron diferencias significativas con la edad y el sexo de los pacientes no portadores (p>0,05), pero si con el tiempo de hospitalización y el uso de esquemas antibióticos de amplio espectro (p<0,05), estando estos dos factores asociados al estado de portación. Se deduce de este estudio, la importancia de maximizar las medidas de prevención y control de las infecciones nosocomiales, analizar los esquemas empíricos empleados, tratar de disminuir el tiempo de hospitalización y continuar con los estudios de vigilancia para evaluar la eficacia de las acciones implementadas.
Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73%) were included in this study. Thirty five of them (28%) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n=18), Enterococcus gallinarum (n=16), and Enterococcus raffinosus (n=1). All of them were resistant to vancomycin (MIC90= 512 µg/ml) and to teicoplanin (MIC90= 32 µg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p>0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Enterococcus/isolation & purification , Intensive Care Units , Intestines/microbiology , Vancomycin Resistance , Argentina , Cohort Studies , Comorbidity , DNA, Bacterial/genetics , Drug Resistance, Multiple, Bacterial , Enterococcus/drug effects , Enterococcus/genetics , Genotype , Prospective Studies , Teicoplanin/pharmacology , Vancomycin/pharmacologyABSTRACT
La enfermedad por arañazo de gato (EAG), es considerada la causa más frecuente de linfoadenopatía benigna crónica en niños y adolescentes. En los casos existe el antecedente de contacto con gatos (90 por ciento) y de rasguño y/o mordedura (60 por ciento). La infección con Bartonella spp se manifiesta como desde una linfoadenopatía (EAG) a una enfermedad sistémica. El 10 po ciento tiene manifestaciones atípicas y 2 por ciento presenta complicaciones graves. Debe sospecharse EAG por exclusión de otras etiologías habituales y por el antecedente epidemiológico de contacto y/o rasguño de gato, con o sin lesión de inoculación primaria. Se presentan 4 casos de EAG atípicas en niños del S.S. Valdivia, donde se confirmó el agente por IFI IgG contra Bartonella henselae, con títulos > 1: 256.