Application value of multiple colostrum feedings in reducing the incidence of neonatal jaundice / 中国基层医药

Objective:To investigate the clinical efficacy of multiple colostrum feedings in reducing the incidence of neonatal jaundice.Methods:We randomly selected 100 full-term neonates delivered in Xiaoshan Hospital from January 2018 to January 2019 and randomly allocated them into control and observation groups ( n = 50/group). The control group was administered colostrum < 4 times/day, and the observation group was administered colostrum > 12 times/day. The incidence of neonatal jaundice, the severity of jaundice, the duration of jaundice, serum bilirubin level 7 days after birth, and the satisfaction of neonatal close relatives were compared between the two groups. Results:Neonatal jaundice was significantly milder in the observation group than in the control group ( P < 0.05). The proportion of healthy neonates was significantly higher in the observation group than in the control group ( P < 0.05). The duration of jaundice was shorter in the observation group than in the control group [(2.10 ± 0.35) days vs. (4.25 ± 1.53) days, t = 8.66, P < 0.001]. There was a significant difference in serum bilirubin level 1-5 days after birth between the two groups (all P < 0.05). The satisfaction of the close relatives of neonates was significantly higher in the observation group than in the control group (96.00% vs. 84.00%, χ2 = 4.00, P = 0.045). All neonates with jaundice healed after multiple short-term blue light phototherapies and had no obvious adverse reactions. Conclusion:Multiple colostrum feedings can greatly reduce the incidence of neonatal jaundice, improve the satisfaction of the close relatives of neonates, play a positive role in promoting maternal and infant health, and thereby are worthy of popularization.

Inflammatory state and autism-like behavioral phenotype of offspring induced by maternal exposure to low-dose chemical mixtures during pregnancy in mice / 浙江大学学报·医学版

To investigate the effects of maternal exposure to 13 chemicals mixture (CM) during pregnancy on pregnancy outcome and health status of maternal/offspring mice. C57BL/6 pregnant mice were given drinking water containing carbaryl dimethoate glyphosate methomyl methyl parathion triadimefon aspartame sodium benzoate calcium disodium ethylene diamine tetra-acetate ethylparaben butylparaben bisphenol A and acacia gum The effects of CM exposure on pregnancy outcome, health status of dams/offspring, levels of circulating inflammatory cytokines in dams/offspring and emotional related behaviors of offspring were evaluated. CM exposure during pregnancy had no significant effect on pregnancy outcome, liver function, body weight of the dams in late pregnancy and uterine/ovarian weight after delivery, however, it led to an increase in maternal serum IFN-γ level （<0.05）. CM exposure during pregnancy had no significant effect on the liver function of offspring, but increased the serum IFN-γ, prefrontal cortex IFN-γ, and TNF-α and hippocampus IFN-γ levels in the offspring（all <0.01）. In addition, the offspring of CM group showed significant abnormal emotion-related (autism-like) behaviors in adulthood, especially in male offspring. Low dose CM exposure during pregnancy may induce inflammation status in dams/offspring, and lead to autism-like behaviors in offspring, indicating the potential effects of low dose CM exposure on human maternal and infant health.

Diagnosis, treatment, and notification of syphilis during pregnancy in the state of Goiás, Brazil, between 2007 and 2017 / Diagnóstico, tratamento e notificação da sífilis durante a gestação em Goiás, de 2007 a 2017

ABSTRACT OBJECTIVE To analyze the evolution of syphilis during pregnancy notification regarding clinical classification, diagnosis and treatment in the state of Goiás, Brazil, between 2007 and 2017. METHODS This is a time-series study, analyzing data provided by the Health Secretariat of the state of Goiás. The variables related to the diagnosis and treatment of pregnant women and their partners were analyzed, and their evolution trend during the years. Descriptive statistics and percentage calculation were used. Cochran-Armitage test with a significance level α = 0.05 was used to determine increase and decrease trends. RESULTS During the period, 7,774 cases were notified. The highest percentage of notifications occurred in the second trimester of pregnancy (39.8%) and corresponded to primary syphilis (34.1%). The most frequent treatment prescribed was benzathine benzylpenicillin with a dosage of 7.2 million (43.8%). Between 2007 and 2017, there was an increasing trend in the notification percentage of latent (14.1% to 30.7%), secondary (5.2% to 19%), and tertiary syphilis (4.4% to 11.4%). The treatment with benzathine benzylpenicillin with a dosage of 7.2 million also increased (19.3% to 59.6%). The percentages of primary syphilis decreased (43.4% to 22.1%), as well as other treatments' percentages. CONCLUSIONS Latent syphilis notification of pregnant women and treatment with penicillin at the dosage of 7,200,000 IU increased. Notification forms' data completeness also increased for the variables clinical classification and treatment, suggesting improvements in the notification process.

RESUMO OBJETIVO Analisar a evolução das notificações da sífilis durante a gestação em relação à classificação clínica, ao diagnóstico e ao tratamento no estado de Goiás, entre 2007 e 2017. MÉTODOS Estudo de série temporal com análise de dados fornecidos pela Secretaria Estadual de Saúde de Goiás. Foram analisadas as variáveis relacionadas ao diagnóstico e tratamento das gestantes e seus parceiros, e sua tendência evolutiva ao longo dos anos. Utilizou-se estatística descritiva, cálculo de porcentagens e verificação das tendências de aumento e diminuição por meio do teste de Cochran-Armitage com nível de significância α = 0,05. RESULTADOS Ao todo, 7.774 casos foram notificados no período. A maior porcentagem das notificações ocorreu no segundo trimestre de gestação (39,8%) e correspondeu à sífilis primária (34,1%). O tratamento prescrito com maior frequência foi a penicilina benzatina em dose de 7,2 milhões (43,8%). Entre 2007 e 2017, observou-se tendência crescente nas porcentagens de notificações de sífilis latente (14,1% para 30,7%), secundária (5,2% para 19%) e terciária (4,4% para 11,4%), assim como no tratamento com penicilina benzatina em dose de 7,2 milhões (19,3% para 59,6%). Tendência decrescente foi observada nas porcentagens de notificação de sífilis primária (43,4% para 22,1%) e nos demais esquemas de tratamento. CONCLUSÕES Houve aumento no número de notificações de sífilis latente em gestantes e no tratamento com penicilina na dose de 7.200.000 UI. Também foi observado aumento na completitude dos dados da ficha de notificação nas variáveis de classificação clínica e tratamento, sugerindo melhora no processo de notificação.

An integrative review of home visiting programs for mothers and infants from birth to 12 months in developed and underdeveloped countries

OBJECTIVES@#To investigate home visiting for mothers and young infants, age birth-to-12 months, program goals, interventions used, home visitor characteristics and qualifications, and the program content and outcomes.@*METHODS@#Electronic databases PubMed, CINAHL, ScienceDirect, and Sagepub were used. Eleven studies investi- gating home visiting from 2011-to-2016 were included. Studies were included if they: 1) were a primary study; 2) commenced during the antepartum or early postpartum period for mothers and finished before or when the infant was 12 months old; 3) and provided a description of home visiting program in terms of goal, type of home visitor, content, length, and outcomes. Data extraction included goals, activities, home visitor characteristics and qualifications, and outcomes. A descriptive approach was used to synthesize data.@*RESULTS@#Home visiting impacted birth preparedness, newborn care practices, breastfeeding practices, and home environment necessary for maternal wellness and child health and development.@*CONCLUSION@#Home visits in developed and underdeveloped countries create positive outcomes for mothers and infants. It is important to understand the process in order to make it more effective.

Representações sociais da nutrizs adolescentes sobre a amamentação / Representaciones sociales de las lactantes adolescentes sobre el amamantamiento / Social representations of nursing teens on breastfeeding

Objetive: This study aims to identify the social representations of adolescent nursing mothers on breastfeeding. Method: An seploratory descriptive study founded on the theory of social representations, and carried out in the coverage area of three Family Healthcare Units in the Metropolitan Area of Curitiba, Parana State, Brazil. Nine adolescents were interviewed by means of a semi-structured interview, data analyzed through thematic category analysis. Results: The following categories were identified: Experience of the family breastfeeding network and Breastfeeding as an obligation. Data evidenced that adolescents underpin their breastfeeding representations on family experience and represent health professionals with an authoritarian attitude to promote breastfeeding. Conclusion: These results may support professional practice redesign from a prescriptive manner to critic, creative, dialogical care, based on principles of wholeness and equity, which entail health needs not only for the mother, but as well, for the child as social subjects.

Objetivo: Conhecer as representações sociais das nutrizes adolescentes sobre amamentação. Método: Estudo descritivo qualitativo embasado na teoria das representações sociais, realizado em três Unidades de Saúde da Família de um município do Estado do Paraná. Foram entrevistadas nove nutrizes adolescentes por meio de entrevista semiestruturada, sendo os dados analisados por análise temática. Resultados: Emergiram dos dados as categorias: Experiência da família como apoio para a amamentação e Amamentação como uma obrigação. Os dados explicitaram que as nutrizes adolescentes ancoram suas representações da amamentação na experiência dos familiares e representam os profissionais de saúde com postura autoritária para a promoção do aleitamento materno. Conclusão: os resultados encontrados podem subsidiar a reorientação da prática profissional de um modelo prescritivo para um cuidado crítico, criativo e dialógico, baseado nos princípios da integralidade e equidade, que abarquem as necessidades de saúde da família e da criança como sujeitos sociais.

Objetivo: conocer a las representaciones sociales de las lactantes adolescentes sobre la red social de apoyo al amamantamiento. Método: Estudio descriptivo cualitativo basado en la teoría de las representaciones sociales, realizado en territorio de tres Unidades de Salud de la Familia en la región metropolitana de Curitiba. Han sido entrevistadas nueve adolescentes por medio de la entrevista semiestructurada, estos datos analizados por análisis categorial temático. Resultado: Se han identificado las categorías: Experiencia de la familia en el amamantamiento y Amamantamiento por obligación. Los datos explicitaron que las lactantes adolescentes anclan sus representaciones de amamantamiento en la experiencia de los familiares y representan los profesionales de salud con apostura autoritaria para promoción del amamantamiento materno. Concluso: Estos resultados pueden subvencionar la orientación práctica profesional para un cuidado crítico, creativo y con diálogo, basado en los principios de la integridad y equidad, que abarque las necesidades de salud tanto de la mujer, como del niño, como sujetos sociales.

Study on the levels of microRNA-146b, microRNA-155 and microRNA-30b in human milk and their correlation with maternal and infant health / 中华实用儿科临床杂志

Objective To explore the expression levels of immune-related microRNA-146b (miR-146b),microRNA-155 (miR-155) and microRNA-30b(miR-30b) in human breast milk and its relationship with maternal and infant's health.Methods One hundred and thirty-four mothers and their infants from obstetrical department were recruited in the study after delivery.The subjects were divided into 2 groups,breast feeding group(n =86) and formula-feeding group(n =48),and were followed up 3 months after delivery.Breast milk samples were collected at 2-5 days after delivery(colostrum) and 3 months after delivery(mature milk).The expression levels of microRNAs in milk samples were detected by real-time PCR.The relationship between levels of microRNAs and maternal and infant-related factors was analyzed.Results 1.MiR-146b,miR-155 and miR-30b expressions were abundant both in human colostrums (5.950 ± 0.823,3.899 ± 0.920,4.057 ± 0.604) and mature milk (4.840 ± 0.805,2.128 ± 0.969,4.929 ± 0.566).The levels of miR-146b and miR-155 were higher in colostrum than that of mature milk (t =7.716,10.215,all P ＜ 0.01),while the level of miR-30b was higher in mature milk than that of colostrums(t =-8.626,P ＜ 0.0l).2.Additionally,the level of miR-30b was negatively correlated with maternal pre-pregnancy body mass index (r =-0.298,P ＜ 0.01).3.The levels of miR-146b and miR-30b were higher in mothers giving birth by vaginal delivery than those who underwent cesarean section(t =2.356,3.108,all P ＜0.05).4.The levels of miR-146b and miR-155 were higher in colostrum-fed girls than boys (t =-2.204,-2.985,all P ＜ 0.05).5.The level of miR-146b in mature milk was negatively correlated with 3-month-old infant' s Z score of body weight (r =-0.425,P ＜ 0.05) and body length (r =-0.569,P ＜ 0.01).6.During follow-up,the incidence of baby eczema in breast feeding group (8.82％,3/34 cases) was lower than that in formula milk feeding group(29.17％,14/48 cases) (x2 =5.012,P =0.025).Conclusions The levels of immunocompetent microRNAs in human milk are influenced by the lactation period,maternal prepregnancy body mass index,mode of delivery and infant sex.The immune-related microRNAs in human milk could be involved in the regulation of infant's immunity and growth.

Análise do programa de prevenção da transmissão vertical do vírus HIV na ONG Associação Céu e Terras, Guiné - Bissau, 2007-2011 / Analysis of the Program for Prevention of Vertical Transmission of HIV virus in the NGO Associação Céu e Terras, Guinea - Bissau, 2007 - 2011

Introdução: Com o surgimento da epidemia da AIDS na década de 80, vários têm sido os desafios enfrentados pela sociedade, devido à rápida disseminação, em escala global. A epidemia acomete cerca de 34 milhões nos diversos continentes, e segundo a UNAIDS (2012), a maior parcela está em países em desenvolvimento. O continente africano, com mais de 800 milhões de habitantes, em 54 países, é o que mais tem sofrido os impactos da doença, apresentando a maior parcela de infectados pelo vírus HIV no mundo, com cerca de 23,5 milhões de infectados registrados. Assim como globalmente, a preocupação que tem suscitado debates é a crescente feminização dessa epidemia em Guiné-Bissau, aumentando as taxas de transmissão vertical do vírus HIV, que, segundo as últimas projeções do país (PEN III, 2012), o risco estimado foi de 8,9 por cento. O advento do antirretroviral (Zidovudina), em 1994, a partir da publicação do protocolo 076 da ACTG veio mudar o cenário da transmissão vertical. Em Guiné-Bissau, a chegada dos antirretrovirais, em 2006, constituiu uma nova fase na luta contra a disseminação do vírus, em particular, no âmbito da transmissão vertical, proporcionando melhor qualidade de vida e chances de uma criança nascer sem AIDS. A ONG Céu e Terras atua no país desde 2001, e, em julho de 2007, adotou o protocolo recomendado pela OMS: tríplice terapia e amamentação exclusiva, visando à redução da transmissão vertical. Objetivo - Analisar a atuação da ONG Associação Céu e Terras quanto à prevenção da transmissão vertical do vírus HIV no contexto da Guiné-Bissau, a partir da introdução do novo protocolo da tríplice terapia antirretroviral e amamentação exclusiva. Método - É um estudo descritivo de dados secundários de mães e de seus filhos, mães estas inscritas no programa da instituição (ONG) Associação Céu e Terras em Bissau, República da Guiné-Bissau, no período de julho de 2007 a junho de 2011...

Introduction: With the emergence of the AIDS epidemic in the decade of the eighties. Around the world, there are several challenges faced by society due to its rapid dissemination in global scale. The epidemic affects approximately 34 million people around the world, according to UNAIDS, the largest portion is observed in third world. The African continent with over 800 million inhabitants, which contains 54 countries, is what most has suffered the impact of the disease presenting the largest portion of HIV patients in the world, with about 23.5 million infected registered. As globally, the concern that has sparked debates is the increasing feminization of the virus in Guinea - Bissau, the country which consequently increased rates of vertical transmission of HIV, which according to recent projections, the risk is estimated at 8.9 percent (PEN III,2012). The advent of antiretroviral (zidovudine) in 1994, from the publication of 076 protocol of the ACTG come to change the scenario of vertical transmission. In Guinea-Bissau, the arrival of antiretrovirals in 2006, marked a new phase in the fight against the spread of the vírus particularly in the context of vertical transmission, providing more life quality and chances of a child born without AIDS. The NGO Associação Céu e Terras acts in the country since 2001, and in 2007 adopted the protocol recommended by WHO with triple therapy and exclusive breastfeeding, in order to reduce vertical transmission in the country. Objective - Analyze the performance of the NGO Associação Céu e Terras as the prevention of vertical HIV transmission in the context of Guinea-Bissau. Examine the proposal from the introduction of the new protocol of triple antiretroviral therapy, exclusive breastfeeding, 2007 2011...

Perfil da clientela atendida pelo enfermeiro na estratégia acolhimento mãe-bebê / Profile of the clientele attended by the nurse in the mother-and-baby embracement strategy / Perfil del cliente atendido por el enfermero en la estrategia acogimiento madre bebé

Trata-se de um estudo quantitativo do tipo descritivo-exploratório que objetivou identificar características sociodemográficas e de saúde de mães e bebês atendidos pelo enfermeiro na Estratégia Acolhimento Mãe-Bebê, em uma unidade básica de saúde do Município do Rio de Janeiro. Os dados foram coletados em 26 prontuários que possuíam o protocolo Roteiro de Atividades da Consulta do Acolhimento Mãe-Bebê, em 2011. A análise dados foi feita com o uso do software Epi-Info 3.5.2. Os resultados mostram que 61,3% das mulheres estavam na faixa etária entre 20 a 30 anos; 46,2% haviam realizado parto normal; 7,7% apresentavam alteração na cicatriz cirúrgica e 11,5% alteração nas mamas. Com relação aos recém-nascidos, 50% possuíam de 2 a 7 dias de vida; a maioria (96,2%) encontrava-se em aleitamento materno exclusivo e 23,1% apresentavam icterícia. Conclui-se que o conhecimento do perfil da clientela atendida no Acolhimento Mãe-Bebê, pelo enfermeiro, constitui importante subsídio para o desenvolvimento de medidas de promoção à saúde que visem redução da morbidade e da mortalidade materno-infantil.

This quantitative study of the descriptive-exploratory type aimed to identify socio-demographic and health characteristics of mothers and babies attended by nurses in the Mother-and-Baby Embracement Strategy in a primary health care unit in the city of Rio de Janeiro. The data was collected from 26 hospital records which had the Guide for Mother-and-Baby Embracement Consultation Activities protocol, in 2011. The data was analyzed using the Epi-infor 3.5.2 software. The results show that 61.3% of the women were in the age range 20 to 30 years old; 46.2% had had a normal birth; 7.7% had changes in the surgical scar and 11.5% had changes in their breasts. In relation to the new-borns, 50% were between 2 and 7 days old; the majority (96.2%) were being exclusively breast-fed, and 23.1% presented jaundice. It is concluded that knowledge of the profile of the clientele attended in the Mother-and-Baby Embracement, by the nurse, constitutes important support for carrying out health promotion measures which aim to reduce maternal and infant morbidity and mortality.

Este es un estudio cuantitativo del tipo descriptivo exploratorio que tuvo el objetivo de identificar características sociodemográficas y de salud de madres y bebés atendidos por el enfermero en la Estrategia Acogimiento Madre Bebé, en una unidad básica de salud del Municipio de Rio de Janeiro. Los datos fueron obtenidos en 26 prontuarios que poseían el protocolo Guion de Actividades de la Consulta del Acogimiento Madre Bebé, en 2011. El análisis de datos fue hecho con el uso del software Epi-Info 3.5.2. Los resultados muestran que 61,3% de las mujeres estaban en la franja etaria entre 20 y 30 años; 46,2% habían realizado parto normal; 7,7% presentaban alteración en la cicatriz quirúrgica y 11,5% alteración en las mamas. Acerca de los recién nacidos, 50% poseían de 2 a 7 días de vida; la mayoría (96,2%) estaba en amamantamiento materno exclusivo y 23,1% presentaban ictericia. Se concluye que el conocimiento del perfil de la clientela atendida en el Acogimiento Madre Bebé, por el enfermero constituye importante subsidio para el desarrollo de medidas de promoción a la salud para la reducción de la mortalidad materno infantil.