Drogadicción embriofetal por abuso de pasta base de cocaína durante el embarazo / Fetal drug addiction as a consequence of maternal cocaine base paste abuse during pregnancy

Background: Fetal drug addiction is a serious public health problem. In the United States 10 to 15 percent of children have been exposed "in utero" to cocaine. In a Chilean public health service, more than 200 offspring of cocaine free base abuser have been detected. Aim: To analyze the clinical and social features of 100 children exposed to cocaine free base during fetal development. Patients and methods: Clinical features of children born from cocaine free base consume mothers were described at birth. During subsequent follow up, growth and development, disease episodes, developmental alterations and social situation were recorded. Data was compared with other newborns from the same health service. Results: Compared to their normal counterparts, exposed children has a lower birth weight, the frequency of premature babies was thrice higher, and small-for-gestational age children were four times more common. There was also a higher prevalence of cardiac malformations, seizures and apnea. Hospital admissions were more frequent, prolonged and required more complex facilities. During follow up, undernutrition and stunting were more prevalent. Psychomotor retardation was present in 67 percent of children and behavioral disturbances in 93 percent. Most of these children are governmental protection. Conclusions: Strategies to prevent drug abuse during pregnancy and its devastating medical and social consequences should be urgently developed

Programa de prevención y control de las enfermedades respiratorias agudas de la infancia en Santiago, Chile / Program for the prevention and control of childhood acute respiratory infections in Santiago, Chile

En el presente trabajo se describen y examinan las actividades de un programa pediátrico para la prevención y el control de las infecciones respiratorias agudas (IRA) en un servicio de salud estatal que atiende a la población de bajos ingresos de Santiago, Chile. En un área de salud correspondiente a una población de algo más de un millón de habitantes, con un hospital de base, 16 consultorios de atención primaria y ocho postas rurales, se desarrollaron actividades específicas de capacitación de personal, así como acciones de controll en atención primaria y de hospitalización de niños con IRA grave. En los primeros 5 años de funcionamiento del programa (1990-1994) se observó entre niños menores de un año una disminución de la mortalidad anual por neumonía de 3,0 a 1,7 por 1000, lo que ha contribuido a un descenso de la mortalidad infantil de 13,5 a 8,9 defunciones por 1000 nacidos vivos. En 1994 los costos del programa alcanzaron los US$ 224.000. A juzgar por los resultados obtenidos, el programa de prevención y control de IRA puede haber sido un aporte valioso a la salud infantil del área

This paper describes and examines the activities for the prevention and control of acute respiratory infections (ARI) carried out by a pediatric program in a government health service that provides care to a low-income population in Santiago, Chile. The study area has a population of just over one million people and is served by one general hospital, 16 primary care clinics, and eight rural health posts. Specific activities carried out by the ARI program include personnel training as well as control measures at the primary care level and hospitalization of children with severe ARI. In the first 5 years of the program (1990­1994), a reduction in annual mortality from pneumonia from 3.0 to 1.7 per 1 000 was observed among children under the age of one year, which contributed to a decline in infant mortality from 13.5 to 8.9 deaths per 1 000 live births. In 1994, program costs amounted to US$ 224 000. Judging from the results obtained, the ARI prevention and control program has made a valuable contribution in the area of child health.