Incidencia de bajo peso al nacer en hijos de madres adolescentes

Se realiza un estudio en el salón de parto del Hospital General Docente Dr Agostinho Neto para determinar la incidencia de bajo peso al nacer en hijos de madres adolescentes durante el año 2009. El universo y la muestra están conformados por 52 neonatos de los nacidos del período estudiado. Las variables estudiadas son: antecedentes patológicos de las madres, peso al nacer, edad materna, procedencia, Apgar al minuto y a los cinco minutos, edad gestacional, tipo de parto al nacer. El dato primario se obtiene de las hojas de parto e historias clínicas. Se muestran en tablas de distribución de frecuencia, donde se aprecia una alta incidencia en sepsis vaginal, con predominio en la zona rural y edad materna entre 16-19 años. La edad gestacional con mayor predominio fue la de 37 semanas y el tipo de parto predominante fue el eutócico (AU)

A study is performed in the delivery room at the General Teaching Hospital "Dr. Agostinho Neto "to determine the incidence of low birth weight in children of teenage mothers, 2009. The universe and the sample are made up of 52 infants born in the studied period. The variables studied include maternal medical history, birth weight, maternal age, and origin, Apgar at one minute and five minutes, gestational age, mode of delivery at birth. The primary data obtained from the leaves of birth and medical records. Tables are shown in frequency distribution, which reveal a high incidence of vaginal sepsis, predominantly rural and maternal age between 16-19 years. Gestational age was more predominant than 37 weeks and birth type was predominant eutocic

Buenas prácticas para el mantenimiento de la lactancia materna exclusiva desde la medicina natural Y tradicional / Good practices for maintenance of exclusive breastfeeding from traditional and natural Medicine

Se propone un documento a partir de una investigación-acción que deviene en intervención terapéutica, en madres diagnosticadas con hipogalactia en el Hospital General Docente Dr Agostinho Neto de Guantánamo, con el objetivo de diseñar una guía de buenas prácticas del uso de la Medicina Natural y Tradicional en la recuperación de la lactancia materna exclusiva, a través del uso de la digito y auriculo puntura en mujeres con un periodo menor de 2 meses de paridas. Se realizan coordinaciones con los servicios de neonatología y puerperio. Se dejan plasmadas las ventajas para la madre, el niño y la familia de manera que constituya un material de consulta de las mismas, y del personal médico y paramédico. Se muestran algunos protocolos de tratamiento (AU)

A document was proposed from an action-- research becomes therapeutic intervention in mothers diagnosed with hypogalactia at the General Teaching Hospital Dr Agostinho Neto in Guantanamo, with the aim of designing a good practice guide on the use of Natural and Traditional Medicine in the recovery of exclusive breastfeeding through the use of the digit and aural puncture in women with a shorter period of 2 months postpartum. It has arranged coordinations with the neonatal and postnatal service. Reflected the benefits in mothers, child and family so as to constitute a reference material to them, as well as medical and paramedical staff. Showing some treatment protocols

Community outreach to patients with AIDS at the end of life in the inner city: reflections from the trenches.

Indigenous community health outreach workers (CHWs), who serve as a bridge between underserved, difficult-to-reach minority populations and health professionals, can play a critical role in bringing palliative care to patients dying of AIDS and other illnesses in the inner city. Although the contribution of CHWs in the delivery of "curative" and preventive services has been well established, little attention has been given to CHWs in palliative care. Integrating the medical literature with experiences of a team providing HIV palliative care in the Bronx, a descriptive typology of critical stages and components in the work of CHWs in end-of-life care in the inner city is presented. A longitudinal case narrative, told from the perspective of the CHW, is used to demonstrate the richness and complexity of the CHW's role. The article concludes with a description of the experience of the CHW, straddling two worlds--the world of the inner city patient and the world of the health care providers--and explores the special characteristics of the individuals who can fill this vital role in palliative care.

Palliative care for AIDS at a large urban teaching hospital: program description and preliminary outcomes.

BACKGROUND: Despite major advances in therapy, acquired immune deficiency syndrome (AIDS) remains an important cause of morbidity and mortality in young adult populations. As AIDS has been converted into a chronic disease, it has resulted for some patients in a more protracted course of symptomatic illness. Comprehensive care for late-stage human immunodeficiency virus (HIV) disease now involves an increasingly complex mixture of disease-specific and palliative therapies, requiring coordination and collaboration between AIDS and palliative care services. We describe the experience of developing a palliative care consultation service for patients with AIDS at a large urban teaching hospital, funded by the Health Resources and Services Administration as one of six national demonstration projects for the integration of HIV and palliative care. SETTING: An 1100-bed medical center in the Bronx, New York. The multidisciplinary consultation team included a physician, nurse practitioner, social worker, chaplain, outreach worker, psychiatrist, and ethicist. Patients were referred from inpatient AIDS services and outpatient care sites. METHODS: Patients underwent standardized assessment with clinical case review, Memorial Symptom Assessment Scale (MSAS), Mini-Mental Status Examination (MMSE), Karnofsky score, and Rapid Disability Rating Scale (RDRS). Interventions and follow-up outcomes were recorded and categorized. All deaths were analyzed and predictors of mortality were determined by bivariate and logistic regression analysis. RESULTS: Program referrals have been steady, with 132 patients followed by the consultation service from July 2000 through October 2001; 73% were referred from inpatient services (representing 12% of all AIDS inpatients admitted to the hospital during the study period); 57% of patients were male, 36% African American, 55% Hispanic; 44% had a history of injection drug use. Median baseline values included: CD4+ T-lymphocyte count = 35/mm3, HIV viral load = 53,813 copies per milliliter, Karnofsky = 40, MMSE = 0 (with a median score of 24 for those able to complete the examination); number of severe symptoms reported by MSAS = 4; 71% had one or more serious impairments in activities of daily living (ADL) by RDRS. In addition to AIDS, 20% of patients had malignancies and 13% had end-stage liver disease. Presenting problems and priority issues identified at consultation included: care decisions/goals of care (68%), pain (40%), psychosocial issues (31%), depression (23%), anxiety (19%), nausea/vomiting (14%), insomnia (13%), and patient/family/team conflict (13%); these problems were fully or partially resolved in 68-91% of cases. 63 patients died (median days enrolled = 35); leading causes of death included AIDS (38%), sepsis (19%), cancer (19%), and liver failure/cirrhosis (17%). Death was predicted only by baseline functional status (Karnofsky, MMSE, ADL impairment), and not by CD4+ count, viral load, or any AIDS-specific variables. CONCLUSION: Results suggest an important and ongoing need for palliative care services for patients with advanced HIV/AIDS, whose needs are likely to increase as AIDS evolves into more of a chronic disease. Patients were readily referred from predominantly inpatient settings, with very advanced disease; problems included a mix of medical and psychosocial issues, and were readily resolved by the consultation team in most cases. Death was predicted only by baseline functional status, not by traditional HIV disease markers. Mortality reflected both AIDS-related and non-AIDS-specific causes. Further studies are needed to identify more specific prognostic variables and to continue to improve palliative care treatment outcomes in late-stage patients with AIDS.