[Nutrition of low birth weight infants]. / Nutritia copilului cu greutate mica la nastere.

The low birth weight infant's (LBW) nutrition needs special attention. Energy requirements are increased due to a high metabolic rate and a low thermogenesis. Increased protein requirements are, easy to be absorbed (from lacto-serum). Lipids, as important energetic source requires an appropriate content in essential fatty acids and medium chain triglycerides (TGM) which are easy absorbed in absence of lipase and deficit of bile salt secretion. The carbohydrates should be represented by lactose or equivalents like di-, oligo or polysaccharides. The addition of maltodextrin avoid an exaggerate supply and incomplete digestion of lactose. Sodium requirement are increased due to exaggerated loss consequence of renal immaturity. The rapid rate of growth impose the addition of Calcium, Phosphorus, Iron, Copper, and vitamins, especially Vitamin D, E and Folic acid. The appropriate nutrition of LBW must cover his special needs to maintain the homeostasis and rapid growth. Precise nutrient requirements are, however, difficult to establish.

[Urinary tract infections in children--aspects of microbiological diagnosis]. / Infectia urinara la copil aspecte ale diagnosticului bacteriologic.

UNLABELLED: Urinary tract infection (UTI) is one of the most common bacterial infections of childhood, with the incidence range between 1-1.5% in boys and 3-8% in girls. AIM: To estimate the value of urine analysis (bacteriology and biochemistry) for diagnostic of UTI in children. MATERIAL AND METHOD: The method was to observe 700 urinary specimens collected from patients hospitalized in 4th Clinic of Pediatric Nephrology between October 2004 and February 2005, the urinalysis (UA) being performed in the Microbiology laboratory of "St. Maria" Emergency Children Hospital Iasi. The sample collection was made from the midstream urine flow, direct microscopy and standard culture were performed immediately after collection. We applied a diagnostic strategy study in order to evaluate sensitivity and specificity of UA for prediction of UTI. The data was assessed according to the Receiver Operator Characteristic Curve. RESULTS AND DISCUSSION: We analysed the relation between leukocituria and positive urine culture and we find a sensitivity equal to 56%, with CI 95% = 0.56 +/- 0.07, and a specificity equal to 10%, with CI 95% = 0.10 +/- 0.02. The likelihood of UTI with negative UA result has been calculated as a negative likelihood ratio = 4.4. If we supplement a number of culture (2-3) we have obtain a sensitivity 97% +/- 0.02%, and the predictive negative value 97% (that mean the possibility to lose UTI in just 3% cases), and a specificity 35%, with a predictive positive value 61% (that mean a decrease of possibility to over-measure UTI). CONCLUSIONS: The sensitivity of UA increase if we correlate more than leukocyturie and the significantly positive urine culture. We must to supplement a number of urine culture for increase the chance to obtain a positive diagnostic of UTI, and to exclude a possibility to over-measure UTI. Through increase a sensibility of method for diagnostic, decrease the possibility to loose and no treaty UTI with serious consequence.

[Erythema toxicum neonatorum]. / Eritemul toxic al nou nascutului.

(ETN) is a benign, self limited, asymptomatic skin condition, that only occurs during the neonatal period. This clinical entity is caractherized by small, sterile, erythematous papules, vesicles, and occasionally pustules, appearing on the trunk, extremities, and the face. The lesions are transitory, appear after 1-2 day of life, and regres after 5-14 days. ETN occurs in 30-50% of full-term infants, and just in 5% of preterm infants, with no significant differences based on race or sex. The ethiology or pathophysiology of ETN are uncertain, but the presence of the eosinophilic infiltrate in the lesions of erythema suggests an allergic ethiology, even no allergens have been identified. The treatment is not required, and the prognosis is excellent with spontaneous resolution.

[Clinical and epidemiologic considerations in the role of newborn diseases causing asthma in children]. / Consideratii clinico-epidemiologice privind implicarea patologiei neonatale în inducerea astmului bronsic la copil.

The authors present results of a multidisciplinary study in 712 children with asthma concerning the role of certain newborns events and the role of feeding in the onset of disease: resuscitation during the delivery--82.68%, respiratory distress--75.5%, Apgar score = 7 - 58.56%, bottle-feeding 50.50%, multi-pregnancy--44.23%, abnormal pregnancy--20.11%, premature infant and small for gestational age infant 10.60%, mother age less then 20 years 8.6%.

[Prematurity--risk factor for morbidity in infants]. / Prematuritatea--factor de risc al morbiditatii la sugar.

UNLABELLED: The premature child from the anatomo-physiological deficiencies represents one of the most important medical problems. In this context we present the results of an retrospective study on 2 lots of infants followed for one year in the Infant Care Clinic of Iasi. The first lot was formed by infants with a normal weight at birth and the second one by premature infants. At this two lots we study the age of admission in Clinic, the care period, the nutritional status, the total number of diseases, the type of affections. We study the most frequent affections of infants such as: respiratory, digestive, otic, cutaneo-mucous. The total number of diseases was 61 for the first lot and 153 for the second lot. From the affections the most frequently were respiratory diseases 60% for the first lot and 104% for the second lot (p < 0.01). The digestive affections were presented at 47.5% of first lot of children and 92% for the second one (p < 0.001); the otic affections 25% for the first lot and 50% for the second one (p < 0.05); cutaneo-mucous affection were represented by 20% from the first lot and 60% for the second one (p < 0.001). CONCLUSIONS: The prematurity continued to represent one of the most important risk factors of morbidity to infant, for that to those children we must to grant a special medical care.

An educational intervention improves developmental progress of young children in a Romanian orphanage.

From 1991 to 1994, a group of Romanian and American colleagues undertook an experimental and humanitarian effort to try to improve the quality of life, mental health, and developmental progress of young children in a Romanian orphanage. In the context of institutional care, we experimentally introduced stable adult-child relationships, small group size, and a protocol of enriched caregiving and educational activities. These procedures were adapted from an intervention in childcare centers in the United States that had been proven effective in reducing intellectual decline in at-risk children. Developmental scores for orphanage children were derived from the Denver II (a revision of the Denver Developmental Screening Test; Frankenburg & Dodds, 1990), which was translated into Romanian and administered as a pre- and posttest to the experimental subjects and comparison groups in the same institution. Mixed models combining both within- and between-subject heterogeneous variance-covariance structures were utilized to analyze the impacts of time, intervention/control group assignment, child sex, child age, and interaction of Group × Time on the developmental scores. For the developmental outcome variables, the effects of group assignment (experimental vs. comparison) were highly significant. There also was a Group × Time interaction effect. We conclude that an educational intervention which includes the addition of resources and training can be initiated and sustained in an orphanage for young children as a way of improving institutional care. ©2005 Michigan Association for Infant Mental Health.