ABSTRACT
The aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks' gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period 'before' (Period I) and 'after' (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks' gestation.
Subject(s)
Cross Infection/prevention & control , Enterocolitis, Necrotizing/prevention & control , Gastrointestinal Microbiome , Infant Nutritional Physiological Phenomena , Infant, Premature, Diseases/prevention & control , Premature Birth/therapy , Probiotics/therapeutic use , Cohort Studies , Combined Modality Therapy , Cross Infection/epidemiology , Cross Infection/immunology , Cross Infection/microbiology , Enterocolitis, Necrotizing/epidemiology , Enterocolitis, Necrotizing/immunology , Enterocolitis, Necrotizing/microbiology , Gastrointestinal Microbiome/immunology , Humans , Incidence , Infant , Infant Mortality , Infant, Newborn , Infant, Premature, Diseases/epidemiology , Infant, Premature, Diseases/immunology , Infant, Premature, Diseases/microbiology , Infant, Very Low Birth Weight , Intensive Care Units, Neonatal , Lactobacillus acidophilus/immunology , Levilactobacillus brevis/immunology , Lacticaseibacillus rhamnosus/immunology , Practice Guidelines as Topic , Premature Birth/immunology , Premature Birth/microbiology , Premature Birth/physiopathology , Probiotics/adverse effects , Retrospective Studies , Risk , Sepsis/epidemiology , Sepsis/immunology , Sepsis/microbiology , Sepsis/prevention & control , Spain/epidemiologyABSTRACT
OBJECTIVE: The goals were to isolate and study the genetic susceptibility to retinopathy of prematurity (ROP), as well as the gene-environment interaction established in this disease. METHODS: A retrospective study (2000-2014) was performed about the heritability of retinopathy of prematurity in 257 infants who were born at a gestational age of ≤ 32 weeks. The ROP was studied and treated by a single pediatric ophthalmologist. A binary logistic regression analysis was completed between the presence or absence of ROP and the predictor variables. RESULTS: Data obtained from 38 monozygotic twins, 66 dizygotic twins, and 153 of simple birth were analyzed. The clinical features of the cohorts of monozygotic and dizygotic twins were not significantly different. Genetic factors represented 72.8% of the variability in the stage of ROP, environmental factors 23.08%, and random factors 4.12%. The environmental variables representing the highest risk of ROP were the number of days of tracheal intubation (p < 0.001), postnatal weight gain (p = 0.001), and development of sepsis (p = 0.0014). CONCLUSION: The heritability of ROP was found to be 0.73. The environmental factors regulate and modify the expression of the genetic code.
Subject(s)
Retinopathy of Prematurity/epidemiology , Retinopathy of Prematurity/genetics , Gene-Environment Interaction , Genotype , Humans , Infant, Newborn , Logistic Models , Prospective Studies , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND: To assess the effectiveness of vitamin A supplementation in very low birth weight (VLBW) infants to prevent complications of prematurity. METHODS: This was a retrospective cohort study to determine the effectiveness of vitamin A in preventing complications of prematurity in VLBW infants. Vitamin A was delivered intramuscularly at a dose of 5000 IU, three times weekly during the first 28 days of life. RESULTS: Of the 187 eligible VLBW infants, we excluded from the analysis (due to death or transfer to another hospital), 16 infants weighing <1000 g and 17 weighing 1000-1500 g. Sixty VLBW infants received the vitamin supplement. We observed no differences between the groups in the duration of oxygen therapy or in the risk of bronchopulmonary dysplasia. The risk of sepsis was up to three times higher among the infants who were given the vitamin A supplement. CONCLUSION: Given the increased risk of sepsis in patients weighing >1000 g, the risk associated with repeated intramuscular injections of vitamin A and the modest clinical results described, we do not believe the universal administration of vitamin A to VLBW infants to be justified as prophylaxis for bronchopulmonary dysplasia.
Subject(s)
Infant, Premature, Diseases/prevention & control , Infant, Very Low Birth Weight , Vitamin A/therapeutic use , Bronchopulmonary Dysplasia/prevention & control , Cerebral Hemorrhage/prevention & control , Female , Humans , Infant, Newborn , Infant, Premature , Male , Oxygen Inhalation Therapy , Retinopathy of Prematurity/prevention & control , Retrospective Studies , Risk Factors , Sepsis/prevention & controlABSTRACT
El síndrome de blefarofimosis, ptosis palpebral, epicanto inverso y telecanto (también denominado con el acrónimo BPES) es una alteración infrecuente, de aparición esporádica, o, más habitualmente, familiar. Han sido descritas en la bibliografía dos formas clínicas de esta última: la tipo T, la más frecuente (en la que las mujeres afectadas suelen presentar infertilidad secundaria a alteraciones en los ovarios), y la tipo II, no asociada con anomalías gonadales. En el presente trabajo se describen dos casos del síndrome BPES, subtipo II, en sendos miembros de una misma familia; ambos casos presentan anomalías asociadas: nistagmo e hipotonía transitoria muscular. Se incide en la necesidad de un estudio precoz de las posibles anomalias asociadas, así como en la cirugía plástica reparadora del defecto palpebral, con el fin de evitar los problemas de visión y cervicales secundarios a un diagnóstico y tratamiento tardíos. (AU)
Subject(s)
Female , Infant , Male , Humans , Eye Abnormalities/genetics , Nystagmus, Pathologic , Syndrome , Blepharophimosis/genetics , Blepharoptosis/genetics , Pedigree , Ocular Motility Disorders/geneticsABSTRACT
No disponible
Subject(s)
Child , Male , Infant, Newborn , Humans , Urachus , Umbilical Cord , Tomography, X-Ray Computed , Vaccines, Conjugate , Pneumococcal Infections , Meningococcal Vaccines , Drug Resistance, Bacterial , Pneumococcal Vaccines , Drug InteractionsABSTRACT
Russel-Silver syndrome is characterized by severe intrauterine growth retardation and is the most characteristic intrauterine dwarfism syndrome. In addition to short stature, low birth weight and reduced postnatal growth, this syndrome is characterized by features such a relative macrocephaly, a typical craniofacial appearance, asymmetry of the body and other abnormalities. Recent studies on developmental delay in these children have shown that most require special education. Attempts to explain the mechanism underlying this condition have been unsuccessful. Recent studies suggest a genetic cause, mainly uniparental disomy 7, although definitive data are lacking. We report a characteristic case of Russel-Silver syndrome: a newborn with fetal growth retardation, the craniofacial features described by Russel, relative macrocephaly, asymmetry of the body and very low weight increase.
Subject(s)
Abnormalities, Multiple/diagnosis , Bone and Bones/abnormalities , Craniofacial Abnormalities/diagnosis , Dwarfism/diagnosis , Fetal Growth Retardation/diagnosis , Infant, Low Birth Weight , Humans , Infant, Newborn , Male , SyndromeABSTRACT
El síndrome de Russel-Silver es una entidad caracterizada por un retraso importante del crecimiento intrauterino, y es el más característico de los nanismos intrauterinos. Además de la baja talla y peso al nacimiento, este síndrome se caracteriza por una serie de hallazgos característicos como macrocefalia relativa, rasgos faciales característicos, asimetría corporal y otra serie de malformaciones. Los últimos estudios realizados sobre posibles alteraciones cognitivas en estos niños detectan que la mayoría de los pacientes requieren seguimiento y atención especial. Los intentos por explicar la etiología de esta entidad han fracasado, aunque los últimos estudios apuntan hacia un origen genético, sobre todo disomía uniparental del cromosoma 7, si bien aún no existen datos definitivos. Se presenta uno de los casos más característicos descritos de síndrome de Russel-Silver, en el que aparecen la gran mayoría de los hallazgos relacionados con este cuadro. Un recién nacido con retraso del crecimiento intrauterino, con las alteraciones faciales descritas por Russel, macrocefalia relativa, asimetría corporal y una curva de ganancia ponderal pobre (AU)
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