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1.
Am J Clin Oncol ; 38(1): 1-4, 2015 Feb.
Article in English | MEDLINE | ID: mdl-23648434

ABSTRACT

PURPOSE: To assess the activity and toxicity of lenalidomide for patients with advanced hepatocellular cancer (HCC) previously treated with sorafenib. MATERIALS AND METHODS: Patients with advanced HCC who progressed on or were intolerant to sorafenib were eligible. Patients received lenalidomide 25 mg orally for 1 to 21 days in a 28-day cycle until disease progression or unacceptable toxicities. RESULTS: Forty patients were enrolled and were classified according to the Child-Pugh score: 19 were Child-Pugh A, 16 patients were Child-Pugh B, and 5 were Child-Pugh C. Seventeen patients had extrahepatic disease. Grade 4 neutropenia occurred in 1 of 40 patients (2.5%). Grade 3 fatigue (n=3) and rash (n=4) were the most common nonhematologic toxicities attributable to lenalidomide. Six of 40 patients (15%) had a partial response. Two patients (5%) have not progressed at 36 and 32 months. The median progression-free survival was 3.6 months and the median overall survival was 7.6 months. CONCLUSIONS: Lenalidomide can be administered to patients with advanced HCC and hepatic dysfunction. Promising, and in a small percentage of patients, durable activity has been demonstrated. Investigations are needed to explore the mechanism of action of lenalidomide in HCC.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Liver Cirrhosis/complications , Liver Neoplasms/drug therapy , Thalidomide/analogs & derivatives , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/pathology , Disease-Free Survival , Female , Humans , Lenalidomide , Liver Neoplasms/complications , Liver Neoplasms/pathology , Male , Middle Aged , Neutropenia/chemically induced , Niacinamide/analogs & derivatives , Niacinamide/therapeutic use , Phenylurea Compounds/therapeutic use , Sorafenib , Thalidomide/therapeutic use , Treatment Failure , Treatment Outcome , Young Adult
2.
J. infect. dev. ctries ; 6(12): 847-853, 2012.
Article in English | AIM (Africa) | ID: biblio-1263621

ABSTRACT

Introduction: Tetanus accounts for high morbidity and case fatality rates in developing countries. This study therefore aimed to identify reasons for the persistence of this disease. Methodology: Paediatric admissions at Ladoke Akintola University Teaching Hospital between 1 January 2006 and 31 December 2008 diagnosed with tetanus were studied. Data was analyzed with SPSS 18 and statistical significance was set at p 0.05. Results: Of the total 1;681 paediatric admissions; 30 (1.8) had tetanus. Of the 878 neonatal admissions; 8 (0.9) had tetanus; while 22 (2.7) of the total 803 post-neonatal admissions had tetanus. Neonatal tetanus admissions were significantly higher in 2006 compared to 2007 and 2008 (7 [2.3] versus 1 [0.2] [?2


Subject(s)
Hospitals , Infant , Infant, Newborn , Patient Admission , Pediatrics , Pregnant Women , Teaching , Tetanus , Tetanus Toxoid
3.
Crescendo ; 2(1): 161-177, ene.-jun. 2011. tab, graf
Article in Spanish | LIPECS | ID: biblio-1107630

ABSTRACT

Las ITS y el VIH/SIDA en Perú afectan principalmente a la población joven, de 15 a 24 años, sexualmente activa, y del sexo masculino; por lo tanto, es en este grupo de edad donde se tienen que desarrollar intervenciones enérgicas, orientadas hacia el cambio de conductas. La realización de investigaciones que monitoreen indicadores relacionados al conocimiento y las actitudes sexuales, como determinantes del comportamiento de riesgo en los jóvenes son fundamentales en al prevención de estas enfermedades. OBJETIVO: Describir el conocimiento y las actitudes sexuales acerca de las ITS y el VIH/SIDA que tienen los adolescentes varones de dos comunidades zonales de Chimbote-Perú en el año 2010. MATERIAL Y MÉTODOS: Investigación cuantitativa, de nivel descriptivo transversal, de ámbito comunitario. Se aplicó una encuesta voluntaria a 100 adolescentes varones de 10 a 19 años de edad con domicilio en el pueblo joven 2 de Junio y la urbanización Laderas del Norte, de Chimbote, durante los meses de abril y mayo de 2010. RESULTADOS: Edad media 15,2 años. La fuente de información citada con más frecuencia y la más importante fueron los medios de comunicación (52%). 28% de varones refieren relaciones sexuales con una edad media de iniciación sexual de 14,7 años, con un rango de 12 a 18 años, habiendo tenido el 64,3% su primera relación coital antes del primer año de relación. El 99% sabía dónde recurrir en situaciones de riesgo. El 75% de varones desconoce las dimensiones básicas sobre las ITS y el VIH/SIDA; y el 74% presenta actitudes desfavorables hacia estas enfermedades. CONCLUSIÓN: La mayoría de adolescentes varones no tiene los conocimientos suficientes sobre las ITS y VIH/SIDA, con actitudes desfavorables frente al tema.


Young people sexually active of male sex are mostly affected by STI and HIV/AIDS of 15 to 24 aged in Perú. Therefore, this group etareo demands intervention in order to change their sexual behaviour. Searches on monitoring indicadors related to knowledge and attitudes toward sex, the ones considered determinants in young people behaviour of risk, are fundamental in the prevention of these illnesses. OBJECTIVE: to describe the sexual knowledge and attitudes toward STI and HIV/AIDS of young people of male sex in two communities in Chimbote-Perú in 2010. METHODOLOGY: It is a quantitative, non experimental, descriptive and transversal study in the communitary field. A voluntary survey was applied to 100 and 19 years of age who lived in the locality of 2010. RESULTS: A verage age 15,2. The most important source of information on sexuality was the mass media (52%). 28% of adolescent males refe their sexual initiation with an age mean of 14,7, ranged from 12 to 18 years of age. 64,3% had their first sexual relation before the first year of sentimental relation. 75% of adolescent males do not know the basic dimensions of STI and HIV/AIDS: 74% present non favorable attitudes toward these illnesses. Conclusion: Most of adolescent males do not have enough knowledge about STI and HIV/AIDS, having non favorable attitudes toward it.


Subject(s)
Male , Humans , HIV , Adolescent , Health Knowledge, Attitudes, Practice , Sexually Transmitted Diseases , Acquired Immunodeficiency Syndrome , Epidemiology, Descriptive , Cross-Sectional Studies , Evaluation Studies as Topic , Peru
4.
Gac Med Mex ; 144(5): 395-401, 2008.
Article in Spanish | MEDLINE | ID: mdl-19043958

ABSTRACT

BACKGROUND: Bronchopulmonary dysplasia (BPD) is associated with frequent events of hypoxemia specially during feeding. OBJECTIVE: Determine peripheral oxygen saturation (SpO2) among infants with BPD before, during and after feeding. METHODS: Patients with diagnosis of BPD were prospectively studied between July-September, 2005. SpO2 was measured with a manual digital pulsioxymeter 5 times during feeding. Alpha levels were set at p<0.05. RESULTS: 67 events were studied in 18 patients. For each participant, oxygen saturation was measured five times yielding a total of 335 recordings. Frequent desaturation episodes were recorded during feeding, (SpO2<88%) in 16 of the 18 cases. SpO2 reached 80% for some recordings among 67% of participants (n=12), with p<0.001. CONCLUSION: Among BDP patients, SpO2 decreases during feeding, reaching severe desaturations (SpO2<80%) among in two thirds of the cases. Oxygen concentration must be sufficiently increased during feeding in order to rise the level of SpO2 to a minimum of 88%.


Subject(s)
Bronchopulmonary Dysplasia/metabolism , Eating , Oxygen/analysis , Oxygen/metabolism , Female , Humans , Infant , Infant, Newborn , Male , Oximetry , Prospective Studies
5.
Gac. méd. Méx ; 144(5): 395-401, sept.-oct. 2008. tab
Article in Spanish | LILACS | ID: lil-568033

ABSTRACT

Antecedentes: La displasia broncopulmonar se relaciona con eventos frecuentes de hipoxemia, en especial durante la alimentación. El objetivo de este estudio fue determinar la saturación periférica de oxígeno (SpO2) en lactantes con displasia broncopulmonar, antes, durante y después de la alimentación. Métodos: Prospectivamente se estudiaron pacientes con displasia broncopulmonar del 1 de julio al 30 de septiembre de 2005, realizando mediciones de SpO2 a través de un pulsioxímetro digital de mano en cinco ocasiones con relación a la alimentación. Se consideró zona de significancia con p<0.05. Resultados: En 18 pacientes se estudiaron 67 eventos, midiendo en cada uno la SpO2 en cinco ocasiones, para un total de 335 mediciones; hubo momentos de desaturación frecuentes (SpO2 menor de 88%) en 16 pacientes de los 18, y SpO2 por debajo de 80% en alguna medición, en 67% de ellos (n=12), con p<0.001. Conclusiones: La SpO2 en pacientes con displasia broncopulmonar disminuye durante la alimentación llegando a niveles severos (menos de 80%) en las dos terceras partes de los casos, por lo que se sugiere que durante la misma se incremente la concentración de oxígeno lo suficiente como para llevarlos a una saturación de 88%, por lo menos.


BACKGROUND: Bronchopulmonary dysplasia (BPD) is associated with frequent events of hypoxemia specially during feeding. OBJECTIVE: Determine peripheral oxygen saturation (SpO2) among infants with BPD before, during and after feeding. METHODS: Patients with diagnosis of BPD were prospectively studied between July-September, 2005. SpO2 was measured with a manual digital pulsioxymeter 5 times during feeding. Alpha levels were set at p<0.05. RESULTS: 67 events were studied in 18 patients. For each participant, oxygen saturation was measured five times yielding a total of 335 recordings. Frequent desaturation episodes were recorded during feeding, (SpO2<88%) in 16 of the 18 cases. SpO2 reached 80% for some recordings among 67% of participants (n=12), with p<0.001. CONCLUSION: Among BDP patients, SpO2 decreases during feeding, reaching severe desaturations (SpO2<80%) among in two thirds of the cases. Oxygen concentration must be sufficiently increased during feeding in order to rise the level of SpO2 to a minimum of 88%.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Bronchopulmonary Dysplasia/metabolism , Eating , Oxygen/analysis , Oxygen/metabolism , Oximetry , Prospective Studies
6.
Gac Med Mex ; 144(3): 207-12, 2008.
Article in Spanish | MEDLINE | ID: mdl-18714588

ABSTRACT

BACKGROUND: Oxygen peripheral saturation (SpO2) is crucial for an adequate management of critically-ill newborns infants (NB). The objective of the present study was to determine SpO2 by pulse oxymetry among healthy term and preterm NBs at an altitude of 2240 m above sea level. METHODS: Observational, cross-sectional and comparative. 218 NBs were prospectively studied between January to April 2004. Eighty nine were term and 128 were preterm. Alpha levels were set at p<0.05. RESULTS: The recorded lower value for SpO2 was 88%, and the maximum was 99%. We observed a significant SpO2 difference among the term NB (93.5+/-2%) and preterm NBs (92.9+/-2%), p=0.01. CONCLUSIONS: SpO2 in Mexico City's altitude is on average lower when compared to that observed at sea level. In general with a minimum and maximum values found in our study the SpO2 needed to maintain a critically sick NB with supplementary O2, is suggested. Values should be kept at between 88% and 94% to avoid hypoxemia and hyperoxemia.


Subject(s)
Oximetry , Oxygen/blood , Altitude , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Infant, Premature , Male , Mexico , Prospective Studies , Reference Values
7.
Gac Med Mex ; 144(2): 111-20, 2008.
Article in Spanish | MEDLINE | ID: mdl-18590031

ABSTRACT

BACKGROUND: Patent ductus arteriosus (PDA) in the preterm neonate (PTN) with respiratory distress is frequent and there are controversies related to its medical and/or surgical treatment. The goal of the present study was to compare the outcome between the two groups of newborns with PDA, operated (group A) and not operated on (group B); and to determine the internal diameter (DI) in ductus arteriosus (DA) on outcome. MATERIAL AND METHODS: The clinical records of PTN hospitalized from January 1999 to January 2002, discharged either by improvement or death, were retrolectively analyzed. Statistical analysis was carried out using the descriptive and inferential statistic. The statistical significance was considered at p<0.05. RESULTS: The was significant difference in DI in DA in favor group A with p<0.01; and DI of 2 mm or more showed significant difference too in favor of group A with a p=0.0006. The mortality was similar in the two groups. CONCLUSIONS: We concluded that in the PTN with significant PDA should intervene medical or surgically and without those data but with DI of 2 mm or more of DA, also.


Subject(s)
Ductus Arteriosus, Patent/surgery , Infant, Premature , Female , Humans , Infant, Newborn , Male , Retrospective Studies , Treatment Outcome
8.
Gac. méd. Méx ; 144(3): 207-212, mayo-jun. 2008. tab
Article in Spanish | LILACS | ID: lil-568070

ABSTRACT

Antecedentes: La saturación periférica de oxígeno (SpO2) es importante para monitorizar al recién nacido (RN) críticamente enfermo. Se llevó a cabo un estudio prolectivo, observacional, transversal y comparativo para determinar la SpO2 por oximetría de pulso en RN de término y pretérmino clínicamente sanos a una altitud sobre el nivel del mar de 2240 m. Métodos: Se estudiaron de enero a abril de 2004, 218 RN, 89 de término y 128 pretérmino. Se consideró zona de significancia a una p<0.05. Resultados: La SpO2 más baja registrada fue de 88% y la máxima de 99%. Hubo diferencia de la SpO2 entre los RN de término (93.5±2%) y los pretérmino (92.9±2%), con p=0.01. Conclusiones: La SpO2 a la altitud de la Ciudad de México se encuentra en promedio menor respecto a la hallada a nivel del mar, pero en general con un mínimo y máximo similar a esa altitud. La SpO2 para mantener a un RN críticamente enfermo con O2 suplementario se sugiere debe de ser igual a lo ya conocido, entre 88 y 94 %, para evitar hipoxemia e hiperoxemia a la altitud estudiada.


BACKGROUND: Oxygen peripheral saturation (SpO2) is crucial for an adequate management of critically-ill newborns infants (NB). The objective of the present study was to determine SpO2 by pulse oxymetry among healthy term and preterm NBs at an altitude of 2240 m above sea level. METHODS: Observational, cross-sectional and comparative. 218 NBs were prospectively studied between January to April 2004. Eighty nine were term and 128 were preterm. Alpha levels were set at p<0.05. RESULTS: The recorded lower value for SpO2 was 88%, and the maximum was 99%. We observed a significant SpO2 difference among the term NB (93.5+/-2%) and preterm NBs (92.9+/-2%), p=0.01. CONCLUSIONS: SpO2 in Mexico City's altitude is on average lower when compared to that observed at sea level. In general with a minimum and maximum values found in our study the SpO2 needed to maintain a critically sick NB with supplementary O2, is suggested. Values should be kept at between 88% and 94% to avoid hypoxemia and hyperoxemia.


Subject(s)
Humans , Male , Female , Infant, Newborn , Oximetry , Oxygen/blood , Altitude , Cross-Sectional Studies , Infant, Premature , Mexico , Prospective Studies , Reference Values
9.
Gac. méd. Méx ; 144(2): 111-120, mar.-abr. 2008. tab
Article in Spanish | LILACS | ID: lil-568115

ABSTRACT

Antecedentes: La persistencia del conducto arterioso (PCA) en el recién nacido prematuro con problema respiratorio es frecuente y su manejo es controvertido. El objetivo del presente estudio fue comparar la evolución final entre dos grupos de recién nacidos pretérmino con PCA operados (grupo A) y no operados (grupo B) y determinar el papel del diámetro interno del conducto arterioso en la evolución final. Material y métodos: Retrolectivamente se analizaron los expedientes de pacientes recién nacidos pretérmino de enero de 1999 a enero de 2002 que egresaron vivos o muertos. Se utilizó la estadística descriptiva y la inferencial. Se consideró zona de significancia con p<0.05. Resultados: Hubo diferencia estadísticamente significativa en el diámetro interno del conducto arterioso a favor del grupo A, con p<0.01; también hubo diferencia significativa a favor del grupo A cuando el diámetro interno del conducto arterioso fue ≥2 mm, con p=0.0006. La mortalidad fue similar en los dos grupos. Conclusiones: Se concluye que en todo recién nacido pretérmino con PCA significativo debe intervenirse médica o quirúrgicamente, y sin esos datos pero con diámetro interno ≥2 mm del conducto arterioso, también.


BACKGROUND: Patent ductus arteriosus (PDA) in the preterm neonate (PTN) with respiratory distress is frequent and there are controversies related to its medical and/or surgical treatment. The goal of the present study was to compare the outcome between the two groups of newborns with PDA, operated (group A) and not operated on (group B); and to determine the internal diameter (DI) in ductus arteriosus (DA) on outcome. MATERIAL AND METHODS: The clinical records of PTN hospitalized from January 1999 to January 2002, discharged either by improvement or death, were retrolectively analyzed. Statistical analysis was carried out using the descriptive and inferential statistic. The statistical significance was considered at p<0.05. RESULTS: The was significant difference in DI in DA in favor group A with p<0.01; and DI of 2 mm or more showed significant difference too in favor of group A with a p=0.0006. The mortality was similar in the two groups. CONCLUSIONS: We concluded that in the PTN with significant PDA should intervene medical or surgically and without those data but with DI of 2 mm or more of DA, also.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant, Premature , Ductus Arteriosus, Patent/surgery , Retrospective Studies , Treatment Outcome
10.
Gac Med Mex ; 143(2): 101-8, 2007.
Article in Spanish | MEDLINE | ID: mdl-17585696

ABSTRACT

OBJECTIVE: To determine the factors that lead to extubation failure among preterm newborns (PTN). MATERIAL AND METHODS: Failure was determined when patients had to be reintubated during the first 72 hours. Critically-ill preterm newborns needing mechanical assisted ventilation at least during 24 hours were studied prospectively. Two groups were included: Group A, who failed in extubation for the first time and Group B, a control group who did not fail. Significance was set a p <0.05. RESULTS: Gestational age and birth weight showed significant differences in Group B (control group). Significant factors in the multivariate analysis were gestational age < 32 weeks, caloric intake < or = 100 calories/kg/day and mean airway pressure (MAP) > or = [corrected] 4.5 cm H2O. CONCLUSIONS: According to our results, an extubation should be planned whenever a patient is a PTN, has a gestational age of <32 weeks, a caloric intake >100 cal/kg/day, and its ventilator MAP is <4.5 cm H2O.


Subject(s)
Infant, Premature , Respiration, Artificial , Birth Weight , Case-Control Studies , Critical Illness/therapy , Female , Gestational Age , Humans , Infant, Newborn , Male , Multivariate Analysis , Prospective Studies , Retreatment
11.
Gac. méd. Méx ; 143(2): 101-108, mar.-abr. 2007. tab
Article in Spanish | LILACS | ID: lil-568795

ABSTRACT

Objetivo: Determinar los factores que originan la falla en la extubación en recién nacidos de pretérmino (RNPT). Material y métodos: Se consideró falla en la extubación cuando hubo necesidad de reintubar al paciente en las primeras 72 horas. Se estudiaron en forma prospectiva a los RNPT críticamente enfermos que habían estado con asistencia mecánica ventilatoria durante por lo menos 24 horas. Se integraron 2 grupos: un grupo A (casos) con RNPT que tuvieron fallas en la primera extubación y un grupo B (control) con RNPT que no tuvieron fallas en la extubación. Se consideró zona de significancia con p menor a 0.05. Resultados: La edad gestacional y el peso al nacer mostraron diferencias significativas a favor del grupo B (control). Los factores que mostraron significancia en el análisis multivariado, fueron la edad gestacional (< 32 semanas), el aporte calórico (≤ 100 cal/Kg/ día) y la presión media de vías aéreas (PMVA) (≥ 4.5 cm H2O). Conclusiones: De acuerdo con lo encontrado en este estudio, antes de realizar la extubación habrá que considerar si el RNPT tiene menos de 32 semanas de edad gestacional, por lo menos un aporte calórico superior a 100 cal/Kg/día y una PMVA en el ventilador menor a 4.5 cm H2O.


OBJECTIVE: To determine the factors that lead to extubation failure among preterm newborns (PTN). MATERIAL AND METHODS: Failure was determined when patients had to be reintubated during the first 72 hours. Critically-ill preterm newborns needing mechanical assisted ventilation at least during 24 hours were studied prospectively. Two groups were included: Group A, who failed in extubation for the first time and Group B, a control group who did not fail. Significance was set a p <0.05. RESULTS: Gestational age and birth weight showed significant differences in Group B (control group). Significant factors in the multivariate analysis were gestational age < 32 weeks, caloric intake < or = 100 calories/kg/day and mean airway pressure (MAP) > or = [corrected] 4.5 cm H2O. CONCLUSIONS: According to our results, an extubation should be planned whenever a patient is a PTN, has a gestational age of <32 weeks, a caloric intake >100 cal/kg/day, and its ventilator MAP is <4.5 cm H2O.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant, Premature , Respiration, Artificial , Birth Weight , Case-Control Studies , Critical Illness/therapy , Gestational Age , Multivariate Analysis , Prospective Studies , Retreatment
12.
Gac Med Mex ; 142(4): 283-9, 2006.
Article in Spanish | MEDLINE | ID: mdl-17022302

ABSTRACT

BACKGROUND: Neonatal sepsis is a frequent diagnosis in neonatal intensive care units and has been associated with a high mortality rate. OBJECTIVE: To determine the possible association between various risk factors and neonatal sepsis mortality rate. DESIGN: Cohort case control. MATERIAL AND METHODS: Two hundred medical records of newborns discharged from a neonatology unit, from January 1998 to June 2002, with a neonatal sepsis diagnosis were reviewed. RESULTS: There was significance in birth weight of 1000 g or less, vein dissection for insertion of central venous catheter, gestational age of 30 weeks or less, and presence of mechanical ventilatory assistance (p < 0.01). Total parenteral nutrition also reached significance but as protective factor (OR: 0.15, CI 95% 0.07 - 0.31) (p < 0.001). The multivariate analysis displayed similar results, except birth weight (p < 0.01). CONCLUSIONS: The above mentioned risk factors should be prevented in as much as possible. A factor to prevent mortality is total parenteral nutrition which should be always employed in cases where this is feasible.


Subject(s)
Sepsis/mortality , Case-Control Studies , Female , Humans , Infant, Newborn , Male , Retrospective Studies , Risk Factors
13.
Rev Invest Clin ; 56(6): 737-47, 2004.
Article in English | MEDLINE | ID: mdl-15791910

ABSTRACT

BACKGROUND: Wardrop's formula to estimate available oxygen has been used to assess non-critically ill pre-term newborn infants (PTNIs) of 28-32 weeks gestational age who may need red blood cell transfusion ( RBCT ). The use of this formula has not been analyzed in critically-ill PTNIs. The objective of this study was to compare available oxygen levels before and after RBCTs in critically-ill PTNIs of 28-36 weeks gestational age, and to assess is potential usefulness. MATERIAL AND METHODS: 113 clinical charts of critically-ill PTNIs with at least one RBCT performed between January 1998 and August 2001 were retrospectively reviewed. Hemoglobin concentrations, available oxygen levels and clinical signs of anemia (tachycardia, polypnea, pallor, failure to gain weight) were measured 3 days before, at the moment and 24-72 hours after the RBCT. Descriptive and inferential statistics were used to analyze the results. Statistical significance was considered when p < 0.05. RESULTS: Mean available oxygen levels were 7.99 +/- 1 mL/dL at the moment of the first RBCT (n = 113), 7.91 +/- 0.91 mL/dL at the second (n = 48), and 8.14 +/- 0.83 mL/dL at the third RBCT (n = 22). Available oxygen was significantly higher 24-72 hours after than before all RBCTs (p < 0.01). The mean available oxygen value at the moment of the first, second and third RBCTs was always near 8 mL/dL. CONCLUSIONS: Available oxygen is a good parameter to assess the need for RBCTs in critically-ill PTNIs of 28-36 weeks gestational age. Available oxygen values < 8mL/dL may be another parameter to consider as a criterion for RBCT in these patients.


Subject(s)
Critical Illness/therapy , Erythrocyte Transfusion , Infant, Premature, Diseases/blood , Infant, Premature, Diseases/therapy , Oxygen/blood , Female , Gestational Age , Humans , Infant, Newborn , Male , Retrospective Studies
14.
Rev Invest Clin ; 56(6): 700-11, 2004.
Article in Spanish | MEDLINE | ID: mdl-15791906

ABSTRACT

BACKGROUND: The mechanical ventilatory assistance (MVA) is a procedure that is used very often in the neonatal intensive care units but its use its linked to a lot of complications. The objective of this study was to determine the risk factors for the presence of complications of the MVA in the newborns infants. MATERIAL AND METHODS: One hundred thirty five medical records from January 98 to June 2000 of newborns that had been discharged by amelioration or death were reviewed retrospectively. All of them had been received MVA; twenty medical record were excluded. They were divided in two groups: group A, neonates that had presented complications during MVA, composed of 40 patients (cases) and B, neonates with MVA, but that had not presented complications due to the procedure of 75 patients (controls). In group A there were 39 preterm neonates and in B, 58 preterm neonates, the rest were term neonates. It was used descriptive and inferential statistics. Odds ratio (OR) and multivariate analysis were used to study risk factors with confidence interval (CI) of 95%. Statistical significance was considered at p < 0.05. RESULTS: There was significative difference in birth weight. Gestational age and Apgar score between the two groups in favor of group B. There was significative difference too in inspiratory oxygen fraction (IOF), the peak inspiratory pressure (PIP) and cycles in favor of group A (before complications occur). The significative risk factors in the bivariate analysis for the presence complications were: birth weight of 1,500 g or less, 36 weeks of gestational age or less, total time of ventilation of seven days or more , IOF of 1 (100%), cycles of 60 per minute or more and peak inspiratory pressure (PIP) of 30 cm of water or more in the first days of life (all with p < 0.05). The combination of prematurity plus respiratory distress syndrome (RDS) as admission diagnosis reached significance for the presence of complications with an OR of 7.34 and CI of 95% from 1.91 to 23.05, p = 0.001 and the multivariate analysis reached significance for the presence of complications: low birth weight, total time of ventilation of seven days or more, IOF of 1 (100%), cycles of 60 per minute or more, and the combination of prematurity plus RDS as admission diagnosis all with p < 0.05. The mortality was associated significatively to the complications with p < 0.009. The more frequent complications were pneumonia, pulmonary interstitial emphysema and bronchopulmonary dysplasia. CONCLUSIONS: We concluded that newborn patients critically ill, with low birth weight, low gestational age, with RDS, who need more ventilatory support will be more liable to have complications and, as consequence, the mortality will be increased. For this reason it is essential a close monitoring of this group of patients for not over supporting them in IOF, PIP and cycles, thus avoiding as far as possible, the complications of the MVA.


Subject(s)
Infant, Newborn, Diseases/therapy , Respiration, Artificial/adverse effects , Female , Humans , Infant, Newborn , Male , Retrospective Studies , Risk Factors
15.
Infectología ; 7(7): 353-7, jul. 1987. tab
Article in Spanish | LILACS | ID: lil-57494

ABSTRACT

Se informa el perfil epidemiológico de infecciones en Hospitales Generales de Zona (HGZ) del área metropolitana de Guadalajara del IMSS en Jalisco, durante el año de 1986. La tasa de frecuencia de 1.6 es inferior a informes nacionales y locales. Se destaca la importancia de los estudios de frecuencia, para conocer la magnitud y naturaleza del fenómeno así como su trascendencia social y económica; asimismo se acepta que el desarrollo del sistema de vigilancia epidemiológica no es óptimo, debido en algunos casos a falta de recursos humanos y tecnológicos y en otros a la escasa participación del equipo de salud en la notificación del suceso, y a la implementación de programas


Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Cross Infection/epidemiology , Mexico
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