Fístula arteriovenosa femoral e insuficiencia cardíaca, diferidas a la retirada de un catéter para hemodiálisis / No disponible

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Rehospitalization because of respiratory syncytial virus infection in premature infants younger than 33 weeks of gestation: a prospective study. IRIS Study Group.

OBJECTIVE: To collect data on hospitalization for respiratory syncytial virus (RSV) infections and presumptive risk factors for rehospitalization among premature infants in Spain. DESIGN: Observational, prospective, longitudinal, multicenter study. SETTING: Fourteen Spanish neonatal units with an annual birth cohort of 57,000 infants. PATIENTS: All children (n = 680) born < or =32 weeks of gestational age between April 1, 1998, and March 31, 1999, and discharged from the hospital before March 31, 1999, were included in the study. A total of 96 were excluded because of administration of prophylactic treatment (n = 55) or were lost to follow-up (n = 41). Five children died during the study period, but death was related to RSV in only 1 case. METHODS AND MAIN OUTCOME MEASURES: Neonatal and demographic data were recorded at the initial visit. Infants were prospectively followed at monthly intervals up to March 31, 1999. In patients rehospitalized for respiratory disorders, further data about RSV status and morbidity were collected. A comparison was made between children rehospitalized for RSV infection and those who were not. The influence of factors on the probability of rehospitalization for RSV infection was assessed by logistic regression analysis. RESULTS: Of the 584 evaluable patients 118 (20.2%) were rehospitalized for respiratory disease during the study period. The causative pathogen was identified in 89 (75.4%) hospital admissions. Of these 59 (66.3%) were a result of RSV infection in 53 children; 6 were reinfections. In a logistic regression model significant independent prognostic variables included: lower risk of RSV hospitalization with increase gestational age [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.72 to 0.99; P < 0.047]; higher risk with chronic lung disease (OR = 3.1; 95% CI 1.22 to 7.91; P < 0.016); and living with school age siblings (OR = 1.86; 95% CI 1.01 to 3.4; P < 0.048). CONCLUSION: This large descriptive study has enabled us to define the influence of specific risk factors that increase the risk of rehospitalization for RSV infection in preterm infants. Such studies help to define the appropriate role of available prophylactic interventions and establish treatment guidelines.

[Regional organization of a neonatal transportation system]. / Organización regional de un sistema de transporte neonatal.

Organization, operational plans, and initial experience of a Regional Neonatal Transport System is described. The system covers provinces of Bizcaia, and Alava in Northern Spain, with a total of 17,500 annual deliveries. In the first 10 months 31 newborn infants were transported. Their mean birth weight was 2,066 +/- +/- 931 Gm. Ten infants had a birth weight less than 1,500 Gm, and in 22 (71%) of them gestational age was under 37 weeks. Some types of respiratory distress was present in 71% of them, and 25.8% required mechanical ventilation during transport. Hypothermia was present in 36% of the infants at referral center, percentage that decreased to only 9% at their arrival to the NICU. During transport mean body temperature increased from 35.33 +/- 1.07 degrees to 35.84 +/- 0.9 degrees C (p less than 0.01). Infants condition was judged to improve in 13% of them. Overall survival rate was 74.2%, being 80.9% in those weighting from 1,000 to 1,500 Gm. Infants who were hypothermic had a lower survival (45.5%) than those who were not (90%) (p less than 0.05).

[Early neonatal pneumococcal infections (author's transl)]. / Infección neonatal precoz por neumococo.

Five newborn infants with early pneumococcal infection are presented, two of them died. Until 1978 no cases of this infection were found in our Nursery. In the last three years pneumococcal septicemia has been responsible for nine percent of early neonatal infections. The clinical findings are identical to those seen in type-B beta hemolytic infections. The maternal genital tract colonization maight fetal colonization.

[Neonatal listeriosis. Presentation of nine cases (author's transl)]. / Listeriosis neonatal. A propósito de nueve observaciones

Nine cases of neonatal listeriosis observed in 1973 and 1974 are presented. Diagnosis was established during life in eight cases by positivity of bacteriological cultures. Given the high incidence of listeria sepsis and the important mortality, it is necessary to establish an early diagnosis, an immediate antibiotic therapy and provide intensive care in an special unit.