[Nosocomial infection in the neonatal period at a third level care center]. / Infección nosocomial en la etapa neonatal en un centro de tercer nivel de atención.

Results are presented on epidemiologic surveillance of nosocomial infection of all neonates attended at the Instituto Nacional de Perinatologia throughout 1988-1990, reporting rates of 2.1, 2.9 and 5.5 per 100 discharge for each of the years studied. Data are presented in full by service, showing rates of 4.7, 9.5 and 23.0 per 100 discharge in Neonatal Intensive Care Unit (NICU) and 1.5, 3.2 and 6.7 per 100 discharge for Neonatal Intermediate Care (NIC) for the same three years. With respect to type of infection, septicemia, pneumonia and conjunctivitis come as the most frequent causes of infection and Staphylococcus sp coagulase negative (30%), Staphylococcus aureus (27%) and Escherichia coli (7%) as the prevailing microorganisms in nosocomial infection.

[Nosocomial infection during puerperium]. / Infección nosocomial durante el puerperio.

Material and methods used to assess the epidemiology of puerperal infection (PI) in the National Institute of Perinatology (Mexico) between 1984 and 1990, are described. We observed that the general rate of PI ranged between 1.6 and 3.1; post-cesarean section posed a higher risk of infection than vaginal partum. Endometritis, associated with cesarean section, was the most frequent form of PI and gram positive flora was the most frequently found etiological agent. In general terms, we found that the rate of PI remained constant through the years of study, even when there was a significant increase in the practice of cesarean operations. Finally, we emphasize the need for the standardization of clinical norms used to assess the epidemiology of infection events. Standard norms will allow health-service institutions to compare results, observe tendencies, predict changes and take preventive actions.

[The neurological and psychomotor evolution at 2 years of age of newborn infants who underwent assisted ventilation]. / Evolución neurológica y psicomotora a los dos años de vida de recién nacidos que fueron sometidos a ventilación asistida.

It is important to evaluate the development of neonates submitted to assisted ventilation since it is one of the most commonly used procedures in patients with respiratory failure. A group of 50 neonates who had been submitted to assisted ventilation were studied and compared to another group of 50 children with the same inclusion criteria, except for the fact that they had not needed ventilation. They were each evaluated since birth and thereafter every two months during their first year of life and every three months in the second year. The Amiel Tison Neurological Assessment was used to evaluate the children during the first year while the Mayo Clinic General Neurological Exploration adapted for nursing children was applied during the following year. In assessing psychomotor development, the Brunette Lezine Scale, standardized for Mexican children, was used. For practical purposes, a sample of the results obtained during the second year are presented while some pertinent variables are commented on. For those included in the ventilated group, results show a higher frequency of hyaline membrane disease (27 cases), intraventricular hemorrhage (19), pneumonia (18), and arterious duct persistence (13). The control group showed the following frequencies, respectively: 0, 4, 5, and 4 cases. The ventilation group was found to have a statistically significant higher relative risk rate (P less than 0.05) and a higher risk for neurologic sequelae (P less than 0.001) when compared to the control group. Asphyxia and hemorrhaging were factors associated and present in the ventilated group (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Etiology of childhood psychoses]. / Etiología de las psicosis infantiles.

When studying etiology of childhood psychosis, causes may be divided in biological and psychodynamic. The present paper focuses on the first, which are divided in infectious, toxic, neurologic, endocrine, biochemical and genetic; these last include chromosomic alterations and hereditary factors. The relevant bibliography is reviewed. In spite of a growing list of research work, a single etiologic factor has not been found. It is probable that brain disorder in the psychotic child is psychological, mediated by chemical disturbance and with environmental correlates.