Growth of exclusively breast-fed infants from a poor urban population.

The growth of two groups of infants were evaluated, one of them exclusively breast-fed (105 infants) and the other exclusively bottle-fed (61 infants), and compared with one another and with international standards (NCHS). All infants were evaluated by anthropometry at 1, 2, 3, 4, 5 and 6 months of age. A fourth order polynomial was adopted for each infant and for each anthropometric measurement in order to estimate individual growth, and the 5th, 50th and 95th percentiles for weight and length were obtained. For the age of 6 months, the weights of breast-fed boys and girls were always statistically equal to or higher than those of infants fed cow's milk or those of NCHS standards. Breast-fed boys presented significantly longer length than bottle-fed boys but shorter than NCHS standards, and breast-fed girls presented significantly shorter length than both bottle-fed girls and than NCHS standards. The greater weight of exclusively breast-fed infants when compared to NCHS standards at six months of age, which differentiates the present study from several other ones carried out in developing countries, was probably due to the association of the beneficial effects of breast-feeding with those of pediatric follow-up.

[Congenital tuberculosis] / Tuberculose congênita.

OBJECTIVE: Considering the rarity and the significance of early diagnosis for planning appropriate treatment, a case of congenital tuberculosis is reported.CASE REPORT: After a prolonged stay in the Neonatal Intensive Care Unit (NICU) of a male pre-term infant without improvement, the diagnosis of tuberculosis was suspected when his mother underwent thoracotomy for valve replacement due to a subacute endocarditis. At this time, multiple pleural granulomas were detected and the diagnosis of tuberculosis was confirmed by histology. His mother seldom went to the NICU to see the baby and she was rarely very close to him in these occasions. After tuberculosis therapy, the baby gradually improved. CONCLUSION: Among the possible ways of transmission, the reported case was probably transmitted by aspiration of contaminated amniotic fluid in utero or at the time of delivery.

Recem-nascido e suporte ventilatorio: demanda, indicacao, duracao e evolucao / Newborn infant and support ventilatory: demand, indications, duration and evolution

Com o objetivo de avaliacao da demanda de suporte ventilatorio de recem-nascidos do HCFMRP-USP, de suas caracteristicas e da evolucao neonatal de criancas submetida a esta forma de terapeutica, estudaram-se 913 criancas que apresentavam fatores sujeitos a utilizacao do mesmo, entre as 10014 criancas nascidas de 1985 a 1987. A proporcao de 3,0% das criancas nascidas no periodo utilizou assistencia ventilatoria, sendo 48,9% atraves de ventilacao mecanica.O retardo do crescimento intra-utero nas criancas de peso entre 1000 e 2000g correlacionou-se negativamente (p < 0,05) com a demanda. As principais complicacoes foram a infeccao hospitalar (19,6%) e os sequestros de ar (13,5%) e 67,2% das criancas ventiladas sobreviveram

[Non-ketotic hyperglycinemia. Study of a case]. / Hiperglicinemia não cetótica. Estudo de um caso.

Non-ketotic hyperglycinemia is one of inborn metabolic errors that manifest by epileptic seizures of difficult control from the first days of life in hypotonic newborn children. The lack of enzyme that catalyzes the conversion of glycine to hydroxymethyltetrahydrofolic acid, carbon dioxide and ammonia, in liver and brain, results in increased concentration of glycine in blood. It is reported in this study a case of non-ketotic hyperglycinemia diagnosed in neonatal period and characterized by hypotonia and non-controlled multiple seizures. The clinical and electroencephalographic findings, treatment as well as anatomopathologic study are discussed.

Total nitrogen and electrolyte levels in colostrum and transition human milk.

The objective of this research was to study the composition of human milk in terms of protein levels and levels of the electrolytes sodium, potassium, calcium, magnesium, phosphorus and chloride in colostrum 48-72 hours post-partum, and in the transition milk (96 +/- 9 hours, 120 +/- 9 hours and 144 +/- 9 hours post-partum) of mothers who had fullterm and pre-term deliveries. The mothers were kept in the hospital with the objective to control a few important lactation parameters such as exercising or resting conditions, sleep, nutrition and suckling stimulation. Only low socioeconomic level mothers took part in the study. The initial period of lactation was studied because this is the time when secretion suffers rapid changes, going from colostrum to transition milk, and then to mature milk. The results observed for the different times and for the two groups were compared both within and between groups. No significant differences were obtained for any of the comparisons, except for transitory oscillations in potassium, calcium, chloride and phosphorus levels observed within groups. In general, it can be said that there was no variation between colostrum and transition milk for the mothers who delivered at full term or pre-term. No differences were found either when the groups were compared at the different times post-partum. This means that, under the conditions used in this study, milk did not vary as its type naturally changed (from colostrum to transition milk) for the two groups and that the levels of the constituents studied also remained unchanged when studied as a function of full-term or pre-term delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Recem-nascidos com menos de 1.500 g.I - Aspectos epidemiologicos em tres epocas distintas nos ultimos 15 anos. / Newborn infants with birth weight with less than 1500 g. I - Epidemiological aspects in 3 different periods in the last 15 years

Alguns aspectos epidemiologicos de criancas nascidas com menos de 1.500 g em 1967/ 68, 1977/78 e 1981, no Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto sao descritos e analisados.As caracteristicas de peso, estatura, sexo e condicoes de nascimento das criancas (Apgar de 1o. minuto),assim como a idade e a frequencia das maes a clinica de pre-natal nao se modificaram nos periodos estudados.Em nenhum dos periodos a porcentagem destas criancas excedeu 2% dos nascimentos; a mortalidade destas criancas diminuiu de 88,6% em 1967/68 para 44,0% em 1981, porem estes obitos representaram cerca da metade da mortalidade geral do bercario. Em media 56,0% destes obitos ocorreram nas primeiras 24 horas de vida e 86,0% na primeira semana.Apos a alta do bercario 52% das sobreviventes foram reinternadas no primeiro ano de vida. Pelo alto risco apresentado por estas criancas, todos os esforcos devem ser feitos no sentido da prevencao do parto prematuro e, quando este for inevitavel, que se realize em centros capacitados para atende-lo adequadamente

Recem-nascidos com menos de 1.500g.II Modificacoes de conduta e avaliacao de desempenho em tres epocas distintas nos ultimos 15 anos. / Newborn infants with less than 1.500g. II.Changes of the management and evaluation of performance in 3 different periods in the last 15 years

O presente trabalho descreve o tratamento de criancas nascidas com menos de 1.500g no Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, nos periodos de 1967/68, 1977/78 e 1981 e analisa as repercussoes das principais mudancas ocorridas. As alteracoes de conduta ente 1977/ 78 foram responsaveis por drastica reducao da taxa de mortalidade destas criancas que passou de 88,6% para 51,3% porem foi alta a frequencia de criancas com sequelas graves entre os sobreviventes de ambos periodos (75% e 45% respectivamente). Entre 1977/78 e 1981, constatou-se nova diminuicao na taxa de mortalidade, que passou de 51,3% para 44,0%, mas houve principalmente acentuada melhora no indice de sequelas graves, que chegou a 0% no ultimo periodo.Estes resultados reforcam a necessidade de unidades preparadas para o atendimento destas criancas de altissimo risco e enfatizam que a politica de prevencao da prematuridade e do baixo peso ao nascer deva ser a meta a ser perseguida

Recem-nascidos com menos de 1.500g III.Achados de necropsia em tres epocas distintas nos ultimos 15 anos. / Newborn infants with weight less than 1,500g. III. Findings in necropsy in 3 different times in the last 15 years

Os principais achados de necropsia de todas as 100 criancas nascidas com menos de 1.500 g no Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto nos periodos de 1967/78 e 1977/78 e 1981 e falecidas antes de terem tido alta de bercario sao descritos e analisados. Os achados de necropsia nao variaram de maneira importante nos 3 periodos estudados. Os problemas pulmonares foram relatados em 87% do total de necropsias, hemorragia cerebral em 11%, malformacoes multiplas em 8%, hemorragia subcapsular do figado em 4% e de incompatibilidade materno-fetal pelo fator Rh em 4%. Os autores sugerem que politica visando a prevencao da prematuridade, do baixo peso ao nascer e da anoxia neonatal deve ser enfatizada e que concomitantemente torna-se necessario o aprimoramento das tecnicas de assistencia respiratoria ao recem-nascido

O uso da lampada fluorescente branca em fototerapia. Aspectos fisicos. / The use of white fluorescent lights in phototherapy. Physical aspects

Os autores relatam um estudo experimental sobre parametros fisicos que poderiam influenciar no desempenho de lampadas fluorescentes brancas na fototerapia. Foram medidas radiancia e temperatura em incubadora e berco, tendo como fonte de luz conjuntos de seis lampadas fluorescentes brancas de 20W, dos tipos "Luz do Dia", "Branca Luxo" e "Branca Fria", a distancias variadas, com ou sem lencol envolvendo o sistema. A lampada "Luz do Dia" mostrou maior radiancia na faixa desejavel de 425 a 475 nm, e manteve condicoes aceitaveis de utilizacao por ate 600 horas de uso. Maior proximidade da fonte resultou em maior radiancia desejavel, porem com temperaturas elevadas, o que foi acentuado pelo uso de lencol. Em incubadora a radiancia util obtida foi menor que em berco, para a mesma distancia. Baseados nestes achados sao feitas algumas sugestoes para fototerapia