Patterns of Infancy Growth and Metabolic Hormonal Profile Are Different in Very-Low-Birth-Weight Preterm Infants Born Small for Gestational Age Compared to Those Born Appropriate for Gestational Age.

BACKGROUND/AIMS: An increased preterm birth survival rate is associated with long-term neurological and metabolic risks; thus, our aim was to evaluate whether early patterns of infancy anthropometry and metabolic hormonal profile differ in preterm infants born small for gestational age (SGA) or appropriate for gestational age (AGA) from birth to 36 months of corrected age (CA). METHODS: We recruited 110 very-low-birth-weight (VLBW) preterm infants (AGA = 60 and SGA = 50) with a mean birth weight of -2.39 ± 0.77 versus 0.57 ± 0.54 standard deviation scores (SDS) (p < 0.01) and birth length of -2.1 ± 1.05 versus -0.44 ± 0.82 SDS (p < 0.01), respectively. Anthropometry and blood sampling for insulin, insulin-like growth factor (IGF)-II, IGF-I, and leptin were performed for up to 3 years. RESULTS: All neonates increased their weight, length, and head circumference SDS during the early inpatient period. Up to 90% reached a normal length within this period. The IGF-II, insulin, and glycemia concentrations changed in parallel with weight. In the first year of CA, only SGA infants gained weight and height SDS. The homoeostatic model assessment had a trend toward higher values in SGA infants at 24 and 36 months (p = 0.06 and p = 0.07). CONCLUSION: Being SGA is the strongest predictor of early recovery of height in VLBW preterm infants. Follow-up will allow us to determine whether the differences in the growth patterns of VLBW preterm infants by birth weight SDS persist.

Klotho Gene and Protein in Human Placentas According to Birth Weight and Gestational Age.

Introduction: Fetal growth restriction may be the consequence of maternal, fetal, or placental factors. The insulin-like growth factors (IGFs) are major determinants of fetal growth, and are expressed in the mother, fetus and placenta in most species. Previously we reported higher placental protein content of IGF-I, IGF-IR, and AKT in small (SGA) compared with those from appropriate for gestational age (AGA) placentas. The protein Klotho, has been reported in placenta and may regulate IGF-I activity. In this study we determined Klotho gene expression and protein immunostaining in term (T-SGA y T-AGA) and preterm (PT-SGA y PT-AGA) human placentas. In addition, we assessed the effect of Klotho on the IGF-IR and AKT activation induced by IGF-I. Methods: Placentas (n = 1 17) from 32 T-SGA (birth weight (BW) = -1.74 ± 0.08 SDS), 37 T-AGA (BW = 0.12 ± 0.12 SDS), 20 PT-SGA (BW = -2.08 ± 0.14 SDS), and 28 PT-AGA (BW = -0.43 ± 0.13 SDS) newborns were collected. mRNA expression by RT-PCR in the chorionic (CP) and basal (BP) plates of the placentas, and the presence of Klotho was evaluated by immunohistochemistry (integral optical density, IOD). In addition, we developed placental explants that were incubated with IGF-I in the presence or absence of Klotho. Results: We found a lower mRNA expression and protein immunoreactivity of Klotho in the CP of SGA (term and preterm) compared with AGA placentas. We also observed a significant reduction in IGF-IR tyrosine activation induced by IGF-I 10 nM when preincubated with 2.0 nM of Klotho (2.4 ± 0.5 arbitrary units vs. 1.3 ± 0.3 AU), and similar results we observed on AKT and ERK42/44 activation. Conclusion: We describe for the first time that Klotho mRNA and protein varies according to fetal growth and gestational age. In addition, Klotho appears to down-regulate the activation induced by IGF-I on IGF-IR and AKT, suggesting that Klotho may be regulating IGF-I activity in human placentas according to intrauterine fetal growth.

Meningitis neonatal precoz causada por transmisión vertical de Escherichia coli productora de beta-lactamasa de espectro extendido en parto prematuro con rotura prematura de membranas / Early neonatal meningitis caused by vertical transmission of extended-spectrum beta-lactamase-producing Escherichia coli in premature labor with premature rupture of membranes

Se comunica el caso de un recién nacido producto de un parto prematuro con rotura prematura de membranas, que desarrolló precozmente meningitis neonatal por Escherichia coli productora de beta-lactamasa de espectro extendido. Los cultivos en líquido céfalo raquídeo y sangre neonatal fueron tempranamente positivos para esta bacteria. No obstante no aislarse este microorganismo en la madre, los hallazgos de la biopsia placentaria y la precocidad de la infección neonatal son determinantes en señalar que se trató de infección intraamniótica con transmisión vertical al neonato. La meningitis neonatal fue tratada con meropenem y el niño se dio de alta en buenas condiciones después de 41 días de hospitalización. Las guías perinatales actuales, preconizan el tamizaje de muestras vaginales para la prevención del parto prematuro y de los resultados adversos asociados a infección bacteriana ascendente durante el embarazo.

We report the case of a newborn resultant of premature delivery with premature rupture of membranes, which developed early-onset neonatal meningitis caused by transmission of Escherichia coli producer of betalactamasa of spectrum extended. Cultures in cerebrospinal fluid and neonatal blood were early positive for this bacterium. Although this microorganism is not isolated in the mother, the findings of the placenta biopsy and the precocity of the neonatal infection are determinant in indicating that it was an intraamniotic infection with vertical transmission to the neonate. Neonatal meningitis was treated with meropenem and the child was discharged in good condition after 41 days of hospitalization. The current perinatal guidelines support the screening of vaginal samples for the prevention of preterm birth and the adverse outcomes associated with ascending bacterial infection during pregnancy.

Elaboración de una escala para valorar los factores de riesgo psicosocial en el trabajo de profesores universitarios / Construction of a scale for assessing at work psychosocial risk factors in professors

El propósito de éste estudio fue generar un instrumento válido y confiable para medir factores de riesgo psicosocial en el trabajo de profesores universitarios mexicanos. Se construyó una escala de 66 ítems con cinco opciones de respuesta. Para realizar su validación psicométrica se aplicó a 500 profesores de escuelas públicas de Cd. de México de entre 21 y 76 años de edad, 331 hombres y 168 mujeres, de nueve instituciones de educación superior públicas. Se realizaron análisis para conocer el poder discriminativo de los reactivos, la confiabilidad y la estructura factorial. La escala arrojó cinco factores: percepción de inequidad, estudiantes difíciles, percepción de inseguridad, sobrecarga académica y falta de recursos en el trabajo. Las escalas presentan un alfa de Cronbach entre .75 y .92. Se concluye que la escala cumple con los requisitos de fiabilidad y validez en población de profesores universitarios (AU)

The aim of this study was to create a valid and reliable instrument to measure psychosocial risk factors at work in Mexican professors. A 66-item scale with 5 response choices was built. In order to validate the scale, it was administered to 500 public professors at Mexico city, aged between 21 an 76, 331 males and 168 females, belonging to nine higher education schools. Statistical analyses were made to know the item discriminant power, reliability, and factor structure. The scale rendered five factors: perceived inequity, difficult students, perceived insecurity, academic overload, and lack of resources at the workplace. The scales had a Cronbach’s alpha between .75 and 92. As a conclusion, the scale fulfills the requirements of reliability and validity in a population of professors (AU)

Serum fibroblast growth factor 21 levels are inversely associated with growth rates in infancy.

BACKGROUND: Fibroblast growth factor 21 (FGF21) is a metabolic and growth regulator. AIM: To investigate the role of FGF21 during growth in infancy. METHODS: Blood samples for FGF21, leptin, insulin and glucose were collected from cord blood obtained from 95 preterm and term newborns (cross-sectional group), and at 6 and 12 months of life in 80 preterm and term infants (longitudinal group). Length and weight were measured at birth, 6 months, and 12 months. RESULTS: From birth through 12 months of age, preterm infants' linear growth and weight gain were larger than those of term infants, irrespective of birth weight SDS. At birth and at 12 months, there was no difference in FGF21 levels between preterm and term infants; in contrast, at 6 months, serum FGF21 in term infants was significantly higher than that of preterm ones. In the 0-6-month period, in the whole longitudinal group, serum FGF21 was inversely correlated to the length change SDS, and such a significant inverse correlation persisted in the preterm-AGA group in the 6-12-month period. In addition, term infants who experienced length catch-up in the first 6 months of life exhibited lower serum FGF21 levels at 6 months, and those with length catch-up growth between 6 and 12 months had a greater decrease of serum FGF21 level in the same time period. CONCLUSIONS: Our results indicate that FGF21 in infancy is inversely correlated with linear growth rate, thus suggesting that FGF21 is a negative regulator of human growth.

IGF-IR signal transduction protein content and its activation by IGF-I in human placentas: relationship with gestational age and birth weight.

INTRODUCTION: The human placenta expresses the IGF-I and IGF-IR proteins and their intracellular signal components (IRS-1, AKT and mTOR). The aim of this study was to assess the IGF-IR content and activation of downstream signaling molecules in placentas from newborns who were classified by gestational age and birth weight. We studied placentas from 25 term appropriate (T-AGA), 26 term small (T-SGA), 22 preterm AGA (PT-AGA), and 20 preterm SGA (PT-SGA) newborns. The total and phosphorylated IGF-IR, IRS-1, AKT, and mTOR contents were determined by Western Blot and normalized by actin or with their respective total content. The effect of IGF-I was determined by stimulating placental explants with recombinant IGF-I 10-8 mol/L for 15, 30, and 60 minutes. RESULTS: The IGF-IR content was higher in T-SGA compared to T-AGA placentas, and the IRS-1 content was higher in PT-placentas compared with their respective T-placentas. The effect of IGF-I on the phosphorylated forms of IGF-IR was increased in T-SGA (150%) and PT-SGA (300%) compared with their respective AGA placentas. In addition, AKT serine phosphorylation was higher in PT-SGA compared to PT-AGA and T-SGA placentas (90% and 390% respectively). CONCLUSION: The higher protein content and response to IGF-I of IGF-IR, IRS-1, and AKT observed in SGA placentas may represent a compensatory mechanism in response to fetal growth restriction.

[Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case]. / Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término.

We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing disease mainly in patients with underlying illness or after surgery. It is a rare perinatal pathogen, causing severe disease in premature infants, in association with maternal chorioamnionitis and premature rupture of the membranes.

Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término / Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case

We report a term neonate who developed early-onset sepsis due to Morganella morganii. The child was vaginally delivered after a short labor, and presented signs of perinatal asphyxia. Blood cultures taken soon after birth and from mother's lochia were positive for this microorganism. The infection was unresponsive to treatment with cefotaxime, to which the microorganism was susceptible, and the infant died at 17 days of age. M morganii is an opportunistic and uncommon pathogen, causing disease mainly in patients with underlying illness or after surgery. It is a rare perinatal pathogen, causing severe disease in premature infants, in association with maternal chorioamnionitis and premature rupture of the membranes (RevMéd Chile 2009; 137: 1201-4).

Neisseria gonorrhoeae produtoras de betalactamase resistentes a azitromicina em Manaus, Amazonas, Brasil / Neisseria gonorrhoeae betalactamase producers resistant to azithromycin

Determina a suscetibilidade in vitro de cepas de N. gonorrhoeae produtoras de betalactamase aos antibióticos azitromicina, ceftriaxona e ciprofloxacina

Factores de riesgo y su correlación con algunos mercadores tumorales en la incidencia de cáncer mamario en pacientes pre y postmenopáusicas / Risk factors and its correlation with some tumoral markers in breast cancer incidence in pre and postmenopausic patients

Entre enero y noviembre de 1992, 48 mujeres con desórdenes benignos de la mama, se estudiaron y compararon con 152 pacientes con enfermedad maligna. Se midió el contenido de Fosfatasa alcalina (FAC) en el suero de estas pacientes premenopáusicas y postmenopáusicas. A todas ellas se los realizó historia clínica que incluyó peso, talla e índice de masa corporal (IMC) (peso/talla²). Las pacientes se agruparon de acuerdo al tipo de lesión mamaria, encontrándose que la FAC presentaba valores frecuentemente más altos en pacientes con enfermedad maligna, que en aquéllas con desórdenes benignos. El estado biológico de esta enzima, relata probablemente la actividad en estos tejidos a través de fibroadenoma hasta adenocarcinoma, en donde presenta mayor actividad. Los valores de FAC (= 90 UI/L), IMC, estado menstrual y tipo histológico, se compararon, encontrándose una correlación significativa entre estos parámetros

Tres formas clínicas de la deficiencia de glucosa-6-fosfato-deshidrogenasa en Cuba / Three clinical forms of glucose-6-phosphate dehydrogenase deficiency

Se describen las tres formas clínicas de la deficiencia de glucosa-6-fosfato deshidrogenasa (G6PD) más frecuentes en Cuba. Se mencionan otros tipos de deficiencia de G6PD), así como la conducta a seguir en estos casos (AU)

Estudio de la deshidrogenasa láctica en el líquido cefelorraquideo en pacientes con leucemia linfocítica aguda / Study of lactic dehydrogenase in cerebro-spinal fluid in patients with acute lymphocytic leukemia

Se estudió la actividad de la deshidrogenasa láctica (LDH) del LCR en trece controles, quince niños con meningitis viral, tres con meningitis bacteriana y treinta y cinco niños con leucemia linfocítica aguda (LLA) en fase de profilaxis de la leucemia meníngea o en recaida meníngea. Se encontró una diferencia significativa en los valores de actividad entre los controles y las meningitis virales y entre los controles y los pacientes con LLA en fase de recaída meníngea, mientras que en la meningitis bacteriana la actividad de LDH realizada en el momento del diagnóstico resultó la más elevada. Se señala la utilidad de estudiar esta enzima como un elemento más para el diagnóstico resultó la más elevada. Se señala la utilidad de estudiar esta enzima como un elemento más para el diagnóstico de infiltración meníngea en la LLA (AU)