[Recommendations for the perinatal management and follow up of late preterm newborns]. / Recomendaciones para el manejo perinatal y seguimiento del recién nacido prematuro tardío.

Prematurity is the main reason for neonatal morbidity and mortality, and has become one of the greatest problems in public health, especially in developed countries. Prematurity rate has increased during the last 2 decades. This increase may be attributed to late preterm babies, that is, those with a gestational age between 34(+0) and 36(+6) weeks. Perinatal morbidities, as well as long term complications, are more frequent in this population than in term babies. The incidence is more similar to the one observed in earlier premature babies. The SEN34-36 group of the Spanish Society of Neonatology suggests these recommendations for the management of late preterm babies. Strategies are offered not only for the early detection of possible complications, but also for the correction of these morbidities, and from the point of view of a family and development centered care. Follow up is strongly recommended due to the high rate of late morbidities.

[Alkaline phosphatase isoenzymes in serum and bronchoalveolar lavage from patients with bronchopulmonary disease]. / Isoenzimas de fosfatasa alcalina en el suero y lavado broncoalveolar de pacientes con patología broncopulmonar.

OBJECTIVE: In this study, we are looking at the principal isoenzymes of alkaline phosphatase (ALP), as injury markers of cellular membranes from bronchial epithelium, in 80 patients diagnosed with bronchopulmonary pathology from different ethology, using serum samples and bronchoalveolar lavage fluid (BAL). METHOD: Patients were grouped according to age as following: 26 preterm neonates suffering respiratory distress syndrome requiring mechanical ventilation; 32 children ranging from 2 to 12 years old, and 22 adults (30-65 years old) examined by bronchoscopy for the purpose of diagnosis. Results obtained from all pathological groups were compared with a control group showing similar characteristics. Isoenzymes were separated by electrophoresis on agarose gel and were quantified by desitometry. Total protein was measured in BAL; ALP activity was expressed in UI/mg x 10-3 of protein. RESULTS: We found that macromolecular ALP fraction was significantly increased in the serum of neonates with distress (p < 0.01), in the patients 2-12 years and adults affected by pulmonary pathology (p < 0.001). The electrophoresis of ALP isoenzymes showed a unique isoenzymatic band corresponding with its macromolecular fraction in the BAL fluid. CONCLUSIONS: We conclude that increased macromolecular fraction of alkaline phosphatase found in the serum of patients diagnosed with respiratory problems could have its origin in damaged pulmonary tissue.