Continuous gastric drip versus intravenous fluids in low birthweight infants

This multicentre randomized study compared a continuous gastric drip (CGD) with intravenous (i.v.) fluid administration. Healthy newborns with birthweight from 1501 to 2000 g whose physician ordered i.v. fluids were randomized before the 2nd hour of life to CGD or i.v. fluids. The major outcome variable was the need for an i.v. line in the CGD group. Serum glucose was measured at 30 min, 1 h and every 6 h thereafter. Serum sodium and potassium were measured at least once during the first 72 h of life. Enteral feedings, feeding intolerance, number of venous lines and i.v. line-related complications were recorded until the interruption of CGD or the i.v. line. Twenty-nine infants were randomized to each group. The two groups were comparable in terms of birthweight and gestational age. Ten percent (3/29) of the infants randomized to the CGD group required i.v. fluids and 90% of them received electrolytes and glucose through an orogastric tube. The incidence of hypoglycaemia, hyponatraemia and episodes of feeding intolerance did not differ between the groups.

CONCLUSION

Fluid administration by CGD reduces the need for i.v. lines without increasing the risk of complications.

Bacteriostatic activity of human lactoferrin against Staphylococcus aureus is a function of its iron-binding properties and is not influenced by antibiotic resistance

The in vitro antistaphylococcal activity of lactoferrin and the antibiotic resistance of clinical Staphylococcus aureus isolates obtained from three different sites of infection were examined. Antibiotic, but not lactoferrin resistance correlated with selective antibiotic pressure, and nosocomial and most community isolates were antibiotic resistant, whereas only a third of each group was resistant to lactoferrin. The antimicrobial activity of lactoferrin, both in defined medium and in normal human plasma serum, was dependent upon its ferrochelating properties. Therapeutic approaches based on the use of ferrochelating agents such as lactoferrin combined with antimicrobial drugs may help to counteract the reduced efficacy of current antibiotics.

[Prevalence of congenital malformations at birth and associated factors in Easter Island, Chile (1988-1998)]

BACKGROUND

Consanguinity plays an important role in the genetic etiology of congenital malformations. In Easter Island the degree of consanguinity could be higher than in continental Chile. Therefore the study of the prevalence of congenital malformations in this island seems worthwhile.

AIM

To study the prevalence of congenital malformations at birth in Easter Island.

MATERIAL AND METHODS

A review of personal and family features of all children born alive between 1988 and 1998 in the Rapa Nui Hospital of Easter Island.

RESULTS

During the study period, 772 newborns were reviewed and 22 were found to have congenital malformations. Among the latter, birth weight fluctuated between 3001 and 4000 g and the male/female ratio was 0.54. No differences in maternal age between children with and without malformations was observed. Heart and circulatory malformations, hemangiomas and Down syndrome were the predominant malformations.

CONCLUSIONS

The prevalence of congenital malformations at birth in Easter Island is similar to that of continental Chile. No neural tube defects were detected in this sample.

Mice immunization with gel electrophoresis-micropurified bacterial lipopolysaccharides

Some evidence on the possible use of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) to elicit antibodies against smooth- or rough-type bacterial lipopolysaccharides (LPS) is shown. Gel-separated LPS were negatively stained with zinc-imidazole to precisely localize the bands of interest under fully reversible conditions. Then the bands of interest were excised and the resulting gel slices washed in a solution of a zinc-complexing agent (e.g., 100 mM EDTA), after which they were extruded through a metal sieve of 32 microm average size contained in a 1 mL syringe, to generate homogeneous gel microparticles. The LPS-containing gel slurries were used directly to immunize female BALB/c mice. Using this procedure, positive mouse polyclonal antibody responses against gel-purified smooth- or rough-LPS forms from Escherichia coli K-235 or Bordetella pertussis were elicited, as tested by a dot-immunoblotting assay. Our results may encourage the use of SDS-PAGE-micropurified LPS to develop optimized immunization procedures for the generation of specific antibodies against LPS bands of defined sizes, and therefore they constitute an intermediate step toward that aim.

[Trends in birth rates, general, infantile and neonatal mortality in Chile from 1850 to date]

BACKGROUND

Chile has experienced great changes in its health conditions, due to economical, social and demographic phenomena.

AIM

To underline the moment of the demographic transition in Chile by means of a chronological epidemiological study, using available information.

MATERIAL AND METHODS

Data was obtained from registries of the National Statistical Office, General Statistics Direction and National Institute of Statistics.

RESULTS

Birth rate was 41/1000 in 1850, remained stable until the thirties, decreased to 35/1000 in 1965, to 21.3/1000 in 1978 and to 20.5/1000 in 1994. The mortality rate increased from 20.3 to 37/1000 from 1850 to 1901 and the it descended to 5.50/1000 in 1993. The annual population growth was 1% in the forties, increased to 2.5% in 1965 and is 1.6% at the present. The population thus increased from 1,400,000 inhabitants in 1850 to 14,000,000 in 1994. The nuptial rate has remained between 7 and 8/1000 since 1934. Infantile mortality was 337 per 1000 newborns in 1950 and dropped to 12 in 1994. It represented 36% of the total mortality until the sixties, and now represents only 5%. This has contributed to the increase in life expectancy and ageing of our population. Neonatal mortality dropped from 136 per 1000 newborns in 1915 to 6.8 in 1994. Fetal mortality changed from 50 per 1000 newborns in 1936 to 5.3 in 1993.

CONCLUSIONS

Several causes have contributed to the changes in the above mentioned indicators. Currently, we are in the third stage of a Demographic transition that began in the sixties.

[Prevention of neutral tube closure defects, apropos of a case of iniencephaly]

We present a newborn with a malformation in the central nervous system that isn't frequent, the ininencephaly: this consist in the absence of the squamous part of the occipital bone, exaggerated cervical-thoracic retroflexion, high raquischisis, and with other malformations. Died at half hour, by global insufficiency respiratory due lug hypoplasia, verify by necropsies. In the Clinic Hospital of the University of Chile the incidence is 1 in 40,000 life newborn. We review the prevent of the nerval tube defect with the use of folic acid in the diet of the future woman who is going to became pregnant.