The development of moderate malnutrition and cell-mediated immune function was studied in 71 Colombian infants from birth through 2 yr of age. Based upon weight-for-age criteria 31 remained normal, 33 were classified as grade I, and seven were grade II malnourished at the end of their 2nd yr of life. Delayed hypersensitivity reactions to purified protein derivative were significantly reduced in all malnourished children 8 wk after Bacille Calmette-Guerin vaccination at birth, and also at 2 yr in the Grade II group. Nearly half of the latter group could not be sensitized to dinitrochlorobenzene at 2 yr of age. A 50% reduction in the blastogenic response of peripheral blood lymphocytes to phytohemagglutinin in vitro was detected in grade II children. Both mildly and moderately malnourished infants exhibited a significant reduction in tonsil size at 2 yr of age. These results indicate that a majority of newborns in this poor, urban setting will develop measurable malnutrition associated with impaired cell-mediated immune function before their 2nd birthday.
The influence of moderate malnutrition on immunoglobulins and enzymes in the sera and secretions of 71 Colombian children was studied. Concentrations of immunoglobulin A, immunoglobulin G, lysozyme, albumin, and aminopeptidase were measured in the sera, tears, and saliva of 27 normal, 32 grade I, 9 grade II, and 3 grade III malnourished children. The most severely malnourished children, grades II and III, had markedly reduced immunoglobulin A concentrations and elevated immunoglobulin G concentrations in tears. Immunoglobulin A levels in whole saliva were also reduced in these malnourished children. In contrast, the concentration of immunoglobulin A in the sera of these children was significantly elevated. There was no influence of malnutrition on levels of lysozyme, albumin, total protein, and aminopeptidase in tears or saliva. These results indicate that secretory immunity may be impaired in moderately malnourished children due to decreased levels of immunoglobulin A in secretions.
To determine if the transition to extrauterine life is facilitated by skin-to-skin contact, six relatively low risk preterm infants experienced six continuous hours of skin-to-skin contact on their mothers' chests beginning within 30 minutes of birth. Heart and respiratory rates and oxygen saturation remained within normal limits and all infant temperatures rose rapidly to thermoneutral range. Two infants developed grunting respirations by the time skin-to-skin contact began, but the grunting disappeared with warm, humidified oxygen and continuous skin-to-skin contact. All infants were fully breastfeeding and ready for discharge by 24-48 hours postbirth. Early skin-to-skin contact was safe and seemed beneficial for these relatively low risk preterm infants.
En el presente trabajo se puede observar cómo los recién nacidos que recibieron el fármaco beta estimulante tuvieron mejor puntaje de Apgar que en el grupo control.Lo anterior nos lleva a sugerir que la terapia con beta adrenérgicos tales como la Orciprenalina en infusión I.V. continua, se deben utilizar en amenaza o trabajo de parto prematuro, no solamente con el objetivo de disminuir o inhibir la contractilidad uterina, hecho suficientemente demostrado por varios investigadores (2), sino también porque en caso de que la paciente progrese al parto, hay menores probabilidades de hipoxia y de isquemia pulmonar fetal con menor incidencia de Síndrome de Dificultad Respiratoria Idiopática en el recién nacido.Igualmente aconsejamos su uso en pacientes en las cuales por cualquier circunstancia de orden obstétrico debe interrumpirse el embarazo prematuramente, como por ejemplo, en la Isoinmunización severa por Rh o en la Diabetes clases C en adelante (de Priscila White).Finalmente es de destacar también que, en nuestra muestra seleccionada al azar y sin patología materna o fetal, no observamos efectos colaterales nocivos, con excepción de los ya conocidos efectos cardiovasculares de los fármacos beta adrenérgicos, los cuales son pasajeros y bien tolerados por las pacientes.
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