RESUMOO objetivo da pesquisa foi identificar o padrão de aleitamento materno exclusivo nos primeiros seis meses de vida de crianças nascidas em um Hospital Amigo da Criança e os fatores que contribuíram para o desmame precoce. Estudo de coorte prospectivo com 261 mães e crianças. Os dados foram avaliados utilizando-se a análise de sobrevivência através da construção da curva de Kaplan--Meier e teste de Log-Rank para a análise univariada. Foi realizada análise multivariada utilizando-se o modelo de Regressão de Cox com riscos proporcionais. Ao longo dos seis meses, o aleitamento materno exclusivo praticado com 30, 90, 120, 150 e 180 dias foi 75%, 52%, 33%, 19% e 5,7%, respectivamente. Na análise multivariada, as variáveis que mostraram risco para o desmame precoce foram a intercorrência mamária hospitalar e, na consulta de retorno, a posição inadequada e a associação das duas anteriores. A Iniciativa Hospital Amigo da Criança favoreceu o aleitamento materno exclusivo. DESCRITORES Aleitamento materno Promoção da saúde Política de Saúde Avaliação de Programas e Projetos de Saúde Enfermagem materno-infantil ABSTRACTThe objective of this research was to identify the pattern of exclusive breastfeeding (EBF) in the first 6 months of infants born in a Baby-Friendly Hospital and the factors that contribute to early weaning. This was a prospective cohort study with 261 mothers and children. The data were analyzed via the construction of a Kaplan-Meier survival curve, and the log-rank test was used for the univariate analysis. A multivariate analysis was performed using the Cox proportional-hazards regression model. During the 6 months, the percentage of mothers who practiced EBF for 30, 90, 120, 150 and 180 days was 75%, 52%, 33%, 19% and 5.7%, respectively. In the multivariate analysis, the variables that conferred a risk for early weaning were the hospital and the occurrence of a follow-up visit due to mammary complication, improper positioning and the association of both of these factors. The Baby-Friendly Hospital Initiative favored EBF. DESCRIPTORS Breast feeding Health promotionHealth Policy Program evaluation Maternal-child nursing RESUMEN El objetivo de la investigación fue identificar el patrón de lactancia materna exclusiva en los primeros seis meses de vida de niños nacidos en un Hospital Amigo del Niño y los factores que contribuyeron para el destete precoz. Estudio de cohorte prospectivo realizado con 261 madres y niños. Fue utilizado el análisis de sobrevivencia a través de la construcción de la curva de Kaplan-Meier y el test de Log-Rank para el análisis univariado. Para el análisis multivariado se usó el modelo de Regresión de Cox con riesgos proporcionales. Durante seis meses, la lactancia materna exclusiva practicada con 30, 90, 120, 150 y 180 días fue del 75%, 52%, 33%, 19% y 5,7%, respectivamente. En el análisis multivariado, las variables que mostraron riesgo para el destete precoz fueron por algún tipo de problema mamario en el hospital y, en la consulta de retorno, la posición inadecuada y la asocia...
Objective: To conduct a literature review about the ten steps of the Baby Friendly Hospital Initiative (BFHI). Methods: We sought documents and scientific papers published in the databases of PubMED, Medline, SciELO and LILACS. Results: We initially identified 110 references about the BFHI, between the years of 1979 to 2009. Approximately 21% were published in the 1990s and 79% between 2000 and 2009; 10.8% were published in books and official documents of the Ministry of Health, Pan American Health Organization and World Health Organization; and, 89.2% were in articles indexed in the consulted databases. Of these, 35 references were selected. The analyzed studies showed that changes in hospital practices according to the Ten Steps of BFHI increased the prevalence of breastfeeding. Conclusion: Through the studies analyzed, the BFHI showed effectiveness in increasing breastfeeding in many regions of the world, contributing to the reduction of infant morbidity and mortality. Los estudios analizados evidenciaron que los cambios en las prácticas hospitalarias de acuerdo con los Diez Pasos de la IHAN aumentaron la prevalencia de la lactancia materna. Conclusión: Por medio de los estudios analizados la IHAN se ha mostrado efectiva en el aumento de la práctica del amamantamiento en muchas regiones del mundo, contribuyendo con la reducción de la morbimortalidad infantil. Descriptores: Lactancia materna; Promoción de la salud; Evaluación de programas y projectos de salud; Política de salud Corresponding Author: Sonia Fontes Figueredo Rua Prof José Miziara, 61 ap. 61B. São Paulo (SP) Brasil.
Introduction: Human Herpesvirus 8 (HHV-8), also known as Kaposi sarcoma-associated herpes virus, is aetiologically associated with all forms of Kaposi's Sarcoma (KS), including transplant-related, as well as rare neoplastic conditions such as primary effusion lymphomas and multicentric Castleman disease. Solid organ transplant recipients have a much higher risk of KS compared to the general population and the role of serological screening in this setting has been long debated; there is currently no standard method of screening for HHV-8 infection and serology has been largely used for sero-epidemiological purposes. The latent nature of the virus makes determination of HHV-8 infection status complex and investigations may lead to inaccuracies. Methods: To fulfil the critical gaps in the diagnosis of asymptomatic virus infection, a combination of serological tools for the detection of antibody to both HHV-8 lytic and latent antigens have been developed and compared with the commercial lytic antigen-based immunofluorescence assay (IFA, Scimedx Corp), which is commonly used in Europe for the detection of antibodies to HHV-8. The developed assays include an in-house latent IFA assay that utilises latently infected PEL cells as well as two Double Antigen Binding Assays (DABAs) which utilise major HHV-8 antigens; ORF73 and K8.1 e(latent and lytic proteins, respectively). Results: Initial data gained from the testing of samples from identified patients with ongoing HHV-8 disease indicate a good concordance between both latent and lytic antibody assays. Studies are underway to determine the performance of these assays for the identification of asymptomatic infection and are being applied to establish the prevalence of HHV-8 antibodies in donor populations. Conclusion: HHV-8 has a complex serological profile and the availability of tools based on a range of formats which target multiple proteins will better inform on seroprevalence rates both at a population level and within specific at-risk groups.
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