The article details the pattern of a home nursing visit of a newborn. The authors advise when after birth the visit should take place and by whom, its purpose, the components of the newborn examination after discharge from maternity hospital, and recommendations for young parents.
Infant mortality is one of the key indicators of demography, characterizing not only the state of health and a social standard of living in a country, region, city, but also an indicator of the level of state development. In recent years there has been a steady downward trend in infant mortality. To the greatest extent, this trend is driven by improved quality of medical care. However, death of children outside healthcare facilities is the least controlled in the structure of infant mortality. The article considers the main causes of deaths of children under the age of one year outside healthcare facilities in the Russian Federation in 2017, presents data of the world and national statistics, analyses possible solutions to the problem.
Adequate nutrition is a key component of the health and optimal growth of a newborn child. The article presents recommendations on support of breastfeeding in healthy newborns, as well as clinical experience in terms of organization of breastfeeding, maintenance of lactation in the mother in case of birth of sick and prematurely born child, indications for breast milk expression. Experience and effectiveness assessment of clinical and individual breast pumps is described. The issues of differentiated consultation on feeding premature infants with various pathologies and optimal conditions of breast milk expression are considered.
Введение. Установлено, что ожирение сопровождается высоким провоспалительным фоном и повышенным содержанием эндотоксина (ЭТ) у взрослых. Одним из факторов риска развития ожирения у взрослых является низкий вес при рождении и чрезмерная прибавка массы тела в раннем возрасте. Цель. Определение взаимосвязи между показателями системной эндотоксинемии (СЭЕ) и жирового обмена у новорожденных детей. Методика. Обследовано 44 ребенка, находившихся в отделении патологии новорожденных и недоношенных детей Научного Центра Акушерства, Гинекологии и Перинатологии им. Кулакова в июле 2016 года. Определяли концентрацию ЭТ в плазме крови; антител к ЭТ; липидный профиль; состав тела методом воздухо-заместительной плетизмографии. Результаты. У детей с патологией, по сравнению с контрольной группой, концентрация ЭТ и липопротеинов высокой плотности (ЛПВП) были выше (2,31 ± 0,15 против 1,2 ± 0,13EU/ml и 1,15 ± 0,05 против 0,69 ± 0,1 ммоль/л соответственно), а содержание антител к ЭТ и холестерина были ниже 122 ± 9 против 202 ± 36 у.е.о.п.. и (1,97 ± 0,34 против 2,91 ± 0,09 мг/дл). Обратная корреляция обнаружена между уровнем ЭТ в крови и процентным содержанием жира в организме и между уровнем ЭТ и индексом атерогенности. Прямая корреляция была между уровнем ЭТ и ЛПВП. Заключение. Феномен системной эндотоксинемии сопровождает период новорожденности, что свидетельствует об участии кишечного ЛПС в адаптации к постнатальному периоду жизни, а избыточный уровень ЭТ в общем кровотоке сопутствует или предшествует развитию неонатальной патологии. Недостаточное содержанием жира в организме новорожденного может являться причиной ограниченного депонирования ЛПС и повышенного содержания его в крови. Background. It is established that obesity is accompanied by a low-grade inflammation and increased Endotoxin (ET) content in adults. Low birth weight and excessive weight gain in early infancy are associated with an increased risk of obesity, metabolic syndrome, cardiovascular disease in adults. Objective. To determine the relationship between systemic endotoxemia and fat metabolism in newborn infants. Materials and methods. Cross-sectional study included 44 infants who were at the department of newborn pathology of Research Center for Obstetrics, Gynecology and Perinatology in July 2016. The concentration of ET in the blood plasma, ET antibodies, lipid profile, body composition using air-displacement plethysmography were assessed. Results. In children with pathology in comparison with the control group the concentration of ET and high density lipids (HDL) were higher (2,31 ± 0,15 vs. 1,2 ± 0,13 EU/ml and 1,15 ± 0,05 vs. 0,69 ± 0,1 mmol/l respectively), while ET antibodies level was lower (122 ± 9 vs. 202 ± 36 O.D.) The inverse correlation observed between the ET plasma level and body fat percentage and between the ET plasma level and atherogenic index. Direct correlation between the ET and HDL levels was found. Conclusion. The phenomenon of systemic endotoxemia accompanies the neonatal period, which indicates the involvement of ET to postnatal adaptation, and excess levels of ET in the general circulation is accompanied or proceed to development of neonatal pathology. Lack of fat in the body of the newborn may be a reason for the limited deposit of ET and its high content in the blood.
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