Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The success of international initiatives for the eradication of measles depends in large part on knowledge about vaccination. In 1992, a cross-sectional study was carried out to evaluate knowledge about measles vaccine among pediatricians in the Brazilian city of Salvador, Bahia. Of the 506 pediatricians residing in the city, 299 (59%) could be located and responded to a questionnaire containing 15 questions that posed hypothetical situations regarding indications and contraindications for this vaccine. The average number of correct responses was 9.3 out of 15, which illustrates the pediatricians' poor knowledge of measles vaccine. Conditions commonly seen in pediatric practice in Brazil--malnutrition, upper respiratory tract infection, diarrhea, and prematurity--were often erroneously considered contraindications for immunization. More than half (62%) of the pediatricians did not know the correct way to administer the vaccine. Knowledge about the vaccine did not differ according to the length of time that had elapsed since the physicians' university training in pediatrics or as a result of working in health centers operated by the State Health Secretariat. University professors, pediatricians with a postgraduate degree, and those pursuing postgraduate studies scored slightly higher than the rest. These results point to the need to strengthen training on measles vaccination in medical schools and programs of continuing education for pediatricians.
Rev Panam Salud Publica 1997 Dec
PMID:[The knowledge of pediatricians in Salvador, Brazil about measles vaccine]. 954 79

In order to determine the biological, sociocultural, and health-care characteristics associated with deaths from pneumonia among infants, this study used cases and controls to obtain quantitative information from a semistructured questionnaire given to those infants' mothers and to 28 doctors (15 who headed inpatient services and 13 who directed outpatient services). The cases were defined as children under 1 year of age who had died from pneumonia in 1995 in the Metropolitan Region of Chile (Greater Santiago). The controls were 118 children who survived after being hospitalized with pneumonia during the same period in the same area. The two groups were paired by age, month of hospitalization, and community of residence. A qualitative study was also done. It consisted of in-depth interviews with the mothers of 20 cases and of 5 controls and with 12 key informants from primary health care staffs. Of the 149 cases identified, 113 (75.8%) were studied, divided into two major groups: those who had died in the hospital (69%) and those who had died at home (31%). Of the deaths, 63.7% occurred during the first three months after birth. Both the cases and the controls had more biological and social risk than the Chilean population in general, although there were significant differences in risk between the cases and controls. The incidence of both low birthweight (< 2,500 g) and of very low birthweight (< 1,500 g) was higher in the two groups than in the general population and was significantly greater in the cases (40.7% and 13.3%, respectively) than in the controls (18.8% and 1.7%). Prematurity (gestational age < 37 weeks) was especially high among the children who had died in the hospital (40.3%), in contrast to 25.7% for those who had died at home and 17.1% among the controls. Those who had died in the hospital also had 10 times as many congenital disorders as did those who had died at home, and seven times as many as did the controls. According to their mothers, more than half (18/35) of the children who had died at home had not shown signs of pneumonia, which suggests sudden infant death syndrome or death from aspiration of food into the lungs. In terms of socioeconomics, the standard of living of the controls was lower than that of the cases. During 1995 or the second half of 1994, 60.3% of the fathers of the controls had been unemployed, as had 58.6% of the fathers of the cases. There were no differences between the cases and the controls with respect to the mothers' having noticed signs of illness or the mothers' knowledge of how to prevent pneumonia. The surveyed physicians generally believed that the primary cause of the deaths had been the high level of biological problems among those children. Since the group of children who died at home differed in both size and other characteristics from those who died in the hospital, there should be different strategies aimed at reducing deaths in the two groups. It is important to do autopsies in all deaths in order to determine if the cause of death is pneumonia, sudden infant death syndrome, or aspiration of food.
Rev Panam Salud Publica 1999 Nov
PMID:[Biological ad social characteristics of infants who died from pneumonia in the Metropolitan Region of Chile, 1995]. 1062 75

This study was intended to explore the conditions under which prenatal care is delivered in the border city of Tijuana, Baja California, Mexico, and to assess the possible associations between that care and neonatal results in terms of birthweight, health of the neonate, and prematurity. Seven hospitals serving persons from different socioeconomic strata were chosen, and between December 1993 and March 1994 interviews were conducted with 279 women who were in the first 24 to 48 hours of puerperium. During the interviews data were collected on socioeconomic level; the mothers' knowledge, attitudes, and practices concerning obstetric health; the mothers' perceptions of access to prenatal care; the quality of prenatal care visits (evaluated in terms of having blood and urine tested and weight and blood pressure measured); and the gynecological and obstetric and health history of the mother. A database was created using the SPSS statistics software package. Possible associations were explored, with prenatal care as the independent variable and various dependent variables, by means of contingency tables and a two-tailed Fisher's exact test. None of the neonates was premature, ill, or had a birthweight of < or = 2,500 g. For this reason it was decided to divide the variable corresponding to birthweight into two groupings, < or = 3,000 g and > 3,000 g. A significant (P < 0.00038) relationship was found between a lack of prenatal care and low birthweight. In addition, a lack of prenatal care was associated with: low family income; the mother's financial dependence on the father; the mother being in an unmarried relationship; little communication with the partner; having no medical insurance; an unwanted pregnancy; and giving delivery at the General Hospital. Out of the total sample of 279 women, 15 (5.4%) had received no prenatal care. None of these 15 women reported they had encountered difficulties that prevented them from obtaining prenatal care, but only 7 of those women answered that question. The prenatal care was of good quality in 190 of the cases (68%). Both the number and the timing of the prenatal visits were adequate in 142 of the cases (50%). The mother's having worked during pregnancy or before had a positive predictive value in terms of utilization of prenatal care services. Additional studies are needed to evaluate the possible relationship between domestic violence and the lack of prenatal care or a delay in seeking such care.
Rev Panam Salud Publica 2000 Feb
PMID:[Prenatal care in the border city of Tijuana, Mexico]. 1074 60

Extreme prematurity is a major risk factor for perinatal and neonatal brain injury, and can lead to white matter injury that is a precursor for a number of neurological diseases, including cerebral palsy (CP) and autism. Neuroinflammation, mediated by activated microglia and astrocytes, is implicated in the pathogenesis of neonatal brain injury. Therefore, targeted drug delivery to attenuate neuroinflammation may greatly improve therapeutic outcomes in models of perinatal white matter injury. In this work, we use a mouse model of ischemia-induced neonatal white matter injury to study the biodistribution of generation 4, hydroxyl-functionalized polyamidoamine dendrimers. Following systemic administration of the Cy5-labeled dendrimer (D-Cy5), we demonstrate dendrimer uptake in cells involved in ischemic injury, and in ongoing inflammation, leading to secondary injury. The sub-acute response to injury is driven by astrocytes. Within five days of injury, microglial proliferation and migration occurs, along with limited differentiation of oligodendrocytes and oligodendrocyte death. From one day to five days after injury, a shift in dendrimer co-localization occurred. Initially, dendrimer predominantly co-localized with astrocytes, with a subsequent shift towards microglia. Co-localization with oligodendrocytes reduced over the same time period, demonstrating a region-specific uptake based on the progression of the injury. We further show that systemic administration of a single dose of dendrimer-N-acetyl cysteine conjugate (D-NAC) at either sub-acute or delayed time points after injury results in sustained attenuation of the 'detrimental' pro-inflammatory response up to 9days after injury, while not impacting the 'favorable' anti-inflammatory response. The D-NAC therapy also led to improvement in myelination, suggesting reduced white matter injury. Demonstration of treatment efficacy at later time points in the postnatal period provides a greater understanding of how microglial activation and chronic inflammation can be targeted to treat neonatal brain injury. Importantly, it may also provide a longer therapeutic window.
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PMID:Systemic dendrimer-drug treatment of ischemia-induced neonatal white matter injury. 2618 52