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Introduction and Aims: Oropharyngeal dysphagia (OD) occurs in children with cerebral palsy. It is important to investigate its relationship with some variables, and the objective of this study was to identify factors associated with OD., Materials and Methods: Case-control study in patients with cerebral palsy from 8months to 15years of age, from November 2018 to November 2019, approved by the Ethics Committee. The diagnosis of OD was made by videofluoroscopy when there was nasopharyngeal reflux, stagnation in the vallecular sinuses, in the piriformis sinuses, penetration, and aspiration. The independent variables were type of cerebral palsy, gross motor impairment classified into five levels, nutritional status and comorbidities. One case with OD was included and the next one without alterations in videofluoroscopy was control. The variables were compared with Chi square and Student's t. The association was measured with odds ratio. The confidence interval was 95%., Results: Thirty patients with OD and 30without OD were studied. Sex, age, birth weight, and gestational age had a similar distribution in the two groups. From the data perceived by the mothers at the time of feeding, the greater frequency of the difficulty in the transfer of the food bolus in the group with OD showed a statistically significant difference (P<.001) and of the studied factors, the levelV of the gross motor involvement was associated with a higher frequency of OD., Conclusions: OD was associated with level V of gross motor involvement., (Copyright © 2021 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.)

We determine the prevalence and trends of open neural tube defects (ONTDs) during 1991 to 2019 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Mexico). Also, details of potential risks were obtained in 662 newborns, including those 143 patients with anencephaly and open spina bifida (OSB) classified as isolated (cases) and 519 controls. Data were analyzed using multivariable logistic regression. Among 267 201 live births during the study period, 336 were born with ONTDs, yielding an overall prevalence of 12.6 per 10 000. After folic acid (FA)-related programs began in Mexico (2003-2019), only OSB showed a decline of 20.6%. For anencephaly, associated risks included relatives with neural tube defects (NTDs) (adjusted odds ratio [aOR]: 67.9, 95% confidence interval [95% CI]: 11.3-409.8), pre-pregnancy body mass index (BMI) ≥25 kg/m 2 (aOR: 2.6, 95% CI: 1.1-6.0), insufficient gestational weight gain (aOR: 3.0, 95% CI: 1.3-7.1), parity ≥4 (aOR: 3.2, 95% CI: 1.3-7.7), and exposure to analgesic/antipyretic drugs (aOR: 9.0; 95% CI: 2.5-33.0). For OSB, associated risks included consanguinity (aOR: 14.0, 95% CI: 3.5-55.9), relatives with NTDs (aOR: 22.4, 95% CI: 4.5-112.9), BMI ≥25 kg/m 2 (aOR: 2.5, 95% CI: 1.6-4.2), insufficient gestational weight gain (aOR: 1.9, 95% CI: 1.1-3.1), and exposures to hyperthermia (aOR: 2.3, 95% CI: 1.2-4.3), common cold (aOR: 6.8, 95% CI: 3.6-12.7), and analgesic/antipyretic drugs (aOR: 3.6, 95% CI: 1.3-10.0). Our high rate probably results from exposures to preventable risks, most related to FA, indicating a need for strengthening existing FA-related programs in Mexico., (© 2020 Japanese Teratology Society.)

Introduction and Aims: Oropharyngeal dysphagia (OD) occurs in children with cerebral palsy. It is important to investigate its relationship with some variables, and the objective of this study was to identify factors associated with OD., Materials and Methods: Case-control study in patients with cerebral palsy from 8months to 15years of age, from November 2018 to November 2019, approved by the Ethics Committee. The diagnosis of OD was made by videofluoroscopy when there was nasopharyngeal reflux, stagnation in the vallecular sinuses, in the piriformis sinuses, penetration, and aspiration. The independent variables were type of cerebral palsy, gross motor impairment classified into five levels, nutritional status and comorbidities. One case with OD was included and the next one without alterations in videofluoroscopy was control. The variables were compared with Chi square and Student's t. The association was measured with odds ratio. The confidence interval was 95%., Results: Thirty patients with OD and 30without OD were studied. Sex, age, birth weight, and gestational age had a similar distribution in the two groups. From the data perceived by the mothers at the time of feeding, the greater frequency of the difficulty in the transfer of the food bolus in the group with OD showed a statistically significant difference (P<.001) and of the studied factors, the levelV of the gross motor involvement was associated with a higher frequency of OD., Conclusions: OD was associated with level V of gross motor involvement., (Copyright © 2021 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.)

Background: Intraoperative findings during gastroschisis surgery are the main predictor associated with increased mortality. The aim of our study was to determine the type of surgical findings associated with inpatient mortality in a cohort of patients with gastroschisis from a university hospital in Western Mexico., Materials and Methods: Infants with surgically repaired gastroschisis during the period 2011-2017 at the Dr. Juan I. Menchaca Civil Hospital of Guadalajara (Guadalajara, Mexico) were studied. Data regarding demographics, perinatal history, and intraoperative findings were collected and compared according to whether they were nonsurvivors (cases) or survivors (controls) at hospital discharge. Data were analyzed using logistic regression, determining its adjusted odds ratio (aOR) and its respective 95% confidence intervals (95% CIs). The proper adjustment of the model was verified using the Hosmer and Lemeshow test., Results: Ninety-four patients with gastroschisis were studied, of which 13 were nonsurvivors (13.8%), and 81 (86.2%) were survivors at hospital discharge. In the group of survivors, primary surgical closure was performed more frequently (P = 0.018), whereas staged reduction with a silo predominated in the group of nonsurvivors (P = 0.018), and an increased frequency of complex gastroschisis (0.0001). After logistic regression analysis, intraoperative findings associated with nonsurvival were severe bowel matting (aOR: 7.3; 95% CI: 1.2-44), and prolapse of the small intestine and large intestine, plus any other organ (aOR: 15.9; 95% CI: 1.1-219.6)., Conclusions: Mortality in our cohort was high (13.8%) and was significantly associated with severe bowel matting, and the prolapse of the small and large intestines, plus any other organ., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The proteinuria selectivity index (PSI) can predict the response to prednisone in the primary nephrotic syndrome (PNS)., Objective: To determine the association of prednisone response with the PSI in patients with PNS., Material and Methods: With analytical cross-sectional design, pediatric patients with PNS were studied with at least six months of prior follow-up, at the Nuevo Hospital Civil de Guadalajara from 2014 to 2015. They were divided into poor response to prednisone (frequent relapses or resistance) and good response (habitual relapses). PSI was calculated with serum and urinary measurement of IgG and transferrin. Chi square and OR were used, with 95% CI., Results: 67 patients with relapsing PNS were studied. The response to prednisone had been good in 33 (49.3%) and poor in 34 (50.7%). The PSI was ≤ 0.10 mg/mg in 23/67 (34.3%); 0.11-0.19 mg/mg in 15/67 (22.4%); and ≥ 0.20 mg/mg 29/67 (43.3%). 3/34 patients (8.8%) presented ≤ 0.1 mg/mg with poor response to prednisone and 20/33 presented good response (60.6%) (p < 0.001; OR: 0.6; 95% CI, 0.010-20). PSI between 0.11-0-19 mg/mg occurred in 8/34 patients (23%) with poor response to prednisone and in 7/33 with good response (21%). PSI ≥ 0.20 mg/mg resulted in 23/34 patients (67.6%) with poor response to the steroid and in 6/33 with good response (18.2%) (p < 0.001; OR: 9.4; 95% CI, 3.01-29.42)., Conclusions: In children with PNS, a PSI ≥ 0.20 mg/mg was associated with a poor response to prednisone treatment and a PSI ≤ 0.10 mg/mg with a satisfactory response., (Copyright: © 2020 Revista Medica del Instituto Mexicano del Seguro Social.)

Background: Exposure to pets can be a predisposing factor in the development of certain diseases, including allergic diseases., Objective: We analyzed the role that exposure to indoor dogs and cats plays in the prevalence of allergic diseases., Methods: We examined the cross-sectional data of 1056 women and 936 men aged 15 to 18 years; these individuals were selected through stratified and cluster random sampling. We asked all participants about their exposure to indoor dogs and cats during the year that preceded our study. The prevalence of allergic diseases was determined through core questions taken from The International Study of Asthma and Allergies in Childhood questionnaire., Results: The prevalence was 12.7% (95% CI: 11.3%-14.2%) for asthma, 9.0% (95% CI: 7.8%-10.4%) for allergic rhinitis, and 5.2% (95% CI: 4.3%-6.2%) for atopic dermatitis. The multivariate analyses showed that exposure to indoor dogs, but not indoor cats, was associated with asthma prevalence (aOR 1.37; 95% CI: 1.03-1.83), as was male sex (aOR=1.42; 95% CI: 1.08-1.86), a personal history of allergic rhinitis (aOR=3.24; 95% CI: 2.25-4.66), and a maternal history of asthma (aOR=3.06; 95% CI: 1.89-4.98). The population attributable risk for exposure to indoor dogs was 18%. Notably, neither allergic rhinitis nor atopic dermatitis was found to be associated with dog or cat exposure (p> 0.05)., Conclusion: Exposure to dogs in late adolescence is a factor associated with asthma, although its contribution to the development of asthma should be investigated in new studies., (Copyright © 2019 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Patients with type 1 diabetes mellitus (T1DM) and overweight have more risk to develop changes in blood pressure that increase cardiovascular morbidity and mortality. In this study, the relationship between blood pressure (BP) with the body mass index (BMI) and the average of the last three measurements of glycated hemoglobin (HbA1c) in patients with T1DM was determined., Methods: A cross-sectional analytical study was conducted in children and adolescents with T1DM with over a year since diagnosis. The dependent variables were systolic and diastolic BP, measured with a mercury sphygmomanometer. The independent variables were BMI and average of the last three measurements of HbA1. A linear regression with a 95% confidence interval was used., Results: Seventy-five patients with T1DM were studied. The median of disease duration was 3.5 years (min 1-max 14.8 years), BMI 19.5 ± 3.1 kg/cm 2 and HbA1c 8.3 ± 2.4%. Sixty-six patients showed BP < percentile 90 and 9 BP ≥ percentile 90 (12%). Two models of linear regression were constructed, with systolic and diastolic BP as dependent variables. The possible predictor variables were suggested by theoretical context and statistical analysis. The predictive variable of high BP was zBMI (body mass index expressed in z-score) for systolic and diastolic BP. Also, the models suggested that for an increase of one unit of zBMI, corresponded a rise of 5.1 and 3.6 mmHg in systolic and diastolic BP, respectively., Conclusions: A positive correlation between systolic and diastolic BP with zBMI was observed., (Copyright: © 2019 Permanyer.)

Introduction: Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility., Objective: To determine the association between periodontal disease and preterm birth., Method: Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression., Results: Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15)., Conclusion: Periodontal disease in pregnancy was an independent risk factor for preterm birth., (Copyright: © 2019 SecretarÍa de Salud.)

We determined the overall prevalence of typical orofacial clefts and the potential risks for nonsyndromic cleft lip with or without cleft palate in a university hospital from West México. For the prevalence, 227 liveborn infants with typical orofacial clefts were included from a total of 81,193 births occurred during the period 2009-2016 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Guadalajara, Jalisco, Mexico). To evaluate potential risks, a case-control study was conducted among 420 newborns, including only those 105 patients with nonsyndromic cleft lip with or without cleft palate (cases), and 315 infants without birth defects (controls). Data were analyzed using multivariable logistic regression analysis expressed as adjusted odds ratio with 95% confidence intervals . The overall prevalence for typical orofacial clefts was 28 per 10,000 (95% confidence interval: 24.3-31.6), or 1 per 358 live births. The mean values for the prepregnancy weight, antepartum weight, and pre-pregnancy body mass index were statistically higher among the mothers of cases. Infants with nonsyndromic cleft lip with or without cleft palate had a significantly higher risk for previous history of any type of congenital anomaly (adjusted odds ratio: 2.7; 95% confidence interval: 1.4-5.1), history of a relative with cleft lip with or without cleft palate (adjusted odds ratio: 19.6; 95% confidence interval: 8.2-47.1), and first-trimester exposures to progestogens (adjusted odds ratio: 6.8; 95% CI 1.8-25.3), hyperthermia (adjusted odds ratio: 3.4; 95% confidence interval: 1.1-10.6), and common cold (adjusted odds ratio: 3.6; 95% confidence interval: 1.1-11.9). These risks could have contributed to explain the high prevalence of orofacial clefts in our region of Mexico, emphasizing that except for history of relatives with cleft lip with or without cleft palate, most are susceptible of modification., (© 2018 Japanese Teratology Society.)

Background: Central venous catheters (CVC) are needed for monitoring and treatment of critically ill patients; however, their use increases the risk of bacteremia. The aim of the study was to quantify the incidence of central venous catheter-related bacteremia (CVCRB) and to identify factors associated with this infection., Methods: A prospective cohort study was conducted in a concentration hospital of western Mexico. The association of CVCRB and study variables was investigated using multivariate Cox regression analysis., Results: Two hundred four patients with CVC were studied. The average age was 4.6 years; 66.2% were male. Insertion sites of the catheters were subclavian vein 72.5% (n = 148), jugular vein 20.1% (n = 41) and femoral vein 7.4% (n = 15). CVCRB incidence was 6.5 events/1,000 catheter days; microorganisms identified were gram-positive cocci 37.5% (n = 6), gram-negative bacilli 37.5% (n = 6) and Candida albicans 25% (n = 4). It was observed that the increase in catheter manipulations per day was associated with bacteremia (HR 1.14, 95% CI 1.06 - 1.23), whereas the use of intravenous antibiotics showed a protective effect (HR 0.84, 95% CI 0.76-0.92)., Conclusions: In addition to strategies of maximum caution when placing or manipulating the catheter, we recommend decreasing, as much as possible, disconnects between the CVC and infusion line. Antibiotics showed a protective effect, but the outcome is uncertain and promotion of antimicrobial resistance should be considered., (Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.)

Background: Although the association between the type of idiopathic nephrotic syndrome (INS) and a peculiar pattern of fingerprints digital would suggest the presence of genetic factors related to both, this has not been previously studied. This study aimed to evaluate if there are fingerprints patterns differences between children with steroid-resistant INS (SRNS) and those with steroid-sensitive INS (SSNS)., Methods: The frequencies distribution of arches, ulnar loops, radial loops, and whorls was studied in 60 children with SRNS, and 60 children with SSNS. Bivariate analysis to detect the relationship between each fingerprint pattern with the study groups was performed by chi-square test and to evaluate its possible association, the odds ratios (OR) were calculated with 95% confidence's intervals (95%CI)., Results: The patients with SRNS had a higher frequency of digital whorls compared with that of patients with SSNS (46.7% vs. 30.7%, p = 0.005). Additional comparisons using a "whorls excesses" definition obtained from normative data in our population (≥ 7 whorls in females or ≥ 8 in males) were associated with increased odds for SRNS (OR 2.96, 95% CI 1.15-7.61)., Conclusions: Our findings indicate that there are differences between children with SRNS and SSNS at the level of digital dermatoglyphics, but further studies are needed to confirm this association and its possible implications.

Introduction: Neonatal sepsis is one of the main causes of death among newborn infants. Empirical antimicrobial treatment is based on epidemiological information and antimicrobial susceptibility tests. The objective of this study was to describe etiologic agents and their antimicrobial susceptibility among newborn infants with early-onset neonatal sepsis (EONS) or late-onset neonatal sepsis (LONS) at a Neonatal Intensive Care Unit., Methods: Cross-sectional study conducted at a tertiary referral hospital in Western Mexico. Determination of antimicrobial resistance of microorganisms isolated in blood or cerebrospinal fluid of patients with EONS or nosocomial LONS., Results: Yeasts and bacteria were isolated from 235 cultures corresponding to 67 events of EONS and 166 events of LONS. Of all isolates, the most common bacteria were Enterobacteriaceae (51.5%), followed by Streptococcus spp. in EONS, and by Staphylococcus spp. in LONS. Of all nosocomial Enterobacteriaceae, 40% were extended spectrum beta-lactamase producing bacteria. Among Staphylococcus species, resistance to oxacillin was recorded in 65.5%. Among Enterobacteriaceae (n: 121), resistance to amikacin, piperacillin-tazobactam, and meropenem was below 3%. Non-fermenting bacteria did not show resistance to amikacin, ciprofloxacin or cefepime; however, the number of isolates was scarce., Conclusions: The most commonly identified bacteria in EONS were Enterobacteriaceae (67.6%) and Streptococcus spp. (17.6%), and Enterobacteriaceae (44.9%) and Staphylococcus spp. (34.7%) in LONS. Forty percent ofnosocomial Enterobacteriaceae were extended spectrum beta-lactamase producing bacteria, and 65.5% of Staphylococcus spp. showed resistance to oxacillin.

Introduction: obesity in pregnancy has been associated with increased morbidity for the mother and fetus., Objective: to quantify the association between obesity in pregnancy with growth deviations of their newborn infants., Methods: a study of non-matched cases and controls was performed based on the Nuevo Civil Hospital of Guadalajara "Dr. Juan I Menchaca" 2012-2013. The dependent variables were the newborn being either large (LGA) or small for gestational age (SGA), and the independent variable was pre-pregnancy obesity. Gynecoobstetric and socioeconomic data were collected. The association between the dependent and independent variables was assessed with logistic regression., Results: one-hundred and forty-three mother-child dyads were studied with growth deviations of their newborn infants, and 137 mother-child dyads without growth deviations were studied. The age of the patients was 24.7 ± 6.3 vs. 24.0 ± 6.0 years, and the gestational age was 38 ± 1.2 vs. 38 ± 1.5. Factors associated with growth deviations were pre-pregnancy obesity (OR 2.65, 95% CI 1.29- 5.44), elevated weight gain during pregnancy (OR 1.98, 95% CI 1.04-3.76) and disease during pregnancy (OR 2.62, 95% CI 1.05-6.76). A multivariate model with the dependent variable LGA and associated covariates showed that pre-pregnancy obesity and high gestational weight gain were predictors of LGA (OR 2.43, 95% CI 1.10-5.40) and (OR 3.31, 95% CI 1.83-5.96)., Conclusions: in a population of young women with scarce economic resources, pre-pregnancy obesity and high weight gain during pregnancy were predictors of LGA., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Mexico is recognized as a country with a high prevalence of gastroschisis, although the cause of this remains unclear. We define the prevalence and potential risk factors for gastroschisis in a public hospital from west México. A case-control study was conducted among 270 newborns, including 90 patients with nonsyndromic gastroschisis (cases) and 180 infants without birth defects (controls), born all during the period 2009 to 2013 at the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" (Guadalajara, Mexico), from a total of 51,145 live births. Potential maternal risk factors for gastroschisis were compared using multivariate logistic regression analysis to evaluate the deviance explained by different variables of interest. The overall prevalence of gastroschisis in live births was 17.6 per 10,000 births (95% confidence interval [CI] 14.0-21.2), whereas in offspring of women ≤ 19 years old was 29.9 per 10,000 births (95% CI 21.9-38.0). Mothers ≤ 19 years (adjusted odds ratio [aOR] 2.8: 95% CI 1.5-5.1), anemia during pregnancy (aOR 10.7; 95% CI 2.0-56.9), first-trimester exposure to hormonal contraceptives (aOR 3.7; 95% CI 1.0-13.0), and first-trimester alcohol consumption (aOR 3.4; 95% CI 1.6-7.3), were associated with gastroschisis. Contrarily, adjusted OR for pre-pregnancy body mass index ≥ 25 kg/m(2) has protective odds (aOR 0.2; 95% CI 0.1-0.5). Our results suggest an increased risk for gastroschisis among mothers under the age of 20, with anemia during pregnancy, and those who used hormonal contraceptives or consumed alcohol during early pregnancy, whereas, pre-pregnancy overweight has a protective OR, and they are discussed as clues in its pathogenesis., (© 2014 Japanese Teratology Society.)

Background: Teenage pregnancy alters family dynamics because it is usually an unplanned pregnancy that significantly affects both the personal life of the teenager and in his social environment. It has been associated with increased risk and poor maternal and perinatal outcomes., Objective: This study was planned in order to determine which are perinatal and maternal complications of pregnancy in adolescents., Methods: Case-Control study in the Civil Hospital of Guadalajara Dr. Juan I. Menchaca, from July 1, 2010 to December 31, 2011. The case group was formed with 550 postpartum adolescents < or = 18 years who had had a pregnancy > 27 weeks, forming a control group of 550 postpartum women 20 to 30 years, and data were obtained by direct survey and analyzed with Chi2 statistical test and odds ratio., Results: There were fewer married adolescents, lack of support from their partners, less use of contraception, most addictions, increased frequency of premature rupture of membranes, threats of preterm delivery and respiratory distress syndrome of the newborn. There was no difference in the number of prenatal visits, type of birth, type of amniotic fluid and discomfort common in pregnancy., Conclusions: The teen pregnancy as well as maternal perinatal repercussions is a sociocultural and economic problem because they are students, dependent on their parents, without support from your partner and not using contraception, so new pregnancies continue to increase its complications.

Background: Late-onset sepsis (occurring after 3 days of age) either cross-infection (CI) or perinatal is the first cause of morbidity and mortality in neonatal intensive care units (NICU) around the world. Our objective was to determine the current incidence of CI risk factors in neonates admitted to the NICU of the Hospital Civil de Guadalajara during a 9-month period., Methods: A case-control study with 114 newborns; 38 with CI and 76 controls. Odds ratio with 95 % confidence interval were calculated., Results: Associated risk factors were total parenteral nutrition (OR = 16.54, CI = 6.30-43.39, p < 0.001); weight < 1000 g (OR = 7.33, CI = 2.15-25.01, p < 0.001); intravascular catheter (OR = 6.79, CI = 2.68-17.00, p < 0.001); gestational age < 30 weeks (OR = 4.54, CI = 1.61-12.81, p < 0.003); intratracheal intubation and mechanical ventilation with (OR = 6.98, CI = 2.94-16.5, p < 0.001)., Conclusions: Total parenteral nutrition and weight < 1000 g showed the greatest association with cross-infection; in this study, male gender was not a risk factor.

Encirclement of a fetal body part by the umbilical cord with or without vascular obstruction in either the umbilical cord or the encircled fetal part is considered an umbilical cord loop (UCL). Significant disruption of the encircled fetal parts is recognized as the umbilical cord disruption sequence (UCDS). UCL around fetal parts is an occasional anomaly in infants with amyoplasia. We report on 2 patients with amyoplasia and damage to the fetal limbs caused by UCDS and a long umbilical cord. Patient 1 showed two deep constrictions on the left lower limb caused by UCL with an intact skin and a mild mark of constriction on the left wrist. The umbilical cord in patient 2 produced 5 entanglements around the left thigh which resulted in a deep groove extending down to the femur and also showed an exposed fracture and gangrene of the entire lower limb with an unusual congenital paraumbilical "stoma" that corresponded to the afferent loops of a jejunal atresia. The UCDS in infants with amyoplasia has been associated with short umbilical cords, whereas in patients without congenital contractures, the UCDS or UCL has been related to long umbilical cords. Our observations of UCDS in patients with amyoplasia but with long umbilical cords suggest the influence of both pathogenic factors or the existence of additional mechanisms. Evidence in patient 2 may support a vascular pathogenesis.

Background: Laboratory test used in the diagnosis of neonatal sepsis have a low specificity. Recently, procalcitonin has been proposed as a marker to identify the presence of systemic infections. The objective of the study was to evaluate the sensibility and specificity of procalcitonin as a marker of systemic infection in newborn with a suspicion of neonatal sepsis using a blood culture as a gold standard., Methods: 21 newborn with a suspicion of neonatal sepsis were included in the study, postnatal age 8.3 +/- 5.2 days in a period from October 2003 to a January 2004. Procalcitonin, were measured at the moment of clinical diagnosis and after 24 and 48 hours and twice blood culture were done., Results: Seven blood cultures were positive at the moment of diagnosis as well as 21 determinations of procalcitonin, sensibility 85.7%, specificity 21.7%; (OR = 1.63, 95% CI = 0.14-19.4); determinations after 24 hours showed procalcitonin sensibility and specificity of 85.7% and 28.5% (OR = 2.4, 95% CI = 0.22-26.6) and after 48 hours 100% of sensibility and 42.8% of specificity (OR = 1.75, 95% CI = 1.11-2.75])., Conclusions: Positive procalcitonin has a good sensibility and moderate specificity 48 hours after clinical diagnosis of neonatal sepsis.

Objective: To determine prevalence and maternal risk factors associated with preauricular tags., Material and Method: A case-control study of 254 newborns with isolated preauricular tags not considered part of a syndrome and their controls, and who were delivered at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca between 1990 and 2003. The maternal risk factors were demonstrated by means of a direct interview with the mother., Results: The prevalence of the isolated preauricular tags was 1.96 per 1,000 newborns alive, in a 1.2 men for each woman. The history of another affected relative was strongly associated with preauricular tags (OR 19.28; 95% CI: 4.44-117.60). Infants with preauricular tags frequently showed parents consanguinity (OR 3.04; 95% CI: 0.28-76.26), maternal age > or =35 years (OR 1.14; 95% CI: 0.53-2.48), exposure to some disease (OR: 1.23, 95% CI: 0.72-2.12), and drugs use in the first trimester of pregnancy (OR: 1.11; 95% CI: 0.65-1.92). No associations were found for the frequency of abortion, exposure to organic solvents and maternal occupation., Conclusions: The prevalence of isolated preauricular tags in this population was similar to that reported in other regions of Latin America, but lower to the prevalences in Sweden and Israel. This malformation has an important hereditary component; however, it is probably that some teratogenic factors, such as diabetes mellitus, can increase its frequency.

Objective: To identify the sociodemographics, obstetrical and perinatology factors of risk most frequently associated to fetal death in greater pregnancies of 27 weeks., Patients and Methods: From January 2001 to May 2005, in the Hospital Civil de Guadalajara Dr Juan I. Menchaca, we carried out a study of cases and controls with 450 cases of fetal death of more than 27 weeks of gestation and 450 newborn alive whose birth happened immediately later. We compared the frequency of different maternal and fetal variables that in previous forms was associated with fetal death, by means of Chi squared test and exact test of Fisher, the association among these variables and fetal death with the reason of momios was considered. In all the cases the chosen interval of confidence was of 95%., Results: The risk factors associated with fetal death were: maternal age over 35 years, low schooling, multiparity, antecedent of abortion and fetal death, deficient prenatal care, complications in the pregnancy, abnormal amniotic fluid, double circular of umbilical cord to neck of the product and great congenital malformations of newborn. It was not associated with fetal death, the single marital status, primigesta, smoking, male sex of the fetus, simple circulate of umbilical cord to the neck and fetal macrosomia., Conclusions: Of the risk factors associated with fetal death, the main one is a deficient prenatal care, that of being improved, might diminish the association of some other variables that were associated with fetal death.

Objective: To identify maternal and neonatal risk factors associated with hyaline membrane disease and its mortality., Patients and Method: A case-control study with 41 newborns with hyaline membrane disease and 123 controls was made between September 2001 and February 2002 in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. The diagnosis of hyaline membrane disease was done with clinical and radiographic data. Maternal risk factors were obtained by direct interview with the mother; the newborn data were obtained of the clinical files. The association was measured with the odds ratios (OR) and the confidence interval of 95%., Results: The frequency of hyaline membrane disease was of 6.8 per 1,000 live births. Mortality rate was of 2.8 per 1,000 live births. There were 17 deaths (41%). The risk factors associated with hyaline membrane were: illness during the first and second trimester of pregnancy, (OR: 3.28 [1.16-9.31]; OR: 8.88 [3.56-22.50], respectively), Apgar score lower than seven at the first minute (OR: 18.57 [4.50-88.67]), and masculine gender (OR: 2.58 [1.15-5.83])., Conclusions: Frequency and mortality were similar to the reported by other studies made in population samples. The exposure to illnesses during pregnancy and the low Apgar score were associated with the increased frequency of hyaline membrane disease.

Objective: To identify the obstetrics and neonatal risk factors associated with transient tachypnea of the newborn., Patients and Methods: Case-control study of 110 neonates with transient tachypnea and 110 newborns controls, between May and October 2000, in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. The diagnosis of transient tachypnea was done by clinical and radiology data and exclusion of the other causes of respiratory distress. The exposure was documented by a direct interview to the mother and clinical information of the clinical expedient. The association was measured with the odds ratios and confidence interval of 95%., Results: The frequency of transient tachypnea was of 2 percent newborn alive. The risk factors that were associated with transient tachypnea was: low Apgar score at minute (OR: 33.74, CI 95%: 4.73-681.52), premature rupture of amniotic membranes (OR: 3.65, CI 95%: 1.53-8.90), cesarean section (OR: 2.01, CI 95%: 1.14-3.57) and masculine gender (OR: 2.02, CI 95%: 1.14-3.60). It was more frequent in the cases the antecedent of diabetes mellitus and bronchial asthma., Conclusions: The results suggest that it's necessary to improve the obstetrics surveillance to diminish the frequency of low Apgar score and risk factors associated with transient tachypnea of the newborn.

Objective: To demonstrate the association between risk factors and abnormal glucosylated hemoglobin detected in women during the postpartum period., Patients and Methods: A case and control study was carried out at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca during six months. Glucosylated hemoglobin and glucose concentration from 160 fasting women with a pregnancy > or =28 weeks was obtained during the postpartum period. With an odds ratio and confidence interval (95%) the epidemiological meaning of risk factors was identified., Results: The abnormal glucosylated hemoglobin was significantly associated to: single, separated and divorced women (p < 0.05); major frequency of previous caesarean (OR: 2.78, IC 95%:1.25-6.22), p = 0.006, and higher proportion of children with congenital malformations (OR: 12, IC 95%: 1.38-104), p = 0.01. In the group cases 48% of caesareans was associated to probable gestational diabetes: moderate preeclampsia, eclampsia, fetal macrosomy, and preterm deliveries., Conclusion: It is necessary to make an early detection of risk factors associated to abnormal glucosylated hemoglobin and to prevent adverse effects as congenital malformations and clinical complications that increase the incidence of caesarean.

Objective: To identify the maternal risk factors associated with preterm birth., Material and Method: A case-control study of 158 preterm birth and 158 term newborns, was done from September to December 2002 in the Hospital Civil Dr. Juan I. Menchaca. Gestational age was determined with Capurro simplified method in > 29 week-babies and with last menstruation date in < 29 week-cases. The exposure was documented by a direct interview to the mother and clinical information of the clinical expedient. The association was measured with the odds ratios and confidence interval of 95%., Results: The frequency of preterm birth was of 3.4 percent of newborn alive, mortality was of 13%. The maternal risk factors associated with preterm birth were: multiple birth (OR: 12.61, IC 95: 3.6-53.0), illnesses during pregnancy (OR: 12.61, IC 95%: 3.6-53.0), premature rupture of amniotic membranes (OR: 7.06, IC 95%: 3.5-14.6), inadequate prenatal care (OR: 4.07, IC 95%: 2.1-7.8), urinary tract infections (OR: 3.20, IC 95%: 1.7-6.2), cervicovaginitis (OR: 2.45, IC 95%: 1.4-4.3) and low socioeconomic level (OR: 1.92, IC 95%: 1.2-3.1)., Conclusions: The association of maternal risk factors with preterm birth requires more study with special design.

Objective: To determine the prevalence of upper and lower neural tube defects and identify its association with the exposure to illnesses and drugs during pregnancy., Material and Methods: This is a case-control study of 107 newborns with upper neural tube defects, 59 with lower neural tube defects, and 166 newborns without malformations, in 56,926 consecutive births between 1989 and 1997. The exposure was documented by a direct interview to the mother of those subject of study. The association was measured by the odds ratios, with confidence interval of 95%., Results: The prevalence of upper neural tube defects was of 1.9 for 1,000 newborn (alive or dead) and of lower neural tube defects of 1.0 for 1,000. The exposure to illnesses of less than a month of duration was associated with upper neural tube defects (OR = 3.11; IC = 1.34-7.39) the most important was flu; also the exposure to drugs (OR = 5.85; IC = 2.97-11.62), the most prominent was acetaminophen. These factors of risk were not associated with lower neural tube defects. The mother's occupation, illness of more than a month of duration and X-ray exposure were not associated with of upper and lower neural tube defects., Conclusions: More studies are needed in the association among illnesses of less than a month of duration and drugs with upper neural tube defects. The different exposure frequencies between upper and lower neural tube defects suggest heterogeneity.

Objective: The purpose of the study is to determine the prevalence of polydactyly, its clinical characteristic and its association with some risk factors., Material and Methods: A retrospective, case-control study, of 45 newborn with polydactyly and their controls, in 26,670 consecutive births in the Nuevo Hospital Civil de Guadalajara, with 20 weeks or more of gestational age, and birth weight greater than 500 g, since November of 1988 to October of 1992. The information were obtained from the database of the Congenital External Malformation Register, carried out by the University of Guadalajara. The prevalence of polydactyly was obtained and clinical characteristic were documented. Continuous variables were compared using t Student test. For discrete variables, analysis were carried out using X2 test and the odds ratio., Results: The prevalence of polydactyly was of 1.73 x 1,000 alive newborn. The polydactyly of the hands in 26 newborn; preaxial in five and 21 was postaxial. The polydactyly in the foot was present in 19 newborn. The only statistics differences with control group were: low length and the antecedent of other malformation in the family., Conclusion: The found prevalence is different to the one informed in the literature. The association with antecedent of another malformation in the family, support the role of hereditary factors in etiology.

Objective: The purpose of this article is to determine the prevalence of the cleft lip and palate and its association with some risking factors., Material and Methods: A retrospective, observational and analytic study, of 44 newborn infants with cleft lip and palate and their controls, in 33,461 consecutive births, with 20 weeks or more, and birth weight more than 500 g, since November of 1988 to June of 1991. The information were obtained from the database of the Congenital External Malformation Register, done by the University of Guadalajara, in four hospitals. The prevalence of the cleft lip and palate was calculated. Of the variables studied their association was searched with congenital malformation in 2 x 2 tables, calculating, its chi square, confidence interval, and old ratio., Results: The prevalence of the cleft lip and palate was of 13.2 x 10,000 births. By categories: cleft lip 2.7 x 10,000, cleft lip and palate 7.8 x 10,000 and cleft palate 2.7 x 10,000. The only statistics differences with control group were the association with antecedent of other malformation in the family and methrorrague during pregnancy., Conclusions: The found prevalence is similar to the one informed in the literature, with some differences by categories. The association with antecedent of another malformation in the family, support the role of the hereditary role in the multifactorial etiology.