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Objective: To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis., Methods: Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a "sham procedure" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay., Results: The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days., Conclusion: The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.

The routing algorithm is one of the main factors that directly impact on network performance. However, conventional routing algorithms do not consider the network data history, for instances, overloaded paths or equipment faults. It is expected that routing algorithms based on machine learning present advantages using that network data. Nevertheless, in a routing algorithm based on reinforcement learning (RL) technique, additional control message headers could be required. In this context, this research presents an enhanced routing protocol based on RL, named e-RLRP, in which the overhead is reduced. Specifically, a dynamic adjustment in the Hello message interval is implemented to compensate the overhead generated by the use of RL. Different network scenarios with variable number of nodes, routes, traffic flows and degree of mobility are implemented, in which network parameters, such as packet loss, delay, throughput and overhead are obtained. Additionally, a Voice-over-IP (VoIP) communication scenario is implemented, in which the E-model algorithm is used to predict the communication quality. For performance comparison, the OLSR, BATMAN and RLRP protocols are used. Experimental results show that the e-RLRP reduces network overhead compared to RLRP, and overcomes in most cases all of these protocols, considering both network parameters and VoIP quality.

Introduction: The macronutrient concentrations of human milk could be influenced by the various processes used in human milk bank., Aims: To determine the effect of various process (Holder pasteurization, freezing and thawing and feeding method) on the macronutrient concentration of human milk., Methods: The samples of donated fresh human milk were studied before and after each process (Holder pasteurization, freezing and thawing and feeding method) until their delivery to newborn infants. Fifty-seven raw human milk samples were analyzed in the first step (pasteurization) and 228 in the offer step. Repeated measurements of protein, fat and lactose amounts were made in samples of human milk using an Infrared analyzer. The influence of repeated processes on the mean concentration of macronutrients in donor human milk was analyzed by repeated measurements ANOVA, using R statistical package., Results: The most variable macronutrient concentration in the analyzed samples was fat (reduction of 59%). There was a significant reduction of fat and protein mean concentrations following pasteurization (5.5 and 3.9%, respectively). The speed at which the milk was thawed didn't cause a significant variation in the macronutrients concentrations. However, the continuous infusion delivery significantly reduced the fat concentration. When the influence of repeated processes was analyzed, the fat and protein concentrations varied significantly (reduction of 56.6% and 10.1% respectively) (P<0.05). Lactose didn't suffer significant reductions in all steps., Conclusion: The repeated processes that donor human milk is submitted before delivery to newborn infants cause a reduction in the fat and protein concentration. The magnitude of this decrease is higher on the fat concentration and it needs to be considered when this processed milk is used to feed preterm infants., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Ethnopharmacological Relevance: Ethnopharmacological survey indicated leaves of Byrsonima fagifolia Nied. (Malpighiaceae) against gastrointestinal disorders., Aim of the Study: The methanolic extract from the leaves of Byrsonima fagifolia (denominated BF) was evaluated for toxic, mutagenic, gastroprotective, antidiarrheal, antibacterial and immunomodulatory activities., Materials and Methods: The preventive and healing action of BF against gastric ulcer was evaluated in experimental models in rodents. We evaluated immunomodulatory (by murine peritoneal macrophages), antidiarrheal (by induced diarrhea with castor oil and intestinal motility) and antibacterial action of BF against standard strain of Escherichia coli, Staphylococcus aureus and Helicobacter pylori. The safety of use of BF was also evaluated by mutagenic (Ames assay) and by analyses of toxicity parameters., Results: Phytochemical BF profile indicated the presence of phenolic compounds with antioxidant and radical-scavenging properties. BF significantly inhibited gastric lesions induced by ethanol and HCl/ethanol and endogenous mucosal sulphydryl groups (SHs) participated efficaciously in BF gastroprotection. BF blocked development of inflammation process and also has antidiarrheal actions. This extract accelerated the healing of the gastric ulcerated mucosa by stimulating proliferative factors and by increasing production of gastric mucus with no toxic action. The substances responsible for the protective action are concentrated in the ethyl acetate fraction that demonstrated no mutagenic action in vitro., Conclusions: Byrsonima fagifolia presents gastroprotective, healing and antidiarrheal activities supporting previous claims that its traditional use by Brazilians can treat these gastrointestinal ailments.

Objective: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight., Methods: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding., Results: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05)., Conclusion: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.

Unlabelled: To assess if sensory-motor-oral stimulation and non-nutritive sucking gavage feeding enhances the oral feeding performance of preterm infants born between 26 and 32 weeks of gestational age., Study Design: Very low birthweight infants (n=98) were randomized into a experimental and control group. Preterm infants in the experimental group received sensory-motor-oral stimulation and non-nutritive sucking and infants in the control group received a sham stimulation program. Both were administered from when they reached enteral diet (100 kcal/kg/day) until the beginning of oral diet. Primary outcome was length of hospital stay., Results: Independent oral feeding was attained significantly earlier in the experimental group than the control group, 38+/-16 days of life (mean+/-S.D.) versus 47+/-17 days of life, respectively (P<0.001) There was significant difference in length of hospital stay between the two groups (41.9+/-17 (mean+/-S.D.) versus 52.3+/-19 days (P<0.01))., Conclusion: Sensory-motor-oral stimulation, together with early non-nutritive sucking (as soon as the newborn reaches full diet and is clinically stable) in very low birthweight preterm infants, as long as they are clinically stable, in this study, earlier initiation of oral feeding and earlier hospital discharge.

Objective: To evaluate and compare the energy content in fresh and processed human milk administered to very low birth weight infants born in the Institute Fernandes Figueira., Methods: Samples of 0.5 ml of fresh and processed human milk were evaluated as for the fat percentile and energy content, which was calculated by mathematical formulas. Four hundred and sixty two human milk samples were analyzed, 401 of processed human milk and 61 of fresh human milk., Results: The median and the standard deviation of the fat percentile checked was 2.9+/-1.2% in the processed samples and 8.9+/-4.6% in the fresh samples (p < 0.001). The median and the standard deviation of the energy content calculated was 53.6+/-7.2 kcal/100 ml in processed samples and 85.9+/-27.9 kcal/100 ml in fresh samples (p < 0.001)., Conclusion: The processed human milk samples had less energy content and less fat than fresh human milk samples suggesting that the complex processes of the human milk manipulation and administration can determine losses in energy content.