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R Closa Monasterolo

Publications and source records attributed to R Closa Monasterolo.

15 recordsLinked to original sources
PubMed2006

[The efficiency (cost-effectiveness) of palivizumab as prophylaxis against respiratory syncytial virus infection in premature infants with a gestational age of 32-35 weeks in Spain].

OBJECTIVES: To evaluate the efficiency (cost-effectiveness) of palivizumab in preventing severe respiratory syncytial virus (RSV) infection in premature infants with a gestational age of 32-35 weeks (GA 32-35) and two or more risk factors (RF) in Spain. METHODS DESIGN: decision tree model using data from the scientific literature and the FLIP I and FLIP II studies (cohort of 326 infants with GA 32-35 and two or more RF who received palivizumab) sponsored by the Spanish Society of Neonatology. Main effectiveness measure: quality-adjusted life years (QALY) gained. PERSPECTIVES: the national health service (NHS), which includes direct costs (administration of palivizumab and hospital admissions), and the societal perspective, which also includes indirect costs (the child's future lost productivity). Discount: 3 % annually for effectiveness and indirect costs. Sensitivity analysis: construction of 37 scenarios modifying variables related to effectiveness and costs. RESULTS: Prophylaxis with palivizumab in premature infants with GA 32-35 and two or more RF produced an incremental cost-effectiveness ratio (ICER) of 13,849 euro/QALY from the NHS perspective, and an ICER of 4,605 euro/QALY from the societal perspective. In the sensitivity analysis, from the NHS perspective the ICER ranged from 5,351 euro/QALY (most favorable scenario) to 23,276 euro/QALY (least favorable scenario). CONCLUSIONS: Palivizumab is a cost-effective therapy as prophylaxis against RSV in infants with GA 32-35 and two or more RF. Its use is efficient from the NHS perspective, since the cost of a QALY, even in the least favorable scenarios, is lower than the threshold of 30,000 Euro/QALY considered socially acceptable in Spain.

Antibodies, Monoclonal↗
PubMed2004

Onset of puberty at eight years of age in girls determines a specific tempo of puberty but does not affect adult height.

AIMS: To analyse the effect of early puberty (onset between 7.5 and 8.5 y) on pubertal growth and adult height in girls, and the implications of this effect for the age limit for normal onset of puberty. METHODS: Longitudinal study in Reus (Spain) of 32 girls with early puberty until they reached adult height. Data from these girls were compared with longitudinal data from girls (116) from the same population with normal onset at 10 (n = 37), 11 (n = 47), 12 (n = 19) and 13 (n = 13)y. We analysed height, target height, adult height, pubertal height increase, duration of pubertal growth, age at menarche and time to menarche. RESULTS: The adult height of girls with early puberty (160.9 +/- 5.4cm) was similar to that of girls with onset at later ages (p = not significant). In these girls, puberty lasted 5.4 +/- 0.7 y and the mean growth during puberty was 31.1 +/- 3.5 cm. As the age of onset of puberty increases, the duration of puberty and mean growth during puberty progressively decreased (p < 0.001). Girls with early puberty reached menarche at a mean age of 10.9 +/- 1.0 y, 3.2 +/- 0.9 y after onset of puberty, and this time span was greater than in the other groups. CONCLUSION: Girls with onset of puberty at 8 y show all the compensatory phenomena related to height at onset, pubertal duration and height increase during puberty. These phenomena cause their adult height to be similar to that of girls who begin puberty at the age of 10 to 13 y.

Adult↗
PubMed2002

[Myocardial stunning].

Explore the source record for details and available documents.

Cardiopulmonary Resuscitation↗
PubMed2001

[Transitory neonatal diabetes].

Transitory neonatal diabetes mellitus is a rare carbohydrate metabolism disorder that usually occurs between the ages of 2 days and 6 months. We report the case of an asymptomatic newborn treated with NPH insulin, in whom genetic study revealed an alteration associated with neonatal diabetes. The patient was a low birth weight infant born after 37 weeks' gestation to a previously childless mother with gestational diabetes controlled by diet. There were familial antecedents of diabetes. Physical examination revealed only syndactylia of the second and third toes. Asymptomatic hyperglycemia higher than 200mg/dl was detected on the second day of life. Treatment with regular subcutaneous insulin was started on the fourth day of life with irregular response. On the forty-first day of life treatment with NPH insulin was started with better response, permitting the reduction of regular insulin until its suppression 15 days later. Treatment with NPH insulin was stopped when the patient was 9 months old. During this time concentrations of insulin, cortisone, peptide C, insulin antibodies, anti-TPO, anti-TG, anti-GAD, anti-tyrosine-phosphatase and glycosylate hemoglobin were normal. Abdominal echography showed no abnormalities. Karyotype: 46 XX, der(6)dup(q22-q23) (long arm duplication of chromosome number 6).In conclusion, NPH insulin could provide an alternative to regular insulin in the treatment of transitory neonatal diabetes mellitus. Its association with genetic alterations could alter prognosis.

Diabetes Mellitus↗
PubMed1999

[An epidemiological analysis of bronchiolitis in the health region of Tarragona].

OBJECTIVE: The purpose of this study was to analyze the epidemiology of bronchiolitis in our area and to determine if changes in our medical installations have affected the course of this disease. PATIENTS AND METHODS: Infants less than 12 months of age with bronchiolitis that had been hospitalized between October, 1992 and January 1996 were studied retrospectively. The patients were divided into two groups; those attended in the old Pediatric Department and those seen in the new installations. RESULTS: In the first group, the majority of the thorax X-rays were normal and in the second air trapping was more frequently seen. The infants in the first group were admitted with a shorter evolution time and the mean hospitalization time was significantly higher (p < 0.05. IC = 95%: 1.68-3.62) than in the second group (7.7 +/- 3.75 vs. 5 +/- 3.36 days, respectively). In addition, this difference was even more significant (p < 0.05. IC = 95%: 1.22-4.38) if syncytial respiratory virus had been isolated (8.93 +/- 2.94 vs. 6 +/- 4.41 days, respectively). CONCLUSIONS: We did not find any epidemiological differences in our area in relationship to bronchiolitis during the past four years. We believe that the shorter hospitalization period in the second group could be attributed to working in the new facilities.

Bronchiolitis↗
PubMed1998

[Kangaroo method in delivery room for full-term babies].

OBJECTIVE: Our objective was to determine the tolerance to kangaroo care in the delivery room. PATIENTS AND METHODS: We have studied 651 normal full term newborn infants delivered in our hospital during an 8 month period. Immediately after birth, the newborn infants were dried and placed in skin-to-skin contact between their mother's breasts. They remained in kangaroo care in the delivery room, during transportation to the post-partum area and in their room as long as two hours. The kangaroo care duration, the infant's post-kangaroo care axillary temperature, the mother's and infant's attitudes and the type of newborn feeding were recorded. RESULTS: Of the patients studied, 533 (82%) were put in skin-to-skin contact and the kangaroo care lasted 49 +/- 23 min (mean +/- SD). Eighty-percent of the mothers had decided previously to breastfeed their child. The post-kangaroo care axillary temperature was > or = 36 degrees C in 96% of the newborns and it was proportional to the kangaroo care duration (r = 0.31, p < 0.0001; IC 95%; beta = 0.0038-0.0068). During kangaroo care, most of the mothers looked at their child and were happy, although 21% felt tired. Almost all infants (98.5%) stayed awake. The newborn infants who spontaneously did the first breastfeeding during the skin-to-skin contact remained more time in kangaroo care (60 +/- 22 vs 36 +/- 17 minutes; p < 0.0001). If the infant remained more than 50 minutes in kangaroo care, he had nearly 8 times more probability of breastfeeding spontaneously (odds ratio = 7.73; IC 95%: OR = 4.02-15.1). CONCLUSIONS: We recommend kangaroo care in the delivery room as a safe and well tolerated method for mothers and newborn infants which contributes to their well-being. In order to improve breastfeeding and the newborn's temperature, we recommend that the infant remains more than 50 minutes in kangaroo care.

Breast Feeding↗
PubMed1998

["Kangaroo method" in the care of premature infants admitted to a neonatal intensive care unit].

OBJECTIVE: More and progressively smaller preterm infants are taken out of the incubator and placed skin-to-skin (kangaroo care) on their mother's chest to promote bonding and breastfeeding. The aim of our study was to know the tolerance to kangaroo care and its security for preterm infants and their mothers, as well as its relationship to breastfeeding. PATIENTS AND METHODS: We studied 445 sessions of 38 stable preterm newborns in our Neonatal Intensive Care Unit (NICU). Their mean birth weight was 1,452 +/- 415 g and gestational age 31.5 +/- 2 weeks (mean +/- SD). The preterm infants, dressed in a diaper and cotton cap, were placed in skin-to-skin contact between their mother's breasts in an upright position and covered with a towel. The kangaroo care duration, temperature, heart rate, respiratory rate, StcO2, and the mother and infant behavioral responses were recorded. During kangaroo care, the preterm infants were nourished by their mother's milk directly by breastfeeding or by intermittent tube feeding, depending on their sucking reflex. The kangaroo care lasted 30-90 minutes, one to eight times a day depending on the availability of the mother. RESULTS: During the kangaroo care, body temperatures, heart rate, respiratory rate and StcO2 remained stable. In the majority of cases, In the majority of cases, the preterm infants showed conduct patterns that indicated good tolerance toward this method, including open hand, sleeping, alert tranquility and even smiles. The breastfeeding sessions were longer than normal because the premature infants alternated short periods of sucking with longer sleep periods. Mothers participated actively looking, talking, touching, smiling and even playing with their preterm infants. CONCLUSIONS: Kangaroo care is a safe and well-accepted method for preterm infants admitted to a NICU and their mothers. Intermittent kangaroo care does not allow for breastfeeding by demand, therefore with the smallest preterm infants, we are obligated to supplement feeding with the mother's milk by tube gavage.

Adult↗
PubMed1989

[Perinatal factors predicting hypoxic-ischemic encephalopathy in asphyxic newborn infants].

Between 1 May 1984 and 30 April 1985, 1,354 term or posterm neonates being white and having asphyxia in controlled delivery were studied to predict development of neurological signs and its seriousness. In each case correlations were estimated between the existence of neurological signs and its grade and 100 gestational, obstetric and neonatal factors of potential predictor. The discriminatory analysis indicated that the more significants predictors were: Apgar at five minutes, prolonged labor, twins, resuscitation, DIP I, cephalhematoma, caput succedaneum, umbilical artery pH, urgent cesarean section, hemorrhagic amniotic fluid, gestational edema, variable DIP, high forceps. A discriminatory value less than or equal to 2 predicts no neurological sign in 93.8%, while a value greater than or equal to 3 predicts moderate or serious signs is 98.4%.

Asphyxia Neonatorum↗
PubMed1988

[Pharmacokinetics of theophylline in children with acute asthmatic crisis].

In order to defined the theophylline dose which produce effective theophylline concentrations with less number of plasmatic controls, we analyzed the theophylline pharmacokinetics of 18 boys and girls between 3-12 year olds of Tarragona, to which we administered 6 mg/kg/6 h of aminophylline by IV intermittent infusion (30 min), following by rapid-release PO aminophylline at the same dose and intervals. In steady-state we did the pharmacokinetic studies at 1 h, 4 h and 6 h after the administration of one dose. The maintenance dose obtained was administered PO as slow-release theophylline, with later controls of theophylline concentration. We found that maintenance dose of 24.1 +/- 4.7 mg/kg/day (mean +/- SD) allowed theophylline concentration between therapeutic levels in the population studied.

Asthma↗