Atención a los recién nacidos en 2009 y a sus madres en un centro de salud urbano de Zaragoza. Oportunidades de mejora Introduction: in recent years has significantly changed the composition of the population and the origin of users of Torrero La Paz Health Primary Care Center of Zaragoza This work aims to analyze the social data and attention of the RN and their mothers corresponding to area of health of Torrero La Paz and throughout the year 2009. Authors are especially interested on rates of prevalence of breastfeeding (LM), its evolution in time and its relationship with other variables. Another issue is to study the improvement opportunities that arise from the analysis of these data, as well as propose appropriate corrective measures. Finally authors pretend to set some criteria easily measurable quality which can serve as indicator of quality of care. Material and methods: we analyzed data from the health care received by 105 newborns and their mothers born during the year 2009 in a primary care center in the city of Zaragoza (Spain). We studied breastfeeding rates. It describes the opportunities for improvement by establishing corrective actions. Results: the first visit of newborn care to health primary care were done within 10 days of age. The percentage of breastfeeding or mixed feeding when they were discharged from the hospital was 85% and 51.9% at 6 months. In this population there was a caesarean section percentage was19.65% and the percentage of mothers who smoke during pregnancy 20.95% younger mothers and those from developing countries had higher rates of breastfeeding than spanish mothers. Children of lower birth weight and gestational age had comparatively lower rates of breastfeeding. Conclusion: corrective measures are proposed which fall within the context of measures called Baby friendly Iniciative for health primary care centers Introducción: en los últimos años ha cambiado considerablemente la composición de la población y la procedencia de los usuarios del Centro de Salud (CS) Torrero La Paz de Zaragoza. Este trabajo pretende analizar los datos sociosanitarios y de atención de los recién nacidos y de sus madres correspondientes a la zona de salud de Torrero La Paz a lo largo del año 2009. Los autores están especialmente interesados interesa en analizar las tasas de prevalencia de lactancia materna (LM) y su evolución en el tiempo, así como su relación con otras variables. Otra cuestión es estudiar las oportunidades de mejora que se plantean a partir del análisis de estos datos y de proponer las medidas correctoras adecuadas. Finalmente, se pretende, si es posible, fijar algún criterio de calidad fácilmente mesurable que pueda servir de indicador de calidad de la atención prestada. Material y métodos: se analizan los datos de la atención sanitaria recibida por 105 recién nacidos nacidos a lo largo del año 2009 y por sus madres en un CS de la ciudad de Zaragoza (España). Se estudian las tasas de LM. Se describen las oportunidades de mejora estableciendo medidas correctoras. Resultados: la...

Lameness in a 20 months girl, is it always a synovitis of the hip?La cojera o el dolor musculoesquelético es una consulta frecuente en la infancia. Su etiología es diversa y frecuentemente banal. En algunas ocasiones la cojera puede ser el síntoma inicial de procesos neoplá-sicos.Presentamos el caso de una lactante de 20 meses de edad que presentó una cojera de dos semanas de evolución. En la valoración inicial en Atención Primaria no se apreció patología de gravedad, se realizó una ecografía de caderas y fue diagnosticada de sinovitis transitoria. Tras un periodo de reposo relativo y antiinflamatorios no se apreció mejoría. Varias semanas después presentó dolor nocturno de extremidades de forma intermitente. Se realizó una analítica en la que se apreciaba una neutropenia. Ante la persistencia de la cojera, la presentación del dolor nocturno y la neutropenia, se procedió a derivar a la paciente al Servicio de Oncohematología de referencia donde se diagnosticó de leucemia linfoblás-tica aguda.Lameness or musculoskeletal pain is a frequent consultation in the infancy. Its etiology is diverse and frequently not severe. In some cases lameness can be the initial symptom of neoplasic processes. Caucasic woman aged 20 months who presented lameness of two weeks of evolution. In the initial evaluation in Health primary care center we didn't appreciate any severity process. An ultrasound scan of hips was realized and she was diagnosticated of transient sinovitis of the hip. After a period of relative rest and anti-inflammatory treatment medical staff didn't appreciate any improvement. Several weeks later she presented intermitent night pain in the legs. A blood sample was taken and discovered neutropaenia. Given the persistence of the lameness, night pain and neutropenia, paediatrician sent the patient to paediatric oncohematology department where the diagnosis of linfoblastic leukaemia was realized after bony marrow aspiration. Key words:Cómo citar este artículo: Traver Cabrera P, Miralbés Terraza S, Alquézar González A, Galbe Sánchez-Ventura J. Cojera en una niña de 20 meses, ¿es siempre una sinovitis de cadera? Rev Pediatr Aten Primaria. 2014;16:337-9. CASO CLÍNICOMujer caucásica de 20 meses de edad sin antecedentes familiares ni perinatales de interés. Tres meses antes del inicio del proceso actual, sufrió una estomatitis aftosa acompañada de fiebre alta y moderada afectación del estado general. Cuando acude a la consulta presenta, desde hace dos semanas, cojera intermitente de la extremidad izquierda. En la exploración no tiene limitación a la

Encuesta sobre las actitudes de los profesionales ante la lactancia materna Introduction: the Initiative of Child-Friendly Hospitals and Healthcare Centres (IHAN) aims at improving the quality of care provided by the different healthcare centres, whether they are hospitals or Primary Care clinics, with the purpose of improving the quality of mother-father interactions with the newborn, also improving the rates of breastfeeding (BF) and the overall wellbeing of families. The implementation of most of these measures requires the favourable attitudes of healthcare professionals, since they do not always require complex means or resources, and thus their establishment in hospitals and healthcare centres is more a matter of motivation than of costly investment. Material and methods: a survey was made of professionals involved in paediatric care to assess their attitudes towards BF. The survey was distributed online using the mailing lists of the Spanish Association of Primary Care Paediatrics (AEPap). Results: 431 questionnaires were collected, of which 70% were filled by paediatricians, 11% by midwives, 8% by family physicians and nurses, and 4% by other professionals. 63% of the total was aware of the IHAN initiative. 45% of the respondents had a written document about BF, and approximately 58.7% knows at least one BF support group. 32% set up the first appointment with the newborn for the first week of life. 62.5% recommend introducing complementary foods after six months. 82.5% recommends the use of non-pharmacological measures for pain management. 37% is aware of and uses the growth charts of the World Health Organization. The use of these charts has a positive correlation with the recommendation of introducing complementary foods at six months. Discusion: we did not find any correlation between the recommendation of introducing complementary foods before six months and having received funding from the breast milk substitute industry.

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