RESUMO
BACKGROUND: Pre-eclampsia (PE) is an important cause of morbidity and mortality in our country. OBJECTIVE: Evaluate if the administration of acetylsalicylic acid (ASA) at a low dose reduces its presence. METHODS: Comparative, cohort study. Pregnant women with risk factors for PE: Primigravidae, PE antecedent and twin pregnancy were included. Primigravidae and multigested with previous vascular pathology weren't included. Group 1: 150, 11 excluded, 80 mg ASA from week 20 at the end of pregnancy. Group 2: 150, without ASA. The presence of PE or gestational hypertension (HG) was monitored. General data and clinical controls were taken. Chi square and relative risk (RR) were calculated. RESULTS: Group 1: n = 139, 26 ± 5.6 years, 9% PE. Group 2: n = 150, 25.5 ± 5.6 years, PE 20% (p = 0.01), RR 0.47 (95% CI 0.19 - 0.87) (p = 0.01), attributable risk -0.11 equivalent to an absolute reduction of 11% for PE in group 1. CONCLUSIONS: Pregnant women with risk factor for PE who received ASA diminished the risk of developing PE in 50%.
INTRODUCCIÓN: los trastornos hipertensivos del embrazo son causa importante de morbilidad grave, discapacidad crónica y muerte entre las madres, fetos y recién nacidos, por lo que es necesaria la prevención de la preeclampsia (PE) en virtud de su alta morbimortalidad en México. OBJETIVO: evaluar si la administración de ácido acetilsalicílico (AAS) a dosis baja reduce la presencia de PE. MÉTODOS: estudio de cohorte, comparativo. Se incluyeron 300 mujeres embarazadas con factores de riesgo para PE: primigesta, antecedente de PE, embarazo gemelar. No se incluyeron las pacientes primigestas y multigestas con patología vascular previa. Grupo 1: 150, 11 excluidas, 80 mg AAS de semana 20 al final del embarazo. Grupo 2: 150, sin AAS. Se vigiló presencia de PE o hipertensión gestacional (HG). Se tomaron datos generales y controles clínicos. Se calculó Chi cuadrada y riesgo relativo (RR). RESULTADOS: grupo 1: 139, 26 ± 5.6 años, PE en 9%. Grupo 2: 150, 25.5 ± 5.6 años, PE 20% (p = 0.01). RR 0.47 (IC95%: 0.19 - 0.87) (p = 0.01), riesgo atribuible de -0.11 equivalente a una reducción absoluta del 11% para PE en grupo 1. CONCLUSIONES: en mujeres embarazadas con factores de riesgo para PE que recibieron AAS, disminuye de forma significativa el riesgo de probabilidad de desarrollar PE a menos de la mitad.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Pré-Eclâmpsia/prevenção & controle , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Aspirina/administração & dosagem , Feminino , Humanos , Gravidez , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate the effectiveness of the combination of ketoconazol 400 mg + clindamycin 100 mg for 6 days compared to ketoconazol 800 mg + clindamycin 100 mg in Candida vaginitis and bacterial vaginosis. MATERIAL AND METHODS: Patients aged 18-60 years, with clinical diagnosis of Candida vaginitis and vaginosis confirmed by culture of genital secretions were included. Patients were assigned at random to one of two treatment groups: group 1 was given ketoconazol 400 mg + clindamycin 100 mg during six days (K/C6D); group 2 received ketoconazol 800 mg + clindamycin 100 mg for three days + placebo during three days (K/C3D). Patients were evaluated at days 7 and 11 after initiating treatment, at day 11 culture of vaginal secretion was repeated; along with treatment and follow up period patients were asked to report presence of adverse events. RESULTS: Eighty-two patients were included, 41 in K/C6D group and 40 in K/C3D group. C. albicans was found at baseline in 19 patients in K/C6D group and in 15 in K/C3D group; at day 11 was cultured in 2/19 patients (10.52%) and in 2/15 (13.33%) (p = 0.626) respectively; G. vaginalis was cultured at baseline in 25 patients of each group, at day 11 was cultured in 1/25 patients (4.0%) of K/C6D group and in 4/ 25 (16.0%) of K/C3D group (p = 0.174). Clinical cure was found in 36/41 cases (87.8%) of K/C6D group and in 34/40 cases (85.00%) of K/C3D (p = 0.965) group. Only five patients presented adverse events, of which three were related to the treatment. CONCLUSION: Treatment of vaginitis and bacterial vaginosis with anyone of both formulations has the same clinical and microbiological effectiveness, and is well tolerated by the patient. The fact that K/C3D formulation is as effective as K/C6D has the advantage of shortening the treatment time of vaginal infections, and allows a better patient compliance.