RESUMO
Introduction: To assess the association of medical nutrition therapy (MNT) consultations and eating behavior with gestational weight gain (GWG) in Mexican women with type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM).Material and methods: Cross-sectional study conducted at (Blinded for Review) from 2013 to 2014. Fifty-seven patients with T2DM or GDM were invited to participate. The dependent variable was GWG and the main independent variables were MNT and eating behaviors. Data were obtained from medical records or interviews. Multiple linear regression models were used to assess associations.Results: Per each additional MNT consultation, GWG was reduced by 1.2 kg (ß = -1.2; 95% CI: -2, -0.3; p = .007). After adjusting for age, in women with normal pregestational weight, for each unit, increase in the EE behavior index, there was a GWG increase of 2.8 kg (ß = 2.8; 95% CI: 1.2, 4.4; p = .003).Conclusions: This study reinforces the need for additional research to determine how eating behaviors are related to GWG during pregnancy. ClinicalTrials.gov Identifier: NCT03767699.
Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Ganho de Peso na Gestação , Terapia Nutricional , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Comportamento Alimentar , Feminino , Humanos , Gravidez , Aumento de PesoRESUMO
Direct (photo)electrochemical production of non-fossil fuels from water and CO2 requires water-oxidation catalysis at near-neutral pH in the presence of appropriate anions that serve as proton acceptors. We investigate the largely enigmatic structural role of anions in water oxidation for the prominent cobalt-phosphate catalyst (CoCat), an amorphous and hydrated oxide material. Co3([(P/As)O]4)2·8H2O served, in conjunction with phosphate-arsenate exchange, as a synthetic model system. Its structural transformation was induced by prolonged operation at catalytic potentials and probed by X-ray absorption spectroscopy not only at the metal (Co), but for the first time also at the anion (As) K-edge. For initially isostructural microcrystals, anion exchange determined the amorphization process and final structure. Comparison to amorphous electrodeposited Co oxide revealed that in CoCat, the arsenate binds not only at oxide-layer edges, but also arsenic substitutes cobalt positions within the layered-oxide structure in an unusual AsO6 coordination. Our results show that in water oxidation catalysis at near-neutral pH, anion type and exchange dynamics correlate with the catalyst structure and redox properties.
RESUMO
The venereal diseases bovine trichomoniasis (BT) and bovine genital campylobacteriosis (BGC) cause economic losses in endemic areas like La Pampa province in Argentina where beef cattle are usually extensively managed. This study used data compiled between 2007 and 2014 by a Provincial Program for the Control and Eradication of venereal diseases in order to develop and analyze retrospective models of time series for BT and BGC. Seasonality and long-term trend were explored with decomposition and simple regression methods. Autoregressive Integrated Moving Average models (ARIMA) were used to fit univariate models for the prevalence and persistence of BT and BGC. Autoregressive Integrated Moving Average with Explanatory Variable models (ARIMAX) were used to analyze the association between different time series, replacement entries and herd samplings. The prevalence and persistence of BT and BGC have decreased from 2007 to 2014. All the BT and BGC time series are seasonal and their long-term trend is decreasing. Seasonality of BT and BGC is similar, with higher rates of detection in autumn-winter than is spring-summer. Prevalence and persistence time series are correlated, indicating their changes are synchronic and follow a similar time pattern. Prevalence of BT and BGC showed the best fitting with the ARIMA (0,0,1)(0,1,1)12 model. While for persistence of BT and BGC, the best adjustment was with the same model with no seasonal difference where the current number of cases depends on the moving averages of the month and the previous season. Including covariates improve the fitting of univariate models, in addition, estimations using ARIMAX models are more precise than using ARIMA models. The time distribution of the samplings could be increasing the false negative ratio. According to the obtained results, the ARIMA and ARIMAX models can be considered an option to predict the BT and BGC prevalence and persistence in La Pampa (Argentina).
Assuntos
Infecções por Campylobacter/veterinária , Infecções Sexualmente Transmissíveis/veterinária , Tripanossomíase Bovina/epidemiologia , Animais , Argentina/epidemiologia , Infecções por Campylobacter/epidemiologia , Bovinos , Feminino , Masculino , Prevalência , Análise de Regressão , Estudos Retrospectivos , Estações do Ano , Infecções Sexualmente Transmissíveis/epidemiologia , Fatores de TempoRESUMO
Introducción: La preeclampsia es aún uno de los mayores problemas obstétricos en países en vías de desarrollo.Objetivo: Identificar los principales factores de riesgo para desarrollar preeclampsia en mujeres mexiquenses atendidas en el Hospital Materno Perinatal "Mónica Pretelini Sáenz".Material y métodos: Estudio de casos y controles, se incluyeron dos grupos, el grupo A casos (n=138) y el grupo B controles (n=276) con relación caso-control de 1:2.Los criterios de definición para los casos fueron: mujeres con diagnóstico inicial de preeclampsia y que cuenten con las siguientes mediciones: Tensión Arterial Sistólica (TAS)=140 ó Tensión Arterial Diastólica (TAD)=90 mmHg más una de las siguientes: concentración de proteínas en orina de 24 h =300 ó Proteinuria =++. El grupo de controles quedó conformado por mujeres que acudieron al hospital para atención del embarazo sin preeclampsia. Resultados: La media de edad fue de 27.5±8.0 para los casos (grupo A) y 25.3±6.7 para los controles (grupo B) (P<0.01). El tener 1 o más óbitos (P<0.045), las cifras iniciales y finales de TAS y TAD, el índice de masa corporal pregestacional (IMCPG), el peso al final del embarazo, y la hipertensión arterial sistémica crónica (P<0.01) así como el haber padecido preeclampsia en algún embarazo previo fueron estadísticamente significativo (P<0.01) para tener preeclampsia. Conclusiones: En nuestra población, además de los factores de riesgo tradicionales para preeclampsia se agrega el antecedente de óbitos como otro factor de riesgo para padecer preeclampsia.
Introduction: Preeclampsia is still a major obstetric problem in developing countries. Objective: To identify the main risk factors to develop preeclampsia in women from the State of Mexico attended at the Maternal Perinatal Hospital "MónicaPreteliniSáenz". Materials and methods: In this case-control study, two groups were included, group A patients (n = 138) and B controls (n = 276) with a case-control ratio of 1: 2. The criteria for defining cases were women initially diagnosed with preeclampsia and who had the following measurements: Systolic Blood Pressure (SBP) =140 or diastolic blood pressure (DBP) =90 mmHg plus one of the following: =300 protein concentration in a 24-h urine sample or proteinuria = ++. The control group was made up of women attended at the hospital who did not develop preeclampsia. Results: The mean age was 27.5 ± 8.0 years for the cases (group A) and 25.3 ± 6.7 years for controls (group B) (P <0.01). Having 1 or more stillbirth (P <0.045), initial and final measures of SBP and DBP, the pre-pregnancy body mass index (IMCPG), weight in late pregnancy, and chronic hypertension (P <0.01) as well as having had preeclampsia in a previous pregnancy were statistically significant (P <0.01) to have preeclampsia. Conclusions: In our population, in addition to the traditional risk factors for preeclampsia, history of stillbirthswas is another risk factor to develop preeclampsia.
Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Adulto Jovem , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/mortalidade , Estudos de Casos e Controles , Indicadores de Morbimortalidade , Estudos Transversais , Fatores de Risco , Morbidade , México/epidemiologiaRESUMO
El presente estudio tuvo como propósitos investigar sistemáticamente los factores actitudinales e interpersonales que inciden en el uso del condón en las relaciones sexuales coitales entre estudiantes de bachillerato, así como elaborar modelos estructurales que muestren las interrelaciones y los efectos directos e indirectos de dichos factores sobre la frecuencia del uso del condón. Participaron 527 adolescentes quienes reportaron haber tenido relaciones sexuales alguna vez en la vida. Se usó un cuestionario que mide prácticas sexuales y frecuencia del uso del condón durante los encuentros sexuales, así como 80 preguntas de tipo ordinal divididas en cinco factores: 1) asertividad sexual, 2) sumisión sexual, 3) baja percepción de riesgo sexual, 4) enamoramiento y 5) aceptación del uso del condón. Con el uso de ecuaciones estructurales, se trazaron modelos de trayectorias con los factores obtenidos y la frecuencia de uso de condón. Los modelos estructurales para hombres y para mujeres muestran niveles aceptables de ajuste a los datos así como efectos directos significativos entre todas las variables, específicamente se reporta el efecto directo de las variables de aceptación del uso del condón y asertividad sexual sobre la frecuencia del uso del condón. Estos resultados amplían las posibilidades de explicación e intervención psicosocial sobre la conducta sexual de riesgo entre adolescentes.
The purpose of this study was to systematically investigate the attitudinal and interpersonal factors that influence condom use in coital sex between high school students and to develop structural models that show the interrelationships and the direct and indirect effects of these factors on frequency of condom use. Participants were 527 adolescents who reported having consensual sex at least once in life. For this matter a questionnaire measuring frequency of sex and condom use during sexual encounters was used, also 80 ordinal questions divided into five factors: 1) sexual assertiveness, 2) sexual submission, 3) low sexual risk perception, 4) infatuation and 5) acceptance of condom use. Using structural equations trajectories and frequency of condom use were drawn. Structural models for men and women show acceptable levels of fitness to the data as well as significant direct effects between all the variables, specifically direct effect of variables acceptance on condom use and sexual assertiveness on the frequency of preservative use. These results extend the possibilities of explanation and psychosocial intervention on sexual risk behavior among adolescents.
RESUMO
OBJECTIVE: To determine the predictors of hypercholesterolemia and of hypertriglyceridemia during the first half of pregnancy in Mexican women. METHODS: Cross-sectional comparative study of pregnant women with less than 21 weeks of gestational age. MEASUREMENTS: Demographic information, obstetric history, prepregnancy body mass index, cholesterol and triglycerides. Cross tabulations and multiple logistic regression were used for statistical analysis. RESULTS: 230 participants; 61 women with normal prepregnancy body mass index, 108 with overweight, and 61 with obesity. Dyslipidemia was defined as elevated cholesterol (>180 mg/dL) or triglycerides (>170 mg/dL). After adjusting by potential confounders, independent predictors of hypercholesterolemia included being overweight (OR=2.8, 95% CI 1.4-5.9), being obese (OR=3.7 95% CI 1.6-8.4) or being on the second trimester of pregnancy. The same predictors were found for hypertriglyceridemia, respectively OR=2.8, 95% CI 1.4-5.6, OR=2.9, 95% CI 1.3-6.5, OR=2.6, 95% CI 1.4-4.7. CONCLUSION: Mexican women with prepregnancy overweight or obesity have greater risk of suffering hypercholesterolemia and hypertriglyceridemia during pregnancy. Women in the second trimester had higher levels of both lipids as compared to the first one. This is the first Mexican study that confirms the increase of lipids as gestational age progresses.
Objetivo: Determinar los predictores de hipercolesterolemia y de hipertrigliceridemia durante la primera mitad del embarazo en mujeres Mexicanas. Métodos: Estudio transversal comparativo de mujeres embarazadas con menos de 21 semanas de edad gestacional. Mediciones: información demográfica, historia obstétrica, índice de masa corporal pregestacional, niveles sanguíneos de colesterol y triglicéridos. Se usaron tabulaciones cruzadas y regresión logística múltiple en el análisis estadístico. Resultados: 230 participantes; 61 mujeres con índice de masa corporal pregestacional normal, 108 con sobrepeso, y 61 con obesidad. Dislipidemia se definió como elevación de colesterol (>180 mg/dL) ó triglicéridos (>170 mg/dL). Después de ajustar con potenciales variables de confusión, los predictores independientes de hipercolesterolemia incluyeron sobrepeso (OR=2.8, 95% CI 1.4-5.9), obesidad (OR=3.7 95% CI 1.6-8.4) o estar en el segundo trimestre del embarazo. Los mismos predictores se encontraron para hipertrigliceridemia, respectivamente: OR=2.8, 95% CI 1.4-5.6, OR=2.9, 95% CI 1.3-6.5, OR=2.6, 95% CI 1.4-4.7. Conclusión: Mujeres Mexicanas con sobrepeso u obesidad pregestacional tienen mayor riesgo de presentar hipercolesterolemia e hipertrigliceridemia durante el embarazo. Mujeres en el segundo trimestre tuvieron niveles más altos de ambos lípidos comparando con el primer trimestre. Este es el primer estudio Mexicano que confirma el incremento de lípidos conforme la edad gestacional progresa.
Assuntos
Hiperlipidemias/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Lipídeos/sangue , México , Obesidade/complicações , Sobrepeso/complicações , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Fatores de Risco , Triglicerídeos/sangue , Adulto JovemRESUMO
Pregnancy presents a large number of metabolic adaptations and requirements of micro and macronutrients could be increased, which are not always covered by the diet making necessary to supplement some of them. The micronutrients are an important part of metabolic reactions and both; their deficiency as their excess could participate in damage to organs and tissues of the mother and the fetus. Actually the hypertension pregnant states (HPS) participate in the leading causes of death during pregnancy, making necessary the search for interventions to prevent or reduce the consequences.The oxidative stress levels are linked with the risk to develop HPS, which has created assumptions about the use of micronutrients with antioxidant power and its possible role as protectors in these pathologies, however, the information is still uncertain and the metabolic action of the use of micronutrients supplementation is not precisely known because some micronutrients have shown a protective effect on the development of HPS. It is necessary to evaluate the nutritional status before and during pregnancy, as well to realize more studies about it and strengthen public policies about the use of micronutrients during the pregnancy.
Assuntos
Suplementos Nutricionais , Hipertensão Induzida pela Gravidez/dietoterapia , Micronutrientes/uso terapêutico , Feminino , Humanos , GravidezRESUMO
BACKGROUND: pharmaceutical forms (presentations) influence treatment compliance and therefore the effectiveness. Here we present the results in the relief of vaginitis and vaginosis with two different dosage forms. OBJECTIVE: To compare the efficacy and safety of a combination of ketoconazole 800 mg + clindamycin in soft vaginal gel capsules 100 mg (vaginal capsules) against ketoconazole 800 mg + 100 mg clindamycin vaginal tablets (TV) in the management of vaginitis by C. albicans and/or vaginosis. MATERIAL AND METHOD: In a randomized, multicenter, comparative open label study, patients between 18 and 60 years with a diagnosis of vaginitis by C. albicans and/or vaginosis were included. Patients were evaluated clinically and direct exam of genital discharge and culture were performed. Patients were randomized to one of two treatments vaginal tablets or vaginal capsules, for 3 days. RESULTS: one hundred an sitxty nine patients were included, 85 in TV Group and 84 in vaginal capsules group. We found significant statistical difference in clinical response for tablet group at day three for burning p = 0.032 and itching p = 0.043. Microbiological cure was observed in patients with vaginitis by C. albicans, 92.5% in Group TV vs. 90.47% vaginal capsules group, all patients with G. vaginalis at baseline were negative for the organism at the end of the study, cure in patients with mixed infections were 78.94% for TV group vs. 78.26% vaginal capsules; group no adverse events were reported during treatment. CONCLUSIONS: Treatment of vaginitis/vaginosis with vaginal tablets is clinically better than vaginal soft gelatin capsules both treatments were well tolerated.
Assuntos
Infecções por Actinomycetales/tratamento farmacológico , Candidíase Vulvovaginal/tratamento farmacológico , Clindamicina/uso terapêutico , Gardnerella vaginalis , Cetoconazol/uso terapêutico , Mobiluncus , Vaginose Bacteriana/tratamento farmacológico , Infecções por Actinomycetales/complicações , Infecções por Actinomycetales/microbiologia , Administração Intravaginal , Adolescente , Adulto , Candida albicans/efeitos dos fármacos , Candida albicans/isolamento & purificação , Candidíase Vulvovaginal/complicações , Candidíase Vulvovaginal/microbiologia , Cápsulas , Clindamicina/administração & dosagem , Quimioterapia Combinada , Feminino , Gardnerella vaginalis/efeitos dos fármacos , Gardnerella vaginalis/isolamento & purificação , Humanos , Cetoconazol/administração & dosagem , Pessoa de Meia-Idade , Mobiluncus/efeitos dos fármacos , Mobiluncus/isolamento & purificação , Aceitação pelo Paciente de Cuidados de Saúde , Comprimidos , Vaginose Bacteriana/complicações , Vaginose Bacteriana/microbiologia , Adulto JovemRESUMO
Quinientos cincuenta y cuatro niños de población general, de 8 a 12 años, respondieron a la Escala de Ansiedad para Niños de Spence en español (SCAS), al ITA-UNAM, que mide ansiedad y al CES-D, que mide depresión. Se investigó si se confirmaba el modelo estructural de la SCAS hallado por Spence. Mediante análisis confirmatorio, se probaron dos modelos: uno de 38 ítems y otro de 32 ítems, ambos con 6 factores relacionados, englobados bajo un factor de orden superior de ansiedad general. El modelo de 38 ítems se ajustó razonablemente, confirmando el encontrado por Spence. Pero, el modelo de 32 ítems ajustó mejor. Ambos coinciden con los trastornos de ansiedad más comunes clasificados por el DSM-IV-R. Los análisis psicométricos adicionales refuerzan la validez de constructo de la SCAS y muestran una consistencia interna aceptable.
Five hundred and fifty four school children, 8 to 12 years of age, completed the Spanish version of the Spence Children's Anxiety Scale (SCAS), the ITA-UNAM, which measures anxiety in children, and the CES-D measuring depression. The study investigated the structural model of the SCAS found by Spence. Two models were tested using confirmatory factor analysis: one 38-item and a second 32-item model, both involving 6 related first-order factors loading in a higher-order factor. The 38-item model provided a reasonably good fit, confirming the one reported by Spence. However, the second model provided the best fit of the data. Both models coincide with the most common anxiety disorders classified by the DSM-IV-TR. Further psychometric analyses reinforced construct validity of the SCAS and showed acceptable internal consistency.
RESUMO
resumen está disponible en el texto completo
SUMMARY Introduction: Childrearing or parenting is the assumption of responsibility for the emotional, social and physical growth and development of a child. Research literature has identified three related components commonly associated to rearing or parenting: a) spontaneous emotions and attitudes that are non-goal directed parental behaviors such as gestures, changes in the tone of voice, temperamental bursts, body language; b) specific goal-directed parental practices, which are better understood in the context of a socialization domain (academic achievement, peer cooperation), and c) the value system and beliefs of parents related to socialization goals of their children. Based on sound empirical data, there is no doubt about the impact of child-rearing environments on a wide variety of outcomes, ranging from normal variations of adaptive functioning and school success to an array of psychopathological results such as drug abuse, aggressive behavior, and anxiety in children and adolescents. During adolescence, parenting implies the transformation of the relationships between parents and children. This is a critical transition period in which the emerging social demands turn it into a particularly vulnerable period of life. Psychological distress that arises in adolescents may threaten their mental health on a medium and long term-basis. Based on an exhaustive literature study related to the parentchild relationship and the shared family environment, Repetti et al. suggest that conflict, lack of cohesion and organization, as well as unsupportive, cold and neglectful environments, were characteristic of families in risk of developing physical and mental problems. Adolescent studies provided evidence related to alcohol and drugs abuse, involvement in pregnancy, aggressive behaviour and delinquency as outcomes for children from families lacking cohesion and orderliness, as well as emotional warmth, support and involvement in parenting. Thus, it is important to rely on instruments that measure parenting and whose dimensions have proven to be relevant to the outcomes evaluated. One empirically evaluated instrument, in terms of internal consistency, construct validity, and convergent and divergent validity in transcultural context, is the Egna Minnen Betraffande Uppfostran-My memories of upbringing (EMBU). It has been extensively used and adapted in more than 25 countries, including Spanish-speaking populations from Guatemala, Venezuela and Spain. Factor analyses have revealed four factors (emotional warmth, rejection, control/overprotection and favouring subject), and multiple studies have documented the validity, reliability and cross-national transferability of the EMBU. Criticism regarding the retrospective nature of the EMBU has been overcome by designs with younger samples confirming its cross-stability for all scales except favouritism scale. There is a lack of instruments measuring parenting in Spanishspeaking countries. It is imperative to evaluate parental perceptions with adolescents as the source of information. There is, therefore, a need to empirically evaluate a reliable and valid parenting measurement, whose relational nature dimensions (warmth/rejection, control) can also be compared with those found in other countries. The purpose of the present study was to explore the psychometric properties of the EMBU-I in a sample of Mexican adolescents. In particular, its aim was to test the reliability (internal consistency), the congruency of the dimensions for fathers and mothers and within the scales comprising the EMBU, and its convergent and divergent validity. Method: Seven hundred seventy five adolescents, with a mean age of 13.81 years, from two secondary schools, one public and one private, participated in the study. Instruments: EMBU-C, parental involvement in studies scale, and the cohesion, conflict and organization scales from the FES. All of them showed reliability values above .50. Results: Emotional warmth, rejection, and control showed evidence of good internal consistency (Cronbach's alphas above or equal .65), except favoritism, in agreement with previous studies. Correlation between both scales, for father and mother (emotional warmth, rejection and control) was positive and high. Negative correlations were found between emotional warmth and rejection, as expect. Interestingly, perception of father control positively correlated with warmth, whereas perception of mother control was higher loaded on rejection than in warmth. The multiple correlation analysis of each scale of the EMBU and the other instruments were as follows: warmth in both parents correlated positively with organization and cohesion in family and rejection, again in both parents, also correlated with conflict. Warmth and control for father, as well as for mother, correlated with parental involvement in studies, but stronger correlations were documented in the case of perception of father's involvement. For mothers, cohesion and organization showed a tendency to correlate higher with involvement in studies. Results support the convergent validity of the scales. Evidence for the divergent validation was provided through the negative correlations found between warmth and conflict. This was also true for cohesion and organization, with regard to rejection. As expected, rejection also showed a negative correlation with parental involvement in studies. In agreement with other studies, the present study corroborates internal consistency in Mexican adolescents, as well as convergent and divergent validity of the EMBU-C scales of emotional warmth, rejection and control. A finding of this study was the different correlation tendency found between the dimension of control for fathers and mothers, suggesting that control in fathers is perceived more as warmth than rejection, in contrast to other studies. Also warmth and control, again in the fathers' case, correlated higher with involvement in studies. This finding is in agreement with Youniss and Smollar, whose findings suggest a differential perception of fathers and mothers, especially in early adolescence. Mexican boys and girls tend to perceive fathers with more deference and as advisors or instructors. Although the risky families' construct has a wider perspective, it is also important to evaluate separately the family unit with regard to the adolescent-parent relationship because intervention strategies are different. According to adolescent perception, parenting dimensions related to emotional climate are notably related to other parental components, such as parental involvement in school or family cohesion and organization. Psychometric properties of EMBU-C were acceptable in terms of reliability and validity. It proved to be a useful tool for future studies, purported to evaluate adolescent perception of parental childrearing. Future studies should provide further data on test-retest reliability, confirmatory factor analyses testing the three factor resolution found in previous studies and on its convergent validity. Limitations of the present study arise from the sample of students and its socioeconomic or demographic restrictions. Future studies could overcome the fact that data come only from one source, i.e., children. Concurrent validity comparing EMBU-C with other parenting indicators is also needed.
RESUMO
INTRODUCTION: Vasoconstriction is a major pathophysiologic finding in preeclampsia due to hyperactivity of the sympathetic nervous system and a consequent increase in concentration of plasmatic catecholamine. Thus, vasodilatation produced by secondary sympathetic block to lumbar epidural blockade favors control of high blood pressure in patients with severe preeclampsia. OBJECTIVE: Our objective was to evaluate whether lumbar epidural blockade with bupivacaine 0.25% decreases high blood pressure of patients with severe preeclampsia within a lapse of 6 h in comparison with customary antihypertensive treatment. MATERIAL AND METHODS: An open, randomized, controlled trial was carried out in 24 pregnant patients with 30 weeks of gestational age or more and diagnosis of severe preeclampsia who entered the Intensive Care Uni of the IMEIM Hospital of Gynecology and Obstetrics for hemodynamic stabilization and resolution of pregnancy. Group 1 (n = 12) was managed with customary antihypertensive treatment and group 2 (n = 12), with lumbar epidural blockade and bupivacaine 0.25%: 10 mg in bolus and 5 mg/h continuous epidural infusion. Patients were monitored non-invasively and with continuous clinical monitoring with MAP, SAP, and DAP during 6 h. Statistical analysis employed consisted of ANOVA measurement repeats. RESULTS: In MAP and SAP, there were no significant differences between the two groups; DAP in first and second h of treatment had significant differences between the two groups (p value of < or = 0.05). CONCLUSIONS: Lumbar epidural blockade with bupivacaine 0.25% can be used as a therapeutic alternative in high blood pressure control in patients with severe preeclampsia during the the first 6 h of hemodynamic stabilization.
Assuntos
Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Pré-Eclâmpsia/tratamento farmacológico , Adulto , Anestesia Epidural , Anestésicos Locais/efeitos adversos , Determinação da Pressão Arterial , Bupivacaína/efeitos adversos , Feminino , Humanos , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/fisiopatologia , Gravidez , Estudos Prospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To determine the relationship between erythrocyte deformations and preeclampsia-eclampsia syndrome before presentation of the triad high blood pressure-edema-proteinuria. MATERIAL AND METHODS: Aleatory study. A total of 308 patients were studied without evidence of preeclampsia, with negative erythrocyte deformation smear, between 12 and 18 weeks of pregnancy. Monthly laboratory samples were performed including arterial blood pressure monitorization, weight, and periphery blood smear considered as positive with presence of 50% of morphologic changes of erythrocyte (equinocyte) deem in 10 fields, with light microscopic and oil immersion at 100X. Statistical studies were performed to determine relative risk (RR), sensitivity (S), and specificity (E), and positive and negative predictive values. RESULTS: A total of 308 patients were studied; 36 patients (100%) had a positive smear, nine (25%) had preeclampsia. Erythrocyte deformation was seen at between 22 and 26 weeks of pregnancy in all patients before onset of high blood pressure, edema, and proteinuria; of 27 patients with positive smear who did not present preeclampsia (75%), five had thrombocytopenia, of five had edema and increased weight, and 17 were normal with normal vaginal delivery. A total of 267 patients who had negative smear until the end of pregnancy (98%), five (2%) had preeclampsia (sensitivity = 64%, specificity = 90%, VP+ = 25%, VP- = 98%, RR = 13.6%). CONCLUSIONS: There is a close relationship between erythrocyte deformations with onset of preeclampsia-eclampsia syndrome prior to presentation of the triad high blood pressure-edema-proteinuria.
Assuntos
Pré-Eclâmpsia/sangue , Estudos de Coortes , Feminino , Humanos , GravidezRESUMO
Los autores presentan un caso de Distrofia Endoepitelial en una señora de 65 años en la que la manifestación biomicroscópica está dada por un aspecto, no descrito en la literatura, de rejilla, bilateral y simétrica, con localización en la menbrana de Descemet. Los autores discuten sobre el concepto y clasificación de las Distrofias Corneales, así como sobre la etiopatogenia. Finalmente sugieren la posibilidad de que tanto las Distrofias Endoteliales Congénitas Hereditarias así como las Distrofias Polimorfas Posteriores y las Distrofias de Fuchs no son sinó también variantes de un mismo estado distrófico cuya etiología aún nos es desconocida