Complicaciones perinatales asociadas con la ganancia excesiva de peso durante el embarazo / Perinatal outcomes associated to overweight gain during pregnancy in women at a regional hospital in northwest of Mexico

Resumen OBJETIVO: evaluar la asociación entre la ganancia de peso durante el embarazo y las complicaciones perinatales: enfermedad hipertensiva del embarazo, diabetes gestacional, cesárea de urgencia y macrosomía fetal. MATERIALES Y MÉTODOS: estudio de casos y controles anidados en una cohorte de pacientes que recibieron control prenatal y atención del parto en el Hospital General Regional del Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora. Los momios se calcularon según las complicaciones perinatales, el índice de masa corporal pregestacional y la ganancia total de peso durante todo el embarazo. RESULTADOS: se seleccionó una cohorte de seguimiento de 714 pacientes de las que solo se estudió a 426 que, a su vez, se dividieron en dos grupos de 213 cada uno: de casos y controles. En el grupo de casos la frecuencia de obesidad fue de 17.6% (n = 55) y 40.3% (n=126) de sobrepeso. En el grupo control 6.7% (n=21) de obesidad y 50.8% (n=159) en los controles. En comparación con las pacientes con peso pregestacional normal, no se observó riesgo significativo de complicaciones perinatales en las pacientes con sobrepeso previo a la gestación (RM=0.79, IC 95%: 0.57-1.11, p=0.189). En las pacientes con obesidad pregestacional se observó un riesgo significativo (RM=2.63, IC 95%: 1.51- 4.60, p=.001). CONCLUSIONES: la ganancia de peso a lo largo del embarazo, superior a la recomendada, es un factor riesgo significativo de complicaciones perinatales, independiente del peso previo a la gestación.

Abstract OBJECTIVE: To evaluate the association between weight gain during pregnancy and perinatal complications: hypertensive pregnancy disease, gestational diabetes, emergency cesarean section and fetal macrosomia. MATERIALS AND METHODS: Nested case-control study in a cohort of patients who received prenatal care and delivery care at the Regional General Hospital of the Mexican Social Security Institute of Ciudad Obregon, Sonora. The odds were calculated according to perinatal complications, pregestational body mass index and total weight gain throughout pregnancy. RESULTS: A follow-up cohort of 714 patients was selected, of whom only 426 were studied, which in turn were divided into two groups of 213 each: cases and controls. In the group of cases the frequency of obesity was 17.6% (n=55) and 40.3% (n=126) of overweight. In the control group 6.7% (n=21) of obesity and 50.8% (n=159) in controls. Compared with patients with normal pregestational weight, no significant risk of perinatal complications was observed in pre-gestational overweight (OR=0.79, CI 95%: 0.57-1.11, p=0.189). A significant risk was observed in patients with pregestational obesity (OR=2.63, CI 95%: 1.51- 4.60, p=.001). CONCLUSIONS: Weight gain during pregnancy, higher than recommended, is a significant risk factor for perinatal complications, independent of pre-gestational weight.

Neuroprotección por ácido valproico y cambios en la expresión de Bcl-2 y caspasa-3 activada en ratas sometidas a isquemia/reperfusión / Neuroprotective action of valproic acid accompanied of the modification on the expression of Bcl-2 and activated caspase-3 in the brain of rats submitted to ischemia/reperfusion

El ácido valproico, que además de ser un conocido antiepiléptico, una serie de trabajos en los últimos años lo proponen como un agente neuroprotector. En éste trabajo se investigó primeramente, si el ácido valproico protege a las neuronas del daño producido por el estrés oxidativo inducido por la isquemia-reperfusión en el cerebro de ratas sanas sometidas a la oclusión transitoria de la arteria cerebral media derecha; en segundo lugar, se indagó si este fármaco induce cambios en la expresión de Bcl-2 y caspasa 3-activada como un posible mecanismo de acción sobre la muerte celular del tipo apoptótico. La evaluación neurológica de los animales que fueron sometidos a isquemia/reperfusión y recibieron ácido valproico fue mejor que los que no lo recibieron. Por otro lado, los niveles de malondialdehído en el hemisferio cerebral derecho en las ratas tratadas con ácido valproico fueron inferiores a los del mismo hemisferio del grupo control, mientras la cantidad de proteínas carboniladas se redujeron un 67% en comparación al grupo control. Además, se encontró por western blot, que en homogeneizados de tejido cerebral de los animales sometidos a isquemia/reperfusión y que recibieron ácido valproico, hubo un aumento significativo de la densidad de las bandas correspondientes a Bcl-2 y una disminución de caspasa 3-activada en comparación a los que no fueron tratados con este fármaco. Se concluye que el tratamiento con ácido valproico previno el déficit neurológico en ratas sanas sometidas a isquemia-reperfusión, bloqueando el efecto de los radicales libres sobre lípidos y proteínas de la corteza cerebral afectada y se sugiere que posiblemente este fármaco interviene en la muerte por apoptosis inducida durante este tipo de lesión, pudiendo ser una alternativa terapéutica en el tratamiento de la isquemia cerebral.

Valproic acid, apart from being known as an anti-epileptic drug, has been proposed in the past few years, as a neuroprotective agent. The purpose of this study was to investigate firstly, if valproic acid protects the neurons from the damage produced by oxidative stress induced by ischemia-reperfusion in the brain of healthy rats, under the transitory occlusion of the right middle cerebral artery. Secondly it was studied if this antiepileptic drug induces changes on the expression of Bcl-2 and activated caspase-3 as a possible mechanism of action on apoptosis. The neurological evaluation of the animals that were subject to ischemia-reperfusion and received valproic acid was better than the ones who didn’t receive it. On another subject, the levels of malondialdehyde on the right cerebral hemisphere in the rats treated with valproic acid were below the levels of the control group in the same hemisphere, whereas the amount of carbonylated proteins was reduced by 67% compared to the control group. Besides, it was found by western blot, that in homogenized brain tissue of the animals under ischemia-reperfusion which received valproic acid, there was a rise on the density of the bands corresponding to Bcl-2, and a reduction of activated 3-capase in comparison to the ones who were not treated with the antiepileptic drug. It’s concluded that the treatment with valproic acid prevented the neurological deficit in healthy rats under Ischemia-reperfusion, blocking the effect of free radicals on lipids and proteins of the affected brain cortex, and it is suggested that the same drug intervenes on apoptosis induced during this type of damage, being able to be a therapeutic alternative in the treatment of cerebral ischemia.

Efecto de las poblaciones de Alabama argillacea (Hübner) (Lepidoptera: Noctuidae) en cultivos de algodón a dos distanciamientos / Effect of the populations of Alabama argillacea (Hübner) (Lepidoptera: Noctuidae) on cotton crop at two sowing distances

The objective of this research was to evaluate the incidence of damage by the leafworm Alabama argillacea (Hübner) on yields of cotton grown under rows spaced 0.38 m and 0.76 m at the irrigation area of Santiago del Estero, Argentina. The period evaluated was extended from first flower to first open boll. Treatments were T1 - without control of larvae, T2 - with control of larvae, T3 - control since first flower to the end of effective blooming, and T4 - with larval control since the end of effective blooming to first open boll. The effect of injuries on the crop was evaluated trough boll cotton yield. Larvae were sampled in a weekly basis and insects were present from the first flower until harvest. Populations of A. argillacea decreased crop yields in the two distances tested, by decreasing the weight or number of open bolls.

Infección cervicovaginal como factor de riesgo para parto pretérmino / Cervicovaginal infection as a risk factor for premature labor

OBJECTIVE: To identify the possible association between cervicovaginal infections (CVI) and preterm delivery. DESIGN: Cohorts. REFERENCE FRAME: Instituto Nacional de PerinatologÝa, Hospital Central Militar and Hospital General Regional No. 1, IMSS, Culiacßn, Sinaloa, MÚxico. PATIENTS: Four hundred and sixty eight patients attending prenatal control and delivery care. INTERVENTIONS: Fresh smears, Gram stain, and cervicovaginal sample culture from samples obtained during the following gestational stages: First sample at 16-24 weeks, second sample at 25-32 weeks, and third sample at 33-42 weeks. The following microorganisms were studied: Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, Streptococcus agalactiae, Mycoplasma hominis, Neisseria gonorrhoeae, Listeria monocytogenes, and Chlamydia trachomatis. In case of a positive culture, the specific treatment was indicated. MEASUREMENTS: Positive or negative culture for each of the studied pathogens, and the presence or absence of a preterm delivery for each of the patients included in the study. RESULTS: Three hundred and ninety eight were still present at the end of the study, of which 156 had a CVI and 242 had no CVI. No differences between both groups were observed concerning preterm delivery. Significant relative risks were: In the first stage, Ureaplasma urealyticum and Mycoplasma hominis with RR = 9.0 (6.81, 11.8); in the second stage, Ureaplasma urealyticum with RR = 6.2 (3.30, 11.7) and Escherichia coli with RR = 3.4 (1.33, 8.6); in the third stage, Ureaplasma urealyticum with RR = 9.19 (6.93, 12.1). The logistic regression analysis identified Ureaplasma urealyticum during the second stage with OR = 16.6 (2.9, 93.7), statistically significant with p = 0.001. The survival analysis showed differences between the two groups concerning pregnancy duration (p < 0.001). CONCLUSIONS: There is a difference in the duration in pregnancy in patients with CVI and without CVI. Ureaplasma urealyticum is consistently associated with preterm delivery.