Evaluation of the Effect of Low-dose Aspirin on the Prevention of Preterm Delivery in Women with a History of Spontaneous Preterm Delivery / Avaliação do efeito da aspirina em baixa dose na prevenção do parto prematuro em mulheres com história de parto prematuro espontâneo

Abstract Objective Currently, uteroplacental vascular disorders are considered one of the main mechanisms of spontaneous preterm delivery (PTD). Low-dose aspirin is used to prevent pre-eclampsia, which has a similar mechanism; hence, the present study aimed to investigate the effect of low-dose aspirin on the prevention of PTD in women with a history of spontaneous PTD. Methods The present pilot randomized clinical trial was conducted on 54 pregnant women in the aspirin group (taking 80 mg daily until the 36th week and classic treatment) and 53 patients in the control group (only receiving classic treatment). Results Forty-three patients (40%) presented before 37 weeks due to symptoms of PTL. Preterm delivery (< 37 weeks) occurred in 28 patients (26%), and there was no significant difference between the aspirin and control groups (10 patients [19%] and 18 patients [34%], respectively; p = 0.069). The time of preterm delivery was early (< 34 weeks) in 6 patients (21%), and its cause was spontaneous labor in 23 patients (82%) which was not significantly different between the two groups (p > 0.05). Out of 40 patients with spontaneous labor, 25 patients (63%) had a PTD, which was significantly lower in the aspirin group than in the control group (9 patients [45%] versus 16 patients [80%], respectively; p = 0.022). Conclusion The findings of the present study demonstrated that despite the reduction in the incidence of PTD using low-dose aspirin, the reduction rate was not statistically significant. On the other hand, in patients with spontaneous labor prone to PTD, aspirin was effective in reducing the incidence of PTD.

Resumo Objetivo Atualmente, os distúrbios vasculares uteroplacentários são considerados um dos principais mecanismos de parto prematuro espontâneo (PTD). A aspirina em baixa dose é usada para prevenir a pré-eclâmpsia, que tem um mecanismo semelhante; portanto, o presente estudo teve como objetivo investigar o efeito da aspirina em baixa dosagem na prevenção de PTD em mulheres com história de PTD espontâneo. Métodos O presente ensaio clínico piloto randomizado foi realizado em 54 gestantes do grupo aspirina (tomando 80 mg diários até a 36ª semana e tratamento clássico) e 53 pacientes do grupo controle (somente tratamento clássico). Resultados Quarenta e três pacientes (40%) apresentaram-se antes de 37 semanas devido a sintomas de PTL. O parto prematuro (< 37 semanas) ocorreu em 28 pacientes (26%) e não houve diferença significativa entre os grupos aspirina e controle (10 pacientes [19%] e 18 pacientes [34%], respectivamente; p = 0,069). O tempo de parto prematuro foi precoce (< 34 semanas) em 6 pacientes (21%) e sua causa foi trabalho de parto espontâneo em 23 pacientes (82%) que não foi significativamente diferente entre os dois grupos (p > 0,05). Das 40 pacientes com trabalho de parto espontâneo, 25 pacientes (63%) tiveram PTD, que foi significativamente menor no grupo aspirina do que no grupo controle (9 pacientes [45%] versus 16 pacientes [80%], respectivamente; p = 0,022). Conclusão Os achados do presente estudo demonstraram que, apesar da redução na incidência de DPT com o uso de aspirina em baixa dosagem, a taxa de redução não foi estatisticamente significativa. Por outro lado, em pacientes com trabalho de parto espontâneo propensas a PTD, a aspirina foi eficaz na redução da incidência de PTD.

Prevalence of asymptomatic bacteriuria among antenatal women and its effects on maternal and perinatal outcome in northern Andhra Pradesh population

xBackground: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than non-pregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome.Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey抯 agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes.Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; 1.37-5.88, p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively).Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.

Parthenolide enhances the apoptosis induced by PKC inhibitor in human gastrointestinal stromal tumors cell lines / 基础医学与临床

Objective To investigate the effect of parthenolide ( PTL) and PKC inhibitor on human gastrointestinal stromal tumor (GIST) cell proliferation and apoptosis and the mechanism involved .Methods Human GIST cell lines were cultured in vitro, and the cell proliferation rate of GIST , was determinate by MTT;flow cytometry was used to test the early apoptosis rate of GIST;Western blot assay was applied to detect the expression of endoplasmic reticulum stress-related proteins , GRP78 and GADD153.There were four groups: control group , PTL group, PKC inhibitor group , combine PTL and PKC inhibitor group .Results PTL and PKC inhibitor combination therapy for GIST was sig-nificantly more effective than a single-drug therapy (P<0.05);as for the early apoptosis rate , the combination ther-apy for GIST cells was significantly higher than that medication alone group (P<0.05).the expression of endoplas-mic reticulum stress-associated protein GRP 78 and GADD153 was obviously higher in PTL and PKC inhibitor combi-nation group than that in medication alone group (P<0.05).Conclusions PTL and PKC inhibitor combination therapy for GIST cells can induce apoptosis , which is possibly mediated via endoplasmic reticulum stress pathway .

Role of Bacterial Vaginosis in Patients with Idiopathic Pre- Term Labour.

Background: To find out the correlation of bacterial vaginosis (BV) in idiopathic preterm labour and find its association with an adverse pregnancy outcome in patients with idiopathic preterm labour. Methods: This is a comparative study, comprising of 150 pregnant females in study group admitted with preterm labour without any obvious cause and 150 pregnant women with singleton pregnancy at term in the control group. Both the groups were tested for BV by using Amsel's criteria and Nugent's criteria. Diagnosis of BV was stamped based on gram staining of vaginal discharge smear. All patients were followed till delivery. Results: In the study group, significantly large number of women tested positive for BV on gram staining of vaginal discharge as compared to control group (20.6% vs 8.0%). In the study group, an adverse pregnancy outcome in the form of preterm delivery (<37 weeks) was noted in 93.4% women testing positive for BV and only in 47.9% women testing negative for BV. The majority of women with BV +ve were more likely to deliver before or at 34 weeks (58.06%) compared to women with BV-ve (14.28%).Conclusion: BV was significantly associated with preterm labour and preterm delivery and adverse perinatal outcomes.

Comunicación afectiva y manejo de las emociones en la formación de profesionales de la salud / Affective communication and the emotions manage in the professionals of the health formation

El insuficiente desarrollo de habilidades para la expresión y regulación de las emociones, que en situaciones comunicativas diversas, manifiesta parte significativa del estudiantado joven que se forma en los cursos regulares diurnos de las carreras de ciencias médicas y la importancia que esto tiene para lograr un aprendizaje de calidad a favor de un exitoso desempeño personal y profesional futuro, exige la revisión del proyecto educativo formativo, así como del currículo para poder corregir, compensar y superar estas deficiencias con que llegan a la educación superior; para que como futuros/as profesionales puedan elevar la satisfacción de la población respecto a los servicios de salud y la calidad de la atención deberán saber atender las necesidades emocionales de pacientes y las propias. El siguiente trabajo propone reflexionar acerca de la necesidad de crear condiciones en el proceso de enseñanza-aprendizaje (PEA) con estudiantes de las carreras de ciencias médicas para contribuir al desarrollo de su educación emocional.

The insufficient development of abilities for the expression and regulation of the emotions that in diverse talkative situations, apparent significant part of the young student body that is formed in the courses regular dailies of the careers of medical sciences and the importance that this has to achieve a learning of quality in favor of a successful personal acting and future professional demands the revision of the formative educational project, as well as of the curriculum to be able to correct, to compensate and to overcome these deficiencies with which they arrive to the superior education. So that as professional futures they can rise the population's satisfaction regarding the services of health and the quality of the attention they will know how to assist the emotional necessities of patient and the own ones. The following work intends to meditate about the necessity of creating conditions in the Process of Teaching Learning (PEA) with students of the careers of medical sciences to contribute to the development of its emotional education.