¿Dos tipos de acalasia en un mismo paciente? ¿Realmente es así? Un caso infrecuente de objetivar en el mismo estudio / Two types of achalasia in the same patient. Is this really the case? An unusual finding in a single study

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Two types of achalasia in the same patient. Is this really the case? An unusual finding in a single study.

Within the functional tests, the High Resolution Manometry has been a great improvement in the diagnosis of esophageal motor disorders, especially those that cause obstruction or difficulty for the normal progress of the alimentary content. We present the case of a patient with dysphagia to which a manometry is performed in the diagnostic process, where the presence of two types of Acalasia is present in the same tracing.

Maternal obesity in early pregnancy and risk of adverse outcomes.

OBJECTIVES: To assess the role of the health consequences of maternal overweight and obesity at the start of pregnancy on gestational pathologies, delivery and newborn characteristics. METHODS: A cohort of pregnant women (n = 6.558) having delivered at the Maternal & Child University Hospital of Gran Canaria (HUMIGC) in 2008 has been studied. Outcomes were compared using multivariate analyses controlling for confounding variables. RESULTS: Compared to normoweight, overweight and obese women have greater risks of gestational diabetes mellitus (RR = 2.13 (95% CI: 1.52-2.98) and (RR = 2.85 (95% CI: 2.01-4.04), gestational hypertension (RR = 2.01 (95% CI: 1.27-3.19) and (RR = 4.79 (95% CI: 3.13-7.32) and preeclampsia (RR = 3.16 (95% CI: 1.12-8.91) and (RR = 8.80 (95% CI: 3.46-22.40). Obese women have also more frequently oligodramnios (RR = 2.02 (95% CI: 1.25-3.27), polyhydramnios. (RR = 1.76 (95% CI: 1.03-2.99), tearing (RR = 1.24 (95% CI: 1.05-1.46) and a lower risk of induced deliveries (RR = 0.83 (95% CI: 0.72-0.95). Both groups have more frequently caesarean section (RR = 1.36 (95% CI: 1.14-1.63) and (RR = 1.84 (95% CI: 1.53-2.22) and manual placenta extraction (RR = 1.65 (95% CI: 1.28-2.11) and (RR = 1.77 (95% CI: 1.35-2.33). Newborns from overweight and obese women have higher weight (p<0.001) and a greater risk of being macrosomic (RR = 2.00 (95% CI: 1.56-2.56) and (RR = 2.74 (95% CI: 2.12-3.54). Finally, neonates from obese mother have a higher risk of being admitted to special care units (RR = 1.34 (95% CI: 1.01-1.77). Apgar 1 min was significantly higher in newborns from normoweight mothers: 8.65 (95% CI: 8.62-8.69) than from overweight: 8.56 (95% CI: 8.50-8.61) or obese mothers: 8.48 (95% CI: 8.41-8.54). CONCLUSION: Obesity and overweight status at the beginning of pregnancy increase the adverse outcomes of the pregnancy. It is important to promote the normalization of bodyweight in those women who intend to get pregnant and to provide appropriate advice to the obese women of the risks of obesity at the start of the pregnancy.

Correction: Maternal Obesity in Early Pregnancy and Risk of Adverse Outcomes.

[This corrects the article DOI: 10.1371/journal.pone.0080410.].

[Prevalence of obesity in pregnant women of Canary Islands, Spain]. / Prevalencia de obesidad en la población gestante de Gran Canaria.

BACKGROUND AND OBJECTIVE: Different epidemiological studies have shown that maternal excess of weight during pregnancy is associated with adverse outcomes of pregnancy, childbirth and morbidity of the neonate. Prevalence of obesity in a pregnant population of Canary Islands is reported here. SUBJECTS AND METHODS: The group studied was an integrated cohort of all the pregnant women being followed-up at the Materno-Infant University Hospital of the Canarias [Hospital Universitario Materno-Infantil de Canarias; HUMIC] and who concluded their gestation during the year 2008 (n=6693). BMI was measured at the beginning of the pregnancy. RESULTS: 25.0% of the sample of pregnant women were overweight and 17.1% were obese, increasing both with age and not influenced with the educational level. CONCLUSIONS: The prevalence of obesity and overweight among pregnant women from the Canary Islands is high. Among the values available from other European countries, only the UK reported values greater than our study sample.