Inflammatory markers in outpatients with schizophrenia diagnosis in regular use of clozapine: a cross-sectional study.

It is known that inflammation worsen the course of schizophrenia and induce high clozapine serum levels. However, no study evaluated this change in function of clozapine daily dose in schizophrenia. We assessed the correlation between inflammation and severity symptoms in patients with schizophrenia that take and do not take clozapine. We also assessed the correlation between clozapine daily dose and inflammatory markers to patients who take this drug. Patients were recruited from Schizophrenia Ambulatory and Psychosocial Care Center of Clinical Hospital of Porto Alegre and from an association of relatives of patients with schizophrenia. Exam results, and other important clinical exam were assessed in patients record or patients were asked to show their exam in the case of outpatients. We included 104 patients, 90 clozapine users and 14 non-clozapine users. We calculate the systemic inflammatory markers [neutrophil-lymphocyte ratio (NLR), systemic immune inflammation index (SII), and the psychopathology severity by the Brief Psychiatric Rating Scaled anchored (BPRS-a)]. These variables were compared between clozapine users and non-clozapine users. It was used mean/median test according to data distributing, with study factor (SII, MLR, and PLR), the clinical outcome: severity of symptomatology (BPRS score), and clozapine daily dose as adjustment factor. Clozapine users exhibited a significantly higher neutrophil count (mean ± SD: 5.03 ± 2.07) compared to non-clozapine users (mean ± SD: 3.48 ± 1.27; p = 0.031). After controlling for comorbidity, other parameters also showed significant differences. These findings are consistent with previous studies that have demonstrated an inflammatory response following the administration of clozapine.

Ketamine study: Protocol for naturalistic prospective multicenter study on subcutaneous ketamine infusion in depressed patients with active suicidal ideation.

Background: Psychiatric disorders are associated with more than 90% of reported suicide attempts worldwide, but few treatments have demonstrated a direct effect in reducing suicide risk. Ketamine, originally an anesthetic, has been shown anti-suicide effects in clinical trials designed to treat depression. However, changes at the biochemical level were assessed only in protocols of ketamine with very limited sample sizes, particularly when the subcutaneous route was considered. In addition, the inflammatory changes associated with ketamine effects and their correlation with response to treatment, dose-effect, and suicide risk warrant further investigation. Therefore, we aimed to assess whether ketamine results in better control of suicidal ideation and/or behavior in patients with depressive episodes and whether ketamine affects psychopathology and inflammatory biomarkers. Materials and methods: We report here the design of a naturalistic prospective multicenter study protocol of ketamine in depressive episodes carried out at Hospital de Clínicas de Porto Alegre (HCPA) and Hospital Moinhos de Vento (HMV). The study was planned to recruit adult patients with Major depressive disorder (MDD) or Bipolar disorder (BD) types 1 or 2, who are currently in a depressive episode and show symptoms of suicidal ideation and/or behavior according to the Columbia-Suicide Severity Rating Scale (C-SSRS) and have been prescribed ketamine by their assistant psychiatrist. Patients receive ketamine subcutaneously (SC) twice a week for 1 month, but the frequency can be changed or the dose decreased according to the assistant physician's decision. After the last ketamine session, patients are followed-up via telephone once a month for up to 6 months. The data will be analyzed using repeated measures statistics to evaluate the reduction in suicide risk as a primary outcome, as per C-SSRS. Discussion: We discuss the need for studies with longer follow-ups designed to measure a direct impact on suicide risk and that additional information about the safety and tolerability of ketamine in particular subset of patients such as those with depression and ideation suicide. In line, the mechanism behind the immunomodulatory effects of ketamine is still poorly understood. Trial registration: https://clinicaltrials.gov/, identifier NCT05249309.

Allergic reaction induced by subcutaneous administration of ketamine: a case report.

Ketamine can be used for depression and suicidal ideation due to its effectiveness and low complication rates; moreover, allergic reactions are rare. Immediately after subcutaneous (SC) ketamine administration, a 22-year-old man rapidly developed hives on the trunk and face without oxygen desaturation. Symptoms disappeared after treatment with prednisolone. This case presents an allergic reaction to ketamine compatible with mast cell activation and release of preformed mediators, without being able to prove whether the event was mediated by immunoglobulin E. This is the only case reported to date of an allergic reaction to SC ketamine for psychiatric treatment.

Aleitamento materno e quimiocinas: diferenças entre esquizofrenia e controles / Breastfeeding and chemokines: differences in schizophrenia and controls

Introdução: Avaliar a associação entre níveis plasmáticos da quimiocina CCL11, coeficiente de inteligência e prática da amamentação em homens com esquizofrenia em condições psiquiátricas estáveis sob acompanhamento ambulatorial em um serviço de saúde pública. Métodos: Foi realizado estudo caso-controle com 60 indivíduos: 30 pacientes com esquizofrenia e 30 controles saudáveis, dos quais 15 de cada grupo foram expostos ao aleitamento materno e 15 não foram. Foi aplicado questionário abordando questões socioeconômicas, história ao nascer, dados clínicos e alimentação ao nascer. Foi dosada a quimiocina CCL11 e aplicados testes psicológicos para avaliar quociente de inteligência, funcionalidade, sintomas psiquiátricos, curso da doença e diagnóstico. Para os controles, foi utilizada uma escala para descartar doença psiquiátrica. Resultados: A quimiocina CCL11 apresentou valores significativamente mais altos (> 0,5) em pacientes com esquizofrenia quando comparados aos controles. No grupo de amamentados, os esquizofrênicos apresentaram valores significativamente mais altos a nível intermediário (entre 0.106 e 0.5). Não houve correlação da CCL11 com o número de hospitalizações, idade, tempo de diagnóstico e escolaridade. Não foi evidenciada correlação entre tempo de aleitamento materno em relação aos fatores do Brief Psychiatric Rating Scale. Houve uma tendência de correlação entre a idade de início da doença e o aleitamento materno. Foi encontrada correlação positiva do CCL11 com o tempo de aleitamento materno. Ao comparar os pacientes esquizofrênicos que foram aleitados com os que não foram, foi encontrada diferença estatisticamente significativa apenas para o quociente de inteligência. Conclusão: O aleitamento materno está associado a níveis mais baixos de CCL11, escores mais altos de quociente de inteligência e a esquizofrenia. A quimiocina CCL11 é mais alta em quem não amamentou, especialmente nos esquizofrênicos. (AU)

Introduction: To evaluate the association between plasma levels of chemokine CCL11, intelligence quotient, and exposure to breastfeeding in men with schizophrenia under stable psychiatric condition and monitored as outpatients in a public health care unit. Methods: A case-control study of 60 individuals, 30 patients with schizophrenia and 30 healthy controls; in each group, 15 were exposed to breastfeeding and 15 were not. A questionnaire addressing socioeconomic issues, history at birth, clinical data, and feeding at birth was administered. Chemokine CCL11 levels were measured, and psychological tests were applied to assess intelligence quotient, functional status, psychiatric symptoms, disease course, and diagnosis. A scale to rule psychiatric illness was used for the controls. Results: Chemokine CCL11 levels were significantly higher (> 0.5) in patients with schizophrenia than in controls. In the breastfed group, patients with schizophrenia also had significantly higher CCL11 levels, but at an intermediate level (between 0.106 and 0.5). There was no correlation between CCL11 and number of hospitalizations, age, time since diagnosis, or level of education, nor between duration of breastfeeding and the Brief Psychiatric Rating Scale factors. A trend toward a correlation was observed between age at disease onset and breastfeeding. There was a positive correlation between CCL11 and duration of breastfeeding. The comparison of patients with schizophrenia who were breastfed vs those who were not breastfed showed a statistically significant difference only in intelligence quotient. Conclusion: Breastfeeding is associated with lower CCL11 levels, higher intelligence quotient scores, and schizophrenia. Chemokine CCL11 levels are higher in those not exposed to breastfeeding, especially in patients with schizophrenia. (AU)

Synthesis of ZnO Nanorod Film Deposited by Spraying with Application for Flexible Piezoelectric Energy Harvesting Microdevices.

Industry 4.0 and the Internet of Things have significantly increased the use of sensors and electronic products based on flexible substrates, which require electrical energy for their performance. This electrical energy can be supplied by piezoelectric vibrational energy harvesting (pVEH) devices. These devices can convert energy from ambient mechanical excitations into electrical energy. In order to develop, these devices require piezoelectric films fabricated with a simple and low-cost process. In this work, we synthesize ZnO nanorod film by a solvothermal method and deposit by spraying on ITO (indium-tin-oxide)/PET (polyethylene terephthalate) flexible substrate for a pVEH microdevice. The results of the characterization of the ZnO nanorod film using X-ray diffraction (XRD) confirm the typical reflections for this type of nanomaterial (JCPDS 36-145). Based on transmission electron microscopy (TEM) images, the size of the nanorod film is close to 1380 nm, and the average diameter is 221 ± 67 nm. In addition, the morphological characteristics of the ZnO nanorod film are obtained using atomic force microscopy (AFM) tapping images. The pVEH microdevice has a resonant frequency of 37 Hz, a generated voltage and electrical power of 9.12 V and 6.67 µW, respectively, considering a load resistance of 107.7 kΩ and acceleration of 1.5 g. The ZnO nanorod film may be applied to pVEH microdevices with flexible substrates using a low-cost and easy fabrication process.

Diagnóstico prenatal de malformaciones congénitas y alteraciones cromosómicas: resultado de la experiencia CIMAF - Hospital Dr. Sótero Del Río / Prenatal Diagnosis of Congenital Malformations and Chromosomal Abnormalities: Single Center Experience - Hospital Dr. Sótero Del Río, Chile

INTRODUCCIÓN: El diagnóstico prenatal de anomalías congénitas tiene como objetivo ofrecer consejería apropiada, identificar aquellas patologías que se benefician de terapia fetal y coordinar la derivación de estas pacientes a centros terciarios para un óptimo manejo perinatal. Para el diagnóstico y manejo de las anomalías congénitas en el Hospital Dr. Sótero Del Río contamos con un equipo multidisciplinario. El objetivo de este estudio es describir nuestra experiencia como centro de referencia en Santiago de Chile en relación al diagnostico prenatal de malformaciones congénitas, estudio genético prenatal y resultados perinatales. MÉTODOS: Estudio retrospectivo y descriptivo. Se incluyó a las pacientes registradas en las bases de datos ecográficas entre 2010 y 2019 del Hospital Dr. Sotero del Rio. Se revisaron fichas clínicas para evaluación y seguimiento postnatal. RESULTADOS: Se evaluaron 404 pacientes con sospecha de malformaciones congénitas o marcadores de aneuploidías. La edad gestacional media de la evaluación fue 29 semanas (14-38 semanas). La mediana de la edad gestacional al parto fue 37.6 semanas (20-41 semanas). Se obtuvo un 78% de recién nacidos vivos, 12% óbitos fetales y 10% mortineonatos. Las malformaciones más frecuentes fueron cardiovasculares, sistema nervioso central, hidrops, extremidades, abdomen y genitourinario. Se realizo el estudio genético en 232 pacientes; 61% resultado normal, 12.5% trisomía 21, 8% trisomía 18, 4% trisomía 13, 4% XO, 4% otras. Se analizaron las pacientes que se acogieron a la ley de interrupción voluntaria del embarazo. CONCLUSIÓN: Destacamos la importancia de derivación a centros de referencia de pacientes con sospecha de malformaciones congénitas para un adecuado diagnostico prenatal, ofrecer un manejo con equipo multidisciplinario y así mejorar los resultados neonatales.

INTRODUCTION: The objectives of prenatal diagnosis of fetal malformations are to offer the patient and her family the proper counseling, identify those conditions that benefits of prenatal therapy and to coordinate the referral to tertiary centers to improve neonatal survival. Our hospital counts with a multidisciplinary team who evaluate the patients together. The objective of this study is to describe our experience as a referral center in prenatal diagnosis, management and neonatal outcomes in Santiago de Chile. METHODS: Retrospective and descriptive study. Patients registered in our prenatal diagnosis database between September 2010 and July 2019 were included. Clinical files were reviewed for neonatal outcomes. OUTCOMES: 404 patients with congenital malformations or aneuploidy markers were evaluated. The average gestational age of the evaluation was 29 weeks. Median gestational age to delivery was 37 weeks plus 6 days. 78% of livebirth, 12% fetal demise and 10% of neonatal death were obtained. The most frequent fetal malformations were cardiovascular, central nervous system, fetal hydrops, extremities, abdominal wall defects and urinary system. Fetal karyotype was performed in 232 patients; 61% normal karyotype, 12.5% trisomy 21, 8% trisomy 18, 4% trisomy 13, 4% monosomy X, 4% others. We also analyze the patients who agreed to termination of pregnancy according to Chilean legislation. CONCLUSION: We highlight the importance of referral of patients with suspected fetal malformations to tertiary centers for an adequate evaluation by a multidisciplinary team of specialists, to improve the survival and neonatal outcome.

El Coronavirus y la pandemia: una crónica sociosimbólica / The coronavirus and the pandemic: A sociosymbolic chronicle

El presente artículo aborda un contexto geohistórico referencial que permite resignificar y recontextualizar este fenómeno que impacta la realidad mundial y la cotidianidad de nuestras vidas hoy desde una mirada histórica, sociológica y cualitativa. Refleja los intersticios de un sistema global, desregularizado y sin parangón como lo ha sido el capitalismo, y las consecuencias que ha dejado en los países que han adoptado este sistema como única forma de hacer política. A la vez, se contrasta con la República Bolivariana de Venezuela y pone en realce los logros que este país ha demostrado en su lucha por hacer frente al COVID19 como Pandemia universal. Presenta la Pandemia como el resultado de los males globales que acecha a nuestros pueblos y la proyecta como una oportunidad para el reordenamiento mundial, la reformulación y reorientación de políticas públicas que fomenten valores éticos, solidarios y revolucionarios que coloquen a la vida humana como valor supremo(AU)

This article addresses a referential geohistorical context that allows to resignify and re-contextualize this phenomenon that affects the world real-ity and the daily life of our lives, from a historical, sociological and qualitative approach. It reflects the interstitials of a global, deregulated and unparalleled system as capitalism has been and the consequences it has left on countries that have adopted this system as the only way to do politics. At the same time, it contrasts with the Bolivarian Republic of Venezuela and highlights the achievements that Venezuela has shown in its struggle to deal with COVID19 as a universal pandemic. It presents the Pandemic as the result of the global ills that haunt our peoples and projects it as an opportunity for global reordering, reformulation and reorientation of public policies that fos-ter ethical, solidarity and revolu-tionary values that place human life as the supreme value(AU)

Comparison of two identification and susceptibility test kits for Ureaplasma spp and Mycoplasma hominis in amniotic fluid of patients at high risk for intra-amniotic infection.

Objective: Ureaplasma urealyticum and Mycoplasma hominis are the most common microorganisms found in the amniotic fluid of patients at risk for preterm delivery. However, culture techniques for genital mycoplasms require special conditions, are barely considered as part of the evaluation of suspected intra-amniotic infection (IAI) and the results are available within 2 and 7 days. The objectives of this study are to validate the use of two commercially available kits (Mycoplasma IES y MYCOFAST® RevolutioN) for the identification of Ureaplasma spp. and Mycoplasma hominis in amniotic fluid, to compare the results of these kits with those obtained by culture and real-time polymerase chain reaction (qPCR) and to report the antibiotic sensitivity profile of the genital mycoplasms identified.Methods: This is a prospective cohort study including women with singleton and twin gestations between 16 and 36 weeks. Patients were admitted to perform an amniocentesis due to pregnancy complications considered at high risk for IAI (e.g. preterm labor with intact membranes, preterm prelabour rupture of membranes, short cervix, etc.), treatment of polyhydramnios, and for the assessment of fetal death and fever without a focus.Results: Overall, 93 patients underwent amniocentesis and 63 had results available for all tests. The prevalence of a positive culture was 6% (4/63). There were four cases of Ureaplasma spp. and none of Mycoplasma hominis. The qPCR identified one case as Ureaplasma spp., one case as Ureaplasma parvum and two cases as Ureaplasma urealyticum. For all tests, the diagnostic performance was as follows: sensitivity 100% [95% CI (39.8-100%)], specificity 100% [95% CI (93.9-100%)], positive predictive value 100% [95% CI (39.8-100%)] and negative predictive value 100% [95% CI (93.9-100%)]. In this cohort, Ureaplasma spp. showed low resistance to erythromycin, but a high resistance to clindamycin and clarithromycin that may change according to the antibiotic concentration.Conclusions: To our knowledge, this is the first study that validates the use of the Mycoplasma IES and MYCOFAST® RevolutioN kits for the identification of genital mycoplasmas in amniotic fluid. The results of these kits are mostly available within 24 hours, have an excellent correlation with those from broth cultures and qPCR and characterize the antibiotic sensitivity profile of the genital mycoplasms identified, providing an opportunity for specific treatment in cases of IAI. Further validation studies in other populations are needed.

Effect of Pleurotus ostreatus (Jacq) and Trichoderma harzianum (Rifai) on Meloidogyne incognita (Kofoid & White) in tomato (Solanum lycopersicum Mill)

Two isolations of fungi from a bank of microorganisms in the Biological Sciences Laboratory at Escuela Superior Politécnica de Chimborazo were tested on the galling caused by Meloidogyne incognita in tomato seedlings grown in pots with substrate infested with a suspension of nematodes, with approximately 2000 juvenile stages (J2) from root galls of plants infested with M. incognita, taken from the Nematology laboratory of the Ecuadorian Agricultural Quality Assurance Agency (AGROCALIDAD). Pleurotus ostreatus was a fungus with nematicidal characteristics through production of toxins; while Trichoderma harzianum is a widely known fungus, although it is a plant growth promoter rather than a nematicide. The two fungi were formulated in wheat straw and rabbit manure. A complete randomized design (CRD) with three replications was used, with a chemical control (Fenamiphos) and an absolute control. Five grams of each formulation was applied per plant before the transplant. The number of galls in the roots, plant height, stem diameter, number of leaves and fresh and dry weight of the aerial part and roots of 180 tomato plants grown in greenhouse were evaluated at 60 days after transplant. The results showed that the two fungi reduced the number of galls and made it possible to obtain dry weights of the aerial and radicular part very close to the chemical control (10.09 and 3.39 g) with 8.68; 8.04; 2.96 and 3.25 g respectively. Besides Trichoderma harzianum proved to be a good promoter of root growth, therefore, the use of these bioformulates is a promising measure for the control of this phytonematode

Management of the pseudobulbar affect (PBA) in Kabuki syndrome combined dextromethorphan-fluoxetine treatment as an alternative to dextromethorphan/quinidine

A case report of a patient with pseudo bulbar affect previous treatments included haloperidol (10mg), Inosina pranobex (600mg), clozapine (600mg), olanzapine (20mg), carbamazepine (200mg), paroxetine (20mg), phenobarbital (100mg) and topiramate (50mg), all suspended at August 2016, with current use of quetiapine (700mg) Chlorpromazine (600mg) (+ 200mg on demand of aggression), clonazepam (4 mg), valproate 2500 mg, propranolol (40mg). that was successful treated with off label treatment (dextromethorphan plus quinidine). Previous Brief Psychiatric Rating Scale and Clinical Global Impression-Improvement was applied after and before treatment with dextromethorphan (20mg) plus fluoxetine (20 mg, further increased to 40 mg). Previous Brief Psychiatric Rating Scale BPRS score 56 points and Clinical Global Impression-Severity (CGI-S) Score was 6 (severely ill). The addition of dextromethorphan (20mg) and fluoxetine (20 mg, further increased to 40 mg), allowed clear improvement of pathological crying and outbursts, with BPRS decrease of 8 points and Clinical Global Impression-Improvement (CGI-I) 2 (much improved) ­ especially pertaining to PBA related symptoms and aggressive behavior. There were no noticeable side-effects. This case report shown an interesting clinical response. It's could be a great alternative in treatment of pseudobulbar affect symptoms. Even though an only case and a great clinical study be necessary. (AU)

Tumores cardiacos primarios fetales: revisión de la literatura / Primary fetal cardiac tumors: review of the literature

Los tumores cardiacos primarios fetales representan una entidad de baja incidencia en la práctica clínica. La gran mayoría corresponde a lesiones benignas, siendo el rabdomioma el tipo más común. Si bien, es frecuente la regresión espontánea de este tipo de lesiones durante el embarazo, los tumores cardiacos fetales pueden asociarse a complicaciones como obstrucción del flujo cardíaco, insuficiencia valvular, arritmias, insuficiencia cardíaca e hidrops fetal, pudiendo conducir incluso a la muerte fetal. El mayor desarrollo de técnicas imagenológicas ha permitido un aumento en el número y precisión de los diagnósticos prenatales de tumores cardiacos, generando al mismo tiempo, nuevos desafíos y alternativas en relación al abordaje terapéutico. El objetivo del presente artículo de revisión es exponer la evidencia actual en relación al diagnóstico prenatal, manejo, complicaciones y condiciones asociadas de los tumores cardiacos fetales más frecuentes.

Fetal primary cardiac tumors represent a low incidence entity in clinical practice. The vast majority corresponds to benign lesions, with rhabdomyoma being the most common type. Although spontaneous regression of this type of lesions during pregnancy is frequent, fetal cardiac tumors can be associated with complications such as obstruction of cardiac flow, valvular insufficiency, arrhythmias, heart failure and fetal hydrops, which can even lead to fetal death. The greater development of imaging techniques has allowed an increase in the number and precision of prenatal diagnoses of cardiac tumors, generating at the same time, new challenges and alternatives in relation to the therapeutic approach. The objective of this review article is to present the current evidence regarding the prenatal diagnosis, management, complications and associated condition s of the most frequent fetal cardiac tumors.

Proinflammatory and anti-inflammatory biomarkers in schizophrenia and influence of simvastatin on the interleukin-6.

The present study sought to assess biomarkers of inflammation in stable patients with schizophrenia (SZ) on clozapine therapy. We recruited 60 outpatients with SZ and 60 healthy controls, matched for sex and age. Compared with controls, patients had significantly increased concentrations of interleukin-6 and tumor necrosis factor-α. Interestingly, patients on simvastatin had lower interleukin-6 levels compared with patients not on simvastatin and controls. This study corroborated previous evidence for increased inflammatory biomarkers in SZ and detected a potential anti-inflammatory action of simvastatin in patients with a clinical diagnosis of SZ on clozapine therapy.

Transabdominal collection of amniotic fluid "sludge" and identification of Candida albicans intra-amniotic infection.

A G3P2 patient who conceived while using an intrauterine contraceptive device (IUD) presented at 20 weeks of gestation with mild irregular uterine contractions and vaginal bleeding. Sonographic examination at admission showed the presence of dense amniotic fluid "sludge" and a long sonographic uterine cervix (42 mm). To assess the microbiologic significance of amniotic fluid "sludge", we performed a transabdominal amniocentesis. The procedure was performed under real-time ultrasound, and fluid resembling pus at gross examination was noted. Rapid amniotic fluid analysis showed the presence of a high white blood cell count and structures resembling hyphae. Amniotic fluid cultures were positive for Candida albicans. Treatment was begun with broad-spectrum antibiotics, including Fluconazole, upon the visualization of pus in the "sludge" material because of the presence of hyphae in the Gram stain. Despite treatment, the patient went into spontaneous preterm labor and delivered five days after admission. Placental examination revealed acute fungal histologic chorioamnionitis and funisitis. This represents the first report of transabdominal collection and analysis of amniotic fluid "sludge" and the microbiologic detection of Candida albicans in this material. This report provides evidence that transabdominal retrieval of "sludge" is possible and may be of significant value for patient management and selection of antimicrobial agents.

Morbimortalidad perinatal en pacientes con rotura prematura ovular ≤24 semanas según cantidad de líquido amniótico al momento del diagnóstico / Perinatal morbidity and mortality in patients with premature ovular rupture ≤24 weeks according to amount of amniotic fluid at diagnosis

Introducción: La rotura prematura ovular (RPO) antes de la viabilidad fetal consiste en una complicación obstétrica de baja incidencia, pero de alta morbimortalidad perinatal asociada. Estudios sugieren que el volumen de líquido amniótico (LA) es un factor importante a considerar. El objetivo de este trabajo es evaluar si en RPO ≤24 semanas, un bolsillo vertical máximo (BVM) <2cm al diagnóstico es un factor de riesgo para aparición de morbimortalidad fetal y neonatal. Métodos: Estudio de cohorte longitudinal retrospectivo de 94 pacientes con RPO ≤24 semanas ingresadas a un hospital terciario para manejo expectante entre los años 2005 y 2014. Embarazo gemelar o malformaciones congénitas fueron criterios de exclusión. Se obtuvieron y compararon 2 grupos según BVM al ingreso (BVM ≥ 2 cm y BVM < a 2 cms) y se comparó la edad gestacional (EG) al momento de la RPO y al parto, la latencia desde la RPO al parto, la presencia de corioamnionitis clínica, el número de óbitos fetales, muerte neonatal precoz (primeros 7 días de vida), tardía (entre los 7 y 28 días) y sobrevida global. Resultados: El 58 por ciento de las pacientes presentó un BVM <2 cm al ingreso, el cual se asoció a menor latencia al parto (p:0,01), menor EG al parto (p:0,02), más óbito fetal (p:0,04), mayor muerte neonatal precoz y tardía (p:0,02 y 0,01 respectivamente) además de menor sobrevida global (p:0,01). Conclusiones: La medición de BVM <2 cm al ingreso en pacientes con RPO ≤24 semanas, es un factor de mal pronóstico y debe ser considerado en el manejo clínico de estas pacientes.(AU)

Introduction: Previable premature rupture of membranes (pPROM) is a low-incidence obstetric complication associated with high perinatal morbidity and mortality. Studies suggest that the volume of amniotic fluid (AL) is an important factor to consider. The aim of this study is to evaluate if in RPO ≤24 weeks, a maximum vertical pocket (MVP) <2 cm to the diagnostic is a risk factor for fetal and neonatal morbidity and mortality. Objectives: Evaluate fetal and neonatal morbidity and mortality according to amniotic fluid (AL) Maximum Vertical Pocket (MVP) ≥ or

Resultado de estudio prenatal invasivo para el diagnóstico de aneuploidía en el Hospital Sótero del Río / Results of an invasive prenatal study for the diagnosis of aneuploidy at Hospital Sótero del Río

ANTECEDENTES: Las aneuploidías y malformaciones congénitas son causa importante de morbi-mortalidad perinatal e infantil en Chile. OBJETIVO: Evaluar la realidad local del diagnóstico genético antenatal para mejorar el resultado perinatal. MÉTODOS: Estudio retrospectivo y descriptivo. Se realizó amniocentesis a embarazadas con indicación de estudio genético prenatal por sospecha ecográfica de alteraciones cromo-sómicas, entre octubre de 2010 y marzo de 2015, en el Hospital Sótero del Río. RESULTADOS: Los hallazgos ecográficos más frecuentes fueron: cardiopatías congénitas, malformaciones del sistema nervioso central y restricción de crecimiento fetal precoz. 164 pacientes aceptaron el estudio invasivo antenatal, obteniéndose resultados de 154. El promedio de edad materna y edad gestacional del examen fueron 30 años y 27+3 semanas, respectivamente. En embarazos con trisomía 21 y 13, el 71% de las pacientes tenía sobre 35 años. Un 31% de las muestras presentaron cariotipo anormal, siendo la más frecuente la trisomía 21 (14%), trisomía 18 (9%), monosomía X (4,5%) y trisomía 13 (2,6%). CONCLUSIÓN: El diagnóstico genético prenatal permite un adecuado manejo perinatal, coordinación apropiada entre las unidades de Obstetricia y Neonatología, y la preparación de las pacientes y sus familias para un pronóstico perinatal adverso.

BACKGROUND: Malformations and aneuploidy are a major cause of perinatal morbidity and mortality in Chile. Invasive techniques are offered to determine the fetal karyotype, when there is an abnormal finding in the ultrasound. AIMS: To assess the local situation of prenatal genetic diagnosis to improve the management of this population. METHODS: This is a retrospective and descriptive study of patients from october 2010 to march 2015, who had an amniocentesis for genetic testing due suspected fetal malformations or aneu-ploidy. RESULTS: The sonographic findings most frequently found were: congenital heart disease, malformations of the central nervous system and early growth restrictions. 164 patients agree to perform invasive prenatal genetic, obtaining 154 results. The average maternal age was 30 years and the mean gestational age at amniocentesis was 27+3 weeks. In trisomy 21 pregnancies, 71% of patients were higher than 35 years. 31% of the samples had abnormal karyotype: trisomy 21 (14%), trisomy 18 (9%), Turner's syndrome (4.5%) and trisomy 13 (3%). CONCLUSIONS: Prenatal genetic diagnosis allows appropriate perinatal management and contributes to prepare the patient and their families for an adverse perinatal outcome.

Evaluación nutricional del recién nacido en hijos de madres adolescentes en el Hospital Hipólito Unanue / Nutritional assessment of the newborn in teenage mothers at the Hospital Hipolito Unanue

Se realiza el estudio de retrospectivo-prospectivo de casos y controles con hijos de madres adolescentes y de madres no adolescentes respectivamente durante el año 2011 en el servicio de neonatología del Hospital Nacional Hipólito Unanue obteniéndose 1430 neonatos considerados en el análisis descriptivo y para el estudio analítico se tomo 210 casos y 420 controles. En las madres adolescentes el estado civil preponderante fue el de conviviente (65 por ciento), el 82 por ciento fueron estudiantes, el 70 por ciento cursaban estudios secundarios, el CPN en el 62.5 por ciento, prematuridad en el 8.8 por ciento, el 78 por ciento con terminación de la gestación por vía vaginal, la patología más frecuente fue la pre-eclampsia, el bajo peso al nacer de 8.01 por ciento, <1500 con 1.2 por ciento, <1000 con 0.6 por ciento, la talla materna promedio de 1.55 cm., peso promedio de 53.6 Kg. y la edad gestacional promedio de 39 semanas y 4 CPN. El peso promedio del neonato con 3,175 y una talla de 49 perímetro cefálico de 34 cm. El 5 por ciento fue GEG y el 12 por ciento PEG. El Apgar fue similar en ambos grupos. La tasa de mortalidad precoz fue de 9.1 por 1000 nacidos vivos 1.66 veces mayor que las no adolescentes, mientras que la mortalidad tardía fue similar. La desnutrición fetal evaluada mediante el TEST de CANS fue más frecuente en las adolescentes. El análisis multivariado muestra la relación entre la maternidad adolescente con el bajo peso al nacer, la prematuridad, el peso al nacimiento, la unión no estable, el grado de instrucción básico y la mortalidad, estadísticamente significativo en conjunto, más que por separado como se evidencio en los análisis anteriores.

The study is realized of retrospectively - market of cases and controls with children of mother's teenagers and of mothers not teenagers respectively during the year 2012 in the service of neonatology of the National Hospital Hipolito Unanue being obtained 1430 neonates considered in the descriptive analysis and for the analytical study I take 210 cases and 420 controls. In the mothers teenagers the preponderant marital status was that of cohabitant (65 per cent), 82 per cent was students, 70 per cent was dealing secondary studies, the CPN in 62.5 per cent, prematurely in 8.8 per cent, 78 per cent with completion of the gestation for vaginal route, the pathology more frequent was the pre-eclampsia, under weight on having been born of 8.01 per cent, <1500 with 1.2 per cent, <1000 with 0.6 per cent, the mother height I mediate of 1.55 cm., I weigh average of 53.6 Kg. and the gestacional age average of 39 weeks and 4 CPN. The weight I divide equally of the newborn with 3,175 and one height of 49 cephalic perimeter of 34 cm. 5 per cent it was GEG and 12 per cent PEG. Paying was similar in both groups. The rate of precocious mortality belonged to 9.1 for 1000 born alive (vivacious) 1.66 times major that them not teenagers, whereas the late mortality was similar. The fetal malnutrition evaluated by means of CANS'S TEST was more frequently in the teenagers. The multivaried analysis shows the relation between (among) the maternity teenager with under weight on having been born, the prematurely, the weight to the birth, the not stable union, the basic degree of instruction and the mortality, statistically significant as a whole, more that separately since I demonstrate in the previous analyses.

Comparación de la percepción del peso de una carga en población laboral femenina: sector industrial versus sector salud / Comparison of the perceptions of load heaviness by female working population: industry sector versus health sector

La evidencia disponible indica que existe fuerte asociación entre dolor lumbar y manejo manual de carga. Atendiendo a la naturaleza de la carga manipulada, se pueden distinguir dos grandes grupos de trabajadoras: las que realizan manejo de materiales y aquellas que realizan fundamentalmente manejo de pacientes. En ambos sectores se han identificado factores de riesgo de naturaleza física, organizacional y psicosocial que estarían asociados a ese diagnóstico, pero a pesar de los esfuerzos en prevención, este problema sigue siendo importante. La evidencia sugiere que el problema sería más crítico en el sector de la salud. Los autores de la presente investigación proponen que es necesario ocupar herramientas que pertenecen al ámbito de la Ingeniería Cognitiva para explorar las causas de esta tendencia. Esta investigación fue llevada a cabo en una muestra de trabajadoras que pertenecen al sector industrial y al sector de la salud con el objetivo de determinar si existe diferencia significativa asociada a distintas categorías de percepción de la carga manipulada (ej., moderada, pesada,máxima, etc.). Los resultados demuestran que existe diferencia en la percepción del esfuerzo entre ambos grupos de trabajadoras. Esencialmente, esto implica que ambas poblaciones deberían ser estudiadas en forma separada y, en particular, las iniciativas de prevención de los trastornos músculoesqueléticos vinculadas al manejo manual de carga deberían incorporar también elementos propios del proceso cognitivo que gobierna la percepción de la carga de trabajo. Esto sería especialmente importante en las investigaciones desarrolladas con el propósito de establecer límites de peso seguros para la población laboral femenina nacional.

The available evidence indicates that there is a strong association between low back pain and manual load handling. According to the type of load, two large groups of workers can be distinguished: those handling materials and those handling mainly patients. Among bothof these groups, physical, organizational and psychosocial risk factors, probably related to this diagnosis, have been identified. In spite of efforts to prevent it, this situation remains relevant. Evidence suggests that this problem is more critical in the health sector. Authors of the present study propose the use of tools pertaining to Cognitive Engineering and thus to explore the causes of this tendency. This research was carried out in a sample of workers from the industry and health sectors. The study’s goal was to determine ifthere is a significant difference associated to different perception categories of load heaviness (e.g. moderate, heavy, very heavy, etc.). Results show a difference in effort perception between groups. Essentially, this implies that both populations should be studied separately and initiatives intended to prevent musculoskeletaldisorder related to load handling should also include elements which are characteristic of the cognitive process controlling the perception of load heaviness. All of this would be especially important in studies conducted with the purpose of establishing safe weight limits for the nation’s female workers.

Percepción del peso de una carga en población laboral masculinachilena: modelamiento basado en la teoría de conjuntos difusos / Perception of load weight in chilean workers population: modeling based on the fuzzy set theory

En el ámbito de la psicofísica normalmente se utilizan expresiones como “Aceptable” o “Moderado” para calificar el peso de los objetos que estaría dentro de rangos seguros o tolerables para los trabajadores. Desde un punto de vista preventivo, es importante examinar con más cuidado a qué cantidad de kilogramos se refieren los trabajadores cuando se ocupan tales categorías. La inexactitud e imprecisión es un problema inherente en este contexto. Este estudio fue llevado a cabo en una muestra de trabajadores industriales con el propósito de estimarla cantidad de peso que le corresponde a distintas categorías lingüísticamente relacionadas con percepción de la carga manipulada (v. g., leve, moderada, pesada, etc.). Para modelar y estudiar este problema se ocupó la teoría de conjuntos difusos. Los resultados indicanque el 100 por ciento de la población evaluada declara que percibe como “Moderada” una carga de 16 kg. Esta misma población declara que percibe como “Pesada” una carga de 37 kg y como “Muy pesada” una carga de 53 kg. En esta investigación se comparan los resultados con los límites de peso establecidos por NIOSH y por la Ley Nº 20.001 del MINTRAB que regula en Chile el peso máximo de carga humana.

In the field of psychophysics expressions such as “acceptable” or“moderate” are usually used to classify the weight of objects that would be within safe or tolerable limits for workers. From a preventive point of view, it is important to examine more closely which quantity of kilograms are workers talking about when using such categories. Inexactitude or imprecision is an inherent problem in this context. This study was carried out on a sample of industrial workers with the objective of calculating the amount of weight corresponding to different categories of perception of handled load. (e.g., light,moderate, heavy etc.). For modelling and studying this problem the fuzzy set theory was used. Results indicate that the 100 percent of evaluated population state that they perceive as “moderate” a load of 16 kg. The same population states that they perceive as “heavy” a load of 37 kg and as “very heavy” a load of 53 kg. This research compares the results with the weight limits established by NIOSH and by LawNº 20.001 of the Work Ministry, which regulates human maximum load weight in Chile.