Characterization of pregnant women who gave birth in 2016 at the Hospital de La Samaritana, Bogotá, Colombia / Caracterización de gestantes con atención del parto durante 2016 en el Hospital Universitario de La Samaritana, Bogotá, Colombia

Abstract Introduction: Maternal mortality and severe maternal morbidity are serious public health problems, so it is essential to work on the identification, recognition and situation analysis of patients treated at high-risk pregnancy centers. Objectives: To characterize the pregnant women treated at the Hospital Universitario de la Samaritana (HUS), Bogotá, Colombia, from a demographic, social and clinical point of view in order to identify common factors that may be intervened and, thus, avoid adverse outcomes. Materials and methods: Cross-sectional study. 785 medical records of patients with a gestational age >24 weeks treated at the HUS in 2016 were analyzed. Sociodemographic data were collected, as well as data on the following variables: history of diseases, antenatal care, biopsychosocial risk, and obstetric outcomes. A univariate analysis was performed for each variable; measures of central tendency and dispersion and absolute and relative frequencies were calculated for quantitative and qualitative variables, respectively. Maternal health indicators were also calculated. Results: 47.51% of the pregnant women had a low educational level, 34.39% were single mothers, 32.10% had a previous comorbidity, and 5.85% had insufficient antenatal care. The proportion of preterm births was 23.6 (95%CI: 20.63%-26.69%), the severe maternal morbidity ratio was 157.96/1 000 live births, and the maternal mortality rate was 246/100 000 live births. Conclusions: Pregnant women treated at the HUS are mainly young women from areas where the health system is not easily accessible, and who have insufficient antenatal care and a low schooling level. This population has a high rate of severe maternal morbidity and maternal mortality compared to the national reference value, so they would benefit from educational interventions or risk approaches that prioritize these factors in order to prevent adverse maternal outcomes.

Resumen Introducción. La mortalidad materna y la morbilidad materna extrema son serios problema de salud pública, por lo que es fundamental trabajar en la identificación, reconocimiento y análisis situacional de las pacientes que acuden a los centros de alto riesgo obstétrico. Objetivos. Caracterizar las gestantes atendidas en el Hospital Universitario de la Samaritana (HUS), Bogotá, Colombia, desde el punto de vista demográfico, social y clínico con el fin de identificar factores en común potencialmente intervenibles y, de esta forma, evitar desenlaces adversos. Materiales y métodos. Estudio transversal. Se analizaron 785 historias clínicas de pacientes con edad gestacional >24 semanas atendidas durante 2016 en el HUS. Se recolectaron datos sociodemográficos y sobre las siguientes variables: antecedentes patológicos, controles prenatales, riesgo biopsicosocial y desenlaces obstétricos. Se realizó análisis univariado de cada variable: para las variables cuantitativas se calcularon medidas de tendencia central y de dispersión, mientras que para las cualitativas, frecuencias absolutas y relativas. También se calcularon indicadores de salud materna. Resultados. 47.51% de las gestantes tenían un bajo nivel educativo, 34.39% eran madres solteras, 32.10% tenían comorbilidad previa y 5.85% no asistieron a ningún control prenatal. La proporción de parto pre-término fue de 23.6 (IC95%:20.63%-26.69%), la razón de morbilidad materna extrema fue 157.96/1 000 nacidos vivos y la tasa de mortalidad materna, 246/100 000 nacidos vivos. Conclusiones. Las gestantes atendidas en el HUS son predominantemente mujeres jóvenes, provenientes de áreas con difícil acceso al sistema de salud, con insuficiente atención prenatal y con bajo nivel educativo. Esta población presenta una alta razón de morbilidad materna extrema y mortalidad materna comparada con el valor de referencia nacional y se beneficiaría de intervenciones educativas o enfoques de riesgo que prioricen estos factores con el fin de prevenir desenlaces maternos adversos.

Volumetric in vivo imaging of microvascular perfusion within the intact cochlea in mice using ultra-high sensitive optical microangiography.

Studying the inner ear microvascular dynamics is extremely important to understand the cochlear function and to further advance the diagnosis, prevention, and treatment of many otologic disorders. However, there is currently no effective imaging tool available that is able to access the blood flow within the intact cochlea. In this paper, we report the use of an ultrahigh sensitive optical micro-angiography (UHS-OMAG) imaging system to image 3-D microvascular perfusion within the intact cochlea in living mice. The UHS-OMAG image system used in this study is based on spectral domain optical coherence tomography, which uses a broadband light source centered at 1300 nm with an imaging rate of 47[Formula: see text] 000 A-scans/s, capable of acquiring high-resolution B scans at 300 frames/s. The technique is sensitive enough to image very slow blood flow velocities, such as those found in capillary networks. The 3-D imaging acquisition time for a whole cochlea is  âˆ¼ 4.1 s. We demonstrate that volumetric reconstruction of microvascular flow obtained by UHS-OMAG provides a comprehensive perfusion map of several regions of the cochlea, including the otic capsule, the stria vascularis of the apical and middle turns and the radiating arterioles that emanate from the modiolus.

Volumetric in vivo imaging of intracochlear microstructures in mice by high-speed spectral domain optical coherence tomography.

There is considerable interest in developing new methods for in vivo imaging of the complex anatomy of the mammalian cochlea for clinical as well as fundamental studies. In this study, we explored, the feasibility of spectral domain optical coherence tomography (SD-OCT) for 3-D in vivo imaging of the cochlea in mice. The SD-OCT system employed in this study used a broadband light source centered at 1300 nm, and the imaging speed of the system was 47,000 A-scans per second using the InGaAs camera. The system was capable of providing fully processed, high-resolution B-scan images [512 (axial) x 128 (lateral) pixels] at 280 frames per sec. The 3-D imaging acquisition time for a whole cochlea was approximately 0.45 sec. The traditional SD-OCT structural imaging algorithm was used to reconstruct 3-D cochlear morphology. We demonstrated that SD-OCT can be successfully used for in vivo imaging of important morphological features within the mouse cochlea, such as the otic capsule and structures within, including Reissner's membrane, the basilar membrane, tectorial membrane, organ of Corti, and modiolus of the apical and middle turns.

D3 dopamine autoreceptors do not activate G-protein-gated inwardly rectifying potassium channel currents in substantia nigra dopamine neurons.

Substantia nigra (SN) dopamine neurons express D2 and D3 dopamine autoreceptors. A physiological role for the D3 receptor has not been identified, but an activation of G-protein-gated inwardly rectifying potassium (GIRK; also known as Kir3) channels is strongly implicated because D3 receptors activate channels composed of GIRK2 subunits in cell lines. We confirmed that acutely dissociated SN dopamine neurons indeed contain D3 and GIRK2 subunit mRNA using single-cell RT-PCR. We then tested whether D3 receptors activate GIRK currents in SN dopamine neurons by comparing acutely dissociated neurons from D2-/- receptor knock-out and congenic wild-type mice. In nearly all (14 of 15) wild-type SN dopamine neurons, the D2/D3 agonist quinpirole activated GIRK currents that were blocked by cesium. Quinpirole, however, elicited no GIRK currents in any SN dopamine neuron (0 of 13) derived from D2-/- receptor knock-out mice. The absence of quinpirole response was not caused by a lack of GIRK activity, because the GABAB receptor agonist baclofen continued to elicit these currents in the mutant neurons. Thus, it appears that D3 activation of GIRK currents in SN neurons does not occur or is exceedingly rare.

Imaging calcium entry sites and ribbon structures in two presynaptic cells.

We investigated the location of calcium entry sites and synaptic ribbons in the type-Mb goldfish bipolar neuron and the bullfrog saccular hair cell. Cells were loaded with a fast calcium indicator (Fluo-3 or Fluo-5F) and an excess of a high-affinity but slow Ca buffer (EGTA). The cell surface was imaged by evanescent field microscopy. Small fluorescent "hot spots" representing calcium entry sites appeared abruptly when a voltage step opened Ca channels and disappeared or dimmed abruptly when Ca channels closed. In bipolar cells, the fluorescence of hot spots tracked the calcium influx. Hair cells showed similar Ca hot spots. Synaptic ribbons or dense bodies were labeled by immunofluorescence with an antibody that recognizes the ribbon protein ribeye. The antibody labeled punctate structures beneath the plasma membrane. In both bipolar neurons and hair cells, the number of Ca entry sites was similar or identical to that of ribbons or dense bodies, consistent with the idea that calcium-channel clusters reside near ribbons, and that both mark active zones. In bipolar cells, the number of Ca entry sites and ribeye-positive fluorescent spots is also strikingly similar to that of exocytic active zones but significantly less than the number of total exocytic sites including solitary fusion events outside active zones. We suggest that in bipolar terminals, active zones, Ca entry sites, and synaptic ribbons all colocalize, but also that a significant number of vesicles can fuse outside active zones and, hence, independently of synaptic ribbons.