Comportamiento de variables clínico epidemiológicas en la atención prenatal / The Characteristics of Clinical-Epidemiological Variables in Prenatal Care

Introducción: La atención prenatal a cada embarazada establece una asistencia médica integral y particularizada, que posibilita determinar y accionar precozmente sobre los factores de riesgo modificables, mediante la vigilancia continua. Objetivo: Describir el comportamiento de la atención prenatal según variables clínico epidemiológicas. Métodos: Estudio observacional descriptivo en el policlínico Pedro del Toro, entre 2014 y 2018. Incluyó 2761 pacientes que representan el total de gestantes en el periodo de estudio que cumplieron los criterios señalados. La información se obtuvo mediante revisión de la base de datos del programa materno infantil, con lo cual se delimitaron las variables que permitieron procesar los datos en una hoja de cálculo EXCEL, utilizando parámetros estadísticos a nivel descriptivo. Resultados: Las gestantes captadas antes de 12 semanas (2442 para 88,44 por ciento) fueron mayoría, primó el rango de 18,9 hasta 25,5 kg/m2 en índice de masa corporal (1657 para 60,01 por ciento). En el parto predominaron gestantes que tenían entre 37 y 41,6 semanas (2531 para 91,66 por ciento) y el rango de peso del recién nacido más relevante fue entre 2500 y 4000 gramos (2443 para 88,48 por ciento). Las edades comprendidas entre 21 a 29 años fueron representativas (1438 para 52,08 por ciento). Conclusiones: De la captación precoz de las embarazadas dependerá, en gran medida, la efectividad de la atención prenatal, a través de la detección oportuna y el seguimiento de todos los elementos que influyen en el bienestar materno fetal(AU)

Introduction: Prenatal care to each pregnant woman establishes a comprehensive and particularized medical assistance, which makes it possible to determine and act early on modifiable risk factors through continuous surveillance. Objective: To describe the characteristics of prenatal care according to clinical-epidemiological variables. Methods: Descriptive and observational study carried out at Pedro del Toro outpatient polyclinic between 2014 and 2018, with 2,761 patients, which represented the total number of pregnant women in the study period who met the indicated criteria. The information was obtained by reviewing the database of the mother and infant program, which permitted to define the variables for processing the data in an Excel worksheet, using statistical parameters at a descriptive level. Results: The pregnant women diagnosed before the twelfth weeks (2442; 88.44 percent) were the majority, with a body mass index range of 18.9 to 25.5 kg/m2 (1657; 60.01 percent). Regarding delivery, pregnant women between 37 and 41.6 weeks predominated (2531; 91.66 percent) and the most relevant newborn weight range was between 2500 and 4000 grams (2443; 88.48 percent). Ages between 21 to 29 years were representative (1438; 52.08 percent). Conclusions: The effectiveness of prenatal care through timely detection and follow-up of all the elements that influence maternal and fetal well-being will depend, to a large extent, on early detection of pregnant women(AU)

Validation of the Special Projects of National Significance adherence tool in HIV/AIDS patients.

BACKGROUND: Adherence to highly active antiretroviral therapy (HAART) is crucial for success. Therefore, having validated tools to help assess adherence is necessary. The Health Resources and Services Administration assessed adherence as a Special Project of National Significance (SPNS). As a result of their study, a 3-question survey was developed as a simple tool to assess adherence in patients with HIV/AIDS. OBJECTIVE: To validate the SPNS adherence survey as an accurate and effective way to assess adherence and to determine whether any other independent variables correlate with a significant reduction in viral load. METHODS: The study was a retrospective chart review of 300 patients actively enrolled in an HIV/AIDS clinic from January 2007 to September 2007. Patients were eligible for the study if they had been on HAART for at least 6 months, were > or =18 years old, and had completed at least 2 surveys. RESULTS: A total of 74 patients met the criteria; the majority were male (75.3%) and African American (91.9%). Twenty-six (35.1%) patients had scores < or =10, indicating poorer adherence, and 48 (64.9%) patients had scores > or =11. The mean number of antiviral plus other medications was 4.4. Dosing of HAART drugs was once (5 nonadherent, 23 adherent pts.) and twice (21, 25 pts., respectively) daily, and mean number of different antiretroviral tablets/capsules being taken was 1.7 and 1.5, respectively. The nonadherent patients' average viral load was 15,202.3 copies/mL, while the adherent patients' average viral load was 163.8 copies/mL (p = 0.001) The SPNS score was significantly associated with HIV-RNA viral load (-0.482, p < 0.001). There also was a significant association between a higher HIV-RNA viral load and the total number of medications a patient was taking, as well as the number of different antiretroviral tablets/capsules being taken (0.299, p = 0.01; 0.249, p = 0.03). There was no significant difference in HIV-RNA viral load when comparing age, sex, race, income, and frequency of HIV drug dosing. CONCLUSIONS: The SPNS survey is a valid and simple tool in measuring adherence that can aid health-care professionals in assessing adherence to HAART.

Stability of metoprolol tartrate injection 1 mg/mL undiluted and 0.5 mg/mL in 0.9% sodium chloride injection and 5% dextrose injection.

PURPOSE: The stability of metoprolol tartrate injection 1 mg/mL undiluted and 0.5 mg/mL in 0.9% sodium chloride injection and 5% dextrose injection was studied. METHODS: Sample set A contained 50 mL of Metoprolol Tartrate Injection, USP, 1 mg/mL transferred directly from the vials. Sample set B contained 50 mL of metoprolol 0.5 mg/mL diluted with 0.9% sodium chloride injection, and sample set C contained 50 mL of metoprolol 0.5 mg/mL diluted with 5% dextrose. All samples were prepared in triplicate and stored at room temperature. The stability of the samples was analyzed in duplicate using stability-indicating high-performance liquid chromatography immediately after preparation and at 6, 12, 18, 24, and 30 hours. The samples were assessed for pH and inspected for color and visible precipitation changes. The stability of metoprolol was determined by evaluating the percentage of the initial concentration remaining at each time interval. Stability of the product was defined as retention of 90% of the initial concentration. RESULTS: The mean +/- S.D. initial concentration in sample sets A, B, and C was 1.006 +/- 0.009 mg/mL, 0.498 +/- 0.002 mg/mL, and 0.499 +/- 0.002 mg/mL, respectively. Throughout the 30-hour study period, at least 99% of the initial concentration of metoprolol tartrate remained in all three preparations at all time points. No appreciable changes in pH occurred. No changes in color and no visible precipitate or microbial growth were detected. CONCLUSION: Metoprolol tartrate injection 1 mg/mL undiluted and 0.5 mg/mL in 0.9% sodium chloride injection and 5% dextrose injection were stable at room temperature for at least 30 hours.