Air pollution and meteorological variables' effects on COVID-19 first and second waves in Spain.

The aim of this research is to study the influence of atmospheric pollutants and meteorological variables on the incidence rate of COVID-19 and the rate of hospital admissions due to COVID-19 during the first and second waves in nine Spanish provinces. Numerous studies analyze the effect of environmental and pollution variables separately, but few that include them in the same analysis together, and even fewer that compare their effects between the first and second waves of the virus. This study was conducted in nine of 52 Spanish provinces, using generalized linear models with Poisson link between levels of PM10, NO2 and O3 (independent variables) and maximum temperature and absolute humidity and the rates of incidence and hospital admissions of COVID-19 (dependent variables), establishing a series of significant lags. Using the estimators obtained from the significant multivariate models, the relative risks associated with these variables were calculated for increases of 10 µg/m3 for pollutants, 1 °C for temperature and 1 g/m3 for humidity. The results suggest that NO2 has a greater association than the other air pollution variables and the meteorological variables. There was a greater association with O3 in the first wave and with NO2 in the second. Pollutants showed a homogeneous distribution across the country. We conclude that, compared to other air pollutants and meteorological variables, NO2 is a protagonist that may modulate the incidence and severity of COVID-19, though preventive public health measures such as masking and hand washing are still very important. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-022-04190-z.

Desenlaces con dos técnicas de sutura hemostática uterina en pacientes con hemorragia obstétrica / Results with two techniques of uterine hemostatic sutures in obstetric hemorrhage patients

Resumen OBJETIVO: Exponer los desenlaces de dos técnicas de sutura hemostática uterina para controlar la hemorragia obstétrica. MATERIALES Y MÉTODOS: Estudio prospectivo, observacional y longitudinal, llevado a cabo en tres unidades hospitalarias de Guanajuato, México, del 1 de enero al 30 de noviembre de 2018. Se incluyeron pacientes con hemorragia transcesárea y posparto. En las primeras se aplicó la técnica de B-Lynch y en las segundas la de Hayman. Se analizaron las variables: 1) cantidad de hemorragia antes y después de aplicar la sutura, 2) tiempo del procedimiento, 3) concentración de hemoglobina al ingreso a la unidad de atención, 1 hora después de la hemorragia y 24 horas posteriores a la intervención quirúrgica, 4) desenlace de las técnicas y 5) complicaciones. Para el análisis de los datos se utilizó el programa SPSS versión 22 para Windows. RESULTADOS: Se registraron 34 pacientes: 26 con aplicación de la técnica de sutura B-Lynch y 8 con la técnica de Hayman. La pérdida sanguínea después de la aplicación de las técnicas fue menor (p < 0.001). El tiempo entre el diagnóstico de hemorragia y la aplicación de la sutura fue de 11.5 ± 5.9 minutos. La concentración de hemoglobina al ingreso al hospital y 1 h posterior a la hemorragia fue significativamente menor (p < 0.01) versus 24 h después (p < 0.05) 30 de 34 pacientes tuvieron reacción favorable al tratamiento quirúrgico. Cuatro mujeres requirieron procedimientos adicionales para el control de la hemorragia. No se reportaron complicaciones ni muertes maternas asociadas con las técnicas de sutura. CONCLUSIONES: Las técnicas de sutura uterina representan un procedimiento útil, rápido y sin complicaciones para el control de la hemorragia obstétrica.

Abstract OBJECTIVE: To present the results obtained with two techniques of uterine hemostatic sutures for the control of obstetric hemorrhage. MATERIALS AND METHODS: Prospective, observational, longitudinal study in three hospital units of the 1st. from January to November 30, 2018. Thirty-four patients with postpartum and transcesarean hemorrhage were included. The postpartum patients underwent Hayman technique and the B-Lynch technique. The following were analyzed: 1) amount of hemorrhage before and after the sutures, 2) time between diagnosis and placement, 3) hemoglobin levels at admission to the care unit, 1 hour after the hemorrhage and 24 hours after treatment, 4) results with the two techniques and 5) complications. Statistical analysis of all these variables was performed with SPSS, 22 version. RESULTS: A total of 34 patients were registered: 26 sutures performed with B-Lynch technique and 8 with Hayman technique. The amount of bleeding after the application was lower (p <0.001). The time between diagnosis of bleeding and placement was 11.5 + 5.9 minutes. The hemoglobin levels at admission to the hospital and one hour after the hemorrhage were significantly lower (p <0.01) and 24 hours later (p <0.05). In 30/34 of cases, a favorable response to surgical treatment was achieved. In four cases, another procedure was required to control bleeding. There were no complications with the use of sutures or maternal deaths. CONCLUSIONS: The use of uterine sutures was a useful, fast and uncomplicated therapy for the control of obstetric hemorrhage.

Encefalopatía posterior reversible durante el puerperio, secundaria a eclampsia. Reporte de dos casos / Reversible posterior encephalopathy during puerperium secondary to eclampsia. Report of two cases

Resumen ANTECEDENTES: El síndrome de encefalopatía posterior reversible es una alteración rara, que aparece en el tercer trimestre del embarazo y en el puerperio, asociada con preeclampsia-eclampsia y síndrome de Hellp. Los estudios de radioimagen son decisivos para establecer el diagnóstico y diferenciarlo de otros trastornos neurológicos, por su tratamiento y pronóstico diferentes. CASOS CLÍNICOS: Reporte de dos casos de encefalopatía posterior reversible con factores de riesgo diferentes para su manifestación (choque séptico, insuficiencia orgánica múltiple y síndrome de preeclampsia-eclampsia). El diagnóstico se estableció con base en la enfermedad subyacente, la sospecha clínica y los hallazgos en la resonancia magnética. En ambos casos coincidió la mayor parte de los síntomas relacionados con eclampsia. El tratamiento oportuno y la corrección del desequilibrio hidroelectrolítico, ácido-base, sepsis y sobrecarga de volumen fueron decisivos para revertir el cuadro y prevenir la evolución del síndrome. El diagnóstico de encefalopatía posterior reversible se corroboró por estudios radiológicos. Las pacientes egresaron de cuidados intensivos con remisión completa del cuadro neurológico. CONCLUSIONES: La prevalencia de encefalopatía posterior reversible en pacientes embarazadas es desconocida, su manifestación obedece a diferentes causas y las mujeres suelen recuperarse completamente; sin embargo, el diagnóstico y tratamiento deben individualizarse en cada caso.

Abstract BACKGROUND: Reversible posterior encephalopathy syndrome is a rare entity. It occurs most frequently in the third trimester and puerperium, associated with cases of preeclampsia-eclampsia and Hellp's syndrome. Radioimage studies are basic for its diagnosis and must be differentiated from other neurological pathologies, due to its different treatment and prognosis. CASES REPORT: This study presents two cases of reversible posterior encephalopathy syndrome with different risk factors for its presentation (septic shock, multiple organ failure and preeclampsia-eclampsia syndrome). The diagnosis is based on the underlying disease, clinical suspicion and magnetic resonance findings. In both cases, most of the symptoms related to eclampsia. The timely treatment and correction of fluid-electrolyte imbalance, acid-base, sepsis and volume overload are decisive in reversing the condition and preventing the evolution of the syndrome. The diagnosis of reversible posterior encephalopathy was corroborated by radiological studies. The patients withdrew from the care unit with complete remission of the neurological symptoms. CONCLUSIONS: Reversible posterior encephalopathy is a rare entity, of unknown prevalence in the pregnant patient, which occurs for different reasons, with full recovery, but which requires a specific diagnosis and treatment.

Evaluation of different agroindustrial waste on the effect of different carcass characteristics and physiological and biochemical parameters in broilers chicken.

AIM: This study was conducted to evaluate the physiological and biochemical effect in chickens of the Ross breed of a food enriched with agroindustrial waste. MATERIALS AND METHODS: The food is one of the main components of the total cost for the production of chickens. Rations should be formulated to provide the correct balance of energy, protein, amino acids, minerals, vitamins and essential fatty acids, to allow optimal growth and performance. This study was intended to evaluate a natural feed for chicken, made from corn, yucca meal, eggshells, orange peel, soybean meal, salt and garlic, enriched with agroindustrial waste (molasses, milk whey and ferment of coffee). The weight gain was evaluated in broilers using a diet enriched with different agroindustrial wastes, with respect to a control food of the same composition but not containing residue. To develop the experiment 120 male Ross 308 chicks were used, these were evaluated for 6 weeks. Physicochemical test for the food and the agroindustrial waste were performed; moisture was determined; organic carbon, organic material and the ash, to characterize the agroindustrial wastes, the reducing sugars content using a spectrophotometer at 540 nm and proteins through the Kjeldahl method was evaluated. During the experiment, the weight gain of chickens and feed conversion was evaluated; the end of the experiment the weight of eviscerated channel relative weight breast, thighs, pancreas, and abdominal fat was determined, besides including blood chemistries as determination of cholesterol, triglycerides, and glucose. Finally, the microbiological analyzes to detect the presence of Escherichia coli in the cecum was determinate. Data were analyzed by InfoStat statistical program using the generalized linear model procedure. The statistical comparison was made by Tukey test at the 95% probability level. RESULTS: After the evaluation, fed chickens with the treatments food + milk whey (FMW) and food + ferment of coffee (FFC) demonstrated increased from 1949 to 1892 g, respectively, to the 42 days of evaluation, showing the best treatment for weight gain. However, the FFC treatment showed the best feed conversion reaching values of 1.79 related to levels of blood glucose (249 mg/dl). Even so the eviscerated channel yields were higher for the treatment FFC reaching 1810.1 g unlike the treatment FMW which it reached a weight of 1718.2 g with increased formation of abdominal fat (7.4 g) unlike other treatments. From the results, it is concluded that food enriched with coffee ferment allows an increase in weight, better feed conversion in addition to high production of lean meat. CONCLUSION: It was shown that the best treatment was the food enriched with the ferment of coffee, due to increased intake and weight gain at the end of 42 days of the experiment.

Experiencia con el balón de Bakri en hemorragia obstétrica / Brakri balloon experience in obstetric hemorrhage

Resumen OBJETIVO: reportar la experiencia con el balón de Bakri en el control de la hemorragia obstétrica, su relación con la cantidad y concentraciones de hemoglobina antes y después de su aplicación. MATERIALES Y MÉTODOS: estudio prospectivo y observacional efec- tuado en dos unidades hospitalarias del 1 de enero al 31 de diciembre de 2016. A todas las pacientes se les aplicó el balón de Bakri por falta de respuesta a los uterotónicos. Variables de estudio: datos clínicos, cantidad de pérdida sanguínea antes y después de la aplicación del balón, cantidad de sangrado en el posparto y transcesárea, tiempo trascurrido entre el diagnóstico y la colocación, tiempo de llenado y volumen administrado, concentraciones de hemoglobina y pruebas de coagulación al ingreso a la unidad de atención, postsangrado y posterior a la aplicación, indicación de hemocomponentes, cantidad y tiempo de permanencia del balón, éxito y complicaciones. Se realizó análisis estadístico de todas estas variables. RESULTADOS: se incluyeron 20 pacientes con hemorragia posparto y transcesárea. La cantidad de sangrado después de la aplicación, tanto en los casos de posparto como transcesárea, fue menor y se obtuvo una adecuada respuesta. El tiempo medio entre el diagnóstico de la hemorragia y la colocación del balón fue de 30 minutos, tiempo medio de llenado de 5 minutos y cantidad media de llenado de 400 mL. El tiempo medio de permanencia del balón fue de 29.5 horas. En 95% de los casos se consiguió una respuesta favorable para el control de la hemorragia, sin complicaciones. CONCLUSIONES: la aplicación del balón de Bakri resultó en una medida útil, rápida y sin complicaciones para controlar la hemorragia obstétrica.

Abstract OBJECTIVE: To present the results obtained by using the Bakri Balloon to control obstetric hemorrhage. MATERIALS AND METHOD: Prospective, observational study within two inpatient medical care units from January 1 to December 31 2016. All of them were applied the Bakri Balloon because of failure to respond to uterotonic drug therapy. The following were analized: clinical data, amount of bleeding before and after the balloon, amount of postpartum or transcesarean bleeding, time between diagnosis and insertion, insufflation time and supplied volumen, hemoglobin levels and coagulation tests results initially, post-hemorrhage and post insertion, use of and amount of haemocomponents ministered, and the balloons use time, success, and complications. RESULTS: 20 patients with postpartum and transesarean hemorrhage are included. The amount of bleeding after insertion, both in postpartum and trans cesarean was reduced and there was an adequate response in hemoglobin levels. The average time between hemorrhage diagnosis and balloon insertion was thirty minutes; average insufflation time, five minutes, and average volumen supplied 400 mL. Balloon's average use time, 29.5 hours. In 95% of the cases there was a positive response for hemorrhage control, with no complications derived from use. CONCLUSIONS: The Bakri Balloon proved to be a useful, quick and complication-free therapy for controlling obstetric hemorrhage.

Review of natural products with hepatoprotective effects.

The liver is one of the most important organs in the body, performing a fundamental role in the regulation of diverse processes, among which the metabolism, secretion, storage, and detoxification of endogenous and exogenous substances are prominent. Due to these functions, hepatic diseases continue to be among the main threats to public health, and they remain problems throughout the world. Despite enormous advances in modern medicine, there are no completely effective drugs that stimulate hepatic function, that offer complete protection of the organ, or that help to regenerate hepatic cells. Thus, it is necessary to identify pharmaceutical alternatives for the treatment of liver diseases, with the aim of these alternatives being more effective and less toxic. The use of some plants and the consumption of different fruits have played basic roles in human health care, and diverse scientific investigations have indicated that, in those plants and fruits so identified, their beneficial effects can be attributed to the presence of chemical compounds that are called phytochemicals. The present review had as its objective the collecting of data based on research conducted into some fruits (grapefruit, cranberries, and grapes) and plants [cactus pear (nopal) and cactus pear fruit, chamomile, silymarin, and spirulina], which are consumed frequently by humans and which have demonstrated hepatoprotective capacity, as well as an analysis of a resin (propolis) and some phytochemicals extracted from fruits, plants, yeasts, and algae, which have been evaluated in different models of hepatotoxicity.

Hepatoprotective effect of silymarin.

The use of medicinal plants in treating illnesses has been reported since ancestral times. In the case of hepatic diseases, several species such as Silybum marianum, Phyllanthus niruri, and Panus giganteus (Berk.) have been shown to ameliorate hepatic lesions. Silymarin is a natural compound derived from the species Silybum marianum, which is commonly known as Milk thistle. This plant contains at least seven flavoligands and the flavonoid taxifolin. The hepatoprotective and antioxidant activity of silymarin is caused by its ability to inhibit the free radicals that are produced from the metabolism of toxic substances such as ethanol, acetaminophen, and carbon tetrachloride. The generation of free radicals is known to damage cellular membranes and cause lipoperoxidation. Silymarin enhances hepatic glutathione and may contribute to the antioxidant defense of the liver. It has also been shown that silymarin increases protein synthesis in hepatocytes by stimulating RNA polymerase I activity. A previous study on humans reported that silymarin treatment caused a slight increase in the survival of patients with cirrhotic alcoholism compared with untreated controls.

Exposure to sodium fluoride produces signs of apoptosis in rat leukocytes.

Fluoride is naturally present in the earth's crust and can be found in rocks, coal, and clay; thus, it can be found in small quantities in water, air, plants, and animals. Therefore, humans are exposed to fluoride through food, drinking water, and in the air they breathe. Flouride is essential to maintain bone strength and to protect against dental decay, but if it is absorbed too frequently, it can cause tooth decay, osteoporosis, and damage to kidneys, bones, nerves, and muscles. Therefore, the present work was aimed at determining the effect of intake of sodium fluoride (NaF) as an apoptosis inducer in leukocytes of rats treated for eight weeks with 1 or 50 parts per million (ppm) NaF. Expression of p53, bcl-2, and caspade-3 were used as apoptotic and general metabolism indicators of leukocyte-like indicators of the (INT) oxidation system. Male rats were exposed to NaF (1 and 500 ppm) for eight weeks, and then sacrificed weekly to obtain blood samples. Expression of p53, bcl-2, and caspase-3 were determined in leukocytes by Western blot, and general metabolism of leukocytes was analyzed with a commercial kit. We found changes in the expression of the proteins described, especially when the animals received 50 ppm of NaF. These results indicate that NaF intoxication can be an apoptosis inducer in rat leukocytes treated with the compound for eight weeks.

Effect of sodium fluoride ingestion on malondialdehyde concentration and the activity of antioxidant enzymes in rat erythrocytes.

Fluoride intoxication has been shown to produce diverse deleterious metabolic alterations within the cell. To determine the effects of sodium fluoride (NaF) treatment on malondialdehyde (MDA) levels and on the activity of antioxidant enzymes in rat erythrocytes, Male Wistar rats were treated with 50 ppm of NaF or were untreated as controls. Erythrocytes were obtained from rats sacrificed weekly for up to eight weeks and the concentration of MDA in erythrocyte membrane was determined. In addition, the activity of the enzymes superoxide, dismutase, catalase, and glutathione peroxidase were determined. Treatment with NaF produces an increase in the concentration of malondialdehyde in the erythrocyte membrane only after the eight weeks of treatment. On the other hand, antioxidant enzyme activity was observed to increase after the fourth week of NaF treatment. In conclusion, intake of NaF produces alterations in the erythrocyte of the male rat, which indicates induction of oxidative stress.

Use of zeolitised coal fly ash for landfill leachate treatment: a pilot plant study.

Treatment of municipal solid waste (MSW) landfill leachate generally results in low percentages of nutrient removal due to the high concentration and accumulation of refractory compounds. For this reason, individual physical, chemical and biological processes have been used for the treatment of raw landfill leachate and sometimes for the mixture of domestic wastewater and landfill leachate. In this work, the possibility of treating landfill leachate was tested in a bench-scale pilot plant by a two-step method combining adsorption and coagulation-flocculation. Zeolite synthesized from coal fly ash, a by-product of coal-fired power stations, was used in this study both as a decantation aid reagent and as an adsorbent of COD and NH4-N. The coagulation-flocculation step was performed by the use of aluminium sulphate and a polyelectrolyte (ACTIPOL A-401). The leachate was collected directly from a storage unit of the organic fraction of MSW, before it was composted. For this reason the raw leachate was diluted before treatment. The sludge was recirculated to enhance the removal efficiency of nutrients as well as to optimize flocculant saving and to decrease sludge production. The results showed that it is possible to remove 43%, 53% and 82% of COD, NH4-N, and suspended solids, respectively. Therefore, this method may be an alternative for ammonium removal, as well as a suitable pre- or post-treatment step, in combination with other processes in order to meet regulatory limits.

Clinical experience with electroconvulsive therapy at the Instituto Mexicano de Psiquiatría.

Electroconvulsive therapy (ECT) is a useful option for the treatment of certain psychiatric illnesses. Its efficacy and few side effects make it an important therapeutic alternative in the management of the patient with major depression. This study describes the clinical experience with ECT at the Instituto Mexicano de Psiquiatría. We retrospectively evaluated the clinical records of patients treated with ECT during the period of April 1990 to June 1994. A total of 55 patients were included in the analysis, the mean age was 42.4 +/- 17.2 years old. Diagnostic categories treated were major depression (43.6%), non-affective psychotic disorders (30.9%), mania (12.7%) and other diagnoses (12.7%). A positive response to ECT was found in 74.5% of patients. Subjects with major depression and mania responded significantly better than the rest of the patients (p < 0.01). Psychotic depression was not a predictor of better response. Only 18.1% of subjects had minor complications, all transitory. ECT is a highly effective therapeutic option in the treatment of psychiatric illness, especially in major depression and mania. The use of ECT in a tertiary psychiatric unit in Mexico reflects similar results as described in the international literature.

Clinical experience with electroconvulsive therapy at the Instituto Mexicano de Psiquiatría

Electroconvulsive therapy (ECT) is a useful option for the treatment of certain psychiatric illnesses. Its efficacy and few side effects make it an important therapeutic alternative in the management of the patients with major depression. This study describes the clinical experience with ECT at the Instituto Mexicano de Psiquiatría. We retrospectively evaluated the clinical records of patients treated with ECT during the period of April 1990 to June 1994. A total of 55 patients were included in the analysis, the mean age was 42.4 ñ 17.2 years old. Diagnostic categories treated were major depression (43.6 percent), non-affective psychotic disorders (30.9 percent), mania (12.7 percent) and other diagnoses (12.7 percent). A positive response to ECT was found in 74.5 percent of patients. Subjects with major depression and mania responded significantly better than the rest of the patients (p<0.01). Psychotic depression was not a predictor of better response. Only 18.1 percent of subjects had minor complications, all transitory. ECT is a highly effective therapeutic option in the treatment of psychiatric illness, especially in major depression and mania. The use of ECT in a tertiary psychiatric unit in Mexico reflects similar results as described in the international literature

[Usefulness of intraperitoneal transfusion under direct ultrasound guidance]. / Utilidad de la transfusión intraperitoneal bajo guía ultrasonográfica directa.

Experience with intraperitoneal blood transfusion, using ultrasonographic guide, in 24 patients with severe isoimmunization to Rh factor, is reported. A total of 57 procedures, were done from 24 weeks of gestation. In 66.6% two or more transfusions were done in the same product. There were 71% of alive newborns and in 29% of the cases it was not possible to improve perinatal survival. The analysis of these results were correlated with antecedents: presence of hydrops, gestational age at the time of resolving pregnancy, and main disease status. The usefulness of intraperitoneal transfusion, is commented upon, and new perspectives, as intravascular transfusion in cases with severe hydrops, are considered.

Significado perinatal del trazo sinusoidal en la isoinmunización al factor Rh / perinatal meaning of the sinusoidal trace

Se estudiaron 74 pacientes Rh negativas isoinmunizadas. En todos los casos se practicó aminocentesis para espectrofotometría, extrapolando el resultado a la gráfica de Liley y cardiografía semanalmente, a partir de las 28 semanas de embarazo. Los registros fueron interpretados por un mismo observador y la presencia de trazo sinusoidal (TS) se definió de acuerdo a los criterios de Manseou, formándose dos grupos en telación al hallazgo cardiotocográfico, grupo I casos sin TS y grupo II con TS. En el recién nacido se determinaron grupo sanguíneo, Rh, isoglutinas directas, bilirrubinas y hemoglobinas. Se correlacionó la presencia o ausencia de TS con la zona en la gráfica de Liley, hemoglobina al nacimiento y tratamiento neonatal, encontrándose p = .005. La mortalidad perinatal fue del 42.3%y el análisis estadístico demostró una diferencia altamente significativa entre ambos grupos p = .001. Se concluye que la presencia de TS asociado a la isoinmunización es potencialmente ominoso en el resultado perinatal.

Tendencia de la curva espectrofotométrica y su correlación con el resultado perinatal / Correlation between the trend of the spectrophotometric curve and perinatal autcome

Se estudiaron 40 pacientes Rh negativo sensibilizadas a quienes se les realizó determinación espectrofotométrica en dos o más ocasiones y que no recibieron transfusión intrauterina. Se correlacionaron las zonas pronósticas de Liley y las tendecias de las curvas espectrofotométricas en forma independiente y con el resultado perinatal. La tendencia se clasifica como descendente, estacionaria y ascendente; el parámetro del resultado perinatal que se correlacionó fue el valor de hemoglobina en sangre de cordón umbilical al nacimiento y se calificó a la enfermedad hemolítica como leve, moderada y severa, misma que determinó el tratamiento neonatal. De los 40 casos revisados 27 correspondieron a la zona I, 12 en zona II tercio inferior y 2 en el tercio medio. En 27 casos de la tendencia de las cifras espectrofotométricas fue descendente y 13 estacionarias o ascendentes. El valor predictivo negativo del esquema de Liley fue de 76.32%y en una especificidad del 96.66%; en cambio cuando se efectuó predicción empleando las tendencias además de las zonas referidas, el valor predictivo negativo aumentó a 89%y la especificidad disminuyó al 80%. Los resultados sugieren que cuando se agrega al análisis de la tendencia espectrofotométrica se mantiene la posibilidad de diagnosticar al feto sano y se eleva su predicción, eliminando las falsas negativas en enfermedad hemolítica severa.

Perspectivas en el tratamiento del embarazo prolongado / Perspectives in the treatment of prolonged pregnancy

Se presenta un protocolo prospectivo en 69 casos de embarazo verdadero, efectuándose registro cardiotocográfico, ultrasonido y búsqueda de meconio para evaluar condición fetal. De acuerdo al resultado se formaron dos grupos: Grupo I, feto probablemente sano y Grupo II, feto probablemente enfermo. En el primero se encontraron 50 casos y 19 en el segundo. Se efectuó conducta conservadora, hasta las 44 semanas en el grupo I y tratamiento intervencionista para el grupo II. El 88%se las pacientes del primer grupo desencadenaron espontáneamente el parto, independientemente de características cervicales y paridad, no encontrándose morbilidad ni mortalidad. En el grupo II se presentaron 12 casos con oligohidrammios, 10 con alteración cardiotocográfica y 8 con meconio. Los casos de sufrimiento fetal, aspiración de meconio y uno con mortalidad, coincidieron en pacientes sometidas a inducción. En el grupo I se presentó el caso con síndrome de postmadurez y la edad promedio al nacimiento fue de 38.5 semanas, en el grupo II fueron 7 casos y 42.1 semanas, respectivamente. Se concluye que la realización de estudios anteparto son un parámetro fidedigno para evaluar el estado fetal y deben ser los resultados de estas pruebas, los que decidan la conducta terapéutica del embarazo prolongado.

Resultado perinatal del embarazo múltiple con un protocolo estándard de tratamiento / Perinatal result of multiple pregnancy with a standard protocol of treatment

Se presentan los resultados obtenidos en un grupo de 36 pacientes con embarazo múltiple, en las que se instituyó un protocolo de manejo, con objeto de disminuir la morbilidad y mortalidad perinatal. El protocolo consistió en la aplicación de siete diferentes puntos. Con dicho protocolon se obtuvo una disminución en la morbilidad perinatal, en cuanto a lo referente a preclampsia, retardo en el crecimiento intrauterino, parto pretérmino y síndrome de insuficiencia respiratroia neonatal. La mortalidad perinatal en este grupo fue sólo de 3.7%. Se concluye que el manejo estandarizado del embarazo múltiple disminuye importante los riesgos perinatales en dicha eventualidad obstétrica

Sindrome de Takayasu y embarazo. / Takayasu's syndrome and pregnancy

Se informa la experiencia de cuatro pacientes con cinco embarazos asociados a sindrome de Takayasu tratados en el Departamento de Perinatologia del HGO 2 del CMN. Se analiza la evolucion de la gestacion, complicaciones y metodo de resolucion. Asimismo, se revisa la literatura mundial en relacion con dicha asociacion, en la que se encontraron solamente quince casos informados hasta la fecha y analizan los resultados de los mismos. El objetivo de este estudio es revisar las complicaciones maternas y fetales de la gestacion complicada con el sindrome de Takayasu; en esta revision se encontro una mayor tendencia a la aparicion de cuadros hipertensivos y a un retardo en el crecimiento intrauterino del feto