Association between maternal infections during pregnancy and congenital defects in their offspring: a population-based case-control study in Bogota and Cali, Colombia 2001-2018.

Infections are frequent during pregnancy and their teratogenic role is well documented in Toxoplasmosis, other infections, Rubella, Cytomegalovirus, and Herpes simplex (TORCH). However, the in-utero development effects of the rest of the infections that affect pregnant women are unknown. We described a cohort of patients with major Birth Defects (BD) and the exposure to infections during pregnancy from the information of Congenital Defects Surveillance Programs of two Colombian cities (Bogota and Cali) between 2001 and 2018. We evaluated associations between groups of maternal infections and BD among 3096 cases and 7446 controls that were registered. BD presentation was more frequent as isolated (64.3%), polymalformed (23.2%), and syndromic (12.4%). Infections during pregnancy were present in 52.5% of cases and 44.6% of controls. The most common single infection between cases and controls was vaginal infection. The most common polyinfection was vaginal and urinary tract infection. We found an association between BD and vaginal infections with an odds ratio (OR) 1.18 (CI 1.08-1.30), urinary tract infections OR 1.16 (CI 1.05-1.28), gastrointestinal infections OR 2.06 (IC 1.18-3.59), respiratory infections OR 1.56 (IC 1.28-1.9) and viral infections OR 1.88 (IC 1.18-3.0). Knowing the teratogenic effect of infections is important to extend prevention, screening, timely diagnosis, and appropriate treatment to pregnant women.

¿Cuáles son las barreras de acceso a la atención odontológica de las mujeres embarazadas? Una revisión de la literatura / What are the barriers of access to women's dental care pregnant? A review of the literature

Introducción: Las enfermedades bucales son altamente prevalentes a nivel mundial; una de las estrategias utilizadas para mejorar el estado de salud bucal de la población es la atención odontológica de la embarazada. En Chile esta atención está garantizada, sin embargo, la cobertura de las atenciones no es la esperada, sólo el 31 por ciento de las mujeres embarazadas accede a la atención odontológica y un 14 por ciento abandona el tratamiento antes de terminarlo. Métodos: El objetivo de este artículo es revisar la evidencia internacional y nacional respecto a las barreras que impiden a las mujeres embarazadas acceder al tratamiento odontológico. Resultados: Se describen diferentes barreras para la atención odontológica de la mujer embarazada, las que se pueden clasificar en las relacionadas con la organización del sistema de salud (costo de la atención, acceso a los prestadores y las características de los proveedores de la atención de salud) y las barreras personales (creencias de las pacientes, percepción de necesidad de tratamiento, miedo a la atención y valoración de la salud bucal). Conclusión: Existe evidencia internacional sobre cuáles son las barreras para el acceso a la atención odontológica de la mujer embarazada, entre ellas, destacan las barreras de acceso, como el costo de atención, sin embargo, a nivel nacional, esa barrera está soslayada, ya que el acceso y la protección financiera están garantizadas gracias a la cobertura GES. Por esta razón son necesarios estudios nacionales que indaguen sobre el fenómeno que impide que las embarazadas chilenas accedan al tratamiento odontológico.(AU)

Introduction: Oral diseases are highly worldwide prevalent; one of the strategies used to improve oral health status of the population is the specific pregnant women dental care program. In Chile this care is guaranteed by law, however, the dental attention coverage is not as well as expected, only 31% of pregnant women have access to dental care and 14percent of them, leave treatment before ending. Methods: The aim of this article is to review international and national evidence regarding the barriers that prevent pregnant women from accessing to dental treatment. Results: Different barriers are described. They can be classified in those related to the organization of the oral health system (care cost access to providers, care health providers characteristics) and personal barriers (patient's beliefs, perceived needs for treatment, fear and oral health assessment). Conclusion: There is international evidence about the barriers to access to pregnant women, dental care including barriers access such the care cost; however, at the national level, this barrier is overlooked since access and the financial protection is guaranteed by GES coverage. More studies are needed to investigate the phenomenon that avoids Chilean pregnant women from accessing to dental treatment.(AU)

Technetium-99m tetrofosmin scintigraphy to evaluate breast lesions.

UNLABELLED: The aim of this study is to characterise benign from malignant breast lesions by using 99mTc-Tetrofosmin. MATERIALS: Fifteen female patients with suspected breast lesions and ten normal controls underwent breast scintigraphy with 99mTc-Tetrofosmin. All patients had conventional mammography. Breast imaging begun 20 minutes after i.v. injection of 740 MBq 99mTc-Tetrofosmin. Patients were imaged in supine and prone position. Results of the 15 patients with suspected breast lesions, 13 showed breast uptake, and 6 of them had suspicious lesions on mammography. Surgery confirmed 10 carcinomas and 3 benign lesions. Two patients demonstrated no abnormal accumulation or suspicious findings in mammography. None of the normal controls had breast uptake or mammographic abnormalities. Our study has a sensibility of 100% and 60%, and a specificity of 80% and 100% in scintigraphy and mammography respectively. CONCLUSION: Our findings suggest that 99m Tc-Tetrofosmin may play a role in evaluating breast masses and that can differentiate benign from malignant lesions.

Efficacy of preoperative diagnostic imaging localization of technetium 99m-sestamibi scintigraphy in hyperparathyroidism.

BACKGROUND: Until now, preoperative parathyroid imaging has been considered unnecessary because currently available techniques do not provide any better results than an expert surgeon. We conducted a multicenter prospective study evaluating the capability of technetium 99m sestamibi scintigraphy in the preoperative identification of pathologic glands. METHODS: Ninety-three patients with hyperparathyroidism, seven of them reoperative cases, were studied. In addition, 20 age-matched normocalcemic control subjects were also studied. RESULTS: Surgical confirmation of scintigraphic images was obtained in 91 of 93 cases (sensitivity, 97.8%). In all reoperative cases (n = 7), in all cases of ectopic glands (whether operated or not; n = 6), and in all patients with a single-gland disease (n = 70), topographic identification of the pathologic gland was correct in 100%. In multiple-gland disease (n = 23), involvement of more than one gland was visualized in only 61% of the patients; however, in 91% of patients, at least one gland was localized. Surgical success-defined as postoperative normocalcemia-with this approach was 100%. All scans of normocalcemic control subjects were negative. Of 31 patients in whom a multinodular goiter coexisted, seven presented a significant radionuclide background at 120 minutes' scan. False-positive images were found together with those corresponding to the pathologic glands in only three cases. CONCLUSIONS: 99mTc-sestamibi is a highly reliable, sensitive, and specific technique for imaging of pathologic glands in hyperparathyroidism, especially in single-gland disease. It may be considered as a first line single-procedure when a preoperative topographic diagnosis is required.