Acceptability, tolerability, and effects on symptoms and signs of vulvovaginitis of a non-soap, herbal-based intimate hygiene solution (Zelesse®).

OBJECTIVE: To evaluate the acceptability, tolerability, and effects on vulvovaginitis symptoms and signs of a non-soap, herbal-based intimate solution (Zelesse®). METHODS: We conducted a prospective, observational, multicenter study including adult women with symptoms and signs of vulvovaginitis with various etiologies, including candidiasis, trichomoniasis, bacterial vaginosis, and atrophic and irritative vaginitis. The presence and intensity of signs (edema, erythema, vaginal discharge) and symptoms (pruritus) of vulvovaginitis were evaluated before and after 5-15 days of daily use of Zelesse® alone or as a coadjuvant in antimicrobial therapy. Variables following a normal distribution and categorical variables were analyzed using the Student t-test and chi-square or Fisher's exact test, respectively. RESULTS: A total 137 women were enrolled in the study; 87 (63.5%) women received concomitant antimicrobials and 50 (36.5%) used Zelesse® only. Global symptom scores and frequency of patients with vulvovaginitis signs and symptoms, and their mean intensity, decreased after treatment in both patient groups. Vaginal pH and (in the Zelesse®-only group) vaginal flora remained unaltered. The product was safe, well tolerated, and highly accepted by patients. CONCLUSIONS: Zelesse®, the non-soap herbal-based solution in this study, may represent a safe and effective option for symptomatic relief of vulvovaginitis.

Manejo perioperatorio y periprocedimiento del tratamiento antitrombótico: documento de consenso de SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT y AEU / Perioperative and periprocedural management of antithrombotic therapy: consensus document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU

En los últimos años, el número de pacientes anticoagulados y antiagregados está aumentando significativamente. Al ser un tratamiento crónico, es de esperar que a lo largo de su vida necesiten un procedimiento quirúrgico o intervencionista que pueda requerir la interrupción del fármaco antitrombótico. La decisión de retirar o mantener dicho tratamiento estará determinada, por un lado, por el riesgo trombótico y, por otro, por el hemorrágico. De la interacción entre estos 2 factores dependerá la actitud ante la anticoagulación y la antiagregación. El objetivo de este documento de consenso, coordinado desde el Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología y certificado por un amplio número de sociedades científicas que participan en el proceso asistencial del paciente durante el periodo perioperatorio o periprocedimiento, consiste en proponer una serie de recomendaciones prácticas y sencillas con el fin de homogeneizar la práctica clínica diaria

During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice

Perioperative and Periprocedural Management of Antithrombotic Therapy: Consensus Document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU.

During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice.

Umbilical artery Doppler at 19 to 22 weeks of gestation in the prediction of adverse pregnancy outcomes.

OBJECTIVE: The aim of this study was to determine the clinical utility of Doppler assessment of the umbilical artery in the second trimester scan for predicting adverse pregnancy outcomes. METHODS: Singleton pregnancies that had undergone routine anomaly scan at 19 to 22 weeks of gestation with umbilical and uterine artery Doppler measurements. Receiver operating characteristic curves were constructed to evaluate the ability of umbilical artery pulsatility index (PI) to predict small for gestational age and preeclampsia. RESULTS: The final study population comprised 4565 singleton pregnancies. Multiple regression analysis showed significant independent contribution of umbilical artery PI in predicting SGA <10th and SGA <5th centiles (adjusted odds ratios of 2.51 and 3.51, respectively). By using a cutoff of umbilical artery PI >90th centile, the likelihood ratio of SGA <5th centile is 2.3 (95% CI: 1.7-3.0). CONCLUSIONS: Umbilical artery PI at 19 to 22 weeks of gestation is significantly associated with SGA below the tenth and fifth centiles. A multivariate model combining umbilical and uterine artery Doppler measurements with additional maternal and sonographic characteristics may help predict small for gestational age, particularly those below the fifth centile.

Urinary osmolality of preschool children with a largely common weekday meal offereing, from the western highlands of Guatemala / Osmolalidad urinaria de niños preescolares con un mismo menú ofrecido durante días hábiles, en el altiplano occidental de Guatemala

Introduction: Urine volume and osmolality are within the most practical methods for measuring human hydration status. Objectives: To describe the distribution and central tendency of urinary osmolality (Uosm) for preschool children, and to assess the reproducibility of Uosm measurements after frozen storage and when determined in two different osmometers. . Methods: We collected three samples of 24-hour urine over three consecutive weeks among children attending three day-care centres in different settings in Quetzaltenango, Guatemala. Volume was determined and samples were stored at different temperatures for different periods of time. Finally, Uosm was measured on two different osmometers in different countries. Data were analyzed using SPSS version 20. Results: Twenty-four hour urine volumes ranged from 65 to 1,670 ml, with a median value of 485 ml; urine osmolality ranged from 158 to 1,088 mOsm/kg, with a median of 475 mOsm/kg (n = 234 urine collections), without differences by sex, centre, or collection order. Seventy-six subjects completed 3 collections; Coefficients of Variation ranged from 1 to 68%. When refrigerated urine samples were compared to split-sample aliquots frozen at -80º, the correlation was r = 0.89 and the difference in medians was 0.2%. Values from frozen samples between a Vogel-Löser 815 and Gonotec-Osmomat 030 had a correlation of r = 0.83, with an 11% difference in the median. Conclusions: Guatemalan children show some of the lowest median Uosm values so far reported. A good reproducibility was found when measuring after different storage times and temperatures, but on the same equipment. However, reproducibility across different osmometer brand, was not within acceptable limits (AU)

Introducción: El volumen y la osmolalidad urinarios son dos de los métodos más prácticos para medir hidratación en humanos. Objetivos: Describir la distribución y tendencia de osmolalidad urinaria (Uosm) en preescolares y determinar los efectos del almacenamiento en congelación y la medición en diferentes osmómetros sobre la reproducibilidad de resultados. Métodos: Se recolectaron tres muestras de orina de 24- horas durante tres semanas, en niños que asistían a tres guarderías de diferentes lugares en Quetzaltenango, Guatemala; se determinó volumen y las muestras fueron conservadas durante diferentes tiempos y temperaturas. Finalmente, la Uosm fue medida en dos diferentes osmómetros y países. Los datos se analizaron usando SPSS versión 20. Resultados: El volumen de orina varió entre 65 y 1.670 ml, con una mediana de 485 mlL; la Uosm entre 158 y 1.088 mOsm/kg con 475 mOsm/kg de mediana, (234 muestras de orina), sin diferencias por sexo, centro ni semana de recolección. 76 sujetos completaron las 3 recolecciones y los CV oscilaron entre 1 y 68%. Al analizar las alícuotas refrigeradas y compararlas con las congeladas (-80ºC), la correlación fue r = 0,89 y la diferencia de medianas fue de 0,2%. Las mediciones de las muestras congeladas entre el Vogel, Löser, y el Gonotec, Osmomat, tuvieron una correlación de r = 0,83 con un 11% de diferencia de medianas. Conclusión: Guatemala tiene uno de los valores más bajos de Uosm observados hasta el momento. Se encontró una buena reproducibilidad en las mediciones en diferentes tiempos y temperaturas, pero en el mismo equipo. La reproducibilidad no fue aceptable entre diferentes marcas de osmómetros (AU)