Evaluating clinical near-infrared surgical camera systems with a view to optimizing operator and computational signal analysis.

Significance: As clinical evidence on the colorectal application of indocyanine green (ICG) perfusion angiography accrues, there is also interest in computerizing decision support. However, user interpretation and software development may be impacted by system factors affecting the displayed near-infrared (NIR) signal. Aim: We aim to assess the impact of camera positioning on the displayed NIR signal across different open and laparoscopic camera systems. Approach: The effects of distance, movement, and target location (center versus periphery) on the displayed fluorescence signal of different systems were measured under electromagnetic stereotactic guidance from an ICG-albumin model and in vivo during surgery. Results: Systems displayed distinct fluorescence performances with variance apparent with scope optical lens configuration (0 deg versus 30 deg), movement, target positioning, and distance. Laparoscopic system readings fitted inverse square function distance-intensity curves with one device and demonstrated a direction dependent sigmoid curve. Laparoscopic cameras presented central targets as brighter than peripheral ones, and laparoscopes with angled optical lens configurations had a diminished field of view. One handheld open system also showed a distance-intensity relationship, whereas the other maintained a consistent signal despite distance, but both presented peripheral targets brighter than central ones. Conclusions: Optimal clinical use and signal computational development requires detailed appreciation of system behaviors.

A Highly Water-Stable meta-Carborane-Based Copper Metal-Organic Framework for Efficient High-Temperature Butanol Separation.

Biofuels are considered sustainable and renewable alternatives to conventional fossil fuels. Biobutanol has recently emerged as an attractive option compared to bioethanol and biodiesel, but a significant challenge in its production lies in the separation stage. The current industrial process for the production of biobutanol includes the ABE (acetone-butanol-ethanol) fermentation process from biomass; the resulting fermentation broth has a butanol concentration of no more than 2 wt% (the rest is essentially water). Therefore, the development of a cost-effective process for separation of butanol from dilute aqueous solutions is highly desirable. The use of porous materials for the adsorptive separation of ABE mixtures is considered a highly promising route, as these materials can potentially have high affinities for alcohols and low affinities for water. To date, zeolites have been tested toward this separation, but their hydrophilic nature makes them highly incompetent for this application. The use of metal-organic frameworks (MOFs) is an apparent solution; however, their low hydrolytic stabilities hinder their implementation in this application. So far, a few nanoporous zeolitic imidazolate frameworks (ZIFs) have shown excellent potential for butanol separation due to their good hydrolytic and thermal stabilities. Herein, we present a novel, porous, and hydrophobic MOF based on copper ions and carborane-carboxylate ligands, mCB-MOF-1, for butanol recovery. mCB-MOF-1 exhibits excellent stability when immersed in organic solvents, water at 90 °C for at least two months, and acidic and basic aqueous solutions. We found that, like ZIF-8, mCB-MOF-1 is non-porous to water (type II isotherm), but it has higher affinity for ethanol, butanol, and acetone compared to ZIF-8, as suggested by the shape of the vapor isotherms at the crucial low-pressure region. This is reflected in the separation of a realistic ABE mixture in which mCB-MOF-1 recovers butanol more efficiently compared to ZIF-8 at 333 K.

Hysteropexy in the treatment of uterine prolapse stage 2 or higher: laparoscopic sacrohysteropexy versus sacrospinous hysteropexy-a multicentre randomised controlled trial (LAVA trial).

OBJECTIVE: To investigate whether laparoscopic sacrohysteropexy (LSH) is non-inferior to vaginal sacrospinous hysteropexy (SSHP) in the surgical treatment of uterine prolapse. DESIGN: Multicentre randomised controlled, non-blinded non-inferiority trial. SETTING: Five non-university teaching hospitals in the Netherlands, one university hospital in Belgium. POPULATION: 126 women with uterine prolapse stage 2 or higher undergoing surgery without previous pelvic floor surgery. METHODS: Randomisation in a 1:1 ratio to LSH or SSHP, stratified per centre and severity of the uterine prolapse. The predefined inferiority margin was an increase in surgical failure rate of 10%. MAIN OUTCOME MEASURES: Primary outcome was surgical failure, defined as recurrence of uterine prolapse (POP-Q ≥ 2) with bothersome bulging/protrusion symptoms and/or repeat surgery or pessary at 12 months postoperatively. Secondary outcomes were anatomical recurrence (any compartment), functional outcome and quality of life. RESULTS: Laparoscopic sacrohysteropexy was non-inferior for surgical failure (n = 1, 1.6%) compared with SSHP (n = 2, 3.3%, difference -1.7%, 95% CI: -7.1 to 3.7) 12 months postoperatively. Overall, anatomical recurrences and quality of life did not differ. More bothersome symptoms of overactive bladder (OAB) and faecal incontinence were reported after LSH. Dyspareunia was more frequently reported after SSHP. CONCLUSION: Laparoscopic sacrohysteropexy was non-inferior to SSHP for surgical failure of the apical compartment at 12 months' follow up. Following LSH, bothersome OAB and faecal incontinence were more frequent, but dyspareunia was less frequent. TWEETABLE ABSTRACT: Laparoscopic sacrohysteropexy and vaginal sacrospinous hysteropexy have equally good short-term outcomes.

A Reversible Phase Transition of 2D Coordination Layers by B-H∙∙∙Cu(II) Interactions in a Coordination Polymer.

Materials that combine flexibility and open metal sites are crucial for myriad applications. In this article, we report a 2D coordination polymer (CP) assembled from CuII ions and a flexible meta-carborane-based linker [Cu2(L1)2(Solv)2]•xSolv (1-DMA, 1-DMF, and 1-MeOH; L1: 1,7-di(4-carboxyphenyl)-1,7-dicarba-closo-dodecaborane). 1-DMF undergoes an unusual example of reversible phase transition on solvent treatment (i.e., MeOH and CH2Cl2). Solvent exchange, followed by thermal activation provided a new porous phase that exhibits an estimated Brunauer-Emmett-Teller (BET) surface area of 301 m2 g-1 and is capable of a CO2 uptake of 41 cm3 g-1. The transformation is reversible and 1-DMF is reformed on addition of DMF to the porous phase. We provide evidence for the reversible process being the result of the formation/cleavage of weak but attractive B-H∙∙∙Cu interactions by a combination of single-crystal (SCXRD), powder (PXRD) X-ray diffraction, Raman spectroscopy, and DFT calculations.

Follow-up of mesh complications using the IUGA/ICS category-time-site coding classification.

INTRODUCTION: The International Urogynecological Association (IUGA) and the International Continence Society (ICS) developed a complication classification to facilitate international comparison and to improve our understanding of complications. This code was applied to surgical cases for the analysis of complications after mesh insertion. METHODS: The study included patients who had undergone vaginal prolapse repair with a trocar-guided polypropylene mesh between 2006 and 2010 in a Dutch peripheral hospital. Complications were assessed at secondary follow-up and classified using category (C), timing (T), and site (S) components (CTS). RESULTS: Of the 107 women included, 84 returned for secondary follow-up (response rate 80 %, median time after surgery 36 months, range 12-64). In 45 patients no complications occurred. In the remaining 39 patients, 43 complication codes were established. Six of the seven categories of complications were found at all different time codes. Concerning the site of the complication codes S1, S2, and S3 were applicable. Perioperative complications (6 %) included hemorrhage and bladder perforation. Six patients were reoperated for symptomatic mesh exposure or local pain. At secondary follow-up exposure was diagnosed in another 4 patients (12 %). In 36 % mesh wrinkling or shrinkage was discovered, although without complaints in most. Eight women had daily complaints or dyspareunia. Eighty-two percent of patients indicated strong improvement after surgery. Several limitations of the classification are discussed. CONCLUSIONS: Despite limitations, the IUGA/ICS code is demonstrated to be useful in describing mesh complications. We advise the use of the CTS code at follow-up consultations after a minimum of 2 years for improved insight into and knowledge on the occurrence of complications.

Arthrodesis of the knee following failed arthroplasty.

PURPOSE: Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and results. We present a practical algorithm for arthrodesis of the knee following a failed (infected) arthroplasty, based on our own results and a literature review. METHODS: Between 2004 and 2010, patients were included with an indication for arthrodesis after failed (revision) arthroplasty of the knee. Patients were analyzed with respect to indication, fusion method and bone contact. End-point was solid fusion. RESULTS: Twenty-six arthrodeses were performed. Eighteen patients were treated because of an infected arthroplasty. In total, ten external fixators, ten intramedullary nails and six plate fixations were applied; solid fusion was achieved in 3/10, 8/10 and 3/6, respectively. CONCLUSIONS: There is no definite answer as to which method is superior in performing an arthrodesis of the knee. Intramedullary nailing achieved the best fusion rates, but was used most in cases without--or cured--infection. Our data and the contemporary literature suggest that external fixation can be abandoned as standard fusion method, but can be of use following persisting infection. The Ilizarov circular external fixator, however, seems to render high fusion rates. Good patient selection and appropriate individual treatment are the key to a successful arthrodesis. Based upon these findings, a practical algorithm was developed.

The biodrying concept: an innovative technology creating energy from sewage sludge.

A full-scale biodrying installation was treating 150 kton (wet weight) of dewatered waste activated sludge per year. The waste was treated at thermophilic conditions (65-75 °C) in a 2-step forced aeration process reducing the total wet sludge weight by 73%. The final product had a high caloric value (7700-10,400 (kJ/kg)), allowing a combustion for energy generation in external facilities. The resulting product met the European microbial and heavy metal quality standards needed for an application as organic fertilizer. The facility used <0.5 MW of electricity and recovered 9.3 MW from biologically produced heat, which was internally used for the heating of office buildings. Produced ammonia, originating from the microbial conversion of organic matter, was recovered from the ventilated air in an acid gas scrubber as an ammonium sulphate solution 40% (w/w) (7.3 kton/year) and was sold as substitute for artificial fertilizers. The sustainability of this process is discussed relative to other sludge handling processes.

[Ergonomic assessment of technical improvements in the work of manual labourers of a porphyry quarry]. / Valutazione ergonomica dell'innovazione tecnologica nel lavoro dei manovali di cava di porfido.

BACKGROUND: Previous investigations have shown an excess of musculoskeletal disorders in quarry workers referable to awkward postures and lifting of heavy weights. Recently several sorts of workbenches equipped with conveyor belts were introduced in order to improve job postures and, therefore, safety. METHODS: Using the OWAS method we investigated the postures of quarry workers using two technologically different workbenches which were compared with the traditional working method (completely manual). RESULTS: Use of workbenches allows quarry workers to work standing with the back on a vertical axis and legs infirm and stable position. CONCLUSIONS: According to the OWAS method most postures adopted in traditional working methods involve a high risk, whereas with the use of workbenches most of these high risk postures are reclassified and no longer require urgent ergonomic redesign. Technical innovations (such as lifting platforms and air suction pad winches) allow workplaces to be planned depending on the size and weight of the stone materials obtained from the quarry face.

Microbiological cultures of allografts of the femoral head just before transplantation.

Allografts of bone from the femoral head are often used in orthopaedic procedures. Although the donated heads are thoroughly tested microscopically before release by the bone bank, some surgeons take additional cultures in the operating theatre before implantation. There is no consensus about the need to take these cultures. We retrospectively assessed the clinical significance of the implantation of positive-cultured bone allografts. The contamination rate at retrieval of the allografts was 6.4% in our bone bank. Intra-operative cultures were taken from 426 femoral head allografts before implantation; 48 (11.3%) had a positive culture. The most frequently encountered micro-organism was coagulase-negative staphylococcus. Deep infection occurred in two of the 48 patients (4.2%). In only one was it likely that the same micro-organism caused the contamination and the subsequent infection. In our study, the rate of infection in patients receiving positive-cultured allografts at implantation was not higher than the overall rate of infection in allograft surgery suggesting that the positive cultures at implantation probably represent contamination and that the taking of additional cultures is not useful.

Is there an association between depressive and urinary symptoms during and after pregnancy?

Depressive symptoms and urinary symptoms are both highly prevalent in pregnancy. In the general population, an association is reported between urinary symptoms and depressive symptoms. The association of depressive and urinary symptoms has not yet been assessed in pregnancy. In this study, we assessed (1) the prevalence of depressive symptoms, over-active bladder (OAB) syndrome, urge urinary incontinence (UUI) and stress urinary incontinence (SUI) during and after pregnancy using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Urogenital Distress Inventory (UDI) and (2) the association of depressive symptoms with urinary incontinence and over-active bladder syndrome during and after pregnancy, controlling for confounding socioeconomic, psychosocial, behavioural and biomedical factors in a cohort of healthy nulliparous women. Our data show a significant increase in prevalence of depressive symptoms, UUI, SUI and OAB during pregnancy and a significant reduction in prevalence of depressive symptoms, SUI and OAB after childbirth. UUI prevalence did not significantly decrease after childbirth. In univariate analysis, urinary incontinence and the OAB syndrome were significantly associated with a CES-D score indicative of a possible clinical depression at 36 weeks gestation. However, after adjusting for possible confounding factors, only the OAB syndrome remained significantly associated (OR 4.4 [1.8-10.5]). No association was found between depressive and urinary symptoms at 1 year post-partum. Only OAB was independently associated with depressive symptoms during pregnancy. Possible explanations for this association are discussed.

[Application of the OWAS method in the study of work postures among quarry manual workers]. / Applicazione del metodo OWAS nello studio delle posture di lavoro del manovale di cava del settore porfidi.

BACKGROUND: Previous ergonomic and epidemiologic studies revealed high postural risk (exceeding the N.I.O.S.H. recommended limits) and relevant damage (significant excess of acute and chronic lumbosacral spinal disease) among the labourers in porphyry quarries in the Province of Trento (Italy). METHODS: An analysis of work postures was made with the OWAS (Ovako Working postures Analysing System) method. RESULTS: A high prevalence of work postures that have a harmful effect on the musculoskeletal system was found. Working methods need to be changed as soon as possible. CONCLUSIONS: The use of the OWAS method permits a detailed analysis of working conditions in order to identify and re-design the activities causing ergonomically problematic postures.

Which factors determine the sexual function 1 year after childbirth?

OBJECTIVE: To evaluate which factors determine sexual activity and satisfaction with the sexual relationship 1 year after the first delivery. DESIGN: Prospective longitudinal cohort study. SETTING: Ten midwifery practices. POPULATION: Three hundred and seventy-seven nulliparous women were included. METHODS: The Maudsley Marital Questionnaire is a standardised and validated questionnaire with 15 items relating to marital and sexual adjustment, with a nine-point (0-8) scale appended to each question. Scores on the sexual scale (MMQ-S) range from 0 to 40. Higher scores are indicative of greater dissatisfaction. Sexual intercourse was dichotomised into having sexual intercourse or not having sexual intercourse. Several obstetric and maternal factors were analysed. MAIN OUTCOME MEASUREMENTS: Sexual intercourse at 1 year postpartum and dissatisfaction with the sexual relationship as assessed by the MMQ-S scale. RESULTS: In multiple logistic regression analysis, the main predictive factor for no sexual intercourse 1 year postpartum was no sexual intercourse at 12 weeks of gestation (beta 11.0 [4.01-30.4]). Women were five times less likely to be sexually active after a third/fourth degree anal sphincter tear as compared with women with an intact perineum (beta 0.2 [0.04-0.93]). Dissatisfaction with the sexual relationship 1 year after childbirth, assessed with the MMQ-S scale, is associated with not being sexually active at 12 weeks of gestation (beta- 0.208, P= 0.004) and with an older maternal age at delivery (beta 0.405, P= 0.032). CONCLUSION: An important prognostic factor for dissatisfaction with the sexual relationship 1 year postpartum was not being sexually active in early pregnancy. Satisfaction with the sexual relationship seems not to depend on pregnancy- and parturition-associated factors.

The Pregnancy Mobility Index: a mobility scale during and after pregnancy.

BACKGROUND: During pregnancy, every second woman will experience some degree of back or pelvic pain. While several validated instruments to assess back pain exist for the general population, these are not suitable for application in a pregnant population and have not been validated for this purpose. A pregnant population not only differs from the general population regarding the type of back pain--frequently a pelvic girdle component is added--but pregnant women also have different mobility patterns and expectations. We therefore present in this study a self-report mobility scale specifically designed for a pregnant population: the Pregnancy Mobility Index. METHODS: Longitudinal cohort study including 672 nulliparous women with a singleton low-risk pregnancy. The Pregnancy Mobility Index consists of items concerning day-to-day activities selected through literature research and clinical experience. Participating women completed the questionnaire at 12 and 36 weeks' gestation and one year after delivery. Reliability, construct and criterion validity were tested. RESULTS: The internal consistency (Cronbach's alpha) was 0.8 or higher. The Pregnancy Mobility Index scales correlated best with the physical and pain scale of the RAND-36, indicating a good construct validity. The assumptions that the Pregnancy Mobility Index scores increase during pregnancy and decrease after delivery and that women with back or pelvic problems scored higher on the Pregnancy Mobility Index domains than women without back or pelvic pain were confirmed, indicating a good criterion validation. CONCLUSION: The Pregnancy Mobility Index has been shown to be a reliable and valid questionnaire well suited for use during and after pregnancy.

Psychosocial factors and mode of delivery.

Childbirth is a substantial physical and emotional endeavor. Because emergency Cesarean and instrumental vaginal delivery impose a greater mortality and physical and emotional morbidity on both the mother and the infant than normal vaginal delivery, it is important to identify factors that are associated with the risk of operative delivery. In previous investigations, some associations have been found, but the effect of psychosocial factors is not clear. In this study we examined several factors which could be associated with the risk for instrumental and surgical delivery. In addition to biomedical factors we included psychosocial factors such as depressive symptoms, quality of the relationship of the woman with her partner, personality, lifestyle and educational level. We assessed 354 healthy nulliparous pregnant women with a child in vertex presentation and spontaneous onset of term labor using validated questionnaires. We found that social support from the woman's partner in pregnancy, lack of depressive symptoms and specific personality traits are not protective against instrumentally assisted vaginal delivery or emergency Cesarean section. Predictive factors for operative delivery after spontaneous onset of labor are higher fetal weight, non-occiput anterior presentation and advanced gestational age, and foremost fetal distress during parturition.

Assessment of vital exhaustion and identification of subjects at increased risk of myocardial infarction in general practice.

Vital exhaustion, a state characterized by unusual fatigue, loss of energy, increased irritability, and feelings of demoralization, is one of the cardiovascular risk factors. The authors investigated whether vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice. In this prospective cohort study, vital exhaustion was assessed with the Maastricht Interview on Vital Exhaustion. Other cardiovascular risk factors established were age, gender, systolic and diastolic blood pressure, total cholesterol, body mass index, smoking habits, cardiovascular disease, and diabetes mellitus. A Cox regression analysis was used. The subjects were adults (41-66 years) in an average Dutch village population. Outcome measures were fatal and nonfatal myocardial infarction. At the univariate level, vital exhaustion doubled the risk of myocardial infarction. The effect of exhaustion was confounded by gender; women had higher exhaustion scores and a lower incidence of myocardial infarction. With control for gender, age, systolic blood pressure, total cholesterol, smoking habits, self-reported cardiovascular disease, and diabetes mellitus, vital exhaustion almost tripled the risk of myocardial infarction. Assessment of vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice.

Fibrinogen levels in hypercholesterolemic smokers and non-smokers in relation to age and gender.

Elevated total cholesterol and plasma fibrinogen levels and smoking are risk factors for cardiovascular disease, whose inter-relationships are influenced by both gender and age. The aim of this study was to investigate the effect of smoking on fibrinogen levels in a hypercholesterolemic population subdivided on the basis of gender and age. The study included 492 hypercholesterolemic subjects, divided into four subpopulations: men and women, aged 26-49 and 50-66 years. Mean fibrinogen levels among smokers and non-smokers in the four subpopulations of this hypercholesterolemic cohort followed mean total cholesterol levels. Three subpopulations (men <50 years, men >/=50 years and women >/=50 years) showed differences in mean total cholesterol and fibrinogen values between smokers and non-smokers (total cholesterol 7.23+/-0.54 vs. 7.40+/-0.93 mmol/l and fibrinogen 2.79+/-0.48 vs. 3.23+/-0.72 g/l in men <50 years; total cholesterol 7.17+/-0.43 vs. 7.50+/-0.60 mmol/l and fibrinogen 3.11+/-0.44 vs. 3.68+/-0.66 g/l in men >/=50 years and 7.41+/-0.59 vs. 7.65+/-0.73 mmol/l and fibrinogen 3.29+/-0.61 vs. 3.58+/-0.71 g/l in women >/=50 years). These values correspond to a percentage difference between smokers and nonsmokers in total cholesterol and fibrinogen of 2.4% and 15.8% in men <50 years, 4.6% and 18.3% in men >/=50 years and 3.2% and 8.8% in women >/=50 years. All differences were significant ( P<0.05), except for total cholesterol in the younger men (<50 years). No differences between smokers and non-smokers were observed in the younger female group (<50 years). Except in the younger female group (<50 years), significant differences between smokers and non-smokers were also observed in the number of subjects exceeding the upper reference value of fibrinogen (>4.0 g/l), the highest percentage being found for the older women smokers (>/=50 years) (29%). In Conclusion, smoking elevates fibrinogen levels in hypercholesterolemic men (<50 years; >/=50 years) and older women (>/=50 years), but not in younger women (<50 years).

Vital exhaustion as a risk indicator for first stroke.

Fatigue is a common condition after stroke. An unresolved question is whether the fatigue is a consequence of the stroke or is one of the precursors. The authors' objective was to investigate whether vital exhaustion is a precursor of first stroke while controlling for other cardiovascular risk factors. The design was a prospective cohort study. Vital exhaustion was diagnosed with the Maastricht Interview Vital Exhaustion scale. The authors controlled for age, gender, diabetes mellitus, systolic and diastolic blood pressure, total cholesterol, body mass index, and smoking habits as possible confounders. Data were analyzed with Cox regression analysis. The subjects were adults ages 41-66 in an average Dutch village population. Outcome measures included first stroke. Vital exhaustion increased the risk of stroke by 13% per vital exhaustion point on the Maastricht Interview Vital Exhaustion scale. This value remained statistically significant after control for other risk factors. Total cholesterol, diastolic blood pressure, systolic blood pressure, diabetes mellitus, and smoking also increased the risk of stroke significantly. A state of exhaustion is one of the risk indicators for stroke. This means that the fatigue so often seen after stroke was already experienced by many patients before the occurrence of the stroke.

Combinación del sacarato férrico y eritropoyetina frente a sulfato ferroso. Sus efectos sobre el binomio madre-feto / Combined iron sucrose and erithropoietin versus ferrous sulphate and its effects on the maternal-foetal binomia

Durante el embarazo, la concentración de hierro en el suero disminuye progresivamente, lo que conlleva a la anemia ferropénica. Para el tratamiento de esta afección se utilizaron la asociación de sacarato férrico con eritropoyetina y el sulfato ferroso. El tamaño de la muestra fue de 40 pacientes embarazadas con 11 g/dl de hemoglobina o menos, con diagnóstico de anemia microcítica e hipocrómica. A las pacientes se les practicaron registros de la frecuencia cardíaca fetal y contractilidad uterina, para determinar el efecto de los fármacos sobre el binomio madre-feto. El segundo y el tercer registros se efectuaron 3 y 28 días después de la administración de los medicamentos, con una duración de 2 h. Al iniciar los registros, a las pacientes se les tomó una muestra de sangre venosa para determinar los valores de hemoglobina, hematocrito y reticulocitos. La saturación de oxígeno se obtuvo con el oxímetro de pulso del cardiotocógrafo. Se cuantificaron la frecuencia cardíaca fetal basal, la amplitud y la frecuencia de los ascensos transitorios o aceleraciones. Para el análisis estadístico se utilizó la prueba del análisis de varianza de una vía. Los valores medios de la frecuencia cardíaca fetal antes, durante y después de la aplicación de la asociación, en los días 3 y 28 fueron 143,28, 141,82, 144,12, 140,94 y 140,91, respectivamente. Para determinar si las diferencias eran o no significativas se calculó la p. La diferencia fue significativa entre las columnas antes y después (p < 0,035), y antes y al tercer día (p < 0,0003).Para el grupo de sulfato ferroso, el análisis fue semejante. Las columnas fueron: antes, A, y después, C, en los días 3 y 28: 141,32, 140,04, 139,76, 142,84.Las diferencias fueron significativas entre las columnas antes y después: p < 0,020; antes y al tercer día: p < 0,027.Para determinar si las diferencias eran o no significativas entre grupos se calculó el valor de p. Fue ron significativas: antes y después, en los días 3 y 28: p < 0,0047; p < 0,000012; p < 0,049; p < 0,0010. La amplitud de los ascensos transitorios en ambos grupos tuvo un rango de 22,839 a 26,462 latidos. Se calculó la media de la frecuencia de los ascensos transitorios: primer grupo: 7,11, 5,455, 3,615, 10,625; 10,333. Segundo grupo: 3,5, 3,00, 6,35, 3,40.Las diferencias entre grupos fueron significativas antes de los fármacos y al tercer día: p < 0,0185; p < 0,0402.El valor de la hemoglobina antes de la aplicación de la asociación fue: 8,77 g/dl (primer control); en el segundo fue de 9,26 g/dl, y en el tercero, de 9,28 g/dl. En el grupo que recibió sulfato ferroso, los valores de la media fueron: 9,48, 9,97, y 10,90 g/dl. La diferencia entre medias fue significativa: p < 0,023; p < 0,036; p < 0,0003.Con la asociación farmacológica el hematocrito alcanzó los valores medios siguientes: el 28,21, el 28,94 y el 29,68 por ciento. Con sulfato ferroso, los valores fueron del 29,77, el 30,46 y el 33,45 por ciento. Los reticulocitos en el primer grupo alcanzaron los valores promedio siguientes: el 2,70, el 3,33 y el 2,38 por ciento. Con el grupo de sulfato ferroso se incrementaron paulatinamente: el 2,33, el 2,41 y el 2,45 por ciento. El estado físico (vigor) de los recién nacidos se valoró con la prueba de Apgar. En el primer grupo, en el primer minuto la puntuación tuvo un rango de 7 a 9.En el quinto minuto el valor general de la puntuación fue de 9. Con sacarato férrico, en el primer minuto la puntuación tuvo un rango de 7 a 9, y en el quinto minuto el valor general de la puntuación fue de 9.Una paciente a la que se administró sacarato férrico por vía intravenosa en el sitio de la punción presentó eritema localizado y dolor leve en el trayecto venoso. La sintomatología fue transitoria y cedió espontáneamente. El efecto del sulfato ferroso fue benéfico para el binomio madre-feto (AU)