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1.
Fetal Diagn Ther ; 50(6): 472-479, 2023.
Article in English | MEDLINE | ID: mdl-37544292

ABSTRACT

INTRODUCTION: Large congenital neck tumors can cause neonatal death due to airway obstruction. The aim of this study was to report outcomes of the first cohort of fetuses with neck masses and suspected airway obstruction managed with fetal laryngoscopy (FL) and fetal endoscopic tracheal intubation (FETI) to secure fetal airways and avoid ex utero intrapartum treatment (EXIT) procedure. METHODS: A prospective observational cohort of consecutive fetuses with neck masses that were candidates for an EXIT procedure due to suspicion of laryngeal and/or tracheal occlusion on ultrasonographic (US) or magnetic resonance imaging (MRI) examination were recruited for FL in a tertiary referral center in Queretaro, Mexico. FETI was performed if the obstruction was confirmed by FL. Maternal and perinatal outcomes were evaluated. RESULTS: Between January 2012 and March 2023, 35 cases with neck masses were evaluated. Airway obstruction was suspected in 12/35 (34.3%), either by US in 10/35 (28.6%) or by fetal MRI in 2/35 (5.7%). In all cases, FL was successfully performed at the first attempt at a median gestational age (GA) of 36+5 (range, 33+5-39+6) weeks+days, with a median surgical time of 22.5 (12-35) min. In 4 cases, airway patency was confirmed during FL and an EXIT procedure was avoided. In 8/12 cases (66.7%), airway obstruction was confirmed during fetoscopy and FETI was successfully performed at a median GA of 36+3 (33+2-38+5) weeks+days, with a median surgical time of 25.0 (range, 12-45) min. No case required an EXIT procedure. All patients underwent conventional cesarean delivery with no maternal complications and all neonates were admitted to the neonatal intensive care unit with a correctly positioned endotracheal tube (ETT) immediately after delivery. Three neonatal deaths (37.5%) were reported due to postnatal unplanned extubation, failed ETT replacement, and tumoral bleeding. CONCLUSION: In fetuses with neck masses and suspected airway obstruction, FL and FETI are feasible and could replace EXIT procedures with good maternal and perinatal outcomes.


Subject(s)
Airway Obstruction , Laryngoscopy , Pregnancy , Female , Infant, Newborn , Humans , Laryngoscopy/adverse effects , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Fetus , Prenatal Care , Airway Obstruction/diagnostic imaging , Airway Obstruction/surgery , Airway Obstruction/etiology
2.
Best Pract Res Clin Obstet Gynaecol ; 84: 155-165, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35490103

ABSTRACT

Up to 20% of monochorionic diamniotic twin pregnancies can be complicated with twin-to-twin transfusion syndrome (TTTS). This complication is diagnosed by ultrasound demonstrating amniotic fluid discordance between both amniotic sacs, with polyhydramnios in the recipient's sac and oligohydramnios in the donor's, secondary to an imbalance in blood volume exchange between twins. Ultrasound evaluation of the amniotic fluid volume, bladder filling, and assessment of fetal Doppler parameters provide the basis for classification of TTTS, allowing severity assessment. The Quintero's staging system provides a standardized prenatal estimate on the risk of intrauterine fetal demise of one or both twins and the need for fetoscopic laser coagulation of placental vascular anastomoses or delivery depending on the gestational age. However, a proportion of TTTS cases may present without a linear progressive deterioration and no ultrasound signs of preceding staging, in rare situations, they arise even without amniotic fluid discordance. Thus, these unusual clinical presentations of TTTS have long been grouped into the category of atypical TTTS. In this review, we show the clues for diagnosis and management of different atypical cases of TTTS highlighting their underlying mechanism to improve the clinical understanding of such atypical situations, avoid misdiagnosis of TTTS, and allow a timely referral to a fetoscopic center.


Subject(s)
Fetofetal Transfusion , Polyhydramnios , Female , Pregnancy , Humans , Fetofetal Transfusion/diagnostic imaging , Fetofetal Transfusion/therapy , Placenta , Fetoscopy , Pregnancy, Twin , Polyhydramnios/diagnostic imaging , Polyhydramnios/etiology , Polyhydramnios/therapy , Gestational Age
3.
Ginecol. obstet. Méx ; 90(4): 356-363, ene. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1385033

ABSTRACT

Resumen INTRODUCCIÓN: El aneurisma del septo interauricular es una deformación sacular del tejido delgado del septo interatrial situado, generalmente, en la zona del foramen oval, cuya deformación puede ocurrir hacia las aurículas derecha, izquiera o ambas. Es un hallazgo raro durante la exploración ecocardiográfica fetal, con prevalencia del 0.6 al 1.7%. CASOS CLÍNICOS: Caso 1: Paciente de 20 años. En la exploración ecográfica cardiaca a las 36 semanas se encontró un situs solitus con eje cardiaco a 40 grados, área cardiotorácica 0.25-0.35 normal, frecuencia cardiaca fetal de 134 latidos por minuto, ritmo regular, sin derrame pericárdico. En la ecocardiografía transtorácica posnatal se encontraron: situs solitus, conexiones concordantes, sin evidencia de cortocircuitos intra o extracardiacos. Caso 2: Paciente de 20 años. En la exploración ecográfica cardiaca avanzada a las 37 semanas se encontraron: situs solitus, eje cardiaco a 47 grados, área cardiotorácica normal, frecuencia cardiaca fetal de 140 latidos por minuto, ritmo regular, sin derrame pericárdico. La ecocardiografía transtorácica posnatal reportó: situs solitus, conexiones concordantes, sin evidencia de cortocircuitos intra o extracardiacos. CONCLUSIONES: Si bien los aneurismas del septo interauricular suelen ser un hallazgo aislado en la ecocardiografía fetal, se consideran un proceso benigno y transitorio. Algunas veces se asocian con otras anomalías cardiacas, por lo que al tener la sospecha diagnóstica debe practicarse una ecocardiografía básica y avanzada para descartar anomalías asociadas.


Abstract BACKGROUND: Atrial septal aneurysm is a saccular deformation of the thin tissue of the interatrial septum usually located in the foramen ovale, whose deformation can occur toward the right atrium, left atrium or both. It is a rare finding during fetal echocardiographic examination, with a prevalence of 0.6 to 1.7%. CLINICAL CASES: Case 1: 20-year-old female patient. On cardiac echocardiographic examination at 36 weeks a situs solitus was found with cardiac axis at 40 degrees, cardiothoracic area 0.25-0.35 normal, fetal heart rate 134 beats per minute, regular rhythm, no pericardial effusion. Postnatal transthoracic echocardiography showed: situs solitus, concordant connections, without evidence of intra or extracardiac shunts. Case 2: 20-year-old patient. Advanced cardiac ultrasound examination at 37 weeks found: situs solitus, cardiac axis at 47 degrees, normal cardiothoracic area, fetal heart rate of 140 beats per minute, regular rhythm, no pericardial effusion. Postnatal transthoracic echocardiography reported: situs solitus, concordant connections, without evidence of intra or extracardiac shunts. CONCLUSIONS: Although interatrial septal aneurysms are usually an isolated finding in fetal echocardiography, they are considered a benign and transient process. Sometimes they are associated with other cardiac anomalies, so when the diagnosis is suspected, basic and advanced echocardiography should be performed to rule out associated anomalies.

4.
Eur J Med Genet ; 58(6-7): 332-5, 2015.
Article in English | MEDLINE | ID: mdl-25882468

ABSTRACT

Timothy syndrome 1 (TS1) is a multisystem disorder characterized by severe QT prolongation and potentially lethal ventricular arrhythmias in the first years of life, plus other cardiac and extracardiac manifestations caused by mutation in the CACNA1C gene, a CaV1.2 L-type calcium channel. Here, we report retrospectively an unusual fetal presentation on a second patient with TS1 with fetal hydrops due to a congenital AV block and its postnatal diagnosis by a marked prolongation of the corrected QTc interval of 570 ms and a missense mutation, p.Gly406Arg, in exon 8A of CACNA1C gene. The observed manifestations in our patient during fetal period indicate a severe form and they were probably exacerbated by the maternal use of amitriptyline during the first 4 months of pregnancy. Unfortunately, he died at 3 months-old due a ventricular tachycardia and fibrillation related to a septic event. Although difficult to diagnose, possibly most fetuses with TS1 have symptoms of long QT syndrome. Despite the fatal outcome for our patient, an early diagnosis of TS may help to prevent life-threatening events or early death in future patients, especially in developing countries where availability of therapies such as cardioverter defibrillator are very limited, or require time for its funding.


Subject(s)
Autistic Disorder/diagnosis , Calcium Channels, L-Type/genetics , Long QT Syndrome/diagnosis , Syndactyly/diagnosis , Adrenergic Uptake Inhibitors/adverse effects , Amitriptyline/adverse effects , Autistic Disorder/genetics , Female , Fetal Heart/diagnostic imaging , Fetal Heart/drug effects , Humans , Infant, Newborn , Long QT Syndrome/genetics , Male , Mutation, Missense , Pregnancy , Syndactyly/genetics , Ultrasonography, Prenatal
5.
Ginecol Obstet Mex ; 82(11): 769-77, 2014 Nov.
Article in Spanish | MEDLINE | ID: mdl-25826959

ABSTRACT

We describe the prenatal sonographic findings in two cases of fetal heterotaxy syndrome evaluated at the Maternal Fetal Medicine Unit of a tertiary hospital over a period of one year and present a review of the literature on the subject.


Subject(s)
Heterotaxy Syndrome/diagnostic imaging , Ultrasonography, Prenatal , Adult , Female , Humans , Pregnancy
6.
Ginecol Obstet Mex ; 81(6): 310-20, 2013 Jun.
Article in Spanish | MEDLINE | ID: mdl-23837296

ABSTRACT

BACKGROUND: Fetal growth has geographical and ethnic variations. Fetuses from different parts of the world show also different growth patterns. Using individualized fetal biometry charts increase the detection of fetuses at risk, probably due to a better identification of intrauterine growth restriction; moreover they correlate better with anthropometric parameters than conventional curves. OBJECTIVE: To determine and describe the reference curves of fetal biometric parameters in the population of western Mexico. MATERIAL AND METHODS: Cross-sectional and descriptive study, conducted between September 2006 and December 2011 in patients admitted to the Maternal Fetal Medicine Unit at Civil Hospital of Guadalajara Dr. Juan I. Menchaca. We included 1,833 patients with single pregnancies without fetal or maternal pathology with established gestational age by the date of the last menstrual period and confirmed by first trimester ultrasound. Percentils 3, 5, 10, 50 and 95 were calculated for every biometric variable. RESULTS: The largest growth rate was seen between 26 to 38 weeks of gestation and a progressive flattening of the growth curve was observed from the 38th week of gestation. CONCLUSION: The percentiles of fetal biometric parameters in the population of western Mexico are lower than those reported in previously published literature.


Subject(s)
Fetus/anatomy & histology , Adolescent , Adult , Anthropometry , Cross-Sectional Studies , Female , Gestational Age , Humans , Mexico , Pregnancy , Reference Values , Young Adult
7.
Ginecol Obstet Mex ; 80(8): 501-8, 2012 Aug.
Article in Spanish | MEDLINE | ID: mdl-23088068

ABSTRACT

BACKGROUND: According to several studies from around the globe, the modified Misgav Ladach technique simplifies the surgical procedure for cesarean section, reduces operation time, costs, and complications, and optimizes obstetric and perinatal outcomes. OBJECTIVE: Compare obstetric outcomes between patients operated on using traditional cesarean section technique and those operated on using modified Misgav Ladach technique. PATIENTS AND METHODS: The study included 49 patients operated on using traditional cesarean section technique and 47 patients operated on using modified Misgav Ladach technique to compare the outcomes in both surgical techniques. RESULTS: The modified Misgav Ladach technique was associated with more benefits than those of the traditional technique: less surgical bleeding, less operation time, less analgesic total doses, less rescue analgesic doses and less need of more than one analgesic drug. CONCLUSION: The modified Misgav Ladach surgical technique was associated with better obstetric results than those of the traditional surgical technique; this concurs with the results reported by other national and international studies.


Subject(s)
Cesarean Section/methods , Cohort Studies , Female , Hospitals , Humans , Pregnancy , Young Adult
8.
Ginecol Obstet Mex ; 80(6): 417-20, 2012 Jun.
Article in Spanish | MEDLINE | ID: mdl-22826970

ABSTRACT

Describe a case of a female patient having anti-Ro/SSA antibodies without any other risk factor or collagen disease. In her first pregnancy a congenital heart block and hydrops in the fetus were diagnosed, and these caused stillbirth. In a second pregnancy an in utero treatment resulted in the succesful delivery of a normal child.


Subject(s)
Antibodies, Antinuclear , Fetal Diseases/immunology , Heart Block/congenital , Adult , Female , Heart Block/immunology , Humans , Pregnancy
9.
Medicina (B Aires) ; 65(1): 31-5, 2005.
Article in English | MEDLINE | ID: mdl-15830790

ABSTRACT

There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the agreement between both methods to measure TGV. We studied eighty consecutive subjects. Only sixty-six performed acceptable plethysmography maneuvers. The patients were measured with a constant volume plethysmograph (Medical Graphics 1085 DL). TGV was performed in the same patient with two techniques: 1) during the airway resistance (Raw) measurement (TGV-Raw) and 2) during quiet breathing at the end of expiration (TGV). The panting frequency was 1 to 2 Hz with both maneuvers. The differences between both techniques were expressed in percentage (deltaTGV %) and absolute values (deltaTGV). The TGV-Raw of the whole group was higher than TGV (3.69 +/- 1.08 l vs 3.28 +/- 1.05 l, p < 0.001). Similarly, the subgroups of patients had a greater TGV-Raw than TGV (Normal: 3.44 +/- 0.77 l vs 2.98 +/- 0.72 l , p < 0.001; Obstructive: 4.08 +/- 1.19 l vs 3.71 +/- 1.15 l, p < 0.001; Restrictive: 2.62 +/- 0.49 l vs 2.25 +/- 0.51 l, p < 0.01). There was a considerable lack of agreement between the TGV-Raw and TGV, with discrepancies of up to +0.95 l or +34%. The deltaTGV % was similar between the patients' subgroups and between the subjects with different degree of airflow obstruction (Normal: 16.5 +/- 10%, Obstructive: 10.8 +/- 9.4%, Restrictive: 18 +/- 14.3%, p NS; mild obstruction: 10.7 +/- 11%, moderate obstruction: 12.3 +/- 5.7, severe obstruction: 10.1+/- 6.6, p NS). In conclusion, TGV-Raw was larger than TGV. This was because the patients generally panted at a volume above FRC when performing the TGV-Raw maneuver. TGV-Raw should not be used to estimate FRC because FRC would be overestimated and the diagnosis of air trapping may be erroneous.


Subject(s)
Airway Obstruction/diagnosis , Airway Resistance , Diagnostic Errors , Lung Volume Measurements/methods , Adult , Humans , Middle Aged , Plethysmography, Whole Body
10.
Medicina [B Aires] ; 65(1): 31-5, 2005.
Article in English | BINACIS | ID: bin-38378

ABSTRACT

There are no data published about the agreement between the measurement of thoracic gas volume (TGV) during the airway resistance (TGV-Raw) and the conventional technique described by Dubois. The aim of this study was to establish the agreement between both methods to measure TGV. We studied eighty consecutive subjects. Only sixty-six performed acceptable plethysmography maneuvers. The patients were measured with a constant volume plethysmograph (Medical Graphics 1085 DL). TGV was performed in the same patient with two techniques: 1) during the airway resistance (Raw) measurement (TGV-Raw) and 2) during quiet breathing at the end of expiration (TGV). The panting frequency was 1 to 2 Hz with both maneuvers. The differences between both techniques were expressed in percentage (deltaTGV


) and absolute values (deltaTGV). The TGV-Raw of the whole group was higher than TGV (3.69 +/- 1.08 l vs 3.28 +/- 1.05 l, p < 0.001). Similarly, the subgroups of patients had a greater TGV-Raw than TGV (Normal: 3.44 +/- 0.77 l vs 2.98 +/- 0.72 l , p < 0.001; Obstructive: 4.08 +/- 1.19 l vs 3.71 +/- 1.15 l, p < 0.001; Restrictive: 2.62 +/- 0.49 l vs 2.25 +/- 0.51 l, p < 0.01). There was a considerable lack of agreement between the TGV-Raw and TGV, with discrepancies of up to +0.95 l or +34


. The deltaTGV


was similar between the patients subgroups and between the subjects with different degree of airflow obstruction (Normal: 16.5 +/- 10


, Obstructive: 10.8 +/- 9.4


, Restrictive: 18 +/- 14.3


, p NS; mild obstruction: 10.7 +/- 11


, moderate obstruction: 12.3 +/- 5.7, severe obstruction: 10.1+/- 6.6, p NS). In conclusion, TGV-Raw was larger than TGV. This was because the patients generally panted at a volume above FRC when performing the TGV-Raw maneuver. TGV-Raw should not be used to estimate FRC because FRC would be overestimated and the diagnosis of air trapping may be erroneous.

11.
Medicina (B Aires) ; 64(4): 357-67, 2004.
Article in Spanish | MEDLINE | ID: mdl-15338983

ABSTRACT

A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.


Subject(s)
Pulmonary Disease, Chronic Obstructive/rehabilitation , Argentina , Humans
12.
Medicina [B Aires] ; 64(4): 357-67, 2004.
Article in Spanish | BINACIS | ID: bin-38647

ABSTRACT

A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.

13.
Medicina [B.Aires] ; 64(4): 357-367, 2004. tab
Article in Spanish | BINACIS | ID: bin-2342

ABSTRACT

Un grupo de neumonólogos y kinesiólogos asociados a la Asociación Argentina de Medicina Respiratoria se reinieron con el objetivo de revisar la evidencia científica en Rehabilitacíón Respiratoria (RR), elaborar recomendaciones basadas en la evidencia para su aplicación local y promover su uso. RR es um programa multidisciplinario para el cuidado de pacientes con una alteración respiratoria crónica, ajustado individualmente, con el objetivo de lograr el máximo de actividad física, social y la independencia funcional de paciente a través de la actividad física supervisada. La RR está particularmente indicada en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) que presentem intolerancia al esfuerzo. Se han definidi los criterios de inclusión y exclusión, las mínimas pautas de evaluaíón y cómo realizar el control posterior a la RR. Se elaboraron normativas sobre los recursos para montar un programa. Se recomendó un programa ambulatorio hospitalario con complemento domiciliario, y al personal mínimo necesario (un neumonólogo y un kinesiólogo). Se recomendó para todos los pacientes el entrenamiento aeróbico de resistencia para miembros inferiores (MI) (Evidencia A) y de miembros superiores (MS) (Evidencia B), de fuerza de MI y MS (Evidencia C), como así también para determinados pacientes el entrenamiento muscular respiratorio a carga resistiva umbral inspiratoria (Evidencia D), y otras técnicas kinésicas. Se hicieron recomendaciones sobre los objetivos educativos, apoyo nutricional y psicológico en todo programa de RR. El beneficio de la RR también fue analizado a través de la reducción de las exacerbaciones, hospitalizaciones y costos para el sitema de salud de los programas de RR. La RR es un componente fundamental del tratamiento de un paciente con EPOC. Este Consenso ha elaborado recomendaciones basadas en la evidencia para ser aplicada a nivel local. (AU)


Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/rehabilitation , Argentina
14.
Medicina (B.Aires) ; 64(4): 357-367, 2004. tab
Article in Spanish | LILACS | ID: lil-401077

ABSTRACT

Un grupo de neumonólogos y kinesiólogos asociados a la Asociación Argentina de Medicina Respiratoria se reinieron con el objetivo de revisar la evidencia científica en Rehabilitacíón Respiratoria (RR), elaborar recomendaciones basadas en la evidencia para su aplicación local y promover su uso. RR es um programa multidisciplinario para el cuidado de pacientes con una alteración respiratoria crónica, ajustado individualmente, con el objetivo de lograr el máximo de actividad física, social y la independencia funcional de paciente a través de la actividad física supervisada. La RR está particularmente indicada en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) que presentem intolerancia al esfuerzo. Se han definidi los criterios de inclusión y exclusión, las mínimas pautas de evaluaíón y cómo realizar el control posterior a la RR. Se elaboraron normativas sobre los recursos para montar un programa. Se recomendó un programa ambulatorio hospitalario con complemento domiciliario, y al personal mínimo necesario (un neumonólogo y un kinesiólogo). Se recomendó para todos los pacientes el entrenamiento aeróbico de resistencia para miembros inferiores (MI) (Evidencia A) y de miembros superiores (MS) (Evidencia B), de fuerza de MI y MS (Evidencia C), como así también para determinados pacientes el entrenamiento muscular respiratorio a carga resistiva umbral inspiratoria (Evidencia D), y otras técnicas kinésicas. Se hicieron recomendaciones sobre los objetivos educativos, apoyo nutricional y psicológico en todo programa de RR. El beneficio de la RR también fue analizado a través de la reducción de las exacerbaciones, hospitalizaciones y costos para el sitema de salud de los programas de RR. La RR es un componente fundamental del tratamiento de un paciente con EPOC. Este Consenso ha elaborado recomendaciones basadas en la evidencia para ser aplicada a nivel local.


Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/rehabilitation , Argentina
15.
Cir Cir ; 71(6): 449-54, 2003.
Article in Spanish | MEDLINE | ID: mdl-14984669

ABSTRACT

BACKGROUND: Antiphospholipid antibodies are associated with thrombocytopenia and fetal loss, and have been reported elevated in patients with preeclampsia-eclampsia. Site: Preeclampsia-Eclampsia Research Unit, Instituto Materno Infantil del Estado de Mexico, Toluca, Mexico and the Specialty Hospital Research Unit, La Raza Medical Center, Mexico City, Mexico. OBJECTIVE: To determine the presence of anticardiolipin antibodies (IgG-IgM) as markers of acute endothelial damage in patients with preeclampsia. MATERIAL AND METHODS: A randomized case control study composed of two groups: Group A (cases), 18 patients with preeclampsia-eclampsia and group B (control), 18 normal pregnancies. Antiphospholipid (anticardiolipin) antibodies were determined in both groups in addition to with coagulation tests and clinical variables in mother and newborn in day of admission and nine weeks after obstetrical resolution. We excluded patients with anticoagulant or dialysis therapy, taking NSAIDs or who recently required transfusion or plasmaferesis. RESULTS: There were significant differences in levels of IgM and in weights and mortality among newborns between the two groups. In terms of maternal complications, we found HELLP syndrome as leading cause. We also observed in the case group significant differences in mean arterial pressure (MAP) and IgM levels between admission day and nine weeks later. Our results lead us to the conclusion that there must be exist immunologic mechanism that induces synthesis of anticardiolipin antibodies (IgM isotype) during acute state of the disease, accounting for vascular changes and prothrombotic state responsible for maternal and neonatal complications.


Subject(s)
Antibodies, Antiphospholipid/blood , Immunoglobulin M/immunology , Pre-Eclampsia/blood , Adult , Antibodies, Antiphospholipid/immunology , Case-Control Studies , Female , Humans , Pregnancy , Random Allocation
20.
Holguín; Holguín; esp; 1990. 107 p. ilus, tab, graf.(Rev. cienc. méd. Holguín, 8, 2).
Monography in Spanish | CUMED | ID: cum-21434

ABSTRACT

La acupuntura y la moxibustión son los métodos terapéuticos tradicionales de China. En el tratado médico "Nei Ying" escrito entre los siglos quinto y segundo a.n.e ya se registraban sistemáticamente los conocimientos teóricos y la experiencia clínica de ambos, desempeñando una gran función en el desarrollo del trabajo médico de los países asiáticos durante los últimos 2000 años. Realizamos la práctica del método en forma sistemática y se aplica no solo en Hospitales, sino también en las diferentes áreas de salud y consultorios del médico de la familia con resultados satisfactorios que ayudan al restablecimiento de la salud


Subject(s)
Humans , Adult , Acupuncture Points , Acupuncture , Acupuncture Therapy/methods
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