Resultados perinatales en gestantes mayores de 40 años / Perinatal outcomes in women older than 40 years

Objetivo: Evaluar la morbimortalidad obstétrica y neonatal en gestantes con gestaciones únicas de nuestro ámbito mayores de 40 años. Material y método Se seleccionaron los partos asistidos en el Hostipal Parc Taulí de Sabadell durante un periodo de 12 meses, excluyendo los partos múltiples. Se incluyeron un total de 3.308 gestantes, dividiéndolas en 2 grupos, de menos de 40 años (grupo 1), y mayores o igual a 40 años (grupo 2). Analizando la morbimortalidad materna y neonatal en ambos grupos de edad para determinar si hubo diferencias. Resultados: Solo 115 (3,5%) gestantes tenían > 40 años. Encontramos en el grupo de más de 40 años mayor número de técnicas de reproducción asistida, y mayor incidencia de estados hipertensivos del embarazo, diabetes y parto por cesárea con p < 0,05. Conclusiones: Las gestantes de edad avanzada ≥ 40 años presentan mayor morbilidad materna, sin que la edad avanzada tenga que repercutir directamente en la morbimortalidad neonatal

Objective: To evaluate obstetric and neonatal morbidity and mortality in pregnant women aged40 years or more with singleton pregnancies in our hospital. Material and methods: We selected deliveries occurring in Hospital Parc Taulí in Sabadell, Spain, in a 12-month period. Multiple deliveries were excluded. A total of 3308 pregnant women were divided into two groups: group 1 consisted of women aged less than 40 years and group 2 consisted of women aged 40 years or more. Maternal and neonatal morbidity were analyzed in both groups to identify any differences. Results: Only 115 (3.5%) pregnant women were aged 40 years or more. Compared with group2, group 1 had undergone a higher number of assisted reproductive technologies and showed a higher incidence of hypertensive diseases, diabetes, and cesarean delivery (p <0.05). Conclusions: Pregnant women aged 40 years more have higher morbidity but advanced age does not directly infuence neonatal morbidity and mortality

Gestación gemelar con mola hidatiforme completa y feto vivo a término / Twin pregnancy with complete hydatiform mole with a live full-term fetus

Resumen La coexistencia de una mola hidatiforme completa y de un feto vivo es una entidad muy poco frecuente que clásicamente se ha asociado a un alto riesgo de aborto espontáneo, muerte intrauterina, parto pretérmino, preeclampsia, hipertiroidismo y malignización. Resumen El mal pronóstico de la gestación y los riesgos maternos generan un dilema sobre la terminación inmediata del embarazo en el momento del diagnóstico o una conducta expectante. Resumen Presentamos el caso de una mola hidatiforme completa coexistente con un feto vivo que llegó a término sin presentar ninguna complicación (AU)

The coexistence of a complete hydatidiform mole with a live fetus is a rare finding that has usually been associated with a high risk of spontaneous miscarriage, intrauterine death, preterm labor, preeclampsia, hyperthyroidism and malignancy. The poor prognosis of the pregnancy and the risks to the mother generate a dilemma between immediately terminating the pregnancy at diagnosis or adopting an expectant attitude. We present a case of a complete hydatidiform mole coexisting with a live fetus that reached term with no complications (AU)

Ta'ta', Huayani: perception of leishmaniasis and evaluation of medicinal plants used by the Chayahuita in Peru. Part II.

AIM OF THE STUDY: A knowledge attitude and practice study centred on leishmaniasis and its treatment was performed among the Chayahuita, an Amazonian Peruvian ethnic group living in an endemic area. This study documents traditional Chayahuita plant's use and disease concepts. Also, activity of some medicinal plants used by the Chayahuita is highlighted and discussed. MATERIALS AND METHODS: Ninety-three Chayahuita people were interviewed, following a semi-structured questionnaire focussed on disease knowledge and perception, personal attitude and healing practices. Simultaneously, a collection of plants was performed in different ecotopes, in order to make an extensive inventory of the pharmacopoeia. RESULTS: For the Chayahuita, cutaneous (CL) and muco-cutaneous leishmaniasis (MCL) are considered as diseases of their own, with specific names, aetiologies, mode of transmission. Regarding CL, Chayahuita people consider that the humid characteristic of the skin ulcer is a discriminative fact orienting the diagnostic forTa'ta' (leishmaniasis). Forty-six different species were designated useful against LC and /or MCL (29 species by means of the questionnaire and 27 species when collecting in different ecotopes). Thirty-seven extracts corresponding to 31 species used medicinally were screened in vitro against Leishmania amazonensis axenic amastigotes, assessing their viability by the reduction of tetrazolium salt (MTT). Six species displayed a good activity (10 microg/ml

Evaluation of the leishmanicidal activity of plants used by Peruvian Chayahuita ethnic group.

AIM OF THE STUDY: A total of 27 ethanolic plant extracts from 27 species were screened for leishmanicidal activity in vitro against Leishmania amazonensis. Most of the selected species (19) are traditionally used by the Chayahuitas, an Amazonian Peruvian ethnic group, to treat skin affections and/or leishmaniasis. MATERIAL AND METHODS: A colorimetric method based on the reduction of tetrazolium salt (MTT) was used to measure the viability of Leishmania amazonensis promastigote and amastigote stages. RESULTS AND CONCLUSIONS: Only the leaves of two species of the Piperaceae family (Piper hispidum Sw., and Piper strigosum Trel.) showed good leishmanicidal activities (IC(50)<10 microg/ml against amastigotes). Roots of Tabernaemontana sananho Ruiz & Pav. (Apocynaceae), together with bark of Vismia tomentosa Ruiz & Pav. (Clusiaceae), fruits of Solanum straminifolium var straminifolium Jacq. (Solanaceae), and stems of Zamia lindenii Regel ex André (Cycadaceae) showed low activity against amastigote stage (IC(50) around 50 microg/ml). Of those only Tabernaemontana sananho displayed also good activity on promastigotes (IC(50)<10 microg/ml). Results are discussed herein, in relation with the traditional use of the plants and compared with other data from the relevant literature.

[Involvement of epidermal growth factor receptor (EGFR) in the etiopathogenesis of prostatic proliferative processes]. / Implicación del receptor del factor de crecimiento epidérmico (EGFR) en la etiopatogenia de los procesos proliferativos prostáticos.

The prostatic growth factors require a membrane specific receptor to which they must bind in order to carry out their biological activities correctly. The aim of this study was to isolate and quantify the epidermal growth factor receptor in prostatic tissue and indirectly determine the growth factors acting on it (EGF, TGF alpha, PDGF, NGF, IGF). From September, 1992 to June, 1993, we studied 55 patients. These were divided into two groups: the first group comprised 49 patients with benign prostatic hyperplasia (BPH) and 6 patients with prostatic carcinoma comprised the second group. Samples of the prostate were obtained following suprapubic (12 cases), TUR (38 cases), radical prostatectomy (1 case) and transrectal biopsy (4 cases). The EGFR was determined by radioimmunoassay (EGFR-RIA, Vienna Lab, Labordiagnostica GmbH). For the overall group of patients, we obtained mean EGFR values of 6.36 +/- 0.59 fmol/mg of protein and a positivity of 96.36% and 100% for BPH and malignant proliferative processes, respectively. The foregoing data show that EGFR was isolated from the tissue we analyzed and has an evident role in the regulation of prostate growth.

[Urinary incontinence and bacteriuria in women]. / Incontinencia urinaria y bacteriuria en la mujer.

We analyzed the urodynamic data and their relationship with significant bacteriuria in 103 consecutive female patients (mean age = 55.7 yrs) with urinary incontinence. Significant bacteriuria was observed in 25.2% of the cases. E. coli was the pathogen most frequently isolated (70.3%). Significant bacteriuria was demonstrated in 29.3% of the patients with urge-incontinence. The most frequent type of incontinence in patients with bacteriuria was no urodynamic reproduction of urinary incontinence (42.8%). Bladder instability was not associated with significant bacteriuria (27.2%). Significant bacteriuria was observed in 75% of the patients with lower urinary tract obstruction, 66.6% of the patients who voided by abdominal straining and 26.3% of those with postvoiding residual urine. These findings indicate that urine culture should be done in patients with no urodynamic reproduction of urinary incontinence. There was no statistically significant correlation between urge-incontinence/bladder instability and significant bacteriuria. Consequently, antibiotics should not be used routinely in female urinary incontinence.