Valoración del margen de error ecográfico entre el peso fetal estimado y el peso al nacer en la Maternidad del Hospital de Clínicas

Introducción: La valoración ultrasonográfica del peso fetal permite valorar el crecimiento y bienestar fetal pudiendo estimar el peso al nacimiento, factor determinante para el pronóstico vital. Objetivos: Determinar el margen de error ecográfico del peso fetal estimado (PFE) en relación con el peso al nacer de los neonatos de la Maternidad del Hospital de Clínicas entre los años 2020 y 2022 Materiales y Métodos: Se realizó un estudio observacional, descriptivo y transversal en mujeres que tuvieron un parto en el lugar y el período mencionado, y que contaban con ecografía obstétrica de crecimiento realizada con menos de 7 días respecto al nacimiento. Se calculó el error del PFE mediante la fórmula: (Peso al Nacer - Peso Fetal Estimado) / Peso al Nacer) x 100. Se contrastó el error del peso fetal estimado con el índice de masa corporal, diabetes y estados hipertensivos del embarazo, utilizando t de Student y con la edad gestacional y edad materna mediante el índice de Pearson tomando valores estadísticamente significativos menores a 0,05. Resultados: Se incluyeron 258 pacientes. El margen de error ecográfico del PFE fue de 8,3% DE ± 7. Se obtuvo un valor p para el IMC de 0,228, diabetes p 0,915, estados hipertensivos p 0,967, días en que se realizaba la ecografía p 0,5 y edad gestacional el p 0,001. Conclusiones: El margen de error ecográfico del PFE se encuentra por debajo de los parámetros internacionales. Se encontró asociación estadísticamente significativa con la edad gestacional, no así con las otras variables.

Introduction: Ultrasonographic assessment of fetal weight allows assessment of fetal growth and well-being and can estimate birth weight, a determining factor for vital prognosis. Objectives: Determine the ultrasound margin of error of the estimated fetal weight (EFP) in relation to the birth weight of neonates at the Maternity Hospital of the Hospital de Clínicas between the years 2020 and 2022. Materials and Methods: An observational, descriptive and cross-sectional study was carried out on women who had their birth in the aforementioned place and period and who had an obstetric growth ultrasound performed less than 7 days after birth. The error of the EPF was calculated using the formula: (Birth Weight - Estimated Fetal Weight) / Birth Weight) x 100. The error of the estimated fetal weight was contrasted with the body mass index, diabetes and hypertensive state of pregnancy, using Student's t and with gestational age and maternal age using the Pearson index taking statistically significant values ​​less than 0.05. Results: 258 patients were included. The ultrasound margin of error of the EPF was 8.3% SD ± 7. A p value was obtained for BMI of 0.228, diabetes p 0.915, hypertensive states p 0.967, days in which the ultrasound was performed p 0.5 and age gestational p 0.001. Conclusions: The ultrasound margin of error of the EPF is below the international parameters. Statistically significant associations were found with gestational age, but not with the other variables.

Introdução: A avaliação ultrassonográfica do peso fetal permite avaliar o crescimento e bem-estar fetal e pode estimar o peso ao nascer, fator determinante para o prognóstico vital. Objetivos: Determinar a margem de erro ultrassonográfica do peso fetal estimado (PFE) em relação ao peso ao nascer dos neonatos atendidos na Maternidade do Hospital de Clínicas entre os anos de 2020 e 2022. Materiais e Métodos: Foi realizado um estudo observacional, descritivo e transversal com mulheres que tiveram o parto no local e período mencionados e que realizaram ultrassonografia obstétrica de crescimento menos de 7 dias após o nascimento. O erro do PFE foi calculado pela fórmula: (Peso ao Nascer - Peso Fetal Estimado) / Peso ao Nascer) x 100. O erro do peso fetal estimado foi contrastado com o índice de massa corporal, diabetes e estado hipertensivo da gestação, utilizando-se o teste de Student. t e com idade gestacional e idade materna utilizando o índice de Pearson assumindo valores estatisticamente significativos menores que 0,05. Resultados: foram incluídos 258 pacientes. A margem de erro ultrassonográfica do PFE foi de 8,3% DP ± 7. Obteve-se valor de p para IMC de 0,228, diabetes p 0,915, estados hipertensivos p 0,967, dias em que foi realizada a ultrassonografia p 0,5 e idade gestacional p 0,001. Conclusões: A margem de erro ultrassonográfica do PFE está abaixo dos parâmetros internacionais. Foram encontradas associações estatisticamente significativas com a idade gestacional, mas não com as demais variáveis.

Spatial maps of T cell receptors and transcriptomes reveal distinct immune niches and interactions in the adaptive immune response.

T cells mediate antigen-specific immune responses to disease through the specificity and diversity of their clonotypic T cell receptors (TCRs). Determining the spatial distributions of T cell clonotypes in tissues is essential to understanding T cell behavior, but spatial sequencing methods remain unable to profile the TCR repertoire. Here, we developed Slide-TCR-seq, a 10-µm-resolution method, to sequence whole transcriptomes and TCRs within intact tissues. We confirmed the ability of Slide-TCR-seq to map the characteristic locations of T cells and their receptors in mouse spleen. In human lymphoid germinal centers, we identified spatially distinct TCR repertoires. Profiling T cells in renal cell carcinoma and melanoma specimens revealed heterogeneous immune responses: T cell states and infiltration differed intra- and inter-clonally, and adjacent tumor and immune cells exhibited distinct gene expression. Altogether, our method yields insights into the spatial relationships between clonality, neighboring cell types, and gene expression that drive T cell responses.

Risk of hypoglycemia in youth with type 2 diabetes on insulin.

BACKGROUND: The objective of this study was to ascertain the risk of hypoglycemia among youth with type 2 diabetes (T2D) on insulin therapy. METHODS: Twenty-two youth with T2D on insulin therapy (M=12, F=10, age=14.4±4.0 years) were enrolled from a single pediatric endocrine practice. They were followed-up for 3 months with weekly phone calls and monthly in-person visits to review blood glucose logs and document any signs or symptoms of hypoglycemia (defined as finger stick glucose of ≤70 mg/dL). Episodes of hypoglycemia were categorized into five categories: severe, documented symptomatic, asymptomatic, probable symptomatic and relative hypoglycemia. In addition to examining the risk of hypoglycemia, the degree to which hypoglycemia was associated with patient demographics (e.g. age, gender and body mass index [BMI]) or clinical factors (i.e. duration of diabetes, duration of insulin treatment, glycemic control or insulin dose and regimen) was determined. RESULTS: Nine hypoglycemic events occurred during the study period in five patients with an incidence rate of nine events per 5.3 patient-years. Of the hypoglycemic events, five were symptomatic and four were asymptomatic. No severe hypoglycemic events occurred. Hypoglycemia was not associated with age, ethnicity, duration of insulin treatment, insulin dose or initial hemoglobin (HbA1c). However, a significant difference in BMI was noted, with T2D youth who experienced hypoglycemia having a lower BMI than those who did not experience hypoglycemia. CONCLUSIONS: The results of this study suggest that the risk of hypoglycemia in youth with T2D on insulin therapy is low.

Osteocalcin and type 2 diabetes risk in Latinos: a life course approach.

OBJECTIVE: To examine associations between circulating levels of the bone-derived protein osteocalcin (OC) and type 2 diabetes (T2D) risk in Latino children and adults. METHODS: Serum OC was measured in 136 children and 531 adults who had the following T2D risk factors assessed, body mass index (BMI), Hemoglobin A1c (HbA1c), fasting and 2-hour glucose during an oral glucose tolerance test. RESULTS: OC was significantly higher in children than adults (209.0 ± 12.1 vs. 41.0 ± 0.9 ng/ml, p<0.0001). In adults, OC was inversely associated (all p<0.001) with BMI (r=-0.2), HbA1c (r=-0.2), fasting glucose (r=-0.16), and 2-hour glucose (r=-0.21), while there were no significant associations in children. There was a stepwise decrease in OC with increasing dysglycemia in adults, normoglycemic (44.1 ± 1.3 ng/ml), prediabetic (39.3 ± 1.3 ng/ml), and T2D (31.8 ± 1.2 ng/ml), (p<0.0001), whereas there were no differences between normal and prediabetic youth (195.7 ± 16.1 vs. 194.7 ± 25.8 ng/ml, p=0.3). CONCLUSIONS: OC was inversely associated with T2D risk in Latino adults; however, this pattern was not observed in children.

[Effect of administration of recombinant LH on the 5th day versus the 8th day in ovarian stimulation cycles]. / Efecto de la administración de LH recombinante en día 5 contra día 8 en ciclos de estimulación ovárica.

BACKGROUND: Ovarian stimulation is a key component in assisted reproduction techniques. Supraphysiologic levels secondary to hormonal stimulation with high doses of exogenous hormones affect endometrial receptivity, the function of the corpus luteum, ovulation and embryo quality. The use of stimulation protocols called "minimal stimulation" may have a beneficial effect in achieving pregnancy. OBJECTIVES: To evaluate the clinical efficacy (pregnancy rate) of rLH treatment on Day 5 (minimum group "A") vs. Day 8 (minimum group "B") of the ovarian stimulation cycle. MATERIAL AND METHODS: Cohort, retrospective, pilot study. Two groups of 22 patients each who received minimal stimulation "A" or "B" (control group) in the period from April to August 2010. RESULTS: No statistically significant difference in the following variables: age, FSH, estradiol and basal follicles. The median of mature follicles at the shooting day, the minimum group "A" was 3 vs. 2 for low B, the number of oocytes at metaphase II: Minimum group "A" 37/65 (57%) vs. 24/38 (63 %) at minimal group "B". Patients with grade 1+ quality embryos were 7 in minimal group "A" vs. 6 in the minimal group "B". In the minimal group "A", the pregnancy rate per started cycle was 27.3% and 37.5% for transfer, in the minimal group "B", the pregnancy rate per started cycle was 22.7% and per patient transfer which underwent 25%. CONCLUSIONS: Receiving the minimal stimulation protocol "A" has a 15% higher risk of becoming pregnant, compared with minimal group "B" based on pregnancy rate per transfer, for the sample size, the p value was 0.32.

Fluid consumption in lithium-treated rats: roles of stimulus novelty and context novelty.

In 5 experiments thirsty rats received an injection of lithium chloride or of saline, and their consumption of fluid was monitored at 5-min intervals for 30 min. The novelty of the fluid and the novelty of the test context was varied. In Experiment 1 a novel fluid (a sucrose solution) was offered in a novel context; in Experiment 2 the fluid was novel and the context was familiar (the home cage); in Experiment 3 the fluid was familiar and the context was novel; and in Experiment 4 both fluid and context were familiar. Lithium influenced fluid consumption in those designs that included at least one novel feature (Experiments 1, 2, and 3, but not in Experiment 4). Consumption was initially enhanced (with respect to the controls) when the context was novel, but was suppressed when the fluid was novel. In Experiment 5, the flavor was over-ingested after lithium treatment when it was presented in a short (5 min) test conducted in a novel place, but was rejected in a subsequent consumption in the home cages. It is argued that the effect of lithium depends on two factors: enhanced attention to salient cues that modifies the exploratory responses evoked by a novel context; rapid conditioning of an aversion when the fluid consumed is novel. Implications for the use of fluid consumption as an index of lithium-induced nausea are considered.

Evaluación del valor pronóstico de la respuesta atemprana de estradiol sérico, FSH y LH con el uso de acetato de leuprolide durante la hiperestimulación ovárica en reproducción asistida / Prognostic value of the early response of the serum estradiol FSH y LH action of leuprolide acetate during the folicular phase, used as an adjuvant to ovarian stimulation in IVF-ET

Objetivo: Evaluar el valor pronóstico de la respuesta temprana del estradiol sérico, FSH y LH usando acetato de leuprolide durante la fase folicular temprana, como adyuvante en ciclos de estimulación ovárica para FIV-TE. Material y métodos: Se analizaron 31 ciclos de estimulación en 26 pacientes con esterilidad primaria y secundaria. Se midió estradiol, FSH, LH del segundo al quinto día del ciclo, para establecer patrones de respuesta a la administración de GnRHa. Se compararon estos patrones de respuesta en relación con el número de ovocitos capturado, estradiol en el día de aplicación de hCG, número de embriones, y porcentaje de fertilización, realizando análisis estadístico (t-student, X2, prueba Wilcoxon). Resultados: Se observaron cuatro distintos patrones de respuesta temprana al estradiol. Patrón A: 13 ciclos, tuvieron una pronta elevación seguida por una caída del estradiol en el día 4 del ciclo. Patrón B: nueve ciclos, elevación retrasada del estradiol, seguida por una caída el día 6 del ciclo. Patrón C: siete ciclos, mostraron elevación persistente del estradiol. Patrón D: dos ciclos, ausencia de respuesta temprana del estradiol (ciclos cancelados). Se encontró diferencia significativa en nivel de estradiol al día de aplicación hCG, número de ovocitos capturados y número de embriones en el patrón A en relación con B y C. No hubo diferencia significativa en porcentaje de fertilización. Los niveles séricos de FSH y LH sin valor predictivo.Concluimos que el patrón de respuesta de estradiol al acetato de leuprolide es un buen indicador pronóstico del resultado de FIV-TE.