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1.
Sci Rep ; 12(1): 6862, 2022 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477949

RESUMO

The rates of both maternal and fetal adverse outcomes increase significantly with higher body mass index. The aim of this study was to calculate national estimates of adverse maternal and fetal outcomes and associated hospitalization cost among obese pregnant women using a national database. This study was a retrospective analysis of data retrieved from Nationwide Inpatient Sample database, collected during 2010-2014. The primary outcomes of this study were adverse maternal and fetal outcomes, hospital length of stay, and hospitalization cost. There was a total of 18,687,217 delivery-related hospitalizations, of which 1,048,323 were among obese women. Obese women were more likely to have cesarean deliveries (aOR 1.70, 95% CI 1.62-1.79) and labor inductions (aOR 1.51, 95% CI 1.42-1.60), greater length of stay after cesarean deliveries (aOR 1.14, 95% CI 1.08-1.36) and vaginal deliveries (aOR 1.48, 95% CI 1.23-1.77). They were also more likely to have pregnancy-related hypertension, preeclampsia, gestational diabetes, premature rupture of membranes, chorioamnionitis, venous thromboembolism, excessive fetal growth, and fetal distress. Obese pregnant women had significantly greater risk for adverse obstetrical outcomes, which substantially increased the hospital and economic burden. Risk stratification of pregnant patients based on obesity could also help obstetricians to make better clinical decisions and improve patient outcomes.


Assuntos
Pré-Eclâmpsia , Complicações na Gravidez , Feminino , Hospitalização , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Gestantes , Estudos Retrospectivos , Estados Unidos/epidemiologia
3.
Med. clín (Ed. impr.) ; 135(11): 485-490, oct. 2010.
Artigo em Inglês | IBECS | ID: ibc-83665

RESUMO

Background and objectives: To assess the use of the Epstein-Barr virus (EBV) viral load as a marker for lymphoma diagnosis in HIV-infected patients. We also aimed to identify the relationship between EBV viral load in plasma and the presence of EBV in lymphoma cells.Patients and methods: Retrospective observational study of two HIV-infected populations: one of patients diagnosed with lymphoma and a control group. Thirty-nine patients with AIDS-related lymphoma (ARL) (32 non-Hodgkin's and 7 Hodgkin's lymphomas) and 134 HIV-positive individuals without neoplasia or opportunistic infections were studied. Blood samples were collected before lymphoma treatment in ARL patients. EBV viral load was measured in plasma by real-time quantitative PCR and the presence of EBV-EBER mRNA in lymphoma tumor was investigated by in situ hybridization. Results: Patients with ARL had higher EBV viral loads than those without lymphoma: 24,180.5 (±73,387.6)copies/mL versus 2.6 (±21.6)copies/mL (p<0.001). HIV-infected patients without lymphoma had negative or very low EBV load values. Among ARL patients, no correlation was found between EBV viral loads and CD4+ lymphocyte counts or between EBV and HIV RNA loads, or any other clinical or biological parameter. Cases with an EBV-EBER-positive lymphoma had higher EBV viral loads than those with EBER-negative tumors.Conclusions: EBV viral load is a useful marker of lymphoma in HIV-infected patients, and may be a useful tool for early diagnosis and treatment (AU)


Fundamento y objetivo: Evaluar el uso de la carga viral del virus de Epstein-Barr (VEB) como marcador para el diagnóstico de linfomas en pacientes infectados por el VIH. Identificar la relación entre la carga viral de VEB en plasma y la presencia del virus en las células del linfoma. Pacientes y método:Estudio observacional retrospectivo de dos poblaciones de pacientes VIH: una de pacientes diagnosticados de linfoma y un grupo control. Se estudiaron 39 pacientes con linfoma asociado a infección por el VIH (32 linfomas no hodgkinianos y 7 de Hodgkin) y 134 individuos con infección por el VIH sin neoplasia ni infecciones oportunistas. Las muestras de plasma de los pacientes con linfoma fueron obtenidas en el momento del diagnóstico. La carga viral en plasma del VEB fue realizada mediante una PCR cuantitativa en tiempo real y la presencia de RNAm VEB-EBER en los tumores fue investigada por hibridación in situ. Resultados: Los pacientes con linfoma asociado a infección por el VIH tenían cargas virales de VEB más elevadas que los pacientes sin linfoma: 24.180,5 (±73.387,6)copias/ml frente a 26 (±21,6)copias/ml (p<0,001). Los pacientes con infección por el VIH sin linfoma presentaron carga viral muy baja o negativa. En los pacientes con linfoma no se halló correlación entre la carga viral del VEB y el recuento de linfocitos CD4+ ni la carga viral de VIH, ni con otros parámetros clínicos o biológicos. Los casos de linfomas VEB-EBER-positivos tuvieron una carga viral de VEB más elevada que la de los linfomas EBER negativos. Conclusiones:En pacientes infectados por el VIH la carga viral del VEB es un marcador de linfoma, potencialmente útil para el diagnóstico y tratamiento precoz


Assuntos
Humanos , Herpesvirus Humano 4/metabolismo , Linfoma não Hodgkin/sangue , Doença de Hodgkin/sangue , /sangue , Herpesvirus Humano 4/isolamento & purificação , Doença de Hodgkin/diagnóstico , Linfoma não Hodgkin/diagnóstico , Linfoma Relacionado a AIDS/diagnóstico , Síndrome da Imunodeficiência Adquirida/complicações , Estudos Retrospectivos , Estudos de Casos e Controles
4.
Med Clin (Barc) ; 135(11): 485-90, 2010 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-20673682

RESUMO

BACKGROUND AND OBJECTIVES: To assess the use of the Epstein-Barr virus (EBV) viral load as a marker for lymphoma diagnosis in HIV-infected patients. We also aimed to identify the relationship between EBV viral load in plasma and the presence of EBV in lymphoma cells. PATIENTS AND METHODS: Retrospective observational study of two HIV-infected populations: one of patients diagnosed with lymphoma and a control group. Thirty-nine patients with AIDS-related lymphoma (ARL) (32 non-Hodgkin's and 7 Hodgkin's lymphomas) and 134 HIV-positive individuals without neoplasia or opportunistic infections were studied. Blood samples were collected before lymphoma treatment in ARL patients. EBV viral load was measured in plasma by real-time quantitative PCR and the presence of EBV-EBER mRNA in lymphoma tumor was investigated by in situ hybridization. RESULTS: Patients with ARL had higher EBV viral loads than those without lymphoma: 24,180.5 (±73,387.6)copies/mL versus 2.6 (±21.6)copies/mL (p<0.001). HIV-infected patients without lymphoma had negative or very low EBV load values. Among ARL patients, no correlation was found between EBV viral loads and CD4+ lymphocyte counts or between EBV and HIV RNA loads, or any other clinical or biological parameter. Cases with an EBV-EBER-positive lymphoma had higher EBV viral loads than those with EBER-negative tumors. CONCLUSIONS: EBV viral load is a useful marker of lymphoma in HIV-infected patients, and may be a useful tool for early diagnosis and treatment.


Assuntos
Herpesvirus Humano 4 , Linfoma Relacionado a AIDS/sangue , Linfoma Relacionado a AIDS/diagnóstico , Carga Viral , Adulto , Biomarcadores/sangue , Feminino , Humanos , Linfoma Relacionado a AIDS/virologia , Masculino , Estudos Retrospectivos
6.
Inflamm Bowel Dis ; 14(10): 1373-9, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18452205

RESUMO

BACKGROUND: Cytomegalovirus (CMV) infection has been reported in ulcerative colitis (UC), especially in severe, steroid-refractory disease. However, its role in steroid-refractoriness remains unknown. Our goals were to evaluate the prevalence of CMV disease in UC, the best diagnostic strategy, and the influence of disease activity and/or treatment in its development. METHODS: Prospective, observational study including 114 subjects with active UC requiring intravenous steroids, steroid-refractory UC, inactive UC on mesalamine, inactive UC on azathioprine, and healthy controls. CMV antibodies, pp65-antigenemia, and rectal biopsies for hematoxylin and eosin staining, immunohistochemistry, and CMV-pp67 mRNA were performed. These procedures were repeated after medical treatment only in patients with active UC. CMV disease was defined by the presence of inclusion bodies and/or positive immunohistochemistry in colonic biopsies. RESULTS: CMV disease was found in 6 steroid-refractory, CMV-IgG-positive UC patients but not among controls, inactive UC, or steroid-responding UC patients. In 5 out of the 6 patients, CMV disease was diagnosed after 7-10 days on cyclosporine. CONCLUSIONS: CMV disease in UC only affects seropositive, steroid-refractory UC patients. Steroid/cyclosporine treatment together with disease activity may predispose to latent colonic CMV reactivation. The impact of antiviral therapy on the clinical outcome of these patients remains to be elucidated.


Assuntos
Colite Ulcerativa/epidemiologia , Colite Ulcerativa/virologia , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Estudos de Casos e Controles , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/tratamento farmacológico , Comorbidade , Ciclosporina/uso terapêutico , Citomegalovirus/imunologia , Citomegalovirus/isolamento & purificação , Diagnóstico Diferencial , Resistência a Medicamentos , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Índice de Gravidade de Doença , Esteroides/uso terapêutico , Adulto Jovem
7.
Am J Public Health ; 98(1): 28-38, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18048802

RESUMO

Healthy People 2010 made it a priority to eliminate health disparities. We used a rapid assessment response and evaluation (RARE) to launch a program of participatory action research focused on health disparities in an urban, disadvantaged Black community serviced by a major south Florida health center. We formed partnerships with community members, identified local health disparities, and guided interventions targeting health disparities. We describe the RARE structure used to triangulate data sources and guide intervention plans as well as findings and conclusions drawn from scientific literature and epidemiological, historic, planning, clinical, and ethnographic data. Disenfranchisement and socioeconomic deprivation emerged as the principal determinants of local health disparities and the most appropriate targets for intervention.


Assuntos
Agentes Comunitários de Saúde/educação , Redes Comunitárias/organização & administração , Participação da Comunidade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde , Serviços Urbanos de Saúde/estatística & dados numéricos , Florida , Grupos Focais , Humanos , Projetos Piloto , Pobreza , Serviços Urbanos de Saúde/economia , População Urbana
8.
In. Centro Pequeño Hans; I.C.F. La sexuación en los niños. Buenos Aires, Ed. CPH;Ed. ICF, Noviembre de 1995. p.101-102. (90194).
Monografia em Espanhol | BINACIS | ID: bin-90194
9.
In. Centro Pequeño Hans; I.C.F. La sexuación en los niños. Buenos Aires, Ed. CPH;Ed. ICF, Noviembre de 1995. p.47-49. (90179).
Monografia em Espanhol | BINACIS | ID: bin-90179
10.
In. Centro Pequeño Hans; I.C.F. Psicoanálisis con niños. Buenos Aires, Ed. Atuel;Ed. CPH;Ed. ICF, Mayo de 1995. p.151-159. (89732).
Monografia em Espanhol | BINACIS | ID: bin-89732
11.
In. Centro Pequeño Hans; I.C.F. II Jornadas Nacionales del CPH Desarrollo y estructura en la dirección de la cura. Buenos Aires, Ed. Atuel;Ed. CPH;Ed. ICF, 1993. p.31-41. (88418).
Monografia em Espanhol | BINACIS | ID: bin-88418
12.
In. E.O.L. La cura psicoanalítica tal como es: treinta relatos clínicos. Buenos Aires, EOL, Marzo de 1992. p.257-263. (90391).
Monografia em Espanhol | BINACIS | ID: bin-90391
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