Higher PAPP-A Values in Pregnant Women Complicated with Preeclampsia Than with Gestational Hypertension.

The purpose of this study is to compare the levels of maternal serum pregnancy-associated plasma protein-A at the first trimester in pregnancies complicated by impaired placental diseases, such as preeclampsia (PE), intrauterine fetal growth restriction (IUGR), and gestational hypertension (GH), with those in pregnancies without the development of any of these outcomes to expand the knowledge of how this protein behaves in the different impaired placental diseases. This current work is an observational study based on a prospective cohort. Pregnancy-associated plasma protein-A was measured in 422 patients who had completed maternal-perinatal outcomes. Comparisons of pregnancy characteristics and the biomarker between outcome groups (PE, IUGR, gestational hypertension, and not impaired placental outcomes) were analyzed. PAPP-A MoM in the IUGR (0.8 IQR: 0.6-0.9) and GH groups (0.5 IQR: 0.3-1.4) compared to the PE group (1.06 IQR: 0.66-1.52) was significantly lower (p < 0.005). Pregnant women who developed early-onset PE (1.11 IQR 1.08-1.18) presented significant differences with the IUGR group (0.83 IQR: 0.59-0.98; p = 0.002) and those who developed preterm-PE (1.19 IQR: 0.66-1.58; p = 0.045). The results demonstrate that the levels of PAPP-A at first trimester in the sample of women who developed PE, and specially term-PE, were higher than those in women who developed GH or IUGR. The GH group had the lowest PAPP-A values in this sample of pregnant women. Research in a population with a high prevalence of preeclampsia is still lacking and deserves more extended studies to define if these patients could have different rates of PAPP-A.

First trimester placental growth factor in maternal blood and placenta related disorders.

OBJECTIVE: To describe and compare the placental growth factor levels at first trimester in patients that developed preeclampsia, gestational hypertension, IUGR and in those patients without impaired placentation diseases. METHODS: Observational study based on a prospective cohort of 422 pregnant women. PlGF values were compared between the different groups (preeclampsia, intrauterine growth restriction (IUGR), gestational hypertension or normal group-patients without impaired placentation diseases). RESULTS: The 85.3% (n = 360, 95% CI = 81.9-88.7) had a normal pregnancy, 7.6% (n = 32, 95% CI = 5.1-10.1) had preeclampsia, 3.8% (n = 16, 95% CI = 2.0-5.6) had IUGR and 3.3% (n = 14, 95% CI = 1.6-5.0) had gestational hypertension. The median level of PlGF for preeclampsia (0.76) and IUGR (0.75) were lower than gestational hypertension (0.82) and normal group (1.02). The groups of preeclampsia >34 weeks (0.76), preeclampsia <37 weeks (0.73), and preeclampsia ≥37 weeks (0.77), were significantly lower than the normal group. The sensitivity and specificity of PlGF for impaired placentation diseases is 65% and 64.9%, respectively. CONCLUSION: It was found in this study that PlGF has significantly lower levels in gestational hypertension than normal pregnancies, in concordance with the other impaired placentation diseases. Additionally, a better comparison of the PlGF values was obtained when separating early onset of preeclampsia <37 weeks and late-onset of preeclampsia 37≥ weeks of gestations.

Prevalence and antimicrobial susceptibility of Staphylococcus aureus methicilin resistant isolated from medical students / Prevalencia y susceptibilidad antimicrobiana de cepas de Staphylococcus aureus meticilino resistentes aisladas de estudiantes de Medicina

Objective: To establish the prevalence and identify the level of resistance to methicillin, vancomycin and alternative antibiotics in Staphylococcus aureus isolates from medical students in clinical training. Materials and methods: A cross-sectional observational design with non-random sampling was used in medical students during clinical training in a tertiary healthcare facility. Samples were taken from nasal and hands swabs and cultured on blood agar. For beta-hemolytic gram-positive cocci, catalase and coagulase tests were performed and then cultured on mannitol salt agar. Susceptibility to cefoxitin, oxacillin, linezolid, clindamycin and trimethoprim sulfamethoxazole was assessed by using the Kirby-Bauer technique, and for vancomycin, an E-test was performed (Biomerieux®). Results: 72 strains of S. aureus were isolated from 82 medical students. 72.2 % were identified as methicillin-sensitive (MSSA) and 27.8 % as methicillin-resistant (MRSA). Four MRSA strains (20 %) showed vancomycin intermediate (VISA 4-8 µg/mL) profile, 65 % of MRSA isolates was resistant to clindamycin, 40 % to linezolid and 45 % to trimethoprim sulfamethoxazole. Conclusions: MSSA, MRSA and VISA strains are present in nostrils and hands of our medical students, with MRSA showing high resistance levels to clindamycin, TMP-SMX and linezolid, and MSSA levels up to 45 %. These findings reiterate the need to accomplish good hands hygiene in order to minimize the spread of S. aureus in community and healthcare facilities.

Objetivo: establecer la prevalencia e identificar el perfil de resistencia a meticilina, vancomicina y antibióticos alternativos en aislamientos de Staphylococcus aureus provenientes de estudiantes de Medicina en rotaciones hospitalarias. Materiales y métodos: estudio observacional transversal no aleatorizado en estudiantes de medicina en entrenamiento clínico en un hospital de tercer nivel de complejidad. Las muestras fueron tomadas de hisopados nasales y de manos y cultivadas en agar sangre. A los cocos gram positivos se les realizó pruebas de catalasa, coagulasa y siembra en agar salado manitol. La susceptibilidad a cefoxitina, oxacilina, linezolida, clindamicina y trimetoprim sulfametoxazol se efectuó mediante la técnica de Kirby-Bauer y para la evaluación de la vancomicina el método de E-test (Biomerieux®). Resultados: 72 cepas de S. aureus fueron aisladas de manos y cavidad nasal de 82 estudiantes de medicina, 72,2 % fueron identificadas como meticilino sensibles (SAMS) y 27,8 % como meticilino resistentes (SAMR). Cuatro cepas (20 %) de SAMR mostraron ser vancomicina intermedio (SAVI 4-8 mg / mL), 65 % de los SAMR aislados fueron resistentes a la clindamicina, 40 % al linezolid y 45 % al trimetoprim sulfametoxazol. Conclusiones: en la cavidad nasal y las manos de estudiantes de medicina están presentes cepas de SAMS, SAMR y SAVI con alto nivel de resistencia para clindamicina, TMP-SMX y linezolid en los SAMR y hasta el 45 % para los SAMS. Estos resultados reiteran la necesidad de realizar una buena higiene de manos para reducir al mínimo la circulación de S. aureus en la comunidad y en los servicios de atención de la salud.