Asymptomatic bacteriuria in pregestational diabetic pregnancies and the role of group B streptococcus.

We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was higher in the control group (OR 0.28, 95% CI 0.09 to 0.91). Diabetic gravidas with ASB or any level of GBS bacteriuria had higher hemoglobin A (1c) values compared with diabetics without ASB (8.31 +/- 1.89 versus 7.31 +/- 1.84, P = 0.0035). Our results demonstrate that gravidas with DM are at increased risk of ASB including GBS bacteriuria compared with non-diabetic gravidas.

The influence of race on the incidence of respiratory distress syndrome after antenatal betamethasone or dexamethasone.

OBJECTIVE: To compare the incidence of respiratory distress syndrome (RDS) in African American and Caucasian neonates after antenatal betamethasone or dexamethasone. STUDY DESIGN: This was a retrospective review of all deliveries occurring at < or = 32 weeks' gestation at Hackensack University Medical Center from 2001 to 2004. Only patients who received a complete course of antenatal steroids were included. The type (betamethasone or dexamethasone) was based on pharmacy supply. Statistical analysis was performed using Pearson's chi2 and Fisher's exact test. RESULTS: The African American (n = 32) and Caucasian (n = 86) groups were similar in terms of maternal age, gestational age and infant birth weight. African Americans receiving dexamethasone had a 1.65-fold increased risk of delivering infants with RDS as compared to those who received betamethasone (91.3% vs. 55.6%, respectively; p = 0.038). No difference was noted among Caucasians. CONCLUSION: Among African American neonates, the incidence of RDS was higher in those who received dexamethasone vs. betamethasone.

Glutaric aciduria type II and narcolepsy in pregnancy.

BACKGROUND: Glutaric aciduria type II is a rare disorder affecting the metabolism of fatty acid oxidation and several mitochondrial dehydrogenase enzymes. Narcolepsy and cataplexy is a disorder affecting sleep cycles and rapid eye movement activity. There is little information on outcome or management for either disorder in pregnancy. CASE: This is a case of a 16-year-old with glutaric aciduria type II and narcolepsy with cataplexy, treated with L-carnitine, riboflavin, fluoxetine, and modafinil during pregnancy. Intrapartum management included intravenous carnitine administration, and the patient underwent cesarean delivery at term without complication. CONCLUSION: This inborn error of metabolism and sleep disorder can be effectively treated during pregnancy with nutritional supplementation and stimulants. Because of the risk of cataplexy during labor, cesarean delivery is recommended to minimize the patient's risk.

Duration of antimicrobial prophylaxis for group B streptococcus in patients with preterm premature rupture of membranes who are not in labor.

OBJECTIVE: The purpose of this study was to determine the duration of the time that is needed to eradicate group B Streptococcus (GBS) in pregnant women with preterm premature rupture of membranes (PPROM). STUDY DESIGN: A retrospective cohort study was performed of pregnant women with PPROM from January 1, 2000, through December 31, 2005. Vaginal/rectal cultures were performed on admission and repeated daily. Patients received antibiotics until cultures were negative for 3 consecutive days. RESULTS: Two hundred fourteen women were identified with PPROM; 169 of the women met the inclusion criteria. Thirty-three patients were GBS positive on admission and had negative cultures by day 3. Neonatal sepsis occurred in 19 neonates (11.2%); 3 neonates (16%) were from mothers who tested positive for GBS on admission, and 16 neonates (84%) were from mothers who tested negative on admission. There were no cases of neonatal sepsis because of GBS. CONCLUSION: A 3-day regimen of antibiotic prophylaxis appears to be adequate to eradicate GBS from the genital tract of patients with PPROM.

Preterm premature rupture of membranes in pregnancies complicated by human immunodeficiency virus infection: a single center's five-year experience.

OBJECTIVE: The objective of this study was to describe one center's five-year experience of the management of human immunodeficiency virus (HIV) positive gravidas with preterm premature rupture of the membranes (PPROM) not in labor at

Septic pelvic thrombophlebitis: diagnosis and management.

Septic pelvic thrombophlebitis (SPT) was initially diagnosed and described in the late 1800's. The entity had a high incidence and mortality during this period of time, and a surgical therapeutic approach was the treatment of choice. Since then, the diagnosis, incidence, and management of the entity evolved. This evolution followed the development of newer diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI), and a better understanding of the pathophysiology of the disease. The treatment of SPT has had significant changes as well, from a surgical approach at the end of the 19th century to a medical approach after the 1960's. By using an adequate broad-spectrum antibiotic therapy, mortality has decreased. However, controversy in the management of this entity remains even till today.

An unusual case of urinary tract infection in a pregnant woman with Photobacterium damsela.

We describe a case of a urinary tract infection with an unusual pathogen, Photobacterium damsela, in a pregnant female. This pathogen has been described as having a virulent life threatening nature, so a detailed history and prompt treatment is needed.

Body mass index through self-reported data and body image perception in Spanish adults attending dietary consultation.

OBJECTIVES: The aim of this study was to explore, based on sex and age, knowledge regarding weight, height, and the perception of body shape in Spanish adults who attend dietary consultation. We also wanted to determine the participants' desired body shapes and what they considered their best health status. METHODS: The sample consisted of 8100 women and 1220 men from Spain. They were between the ages of 18 and 75 y. Weight (kg) and height (cm) were measured and body mass index (BMI) was calculated. Participants were nutritionally classified following the cutoffs proposed by the World Health Organization. Each individual was asked about his or her weight and height and self-reported BMI was calculated. They also answered a test of body image perception through drawings of human silhouettes that corresponded to an exact BMI. With this, perceived BMI, desired BMI, and BMI considered healthy were estimated. Parametric statistic tests for contrast of mean and percentages were applied. RESULTS: Self-reported and perceived BMI underestimate the BMI obtained through anthropometry. Differences between measured and self-reported BMI are lower in women and increase with age in both sexes. The same result was obtained when comparing measured BMI with perceived BMI through silhouette test. On average, desired BMI and healthy BMI were in the limits of normal weight for all ages and both sexes. However, the difference between them was also lower in women. CONCLUSION: Age and sex influence the perception of excess weight and body image. This could condition the demand of dietary treatment to improve the nutritional status.

Association between adiposity and blood pressure levels between the ages of 6 and 16 years. Analysis in a student population from Madrid, Spain.

INTRODUCTION AND OBJECTIVES: The increase in the incidence of hypertension in children can be attributed to the rising prevalence of obesity. The objective is to analyze the impact of overweight and the degree or distribution of adiposity on blood pressure levels in a population of Spanish schoolchildren. METHODS: A cross-sectional study was carried out in 1511 schoolchildren between 6 years and 16 years of age. We measured weight, height, waist circumference, subcutaneous skinfolds, and blood pressure. Nutritional categories were established on the basis of body mass index, waist-to-height ratio, and percent body fat. According to the National High Blood Pressure Education Program Working Group, subjects whose blood pressure was above the 90th percentile of the standard normal distribution were considered to have high blood pressure. RESULTS: In all, 3.17% of the boys and 3.05% of the girls had high blood pressure. According to odds ratio analysis, the risk of high blood pressure increased in individuals with a body mass index indicative of obesity (7.87-fold in boys, 12.32-fold in girls), with a percent body fat>97th percentile (6.98-fold in boys, 18.51-fold in girls), or with a waist-to-height ratio ≥0.5 (10.56-fold in boys, 7.82-fold in girls). CONCLUSIONS: Overweight and obesity increase the risk of high blood pressure in children between 6 years and 16 years of age, although the risk level varies depending on the amount and distribution of adipose tissue. Anthropometric indicators of relative adiposity and fat distribution are especially useful in the identification of children and adolescents with high blood pressure.

Management of missed abortion in a patient with congenital uterine anomalies.

Uterine anomalies are rare entities, vary from 0.1 to 4%, and are related to an increase risk of obstetrical complications. We report a case of a uterine anomaly, diagnosed during the management of a patient who presented with a missed abortion.

Ovulatory status and follicular response predict success of clomiphene citrate-intrauterine insemination.

OBJECTIVE: To test the hypothesis that anovulatory women would have good pregnancy rates (PRs), regardless of single or multiple follicular development, in response to clomiphene citrate (CC), whereas ovulatory women would have good PRs only when achieving multifollicular responses to CC. DESIGN: Retrospective chart review. SETTING: University-based infertility center. PATIENT(S): Two hundred and fifty-four women underwent 585 CC-IUI treatment cycles over a 3-year period. INTERVENTION: Treatment with CC-IUI. MAIN OUTCOME MEASURE(S): Various factors were examined as predictors of clinical pregnancy rate (CPR) and live-birth rate (LBR) per cycle with the use of logistic regression. RESULT(S): Overall, the CPR was 11.1%, and the LBR was 8.7%. Of 65 clinical pregnancies, 81.5% resulted in live births (singletons, 67.7%; twins, 13.8%). There were no higher-order deliveries. In anovulatory women, the CPR and LBR were 15.7% and 13.6%, respectively. In ovulatory women, the CPR and LBR were 8.8% and 6.3%, respectively. As the number of large follicles increased from one to two, the LBR increased from 6.8% to 10.5%. Regarding the interaction of follicles with ovulatory status, anovulatory women had nearly double the CPR and LBR compared to those in ovulatory women, irrespective of the number of large follicles. CONCLUSION(S): Treatment with CC-IUI is more successful in anovulatory women than in ovulatory women. The multiple follicular response in both ovulatory and anovulatory women increases PRs.

Follicular dendritic cell sarcoma in pregnancy: case report and review of the literature.

Follicular dendritic cell (FDC) sarcoma is a rare tumor. Most cases that have been described involve lymph nodes in young adults, but have not been reported in pregnancy. We describe the case of a 20-year-old woman with a FDC sarcoma diagnosed during pregnancy that initially presented as a painful mass in the right axilla. The patient underwent a tumor excision and chemotherapy. The intrapartum course was uncomplicated and she delivered a live female child at 34 weeks. During her postpartum course, she received radiation therapy and chemotherapy.

Malaria in pregnancy.

Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be alert of the disease and its effects on pregnancy.

Mitos y errores en el diseño de dietas para la recuperacion de un peso saludable / No disponible

Se ha realizado un estudio crítico de los principales gruposde dietas milagro o mágicas, de su aparición, del por quétienen una gran incidencia en muchos núcleos de la población,haciendo especial mención de los errores más gravesque existen en las de mayor significación y llegando a laconclusión de que no son útiles y debemos luchar para queno tengan la importancia que hoy por hoy poseen(AU)

There have carried out a critical study of the principalgroups of diets miracle or magic, of their appearance, ofwhy they have a great incident in many nucleuses of thepopulation, doing special mention of the most seriousmistakes that exist in those of major meaning and comingto the conclusion from that are not useful and that we mustfight in order that they do not have the importance thattoday they possess(AU)

Publicidad de alcohol y tabaco en revistas de divulgación científica españolas / Advertising of alcohol and tobacco in Spanish scientific magazines

Objetivo: comparar diversos aspectos de la publicidadsobre tabaco y bebidas alcohólicas aparecidaen revistas de divulgación científica españolas.Material y método: se realizó un estudio descriptivotransversal analizando la publicidad de variasrevistas durante cuatro años.Resultados: la publicidad de tabaco y alcohol ocupabacasi un 32% de la superficie total de las revistasestudiadas. Predominaba la publicidad debebidas de alta graduación como el whisky, situándosela cerveza entre las que menos espacios publicitariosutiliza.Conclusiones: las revistas de divulgación científicadedican un tercio de su superficie a la publicidad,predominando la de bebidas alcohólicas frente altabaco, aspecto que justifica la necesidad urgentede desarrollar la capacidad de análisis y del espíritucrítico de los consumidores ante la publicidad

Objective: to compare the different aspects of theadvertising of tobacco and alcoholic beverages inSpanish scientific magazines.Material and method: This transversal descriptivestudy analyses the advertising appearing in severalmagazines over a 4-year period.Results: the advertising of tobacco and alcohol occupiednearly a 32% of the total surface of the studiedmagazines. High content beverages such aswhisky were predominant, being beer the least advertisedbeverage.Conclusions: scientific magazines dedicate a thirdof their surface to advertising, with a predominanceof alcoholic beverages vs tobacco. This justifiesthe urgent need to develop the capacity for analysisand critical spirit of consumers in the light ofthis advertising bombardment