Complications associated to percutaneous catheter in preterm and term born children / Complicaciones asociadas al catéter percutáneo en recién nacidos pretérmino y a término

Objective: Identify percutaneous catheter-related complications in preterm and term newborns. Methods: Comparative cross-section. Were included newborns whit percutaneous catheter insertion, blood culture results and distal catheter segment. Were formed two groups: Preterm and term. Results: Were analyzed the data of preterm (n = 50) and term (n = 50) newborn, the gestational age was 30 ± 3 and 40 ± 2 (p = 0.01). The frecuency in preterm and term newborn was respectively, sepsis catheter 36 and 18% (p = 0.02; OR: 2.56; 95% CI: 1.02-7.17), infected catheter 50 and 22% (p = 0.01; OR: 5.92; 95% CI: 1.66-23.12), colonized catheter of 24 and 14% (p = 0.01; OR: 3.58; 95% CI: 1.32-9.90), local infection 14 and 8% (p = 0.03; OR: 1.87; 95% CI: 1.45-8.29), infiltration 18 and 4% (p = 0.02; OR: 5.27; 95% CI: 1.17-59), accidental removal 6 and 22% (p = 0.02; OR: 0.23; 95% CI: 0.05-0.87) and catheter rupture 10 and 28% (p = 0.02; OR: 0.29; 95% CI: 0.08-0.98). Conclusions: We found a higher association of infections and infiltrations by percutaneous catheter in preterm and term prevailed in accidental removal and catheter rupture.

Objetivo: Identificar las complicaciones asociadas al catéter percutáneo en recién nacidos pretérmino y a término. Método: Estudio transversal comparativo. Se incluyeron recién nacidos que tenían insertado un catéter percutáneo, con resultados de cultivo de sangre y segmento distal del catéter. Se formaron dos grupos: pretérmino y a término. Se calcularon la razón de momios (RM) y el intervalo de confianza del 95% (IC 95%). Resultados: Se analizaron datos de 50 recién nacidos por grupo. En los pretérmino y a término se encontró un valor de la media de edad gestacional de 30 ± 3 y 40 ± 2, respectivamente (p = 0.01), y unos porcentajes de sepsis por catéter del 36 y el 18% (p = 0.02; RM: 2.56; IC 95%: 1.02-7.17), de catéter infectado del 50 y el 22% (p = 0.01; RM: 5.92; IC 95%: 1.66-23.12), de catéter colonizado del 24 y el 14% (p = 0.01; RM: 3.58; IC 95%: 1.32-9.90), de infección local del 14 y el 8% (p = 0.03; RM: 1.87; IC 95%: 1.45-8.29), de infiltración del 18 y el 4% (p = 0.02; RM: 5.27; IC 95%: 1.17-59), de retiro accidental del 6 y el 22% (p = 0.02; RM: 0.23; IC 95%: 0.05-0.87) y de rotura del catéter del 10 y el 28% (p = 0.02; RM: 0.29; IC 95%: 0.08-0.98). Conclusiones: Se encontró mayor asociación de infecciones e infiltraciones por catéter percutáneo en los pretérmino, y de retiro accidental y rotura del catéter en los nacidos a término.

Expression of TREM-1 in maternal leukocytes in preterm, prelabour rupture of the membranes.

Studies have shown that triggering receptor expressed on myeloid cells-1 (TREM-1) is the mediator and activator of neutrophils and monocytes after stimulation with lipopolysaccharide (LPS), heat-inactivated Gram (-) bacteria, Gram (+) bacteria or fungi. Different studies have measured the expression of TREM-1 in patients with bacterial infections and critical states. The purpose of this study was to evaluate the expression of TREM-1 in circulating maternal leukocytes in premature rupture of the membranes (PRM). Two groups of patients were included in this case control study: pregnant women with PRM and healthy controls. All patients were free of any infection, including cervix and urinary tract. Although all patients expressed TREM-1 to some extent, there was no statistically significant difference in the expression of different cellularities in both groups; except for the mononuclear leukocytes (p < 0.05). In this study, TREM-1 was not altered in PRM.

Effects of a Multicomponent Preventive Intervention in Women at Risk of Sarcopenia: A Pilot Study.

Sarcopenia is defined by the presence of decreased skeletal muscle mass, strength, and functionality in older people. Multicomponent interventions represent an alternative to non-pharmacological treatment for preventing disease progression. This study aimed to evaluate the effects of a multicomponent intervention approach in women at risk of sarcopenia. METHODS: A quasi-experimental pilot study of 12 weeks was conducted, with 24 sessions of dancing and resistance exercises and 12 sessions of nutritional education. The outcomes were changes in muscle mass, grip strength, gait speed, and body composition. The project was registered on Clinical Trials: NCT06038500 (14 September 2023). RESULTS: Twelve women aged 55-75 years participated in this study; after the intervention, changes were found in the following variables: grip strength, from 18.70 (17.98-19.23) at baseline to 21.57 (20.67-23.16) kg (p = 0.002); gait speed, from 0.95 (0.81-1.18) at baseline to 1.34 (1.20-1.47) m/s (p = 0.003); and hip circumference, from 99.75 (94.75-110.37) at baseline to 97.65 (93.92-109.50) cm (p = 0.023). Other measurements that appeared without changes were appendicular skeletal muscle mass, from 21.17 (18.58-22.33) at baseline to 20.77 (18.31-22.39) kg (p = 0.875), and the appendicular skeletal muscle mass index, from 8.64 (8.08-9.35) at baseline to 8.81 (7.91-9.38) kg/m2 (p = 0.875) after the intervention. CONCLUSIONS: The three-month multicomponent intervention in women at risk of sarcopenia improved their grip strength and gait speed.

Raloxifene modifies the insulin sensitivity and lipid profile of postmenopausal insulin resistant women.

OBJECTIVE: To investigate the effects of raloxifene on the insulin sensitivity and lipid profile in insulin-sensitive and insulin-resistant postmenopausal women. STUDY DESIGN: This placebo-controlled, double-blind, randomized study involved 64 postmenopausal women aged between 45 and 55 years. All subjects were screened with the insulin resistance homeostasis model assessment (IR-HOMA) and those patients in the lowest quartile (n = 16) were assigned as insulin sensitive and those in the highest quartile as insulin resistant (n = 16). Patients in both groups received either raloxifene hydrochloride (60 mg/day) or a placebo for a period of 12 weeks. Insulin sensitivity, the serum lipid profile and anthropometric measurements were established before and after therapy. RESULTS: Women with the highest IR-HOMA scores were associated with a significantly higher weight, body mass index, waist and waist-to-hip ratio (p < 0.05). Raloxifene significantly reduced the IR-HOMA scores from 5.76 ± 2.91 to 1.93 ± 0.96 (p = 0.02) and modified the lipid profile in insulin-resistant patients when compared with the placebo group and those patients receiving raloxifene in the insulin-sensitive group. CONCLUSION: Raloxifene reduced insulin resistance and modified the lipid profile in insulin-resistant postmenopausal women.

Obesity and oxidative stress: a direct link to preeclampsia?

Overweight is associated with alterations in lipid concentrations and an activation of inflammatory markers and both of these metabolic abnormalities are characteristic of preeclamptic pregnancies before the onset of clinically evident disease. Reactive oxygen species, particularly superoxide anions, evoke endothelial cell activation through many pathways. Markers of lipid peroxidation, including malondialdehyde and 8-epiprostaglandin-F2α, is increased in the plasma of women with preeclampsia, and the low concentrations of water- and lipid-soluble antioxidants in the plasma and the placenta further suggest a state of oxidative stress. This review focuses in the relation between maternal obesity, oxidative stress with development of preeclampsia.

[Laparoscopic surgery complications in a reproductive biology service]. / Complicaciones de la laparoscopia ginecológica en un servicio de biología de la reproducción.

BACKGROUND: Poor report of difficulties in using laparoscopic technique has limited the knowledge of its advantages and disadvantages. OBJECTIVE: To evaluate complications in patients treated with laparoscopic surgical procedures in a biologic reproductive service, MATERIAL AND METHODS: Retrospective study in 525 patients treated with conventional laparoscopy due to any gynecological procedure. All pre- and post-operative variables were considered. RESULTS: There were 16 (3%) complications within the 525 patients studied: six (37.5%) cases with uterine perforation, three (18.8%) with wall bleeding, and two (12.5%) with subcutaneous emphysema. The rest of complications (31.2%) were: post-puncture headache (1), anaphylactic reaction (1), perirectal serous laceration (1), anexial hematoma (1), and ovarian vessels bleeding (1). There was a case of wall hematoma and another with ovarian vessels injury that required a second intervention. Patient with anaphylactic shock required intensive care attention and mechanic ventilation. Mean physicians years of experience were 12 +/- 7 (1 to 20 years). During the period of time of the study there were no dead due to gynecologic laparoscopic procedures. CONCLUSION: Gynecological surgical laparoscopy is a viable alternative to traditional surgery due to less postoperative pain, minimal hospital stay, fast recovery, and better esthetic results and less infectious morbidity.

[The effect of ibuprofen and acetylsalicylic acid on cognitive impairment, total antioxidant power and isoprostane serum]. / Efecto del ibuprofeno y ácido acetilsalicílico sobre el deterioro cognitivo, poder antioxidante total e isoprostanos en suero.

INTRODUCTION: There are controversial studies on the prevention of Alzheimer's disease with nonsteroidal antiinflammatory drugs (NSAIDs). The objective of this study was to evaluate the effect of ibuprofen and acetylsalicylic acid on cognitive impairment, serum total antioxidant power (TAP) and isoprostane (8-iso-PGF2alpha). METHODS: From April 2004 to February 2006, a Folstein mini-mental state (MMSE), Syndrome Kurtz Test (SKT) and a geriatric depression scale (Yasevage) were applied to eighteen, 55-56 years old eligible women. All women (n= 18) with normal cognitive state were randomized to ibuprofen 400 mg per day (n= 9) and acetylsalicylic acid 500 mg per day (n= 9) for one year. Serum TAP and 8-iso-PGF2alpha were performed at baseline, after six months and one year of treatment. RESULTS: After one year of treatment with acetylsalicylic acid five women (55.6%) raised their score 4 points in MMSE compared with 3 points increased (33.3%) showed by the ibuprofen group. TAP increased (p=0.01) and 8-iso-PGF2alpha reduced (p=0.01) in both groups compared with baseline. CONCLUSIONS: Both drugs improved the cognitive state andoxidative status of our population.

[Acetazolamide in the resolution of cerebrospinal fluid cutaneous fistula after peridural analgesia: case report]. / Acetazolamida en el manejo de la fístula de líquido cefalorraquídeo posterior a analgesia peridural: reporte de caso.

BACKGROUND: Cerebrospinal fluid cutaneous fistula following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. CLINICAL CASE: Female aged 50 with a stage IIB cervical carcinoma; a peridural catheter was passed at lumbar level; three days after surgery, refers severe headache and to corroborate leakage cerebrospinal fluid through the puncture. The prescription was antibiotics and acetazolamide 250mg every 8hours for five days with favorable evolution. CONCLUSION: In this case, management with acetazolamide and suture of the fistula inhibits cerebrospinal fluid leakage without blood patch.

Endothelial dysfunction and cardiovascular risk factors.

UNLABELLED: The endothelium plays an integral role in the regulation of vascular tone, platelet activity, leukocyte adhesion, and thrombosis and is intimately involved in the development of atherosclerosis. Endothelial dysfunction has been observed in patients with established coronary artery disease or coronary risk factors, both in the coronary and peripheral vasculature. Therapeutic interventions with lipid-lowering drugs, ACE inhibitors, physical activity, and antioxidant agents have been shown to improve endothelial function in coronary and peripheral vessels. This systemic manifestation and improvement of endothelial function suggests that a common mechanism may contribute to endothelial dysfunction in the coronary and peripheral circulation. TARGET AUDIENCE: Internist, Cardiologists, Family physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to define the participation of cardiovascular risk factors in the various complications associated with endothelial dysfunction.

Adipokines and insulin resistance during pregnancy.

Normal pregnancy has been characterized as a "diabetogenic state". On the other hand, the adipose tissue is now considered an active organ, capable of secreting substances such as adipokines, which may play a role in the pathogenesis of insulin resistance. Resistin, leptin serum and placental levels increase as pregnancy progresses, which is in contrast to levels of adiponectin. These levels correlate with the state of reduced insulin sensitivity often developed in the latter stages of pregnancy. The objective of this article is to review recent advances in our understanding of adipokines and insulin resistance during pregnancy.

Efecto del ibuprofeno y ácido acetilsalicílico sobre el deterioro cognitivo, poder antioxidante total e isoprostanos en suero / The effect of ibuprofen and acetylsalicylic acid on cognitive impairment, total antioxidant power and isoprostane serum

Introducción: Existen estudios controvertidos sobre la prevención de la enfermedad de Alzheimer y el uso de antiinflamatorios no esteroideos. El objetivo fue evaluar el efecto del ibuprofeno y ácido acetilsalicílico sobre el deterioro cognitivo, poder antioxidante total (PAT) e isoprostanos (8-iso-PGF2á) séricos. Material y métodos: Entre abril de 2004 y febrero de 2006, a 18 mujeres mayores de 55 años de edad se les realizó escrutinio con la Prueba Mínima del Estado Mental de Folstein (MMSE); Prueba Corta para la Evaluación de la Memoria y la Atención, Syndrome Kurtz Test (SKT) y Escala de Depresión Geriátrica de Yasevage. Fueron asignadas aleatoriamente para recibir 400 mg/día de ibuprofeno (n=9) o 500 mg/día de ácido acetilsalicílico (n=9) durante un año. En la visita basal, seis meses y al año se determinó PAT y 8-iso-PGF2á séricos. Resultados: A un año de intervención, en cinco mujeres (55.6%) el MMSE aumentó cuatro puntos con ácido acetilsalicílico comparado con tres (33.3%) de ibuprofeno (p=0.028). El PAT aumentó (p=0.01) y disminuyeron los 8-iso-PGF2á (p=0.01) en ambos grupos en comparación con los valores basales. Conclusiones: Ambos medicamentos mejoraron el estado cognitivo y el perfil oxidativo en la población estudiada.

INTRODUCTION: There are controversial studies on the prevention of Alzheimer's disease with nonsteroidal antiinflammatory drugs (NSAIDs). The objective of this study was to evaluate the effect of ibuprofen and acetylsalicylic acid on cognitive impairment, serum total antioxidant power (TAP) and isoprostane (8-iso-PGF2alpha). METHODS: From April 2004 to February 2006, a Folstein mini-mental state (MMSE), Syndrome Kurtz Test (SKT) and a geriatric depression scale (Yasevage) were applied to eighteen, 55-56 years old eligible women. All women (n= 18) with normal cognitive state were randomized to ibuprofen 400 mg per day (n= 9) and acetylsalicylic acid 500 mg per day (n= 9) for one year. Serum TAP and 8-iso-PGF2alpha were performed at baseline, after six months and one year of treatment. RESULTS: After one year of treatment with acetylsalicylic acid five women (55.6%) raised their score 4 points in MMSE compared with 3 points increased (33.3%) showed by the ibuprofen group. TAP increased (p=0.01) and 8-iso-PGF2alpha reduced (p=0.01) in both groups compared with baseline. CONCLUSIONS: Both drugs improved the cognitive state andoxidative status of our population.

Gravedad del hidrops fetal por hemólisis Rh asociado con los resultados perinatales en transfusiones intrauterinas / Severe fetal hydrops in Rh hemolysis associated with perinatal results after intrauterine transfusions

Objetivo: Evaluar el grado de gravedad del hidrops fetal por isoinmunización materna Rh(D) y su repercusión sobre el resultado perinatal en una serie de casos de transfusión intrauterina. Material y método: Análisis retrospectivo, analítico y transversal de 150 fetos que recibieron 531 transfusiones intrauterinas en un período de 21 años. Todos presentaban un proceso evolutivo de gravedad y la presencia de hidrops previo al tratamiento se demostró en 67 fetos (45%), los cuales se clasificaron, de acuerdo con los hallazgos ultrasonográficos, como portadores de hidrops moderado o de hidrops grave. Las variables incluyeron edad gestacional, niveles de hemoglobina y hematocrito, número de transfusiones, tasas de supervivencia, la mortalidad acaecida por el procedimiento y las condiciones neonatales y evolutivas de los homigénitos. Resultados: Hubo 123 nacidos vivos (82%). Cuando no existió hidrops al inicio de la primera transfusión, la supervivencia global de los fetos que se presentaron con hidrops moderado fue del 76%, en tanto que los casos con hidrops grave fueron 52%. La reversión intrauterina del hidrops se documentó en el 81% de los fetos con hidrops moderado y en el 30% de aquellos con hidrops grave. La pérdida fetal como complicación durante el procedimiento fue baja. Condiciones neonatales pronósticas como el puntaje de Apgar a los 5 minutos y el peso obtenido fueron más favorables entre los fetos sin hidrops o con hidrops moderado que en los grados graves de afección hidrópica...