Screening and diagnosis of gestational diabetes: a hybrid method

Background: In Mexico the gestational diabetes prevalence varies between 4 and 13%. The main purpose of this study is to determine the prevalence of gestational diabetes, the relevance of its risk factors, and its repercussions in pregnancy with a hybrid diagnostic method. Methods: This prospective, longitudinal, and observational study includes 347 pregnant women. Screening for gestational diabetes was performed with the O’Sullivan test, with a cut-off point of 140 mg/dL of glucose, followed by a 75-gram oral glucose tolerance test in patients with an abnormal screening test. The diagnosis was made with one or more abnormal results. Different variables were evaluated in these patients; from risk factors, to complications of gestational diabetes. Results: Of the 347 patients studied, 77 (22.2%) had a positive screen and 34 patients were confirmed with gestational diabetes (9.8%). A body mass index greater than or equal to 25 increased the relative risk by 2.52, the history of macrosomia by 4.10, a maternal age greater than or equal to 36 years by 2.54, and the presence of a twin pregnancy by 6.94. Regarding complications, there was an increase in prevalence of macrosomia (RR=4.09). Conclusions: The prevalence of gestational diabetes, using the combination of the two existing classical methods, is similar to that reported in other national and international studies, while also avoiding overdiagnosis, over-monitoring, and reducing typical discomforts that may come by using the one-step method.

Cinética de crecimiento y producción de proteasas de Pseudomonas fluorescens en leche cruda a temperaturas de refrigeración / Growth kinetics and proteases production of Pseudomonas fluorescens in raw milk at refrigeration

The general use of refrigeration of raw milk has contributed to maintenance of its quality, but has induced the selection of a psychotrophic bacteria which during its growth produces heat-resistant enzymes responsible, in part, for the deterioration of long-life products. Given the condition of the prolonged refrigeration of the milk before the process, it was necessary to determine the growth curves for bacteria at temperatures between 2 degrees C and 10 degrees C and the kinetics of production of proteases in raw fresh milk, inoculated with Pseudomonas fluorescens RV1O, using an automatic fermentation system, with minimal agitation under conditions of controlled temperature and pH. The results show a development over 10(5) ufc/mL in the cultures at 6 degrees, 8 degrees and 10 degrees C during the first 30 h and proteasic activities over 30 microM p-NA/2 h getting levels of de 80-180 microM p-NA/2 h over 50 h of cultivation. Only the cultures at 2 degrees C appeared stable with inferior cell counts and without inducing enzymatic activity. At 4 degrees C an intermediate situation occurs.

Endocarditis infecciosa de válvula nativa: fisiopatología, tratamiento y prevención / Primary valve infectious endocarditis: physiopathology, prevention and treatment

Se hace una revision del tema de la endocarditis infecciosa de válvula nativa, en la cual se incluye la definicion aceptada hoy en dia, los aspectos etiologicos y el daño mismo desde el punto de vista patologico, asi como las implicaciones funcionales a que puede dar lugar la presencia de esta entidad. Se analizan los factores predisponentes y las causas etiologicas asi como tambien la microbiolologia concomitante y se dan pautas tanto para la prevencion como para el tratamiento.