RESUMEN
BACKGROUND: Drug use during pregnancy is associated with adverse perinatal outcomes. This study was conducted to assess the prevalence of consumption of drugs of abuse in pregnant women at the end of gestation. METHODS: Cross-sectional study of all consecutive pregnant women in labor admitted to a regional hospital in Calella (Barcelona, Spain) in labor over one year (2014-2015). Women who gave written consent to take part in the study provided a urine sample on admission and completed a questionnaire with toxic-habit-related questions. RESULTS: The study population included 862 women, 721 (83.6%) of which agreed to participate. Of the 721 urine samples obtained, 719 (99.7%) were valid for analysis. The prevalence of drugs of abuse was 5.4% (N.=39). Cannabis was the most frequently detected substance. No participant tested positive for opioids. In the multivariate analysis, predictors of illicit drug use were history of more than two abortions, premature delivery, self-reporting of consumption during pregnancy, poor obstetric control during gestation, and consideration of vulnerable pregnant woman. Based on the ß coefficients of these five factors, a scoring system for discriminating positivity or negativity of drugs of abuse in urine testing was calculated (area under the ROC 0.84). CONCLUSIONS: The prevalence of consumption of drugs of abuse at the end of pregnancy was 5.4%. A simple test based on five anamnestic variables is useful to discriminate women with positive and negative results of urine testing for drugs of abuse tested in this study.
Asunto(s)
Drogas Ilícitas , Complicaciones del Embarazo/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Aborto Inducido/estadística & datos numéricos , Adulto , Área Bajo la Curva , Estudios Transversales , Femenino , Humanos , Drogas Ilícitas/orina , Abuso de Marihuana/epidemiología , Abuso de Marihuana/orina , Análisis Multivariante , Parto , Embarazo , Complicaciones del Embarazo/orina , Nacimiento Prematuro/epidemiología , Atención Prenatal/normas , Prevalencia , Autoinforme/estadística & datos numéricos , Sensibilidad y Especificidad , España/epidemiología , Trastornos Relacionados con Sustancias/orina , Poblaciones VulnerablesRESUMEN
OBJECTIVE: To demonstrate and investigate the activation patterns of the primary auditory cortex (Heschl's gyrus) using functional magnetic resonance imaging (fMRI). MATERIAL AND METHODS: Pure tone stimuli at 750 Hz and 2000 Hz were delivered to the right and left ear of 32 normal-hearing volunteers (18-49 years old) in 20-second on-off cycles. The fMRI data were obtained using a 1.5 Tesla scanner and processed with SPM2. RESULTS: For both tone frequencies, bilateral hemispheric activation was identified in the transverse temporal gyrus (Heschl's gyrus) in 29 subjects (90.62 %) in response to pure tone stimuli with a probability level of p < 0.001. For monaural stimulation, bilateral hemispheric activation was observed with generally greater extent of activation in the Heschl's gyrus (HG) contralateral to the stimulated ear. CONCLUSIONS: These results demonstrate that fMRI is a useful imaging technique to investigate the auditory cortex. The contralateral auditory cortex is more responsive than the ipsilateral cortex to tones presented monaurally.
Asunto(s)
Corteza Auditiva/fisiología , Imagen por Resonancia Magnética , Estimulación Acústica , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
CONCLUSIONS: These results demonstrate that functional magnetic resonance imaging (fMRI) is an optimal tool to investigate the auditory cortex. The study suggests that there is a medio-lateral gradient of responsiveness to high frequencies medially and low frequencies laterally. The contralateral auditory cortex is more responsive than the ipsilateral cortex to tones presented monaurally. OBJECTIVES: To demonstrate the activation of the primary auditory cortex in normal-hearing subjects using fMRI and to examine the response and topographic location of activation in the human auditory brain to stimulation with two different frequencies in a large group of volunteers. SUBJECTS AND METHODS: Scanning was performed on a 1.5 Tesla MR with head gradient coils and a birdcage radiofrequency coil. Multiplanar echo-planar images were acquired in 32 subjects aged between 18 and 49 years. Two groups were defined, according to age (group A, 18 to <35 years old; group B, 35 to <50 years old). We studied normal-hearing subjects scanned while listening to auditory stimuli: narrative text in one volunteer and non-speech noise (pure tones 750 Hz and pure tones 2 KHz) in all subjects. RESULTS: For both tone frequencies, auditory activation was observed bilaterally across the supratemporal plane in 29 of the 32 subjects (90.62%) with a probability level of p<0.001. In Heschl's gyrus (HG) contralateral to the stimulated ear, the extent of activation was generally greater than in homolateral HG. There were no statistical differences in HG activation according to age or sex. The 750 Hz tone activated more voxels in the medial area of the transverse temporal gyrus (TTG) whereas the 2000 Hz tone activated more voxels in the lateral TTG.
Asunto(s)
Corteza Auditiva/fisiología , Percepción Auditiva/fisiología , Imagen por Resonancia Magnética , Estimulación Acústica , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Objetivo: Investigar y demostrar los modelos de activación en el córtex auditivo primario mediante la resonancia magnética funcional (RMf). Material y métodos: Se estimuló la audición, a 32 voluntarios normo oyentes (intervalo de edad, 18-49 años), con tonos de 750 y 2.000 Hz en ciclos de 20 s de estimulación, seguidos por 20 s de reposo. Se empleó un escáner de RM de 1,5 T y la herramienta estadística SPM2. Resultados: Para ambas frecuencias (750 y 2.000 Hz) en 29 de 32 sujetos (90,62 %) se registró una activación cortical auditiva en la circunvolución de Heschl de ambos hemisferios con una p < 0,001. Ante la estimulación auditiva monoaural se ha registrado una activación cortical auditiva bilateral que, generalmente, fue mayor en el hemisferio contralateral al oído estimulado. Conclusiones: Estos resultados demuestran que la RMf es una técnica de imagen útil para la investigación del córtex auditivo. La estimulación monoaural con tonos puros activa, predominantemente, el córtex auditivo contralateral (AU)
Objective: To demonstrate and investigate the activation patterns of the primary auditory cortex (Heschls gyrus) using functional magnetic resonance imaging (fMRI). Material and methods: Pure tone stimuli at 750 Hz and 2000 Hz were delivered to the right and left ear of 32 normal-hearing volunteers (18-49 years old) in 20-second on-off cycles. The fMRI data were obtained using a 1.5 Tesla scanner and processed with SPM2. Results: For both tone frequencies, bilateral hemispheric activation was identified in the transverse temporal gyrus (Heschls gyrus) in 29 subjects (90.62 %) in response to pure tonestimuli with a probability level of p < 0.001. For monaural stimulation, bilateral hemispheric activation was observed with generally greater extent of activation in the Heschls gyrus (HG) contralateral to the stimulated ear. Conclusions: These results demonstrate that fMRI is a useful imaging technique to investigate the auditory cortex. The contralateral auditory cortex is more responsive than the ipsilateral cortex to tones presented monaurally (AU)