ABSTRACT
Resumen La diabetes mellitus gestacional se define como cualquier intolerancia a los carbohidratos diagnosticada durante el embarazo. La prevalencia de esta enfermedad es aproximadamente de 2 a 5% de los embarazos normales y depende de la prevalencia de la población a la diabetes mellitus tipo 2. Se asocia con resultados adversos para la madre, el feto, el recién nacido, el niño y los hijos adultos de madre diabética. La detección de la diabetes mellitus gestacional está en el cribado, realizado como sea necesario a través de medidas de diagnóstico. La poroyección puede ser selectiva, basada en la estratificación del riesgo o ser universal. Las pruebas oportunas permiten al médico obstetra evaluar la tolerancia de la glucosa relacionada con el estado resistente a la insulina del embarazo y permite iniciar el tratamiento antes de que ocurra el crecimiento fetal excesivo. Una vez que se estableció el diagnóstico de diabetes mellitus gestacional se justifica la estrecha vigilancia perinatal. El objetivo del tratamiento es reducir la morbilidad y mortalidad materno-fetal relacionadas con la enfermedad. Los valores exactos necesarios de glucosa todavía no están demostrados de manera absoluta. La decisión de inducir el parto y cuándo depende de la edad gestacional, el peso fetal estimado, el control de la glucemia materna y la puntuación obispo. Se necesitan investigaciones futuras en materia de prevención de diabetes mellitus gestacional, los objetivos del tratamiento y eficacia de las intervenciones, las directrices en la atención del embarazo y la prevención de las secuelas metabólicas a largo plazo para el niño y la madre.
Abstract Gestational diabetes mellitus is defined as any carbohydrate intolerance first diagnosed during pregnancy. The prevalence of gestational diabetes mellitus is about 2-5% of normal pregnancies and depends of the prevalence of same population to diabetes mellitus type 2. It is associated with adverse outcome for the mother, the fetus, neonate, child and adult offspring of the diabetic mother. Detection of gestational diabetes mellitus lies on screening, followed as necessary by diagnostic measures. Screening can either be selective, based upon risk stratification or universal. Timely testing enables the obstetrician to assess glucose tolerance in the presence of the insulin-resistant state of pregnancy and permits treatment to begin before excessive fetal growth has occurred. Once a diagnosis of gestational diabetes mellitus was made close perinatal surveillance is warranted. The goal of treatment is reducing fetal-maternal morbidity and mortality related with gestational diabetes mellitus. The exact glucose values needed are still not absolutely proved. The decision whether and when to induce delivery depends on gestational age, estimated fetal weight, maternal glycemic control and bishop score. Future research is needed regarding prevention of gestational diabetes mellitus, treatment goals and effectiveness of interventions, guidelines for pregnancy care and prevention of long term metabolic sequel for both the infant and the mother.
ABSTRACT
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Subject(s)
Aged , Humans , Male , Constriction, Pathologic/diagnosis , Celiac Artery/physiopathology , Arterial Occlusive Diseases/surgery , Pancreatic Neoplasms/complications , Risk Factors , PancreaticoduodenectomySubject(s)
Celiac Artery/abnormalities , Constriction, Pathologic/etiology , Pancreaticoduodenectomy/adverse effects , Postoperative Complications/etiology , Aged , Celiac Artery/surgery , Constriction, Pathologic/surgery , Humans , Male , Median Arcuate Ligament Syndrome , Postoperative Complications/surgery , Risk FactorsABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Biliary Fistula/diagnosis , Postcholecystectomy Syndrome/diagnosis , Cholecystectomy, Laparoscopic/adverse effects , Postoperative ComplicationsABSTRACT
This paper describes a study of the different methods of sample preparation for the determination of iron in grape juice, wines, and other alcoholic beverages by atomic absorption spectrometry with electrothermal atomization; results are also reported for the practical application of these methods to the analysis of commercial samples produced in Spain. The methods examined include dealcoholization and dry and wet mineralization treatment using different acids and/or mixtures of them, both with and without heating. The sensitivity, detection limit, accuracy, precision, and selectivity of each method were established. The best results were obtained for wet mineralization with heated acid (HNO3-H2SO4); the results for table wines had an accuracy of 97.5-101.6%, a relative standard deviation of 3.51%, a detection limit of 19.2 micrograms/L, and a determination limit of 32.0 micrograms/L. The method was also sufficiently sensitive and selective. It was applied to the determination of iron in grape juice, different types of wines, and beverages with high alcoholic content, all of which are produced and widely consumed in Spain. The values obtained ranged from 3.394 +/- 2.15 mg/L for the juice, 2.938 +/- 1.47 mg/L for the white wines, 19.470 +/- 5.43 mg/L for the sweet wines, 0.311 +/- 0.07 mg/L for the brandies, and 0.564 +/- 0.12 mg/L for the anisettes. Thus, the method is useful for routine analysis in the quality control of these beverages.
Subject(s)
Alcoholic Beverages/analysis , Beverages/analysis , Iron/analysis , Rosales , Spectrophotometry, Atomic , Wine/analysis , Nitric Acid , Quality Control , Sensitivity and Specificity , Sulfuric AcidsABSTRACT
BACKGROUND: Acinetobacter sp. is an important cause of nosocomial infections and it is often resistant to many antibiotics. In our hospital it often causes infections in patients on the intensive care unit. The aim of this study was to know the susceptibility of Acinetobacter sp. strains isolated in our hospital. METHODS: The in vitro activities of nine antimicrobial agents (ticarcillin, piperacillin, ceftazidime, imipenem, meropenem, gentamicin, tobramycin, amikacin and colistin) and three beta-lactamase inhibitors (sulbactam, clavulanate and tazobactam) against 107 clinical isolates of Acinetobacter baumannii were studied. MICs were determined by a dilution agar method, except for colistin, which we used the disk-diffusion agar method. RESULTS: Of the antimicrobial agents tested imipenem and colistin were highly active against all isolates (100% susceptibility), meropenem presented good activity (96.3% susceptibility), ticarcillin presented moderated activity (84.1% susceptibility). Most of the strains were resistant to ceftazidime (4.7% susceptibility), piperacillin (3.7% susceptibility) and the aminoglycosides (amikacin 21.5% susceptibility, gentamicin 2.8% susceptibility and tobramycin 4.7% susceptibility). Sulbactam was the most active agent among the beta-lactamase inhibitors studied (CMI90 = 4 micrograms/ml). CONCLUSIONS: Recent trends indicate increasing antimicrobial resistance of Acinetobacter baumannii, posing a serious threat to hospitalized patients. An strict attention to maintain a good housekeeping and control of the environment and of the antimicrobial usage, appears the measures most likely to control the spread of Acinetobacter baumannii in hospitals.
