Validation and adaptation to Spanish of the quality-of-life questionnaire in patients with hemorrhoidal disease and anal fissure (HEMO-FISS-CdV).

Haemorrhoidal disease and anal fissure are the two most frequent entities within benign anal pathology, both of which have a negative impact on patients' quality of life. To date, there is no specific questionnaire in Spanish to assess the impact on quality of life in patients suffering from these conditions. The aim of our study is to validate in Spanish a questionnaire for this purpose, adapting it to our daily clinical practice. The HEMO-FISS-CdV is the Spanish version of the original HEMO-FISS-QoL by Abramowitz. The questionnaire consists of 23 items organised in 4 dimensions (physical, psychological, defecation and sexuality). The reliability of the new tool was assessed by determining internal consistency using Cronbach's alpha and Guttman's coefficient. It was also correlated with the quality of life questionnaire SF12 version 2. The Cronbach's alpha obtained for our questionnaire (HEMO-FISS-CdV) was 0.951 (ICC 95% +-0.016), with a range between 0.935 and 0.967. The Guttman two-half coefficient had a value of 0.910. Patients with internal haemorrhoids, anal fissure or both had higher values on the HEMO-FISS-CdV questionnaire than patients without internal haemorrhoids and these differences were significant (p<0.05). Both diseases have a negative impact on patients' quality of life. The HEMO-FISS-CdV questionnaire provides a tool in Spanish that easily and specifically assesses the impact of haemorrhoidal disease and anal fissure on quality of life.

Serum 25(OH) Vitamin D Levels in Pregnant Women with Coronavirus Disease 2019 (COVID-19): A Case-Control Study.

The physiological changes during pregnancy may increase the risk of complications in pregnant women with coronavirus disease 2019 (COVID-19). Vitamin D is a fat-soluble secosteroid hormone and its role in immunity is appears to be of particular importance in this recent pandemic. Nevertheless, there is little research about the role of vitamin D levels regarding COVID-19 in pregnant women to date. This study aimed to establish a relationship between serum 25-hydroxyvitamin D (25(OH)D) levels in pregnant women and COVID-19. A comparative case-control study was performed with a study population of 256 pregnant women (82 pregnant women with infection and 174 women in control group). Serum 25(OH)D levels were significantly lower in pregnant women with COVID-19 infection than in those without infection. In addition, 89% of COVID-19-positive pregnant women had 25(OH)D deficiency, while in the control group the percentage was 75.30%, finding statistically significant differences (ORa = 2.68; 95% CI 1.19-6.06; p = 0.01). Our results find a relationship between vitamin D deficiency in pregnant women and COVID-19 infection. This finding could be relevant for actual clinical practice. Thus, more research is needed in this field.

Users evaluation of a Spanish eHealth pediatric website.

BACKGROUND: Parents use the Internet to take decisions about their children's health, but few resources have focused on eHealth technology evaluations from their point of view. OBJECTIVE: The main aim of this research was to evaluate a Spanish eHealth pediatric website for parents. METHODS: A previously validated web questionnaire was used to evaluate five domains: usability, utility, trust and confidence, well-child section and accessibility of the website. Univariate, bivariate and multiple linear regression analyses were performed. RESULTS: 516 users participated in the research and rated the website as usable, useful, trustworthy and accessible. Higher scores were given by the participants who relied most on the Internet for taking decisions about health; by the participants who used a smartphone to access the pediatric website; by the participants who knew the website the longest; and by the participants who had accessed it more times. No differences in the evaluations of the website were found regarding age, education level or household income of the participants. CONCLUSIONS: eHealth pediatric websites, written by a pediatrician in an easy to understand language, can be perceived as usable, trustworthy, useful and accessible by their users and consequently help them with their decisions making. Some characteristics of the users are associated with a better perception of these websites.

Association of ABO and Rh blood groups with obstetric outcomes in SARS-CoV-2 infected pregnancies: A prospective study with a multivariate analysis.

OBJECTIVE: To evaluate the influence of ABO and Rh blood groups on morbidity among SARS-CoV-2 infected pregnancies. DESIGN: Prospective observational study. SETTING: 78 centers of the Spanish Obstetric Emergency Group. POPULATION: Pregnant women with SARS-CoV-2 tested with polymerase-chain-reaction between 26-February and 5-November 2020. A cohort of 1278 SARS-CoV-2(+) pregnant women was analyzed and a concurrent comparison group of 1453 SARS-COV-2(-) patients was established. METHODS: Data were collected from medical charts. SARS-COV-2(+) was compared with SARS-COV-2(-) for differences in distribution of blood groups. We performed multivariate analysis, controlling for maternal age and ethnicity, to evaluate association of ABO and Rh blood groups with maternal and perinatal outcomes in SARS-CoV-2(+) patients with adjusted odds ratios (aOR) and 95% confidence intervals (CI). MAIN OUTCOMES MEASURES: Medical morbidity: Symptomatic COVID-19 and medical complications. Obstetric outcomes: caesarean delivery, preterm deliveries, preterm premature rupture of membranes (PPROM), hemorrhagic events, pre-eclampsia, maternal and neonatal mortality, stillbirth. RESULTS: Differences were noted between blood types and Rh for age and ethnicity comparing SARS-CoV-2(+) and SARS-CoV-2(-) groups (p < 0.05). Among the SARS-CoV-2(+) cohort, the odds of symptomatic COVID-19 and obstetric hemorrhagic event were higher in Rh+ vs Rh- mothers (aOR 1.48, 95% CI 1.02-2.14, p = 0.037, and aOR 8.72, 95% CI 1.20-63.57, p = 0.033, respectively), and PPROM were higher among blood type A vs non-A mothers (aOR 2.06, 95% CI 1.01-4.18, p = 0.046). CONCLUSIONS: In SARS-CoV-2(+) pregnant women, Rh- status was associated with a lower risk of symptomatic COVID-19, while Rh+ and blood group A were associated with obstetric hemorrhage and PPROM, respectively.

Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study.

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients' information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

Coste y ahorro potencial generado por una web de eSalud de pediatría para padres / Cost and potential savings generated by a paediatrics e-Health web site for parents

INTRODUCCIÓN: Son pocas las intervenciones de eSalud dirigidas a padres que analizan sus costes y el ahorro potencial que pueden generar. Los objetivos de este trabajo consistieron en calcular los costes de desarrollo y mantenimiento de una web de pediatría para padres, el coste por visita y por visitante, y el ahorro potencial generado en función de las visitas médicas evitadas como consecuencia de su uso. MÉTODOS: Para los costes de la web se consideraron los costes tecnológicos y del trabajo de los profesionales. El cálculo del coste de los profesionales y de ahorro potencial se basó en los honorarios oficiales y en los precios públicos del Sistema Sanitario Público de Andalucía. RESULTADOS: Durante los 5 años y 6 meses del estudio el coste total de la web fue de 45.201,56 (Euro). El coste por visita recibida fue de 0,0155 (Euro), y por cada visitante único, de 0,0186 (Euro). Entre los 516 usuarios que participaron en el estudio se evitaron visitas presenciales a las consultas de pediatría de atención primaria y a los servicios de urgencias de pediatría por un valor de 22.263,89 (Euro). CONCLUSIONES: Los costes de desarrollo de una web de eSalud de pediatría para padres escrita en español, usando tecnología existente y gratuita, son bajos en comparación a otras formas de desarrollo de eSalud. Además, los costes son considerablemente bajos si se dividen entre el número de visitas totales o el número de visitantes. También existe un potencial considerable de ahorro económico al contribuir a evitar visitas presenciales

INTRODUCTION: There are few studies on e-Health interventions directed at parents that analyse their costs and any potential savings that may occur. The aims of this study consisted of calculating the costs of the development and maintenance of paediatric web site for parents, including the costs per visit and per visitor, and the potentially savings made as regards medical visits avoided as a result of its use. METHODS: The technology costs as well as the work of the professionals were considered as costs of the web site. The calculation of the cost of the professionals and the potential savings were based on the official fees and public prices of the Andalusian Public Health Service. RESULTS: During 5 years and 6 months of the study, the total cost of the web site was (Euro)45,201.56. The cost per visit received was (Euro) 0.0155(Euro), and (Euro) 0.0186 for each single visitor. Among the 516 users that took part in the study, face-to-face visits to Primary Care paediatric clinics were avoided, as well as those to Paediatric Emergency Department, at a savings of (Euro) 22,263.89. CONCLUSIONS: The costs of developing a paediatric e-Health website for parents written in Spanish, using existing and free technologies, are low compared to other forms of e-Health development. Furthermore, the costs are considerably low if they are divided by the total number of visits or the number of visitors. There is also a considerable potential financial saving on contributing to avoid face-to-face visits

[Cost and potential savings generated by a paediatrics e-Health web site for parents]. / Coste y ahorro potencial generado por una web de eSalud de pediatría para padres.

INTRODUCTION: There are few studies on e-Health interventions directed at parents that analyse their costs and any potential savings that may occur. The aims of this study consisted of calculating the costs of the development and maintenance of paediatric web site for parents, including the costs per visit and per visitor, and the potentially savings made as regards medical visits avoided as a result of its use. METHODS: The technology costs as well as the work of the professionals were considered as costs of the web site. The calculation of the cost of the professionals and the potential savings were based on the official fees and public prices of the Andalusian Public Health Service. RESULTS: During 5years and 6months of the study, the total cost of the web site was €45,201.56. The cost per visit received was €0.0155€, and €0.0186 for each single visitor. Among the 516 users that took part in the study, face-to-face visits to Primary Care paediatric clinics were avoided, as well as those to Paediatric Emergency Department, at a savings of €22,263.89. CONCLUSIONS: The costs of developing a paediatric e-Health website for parents written in Spanish, using existing and free technologies, are low compared to other forms of e-Health development. Furthermore, the costs are considerably low if they are divided by the total number of visits or the number of visitors. There is also a considerable potential financial saving on contributing to avoid face-to-face visits.

Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission.

BACKGROUND & AIM: Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). METHODOLOGY: Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. RESULTS: HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). CONCLUSIONS: The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.

Validation of a Questionnaire Developed to Evaluate a Pediatric eHealth Website for Parents.

There is a need for health professionals to provide parents with not only evidence-based child health websites but also instruments to evaluate them. The main aim of this research was to develop a questionnaire for measuring users' evaluation of the usability, utility, confidence, the well-child section, and the accessibility of a Spanish pediatric eHealth website for parents. We further sought to evaluate the content validity and psychometric reliability of the instrument. A content validation study by expert review was performed, and the questionnaire was pilot tested. Psychometric analyses were used to establish scales through exploratory and confirmatory factor analyses. Reliability studies were performed using Cronbach's alpha and two split-half methods. The content validation of the questionnaire by experts was considered as excellent. The pilot web survey was completed by 516 participants. The exploratory factor analysis excluded 27 of the 41 qualitative initial items. The confirmatory factor analysis of the resultant 14-item questionnaire confirmed the five initial domains detected in the exploratory confirmatory analysis. The goodness of fit for the competing models was established through fit indices and confirmed the previously established domains. Adequate internal consistency was found for each of the subscales as well as the overall scale.

Nuestra experiencia con la banda de incisión única AJUST(R) insertada con anestesia local. Seguimiento a un año / Our experience with the AJUST(R) single incision band inserted with local anesthesia. Follow-up at one year

OBJETIVOS: evaluar la tasa de curación objetiva y subjetiva al año de la colocación del dispositivo Ajust® con anestesia local. Como objetivos secundarios analizamos la tasa de complicaciones intra y posoperatorias y la tolerancia al dolor durante el procedimiento. MATERIAL Y MÉTODOS: estudio prospectivo realizado en un único centro en el que se incluyeron 94 pacientes con incontinencia genuina de esfuerzo o con incontinencia mixta en la que predominaba el componente de esfuerzo, todas intervenidas por varios ginecólogos con experiencia en cirugía de incontinencia. Las cirugías se realizaron solo con anestesia local, dando el alta a las pacientes tras la primera micción posoperatoria. El análisis estadístico se realizó con el paquete estadístico SPSS versión 24,0 (IBM, Armonk, NY). RESULTADOS: 81,9% de las pacientes presentaban un test de la tos negativo al año de la intervención, siendo la tasa de curación subjetiva del 80,84%. La tasa de complicaciones intraoperatorias fue mínima, pero con un porcentaje de erosiones/extrusiones alto (8,5%). La tolerancia al dolor fue muy buena (2,5/10 en escala visual analógica). CONCLUSIONES: la banda de incisión única Ajust® permite la corrección de la incontinencia urinaria de esfuerzo de forma ambulatoria. En comparación con los minislings previos, tiene un anclaje más seguro, es reajustable y puede insertarse con anestésico local

OBJECTIVES: Our main objective is to evaluate the objective cure rate one year after the placement of the Ajust® device. As secondary objectives we analyze the rate of intra and postoperative complications and pain tolerance during the procedure. MATERIAL AND METHODS: This is a prospective study conducted in a single center, which included 94 patients with genuine stress incontinence or mixed incontinence in which the stress component predominated and which were operated by several gynecologists with experience in surgery of incontinence. All surgeries were performed only with local anesthesia, discharging patients after the first postoperative urination. The statistical analysis was performed with the statistical package SPSS version 24.0 (IBM, Armonk, NY). RESULTS: 81.9% of the patients had a negative cough test one year after surgery, being the subjective cure rate of 80.84%. The rate of intraoperative complications was minimal but we found that the percentage of erosions/ extrusions was high (8.5%). The tolerance to pain was very good (2.5/10 in visual analogue scale). CONCLUSIONS: The Ajust® single incision band allows the correction of stress urinary incontinence on an outpatient basis, with the advantage of having a safer anchorage than the previous minislings, being readjustable and being available to be inserted with a local anesthetic

Satisfacción vital y factores sociodemográficos en mujeres de mediana edad / Life satisfaction and related socio-demographic factors during female midlife

OBJETIVO: El presente estudio investiga el grado de satisfacción vital en mujeres de mediana edad. MÉTODO: Estudio observacional transversal de 235 mujeres de edad comprendida entre 40 y 65 años, domiciliadas en Granada, acompañantes sanas de pacientes asistentes a las consultas de obstetricia y ginecología, que cumplimentaron la Escala de Satisfacción Vital de Diener, la Escala de Puntuación de la Menopausia, la Escala de Estrés Percibido, el Índice de Severidad de Insomnio y un cuestionario sociodemográfico incluyendo datos personales y de la pareja. También se calculó la consistencia interna de cada instrumento. RESULTADOS: El 61,3% de las mujeres eran postmenopáusicas, el 43,8% tenían obesidad abdominal, el 36,6% sufría insomnio, el 18,7% tenía mala calidad de vida relacionada con la menopausia, el 31,9% hacia ejercicio con regularidad, y el 5,1% tenía problemas económicos graves. La satisfacción vital tuvo correlaciones (prueba de Spearman) positivas significativas con la edad femenina y la masculina, y negativas significativas con la calidad de vida relacionada con la menopausia, el estrés percibido y el insomnio. En el análisis de regresión lineal múltiple, la alta satisfacción vital se correlacionó positivamente con tener una pareja que hiciese ejercicio, e inversamente con tener problemas laborales, el grado de estrés percibido y la sospecha de infidelidad de la pareja. Estos factores explican el 40% de la varianza en el análisis de regresión múltiple para la satisfacción vital en mujeres de mediana edad. CONCLUSIÓN: La satisfacción vital es un constructo relacionado con el estrés percibido, los problemas laborales y tener pareja, mientras que los aspectos relacionados con la menopausia y la salud general no tuvieron influencia significativa

OBJECTIVE: To assess life satisfaction and related factors in middle-aged Spanish women. METHOD: This was a cross-sectional study including 235 women aged 40 to 65, living in Granada (Spain), healthy companions of patients visiting the obstetrics and gynecology clinics. They completed the Diener Satisfaction with Life Scale, the Menopause Rating Scale, the Perceived Stress Scale, the Insomnia Severity Index and a sociodemographic questionnaire containing personal and partner data. Internal consistency of each tool was also calculated. RESULTS: Almost two-thirds (61.3%) of the women were postmenopausal, and 43.8% had abdominal obesity, 36.6% had insomnia, 18.7% had poor menopause-related quality of life, 31.9% performed regular exercise, and 5.1% had severe financial problems. Life satisfaction showed significant positive correlations (Spearman's test) with female and male age, and inverse correlations with menopause-related quality of life, perceived stress and insomnia. In the multiple linear regression analysis, high life satisfaction is positively correlated with having a partner who performed exercise, and inversely with having work problems, perceived stress and the suspicion of partner infidelity. These factors explained 40% of the variance of the multiple regression analysis for life satisfaction in middle-aged women. CONCLUSIÓN: Life satisfaction is a construct related to perceived stress, work problems, and having a partner, while aspects of menopause and general health had no significant influence

[Life satisfaction and related socio-demographic factors during female midlife]. / Satisfacción vital y factores sociodemográficos en mujeres de mediana edad.

OBJECTIVE: To assess life satisfaction and related factors in middle-aged Spanish women. METHOD: This was a cross-sectional study including 235 women aged 40 to 65, living in Granada (Spain), healthy companions of patients visiting the obstetrics and gynecology clinics. They completed the Diener Satisfaction with Life Scale, the Menopause Rating Scale, the Perceived Stress Scale, the Insomnia Severity Index and a sociodemographic questionnaire containing personal and partner data. Internal consistency of each tool was also calculated. RESULTS: Almost two-thirds (61.3%) of the women were postmenopausal, and 43.8% had abdominal obesity, 36.6% had insomnia, 18.7% had poor menopause-related quality of life, 31.9% performed regular exercise, and 5.1% had severe financial problems. Life satisfaction showed significant positive correlations (Spearman's test) with female and male age, and inverse correlations with menopause-related quality of life, perceived stress and insomnia. In the multiple linear regression analysis, high life satisfaction is positively correlated with having a partner who performed exercise, and inversely with having work problems, perceived stress and the suspicion of partner infidelity. These factors explained 40% of the variance of the multiple regression analysis for life satisfaction in middle-aged women. CONCLUSION: Life satisfaction is a construct related to perceived stress, work problems, and having a partner, while aspects of menopause and general health had no significant influence.

Ictus paradójico asociado a histersalpingografía / Paradoxical embolism associated with hysterosalpingography

La histerosalpingografía (HSG) es un procedimiento utilizado en el estudio de la infertilidad. La embolia del medio de contraste es una complicación infrecuente y está favorecida por ciertos factores. La persistencia del foramen oval permeable (FOP) complica el pronóstico, ya que puede producir embolias paradójicas. Presentamos el caso de una mujer de 32 años, derivada de un hospital comarcal por accidente cerebrovascular isquémico tras realizarse una HSG informada como dificultosa, precisando una dosis mayor de contraste (ácido diazitroico) que la habitual. Se realizó una tomografía computarizada craneal que mostró infarto cerebral hemisférico derecho. La ecocardiografía posterior al acontecimiento reveló la existencia de un FOP. Tras 8 días de evolución, la paciente presentó mejoría progresiva del déficit, con capacidad para deambular autónomamente, por lo que se procedió al alta hospitalaria con tratamiento antiagregante domiciliario. La clínica acontecida en esta paciente y los hallazgos encontrados en las pruebas diagnósticas son altamente sugestivos de ictus isquémico de la arteria cerebral media secundario a embolismo paradójico del medio de contraste a través del FOP, por lo que resulta interesante realizar una revisión del tema (AU)

Hysterosalpingography is a procedure used in the study of infertility. Embolism of contrast dye is a rare complication and is facilitated by certain factors. Persistence of permeable foramen ovale (PFO) complicates the prognosis and may produce paradoxical embolisms. We present the case of a 32-year-old woman who was referred from a district hospital due to an ischemic stroke following a hysterosalpingography reported as difficult, requiring a higher dose of contrast medium (diatrizoic acid) than usual. A cranial computed tomography scan was performed, which showed a right hemispheric stroke. Post-event echocardiography revealed a PFO. Eight days after the event, the patient showed progressive improvement and was able to walk without assistance. Consequently, she was discharged from hospital with antiplatelet therapy. The symptomology in this patient, as well as the findings of the diagnostic tests, are highly suggestive of ischemic stroke of the middle cerebral artery secondary to paradoxical embolism of the contrast medium through the PFO. A review of the topic is provided (AU)

Quality of life in a large cohort of mid-aged Colombian women assessed using the Cervantes Scale.

OBJECTIVE: The aim of this study was to assess quality of life (QoL) in a cohort of mid-aged Colombian women using the Cervantes Scale (CS). METHODS: In this cross-sectional study, 1,739 healthy women aged 40 to 59 years were asked to simultaneously fill out the CS and a questionnaire containing general female demographic data. The CS includes four domains: menopause and health (15 items), psychological (9 items), sexuality (4 items), and couple relationship (3 items). In addition, the menopause and health domain includes three subdomains: vasomotor symptoms, health, and aging. The global CS score may range from 0 to 155 (from better to worse QoL). RESULTS: Multiple linear regression determined that CS scores (global and domains) significantly increased (therefore, worse QoL) with age, menopause status, body mass index, parity, race, and marital and working status. The CS displayed a high internal consistency as Cronbach α values for the global and domain scores were above 0.80. CONCLUSIONS: This is the first study to report QoL assessment using the CS among mid-aged Latin American women from Colombia in whom age, menopause status, body mass index, and other personal factors influenced QoL.

Eficacia de la tromboprofilaxis obstétrica / Efficacy of obstetrical tromboprophylaxis

Valorar la incidencia de enfermedad tromboembólica durante el embarazo, parto y puerperio en gestantes con riesgo y la efectividad de las tromboprofilaxis. Seguimiento de 2 727 gestantes con parto durante un año. Se realiza análisis descriptivo de nuestra población, de los factores de riesgo y de la duración de la tromboprofilaxis, analizando su relación con la incidencia de eventos tromboembólicos. Hospital Universitario San Cecilio de Granada, España. Nuestras gestantes tienen pocos factores de riesgo: cesárea, anemia posquirúrgica, tabaquismo, hipertensión inducida por el embarazo o previa, diabetes, cardiopatía y trombofilia, siendo la cesárea y la anemia los más frecuentes. La tromboprofilaxis postcesárea con nadroparina cálcica 0,4 diaria durante su hospitalización ha sido efectiva. No hubo ningún tromboembolismo. En nuestra población, con un adecuado control obstétrico y profilaxis con antiagregantes plaquetarios y/o heparinas de bajo peso molecular, se han evitado eventos tromboembólicos relacionados con el embarazo, parto puerperio.

Sífilis y embarazo: incidencia y evolución histórica en el área sur de Granada / Syphilis infection in pregnancy. Incidence and changing patterns in the south of Granada (Spain)

Objetivo: Evaluar la prevalencia de la infecciónpor sífilis en el embarazo y los resultados delmanejo de esta afección.Material y métodos: Revisión retrospectiva detodos los casos de sífilis y embarazo diagnosticadoy tratados entre enero de 1996 y diciembre de2006 en el Hospital Universitario San Cecilio deGranada.Resultados: La incidencia global de sífilis duranteel embarazo en nuestro medio en los 11 últimosaños es de 2,42 × 10–04 (7 casos), 3 de ellos en elúltimo año.Conclusiones: En nuestro medio, presentamos unaincidencia de sífilis durante el embarazo superior ala media de los países con nuestro nivelsocioeconómico, como EE.UU. con 1,1/100.000gestaciones, posiblemente debido a un incrementode la población inmigrante

Objective: To evaluate the prevalence of syphilisinfection in pregnancy and the results of themanagement of this disease.Material and methods: We performed aretrospective study of all cases of syphilis infectionin pregnancy diagnosed and treated betweenJanuary 1996 and December 2006 in the SanCecilio University Hospital in Granada.Results: During the 11-year period studied, theoverall incidence of syphilis infection in pregnancywas 2.42 × 10–04 (seven cases), with three casesoccurring in the final year.Conclusions: In our area, the incidence of syphilisin pregnancy was higher than the average reportedin other countries of a similar socioeconomic level(e.g. the USA with 1.1 × 100,000 pregnancies),possibly due to the increase in the immigrantpopulation

Fractura subcapital de fémur secundaria a osteoporosis idiopática en el embarazo: a propósito de un caso / Subcapital fracture of the femur due to a idiopathic osteoporosis during pregnancy: a case report

Presentamos el caso de una paciente imposibilitada para la deambulación durante el puerperio, consecuencia de una fractura de fémur producida por una osteoporosis idiopática durante el embarazo. A los 11 meses del parto, la paciente presenta una evolución favorable con tratamiento médico con bifosfonatos y calcio.

We present the case of a mobility disabled person during puerperium as a consequence of a femur fracture due to an idiopathic osteoporosis during pregnancy. Eleven months after delivery, the patient's evolution was favourable with a medical treatment using bisphosphonates and calcium.