Gout and pregnancy: A report of a new case and systematic review / Gota y embarazo: revisión sistemática, incluyendo el reporte de un nuevo caso

Abstract Article history: Received 4 January 2017 Accepted 17 October 2017 Available online 24 May 2018 Introduction: Unlike other rheumatic diseases, gout is rare in women of childbearing age. Due to the low number of cases available for the study, current information is based mainly on case reports. Objective: To describe the characteristics and the outcome of the pregnancy of women with gout. Methods: A systematic literature search was undertaken by the investigators in the PubMed and Embase databases, from the inclusion date to August 2016. Patients were included if they met the definition of gout according to the American Rheumatism Association criteria, and that they had the description of its follow-up during the pregnancy. Data collection and analysis: each pregnancy was treated as a separate observation for analysis. The maternal and fetal-neonatal outcomes data were extracted from the articles finally selected. Results: The search identified 125 potentially relevant articles, but after a full-text review only 12 articles met the inclusion criteria. Of the 23 pregnancies described, there were 16 (69.5%) live births, 5 (21.7%) were aborted, in one (4.3%), the pregnancy was terminated, and in one case report (4.3%) there was no description on the term of pregnancy. No maternal deaths were reported. Two babies died a few hours after birth. Congenital malformations were not described in any case report. The most frequent maternal complications were renal damage, anemia, preeclampsia, and postpartum uremia. Conclusions: Gout during pregnancy is not common, but it is known to occur. While the majority of women with gout delivered healthy infants, they were at increased risk of having maternal complications.

Resumen Introducción: A diferencia de otras enfermedades reumáticas, la gota es una enfermedad rara en mujeres en edad fértil. Debido al escaso número de casos disponibles para el estudio, la información actual se basa, principalmente, en reportes de casos. Objetivo: Describir las características y el desarrollo del embarazo en mujeres con gota. Métodos: Una búsqueda sistemática de literatura fue realizada en las bases de datos PubMed, Lilacs, Ebsco y Embase, desde la fecha de inclusión hasta agosto del 2016. Se incluyó a pacientes que cumplieron con la definición de gota según los criterios de la American Rheumatism Association y que tenían la descripción de su seguimiento durante el embarazo. Cada embarazo se trató como una observación independiente para el análisis. A partir de los artículos finalmente seleccionados, se extrajeron los desenlaces materno-fetales. Resultados: La búsqueda identificó 125 artículos potencialmente relevantes, después de la revisión de texto completo, 12 artículos cumplieron los criterios de inclusión. Se describen 23 embarazos que resultaron en 16 (69,5%) nacimientos vivos, 5 (21,7%) abortos, una (4,3%) interrupción del embarazo y en un caso (4,3%) no se describió el desenlace. No se reportaron muertes maternas. Dos recién nacidos fallecieron después del parto. No se documentaron malformaciones congénitas. Las complicaciones maternas más frecuentes fueron la insuficiencia renal, la anemia, la preeclampsia y la uremia posparto. Conclusiones: La gota durante el embarazo no es común, pero se sabe que ocurre. Mientras que la mayoría de las mujeres con gota tuvieron bebés sanos, presentaban un mayor riesgo de tener complicaciones maternas.

Oxidative stress in Cyprinus carpio induced by hospital wastewater in Mexico.

The very wide range of activities performed in hospitals (care, diagnosis, hygiene, maintenance, research) require the use of a large variety of potentially ecotoxic substances such as surfactants, metals, disinfectants and pharmaceuticals. This study aimed to determine oxidative stress in the common carp Cyprinus carpio induced by hospital wastewater (HWW) in Mexico. The median lethal concentration (LC50) and subsequently the lowest observed adverse effect level were determined. Carp were exposed to the latter value (0.5 %) for 24, 48, 72 and 96 h, and the following biomarkers were evaluated in gill, brain, liver and blood: hydroperoxide content (HPC), malondialdehyde (MDA) content, protein carbonyl content (PCC) and activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). Significant increases in HPC, MDA content and PCC were observed in exposed specimens, particularly in gill, liver and brain. SOD and CAT activity also increased in liver and brain. In conclusion, this particular HWW induces oxidative stress on C. carpio, this damage being most evident in gill, liver and brain.

[Epidemiological pattern of breast cancer mortality in Mexico State]. / Patrón epidemiológico de la mortalidad por cáncer de mama en el Estado de México.

BACKGROUND: breast cancer (BC) is the leading cause of death secondary to malignancy in women. It ranks third in mortality in women in reproductive age, produced by non-modifiable (genetic and hormonal) and modifiable factors. Our objective was to describe and analyze the epidemiological characteristics of deaths from BC in the State of Mexico. RESULTS: of 273 verbal autopsies, the most common age (23.07 %) was between 40 and 49 years. The educational level of schooling were complete elementary school (20.51 %), incomplete elementary school (19.04 %) and complete high school (13.91 %). the institution with the highest number of patients was the Instituto Mexicano del Seguro Social with 139 (50.91 %). The towns with a higher frequency were Malinalco, Ayapango, Atizapán, Zacualpan and Apaxco. The Mortality was higher in Valle de Bravo, Coatepec Harinas and Toluca. CONCLUSIONS: the increase in BC has permitted the emergence of a new hypothesis known as endocrine disruption, according to this premise, this results from exposure to chemicals introduced into the environment by human activity capable of altering the hormonal balance.