Morbimortalidad en pacientes sometidas a ligadura de arterias hipogástricas con riesgo de hemorragia obstétrica / Morbi-mortality in patients undergoing ligation of hypogastric arteries at risk of obstetric haemorrhage

Antecedentes: La hemorragia obstétrica es la principal causa de mortalidad materna en países subdesarrollados; representan un tercio de las muertes. Existen técnicas quirúrgicas alternativas para detener la hemorragia como lo es la ligadura de arterias hipogástricas. Objetivo: Determinar la morbimortalidad materna en pacientes sometidas a ligadura de arterias hipogástricas con riesgo de hemorragia obstétrica de junio a diciembre de 2012 en el Hospital General Regional n.o 36 del Instituto Mexicano del Seguro Social, Puebla (HGR n.o 36, IMSS, Puebla). Material y métodos: Estudio descriptivo, observacional, transversal, retrospectivo, homodémico. Se incluyeron pacientes con riesgo de hemorragia obstétrica sometidas a «ligadura de arterias hipogástricas» de junio a diciembre de 2012 en el HGR n.o 36, IMSS, Puebla, de cualquier edad materna y gestacional. El tipo y tamaño de muestra fue finita, no probabilística. Método estadístico: descriptivo y odds. Resultados: Treinta y ocho pacientes se sometieron a ligadura de arterias hipogástricas. Edad promedio: 26,9 años. El acretismo placentario (44,74%) fue la indicación más frecuente (odds=0,78), seguida de hipotonía uterina (7,89%; odds=0,07) y placenta previa (7,89%; odds=0,07). Se registraron 22 (57,8%) pacientes con hemorragia obstétrica, 15 (68,18%) contaron con antecedente de cesárea previa (odds=2,12). La razón de probabilidad de culminar en histerectomía por hemorragia obstétrica odds=4,2. Se documentó un (2,63%) paciente con complicación ureteral posterior a la ligadura (odds=0,027). Mortalidad materna y perinatal del 0%. Conclusión: La complicación posterior a la ligadura de arterias hipogástricas se presentó en un paciente con ligadura ureteral. No hubo complicaciones vasculares. La mortalidad materna y perinatal fue de 0 pacientes.(AU)

Background: Obstetric haemorrhage is the leading cause of maternal death in underdeveloped countries, accounting for a third of deaths. There are alternative surgical techniques to stop bleeding, such as ligation of the hypogastric arteries. Objective: To determine maternal morbidity and mortality in patients sometimes linked to hypogastric arteries at risk of obstetric haemorrhage from June to December 2012 in Hospital General Regional n.o 36, Instituto Mexicano del Seguro Social, Puebla (HGR # 36, IMSS, Puebla). Material and methods: Descriptive, observational, cross-sectional, retrospective, homodemic study. Patients at risk of obstetric haemorrhage undergoing “hypogastric artery ligation” from June to December 2012 were included in the HGR # 36, IMSS, Puebla, of any maternal and gestational age. Sample type and size was finite, not probabilistic. Statistical method: descriptive and Odds. Results: Thirty-eight patients underwent a ligation of the hypogastric arteries. Average age: 26.9 years. Placental accretion (44.74%) was the most frequent indication Odds=.78, subsequent uterine hypotonia (7.89%) Odds=.07 and placenta previa (7.89%) Odds=.07. 22 (57.8%) patients with obstetric haemorrhage were considered, 15 (68.18%) had a history of prior caesarean section Odds=2.12. The probability ratio of completing a hysterectomy for obstetric haemorrhage=4.2. One (2.63%) patient with ureteral complication after ligation was documented Odds=.027. Maternal and perinatal mortality in 0 patient. Conclusion:The complication after ligation of the hypogastric arteries presented in 1 patient with ureteral ligation. There were no vascular complications. Maternal mortality was 0%. Perinatal mortality was 0%.(AU)

Metabolic profiling in children with autism spectrum disorder with and without mental regression: preliminary results from a cross-sectional case-control study.

INTRODUCTION: It is challenging to establish the mechanisms involved in the variety of well-defined clinical phenotypes in autism spectrum disorder (ASD) and the pathways involved in their pathogeneses. OBJECTIVES: The aim of the present study was to evaluate the metabolomic profiles of children with ASD subclassified by mental regression (AR) phenotype and with no regression (ANR). METHODS: The present study was a cross-sectional case-control study. Thirty children aged 2-6 years with ASD were included: 15 with ANR and 15 with AR. In addition, a control group of 30 normally developing children was selected and matched to the ASD group by sex and age. Plasma samples were analyzed with a metabolomics single platform methodology based on liquid chromatography-mass spectrometry. Univariate and multivariate analysis, including orthogonal partial least squares-discriminant analysis modeling and Shared-and-Unique-Structures plots, were performed using MetaboAnalyst 4.0 and SIMCA-P 15. The primary endpoint was the metabolic signature profiling among healthy children and autistic children and their subgroups. RESULTS: Metabolomic profiles of 30 healthy children, 15 ANR and 15 AR were compared. Several differences between healthy children and children with ASD were detected, involving mainly amino acid, lipid and nicotinamide metabolism. Furthermore, we report subtle differences between the ANR and AR groups. CONCLUSIONS: In this study, we report, for the first time, the plasmatic metabolomic profiles of children with ASD, including two different phenotypes based on mental regression status. The use of a liquid chromatography-mass spectrometry platform approach for metabolomics in ASD children using plasma appears to be very efficient and adds further support to previous findings in urine. Furthermore, the present study documents several changes related to amino acid, NAD+ and lipid metabolism that, in some cases, such as arginine and glutamate pathway alterations, seem to be associated with the AR phenotype. Further targeted analyses are needed in a larger cohort to validate the results presented herein.

Frequency of canine degenerative myelopathy SOD1:c.118G>A mutation in 22 dog breeds in Guadalajara, Mexico / Frecuencia de la mutación SOD1:c.118G>A de mielopatía degenerativa canina en 22 razas de perros en Guadalajara, México / Frequência da mutação SOD1: c.118G>A de mielopatía degenerativa canina em 22 raças de cães no Guadalajara, México

Abstract Background: Canine degenerative myelopathy (DM) is a late-onset disease that primarily affects large-breed dogs. The disease involves the spinal cord and produces progressive paresia and, eventually, complete loss of mobility. DM has been related to missense mutation c.118G>A in the SOD1 gene. Objective: To determine the genotypic and genic frequencies of DM in Mexico. Methods: In total, 330 samples from 22 different dog breeds were genotyped using the polymerase chain reaction and restriction fragment length polymorphisms (PCR-RFLP) technique. Results: The mutation was identified in 71 animals from 11 different breeds. Observed genic frequencies were 0.78 for the G allele and 0.14 for the A allele. Genotypic frequencies were 0.79 for the G/G wild-type, 0.14 for the G/A heterozygote, and 0.7 for the A/A homozygote. Conclusion: The genic frequency of this allele is high among the studied populations. A molecular marker program that identifies the DM mutation in breeding dogs should be implemented in order to reduce this frequency.

Resumen Antecedentes: La mielopatía degenerativa canina (MD) es una enfermedad progresiva de presentación tardía que afecta a la médula espinal, generalmente en caninos de razas grandes, y que produce paresis progresiva y eventual pérdida completa de la movilidad. Se ha relacionado con una mutación puntual por sustitución de bases en el gen SOD1 recientemente identificado como c.118G>A. Objetivo: Determinar las frecuencias genotípicas y génicas para la presentación de DM en México. Métodos: Se genotipificaron 330 muestras de perros de 22 razas mediante la técnica de reacción en cadena de la polimerasa y polimorfismos de longitud de fragmentos de restricción (PCR- RFLPs). Resultados: Se identificó la mutación en 71 animales de 11 razas diferentes. Las frecuencias génicas encontradas fueron de 0,78 para el alelo G y de 0,14 para el alelo A. Las frecuencias genotípicas fueron de 0,79 para el tipo silvestre G/G, 0,14 para el heterocigoto G/A y 0,7 para el homocigoto A/A. Conclusión: La frecuencia encontrada para la mutación es alta en las poblaciones estudiadas. La aplicación de un programa de selección asistida por marcadores moleculares contra la mutación causante de MDC en perros reproductores resultaría útil para reducir su frecuencia.

Resumo Antecedentes: A mielopatía degenerativa canina (MD) é uma doença progressiva de apresentação tardia que afeta a medula espinal geralmente de caninos de raças grandes e que produz paresia progressiva e eventualmente a perda completa da mobilidade. Tem sido relacionada com uma mutação pontual por substituição de bases no gen SOD1, recentemente identificado como c.118G>A. Objetivo: Determinar as frequências genotípicas e genéticas para a apresentação de DM no México. Métodos: Genotipagem de 330 amostras de cães de 22 raças por meio da técnica de reação em cadeia da polimerase e polimorfismos no comprimento de fragmentos de restrição (PCR- RFLPs). Resultados: A mutação foi identificada em 71 animais de 11 raças diferentes. As frequências gênicas encontradas foram de 0,78 para o alelo G e de 0,14 para o alelo A. As frequências genotípicas foram de 0,79 para o tipo silvestre G/G, 0,14 para o heterozigoto G/A e 0,7 para o homozigoto A/A. Conclusão: A frequência encontrada para a mutação é alta nas populações estudadas. A implementação de um programa de seleção assistida por marcadores moleculares contra a mutação que causa MDC seria útil para reduzir a sua frequência.

Fragment size does not matter when you are well connected: effects of fragmentation on fitness of coexisting gypsophiles.

Most habitat fragmentation studies have focused on the effects of population size on reproductive success of single species, but studies assessing the effects of both fragment size and connectivity, and their interaction, on several coexisting species are rare. In this study, we selected 20 fragments along two continuous gradients of size and degree of isolation in a gypsum landscape in central Spain. In each fragment, we selected 15 individuals of each of three dominant gypsophiles (Centaurea hyssopifolia, Lepidium subulatum and Helianthemum squamatum, 300 plants per species, 900 plants in total) and measured several reproductive traits: inflorescence number, fruit set, seed set and seed mass. We hypothesised that plant fitness would be lower on small and isolated fragments due to an interaction between fragment size and connectivity, and that response patterns would be species-specific. Overall, fragment size had very little effect on reproductive traits compared to that of connectivity. We observed a positive effect of fragment connectivity on C. hyssopifolia fitness, mediated by the increased seed predation in plants from isolated fragments, resulting in fewer viable seeds per capitulum and lower seed set. Furthermore, seed mass was lower in plants from isolated fragments for both C. hyssopifolia and L. subulatum. In contrast, few reproductive traits of H. squamatum were affected by habitat fragmentation. We discuss the implications of species-specific responses to habitat fragmentation for the dynamics and conservation of gypsum plant communities. Our results highlight the complex interplay among plants and their mutualistic and antagonistic visitors, and reinforce the often-neglected role of habitat connectivity as a key component of the fragmentation process.