RESUMO
Introduction: The mother's colostrum carries immunological components, such as cytokines and immunoglobulins (Igs), derived from the maternal circulation with bacteriostatic properties. Objective: The objective of this study was to evaluate the effect of oropharyngeal administration of colostrum (OPAC) vs. placebo in the first 4 days of life in premature newborns ≤32 weeks of gestation on serum Ig concentration, neonatal morbidity, and total days of hospitalization. Hypothesis: The OPAC increases serum Igs and decreases morbidity and total days of hospitalization. Materials and Methods: A double-blind randomized controlled trial was carried out. Participants were randomly assigned to one of the two groups, namely, group 1: placebo (P) (n = 50) and group 2: colostrum (C) (n = 46). A blood sample was obtained at baseline and 7 and 28 days of life to quantify immunoglobulin G (IgG), immunoglobulin A (IgA), and IgM. Results: The C group showed an increase in serum IgA on day 28 expressed as median and [interquartile range]; C: 25 [12-35] vs. P: 11 [8-18], p < 0.001. There were no significant differences in neonatal morbidity. Newborns in the colostrum group showed the completed enteral feeding earlier (days), C: 13.9 ± 7 vs. P: 17.4 ± 8.4, p < 0.04; they reached the birth weight earlier, C: 10.9 ± 2.8 vs. P: 12.9 ± 4, p < 0.01, and had less days of hospitalization, C: 60.2 ± 33.8 vs. P: 77.2 ± 47.3, p < 0.04. Neonatal mortality was lower in the colostrum group than the placebo group 0% vs. 12%, respectively, without a statistical difference (p = 0.06). Conclusion: In premature newborns ≤32 weeks of gestation, the OPAC within 4 days after birth increases serum IgA concentration at day 28 compared to placebo. Similarly, OPAC decreased the days to complete enteral feeding and reach the birth weight and total days of hospitalization. Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT03578341], identifier: [NCT03578341].
RESUMO
Objetivo: Determinar la frecuencia de infección por el virus del papiloma humano en pacientes que acudieron a un hospital de tercer nivel de atención en la Ciudad de México. Método: Se realizó un estudio prospectivo, transversal y descriptivo que incluyó 65 mujeres entre 15 a 46 años que asistieron a consulta para atención gineco-obstétrica. A todas las participantes se les tomó una muestra cervical para la detección/genotipificación del papiloma virus mediante la prueba Linear Array HPV Genotyping Test in vitro® (Roche Molecular Systems, Inc., Branchburg, NJ). Resultados: Un total de 36 (55,4%) pacientes resultaron positivas al virus, en las que se identificaron 65 genotipos virales tanto en infección única (38,9%) como en infección por múltiples (61,1%) genotipos. El 29,2% de los genotipos identificados, fueron de alto riesgo. Los genotipos de alto riesgo más frecuentes fueron: VPH52 y 51; mientras que los genotipos de bajo riesgo más comunes fueron: VPH6 y 53. Un tercio de las pacientes con infección mostraron al menos un genotipo de alto riesgo. Conclusión: En este estudio, se observó una frecuencia relativamente baja de genotipos de alto riesgo del virus del papiloma humano, sin embargo se identificó un porcentaje importante de co-infección por múltiples genotipos. Por esta razón, se considera necesario dar seguimiento a mediano y largo plazo para monitorear la evolución de la infección.
Objective: To identify which are the most frequent genotypes of human papilloma virus among a group of gynecologic-obstetric patients at tertiary care hospital in Mexico City. Method: A prospective and descriptive cross-sectional study was carried out among a group of 65 women, aged 15-46 years, receiving gynecological-obstetric care. Cervical specimens were taken from all participants for direct HPV detection/ genotyping by means of a Linear Array HPV Genotyping Test in vitro® (Roche Molecular Systems, Inc., Branchburg, NJ). Results: Virus detection was achieved in 36 patients (55.4%), with a total of 65 genotypes, either as single (38.9%) or multiple-genotype (61.1%) infections. High risk genotypes accounted for only 29.2% of all genotype. The most frequent high risk genotypes were HPV52 and 51, while HPV6 and 53 were the most frequent low risk ones. At least one high risk genotype was present in one third of infected patients. Conclusion: The relative low frequency of oncogenic human papilloma virus genotypes among the women in this study was observed, however a significant percentage of co-infection with multiple genotypes were identified. Thus, mid- to long-term follow up might be necessary for those patients to monitor the evolution of the infection.
