Association between ABO blood groups and preeclampsia.

OBJECTIVE: To determine the association between the ABO blood group and preeclampsia. METHODS: This is a case-control study that included patients with (n = 253) and without (n = 457) preeclampsia/eclampsia in Northeastern Mexico. Data were obtained from electronic medical records. Binary multiple logistic regression analysis was used for analyzing the association between the ABO blood group and preeclampsia according to parity status while adjusting for potential confounders. RESULTS: Blood groups A, B, and AB showed adjusted odds ratios of 0.6 (95%CI 0.3-1.0), 1.1 (95%CI 0.6-2.2), and 0.3 (95%CI 0.1-1.1) in multiparous women, respectively. No association was found in nulliparous women either. CONCLUSIONS: ABO blood groups were not associated with preeclampsia in Mexican women. [Figure: see text].

Validación de un instrumento para evaluar el nivel de conocimiento en la aplicación de fórceps obstétrico / Validation of an instrument to assess the level of knowledge about the application of obstetric forceps

Resumen OBJETIVO: Diseñar y validar un instrumento para evaluar el nivel de conocimiento en la aplicación del fórceps Salinas en médicos residentes de Ginecología y Obstetricia. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, tipo validación de un instrumento. El primer constructo se desarrolló con base en el marco teórico; el cuestionario fue objeto de análisis por parte de un grupo de expertos que se basaron en la metodología Delphi. Se obtuvo un constructo de 20 preguntas y se emprendió un estudio para evaluar la pertinencia del instrumento. La confiabilidad se evaluó con el coeficiente de Kuder-Richardson, prueba Kaiser-Meyer-Olkin y de esfericidad de Bartlett. Los datos se procesaron en el programa SPSS versión 21. RESULTADOS: El instrumento se aplicó a 66 médicos residentes con media de edad de 28.5 ± 0.7 años. El coeficiente de Kuder-Richardson fue 0.608. Las pruebas de Kaiser-Meyer-Olkin y Bartlett mostraron que se trató de un instrumento multidimensional. CONCLUSIONES: Se obtuvo un instrumento válido, confiable y multidimensional para determinar el nivel de conocimientos en relación con la aplicación del fórceps Salinas en médicos residentes de Ginecología y Obstetricia.

Abstract OBJECTIVE: To design and validate an instrument to assess the level of knowledge of Salinas forceps application in Gynecology and Obstetrics residents. MATERIALS AND METHODS: Descriptive, cross-sectional, validation-type study of an instrument. The first construct was developed based on the theoretical framework; the questionnaire was analyzed by a group of experts based on the Delphi methodology. A construct of 20 questions was obtained and a study was undertaken to assess the relevance of the instrument. Reliability was evaluated with the Kuder-Richardson coefficient, Kaiser-Meyer-Olkin test and Bartlett's sphericity test. The data were processed in SPSS version 21. RESULTS: The instrument was applied to 66 resident physicians with a mean age of 28.5 ± 0.7 years. The Kuder-Richardson coefficient was 0.608. The Kaiser-Meyer-Olkin and Bartlett tests showed that it was a multidimensional instrument. CONCLUSIONS: A valid, reliable and multidimensional instrument was obtained to determine the level of knowledge in relation to the application of Salinas forceps in Gynecology and Obstetrics residents.

Genomic analysis of virulence factors and antimicrobial resistance of group B Streptococcus isolated from pregnant women in northeastern Mexico.

INTRODUCTION: Group B Streptococcus (GBS) causes infections in women during pregnancy and puerperium and invasive infections in newborns. The genes lmb, cylE, scpB, and hvgA are involved with increased virulence of GBS, and hypervirulent clones have been identified in different regions. In addition, increasing resistance of GBS to macrolides and lincosamides has been reported, so knowing the patterns of antibiotic resistance may be necessary to prevent and treat GBS infections. This study aimed to identify virulence genes and antibiotic resistance associated with GBS colonization in pregnant women from northeastern Mexico. METHODS: Pregnant women with 35-37 weeks of gestation underwent recto-vaginal swabbing. One swab was inoculated into Todd-Hewitt broth supplemented with gentamicin and nalidixic acid, a second swab was inoculated into LIM enrichment broth, and a third swab was submerged into a transport medium. All samples were subcultured onto blood agar. After overnight incubation, suggestive colonies with or without hemolysis were analyzed to confirm GBS identification by Gram staining, catalase test, hippurate hydrolysis, CAMP test, and incubation in a chromogenic medium. We used latex agglutination to confirm and serotype GBS isolates. Antibiotic resistance patterns were assessed by Vitek 2 and disk diffusion. Periumbilical, rectal and nasopharyngeal swabs were collected from some newborns of colonized mothers. All colonized women and their newborns were followed up for three months to assess the development of disease attributable to GBS. Draft genomes of all GBS isolates were obtained by whole-genome sequencing. In addition, bioinformatic analysis to identify genes encoding capsular polysaccharides and virulence factors was performed using BRIG, while antibiotic resistance genes were identified using the CARD database. RESULTS: We found 17 GBS colonized women out of 1154 pregnant women (1.47%). None of the six newborns sampled were colonized, and no complications due to GBS were detected in pregnant women or newborns. Three isolates were serotype I, 5 serotype II, 3 serotype III, 4 serotype IV, and 2 serotype V. Ten distinct virulence gene profiles were identified, being scpB, lmb, fbsA, acp, PI-1, PI-2a, cylE the most common (3/14, 21%). The virulence genes identified were scpB, lmb, cylE, PI-1, fbsA, PI-2a, acp, fbsB, PI-2b, and hvgA. We identified resistance to tetracycline in 65% (11/17) of the isolates, intermediate susceptibility to clindamycin in 41% (7/17), and reduced susceptibility to ampicillin in 23.5% (4/17). The tetM gene associated to tetracyclines resistance was found in 79% (11/14) and the mel and mefA genes associated to macrolides resistance in 7% (1/14). CONCLUSIONS: The low prevalence of colonization and the non-occurrence of mother-to-child transmission suggest that the intentional search for GBS colonization in this population is not justified. Our results also suggest that risk factors should guide the use of intrapartum antibiotic prophylaxis. The detection of strains with genes coding virulence factors means that clones with pathogenic potential circulates in this region. On the other hand, the identification of decreased susceptibility to antibiotics from different antimicrobial categories shows the importance of adequately knowing the resistance patterns to prevent and to treat GBS perinatal infection.

Factors Associated with Urethral and Bladder Neck Stricture After Transurethral Resection of the Prostate.

Introduction: Urethral and bladder neck stricture (U/BNS) is a complication that occurs in up to 9% of patients following transurethral resection of the prostate (TURP). The most relevant risk factors reported are prolonged surgical duration and prostatic volume. The purpose of this study is to analyze risk factors associated with the development of U/BNS following TURP. Materials and Methods: Case-control study. Population: patients who underwent TURP. Cases: patients with U/BNS following TURP, diagnosed between January 2010 and December 2018. We included patients with obstructive symptoms after TURP with clinical or radiographical evidence of U/BNS. Controls were patients who underwent TURP between January 2016 and December 2017, without evidence of stricture. Patients with history of pelvic fracture and previous U/BNS were excluded. We analyzed as risk factors age, prostatic volume, diabetes mellitus, previous use of transurethral catheter, urinary tract infection, bladder calculi, prostate cancer, previous TURP, resection time, resected volume during TURP, transoperative complications, and number of surgical procedures performed during the same event. We used chi-square or Mann-Whitney's U test for between-group comparison; association was established by odds ratios (ORs) and 95% confidence interval (CI), variables with p < 0.05 were included in the logistic regression. Results: We included 101 cases and 207 controls. Cases had lower incidence of prostate cancer, smaller prostates, less resection time during TURP, lower grams resected and prostate-specific antigen values than controls. History of transurethral catheter was more frequent in controls than cases (46% vs 29%, p = 0.004); there were no differences between groups in the other factors analyzed. On multivariate analysis, the use of a transurethral catheter was a protective factor against U/BNS (OR 0.16, 95% CI 0.064-0.442, p < 0.001). Conclusions: In this study, the use of urethral catheter before TURP is a protective factor against U/BNS.

Síndrome metabólico y otros factores asociados a gonartrosis.

OBJECTIVE: To evaluate whether an association exists between gonarthrosis and metabolic syndrome X (MS) as well as other potential risk factors. METHOD: Comparative cross-sectional study of 310 patients evaluated by pathology of knee grouped in patients with gonarthrosis and without it. Sociodemographic, anthropometric and laboratory data was obtained. Gonarthrosis was defined as a ≥ 2 score in Kellgren-Lawrence radiological scale, and MS was assessed using the International Diabetes Federation criteria. Odds ratio and logistic regression were used for bivariate and multivariate analysis respectively. RESULTS: The prevalence of MS in patients who had gonarthrosis was 79.9%, statistically higher than in patients without gonarthrosis (p = 0.001). Other factors that had a statistically higher frequency in this group included diabetes mellitus (p = 0.02) and hypertension (p = 0.02). Multivariate analysis revealed MS had an association with a higher prevalence of gonarthrosis (p = 0.003), while high density lipoproteins (p = 0.02) was associated with a lower prevalence. CONCLUSIONS: MS and its related alterations are associated to gonarthrosis; their adequate control could prevent patients from developing the disease.

[Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours]. / Exactitud diagnóstica del índice de riesgo de malignidad II en mujeres posmenopáusicas con tumor anexial.

BACKGROUND: The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. OBJECTIVE: To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. MATERIAL AND METHODS: A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. RESULTS: The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. CONCLUSIONS: The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%.

[Epidemiologic profile of very low birth weight infants treated with red blood cell transfusions]. / Perfil epidemiológico de los recién nacidos con muy bajo peso transfundidos con concentrados eritrocitarios.

INTRODUCTION: during the neonatal period seventy to ninety percent of very low birth weight (VLBW) infants (birth weight < 1500 g), are transfused with red blood cells (RBC) at least once; that represents infectious, biochemical, immunologic and oxidative risks. The objective of this paper is to describe the epidemiological profile of the VLBW infants that are transfused with RBC. METHODOLOGY: a retrospective review of 61 VLBW newborns admitted to the Neonatology Unit of a tertiary care hospital in Monterrey, México was conducted. The sample was collected consecutively. The information included the newborns epidemiological profile and the characteristics of transfusion events. RESULTS: the prevalence of transfused newborns was 70.5%, 82 transfusions were in the early postnatal period (<28 days) and 32 in the late postnatal period (> or = 28 days); 43.9% of newborns had mechanical ventilation and their fraction of inspired oxygen was > or = 0.3. Mean birth weight and standard deviation of VLBW newborns were 1206 +/- 198 g; the hematocrit before transfusion was 33.63 +/- 4.17 mg/dL, and the RBC volume per transfusion was 16.85 +/- 4.85 mL. On average, the newborns had two donors and two transfusions. CONCLUSIONS: the epidemiological profile of the newborns included in this analysis was similar to published international reports. The transfusion characteristics suggest the possibility to apply restrictive guidelines and to evaluate a single-donor blood program for these newborns.

Utilidad de la gasometría capilar para detectar hiperoxemia en el recién nacido grave / Utility of capillar gasometry to detect hyperoxia in neonates

Introducción. Objetivo: determinar la sensibilidad y especificidad de la gasometría capilar para detectar hiperoxemia en el recién nacido (RN) grave. Material y métodos. Tipo de estudio: observacional, prueba diagnóstica. Diseño: se realizó un estudio prospectivo, transversal en la unidad de Cuidados Intensivos Neonatales (UCIN), en RN con dificultad respiratoria grave en ventilador mecánico. Se tomaron 100 gasometrías simultáneas de artería y por punción capilar, midiendo además la suturación de oxígeno. Se analizó la sensibiliad, especificidad, valores predictivos y probabilidades después de la prueba para detectar hiperoxemia. Resultados. Cuarenta y ocho pacientes presentaron hiperoxemia; 37 tuvieron presión capilar de oxígeno (PcO2) mayor de 50 mm Hg, en comparación a 11 de 52 de los RN normales. La sensibilidad de la prueba fue de 77 por ciento y la especificidad de 78.8 por ciento. Los valores predictivos mostraron resultados similares. La probabilidad postprueba fue de 85 por ciento para valores mayores de 55 mm Hg. Conclusión. Los valores considerados normales de PcO2 tienen baja sensibilidad y especificidad para detectar hiporoxemia en el RN grave