Does cerclage improve neonatal outcomes in a molar pregnancy and a coexistent fetus? A case report.

BACKGROUND: Complete hydatiform mole and coexistent viable fetus is very rare. The use of a cervical cerclage for cervical indications in the presence of this condition has never been reported. Although the diagnosis was made postnatal, the objective is to present a case with good neonatal outcome. CASE PRESENTATION: A patient presented with vaginal spotting around 23 weeks. She has a history of four preterm deliveries. Her cervix was dilated and a cerclage was placed. She presented again with PPROM around 25 weeks. She went into spontaneous preterm labor and delivered a viable fetus that is a healthy girl today. Eventually the pathology of the placenta showed a complete hydatidiform mole. CONCLUSION: It is necessary to inform patients about the potential risks and poor outcomes of this condition. For those who desire all potential interventions, cerclage placement could be considered.

Amniotic fluid inflammation with negative culture and outcome after cervical cerclage.

OBJECTIVE: To determine whether amniotic fluid (AF) inflammation, in the absence of infection, is associated with adverse pregnancy outcomes in nonelective cervical cerclage patients. METHODS: A retrospective case-control study was carried out. The patient population included 82 singleton pregnancies with negative AF cultures. The variables used to define AF inflammation were white blood cell count (WBC) >50 cell/mm(3), glucose <14 mg/dl or interleukin-6 (IL-6) >11.3 ng/ml. The study group consisted of cases with intra-amniotic inflammation. Sub-analysis was performed for the groups in which IL-6 concentrations were measured. Adverse outcomes were evaluated with variables such as gestational age at delivery, interval from cerclage to delivery, chorioamnionitis and cumulative neonatal morbidity. RESULTS: Elevated AF WBC was correlated with severe and extreme preterm delivery (p < 0.05). Decreased AF glucose was associated with histological chorioamnionitis and a decreased cerclage to delivery interval (p < 0.05). Elevated AF IL-6 correlated significantly with decreased gestational age at delivery (p < 0.012) and decreased cerclage to delivery interval (p < 0.001). Elevated IL-6 concentrations were associated with severe, extreme preterm delivery (p < 0.001) and neonatal death (p < 0.001). CONCLUSION: Elevated AF IL-6, elevated WBC and low AF glucose, in the absence of a positive AF culture, are significantly associated with adverse pregnancy outcomes in patients undergoing nonelective cerclage.

Morbilidad oftalmológica en escolares de comunidades rurales en Venezuela / Ophthalmologic morbidity in schoolchildren of rural communities in Venezuela

Introducción: el deterioro de la función visual limita el desarrollo adecuado de los niños y repercute en el rendimiento escolar. Objetivo: determinar la frecuencia de morbilidad oftálmica en escolares que asisten a las escuelas ubicadas en las comunidades rurales de Puerto Cabello, Venezuela. Métodos: estudio descriptivo de tipo transversal en 1 183 escolares mediante un cuestionario elaborado para tal fin. Resultados: se registraron 1 183 diagnósticos, de los cuales 981 (82,94 %) no mostraron ninguna enfermedad oftálmica, y los restantes 202 (17,06 %) se evaluaron como patológicos. Las ametropías constituyeron la enfermedad más frecuentemente encontrada, 10,65 %, seguido por conjuntivitis en el 4,05 % de los casos. Conclusiones: hay una alta incidencia de enfermedades oftalmológicas que repercuten en el desarrollo integral del niño y su adaptación al medio escolar. Se recomienda la implementación de programas de detección o pesquisa de enfermedades oftalmológicas en escolares y profundizar en las acciones de educación y orientación a las familias y a la población en general.

Introduction: the deterioration of visual function limits the appropriate development of children and affects school performance. Objective: to determine the prevalence of ophthalmic morbidity in students attending schools in rural communities of Puerto Cabello, Venezuela. Methods: a descriptive cross-sectional study performed on 1183 schoolchildren through a customized questionnaire for this purpose. Result: there were 1183 diagnoses, of which 981 (82.94%) did not show any ophthalmologic disease, and the remaining 202 (17.06%) were evaluated as pathological. Ametropia was the most frequent pathology found in 10.65%, followed by conjunctivitis in 4.05% of cases. Conclusions: high incidence of ophthalmologic diseases that affect the comprehensive development of children and their adaptation to the school environment was found. Finally, it was recommended to implement programs of detection or screening of ophthalmologic diseases in schoolchildren, and to delve into the educational and orientation actions aimed at families and general population.

Desarrollo de la Misión Milagro en Venezuela / Development of the "Mission Miracle" in Venezuela

La Misión Milagro, iniciativa Cubana apoyada por Venezuela, es una campaña de contenido social y humanitario, cuyo propósito es devolver la visión o curar diversos padecimientos oftalmológicos en los pueblos latinoamericanos. Debido a la deuda con las personas excluidas de la atención de salud y apartadas de la vida social y productiva por padecer problemas solucionables de salud visual, se considera necesario evaluar el desarrollo de la Misión Milagro en el territorio Venezolano. Se realizó un estudio exploratorio sobre el tema basado en el análisis de documentos y artículos publicados. La Misión Milagro en Venezuela, en menos de cinco años, le ha devuelto la vista a 668 844 latinoamericanos, atendidos por especialistas cubanos y venezolanos. La Misión Milagro es un verdadero y eficiente mecanismo integrador latinoamericano de combate a la pobreza y la exclusión social, con un gran impacto social, ya que ha proporcionando una mejor calidad de vida a miles de venezolanos y latinoamericanos.

The Mission Miracle, a Cuban initiative supported by Venezuela, is one of the social and humanitarian campaigns aimed at recovering the vision or curing several eye diseases of the Latin American people. Due to the pending debt with those persons excluded from the health care and separated from the social and productive life because of visual health problems that can be solved, it is deem necessary to evaluate the development of the Mission Miracle in Venezuela. An exploratory study was conducted on this topic based on the analysis of documents and published articles. The Mission Miracle in Venezuela has given the vision back to 668 844 Latin Americans cared by Cuban and Venezuelan specialists. The Mission Miracle is a real and efficient Latin American integrating mechanism of struggle against poverty and social exclusion, with big social impact since it has provided better quality of life to thousands of Venezuelan and other Latin American people.

Prevención de parasitosis intestinal mediante técnicas de educación a distancia / Prevention of intestinal parasitosis based on the distance learning techniques

Introducción La parasitosis es una enfermedad propia de los países subdesarrollados. Según la OMS, una de las seis enfermedades más frecuente en poblaciones de países subdesarrollados. Objetivo Desarrollar una técnica a distancia en el área de la salud, mediante la producción de un video digital educativo para la enseñanza de las medidas de prevención sobre parasitosis intestinal. Métodos Diseño de campo con la aplicación de la metodología del College of Public Health de la Universidad del Sur de la Florida. La producción del video se concibió en cinco etapas: 1. Tema a tratar y objetivos del video digital, a quien va dirigido, duración, fecha de realización: desde el 1 de noviembre de 2008 hasta el 31 de marzo de 2009, recursos humanos, financieros e institucionales, elaboración del guión técnico, lista de escenas, descripción del tiempo de inicio y finalización de las escenas. 2. Etapa de pre-producción del video, tomas, encuadres y filmación. 3. Edición del video con el apoyo del software Pínnacle. 4. Posproducción del video, que se realizó en formato de DVD, el cuál puede ser observado en la televisión y en la computadora, facilitado por la colaboración del programa satelital "Simón Bolívar" que intercomunica a los pueblos de Suramérica. 5. Validación por expertos del producto terminado. Se utilizaron como instrumentos las entrevistas y la observación participante. Resultados El video tiene cinco escenas con las medidas de prevención. Incluye un ponente que explica el texto correspondiente. La presentación de cada escena tiene un tiempo de duración de 5 minutos. Conclusiones El desarrollo de la técnica de educación a distancia permite una instrucción de calidad y proporciona mayor adquisición de información educativa a mayor número de personas, en menor tiempo y a menores costos.

Introduction Parasitosis is a disease inherent to the underdeveloped countries. According to the WHO, it is one of the six most frequent illnesses in underdeveloped country populations. Objective To create a distance learning technique in the healthcare area on the basis of educational digital video for teaching preventive measures for intestinal parasitosis. Methods Field design using the methodology of the College of Public Health in South Florida University. The production of the video was organized in five phases: 1st-Topic and objectives of the digital video, audience to be addressed, duration, date of filming (November 1st 2008 to March 31st 2009); human, financial and institutional resources; preparation of the technical script; listing of scenes, and description of the length of start and ending of the scenes. 2nd- Pre-production of the video including shots, framing and filming. 3rd- Pinacle software-aided video edition. 4th- Video post-production in DVD format, which can be accessed by TV and computer thanks to Simón Bolívar satellite program-based cooperation linking the South America nations. 5th- Validation of the final product by experts. Interviews and participating observations were the instruments used for this end. Results A five-scene video, taking 5 minutes each, with the preventive measures. It includes a presenter who explains all about the respective texts. Conclusions The creation of this distance learning technique allows giving quality teaching aimed at the public and at greater acquisition of educational information by a higher number of persons in less time and at lower costs.