[Acetylsalicylic acid in prevention of pre-eclampsia]. / Prevención de la preeclampsia con ácido acetilsalicílico.

BACKGROUND: Pre-eclampsia (PE) is an important cause of morbidity and mortality in our country. OBJECTIVE: Evaluate if the administration of acetylsalicylic acid (ASA) at a low dose reduces its presence. METHODS: Comparative, cohort study. Pregnant women with risk factors for PE: Primigravidae, PE antecedent and twin pregnancy were included. Primigravidae and multigested with previous vascular pathology weren't included. Group 1: 150, 11 excluded, 80 mg ASA from week 20 at the end of pregnancy. Group 2: 150, without ASA. The presence of PE or gestational hypertension (HG) was monitored. General data and clinical controls were taken. Chi square and relative risk (RR) were calculated. RESULTS: Group 1: n = 139, 26 ± 5.6 years, 9% PE. Group 2: n = 150, 25.5 ± 5.6 years, PE 20% (p = 0.01), RR 0.47 (95% CI 0.19 - 0.87) (p = 0.01), attributable risk -0.11 equivalent to an absolute reduction of 11% for PE in group 1. CONCLUSIONS: Pregnant women with risk factor for PE who received ASA diminished the risk of developing PE in 50%.

INTRODUCCIÓN: los trastornos hipertensivos del embrazo son causa importante de morbilidad grave, discapacidad crónica y muerte entre las madres, fetos y recién nacidos, por lo que es necesaria la prevención de la preeclampsia (PE) en virtud de su alta morbimortalidad en México. OBJETIVO: evaluar si la administración de ácido acetilsalicílico (AAS) a dosis baja reduce la presencia de PE. MÉTODOS: estudio de cohorte, comparativo. Se incluyeron 300 mujeres embarazadas con factores de riesgo para PE: primigesta, antecedente de PE, embarazo gemelar. No se incluyeron las pacientes primigestas y multigestas con patología vascular previa. Grupo 1: 150, 11 excluidas, 80 mg AAS de semana 20 al final del embarazo. Grupo 2: 150, sin AAS. Se vigiló presencia de PE o hipertensión gestacional (HG). Se tomaron datos generales y controles clínicos. Se calculó Chi cuadrada y riesgo relativo (RR). RESULTADOS: grupo 1: 139, 26 ± 5.6 años, PE en 9%. Grupo 2: 150, 25.5 ± 5.6 años, PE 20% (p = 0.01). RR 0.47 (IC95%: 0.19 - 0.87) (p = 0.01), riesgo atribuible de -0.11 equivalente a una reducción absoluta del 11% para PE en grupo 1. CONCLUSIONES: en mujeres embarazadas con factores de riesgo para PE que recibieron AAS, disminuye de forma significativa el riesgo de probabilidad de desarrollar PE a menos de la mitad.

Auditory impairment in patients with type 2 diabetes mellitus.

BACKGROUND: We assessed the auditory function of 94 patients with type 2 diabetes mellitus and 94 age- and sex-matched healthy subjects. METHODS: To study the influence of the clinical characteristics of the disease on the auditory function, after a clinical interview with ophthalmological assessment, subjects were evaluated using pure-tone audiometry, speech audiometry, auditory brainstem responses, the Michigan Diabetic Neuropathy Score and albuminuria. The mean age when diabetes was diagnosed was 42.8 +/- 6.5 years (mean +/- SD) and the time elapsed since diabetes diagnosis was 7.2 +/- 5.4 years. RESULTS: Forty-eight patients (62%) had HbA1c >8%; diabetic retinopathy was evident in 14 patients (14%) and microalbuminuria was identified in 12 patients. Compared to healthy subjects, diabetic patients showed an increase of the perception threshold at 8000 Hz (p <0.01), higher hearing levels to discriminate at least 90% of 10 monosyllables (p <0.01), and longer latencies of wave V, interwave I-V and interwave III-V (p <0.01). Significant correlation was found between the hearing threshold at 8 KHz and patient age, and the former and the time elapsed since the diabetes was diagnosed (p <0.001). CONCLUSIONS: Patients with type 2 diabetes mellitus can have subclinical hearing loss and impaired auditory brainstem response, independent of peripheral neuropathy, retinopathy or nephropathy.